﻿162 The Philippine JournCbl of Science i9i4 



goes only with sound, healthy workmen). The second hypo- 

 thesis, and the one I choose to accept, is simply this: Neither 

 of the companies concerned realizes that it is actually clothed 

 with absolute control over the laborers, by virtue of the discharge 

 and exclusion power; nor do the companies realize the true ser- 

 iousness of the situation and the extent of malarial infection and 

 invalidism. This last impression is emphasized by the repeated 

 statement of company officials that "in spite of malaria" the 

 sugar camps are as healthful as any villages of similar size in 

 the Philippine Islands. 



The study of the commission absolutely negatives this con- 

 tention, and the death rates settle the matter beyond question; 

 there is no need to dwell longer upon this point. 



I have no hesitancy in stating that less than one-half of the 

 people who suffer from acute malaria at San Jose come under 

 the observation or treatment of the medical officers. These un- 

 treated individuals cannot fail to perpetuate the disease in the 

 sugar camps- 



3. Inadequate hospital facilities and medical forces. — There is 

 evident need of another hospital at San Jose. The present plan 

 of treating surgical cases, diarrhoeal diseases, skin diseases, 

 tuberculosis, and malaria in common wards is a poor one, to say 

 the least, and the present hospital is badly crowded. Floor space 

 and cubic-air space at least twice as great as the present hos- 

 pital offers are needed for the present service and, as I have 

 already indicated, the number of patients treated in hospital and 

 for the adequate period of detention should be doubled. Malaria 

 cases and tuberculosis cases should be separately housed in well- 

 screened buildings equipped with modern facilities. Elaborate 

 and expensive buildings and apparatus are unnecessary ; but the 

 hospitals should be of ample size, comfortable, and well arranged, 

 having in view utility and modern sanitary administration. A 

 laboratory room should be provided. 



The medical force should be doubled at least. The addition of 

 another medical officer, who should be a clinician and a microsco- 

 pist, is absolutely necessary if good work is to be done. It is 

 manifestly impossible for the present staff to handle the hospital 

 administration, the clinical material at hand, the laboratory 

 work and the out-door sanitary supervision, and antimosquito 

 work required at present. Then, too, the demands will be 

 greater, rather than less, for some time to come if the general 

 plan of hospitalization of all the sick be carried out, as I strongly 

 recommend. I can see no escape from this conclusion. Imagine 



