﻿178 The Philippine Journal of Science 1914 



from the one now in use. It is altogether probable that tuber- 

 culosis is a more important factor in the decreased capacity for 

 labor among employees at San Jose than is malaria or any other 

 one physical abnormality of the people. 



HEART AND BLOOD VESSELS 



Physical examination of the circulatory system of the 1,110 

 people gives the following result: 



Valvular disease: 



Positive 78 



Doubtful 4 



Negative 1,028 



Total 1,110 



Hasmic murmur 20 



Chronic myocarditis • 4 



Tachycardia 11 



There are no available statistics of the incidence of cardiac 

 diseases among supposedly healthy people of the laboring classes 

 in other countries, and it is, therefore, impossible to say whether 

 the rather striking picture shown in these statistics is an unusual 

 one. 



The question of etiology and incidence of diseases of the heart 

 and blood vessels in the tropics has received practically no con- 

 sideration in medical literature. These conditions are among 

 the important considerations in the medical work in this country. 

 Whatever the difference in incidence between valvular diseases 

 in the tropics and in the temperate climates may be, it seems 

 very likely that the etiological factors are somewhat different. 

 Statistical work dealing with this subject, based upon findings 

 in our clinics of the College of Medicine and Surgery and the 

 Philippine General Hospital, now are being made, and sufficient 

 work has already been done to justify the statement that there 

 exist in the tropics destructive valvular diseases of the heart that 

 are not explained by the usual etiological consideration in these 

 diseases. At this time, only two of the causative agents will 

 be referred to; namely, environment and malnutrition. 



The rather constant low blood pressure found among natives 

 of the tropics as well as among foreign residents in the tropics 

 is, in all probability, environmental in origin. Whatever is the 

 exact cause, there is in the tropics a relaxed condition of mus- 

 cular tone, with dilated peripheral blood vessels, slight tendency 

 to oedema in dependent parts of the body, and a sluggishness of 

 gastrointestinal metabolism and absorption as well as in the 



