﻿IX, B, 4 Gutierrez: Typhoid Fever in the Philippines 2tH 



Blood cultures were not taken in all of these cases, owing to 

 the patients coming to the hospital late in the course of the dis- 

 ease. However, 45 blood cultures were taken by Dr. E. H. 

 Ruediger of the Bureau of Science, and of the 13 cases in which 

 the blood was taken during the first six days of the disease 8 

 cases, or 61.53 per cent, were positive for Bacillus typhosus. 

 After the sixth day of the disease there were 32 blood cultures 

 taken with 12 positive findings, or 37.5 per cent. 



SUMMARY 



1. The age incidence of typhoid fever as seen in the Philip- 

 pine General Hospital corresponds with that of other countries, 

 but is not so high as claimed by Rogers, Manson, and Nichols. 



2. The fever course of the disease is essentially the same as 

 in the United States and in Germany, but the temperature is 

 much lower and the stage of fastigium is not as typical. 



3. Relapses occur about as frequently as in other countries. 



4. Abortive cases are rather common and often difficult to 

 diagnose. Every continued fever with slow pulse and enlarged 

 spleen should have a serum reaction and other confirmatory 

 tests. Blood culture should be employed in all cases of doubt. 



5. Delirium and the typhoid state are not so common as in 

 other countries. This is probably due to the lower temperature 

 in typhoid in the Philippines. 



6. Intestinal haemorrhage occurred in 15.23 per cent of all 

 cases. I am unable to ascertain the cause of such a large num- 

 ber. It may be due to neglect of the gastrointestinal canal con- 

 sequent to delay in receiving medical attention. 



7. Perforation is also common, for which no special cause 

 can be attributed. 



8. The mortality on superficial examination seems to be high, 

 but after eliminating these cases that came to the hospital in a 

 dying or hopeless condition we obtain a more normal death rate. 

 The further slightly higher percentage of death rate may be 

 due to the lower resistance of the Filipinos consequent to their 

 modes of life, undevelopment, and limited diet. 



Since this paper was written, the number of intestinal haemor- 

 rhages and mortality has been decreased, because the cases were 

 admitted to the hospital earlier in the course of the disease and 

 the diet of the people in general has been improved. 



In conclusion I wish to express my sincere gratitude to Dr. 

 W. E. Musgrave for his interest in the course of the preparation 

 of this article and to Dr. L. Gomez for his suggestions. 



