The Twenty-third Infantry was removed about March 15 of the present year and the post was then garrisoned by the Twenty-first Infantry. During a period of more than three months since the arrival of this regiment at the post only one case of typhoid fever has developed. This seems to demonstrate rather clearly that contact, as pointed out in Captain Bloomburg's report, must have played a very important part in the continuous epidemic of typhoid in the Twenty-third Infantry while at this post.

It is now the general opinion among the medical officers serving in the Philippines that typhoid fever is very prevalent among the native population.

TABLE NO. 37.-Typhoid fever, American troops, Philippine Islands, year 1909.

The admission ratio for all fevers of this class was 112.35, as compared with 123.97 for 1908, 167.79 for 1907, 304.20 for 1906, and 261.55 for 1905. Malaria stands fourth among causes of admission for all troops, fifth for Americans, and first among Filipino troops. The rate for the army as a whole was 38.42. This continued improvement is to be ascribed to the steps taken to protect the men at night from the bites of anopheles mosquitoes and doubtless also to the measures taken to destroy the breeding places near the garrisons and to the screening of barracks and quarters wherever practicable.

UNDETERMINED FEVERS.

The admission rate for these fevers was 25.46, as compared with 25.31 for last year. The various diagnoses under this head are as follows:

CHART S.-Showing the relative admission, death, and noneffective ratios per thousand of mean strength for certain special diseases in the Philippine Islands (American troops). Scale 300tolinch.

Admissions.

CHART T.-Showing the relative admission and death rates per thousand of mean strength for malarial diseases in the Philippine Islands (American troops), by years, 1898-1909.

'ASIATIC CHOLERA.

This disease has been especially prevalent throughout the Archipelago during the past year, and at the present time is still prevalent. The records of the bureau of health show 8,055 cases in the provinces during the year, with 5,524 deaths. This probably does not represent the majority of the cases actually occurring, as the natives conceal cases whenever possible. From January 1, 1909, to December 25, 1909, there were 263 cases confirmed in the city of Manila, with 211 deaths. It is, therefore, gratifying to be able to report that there was no case of cholera among the American troops and but 9 cases, with 7 deaths, among the native troops. In numerous towns adjacent to military posts this disease was epidemic at some period during the year. In the town of Zamboanga, Mindanao, P. I., there were 121 cases, with 89 deaths, among the native population from June 23 to October 18, 1909.

The following is a quotation from the report of this epidemic by Maj. Jere B. Clayton, Medical Corps:

The first 4 cases were reported from Caua Caua, June 23, the victims being Moros. Of these, 3 proved fatal after a duration of only a few hours. Such a high mortality seemed suggestive of an intensely virulent type of infection. This, together with the proverbial disregard of the Moro of personal hygiene, the abject squalor and filth under which he lives, his utter indifference to even a modicum of care or cleanliness in the preparation of his food, or to the character and quality of his food, being often content with tainted fish and semiputrid offal, bespoke an outbreak of serious proportions among an element comprising more than one-sixth of the total population of this community.

In view of the facility with which these people might conceal cases, if they cared to do so, thus largely nullifying the work of the health authorities, it was found necessary to deal with them only with the utmost diplomacy and tact. And it was for this reason that, out of respect for their religious prejudices, as well as to gain their cooperation and good will, no post-mortem examinations of Moro subjects were made. Fortunately, however, but few other cases occurred among them. One man was found on the beach, near constabulary headquarters, in a dying condition, September 7. Subsequently another case brought consternation to many, especially to Americans, on account of its having occurred in one of the stalls of the Moro exchange, where various popular foodstuffs are sold (September 8).

This afforded opportunity for a thorough renovation and disinfection of the building and its premises, which made it essential to close the same for a period of four days, during which time 47 people were held in strict quarantine. As an additional precaution, certain food substances, such as green fruits and vegetables, as well as a considerable quantity of dried fish, were destroyed. From this, however, no loss accrued to the vendors, as they were promptly reimbursed by the government.

According to the records of this office, which are the outcome of the most careful and painstaking investigation and therefore believed to be accurate, there were, in all, only 11 cases, with 6 deaths, among Moros-a fact as surprising as it is gratifying. Meanwhile, cholera had made its first appearance for the season among the Filipinos, a number of cases having been reported July 15 from that section of the city known as Tetuan.

The situation had by this time developed the usual quota of self-wise carping critics, even among the most intelligent classes, who, restive under what they chose to term the "unwarranted" and "unnecessary" restrictions imposed upon them by this office, published broadcast all manner of groundless and harmful reports, with a view to minimizing the seriousness of the situation as well as thwarting the plans of the health authorities. It was loudly proclaimed that the "prevailing malady" was not cholera; that it was not transmissible; that it was merely a stomach and intestinal trouble which appeared each year coincidentally with the marketing of certain green fruits, such as mangoes, and that there was no occasion for alarm.

While the health officer was convinced, from the clinical manifestations alone, of the true nature of the disease, yet, in order to remove all possibility of doubt, a postmortem examination was made in the case of the first Filipino fatally attacked, and a positive conclusion reached through laboratory methods of diagnosis. This should have convinced the most skeptical, if willing to be convinced.