Conditions in the provinces were proportionately worse.  As a rule, there was no evidence of any effort to put provincial towns into decent sanitary conditions.  I must, however, note one striking exception.  Brigadier General Juan Arolas, long the governor of Jolo, had a thorough knowledge of modern sanitary methods and a keen appreciation of the benefits derivable from their application.  When he was sent to Jolo, practically in banishment, the town was a plague spot to which were assigned Spaniards whose early demise would have been looked upon with favour by those in power.  He converted it into a healthy place the death rate of which compared favourably with that of European cities, thereby demonstrating conclusively what could be done even under very unfavourable conditions.  No troops in the islands were kept in anything like such physical condition as were the regiments assigned to him, and he bore a lasting grudge against any one inconsiderate enough to die in Jolo.

Everywhere I saw people dying of curable ailments.  Malaria was prevalent in many regions in which it was impossible to secure good quinine.  The stuff on sale usually consisted largely of cornstarch, or plaster of Paris.  Fortunately we had brought with us from the United States a great quantity of quinine and we made friends with the Filipinos in many a town by giving this drug gratis to their sick.

Smallpox was generally regarded as a necessary ailment of childhood.  It was a common thing to see children covered with the eruption of this disease watching, or joining in, the play of groups of healthy little ones.

The clothing of people who had died of smallpox was handed on to other members of the family, sometimes without even being washed.  The victims of the disease often immersed themselves in cold water when their fever was high, and paid the penalty for their ignorance with their lives.

The average Spaniard was a firm believer in the noxiousness of night air, which he said produced paludismo. [499] Most Filipinos were afraid of an imaginary spirit, devil or mythical creature known as asuang, and closed their windows and doors after dark as a protection against it.  Thus it came about that in a country where fresh air is especially necessary at night no one got it.

Tuberculosis was dreadfully common, and its victims were conveying it to others without let or hindrance.

A distressingly large percentage of native-born infants died before reaching one year of age on account of infection at birth, insufficient clothing, or improper food.  I have many times seen a native mother thrust boiled rice into the mouth of a child only a few days old, and I have seen babies taught to smoke tobacco before they could walk.

Before our party left the islands in 1888, cholera had broken out at a remote and isolated place.  A little later it spead over a considerable part of the archipelago.  On my return in 1890 I heard the most shocking stories of what had occurred.  Victims of this disease were regarded with such fear and horror by their friends that they were not infrequently carried out while in a state of coma, and buried alive.  It became necessary to issue orders to have shelters prepared in cemeteries under which bodies were required to be deposited and left for a certain number of hours before burial, in order to prevent this result.