The epidemic came soon after the close of a long-continued war, and there were at that time in Manila not a few evil-intentioned persons, both foreign and native, who welcomed every opportunity to make trouble.  The difficulties arising from the claim advanced by a number of reputable but ignorant medical men that the disease was not cholera at all were sufficiently great.  They were enormously increased by false and malicious stories to the effect that “contacts” were killed at the detention camp; that patients on arrival at the cholera hospital were given a drink of poisoned vino [500] and instantly dropped dead; that the distilled water distributed free of charge was poisoned, and that the Americans were poisoning the wells.

The necessary use of strychnine as a heart stimulant at the cholera hospital was made the basis for a story that the sick were being poisoned with this drug.

These silly tales were widely circulated and quite generally believed, and as a result of the fear thus engendered, and of the desire on the part of relatives and neighbours of stricken persons to escape disinfection and quarantine, strong efforts were often made to conceal the sick and the dead, and when this was not possible the “contacts” usually ran away.  There were not wanting instances of the driving of cholera victims into the streets.

In spite of the generally hostile attitude of the public and some grave mistakes in policy, the measures adopted sufficed at the outset to hold the disease in check to an extent which surprised even the health officers themselves.

On May 15 there began a rapid and quite steady decline in the number of cases.

In June, however, it increased.  During July it grew steadily larger, and on the 25th of that month there were ninety-one cases, the largest number which has ever occurred in Manila on any day since the American occupation.

Throughout the early months of the epidemic Major Maus had laboured unceasingly to check it, displaying an energy and an indifference to fatigue and personal discomfort which were highly commendable.  The long-continued strain ultimately began to tell on him severely.  On May 17 orders were received from the Adjutant-General’s Office providing for his relief on or about July 30, and stating that Major E. C. Carter, of the United States Army Medical Corps, would be available for detail as commissioner of public health on that date, if his services were desired.  Arrangements were accordingly made to have Major Carter proceed to the Philippines.  Major Maus’s resignation was accepted, effective July 31.  Dr. Frank S. Bourns was urged to take temporary charge of the situation, and consented to do so.

On the 8th of August Major Carter arrived and announced his readiness to assume his duties, but it was suggested to him that he ought first to have some time to familiarize himself with them, and Dr. Bourns was left free to carry out the special work for which he had been appointed.