The results obtained in combating malaria are often very striking.  Calapan, the capital of Mindoro, was in Spanish days known as “the white man’s grave” on account of the prevalence of “pernicious fever” there.  To-day it is an exceptionally healthy provincial town.

At Iwahig, in Palawan, the Spaniards attempted to conduct a penal colony.  They were compelled to abandon it on account of pernicious malaria, which caused continued serious mortality when the American government attempted to establish a similar institution there.  Application of the usual sanitary measures has made it a healthful place.

Old jails throughout the islands have been rendered sanitary, or replaced by new ones.  The loathsome skin diseases from which prisoners formerly suffered have in consequence disappeared.  The practical results obtained in Bilibid, the insular penitentiary, are worthy of special note.  The annual death rate at this institution was 78.25 per thousand for the calendar year 1904.  It increased steadily each month from January, 1904, to September, 1905, when it reached its maximum, deaths occurring at the rate of 241.15 per thousand per year.  At this time the director of health was given charge of the sanitation of this prison.

By remedying overcrowding, improving drainage, installing sewers and regulating diet along scientific lines, the rate was reduced in six months to 70 per 1000, and there it stuck.

A systematic examination of the stools of prisoners was then made.  Eighty-four per cent were found to be afflicted with at least one intestinal parasite.  Fifty per cent had two or more, and twenty per cent had three or more.  Fifty-two per cent of the total had hookworm.  Active treatment for the elimination of these parasites was begun in one barrack, and after the work was completed it was noted that there was much less disease there than in the remainder.  All of the thirty-five hundred prisoners were ultimately examined, and intestinal parasites eradicated if present.  The death rate then dropped to thirteen to the thousand, and has remained at or near this figure up to the present time.

I have already referred to the discovery of the cause of beri-beri, and to the effect of the governor-general’s order forbidding the use of polished rice in government institutions or by government organizations.

I subsequently made a strong effort to secure legislation imposing a heavy internal revenue tax on polished rice, thus penalizing its use.  I failed, but such effort will be renewed by some one, let us hope with ultimate success.

In Spanish days cholera, leprosy, smallpox and other dangerous communicable diseases were constantly reintroduced from without.  This is no longer the case.  The United States public health and marine hospital service has stretched an effective defensive line around the archipelago and has sent its outposts to Hongkong, Shanghai and Amoy, to prevent, so far as possible, the embarkation for Manila of persons suffering from such ailments.  We now have the most effective quarantine system in the tropics, and one of the best in the world.  At Mariveles there is a very large and complete disinfecting plant, and vessels may also be satisfactorily disinfected at Cebu and Iloilo.