The evening times. [volume] (Washington, D.C.) 1895-1902, 1900-04-23


Or. Simon Flexner and DR.. L. F. Bar
ker. who were sent by Johns Hopkins
University TO the Philippine Islands for
the purpose of studying the diseases ex-
listing among the natives and American
troops in Manila and at Cavite. say in
their report concerning diseases affecting
Americans:
The chief causes Of disability among
the American land forces are the enteric
diseases. These are di4rrhoea. dysentery.
typhoid fever and CASTRO intestinal ca
tarrhs. Many of the diarrhoeas are mere
ly preliminary to the symptoms of dys-
EMERY. Other infectious fevers are rela
lively infrequent. A small number of
cases of scarlet fever and diphtheria only
were encountered The malarial feyers
prevailed. but not seriously, during the
months of May June. and July. Dysten-
terry is responsible for the greatest amount
Of invalidation and the highest mortality.
1t appears In acute, sub-acute, and chron-
ic forms. The chronic form is sometimes
attended by secondary abscess of the liv-
CT. The acute form may end in "A, IS, or
y hours In it the whole OF the large
intestine and usually the lower portion
Of the ilsum is involved. The mucous
membrane of the gut is swollen, longest
ed, and Oedematous. in places hemor
rhages have taken place into the mucous
membrane and the sub-mucosa is swollen
and its blood vessels greatly dilated- No
ulcers existed in such cases. Amoebae
were absent or very difficult to find in the
fresh stools and in the intestinal contents
Immediately after death. In the sub-acute
and chronic forms ulcers are present in
The mucosa; the coats of the intestine are
greatly thickened; at Dimes large sloughs
of mucous membrane, partly detached. oc-
cur. and the LESSONS are confined 10 the
large intestine Amoebae are more COM
monty present in these cases but are va
riable as 10 actual occurrence and num-
bers. Large hepatic assesses. usually
single, were encountered in a number OF
these cases.
"Amoebae were variable in the contents
of the assesses. In one very large alb
scess. occupying both right and left lobes
of the liver, no amoebae but pure culture
of the Staphylococcus pyogenescitreus was
obtained. The clinical study Of the cases
of dysentery with reference to amoebae
was equally unsatisfactory. In cases with
marked symptoms both IN patients con-
fined to bed and those beginning 10 go
about but still with persistent loose bowels.
these organisms were frequently missed,
while in instances ready TO be discharged
they might az certain examination, he
found TO be very abundant. In morphOlogy,
the amoebae studied corresponded with the
amoebae coli found in Egypt and in this
country. The ARCHAEOLOGICAL study Of cases
Of dysentery was carried out upon the
fresh stools Of acute and chronic cases and
with the intestinal contents. meseuteric
glands. liver. etc, OF cases dying and sub
iected to autopsy The intestinal fora was
studied in its entirety by means OF plate
cultures"
Regarding typhoid fever the report has
the following to say. The total number Of
cases of typhoid fever in the hospitals dur
ng May. June. and July was far below
those OF dysenteTy the number Of deaths
Iso was less. Ii was, however, a frequent
Election among Americans. The examina-
tion OF the blood. micrOsc0pically and with
the Vidal test was Of the greatest help in
diagnosis. The disease came to autopsy
presenting the classical intestinal LESSONS
and also in atypical forms. In the small
number of autopsies made upon those dead
OF the disease. several instances Of slight
intestinal Involvement on even entire es-
cape were met with. In some instances the
typhoid bacillus was found widely dissent
mated throughout the body, the autopsy be-
ing made Immediately after death
Another serious sickness is malarial fe-
yer. large proportion Of the cases sent
in from the field and outlying mill
tary stations where examinations had
to be hastily made as instances of 'mala
ria or in;erInittest fever turned out to be
cases of other Diseases. The archipelago is
favorable also Tor the study of the relation
of mosquitoes and other insects to malarial
infection very small number Of deaths
was referabIe TO malaria.
"A number OF cases of pulmonary tuber-
culosis developed among the soldiers in the
American troops. definite history Of ex-
pOsure to wet and various hardships was
eIicitable in many Of these cases.
AT Cavite there occurred a large out
break of an epidemic fever of short dura-
ton. known locally as Cavite fever. Mus
cular pains were severe in some cases and
not in others. slight exanthem was
present in many Of the cases. Flushing
Of the face, restlessness, and general ma
laise accompanied the fever and rapid
heart action. The epidemic is regarded
as one of Dengue
"A number o the American soldiers
suffered from a form of indolent ulcera-
ton, locally known as tropical ulcer
These ulcers occurred singly sometimes,
but were more often multiple. They be-
gan as small pustules. which gradually
extended. They were most frequent
among those who had been compelled to
make long marches through swampy dis
tricts, and the patients themselves attri-
buted the liberation to poisoning in the
marshes
"Our experience with wound infections
was rather limited. Certain observations
OF interest were made. PyOgenic infec-
tons due to the common pus cocci occur
red. In a small number Of gunshot wounds
causing compound fractures emphysema-
lions gangene occurred and the bacillus
| aerogenes capsulatus was Isolated. The
Army surgeons we're enthusiastic as to