CHAPTER XIV.

THE PHILIPPINE SERVICE.

When Congress reorganized the government of the Philippine Islands, a special medical service and publichealth department was constituted to direct the sanitation; control the epidemics; prevent the introduction of plagues; regulate the manufacture and sale of foods and drugs; exercise supervision of water supplies and the building of tenements; to establish, wherever necessary, hospitals and asylums and to regulate the practice of medicine. In the continental United States some of the governmental machinery for public-health work is under the control of the national government, part of it is supervised by the state and part by the municipalities, and some by privately supported organizations. The vagaries of our patchwork system can be more readily understood after a consideration of the complete modern system which was created for these islands.

When the American army of occupation came into the islands, they found malaria, the bubonic plague, typhoid fever, dysentery and cholera everywhere. The great cities were at once transformed. Wholesome artesian water supplies were provided for; sewerage systems were instituted; vermin-infested old buildings were removed; the milk and food supplies were carefully inspected; dance halls and public assemblies were regulated; hospitals and free clinics were founded; medical and training schools for training native physicians and nurses were instituted; and research laboratories for studying climatic conditions and tropical disease were established.

The duties assigned to the bureau of public health were to include not only those usually imposed upon similar departments in the United States, such as the collection and compilation of vital statistics and the protection of the public from communicable diseases, but also to embrace the distribution of certain charitable funds; the care of the insane; the supervision of orphans and the aged; the supervision of hospitals, the hygienic and medical care of over 12,000 civilian employees; the administration of the food and drug act; the performance of coroner's duties; the examination of candidates for the public service; the supervision of sanitary and housing regulations and the control of water supplies.

It will thus be seen that the members of this service must be skilled in administrative work as well as in medical practice; sanitary engineers as well as trained investigators; and that their work is to a much larger extent preventative than curative, than in the American communities, where officials are hampered on all sides by restrictions. Abroad they are in positions to work out gradually such service as progressive medical men have been seeing in their dreams for many years.

As the islands become more prosperous they will afford, no doubt, fine fields for private practitioners. With a population of over 8,000,000 there are now only 620 physicians in the islands, not including the untrained medical native men. In Bana, with a population of 39,000, there is only one physician; in Batanges, with 33,000, only four; in Baybay, with 23,000, only one; in Cadiz, with 20,000, one; Dumaguete, with 15,000, four; in Calbyog, with 16,000, one; in Caragayra, with 17,000, one; in Tabaco, with 22,000, one; in San Pablo, with 22,600, three; and in Jaro, with 10,600, two.

With the influx of Europeans and Americans, the development of manufacturing industries and the larger education of the natives there will be a demand for more trained men, not only in these larger cities, but in more remote districts.

The private practice of medicine is regulated in the same way as in the states, the bureau of health having control of the licensing of physicians.

Applicants for admission to this service and candidates for license to practice in the islands must be graduates of reputable medical colleges recognized by the Board of Health. They must pass such examinations as the board directs, which include the subjects usually prescribed by the board of medical examiners of the states, in addition to the medical laws of the islands; candidates, of course, must learn the languages which are spoken in the districts to which they are sent, or which they select for practice.

The advance guards of modern science, by performing in these remote regions marvelous changes, win such rewards of gratitude and esteem as do the medical men at mission stations, of whom we will treat in another chapter.

It was in the Philippine Service that one of the American physicians made a discovery in medicine that has been of great service to all mankind-the use of ipecac and its active principle in the cure of dysentery. The investigation which he conducted proved that the disease was due to the amoeba, and that the amoeba could not live in a system thoroughly impregnated with ipecac. It was through the further development of this discovery that, today, dysentery, typhoid fever, pyorrhea alveolaris, etc., are treated much more intelligently.