APPENDIX H.

REPORT OF THE ATTENDING "PHYSICIAN AND SURGEON IN CHARGE OF THE CIVIL SANITARIUM AT BAGUIO, BENGUET, FOR THE YEAR ENDING AUGUST 31, 1902.

SIR: In compliance with vou telegram of recent date, I have the honor to transmit herewith a brief repor2of the progress of the sanitarium from the time of its establishment to September 1, 1902.

Very respectfully,

J. B. THOMAS, Attending Physician and Surgeon.

The United States Philippine Commission early recognized the necessity for some mountain retreat or station in the islands themselves where the civil employees of the government might retire to recuperate from the debilitating effects of continuous service in the tropical heat of the lowlands, thus taking advantage of high altitude and making it in a way compensate for latitude. One of its first acts was to detail Commissioners Worcester and Wright to visit the mountains of Benguet, concerning the climate of which province some noteworthy reports had been issued by the Spanish Government, and as a result of this visit Baguio, a small Igorrote village in the pine belt nearly 5,000 feet above the China Sea, was chosen as the location of the future "hill station."

As a nucleus of the institution the improvements on a small piece of land occupied by Mr. Otto Scherer were bought by the insular government, and these included a substantial native house, with pine floors and siding and grass roof. This building contained a dining room, kitchen, and three bedrooms, with capacity for about eight beds; it was surrounded on two sides by a broad porch, and the ground floor was entirely open. This was the original sanitarium, and it was inaugurated as a branch of the Manila Civil Hospital on February 3, 1902, when Dr. H. E. Stafford and party arrived at Baguio with the first supplies. The personnel consisted of an acting superintendent, one nurse, and one attendant.

Within a few weeks siding was added to the lower part of the house and the ground floor curtained off as a dispensary and sleeping place for employees and builders. In May Governor Pack completed a small provincial hospital, with a capacity of ten or twelve beds, and by agreement with the secretary of the interior the male employees of the sanitarium now occupy a portion of that building, and the sanitarium reciprocates by furnishing subsistence and free medical attendance to the wards of the province.

About the middle of April a force of Chinese carpenters, under the direction of the bureau of architecture, began to cut and prepare timber for an enlarged sanitarium and system of six cottages, the latter designed for occupancy by families. This work of lumbering and building has progressed in the face of many difficulties, including strikes, cholera, bad transportation, extraordinary rains and scarcity of labor, and at the present date one-third of the new sanitarium is about ready to turn over to the furnishers. The old building forms the center of the new system, and will be divided into a dining room and sitting room, with a commodious fireplace, the latter being a grateful and almost indispensable feature of the place during the winter months and during the evenings throughout almost the entire year. The north extension is almost twice as long as the original building, and contains a large kitchen, rooms for stores, and four large bedrooms on the main floor fronted by a

broad veranda about 50 feet long. The lower floor includes four more bedrooms, storerooms, a dispensary, emergency ward, and rooms for employees. For building material the white pine of Benguet has been used exclusively, the roofs being covered with rubberoid. The work is handsome and substantial, every board having been cut, sawed, dressed, planed, tongued and grooved, and put in place by hand. By October 1 it is hoped to begin work on the south extension of the sanitarium, which will consist of two wards, an upper and a lower, fronted by a veranda and capable of accommodating 36 patients in all. This extension should be completed by November 1, making the total capacity of the sanitarium about 60 beds.

Pending the establishment of the completed sanitarium, the Commission passed act 429 at the beginning of the present fiscal year, making temporary provision for the conduct of the sanitarium by appointing an attending physician and surgeon with the added functions of disbursing officer and superintendent of buildings, the surgeon to be directly responsible to the Secretary of the Interior and to make weekly reports to him. The force was reduced to 1 nurse, 1 attendant, 1 cook, and 2 native servants, thus providing for the care of a limited number of patients and of the employees of other bureaus working at the sanitarium.

From the opening of the sanitarium to the present date 43 patients have been received, a portion of whom might appropriately be called guests, as they were in good health and were members of the families of the real patients. No medical records were kept up to July 1, but it is safe to assert that four-fifths of the patients sought relief from general debility induced by a tropical climate, and it is a matter of common knowledge here that the great majority of the patients reacted promptly to the bracing atmosphere and improved rapidly. Medical records of all patients are now being kept, and their preparation and study will be a matter of particular attention in the future, but the data accumulated up to the present time are too meager to permit of any generalizations or deductions as to the classes of diseases that derive special benefit from the local climatic conditions.

Bills accruing to the sanitarium for attendance and subsistence of patients have aggregated $1,521.33 United States currency.

APPENDIX I.

REPORT OF THE COMMITTEE APPOINTED TO SELECT A SITE FOR A LEPER COLONY.

The UNITED STATES PHILIPPINE COMMISSION.

MANILA, P. I., January 1, 1902.

GENTLEMEN: On December 10 a committee consisting of the commissioner of public health, the sanitary engineer of the board of health for the Philippine Islands, and the secretary of the interior sailed on the U. S. S. General Alava to investigate the fitness of the island of Cagayan de Jolo for a leper colony. This island had been previously visited by a board of officers appointed by General MacArthur, and this board had reported unanimously in favor of its selection for this purpose, stating that the population numbered about 200 or 300 poverty-stricken natives, who could probably be removed without serious difficulty, and that there was little property on the island, so that any property rights possessed by its present inhabitants could be acquired by the Government at very small expense.

A short stop was made at Calapan, in Mindoro, to investigate political conditions there, and another short stop at the island of Cuyo, where an unsuccessful attempt was made to secure a competent interpreter, in order that the committee might be sure of being able to communicate with the inhabitants of Cagayan de Jolo.

Cagayan de Jolo was reached on the morning of December 14, shortly before noon. An attempt was made to anchor at the northwestern extremity of the island, near where the interpreter and United States representative was understood to live. It proved impossible to find an anchorage, however, and the steamer was obliged to stand on and off while we landed and attempted to get in communication with the interpreter. The men whom we met on shore were all armed, and, while apparently not unfriendly, either could not or would not understand either Spanish or Tagalog. After great difficulty we gathered information to the effect that Capitan Mariano, the man whom we were seeking, lived to the westward behind a projecting point, which was shown to us. Returning to the steamer, we followed the coast line to this point and made a second landing. Here we found the people more inclined to be communicative, and Mariano's house, distant some 5 miles, was pointed out to us. We again returned to the steamer, but as thick weather, with heavy squalls, came on, were obliged to give up the attempt to get in touch with the interpreter and run to the south coast of the island for protection.

During the night the wind changed and blew strongly from the southwest, and the vessel was obliged to get under way and run for the open sea. The following morning we returned to the vicinity of Mariano's house, but the sea was so rough as to make it impossible to lower a boat. We finally found a somewhat protected anchorage near the eastern extremity of the island, and landed three parties. One, under the sanitary engineer, set out for the top of the highest hill on the island, in order to take bearings of all important points, and to verify the existence of certain bodies of water shown on the chart; another, under the commissioner of public health, started directly toward the center of the island; and a third, under the secretary of the interior, followed a trail which showed conspicuously, crossing a range of hills to the eastward. The entire day was spent in exploring the island. It proving impracticable for any of the parties to reach Mariano's house, a runner was dispatched with a request for him to come overland and board our vessel.

The day's work conclusively showed that several small streams and one river indicated on the chart had no existence in fact, and that a lake which appeared on the chart near the center of the island did not exist, there being only a bog hole at the center of a somewhat extensive valley, into which surface water drained from all

directions, but from which there was no outlet. This bog, we were informed, dries up completely during the dry season.

The day's work also showed that the number of the people on the island had been greatly underestimated by the board which had previously reported upon it.

At 8 o'clock that evening the interpreter, Mariano de Leon y Legaspi, came on board our vessel, and we had a long interview with him. This gentleman has resided in Cagayan de Jolo, first as a representative of the Spanish Government and subsequently as the United States representative, for eleven years, and is thoroughly familiar with the island. He informed us that the Moro population numbered not less than 3,000 souls; that there were two important datos, namely, Dato Dakulá and Haji Dato Hamil Tamya. There are also four other datos, sons or nephews of the two above mentioned, who have no following as yet, and exercise little or no political influence.

It was ascertained that there were upon the island some 40,000 cocoanut trees in bearing, and that extensive areas were also planted in bananas. A small amount of land was planted with rice, and there were some 500 head of cattle, the number being strictly limited by the lack of any adequate water supply.

The Moros obtain their drinking water from shallow wells 6 to 10 feet in depth, which at the time of our visit contained from 1 to 2 feet of water, showing a pearly color and evidently containing mineral substance in some quantity. We were informed that during the dry season nearly all of these surface wells failed, so that it was necessary for many of the inhabitants to go from 5 to 10 miles for drinking water, and that during the height of the wet season the water in these wells became very foul from surface drainage.

Detailed inquiries were made as to the water supply of the island, and the fact was developed that there is at one point a pool some 24 yards in diameter known as Bojekukúk, which is very deep and discharges by a subterranean passage believed by the natives to connect with a small circular lake filled with fresh water, situated within a few hundred yards of the south coast of the island and separated from it by a solid wall of rock. The surface of the water in this lake is approximately on a level with the sea, and the small pool above referred to is situated near the bottom of an extensive valley, so that even should the water from either of these sources prove suitable for drinking purposes and adequate in amount, an extensive pumping plant would be necessary in order to distribute it among the population of 8,000 to 10,000 souls, which is probably the low limit to be anticipated as the ultimate population of our leper colony.

Finally, it was definitely ascertained that Cagayan de Jolo had no port and that there was no good anchorage. The island is so small that heavy seas run around it and either break directly or back in upon every part of the coast line, which is throughout its entire extent fringed by a reef in some places wide and in others narrow, but everywhere coming so near the surface as to cause a dangerous surf during heavy weather.

It is believed that the climate of the island of Cagayan de Jolo is healthful and that its soil is fertile. But in view of the absence of any safe port or good anchorage, the lack of any adequate supply of fresh water which can be utilized without the incurring of a heavy expenditure, and the great difficulty and expense involved in acquiring the property rights of a population of 3,000 Moros and in removing them from the island, the committee decided unanimously and without hesitation that Cagayan de Jolo was not adapted to the needs of the contemplated leper colony.

On the following morning we accordingly sailed for Culion. A very severe storm was encountered and, after battling with it for a day and a half, we put into Puerto Princesa, Palawan, and remained there for twenty-four hours in order to allow the officers and crew of the Alava to secure much needed rest. We then continued our voyage to Culion, arriving there on the evening of December 17. We landed immediately, and the evening was spent in a conference with the lieutenant in command of the small garrison at present situated at the town of Culion, a small place of about 67 buildings, all but 7 of them being huts of bamboo and nipa palm. The estimated population of the town is 250 souls, of whom all but three families are poor day laborers.

The island of Culion had been visited by the army board above referred to, but they had confined their investigations to a tramp over the hills from the town of Culion to the barrio known as Baldat, and had reported that the island was suited to the needs of a small colony, believing that the lack of suitable and extensive agricultural lands would prove an insurmountable obstacle to the establishment of a large one.

This board had failed to reach the extensive and fertile valley known as the Cogonal Grande (the great grass field), which occupies the central part of the island and sends side valleys down to the northeastern and southwestern coasts.

The Secretary of the Interior, having visited this valley in the years 1891 and 1892, had personal knowledge of its existence and extent, and an overland march was arranged for the following day in order that it might be fully investigated.

The early morning hours of this day were spent in examining into the water supply of the town of Culion. There is a fine spring which flows 19,400 gallons per day at the height of the dry season. This water is said to be of excellent quality. It is distant from the town about a quarter of a mile, and could be readily piped along the beach.

In order to avoid a 3-mile tramp over the hills we went to Baldat by boat. From that point a walk of three hours and a half brought us to a beautiful side valley which extends to the westward, connecting with the Čogonal Grande, and to the eastward nearly to the coast. Ten years ago there were a number of houses in this valley, but at the present time there remains but one. The trail which we followed crosses a range of hills and at its highest point reaches an elevation of 850 feet. The descent from this point to the side valley above referred to is somewhat abrupt, and, while it would be practicable to build a carriage road along this route, it would be a somewhat expensive undertaking. The distance from Baldat to the side valley is approximately 6 miles. On the march from Baldat we crossed five fine streams of pure water, the fourth following along the side valley itself, and the fifth coming down the high hills immediately back of the single house above referred to.

After a short rest we pushed on to the Cogonal Grande, distant a mile and a half. The route which we followed could be made practicable for an army wagon by simply burning off the dry grass and bridging two narrow dry gullies. The land is practically

The Cogonal Grande itself is a flat valley, which was probably at one time the bed of a fresh-water lake. It slopes very gently from all sides toward the center, where there is a considerable area of low, swampy ground, suitable for rice culture. In this low ground a stream originates which joins the large stream flowing along the side valley above referred to.

The committee were agreed that the side valley and the Cogonal Grande afforded an ideal site for the proposed colony, and furnished abundant and suitable lands for agriculture and stock raising. A tramp of twenty minutes to the southward along the second side valley-partly open and partly overgrown with low bamboo-brought us to another fine stream of pure water, and the sanitary engineer followed up its bed for a sufficient distance to ascertain that it could be piped over the low divide into the Cogonal Grande. We were informed by the natives whom we took with us that this stream flowed continuously throughout the year, although with a somewhat reduced volume at the height of the dry season.

We were also informed that there was an extensive and safe harbor on the southwest coast of the island but a short distance from the point where we then were, which could be reached without crossing any hills. This harbor was said to be landlocked, and to afford a safe refuge during typhoons, although this information was in direct contradiction of the China Sea sailing directions, which state that this coast of Culion is fringed at a distance of 5 to 7 miles by dangerous reefs. We decided to investigate the practicability of reaching this alleged harbor, and, should the facts prove to be as stated, to request the captain of the General Alava to attempt to enter it from the sea. We accordingly made an early start on the following day. We reached tide water about 12.30, after a tramp of some 5 or 6 miles, during which we had descended about 150 feet with practically no lost distance, the ground along the entire route, with the exception of the last quarter of a mile, being so level that an army wagon could be driven for the entire distance after the low bamboo had been cleared and the low grass burned. For the last quarter of a mile the trail runs along a side hill, and for a short distance through a nipa swamp.

We were assured that ships' boats could come up to the point which we had reached. It being evident that a road from this point to the Cogonal Grande would be shorter, and could be constructed at far less expense than could one from the town of Culion, we decided to request Captain Halsey, of the General Alava, to fully investigate the practicability of entering the alleged port. We accordingly marched that afternoon entirely across the island, the secretary of the interior remaining at Baldat to gather further information as to the population and resources of the island, and the remainder of the party going on board the steamer, which sailed the following morning for the southwest coast. The investigations carried on by Captain Halsey and the other officers of the General Alava resulted most satisfactorily. They discovered a completely landlocked inlet, which they entered for the distance of 4 miles, finding nowhere less than 17 fathoms of water. It was ascertained that they might have entered a mile and a half farther. Captain Halsey characterized the harbor as "grand," and Executive Officer Chase stated it was without exception the