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.

This he did with promptness and despatch, the number of cases for
August being but seven hundred twenty as against thirteen hundred
sixty-eight for the previous month. On the 8th of September, having
brought the disease under control at Manila, he insisted on resigning
in order to attend to his private affairs, which were suffering from
neglect, and his resignation was reluctantly accepted.

Dr. Bourns's remarkable success in dealing with a very difficult
situation was largely due to his ability to devise measures which,
while thoroughly effective, were less irritating to the public than
were those which had been previously employed.

The policy which he had inaugurated was followed by his successor
with the result that the cases fell to two hundred seventy-five
in September and eighty-eight in October. In November there was
a slight recrudescence, but the disease did not again threaten to
escape control and in February practically disappeared, there being
but two cases during the entire month.

The return of hot, damp weather again produced a slight recrudescence,
and scattering cases continued to occur until March, when the epidemic
of 1902-1904 ended in Manila.

In view of the conditions which then prevailed and of the extreme
risk of a general infection of the city water supply, which, had it
occurred, would doubtless have resulted in the death of a third of
the population, this is a record of which the Bureau of Health may
well be proud.

The effort to prevent the spread of infection by maintaining a land
quarantine around Manila proved entirely ineffective. The disease
promptly appeared in the provinces where the campaign against it
was from the outset in charge of newly appointed Filipino presidents
of provincial boards of health, aided, when practicable, by medical
inspectors from Manila.

Before it was finally checked in Manila