rited a
fairly well developed epidemic of bubonic plague. In 1901 this disease
caused four hundred twenty-seven deaths, in 1902 it caused ten only,
but the demands made on the sanitary force by the cholera epidemic
which began in that year rendered it impossible to give to plague
the attention which it otherwise would have had, with the result
that in 1903 we had one hundred seventy-four deaths. In 1904 there
were seventy-eight; in 1905, forty-three; in 1906, seven; in 1907,
none; and from 1907 until 1912, none. In the latter year the disease
was reintroduced.

Rats become infected with it, and fleas transmit it from them to human
beings. It was probably brought in by pestiferous rodents hidden
inside packages of vegetables, as it appeared in a district where
crates of vegetables are opened in large numbers, and did not appear
in the vicinity of the piers, although shore rats are abundant there,
and if diseased rodents had landed from shipping, would promptly have
become infected,--a thing which did not occur.

At about the same time plague also appeared at Iloilo, where it was
eradicated with a total of nine deaths. At Manila there have been
up to the present time [504] fifty-nine deaths, and scattering cases
continue to occur at considerable intervals.

Had plague not been promptly and effectively combated, it would
unquestionably have spread rapidly, causing untold misery and heavy
property losses.

As I have previously stated, at the time of the American occupation
smallpox was by many people regarded as an almost inevitable ailment
of childhood. It proved necessary to secure the passage of legislation
forbidding the inoculation of human beings with it to prevent misguided
Filipinos from deliberately communicating it to their children, not
because they did not dearly love them, but because they regarded
infection with it as a calamity sure to come sooner or later, and
desired to have it over with once for all.

We have performed more than ten million vaccinations, with the result
that the annual deaths from this disease have decreased from forty
thousand at the outset to seven hundred for the year just ended. There
is now less smallpox in Manila than in Washington.

In the six provinces nearest Manila it was killing, on the average,
six thousand persons annually. For a year after we finished vaccinating
the inhabitants of these provinces it did not cause a death among them;
nor has it since caused such a dea