Report. [1918]

ANNUAL REPORT OF THE PHILIPPINE HEALTH
SERVICE, FISCAL YEAR 1918.
DEPARTMENT OF PUBLIC INSTRUCTION,
PHILIPPINE HEALTH SERVICE,
MANILA, October 1, 1919.
SIR: I have the honor to transmit herewith the annual report
of the Philippine Health Service for the fiscal year ending
December 31, 1918.
THE YEAR IN BIRIEF.
While all the usual activities and routinary work of the Service were carried on during the year, it was found possible to
effect but few permanent sanitary improvements, as the personnel had to devote most of their time and efforts to combating
the epidemics with which the year was fraught. Indeed, the
year 1918 turned out as a specially bad year from the standpoint of epidemiology, and never in the history of the Service,
excepting perhaps the cholera years of 1902 and 1903, had its
resources been so heavily taxed. Yet, disastrous as the epidemiological record of 1918 has been-and in this respect, the rest
of the world was not better off, as influenza was distributed
evenly in all continents and islands-it will probably serve a
good turn in that it clearly brought out in relief such organic
deficiencies as needed correction and improvement.
VITAL STATISTICS.
The noteworthy feature of the year from the standpoint of
vital statistics was the overdraft caused on the expected annual
increment of population by the influenza epidemic, the mortality
from which numbered about 85,000 in all. In a minor degree,
the epidemic of smallpox and the cholera outbreaks, on the one
hand, and on the other, the increased general mortality rate from
other diseases, and the deaths from malaria and pulmonary tuberculosis, helped to swell the total number of deaths to the
extent of causing a natural decrement of 12,921 in the population during the year 1918. The comparative vital statistics
for 1917 and 1918 are given below:
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