The pupillary reactions also require little time for eliciting and are of much value in differentiating a peripheral neuritis from a cord lesion.
Cosmopolitan Diseases in the Tropics
In considering the matter of the general prevalence of disease in the tropics it has seemed advisable to present statistics from the standpoint of deaths rather than admissions for disease, the probability of accuracy in diagnosis being greater where there may be the assistance of an autopsy.
In the following table I have selected three tropical places under American sanitary control, the city of Manila, the city of Panama and the Island of St. Thomas, Virgin Islands. The statistics embrace the calendar years of 1918, 1919 and 1920 The statistics of Manila relate solely to the Filipino population resident in Manila, it does not include Americans or other nationalities. The Filipino population of Manila in 1920 was 263,386. The three years covered had respectively a death rate of 49.97, 28.66 and 27.48 per 1000.
| Place | City of Manila (Filipinos only) | City of Panama | St. Thomas, Virgin Islands of United States | ||||||
| Population | 263,386 | 60,500 | 10,191 | ||||||
| No. of deaths | 11,840 | 7,378 | 7,238 | 1,314 | 1,211 | 1,297 | 248 | 176 | 185 |
| Rate per 1000 | 49.97 | 28.66 | 27.48 | 21.41 | 19.73 | 21.44 | 24.33 | 17.27 | 18.15 |
| Calendar year | 1918 | 1919 | 1920 | 1918 | 1919 | 1920 | 1918 | 1919 | 1920 |
| Typhoid fever | 180 | 171 | 226 | 0 | 3 | 2 | 4 | 0 | 0 |
| Malaria | 64 | 46 | 75 | 14 | 10 | 4 | 1 | 1 | 0 |
| Smallpox | 837 | 31 | 1 | 0 | 0 | 0 | 0 | 0 | 0 |
| Measles | 16 | 3 | 12 | 2 | 0 | 1 | 0 | 0 | 0 |
| Whooping-cough | 7 | 0 | 5 | 1 | 7 | 2 | 0 | 1 | 1 |
| Diphtheria | 14 | 16 | 9 | 4 | 10 | 5 | 0 | 0 | 0 |
| Influenza | 424 | 42 | 31 | 7 | 1 | 29 | 8 | 1 | 0 |
| Asiatic cholera | 108 | 328 | 2 | 0 | 0 | 0 | 0 | 0 | 0 |
| Dysentery | 678 | 390 | 253 | 3 | 9 | 5 | 2 | 1 | 0 |
| Leprosy | 2 | 2 | 3 | 3 | 1 | 2 | 0 | 0 | 0 |
| Purulent infection and septicaemia | 26 | 23 | 28 | 9 | 9 | 7 | 0 | 1 | 0 |
| Tetanus | 82 | 83 | 84 | 3 | 2 | 1 | 1 | 1 | 0 |
| Pellagra | 0 | 0 | 0 | 6 | 5 | 5 | 15 | 4 | 0 |
| Beriberi | 551 | 324 | 548 | 1 | 2 | 1 | 0 | 0 | 0 |
| Tuberculosis of the lungs | 1,605 | 1,334 | 1,340 | 223 | 206 | 169 | 20 | 20 | 27 |
| Cancer and other malignant tumors | 80 | 73 | 65 | 26 | 34 | 44 | 6 | 11 | 6 |
| Alcoholism | 3 | 3 | 2 | 2 | 1 | 2 | 0 | 1 | 0 |
| Diabetes | 6 | 6 | 11 | 3 | 3 | 0 | 0 | 0 | 0 |
| Simple meningitis | 448 | 292 | 300 | 12 | 11 | 14 | 1 | 2 | 0 |
| Cerebral hemorrhage | 109 | 99 | 93 | 27 | 39 | 40 | 10 | 9 | 4 |
| Convulsions (infants) | 224 | 148 | 91 | 3 | 4 | 5 | 4 | 1 | 1 |
| Acute endocarditis | 46 | 29 | 28 | 17 | 14 | 7 | 0 | 1 | 2 |
| Organic diseases of the heart | 118 | 95 | 93 | 63 | 37 | 45 | 9 | 17 | 27 |
| Diseases of the arteries | 18 | 23 | 15 | 15 | 27 | 34 | 9 | 7 | 9 |
| Acute bronchitis | 975 | 335 | 630 | 34 | 14 | 17 | 0 | 0 | 0 |
| Chronic bronchitis | 286 | 331 | 235 | 4 | 1 | 3 | 0 | 0 | 0 |
| Broncho-pneumonia | 872 | 293 | 372 | 86 | 109 | 108 | 15 | 10 | 6 |
| Pneumonia | 220 | 86 | 101 | 60 | 62 | 59 | 5 | 8 | 8 |
| Diarrhoea and enteritis (under two years) | 642 | 365 | 365 | 156 | 136 | 162 | 13 | 4 | 11 |
| Diarrhoea and enteritis (over two years) | 429 | 253 | 164 | 9 | 16 | 13 | 9 | 4 | 5 |
| Acute nephritis | 159 | 88 | 102 | 18 | 21 | 14 | 0 | 1 | 1 |
| Chronic nephritis | 265 | 248 | 156 | 72 | 63 | 63 | 15 | 16 | 21 |
| Intestinal parasites | 16 | 12 | 5 | 0 | 2 | 0 | 1 | 0 | 0 |
| Congenital debility | 614 | 460 | 611 | 32 | 13 | 21 | 13 | 14 | 6 |
| Senility | 531 | 451 | 357 | 17 | 7 | 9 | 13 | 0 | 1 |
| 10,655 | 6,483 | 6,413 | 932 | 879 | 893 | 174 | 136 | 136 | |
The population of the city of Panama during the year 1920 was 60,500. The death rate during the years covered was 21.41, 19.73, and 21.44 per 1000, respectively.
It may be stated that the average population of the Canal Zone during 1920 was 27,459, with 242 deaths, giving a death rate of 8.81 per 1000.
The population of St. Thomas during 1920 is estimated at 10,191. The death rate during 1918 was 24.33, during 1919, 17.27 and during 1920, 18.15 per 1000.