Theatre Disinfection.—All the cinematographs and theatres in the city were disinfected upon repeated occasions by spraying with petroleum and cresols, with a view to destroying fleas and preventing plague infection.
Attempts at deception and concealment of plague patients, upon the part of members of their families, were numerous, but with the close scrutiny of death certificates and dead bodies exercised at all health stations it is believed that all cases were recognized.
One case of extremely careless diagnosis occurred. A death certificate was furnished by a local native doctor who certified the cause of death to be "uterine hemorrhage." Suspicion arising, an autopsy was ordered and a pronounced case of bubonic plague was disclosed postmortem. No evidence of uterine hemorrhage, except slight menstrual signs, was found.
The destruction of infected fleas in plague houses is of course the primary object of the disinfection by spraying, which is thoroughly carried out in every house where a case of human plague or rat plague appears. The method is a simple one and consists in spraying a mixture of cresols (2 per cent.) and kerosene (98 per cent.) over all surfaces of the house, floors, walls, underlying ground, furniture and the spaces above ceilings, etc., using the mixture liberally and securing a general surface distribution. There is no doubt of the toxicity of this mixture to all fleas and bed-bugs which it reaches, and it is undoubtedly an effective measure in rendering an infected house safe. All of the instances of multiple house infections, where the cases recurred after disinfection, in Manila, have been in houses where, for one reason or another, the recommended structural rat-proofing has been postponed or where it has not been done. Thus, on Calle San Fernando the sequence of the four cases (their progress by days and in consecutive houses) is explained by the travel of rats through efficient rat runs present in the walls and ceilings, rather than by the passage of fleas through partition walls, from uncommunicating house to house.
A RAT INFESTED PLAGUE INTERIOR
So also at Calle Cabildo, where the superstructure of the house was a veritable sieve, there was a series of communicating double walls.
At the house on Calle T. Alonso a similar condition existed, but here the two cases which occurred may have been synchronously infected, or nearly so, previous to disinfection of the premises.
At Calle Comercio, where six days elapsed between two cases, the rooms and building were piled full of merchandise, defeating immediate disinfection, that is, efficient disinfection, until all the merchandise was moved and the rooms were emptied.
At 1364 Calle Sande, Tondo, where 5 cases originated, the infections were undoubtedly almost synchronous and no infection occurred after disinfection of the house, while at 1226 Calle Juan Luna, Tondo, the two cases were plainly infected at about the same time and this previous to disinfecting the premises.