April 11.-Ladrone band entered the town of Sampaloc but were driven out by police. Ladrones numbered about 20 but had only 2 guns. One ladrone was killed. May 7.-Capt. G. K. Armstrong relieved First Lieut. S. W. Tilden as supply officer. June 4.-Band of ladrones entered barrio of Tiason and attacked and completely surprised the constabulary detachment (under a corporal) and the municipal police. A Remington rifle and revolver were taken by the ladrones, who immediately fled before the constabulary had sufficiently recovered from their surprise to retaliate. CONDITIONS JUNE 30, 1903. With the possible exception of the province of Albay, conditions throughout the district are very satisfactory at the present date. The active operations conducted in Tayabas by Capt. J. B. Murphy and in Mindanao by First Lieut. C. E. Manison have been conducive to splendid results, and both provinces have become fair examples of what energetic and intelligent cooperation of the provincial authorities can accomplish toward establishing and maintaining a satisfactory status of peace. Conditions in the province of Ambos Camarines and Sorsogon have been particularly satisfactory, in that their close proximity to the troublesome province of Albay would appear to offer an excellent opportunity to infection from the exceedingly infectious disease of ladronism. However, active and constant patrols along the borders of both provinces and the lack of encouragement to the ladrones from the inhabitants themselves, which feeling has been well fostered and encouraged by the provincial authorities of both provinces, have been the factors which have proven so efficacious in keeping these provinces clear from ladrone infection. In the island provinces of Masbate and Romblon the constabulary has performed the usual routine duties and no difficult or extraordinary problems have presented themselves. What few ladrones exist are more in the nature of fugitives from justice than active agents of discord. In the province of Albay the cause of the present lawlessness and ladronism might be attributed to a variety of reasons, among these being the peculiar topographical formation of the province and its wealth, which, being for the most part in hemp plantations lying remote from population centers, is exposed and difficult of protection, and for this reason can be made the means of securing and to an extent forcing the support of some few of the wealthier inhabitants whose laborers may only work their plantation by favor and permission of the controlling outlaw. The great majority of the ladrone leaders now out in this province were formerly insurgent officers of more or less rank who have tasted the almost unlimited authority of an insurgent officer that raised them from the grade of the most ordinary citizen to that of temporary affluence and command, and are loath to return to the old life of poverty and labor. Vigorous operations are now being conducted by the constabulary and scouts acting in conjunction, and it is only a question of time before Albay Province will be cleaned of its present ladrone contingent. MEDICAL DIVISION. The report of Capt. Justus M. Wheate, surgeon, Philippine constabulary, chief medical officer of this district, here follows: HEADQUARTERS SECOND DISTRICT, PHILIPPINES CONSTABULARY, MEDICAL DIVISION, Lucena, Tayabas, July 3, 1903. The ADJUTANT, SECOND DISTRICT, PHILIPPINES CONSTABULARY, Lucena. SIR: In compliance with the following letter of instructions from your office, I have the honor to submit my report of the work of the medical division in the second district covering the period from February 1 to the close of the fiscal year ending June 30, 1903. * * * * * "HEADQUARTERS, SECOND DISTRICT PHILIPPINES CONSTABULARY, "CHIEF MEDICAL OFFICER, SECOND CONSTABULARY DISTRICT, Lucena. "SIR: The district commander directs me to inform you that a report is desired from you covering the organization and administration of the medical division in this district from the date of its inception to June 30, 1903. "This report should be rendered with the least practicable delay. "Very respectfully, “E. R. HIGGINS, Adjutant.” ORGANIZATION OF THE MEDICAL DIVISION. On February 1, 1903, I reported for duty to the adjutant of the second district pursuant to paragraph 1, G. O., No. 9, headquarters Philippine constabulary, dated Manila, January 31, 1903. Act No. 595 of the United States Philippine Commission provides for the appointment of three surgeons for the constabulary, but it does not create a medical division or embody any plan of organization or administration of a medical division. At the time of reporting for duty there was practically no plan or specified line of duty authorized in which to engage, and the only instruction given us by the chief of constabulary was that the three surgeons confer together with a view to evolving a practical method of organizing a medical division with the limited resources at their command. This meant vastly more than at first appeared, when, after taking into account the manifest impossibility of 3 surgeons attempting to render professional services to some 6,000 men disposed over 1,000 miles of territory, and, so far as known, not an enlisted man in the service who could be utilized as a hospital nurse or attendant upon the sick. There was found one junior officer who had a degree from a medical college and who was dividing his time between campaigning in the field and administering to the sick and injured, and one or two other officers who had previously served in the Hospital Corps, U. S. Army. These few assistants whose services were available, together with an ill-assorted and extremely limited amount of medicines and surgical supplies, constituted the available resources. A careful inventory was taken of all supplies for use in the proposed medical division and pro rata apportionment allotted to each district. From the outset economy was the paramount issue; economy in appropriations, economy in the number of officers, and economy in the available enlisted detail asked for, and any policy presented for consideration was modified by this expedient. An adjustment of the various difficulties at length resulted in the acceptance of the plan which is at present in force with such modifications from time to time as experience warranted, and which provides for a chief medical officer for the first, second, and third districts, with the senior officers designated as superintendent, medical division, three medical inspectors, and such number of enlisted men to be detailed from the provincial commands as may be deemed necessary, and with the approval of the senior inspector. In addition to this force, authority has been granted by the chief of constabulary to enlist 10 native practicantes whose capabilities and fitness are to be predetermined, and who shall be given the rank, pay, and allowances of sergeants of the constabulary. The duties of these practicantes are in all essentials those of a hospital steward in the United States Army. The medical inspectors are officers of the constabulary chosen for detail in the medical division because of necessary qualifications to enable them to take command of a hospital, and to properly treat such minor injuries or illnesses as do not require the presence of the chief medical officer, and which make up the major portion of disabilities. At present there are but 2 medical inspectors on duty in this district, but they are both exhospital stewards of the United States Army, of experience, and capable of rendering the services required of them. There is but one practicante in the service in this district, who is on duty in the Albay provincial hospital. In lieu of a hospital corps provided by legislation, enlisted men of the line are detailed for such duty temporarily, only such men as present evidence of intelligence and a knowledge of the Spanish language being selected. ORGANIZATION OF THE MEDICAL DIVISION IN THE SECOND DISTRICT. Upon assuming the duties of my office, I at once endeavored to ascertain what medicines and medical supplies were on hand in the various posts throughout the district, as well as what, in the opinion and experience of the officers in charge, were needed. In addition, I desired to know how the sick were being treated, and at what expense to the government, and with what success. Also what was the general state of health or disease of the garrison. With these objects in view, I accordingly addressed to each senior inspector in my district, as well as junior officers commanding important stations, the following cir cular: "HEADQUARTERS SECOND DISTRICT, PHILIPPINES CONSTABULARY, "SIR: By direction of the district commander, I have the honor to address to you the following communication, in order to further the work of the medical division, and to request that you furnish a reply at your earliest convenience: "1. What is the total number of enlisted men at your station—(a) able for duty, (b) unable for duty? "2. What is the per cent of sickness or disability for the month of January? "3. Give a complete list of medicines, surgical supplies and dressings, and first-aid packets at your station. "4. What medicines, if any, do you need? "5. Have you any especial knowledge of medicines or training in the use or administration of drugs? "6. What facilities have you at your station for treating sick or wounded-i. e., whether in quarters, special building, or civil hospital? "7. Where is your nearest civil hospital? "8. Have you ever served in the Hospital Corps, U. S. Army? "9. Have you any enlisted men in your command who, by reason of superior intelligence and adaptability, would become efficient hospital-corps men? "10. Do you know of any practicantes who have had hospital training that could be enlisted with the rank of sergeant in the hospital corps? "Very respectfully, "J. M. WHEATE, "Captain and Surgeon, Philippines Constabulary, Chief Medical Officer." The replies to this letter came in slowly, and in several instances none were received, but from those obtained it was shown that the percentage of disabilities varied from 2 to 35 per cent during the month of January, and that the usual method of treating the sick was to render such assistance as was available to the man in quarters. The replies showed but one officer who had previously been in the Hospital Corps, U. S. Army, or who had any knowledge of medicines or surgery, and yet the drugs distributed throughout the district included such medicines as cocaine, hydrochlorate, chrysarobinum, atropin sulphat, morphin sulphat, tr. digitalis, and a varied assortment of more or less highly potent drugs, the use of which would be dangerous except by those skilled in their administration, and it occasioned surprise that such remedies as these were being asked for as well. It is superflous to add that men not scientifically trained in the use and knowledge of action of such virulent drugs should not be entrusted with their administration, to say nothing of the needless extravagance in their expenditure, for they are all of the very expensive calls of medicines. Furthermore, I found but a meager supply of simple, minor surgical dressings, as a rule, and but 18 first-aid packets in the entire district of approximately 2,000 men. PROVINCE OF ALBAY. During the month of February preparations were being made to conduct a vigorous campaign against the lawless element which had assumed rather unusual prominence in the province of Albay, and it became necessary to make equivalent preparations to care for a probable increase in the sick report. I was therefore ordered by the district commander to provide such emergency supplies as would serve the purpose in hand, and to proceed to Albay, and there confer with the senior inspector of that province with a view to establishing a hospital at the most practicable point in the disaffected territory. I was instructed to carry with me only such supplies as were believed to be absolutely indispensable, since it was intended that this hospital would be but a temporary expedient. I arrived at Albay on February 28, 1903, with the hospital equipment. On the following morning, March 1, a telegram was received by the senior inspector, informing him of the attack on the garrison at Oas, in the interior of the province, on the preceding night, and reporting a list of wounded, 4 of whom were believed to be fatally injured. I made hasty preparations to proceed to Oas with such necessary supplies as could be carried by myself and an orderly, but upon reaching Guinobatan I found that the 4 seriously injured men had been brought there, having arrived some half or three-quarters of an hour preceding me. These men were wounded at or about 7.30 p. m. on the preceding night, and received no surgical aid whatever up to this time, save for well-meant endeavors of some comrade who thought to staunch the appalling flow of blood from one of the most serious wounds by filling it, and incidentally the pleural cavity of the victim with carabao dejecta. After lying unattended during the night and forenoon of the succeeding day, when in extremis from loss of blood and shock, they were placed in hammocks and carried through the midday sun over some 9 or 10 miles of dusty road to Guinobatan, where I found them on my arrival at half-past 3 in the afternoon, twenty hours after their injuries had been received, and almost moribund. I need not describe in detail these cases, but after four hours of arduous labor I finished the work of cleaning them and dressing their various wounds. This in reality formed the nucleus for the contemplated hospital, and this town seemed to afford better facilities than any other interior town. I spent some days in the effort to secure a suitable house for a hospital before I succeeded. Finally a fairly satisfactory house was obtained and preparations at once begun to equip it. My supplies had already reached me from Albay, in response to a telegraphic request to the supply officer, and we soon had a fairly acceptable place in which to care for the wounded men from Oas, as well as some four or five others sent in from neighboring posts for treatment. It soon became apparent that, at the rate at which the hospital was filling, additional supplies would be required, and upon the arrival of Colonel Baker at Albay to take charge of operations in the province, I consulted him, with a view to securing the necessary additional equipment, and was ordered to Manila to procure such supplies as I thought necessary. Returning to Albay on March 22, I brought sufficient equipment in medicines and hospital supplies to establish a fairly good hospital, adequate for the accommodation of from 20 to 24 patients, in the event of emergency. I remained on duty at this hospital, and, in addition, attending to such of my district work as could be managed from that point, until April 22, during which time the admission to the hospital increased, by the arrival of both acute and chronic cases of disabilities from detachments in the surrounding country, until there were 18 inmates present. During the month of March cholera made its appearance throughout the interior and western portion of the province, becoming alarming in some parts, particularly in Joveller, an isolated mountain pueblo, where a detachment of the constabulary was stationed, and of which four of the soldiers contracted the disease. I was directed by the district commander, Colonel Baker, on April 3, to proceed to Joveller to render such assistance as I might be able to furnish and to make an effort to rid the town of the disease. I arrived there on the following day and found three soldiers sick with cholera, one beginning convalescence. They were isolated some 40 yards distant from the quarters, in a temporary shelter of nipa, and were being nursed by a soldier, under the direction of the commanding officer of the station. The deaths recorded in the town for the preceding day were 45, with probably 100 more cases in various stages. I arranged for a conference with the town officials and the padre and the officer commanding the station, with the result that on the following morning (Sunday) we made a thorough inspection of the town and indicated what work should be done in the interest of sanitation, and a generous detail of laborers was at once set to work and a creditable cleaning was accomplished. During the three days I remained in town much was accomplished in the efforts to lessen the spread of the disease, and, in fact, from that time forward there was a gradual decline in the number of cases, until a sanitary inspector in the employ of the insular board of health arrived to take up the work. There were no further cases among the constabulary, and by the 17th of the month cholera had disappeared from the town. A few cases appeared in Guinobatan as early as April 7 or 8, and on account of the concentration of the country people in the town a favorable field for the spread of the disease was present. It at no time became serious as an epidemic, but the disease continued present until some time in May. During this period two soldiers had it, both recovering, and during March a soldier died of smallpox and one of beri beri, these being the only deaths occurring among the soldiers during my tour of duty in the province. Owing to the increasing admissions to hospital of cases of chronic beri beri, and an occasional worn-out or otherwise useless soldier, I addressed the following communication to the district commander, recommending the discharge of seven men for reasons set forth in the communication: "Col. D. J. BAKER, "GUINOBATAN, ALBAY, April 20, 1903. "Commanding Second District, Philippine Constabulary. "SIR: I have the honor to invite your attention to the following cases of enlisted men of the Philippine constabulary now undergoing treatment at the constabulary hospital at Guinobatan, and to recommend that these men be discharged by reason of physical unfitness for the service. It is no doubt that a moral obligation, viewed from a humanitarian standpoint, or as compared to the custom of the United States Army, to keep all sick or disabled soldiers in the service for treatment unless they specially desire discharge; but, as I understand the law governing the constabulary service, such liberality is not compatible with the service required of the men by the government. We are wholly without facilities for properly caring for this class of patients, and it is very probable to the mutual interest of both employer and employee that they be discharged. The men whose names with accompanying data follow are incapable of rendering further service to the government in their present capacity, and at the same time they are overtaxing the capacity of the hospital to care for them and other cases of remediable disabilities, I believe it will be of the greatest good to the greatest number to discharge these men and furnish them with transportation to their respective homes, where they will be better satisfied with their families, and, in most essentials, as well off as here in the hospital. "The following are the names of the men, with diagnosis and province in which they live: "Very respectfully, 66 "J. M. WHEATE, Captain and Surgeon Philippines Constabulary, Chief Medical Officer." On April 22, in compliance with verbal instructions of Colonel Baker, I proceeded overland to Nueva Caceres, Ambos Camarines, at that time the headquarters of the second district, leaving Third Lieut. W. L. Brown, medical inspector, Philippines Constabulary, in command of the hospital at Guinobatan. Lieutenant Brown was ordered from duty in Sorsogon Province by the district commander to report to me for duty with the medical division, and being an ex-regimental hospital steward and a man of several years' service in the Hospital Corps, U. S. Army, he proved himself an exceedingly valuable man for the duties with which he is charged, and his work has been such as to call forth commendation, and in recognition of his services I recommend that he be transferred to permanent duty with the medical division. During my tour of duty at Guinobatan I organized a school of instruction at the hospital for the training of all enlisted men in hospital, in the method of rendering first aid to the sick or injured as soon as they reach the period of convalescence, and for the more thorough training of men for a hospital corps. The plan that Í endeavored to pursue was to request that a given number of men from the various posts of the provinces be detailed for duty with the medical division indefinitely, or, in other words, to be hospital corps men, until such time as a hospital corps should be created by proper authority; also to recommend that one or two men from each post in the province be detailed to attend the school of instruction one month, at the conclusion of which they should be returned to duty with their commands and others detailed in their stead; while all convalescents should be regarded as pupils of the school at the earliest date consistent with their physical welfare, so that, ultimately, every man who enters the hospital will leave it with at least some useful knowledge more than when he entered, and together with the men detailed especially to attend the school, there will eventually come a time when well equipped and trained men will be found in every post who are proficient in the requisites for rendering intelligent assistance to their comrades in arms, and that no detachment need go on a march without trained men equipped with a hospital corps to accompany it. Had such a system been in operation some months previous, the deplorable state of the victims of the Oas affair would not have presented itself as an evidence of the unpreparedness of the constabulary to take humane care of itself. Owing to the state of activities which required all the available men in the province, I could not carry out my plans of having men especially detailed to attend the school of instruction, but of the others it is gratifying to state that the results attained have been all we anticipated. The work is now being carried on successfully by Lieutenant Brown at the new hospital in Albay, where it was removed from Guinobatan during the month of June. It is now located at provincial headquarters, and is besides more accessible to Virac, on the island of Catanduanes and other coast towns of the province of Albay. PROVINCE OF AMBOS CAMARINES. Upon my arrival at Nueva Caceres, I took immediate steps to organize a similar school of instruction to the one in operation in Albay Province. It was originally intended, upon removal of district headquarters to Nueva Caceres, to establish one of the three provincial hospitals authorized for each district at that point, but even before my arrival it had been decided to remove the headquarters to Lucena, Tayabas, and with it the provincial hospital, and hence, while a hospital could not be provided for Nueva Caceres, still, by reason of the extent of territory subadjacent it was necessary to provide some improved means of caring for the sick and disabled. My plan of providing for this will be seen in the following extract from a communication addressed to Col. H. H. Bandholtz, the new district commander: |