[Chapter i relates "the urgent reasons for the present treatise; and the necessity for, and usefulness of, our hospital order in Philipinas." In the last paragraph of the chapter Maldonado says: "These islands are in need of physicians and surgeons, as well as of medicines; for excepting the capital Manila and the port of Cabite--where we have hospitals, and where the few secular persons who exercise the profession [of medicine] can render assistance--the rest of the provinces, and the many dependent towns, are supported by Providence alone, being helped by herbs and other simples about which they have been instructed by continual use. But, as this is so complicated a matter, whenever the patient's constitution and the dose disagree, or when other substances are added to make the latter more effective, the very article which was regarded as a remedy usually aggravates the sickness, and consequently there are continual deaths among those who make mistakes. In this capital, although there are apothecary shops, and practitioners who write prescriptions--whose charity is taken for granted, so far as they can exercise it--the crowd of patients who resort to them does not allow them to succor all, and it results that there is a great number who are unprovided [with medical aid]. Others, because their poverty cannot bear the cost of the medicines, and who have no one from whom to obtain food, find their only asylum in our hospitals--where, without any hesitation, all are received; and, making a distinction in the respect paid to them, in regard to the rank or character of various persons who have entered these houses, in so far as our abilities extend, the institution has succeeded in giving entire satisfaction. Although the royal charity maintains here a hospital and chapel at enormous cost, it is understood that this is only for officers, soldiers, seamen, and Pampangos who have positions and render actual service; for the men retired from service are excluded by this rule, except by special favor of the superior government. On this account, our attention to our duties brings us in contact with a variety of people--priests, citizens, militiamen, retired officers, Indians, negroes, besides foreigners who trade in these ports. [These constitute] a great throng of patients, and convince us that if so important a charity were to fail or be neglected many dead persons would, to our sorrow, be found in the streets and entresuelos [24] (the dwellings of the poor); and others, worn out by their afflictions, would be suffering the pangs of their necessities. These are relieved, in the present circumstances; but the permanency of the work demands that the superiors to whom the matter belongs shall aid us with laborers and encourage us with their support, obtaining from the Catholic royal piety what they shall deem suitable for this purpose."]