Report of the Department of Sanitation of the Isthmian Canal Commission for the year ...

^NTUL report
or fw
DE?A RTMBHt 0? SAN IT AT |C3K
OF THE
IST;n:iAIJ CANAL COMMISSION
1908

AXISHSAINta

ANNUAL REPORT
OF THE
DEPARTMENT OF SANITATION
OF THE
ISTHMIAN CANAL COMMISSION
FOR THE
YEAR 1908
W. C. GOKGAS
Coionel, Medical Corps, U. S. Army
Chief Sanitary Officer
WASHINGTON
government printing office
v

c

ANNUAL REPORT
OF THE
DEPARTMENT OF SANITATION
OF THE
ISTHMIAN CANAL COMMISSION
FOR THE
YEAR 1908
W. C. G0RGA5
Colonel, Medical Corps, U. S. Army
Chief Saniiary Officer
c t
WASHINGTON
overnment printing office
1909

7
tils.
�
c
c
I C 1
< ft �
c c �
1
C 1
1 < c
4
ff �
ft
C ft C 1
1
4

CONTENTS.
Page.
Letter of transmittal...................................... 5
General statistics......................................... 9
Deaths during the year 1908.......................... 9
Deaths in citie3 of Panama and Colon and the Canal
Zone.............................................. 9
Deaths by color and sex.............. ................ 10
Deaths by nationality................................ 10
Deaths by ages......................................- - 11
Deaths of Isthmian Canal Commission and Panama Railroad employees by nationality....................... 11
Causes of death of Isthmian Canal Commission and
Panama Railroad employees........................ 12
List of deaths of white employees from the United States, by months, with totals and death averages per thousand................................................ 14
Deaths of white American women and children......... 17
Causes of death.......................................... 20
Table showing discharges and deaths of employees in the hospitals of the Isthmian Canal Commission, from all causes, for
the year 1908........................................... 24
Consolidated hospital report............................... 28
Consolidated sick camp report............................. 29
Consolidated hospital and sick camp report................ 30
Consolidated dispensary report..................^........- - 31
Average number of employees constantly sick during year in
hospitals, sick camps, and quarters...................... 31
Outside patients treated in Isthmian Canal Commission hospitals, including Taboga Sanitarium and Palo Seco Leper
Asylum, and amounts collected from pay patients........ 32
Surgical operations performed in hospitals of the Isthmian
Canal Commission...................................... 33
Consolidated laboratory report of all hospitals............... 38
Report of:
Ancon Hospital....................................... 40
Colon Hospital........................................ 41
Culebra Hospital...................................... 42
Palo Seco Leper Asylum............................... 44
Taboga Sanitarium................................... 45
Santo Tomas Hospital................................ 45
7

4
Report of�Continued.
Tivoli dispensary and sick camp, and employees excused from work for quarters........................
La Boca dispensary and sick camp, and employees excused from work for quarters........................
Corozal dispensary and sick camp, and employees excused from work for quarters........................
Miraflores dispensary and sick camp, and employees excused from work for quarters........................
Pedro Miguel dispensary and sick camp, and employees excused from work for quarters......................
Paraiso dispensary and sick camp, and employees excused from work for quarters........................
Empire dispensary and sick camp, and employees excused from work for quarters........................
Las Cascadas dispensary and sick camp, and employees excused from work for quarters......................
Bas Obispo dispensary and sick camp, and employees excused from work for quarters......................
Gorgona dispensary and sick camp, and employees excused from work for quarters........................
San Pablo dispensary and sick camp, and employees excused from work for quarters........................
Tabernilla dispensary and sick camp, and employees excused from work for quarters........................
Gatun dispensary and sick camp, and employees excused from work for quarters........................
Cristobal dispensary and sick camp, and employees excused from work for quarters........................
Porto Bello dispensary and sick camp, and employees excused from work for quarters........................
Board of Health Laboratory...........................
Vaccinations........................................
Issues of quinine.....................................
Sanitation:
Panama.............................................
Page
Recapitulation.......................................
Quarantine service (ports of Panama, Ancon, Colon, and Cristobal).................................................
Bocas del Toro........................................
Personnel report.......................................
Table of malarial cases among employees in hospitals, with
averages, etc...........................................
41
4/
4�
4<
5(
5(
5:
5:
5:
5:
5-
5
I
I
I
I
I
I
Colon (including Cristobal and Mount Hope)........... I
Canal Zone..........................................
i

LETTER OF TRANSMITTAL.
Office of Chief Sanitary Officer,
Ancon, Canal Zone, February 25, 1909.
Chairman Isthmian Canal Commission,
Culebra, Canal Zone.
Sir: I herewith forward report of the department of sanitation for the calendar year 1908.
I would like to call your attention to several points in this report. In the first place, to the low death rate among employees. The figures for the past five years are as follows:
Year. 1 Force. Deaths. Rate per thousand.
1904........................... 6, 213 16, 511 26, 705 39, 343 43, 890 I 82 427 1,105 1,132 571 13. 26 25. 86 41. 37 28. 77 13.01
1905...........................
1906...........................
1907...........................
1908...........................
1
This means that, out of every thousand employees, we had in 1908 one-third the number die that we had die in 1906, and one-half the number that we had die in 1907.
In this connection it is particularly interesting to note how the death rate among the blacks has fallen:
Year. �' i Force. Deaths. Rate per thousand.
1905........................... 13, 482 21, 441 28, 634 31, 507 i 354 1,013 953 402 26. 25 47. 24 33. 28 12. 76
1906...........................
1907...........................
1908...........................1
1
(5)

6
This means that in 1906, out of every thousan blacks on our rolls, 47 died; whereas in 1908, out of every thousand on our rolls, only 12 died. The black death rate was slightly less in 1908 than the white death rate. This is the first year, since we have been on the Isthmus, that the black death rate has been smaller than the white death rate. In 1906 the death rate among the blacks was nearly three times as high as that among the whites.
Considering the total population of Panama, Colon, and the Canal Zone, we have the following:
Year. Population. Number of deaths. Rate per thousand.
1904........................... 35, 000 42, 699 66, 011 102, ] 33 120,097 1,224 2, 793 3,544 3,435 2,983 52. 45 65. 41 49.10 33. 63 24. 83
1905...........................
1906...........................
1907...........................
1908...........................

This means that out of every thousand people on the zone considerably less than one-half as many died in 1908 as died in 1905.
Taking special diseases, we find that in 1906 we had among the 26,705 employees 69 deaths from dysen-terv; in 1907, with 39.343 employees, 48 deaths; and in 1908, with 43,890 employees, 16 deaths. That is, with 43,890 employees in 1908 we had less than one-quarter the number of deaths from dysentery than we
had among 26,705 employees in 1906.
In 1906 we had from malaria 233 deaths; in 1907, 154 deaths; and in 1908, 73 deaths. That is, with a force more than one-third Larger in 1908 we had from malaria less than one-third the deaths that we had in 1906. j
In 1907 we had from typhoid fever 98 deaths, and in 1908, with a larger force, we had only 19 deaths.

7
In the number of deaths from pneumonia there has also been a great fall. In 1906 we had 431 deaths from this disease; in 1907, 328 deaths; and 1908, 93 deaths.
Among white Americans from the United States we had 42 deaths during the year. Exactly one-half of these were from violence. Our death rate from disease among this class was 3.84 per thousand�about the same rate as occurred in the year 1907 in our army.
During the year we had on the Isthmus 2,674 American women and children connected with the commission. The death rate among these was 9.72 per thousand. This is an exceptionally small rate for this class of population.
I consider malaria the best measure of the sanitary work done. In 1906, out of every thousand employees we admitted to our hospitals, from malaria, 821; in 1907, 424; and in 1908, 282. That is, we now have . only about one-third the amount of malaria among our employees that we had three years ago.
Beriberi is also a disease that has considerably decreased in the past three years. In 1906 we had 68 deaths in the total population from this disease; in 1907, 53 deaths; and in 1908, 38 deaths.
It has been more than three years now since a case of yellow fever has developed on the Isthmus. The last occured in November, 1905. The last case of plague occurred in August, 1905. No case of smallpox occurred during the year.
Taken as a whole, the health report for 1908 shows verv much better conditions than have occurred in anv previous year since we have been on the Isthmus, and the death rates and sick rates among our employees
will compare favorably with those of most parts of the United States.
Very respectfully,
Wm. C. Gorgas,
Cliief Sanitary Officer.
t

ANNUAL REPORT
of
DEPARTMENT OF SANITATION, ISTHMIAN CANAL
FOR THE YEAR 1908.
GENERAL STATISTICS.
Deaths op Employees op the Isthmian Canal Commission
and Panama Railroad Company.
YEAR 1908.
9 Color. Average number of employees. Total numb" deaths fron KT Of Annual average per 1,000.
Disease. Violence. Total. Disease. Violence. ft Total.
White.............. Black............... Total......... 12,383 31,507 90 291 79 111 169 402 7.27 9. 24 6.38 3. 52 13.65 12. 76
43,890 381 190 571 8. 68 4.33 13.01
Deaths in the Cities op Panama and Colon and the Canal
Zone.
Place.
Panama____
Colon......
Canal Zone.
Total
Average population.
Total
deaths.
Annual average per 1,000
37, 073 15,878 67,146
120,097
1,292 418 1,273
34. 83-26. 32 18. 95
2, 983
24. 83
Note.�Figures relating to number of employees are compiled from the pay rolls of the different months. The population and deaths as given for the cities of Panama and Colon, and for the Canal Zone, in the tables above, include employees and civil population.
Total admissions of employees to hospitals and sick camps, including those sick in quarters......................... 49, 709
Average per thousand of employees admitted to hospitals and sick camps, including those sick in quarters......... 1,132
75952�09
2
(9)

10
Deaths by Color and Sex.
White:
Male
462
Female............................................. 208
Black:
Male.................................................
Female............................................. 747
Yellow (Chinese):
Male... Female
Unknown
44
5 3
Total............................................. 2,983
Deaths by Nationality.
........... 22 I
.................. 5
Bahama Islands.......... 1
Barbados................. 255
Antigua
Austria.
Bohemia
1
Colombia................ 163
Costa Rica China.....
Chile.....
Cuba.....
Curasao.. Demerara Denmark. Dominica Ecuador.. Endand.
11
48 4
3
2
7
2
4
8 8
Fiji Islands.....
Fortune Islands France.........
Guadeloupe Greece......
7
24 29
Germany Grenada.
Guiana, British
Holland........
Haiti..........
Ireland........
Iceland........
tfndia..........
26 2
1
1
I
5
Italy....................
Jamaica................. r>~>7
Montaerrat
17
Martinique............... 101
.............. 9
.............. 1
............... 4
.............. 1
Mexico...
Nassau____
N icaragua
Norway.................
Panama................. 1,149
Peru.......
Philippines Porto Rico. Portugal � Russia.....
Salvador...----
Santo Domingo
Spain... Scotland
Sweden. 1 St. Kitts
St. Thomas St. Croix...
St. Vincent 8 St. Martin 4
St. Lucia Syria
Trinidad Turkey
Turks Island West Indies.
United States Venezuela�
27 Not stated
8 1 3 3 3 4 2
177 2 1 3
10 1
3
1
60 3
26 2 1 6
94 6 36
Total.............. 2,983

11
Deaths by Ages.
Under 1 year
680
From 1 to 4 years........ 147
From 4 to 10 years....... 89
From 60 to 70 years...... 112
From 70 to 80 years...... 36
10 8 1
146
From 80 to 90 years......
From 90 to 100 years.....
From 100 to 110 years.... Unknown................
From 10 to 20 years...... 147
From 20 to 30 years...... 625
From 30 to 40 years...... 421
From 40 to 50 years...... 376
From 50 to 60 years...... 185
Deaths of Isthmian Canal Commission and Panama Railroad
Employees by Nationality.
Total.............. 2,983
Antigua................. 10
Austria................... 1
Bahama Islands.......... 1
Barbados................. 160
Colombia................ 12
Costa Rica............... 4
Demerara............... 3
Dominica............... 2
Ecuador................ 1
England................. 2
Fiji Islands............. 1
Fortune Island.......... 7
France.................. 1
Germany................. 1
Greece................... 8
Grenada................ 7
Guadeloupe.............. 20
Haiti................... 2
Italy.................... 9
Jamaica................. 84
Martinique............... 39
Mexico.................. 2
Montserrat............... 9
Panama................. 13
Portugal................. 1
Spain.................... 87
St. Lucia..........�...... 7
St. Kitts................. 3
St. Martin................ 1
St. Vincent............. 2
St. Croix................. 1
Trinidad................ 12
Turkey.................. 2
West Indies.............. 2
United State3........... 46
Venezuela............... 1
Unknown................ 7
Total.............. 571

12
Causes of Death of Isthmian Canal Commission and
Panama Railroad Employees.
Diseases.
Apoplexy..
Abscess:
Throat
White.
Perirectal... Periurethral
Angina pectoris..........
Anaemia, primary........
Aneurism of arch of aorta Arthritis................
Appendicitis.........................
Brain, acute softening of...............
Cancer (adenoid carcinoma, involving the gland of abdominal cavity)...
Cholangitis, acute suppurative.........
Congestion, pulmonary................
Colitis, acute.........................
Debility, general......................
Dysentery............................
Empyema.............................
Endocarditis..........................
Fever:
Malarial.........
Hsemoglobinuric Undiagnosed____
Typhoid
Gastric ulcers with perforation Heart:
Organic disease of.........
Acute dilatation of.......
Infection, origin undetermined
Intestinal obstructions........
Liver:
Abscess of................
Ecchinococcus cysts of____
Amoebic abscess of........
Sarcoma of................
Lungs:
Abscess of.....
Gangrene of...
Hemorrhage of Lymphangitis.....
1
1 1
1
5
20 13 1 2 1
3 1 1
2
2 1 1
Black.
1
1 1 1 1
2 2 1 1
1 1 2 1 1] 1 1
25 6
17 1
8
3
2
3
1
1 3 1 1
Total.
2
1 1 1 1
2 2 1 2 1
1 1 1
2 1
16 1 1
54 19
1 19
2
11 1 4 4
5 1 1 1
1 3 1 1

13
Death of Isthmian Canal Commission and
Causes of
Panama Railroad Employees
Continued.
Diseases.
White.
Meningitis:
Acute..................- �
Cerebro-spinal, epidemic
Pneuinocoecic...........
Mitral insufficiency Myocarditis........
Nephritis:
Acute..........
Chronic Pneumonia.
Pyaemia..........................
Splenitis, acute....................
Sarcoma of mesenteric lymphnodes
Septicemia, purulent infection-----
Stricture of urethra...............
Tetanus..........................
Tuberculosis:
Pulmonary........
Miliary...........
General...........
Chronic ulcerative
(Pott's disease)____
(Osteomyelitis)____
Uraemia............
Uncinaria.........
Ulcer of duodenum
Violence...........'
Total
1 1
1
2
1
79
169
Black. Total.
5 6
1 2
5 5
1 1
1 2
12 12
16 19
82 93
5 6
1 1
1 1
7 10
1 1
4 6
! 33 34
i 5 I 5
i 2 2
1 1 1
1 1 1
1 1
3 3
1 1
1 1
111 190
402 571

14
List of Deaths of Wtttte Employees from the United States, by Months, with Totals and Death Averages per Thousand.
JANUARY.
Name. Occupation. Time on* Isthmus. Age. Cause of death.
Hoard, Samuel R... Panama Railroad. 13 months. Fever, haemoglobinu-ric.
FEBRUARY.
Davis, Cleon Leslie. Ergireering and i construction department. 45 months! 1 Gunshot wound, accidental.
fc MARCH.
Cooper. David...... Forbes, IT. D....... Perkins, Mrs. P. I.. Rich, M. P......... Sykes, Henry W... Store, Jean B...... Locomotive engi-r eer. Mechanical department. Teacher........... Foreman.......... Machinist......... Engineer.......... 2 years____ 4 months.. ....do..... 3 years____ 22 months. 49 33 27 ' 33 1 48 ; 42 Intestinal obstruction. Malaria, complicated with nephritis. Amoebic dysentery. Abscess of liver. Hemorrhage and exhaustion, gastric ulcers. Malarial fever.
APRIL.
Bath, George K____ Gerdes, Max J..... Lov, Robert Faxon. Riddle, Paul L..... Engineering and construct ion department. Physician......... Conductor........ Clerk............. 4 months.. 10 months. 1 year_____ 2"! years... � 21 1 85 1 30 Accidental drowning. Organic heart disease. External violence. Pulmonary tuberculosis.

15
List op Deaths of White Employes from the United States> by Months, vith Totals and Death Averages per Thou-
sand�Continued.
MAY.
Name.
Occupation.
Brown, John A
Coggan, Clifford.
Nice, Ada J......
Roche, Joseph P
Roch, Frank
Engineering and construction department.
Excavation and dredging depart-partment.
Nurse.............
Excavation and dredging department.
Foreman..........
Time on Isthmus.
Age.
Cause of death
10 months.
----do..
13 months. 10 months.
43 months..
CO
Accidental tism.
trauma-
24 Dynamite explosion
34 34
Cancer (abdominal) Dynamite explosion
56 Myocarditis, chronic
JUNE.
Alexandre, John J.. Caswell, Arthur O..
O'Shea, Dennis
O'Brien, Michael J.
Engineering department.
Engineering and construction department.
Excavation and dredging department.
Panama Railroad.
11 months. 9 months..
8 months
40 19
48
Acute dilatation of heart.
Accidental traumatism (on the Panama Railroad).
Fracture of skulk
Cerebral - hemorrhage (probably murdered).
JULY.
'cKenzie, M. M., alias Murdock.
Rose, Charles A
Engineering and construction department.
____do...........
4 years____
2| years...
52
43
Suicide, gunshot wound of head.
Suicide, hanging.
AUGUST.
Mills, William J.
Mechanic
5 months..
4G
Drowning, suicide.

List of Deaths of White Employees from the United States, by Months, with Totals and Death Averages per Thousand�Continued.
septe MBER.
Name. Occupation. Time on Isthmus. Age. Cause of death.
Mickle, Louis....... Townsend, Edwin.. Vanderstop, Paul... Wagner, Wm. Hendricks. Atlantic division.. Engineering and construction. Foreman.......... 33 months. 19 months. ...do...... 37 33 29 38 Appendicitis, perforative, with general peritonitis. Accidental traumatism (accidental discharge of rille). Malarial fever, e. A..
Atlantic division.. 3 years____ pernicious. Violence, railroad. �
OCTOBER.
Averill, J. H.......1 Davies, David R... Goodley, William... McKee, William J... Steam shovel engineer. .....do............ Craneman......... Machinist........ 3 years____ 7 months.. 13 months. 4 months.. 40 32 21 45 Angina pectoris. Dynamite explosion. Do. Pernicious malaria.
NOVE] MBER.
Vanne, Charles..... Quartermaster's department. 5 years____ 62 Pneumonia, broncho.
DECEMBER.
Beale, William____
Curtin, Patrick J..
Caldwell, William (naturalized).
Hummer, James L.
Harper, G. II......
House, Amos B____
Korp, John J____
Miller, Inguard J
Reidy, John J
Panama Railroad. Engineering and
construction. ....do...........
....do...........
Trainman........
Engineering and construction.
....do...........
Panama Railroad
Engineering and construction.
3 years____ 59
21 months. 48
14 months. 40
3 years____ 24
28
2 months.. 40
37 months. 25
4 months.. 21
G weeks... 30
Amoebic dysentery. Railroad accident.
Lobar pneumonia. Dynamite explosion.
Railroad accident. Amuebic dysentery.
Dynamite explosion.
ILemoglobinuric fever.
Dynamite explosion.

17
Average number of white employees from the United States
on the Isthmus for the year............................. 5,459
Total number of deaths among white employees from the United States for the vear...............................
Annual average per 1,000 of deaths among white employees
Total number of deaths from disease
among white em-
ployees from the United States for the year
Annual average per 1,000
of deaths from disease among
Total number of deaths from violence among white employees from the United States for the year
Annual average per 1,000 of deaths from violence among
42
from the United States................................. 7. GO
21
white employees from the United States................. 3. 84
21
white employees from the United States................. 3. 84
Deaths of White American Women and Children.
MARCH.
Name. Time on Isthmus. Age. i Cause of death.
Cate, Charles I......... Colegrove, Sybil........ Daken (baby).......... Perkins, Mrs. P. I...... 3 days....... 4 months____ 3 days....... 4 months____ 5 months____ 3 years...... 3 days....... 27 years..... Capillary bronchitis. Fracture at base of skull, accident. Congenital heart disease. Amoebic dysentery.
APRIL.
Boyd (baby)
Costley, Percival F..... 4 months____
Premature birth. Accidental drowning
MAY.
Beattie (baby).......
Nice, Ada J..........
O'Day, Mrs. William.
3 days_____
13 months 6 months.
3 days.. 34 years 22 years
Meningitis. Cancer (abdominal). Malnutrition, with vomiting of pregnancy.
JUNE.
Smith, Charles Le Roy Dennis, Wilhelmina Goethals.
75952�09
8 months 3 months
3
Convulsions. Cholera infantum

18
Deaths of White American Women and Children�Cont'd
JULY.
Name.
Hammond, Marion M
Womack, Glenys.....
Warren (baby).......
Mills, Helen Adams..
Grant, Pearl May
Belknap, Mrs. A. G..
Eberenz, Mable......
Roarlr, Mrs. F. ] Williams, Mrs. May belle T.
Time on Isthmus.
1 year
8 months...
5 days......
4 months...
Age
51 years
Cause of death.
13 years.....
5 days.......
4 months____
Uremia, secondary to chronic parenchymatous nephritis.
Malarial fever.
Congenital marasmus.
Endocarditis.
AUGUST.
Eclampsia
SEPTEMBER.
1 month...
6 months..
2 years____
....do ....
26 years.
2 years.. 31 years. 37 years.
Pelvic abscess with general
peritonitis. Malaria.
Amoebic dysentery. Heart failure (after childbirth).
OCTOBER.
Brennan, Mrs. Hattie Stevens (baby).......
Capwell, Guy........
Shuck, Mrs. F. E____
Farrell, Maria Rose.. Persons (baby).......
19 years..... Puerperal albuminuria
convulsions. Premature birth.
and
NOVEMBER.
3 months, 7
days. 2 months____
15 months. 32 years...
Tuberculosis, miliary. Pelvic abscess, septicaemia
DECEMBER.
Congenital heart disease Congenital debility.

19
Average number of white American women and children on
the Isthmus for the year............................... 2,674
Total number of deaths among white American women and
children for the year.................................. 26
Annual average per 1,000 of deaths among white American women and children................................... 9. 72
Total number of deaths from disease among white American
women and children for the year........................ 21
Annual average per 1,000 of deaths from disease among
white American women and children................... 7. 85
Total number of deaths from violence, parturition, prematurity, etc., among white American women and children. 5
Annual average per 1,000 of deaths from violence, parturition, prematurity, etc., among white American women and children............................................. 1.87
Average number of white Americans connected with the Isthmian Canal Commission and Panama Railroad for the year (Americans and their families)..................... 8,133
Total number of deaths from all causes among white Americans connected with the Isthmian Canal Commission and Panama Railroad...................................... 68
Annual average per 1,000 of deaths from all causes among white Americans connected with the Isthmian Canal Commission and Panama Railroad...................... 8. 36
Total number of deaths from disease among white Americans connected with the Isthmian Canal Commission and Panama Railroad...................................... 42
Annual average per 1,000 of deaths from disease among white Americans connected with the Isthmian Canal Commission and Panama Railroad.............................. 5.16
Total number of deaths from violence, parturition, prematurity, etc., among white Americans connected with the Isthmian Canal Commission and Panama Railroad....... 26
Annual average per 1,000 of deaths from violence, parturition, prematurityj etc., among white Americans connected with the Isthmian Canal Commission and Panama Railroad ................................................. 3.19

20
�
Causes op Death
[Embracing deaths among employees of the Isthmian Canal Panama Railroad Company, and also among the civil po]
D iseases
I. General diseases.
Typhoid fever (abdominal typhus)
Malarial fever......................
Aestivo aatumnal malaria.........
Malarial cachexia..................
Hemoglobin jric fever..............
Measles............................
Whooping cough..................
Diphtneria and croup..............
Diphtheria........................
Influenza..........................
Dysentery................................
Amoeoic dysentery.......................
Leprosy..................................
Berioeri..................................
Purulent infection and septicaemia.......
Rabies....................................
Tuberculosis of the larynx................
Tuberculosis of the lungs.................
Tuberculosis of the meninges.............
Abdominal tuberculosis..................
Pott's disease.............................
Cold abscess and abscess by congestion...
Tuberculosis of other organs..............
General tuberculosis......................
Scrofula..................................
Syphilis..................................
Cancer and other malignant tumors of the ;
buccal cavity...........................
Cancer and other malignant tumors of
stomach and liver......................
Cancer and other malignant tumors of
peritoneum, intestines, and rectum____
Cancer and other malignant tumors of the female genital organs...................
Cancer and other malignant tumors of the skin....................................
Cancer and other malignant tumors of other organs or of organs not specified...
Acute artic.ilar rheumatism..............
Chronic rheumatism and gout............
Diabetes..................................
Leucaemia................................
Anaemia, chlorosis........................
Other general diseases....................
Ac.ite and chronic rheumatism...........
Other chronic poisoning..................
Alcoholism...............................
Total
2 3
3
2 1
1 1
2
3 6
1
1
9 1
5 6 1 1
2 2
4
2 1
8
1
2
2
3 1
34 291 108
5
27 1 1 3 4 1
80 17 1 38 38 3 1
308
2 2
1 1
3
39 1
12 3 10
4
11
1
9
8 1 2 2 12
2 1
X

21
Causes of Death�Continued.
Diseases.
An-con hospital.
II. Diseases of the nervous system and the
organs of spedal sense.
Encephalitis..............................
Simple meningitis........................
Epidemic cerebro-spinal meningitis.......
Pneumocoocus meningitis................
Other diseases of the spinal cord..........
Congestion and hemorrhage of the brain..
Softening of the brain....................
Paralysis without specified cause.........
General paralysis.........................
Other forms of mental alienation.........
Colon hospital.
7
1 1
4 1
2 1
Epilepsy................................
Convulsions (nonpuerperal, 5 years and
over)..................................
Convulsions (under 5 years).............
Tetanus.................................
Other diseases of the nervous system----
3 1
III. Diseases of the circulatory system.
Pericarditis..............................
Acute endocarditis......................
Septic endocarditis......................
Organic diseases of the heart.............
Angina peetoris.........................
Diseases of the arteries (atheroma, aneurism, etc.).............................
Diseases of the veins (varices, hemorrhoids, phlebitis, etc.).................
Hemorrhages............................
Other diseases of the circulatory system..
1 1
12 1
4
1
IV. Diseases of the respiratory system.
Diseases of the nasal fossae
Diseases of the larynx____
Acute bronchitis.........
Chronic bronchitis........
Broncho-pneumonia......
Pneumonia...............
Pleurisy...............................
Congestion and apoplexy of the lungs..
Gangrene of the lungs.................
Asthma...............................
Pulmonary emphysema...............
Other diseases of the respiratory syste: (phthisis excepted)..................
13
54 1 1 7
1
Panama
Colon.
Zone.
1
3
6
3
1
3 1
5
4
52 1
1
3
14
24
6
2
3
5 24
17 5
17 1
1
1
G 1
1
14
6 15 62 10 16
6
10
1
1 5 1
13 2
5 2
3
2
2 1 20 1
1
1 1
2 5
1 1
2 18
15 33
1
Total.
1
4 13
3
3
33 5 7 1
44 1 7 6 2 4
5 23 34
2
1
22 9
70 5
11
1 9 5
1
2 21 8 52 216 13 17 9 2 1
if

22
Causes of Death�Continued
Diseases.
An-con hospital.
Colon
hospi
tel.
V. Diseases of the digestive system.
Diseases of the mouth and its adnexa.....
Diseases of the pharynx..................
Ulcer of the stomach......................
Other diseases of the stomach (cancer excepted).................................
Diarrhea and enteritis (under 2 years)----
Chronic diarrhea and enteritis (under 2
years)..................................
Diarrhea and enteritis (2 years and over)..
Intestinal parasites.......................
Uncinariasis..............................
Hernia and intestinal obstructions........
Other diseases of the intestines...........
Hydatid tumors of the liver..............
Cirrhosis of the liver......................
Biliary calculi............................
Other*diseases of the liver................
1
1
Simple peritonitis.......................
Appendicitis and abscess of the iliac fossa
VI. Diseases of the genito-urinary system
and its adnexa.
Acute nephritis...........................
Bright's disease...........................
Other diseases of the kidneys and their adnexa...................................
Calculi of the urinary tract...............
Diseases of the bladder...................
Diseasesof the urethra, urinary abscess, etc.
Metritis..................................
Nonpuerperal diseases of the breast (cancer excepted)...........................
3
2 2
1 1 1
4 1
14
30
1
1 1 1
VII. The puerperal state.
Accidents of pregnancy...................
Puerperal hemorrhage....................
Other accidents of labor..................
Puerperal septicemia....................
Puerperal albuminuria and convulsions...
Phlegmasia alba dolens (puerperal).......
Other puerperal accidents�sudden death.
VI1T. Diseases of the skin and cellular tissue.
1
Gangrene...............................
Acute abscess, phlegmon...............
Other diseases of the skin and its adnexa
2
2 1
1
3 1 1
5 1
S
3
3 40
3
1
1
2 1
I
19 1
6 5 2
19
30
1 I
4 1
3
2 L
3
Panama. Colon. Zone.
3
1
2 1
6 . 3
169 24 20
16 ! 4
27 2 8
1 7
3
1 3
4

2
2
7
5
1
1
3
2
7 13
1
1
3 3 2
2
1
3 1 4
10 214
20 42 8 9 7 7 1 30 3 18 10 5
50 124
6 1
2 I
1
7 4
3 9 6 1 1
3 1 3

23
Causes of Death�Continued
Diseases.
IX. Diseases of the organs of locomotion.
Nontuberculous diseases of the bones.....
Arthritis and other diseases of the joints (tuberculosis and rheumatism excepted)
X. Malformations.
Congenital malformations (stillbirths excepted).................................
An-con hospital.
1
Colon
hospi tal.
XI. Early infancy.
Congenital debility, icterus, and sclerema. Other diseases peculiar to early infancy...
Lack of care..............................
Premature births.........................
5
XII. Old age
Senile debility
3
XIII. External causes.
Suicide by poison..................
Suicide by hanging or strangulation
Suicide by drowning...............
Suicide by firearms.................
Suicide by cutting instruments.....
Other suicides......................
Fractures..........................
Other accidental traumatisms......
Burns and scalds...................
Electric shock......................
Accidental drowning...............
Inanition (starvation)..............
Other acute poisoning..............
Other external violence.............
Legal execution (hanging)..........
Dynamite explosion................
1
o 20
1
0
XIV. Ill-defined diseases.
Dropsy...................................
Sudden death............................
Causes of death unspecified or ill defined..
2
Pan- Co-ama. Ion
1
2
1
1
6 17
1 1
1
Total...............................' 445
Stillbirths................................;.....
1
1
19 7 2
9
1
7
4
6 4
3 2 1
2 1
59
335 1,204
____i 100
Grand total
445
335 1,304
Zone.
24 11
1
9
7
2
3
14
250 I 00
310
2
72 23 2 2
15
2 1
2
1 15 101 1 3 41
2 1
17
10
22
749
59
Total
1
3
121 43 4
6
33
1
3 2 9 1
30 151 5 3
46 2 5 4 1
23
12 1
98
2,983 219
808 | 3,202
Note.�The deaths occurring in Ancon and Colon hospitals result from sick, injury, or other cases taken from the cities of Panama and Colon, or'from the Canal Zone, and in the table of
Panama
or the Canal Zone.

24
Table showing Discharges and Deaths of Employees in the Hospitals of the Isthmian Canal Commission, from all Causes, for the Year 1908.
Diseases.
I. General diseases
Tyhoid fever (abdominal typhus)
Relapsing; fever.................
Malarial fever....................
iEstivo-autumnal malaria.......
Tertian malaria.................
Mixed malaria..................
Malarial cachexia................
Haemoglooinuric fever..........
Measles.........................
Diphtheria......................
Influenza........................
Died
Dysentery............................
Bacillary dysentery...................
Amoebic dysentery...................
Leprosy...............................
Beriberi...............................
Erysipelas............................
Other epidemic diseases...............
Purulent infection and septicaemia____
Tuberculosis of the lungs..............
Tuberculosis of the meninges..........
Abdominal tuberculosis...............
Pott's disease.........................
Cold abscess and abscess by congestion
Tuberculosis of other organs...........
General tuberculosis...................
Ssrofula...............................
Syphilis.......................................................
Gonorrhea (five years and over)...............................
Cancer and other malignant tumors of the buccal cavity.......
Cancer and other malignant tumors of stomach and liver......
Cancer and other malignant tumors of peritoneum, intestines,
and rectum.................................................
Cancer an d other malignant tumors of the female genital organs.
Cancer and other malignant tumors of the skin................
Cancer an 1 other malignant tumors of other organs or of organs
not specified................................................
Other tumors (tumors of the female genital organs excepted).. Acute articular rheumatism...................................
Chronic rheumatism and gout.
Exophthalmic goiter..........
Anemia, chlorosis............
Other general diseases.........
Acute and chronic rheumatism
Chronic leal poisoning........
Other chronic poisoning.......
Adkoholismus.................
Vaccinia......................
226 19
3 0
4,429 9
5,891 32
1,737 1 0
157 0
35 0
64 19
3 0
2 0
75 0
170 5
10 0
85 9
3 0
2 0
8 0
13 0
19 12
159 34
0 1
1 0
3 1
41 1
20 1
14 13
4 0
143 0
137 0
3 1
1 0
1 1
1 0
3 0
4 0
9 0
42 0
18 0
3 0
86 2
298 1
78 0
8 0
3 0
no 1
1 0

25
Table showing Discharges and Deaths of Employees in the Hospitals of the Isthmian Canal Commission, from all Causes, for the Year 1908�Continued.
Diseases.
II. Diseases of the nervous system and the organs of special sense.
Simple meningitis......................
Epidemic cerebro-spinal meningitis.....
Pneumococcus meningitis..............
Progressive locomotor ataxia...........
Other diseases of the spinal cord........
Congestion and hemorrhage of the brain
Softening of the brain..................
Paralysis without specified cause.......
General paralysis.......................
Other forms of mental alienation.......
Epilepsy....................................
Convulsions (nonpuerperal, 5 years and over)
Tetanus.....................................
Other diseases of the nervous system........
Diseases of the eye and its adnexa...........
Diseases of the ear...........................
III. Diseases of the circulatory system.
Pericarditis....................................................
Pneumococcus pericarditis....................................
Acute endocarditis............................................
Septic endocarditis............................................
Organic disease of the heart....................................
Angina pectoris...............................................
Diseases of the arteries (atheroma, aneurism, etc.).............
Embolism and thrombosis....................................
Diseases of the veins (varices, hemorrhoids, phlebitis, etc.). Diseases of the lymphatic system (lymphangitis, etc.).........
Hemorrhages..................................................
Other diseases of the circulatory system.......................
IV. Diseases of the respiratory system.
Diseases of the nasal fossae.....................................
Diseases of the larynx.........................................
Diseases of the thyroid body...................................
Acute bronchitis..............................................
Chronic bronchitis.............................................
Broncho-pneumonia...........................................
Pneumonia....................................................
Pleurisy.............................
Congestion and apoplexy of the lungs
Gangrene of the lungs...............
Asthma.............................
Pulmonary emphysema....................................
Other diseases of the respiratory system (phthisis excepted)
4
0 1
5 2 3 0 4 2
22 8 1 0 170 429 132
3 4 2 0
30 5
23 3
93 132 4
11
Died
3 2 5 0 0 2 1 0 0 2 0 0 3 0 0 0
1
0
1 1
7 2 1 0
2 1 4 0
80 0
28 0
3 0
172 0
33 0
14 12
211 1 67
50 1
14 0
0 3
17 0
14 0
87 1
75952�09
4
J
J >
>

26
Table showing Discharges and Deaths of Employees in the - Hospitals op the Isthmian Canal Commission, from all Causes, for the Year 1908�Continued.
Diseases.
V. Diseases of the digestive system.
Discharged . Died.
�
Diseases of the mouth and its adnexa...........
Diseases of the pharynx........................
Ulcer of the stomach...........................
Other diseases of the stomach (cancer excepted)
Diarrhea and enteritis (2 years and over).......
Intestinal parasites.............................
Uncinariasis....................................
Hernia and intestinal obstructions..............
Other diseases of the intestines.................
Hydatid tumors of the liver....................
Cirrhosis of the liver............................
Biliary calculi............
Other diseases of the liver
Diseases of the spleen.........................................
Simple peritonitis............................................
Other diseases of the digestive system (cancer and tuberculosis
excepted)...................................................
Appendicitis and abscess of the iliac fossa.....................
VI. Diseases of the geniio-urinary system and its adnexa.
Acute nephritis......................................
B right's diseavse......................................
Other diseases of the kidneys and their adnexa......
Calculi of the urinary tract...........................
Diseases of the bladder..............................
Diseases of the urethra, urinary abscess, etc..........
Diseases of the prostate..............................
Nonvenereal diseases of the male genital organs......
Metritis.............................................
Uterine tumors (noncancerous)......................
Other diseases of the uterus..........................
Cysts and other tumors of the ovary.................
Other diseases of the female genital organs..........
Nonpuerperal diseases of the breast (cancer excepted) Chancroids..........................................
VII. The puerperal state.
Accidents of pregnancy
VIII. Diseases of the skin and cellular tissue
Gangrene................................
Furuncle................................
Acute abscess, phlegmon................
Other diseases of the skin and its adnexa
49 47
3
82 194
9 36 213 93
5 25
5 38
5
1
48 60
0 0
0
1
'2
38 14
58 13
31
3
33 1
105 2
6 0
244 0
2 0
1 0
4 0
1 0
5 0
1 0
163 0
1 0
1 0
91 0
212 0
317 0

27
Table showing Discharges and Deaths of Employees in the Hospitals of the Isthmian Canal Commission, from all Causes, for the Year 1908�Continued.
Diseases.
IX. Diseases of the organs of locomotion.
Nontuberculous diseases of the bones.........................
Arthritis and other diseases of the joints (tuberculosis and
rheumatism excepted)......................................
Amputation..................................................
Other diseases of the organs of locomotion....................
XII. Debility.
Debility......................................................
XIII. External causes.
Suicide by drowning.........................................
Fractures....................................................
Dislocation...................................................
Other accidental traumatisms................................
Burns and scalds.............................................
Other external violence.......................................
XIV. Ill-defined diseases.
Causes of death unspecified or ill defined.....................
Not sick......................................................
X-ray examination...........................................
Total...................................................
Discharged.
33
97 9 154
3
0
217 16
674 52
255
Died
1
1
0 0
0
1
2
28 0 3
0 5
52 1
1 0
19,732 392

28
Consolidated Hospital Report.
Re- | 9 Re-
Hospitals. maining Dec. 31, Admitted. Died. Discharged. Transferred. maining Dec. 31,
1907. 1908.
A neon Hospital.
Employees..................... 409 13,925 247 11,S94 1,555 638
Nonemployees................. ! 51 1,722 166 1,472 40
Insane......................... 140. 233 1 32 123 0 218
Total..................... 600 15,880 445 13,489 1,595 | 951
Colon Hospital.
Employees..................... 256 6,324 ; 142 i 6,040 ' 250 148
Nonemployees................. 61 1,368 i 194 1,145 28 I 62
Total..................... 317 7,692 336 7,185 278 | 1 210
Culebra Hospital.
Employees..................... 1 2 0 2 0 1
Nonemployees................. 8 79 3 68 11 5
Total..................... 9 81 3 70 11 6
Palo Seco Leper Asylum.
Employees..................... 0 2 0 2 0 0
Nonemployees................. 14 12 0 4 0 22
Total....................... 14 14 0 6 0 22
Taboga Sanitarium.
Employees..................... 43 2,873 0 2,846 0 70
Nonemployees................. 13 711 2 713 0 9
Total..................... 56 3,5S4 2 3,559 0 79
Grand totals:
Employees............... 709 23,126 389 20,784 1, S05 857
Nonemployees........... 147 3,892 365 3, 402 79 193
Insane................... 140 233 32 123 0 218
Total................. 996 27,251 786 24,309 1,884 1,268

29
Cost of subsistence:
Number of days' rations issued to patients....... 386, 803
Total cost of rations issued to patients.......... $131, 010. 24
Cost of subsistence per patient per day.......... $0. 3387
Operating expenses:
Number of days' relief furnished............... 386, 803
Total cost of hospitals........................... $736, 565. 01
Cost per capita per day........................ $1. 90
Consolidated Sick Camp Report.
Sick camps.
Tivoli..........
La Boca........
Corozal.........
Miraflores......
Pedro Miguel...
Paraiso.........
Empire.........
Culebra.........
Las Cascadas...
Bas Obispo.....
Gorgona........
San Pablo......
Tabernilla......
Gatun..........
Gatun Spillway
Cristobal.......
Porto Bello.....
Total
Re- 1 | Re-
maining Dec. 31, Admitted.; Died. Discharged. Transferred. maining Dec. 31,
1907. 1908.
. i 2,022 0 1,997 19 7
13 879 0 876 16 0
2 1,143 0 999 146 0
9 1,155 0 921 239 4
13 994 0 815 188 4
11 1 1,736 1 1,317 423 6
21 2,751 1 2,499 270 2
15 2,547 5 2,059 482 16
9 1,692 8 1,330 354 9
9 2,254 1 1,795 444 23
10 2,305 1 1,919 387 8
� 2 949 1 766 173 11
18 ' 1,644 0 1,360 299 3
20 2,314 4 1,772 544 14
5 613 0 373 245 0
7 682 0 546 137 6
6 1,848 1 1,386 461 6
171 27,528 23 22,730 4,827 119
Cost of subsistence:
Number of days' rations issued to patients........ 51, 849
Total cost of rations issued to patients............ $14, 040. 71
Cost of subsistence, per patient, per day.......... $0. 2708
Operating expenses:
Number of days' relief furnished patients......... 51, 849
Total cost of sick camps.......................... $25, 566. 47
Cost per capita, per day......................... $0. 49

30
Consolidated Hospital and Sick-Camp Report.
0 Re- 1 main-ing Dec. 31, 1907. Admitted. Died. Discharged . Transferred. Remain ing Dec. 31, 1908.
Hospitals....................... Sick camps..................... Total.................... 996 171 27.251 27,528 786 23 24,309 22,730 1,884 4,827 1,268 119
1,167 54.779 809 1 47,039 6,711 1.387
Total admissions to hospitals and sick camps........ 54, 779
Xumber of employee? sick in quarters.............. 5, 687
60,466
Less number of patients transferred from sick camps to hospitals and from hospitals to sanitarium, whose admissions are duplicated in above figures........ 6, 711
Net admissions to hospitals and sick camps, including number of employees sick in quarters ....................................... 53,755
Cost of subsistence:
Number of days' rations issued to patients...... 438, 652
Total cost of rations issued to patients............ $145, 080. 95
Cost of subsistence, per patient, per day........ $0. 33
Operating expenses:
Number of days' relief furnished patients....... 438, 652
Total cost of hospitals and sick camps.......... $762,131. 48
Cost, per capita, per day........................ $1. 737
Total cost of hospitals and sick camps, with amounts
received from pay patients deducted.............. $682,133.16
Cost, per capita, per day, with amounts received from
pay patients deducted........................... $1. 55

31
Consolidated Dispensary Report
Class.
Whi te.
Black.
Total
Employees......................... 235,438 170,978 406,416
Nonemployees....................... 29,051 16,227 45,278
Total........................! 264,489 I 187, 205 I 451, 694
Operating expenses:
Total cost of dispensaries........................ $166,182. 07
Average Number of Employees Constantly Sick'During
Year in Hospitals, Sick Camps, and Quarters.
Ancon Hospital.........
Colon Hospital..........
Palo Seco Leper Asylum
Taboga Sanitarium.....
Culebra Hospital........
White.
245.75 101.25
54.26 .25
Black.
244. 98 129.08 .83
.07
Total........................................... 401. 51
374. 96
Average number of employees sick daily in hospitals, per thousand.......................................
32.42
SICK CAMPS.
11.90
Total.
490.73 230.33 .83 54.26 .32
776. 47
17.69
Tivoli...........
La Boca........
Corozal.........
Miraflores.......
Pedro Miguel...
Paraiso.........
Culebra.........
Empire.........
Las Cascadas____
Bas Obispo.....
Gorgona........
San Pablo......
Tabernilla.
Gatun..........
Gatun (spillway)
Cristobal........
Porto Bello.....
4.03 3.63 5.22
4. 44 6.71
5. 23 6.95 7.13
7. 87
8. 38 3.94 3.51 2. 77 3.90 1.75 3.87 5. 33
3. 64 1.31
2. 94 2. 38 4.59 4.12 7.26
4. 70 4.09
5.24 6. 07 2.59
6.98 12. 54 1.63 6. 30 3.64
7.67 4.94
8.16
6. 82 11.30
9.35 14.21 11.83 11.96 13. 62 10.01
6.10
9. 75 16. 44
3.38 10.17
8.97
Total........................................... 84. 66 80.02 164. 68
Average number of employees sick daily in sick camps,
per thousand........................................ m 6. 83 2.54 3.75 1

32
Average Number of Employees Constantly Sick During Year in Hospitals, Sick Camps, and Quarters�Cont'd.
quarters.
Tivoli...........
La Boca.........
Corozal..........
Mirafiores........
Pedro Miguel____
Paraiso..........
Culebra..........
Empire..........
Las Cascadas.....
Bas Obispo......
Gorgona.........
San Pablo........
Tabernilla.......
Gatun...........
Gatun (spillway)
Cristobal.........
Porto Bello......
White. Black. Total
1.16 1.13
.97 .25
1.48 2.39 4.08 5.99 1.48 1.27 5.01
.50
.82 1.69
.02 5.79
.78
0.20 .03
.01
.09 I .71 .57 .13
.88
.08
.88
1.36 1.17 .96 .26 1.48 2.48 4.79 6. 56 1.61 1.27 5.89 .50 .90 1.69 .02 6.67 .78
Total
Average number of employees sick daily in quarters, per thousand.......................................
Total average number of employees sick daily in hospitals, sick camps, and quarters ...................
Total average number of employees sick daily in hospitals, sick camps, and quarters, per thousand.....
| 34.81 2.81 3.58 .11
520. 98 42.07 1 458. 56 14. 55 J
38. 39 .87
979. 54 22. 31
Outside Patients Treated in Isthmian Canal Commission Hospitals, Including Taboga Sanitarium and Palo Seco Leper Asylum, and Amounts Collected from Pay Patients.
Patients for whom the Republic of Panama paid 39 cents and 75 cents per day. (Increased to 75 cents per day, effective May 1,1908.)...........
Patients for whom the zone municipalities paid 30 cents per day...............................
Patients who paid 30 cents per day for themselves.........................................
Patients from Republic who did not pay........
Patients from zone who did not pay............
Patients from Republic who paid other prices____
Patients from zone who paid other prices........
Total.....................................
Number cases treated. Days relief furnished.
2,407 64,333
305 7,317 �
679 330 I 1,677 954 1,636 6,939 4,827 25,156 8,140 13,182
8,048 ; 129,894
Amount paid for treatment
S38,589. 60 2,204. 69 2,081.70
18,948.10 18,174.23
79.998. 32
Note. casas.
Patients carried from one month to another are considered as separate

33
Surgical Opekations Performed in Hospitals of the Isthmian
Canal Commission.
Amputations:
Arm...............................
Foot...............................
Forearm...........................
Hands, both.......................
Hand..............................
Hip................................
Legs...............................
Legs, double, trauma...............
Thigh..............................
Thigh, double......................
- Breast..............................
Penis and castration...............
Adenectomies:
Inguinal, single....................
Inguinal, double...................
Inguinal and femoral, double filarial
Femoral............................
Cervical, tuberculous...............
Cervical............................
Axillary............................
Abscess:
Psoas, lumbar incision..............
Ventral............................
Adenoma of breast, excision of.........
Aneurism, popliteal....................
Accouchement force....................
Curettage, uteri........................
Curettage following abortion and sepsis.
Circumcisions..........................
Carbuncle of arm (septic pneumonia)...
Castration..............................
Castration and lymphangitis...........
Eye, ear, nose, and throat operations:
Adenectomy and tonsillotomy......
Advancement, internal rectus......
Abscess, lachrymal sac.............
Adenoids............................
Cataract, needling..................
Cataract extract'on.................
Cataract extraction and iridectomy.
Cauterization of turbinate bones----
Dacryo-cystitis.....................
Drainage, left antrum..............
Evisceration of eye.................
Enucleation of eye.................
Furuncle...........................
Frontal sinus......................
Follicular conjunctivitis lids rolled..
Haematoma, auricle................
Iridectomy.........................
Kiliani.............................
Died.
Mule's operation
75952�09-
8 5 1 1 3 1
14 2
12
3 4
1
324 10 1 14
7
15
2
2 1 1 1 1
47 1 5 1
3 1
26 2 1 3
28
13
2
4 1 1 9 11 10 5
1
2
1 i 1
1
2 4 1
1 1 1
1
1
5

34
ft
tions Performed in Hospitals i Canal Commission�Continued.
Number. Died
Eye, ear, nose, and throat operations�Continued.
Mastoid.......................................
Mastoid, radical...............................
Mastoid and ossiculectomy....................
Myomatous polypi, nasal, removed............
Necrosis of jaw................................
Necrosed bone, middle ear, removal of.........
Nasal operation...............................
Ossiculectomy.................................
Paracentesis...................................
Pterygium....................................
Pterygium, double............................
Polypoid growth, tonsil.......................
Peritonsillar abscesses incised..................
Plastic on lid..................................
Plastic on face and nose.......................
Plastic on face..........*.......................
Plastic on nose................................
Plastic for ectropion...........................
Resection turbinated..........................
Septal resections...............................
Submucous resections.........................
Straightening of nose..........................
Tenotomy, internal rectus.....................
Tenotomy, external..........................
Tracheotomy.................................
Turbinectomy................................
Trachoma, roiled.............................
Trachoma expressions........................
Tonsillectomy and adenoids..................
Tonsillotomy.................................
Various minor operations.....................
Empyema, resection of ribs.......................
Empyema, Beck's resection......................
Empyema (abscess of liver)......................
Fistula in ano....................................
Fractures:
Ankle joint-, compound, excision of............
Arm, compound, wired.......................
("om pound, wired............................
Carpals, compound...........................
ftlbow joint, compound......................
Femur, comminuted.........................
Femur, wired................................
Femur,compound, wired.....................
Foot.........................................
Forearm.....................................
Poieann,compound, wired...................
Humerus, compound, wired..................
Jaw, compound, wired.......................
Leg, compound, wired........................
lycgs, compound, both (dyuamite explosion).
Radius and ulna, wired.......................
Spine,cervical, with laceration of cord......
Spine, laminectomy for.......................
3 1 1
9 1
1
l
5
54
14 1 1
3
4
1 1
2 i J
26 28 1 4 J
1
12
2 L5
42
593
31 3 I
8
1 1
2
3 2
2
3
i
I
i
1 1

:* 5
Surgical < Operations Performed in Hospitals of the Isthmian
Canal Commission�Continued.
Fractures�Continued.
Small hones, compound....................
Skull.......................................
Skull, compound...........................
Skull, with hemorrhage, multiple into brain
Skull, with cerebral hemorrhage............
Thigh, compound wired....................
Thighs, double, compound wired...........
Tibia and fibula, compound wired.........
Tibia and fibula, compound................
Goiter, excision of..............................
Herniotomies:
Inguinal, single............................
Inguinal, double...........................
Inguinal, double and ventral...............
Inguinal, double with femoral hernia.......
Inguinal, strangulated......................
Ventral....................................
Femoral....................................
Femoral, double...........................
Umbilical..................................
Number.
Hydrocele..............................
Hydrocele, radical......................
Hydrocele, scrotal with double resection
Hemorrhoids...........................
Hemorrhoids, Whitehead's operation...
Hemorrhoids, clamp and cautery.......
Hemorrhoids, clamp and ligature.......
Hysterectomy, vaginal.................
Laparotomies:
Appendectomy...............................................
Appendectomy with general peritonitis......................
Appendeeostomy.............................................
Abscess of liver...............................................
Abscess of liver, multiple.........................-...........
Abscess of liver, suspected....................................
Cholecystostomy.............................................
Cholecystectomy for gangrenous cholecystitis.................
Cecostomy...................................................I
Colostomy and resection of rectum and part of sigmoid for
carcinoma..................................................
Closure, fecal fistula..........................................
Closure, colostomy...........................................
Cancer of uterus..............................................
Cirrhosis of liver..............................................1
Ectopic gestation............................................
Enterorrhaphy (typhoid perforation)........................
Exploratory, rupture of liver................................
Exploratory, rupture of diaphragm..........................
Exploratory, hemorrhage...................................
Exploratory, stab wound of gall bladder....................
Exploratory, fracture of pelvis with intra abdominal hemorrhage ......................................................
Exploratory, for liver abscess................................
3 3 8 1 1 1 1 8 1 2
144 109 1 1
11
7
3 l
4
70 32 3 43 45
6
17 1
75 3 10
23 1 1
10 1
3 1
3 I
1 2 2 7 3 1 I I
1 I
Died.
4 1 i
1
3
2 7
I
2
6 2 I
I

36
I
Surgical Operations Performed in Hospitals of the Isthmian
Canal Commission�Continued.
Laparotomies�Continued.
Exploratory, for traumatic intra peritoneal hemorrhage
Exploratory (inoperable cancer uteri).................
Gilliam's round ligament operation....................
Hysterectomy.........................................
Hysterectomy and appendectomy.....................
II ysteromyomectom y.................................
Uysteromyomectomy and appendectomy.............
Hemorrhage, traumatic...............................
Intestinal obstructions................................
Multiple gastric ulcers........................................
Oophorectomy and appendectomy...........................
Oophorectomy, doable.......................................
Ovariotomy..................................................
Ovariotomy and appendectomy..............................
Ovarian cyst.................................................
Ovarian cystectomy and appendectomy......................
Peritonitis, general ecchinococcus.............................
Peritonitis, general traumatic, with rupt ure of liver and spleen.
Peritonitis, general appendiceal with appendectomy..........
Peritonitis, general appendiceal origin........................
Peritonitis, general traomatic rupture........................
Peritonitis, exploratory, tuberculous..........................
Peritonitis, exploratory, general perforation...................
Peritonitis, tuberculous......................................
Peritonitis, localized appendiceal.............................
Peritonitis, pelvic, spreading tubal...........................
Peritonitis, chronic, with fecal fistula.........................
Psoas abscess.................................................
Pelvic abscess................................................
Pelvic abscess, with general peritonitis........................
Pelvic adhesions..............................................
Pelvic inflammatory disease..................................
Panhysterectomy.............................................
Hound ligament suspensio uteri..............................
Round ligament suspensio uteri and appendectomy...........
Ruptured intestine (traumatic)...............................
Resection caecum, ascend colon and part of ileum for carcinoma.
Rupture of liver.....................'.........................
Salpingo-oophorectomy.......................................
Salpingo-oophorectomy, double...............................
Salpingo-oophorectomy and appendectomy...................
Salpingo-myomectomy and appendectomy...................
Salpingectomy, double......................................
Salpingectomy, double, with appendectomy.................
Salpingectomy for tubal pregnancy..........................
Salpingectomy and appendectomy...........................
Sigmoidopexy................................1..............
Suspensio uteri..............................................
Tubal pregnancy and oophorectomy.........................
Total laparotomies........................................
�j umber. Died.
2 1
1
1
14 1
2
9
3
1
2 2
1 1
4
1
i
3
3
1
1 1
1
� 3
1
1
1
1 i
2 * * � � � �
4 i
1 | i
1 1
2
1
3 2
1
2
2
6
15
1
1 1
1 1
o 2 � * � � m �
6
1
2
2
5
3
4
1
1
285

37
tions Performed in Hospitals < Canal Commission�Continued.
Nephropexy................................................-
Operations following external violence (dynamite explosion and
railroad accidents).............................................
Osteo mvelitis tibia................................<.............
Perineorrhaphy........................
Perineorrhaphy and trachelorrhaphy..
Pneumonorrhaphy....................
Perineoplasty.........................
Plastic, harelio...................----
Perineal lHhotomv....................
Repair of ruptured vaginal vault......
Resection varicose veins, both lees----
Resection of head of radius, tubercular
Resection of wrist, tubercular.........
Stricture of rectum....................
Stricture of rectum with fistula........
Stricture of urethra....................
Skin graft............................�
Stab wound of thigh into femoral vein
Supra pubic cystotomy................
Trachelorrhaphy.......................
Trephine, gunshot wound of skull......
Trephine for caries of ealvarium.......
Trephine for intercranial hemorrhage.. Trephine for depressed fracture of skull
Trephine for Ja^ksonian epilepsy......
Trephine f3r cerebral hemorrhage......
Throplasty, Schede's operation........
Thyroidectomy.......................
Urethrotomy, internal................
Urethrotomy, perineal................
Urethrotomy, external................
Urethrotomy...............>..........
Varicocele.............................
Vaircose veins.................
Various other major operations Various other minor operations
Total....................
7 1
20 6 1 6 2 I 1 1 1 1 4 2
21 4 1 1
15 1 1 1 2 1 i 1
2
26
19
3 2 26
3
208 2,762
5,477
Died.
7
1
1
1
1 1
1 I
1
3
84

38
Consolidated Laboratory Report of all Hospitals
Blood examinations
20, 635
iEstivo autumnal................................... J> 537
Tertian single...................................... 2,13(5
Tertian double..................................... 147
Tertian and sestivo autumnal.......................
Quartan......................
^Estivo autumnal and crescents Differential counts...........
.................. 126
.................... 1
................... 12
..................... 601
Leucocyte counts................................... L 668
Haemoglobin estimations............................ 470
Haemoglobin determinations........................ 3, 705
I \ [ II! I "I IIS. II \ I II V. 26
.............. 24
..................... 271
..................... 6
................... 138
________............. 690
For filarial infection For malarial infections Spirillum obermeieri. (
Red blood counts
White blood counts.........
Red and white blood counts Widals.....................
Guaiac turpentine tests for invisible blood........... 1,128
Stool examinations..................................... 16, 423
_______............... 972
Ascaris lumbricoides...............................
Uncinaria ova...................................... 2,
Tricocephalus dispar................................ 2, 812
Strongyloides intestinalis........................... 643
Taenia saginata..................................... 25
Taenia nana........................................ 8
Amoeba coli........................................ 1? L15
Amoeba dysenteria Ciliated monads
........................... 39
................................ 303
Pus and blood...................................... 1,159
.................... 19
................... 8
__________................ 63
liilharzia Oxvuris.
Tubercle bacilli
Flagellated monads................................. s86
Halantidium coli....... ----------................ 20
Pus and ej>ithelial cells
....................... 71
Urine examinations..................................... 23, 799
Albumen.......................................... 6,798
Albumen and casts.................................. 2,161
.................. 9
.................. 1
....................... 25
................ 4
.................... 63
...................... 28
................. L000
Sugar...........
Albumen and pus Urinalyses
Diazo reactions
Diazo tests_____
Tubercle bacilli............
Mirroscopical examinations..

Urine examinations�Continued.
Pus and blood...................................... 91
Bile............................................... t 8
Specific gravity estimations.......................... 307
Sputum examinations.................................. 2,107
Tubercle bacilli.................................... 270
Pneumococci....................................... 2
Gonococci......................................... 43
Miscellaneous:
Examinations of pus, blood, and tissue.............. 105
Hydrocele fluid.................................... 1
Pleural effusion.................................... 1
Splenic puncture................................... 1
Spinal fluid............................-.......... 2
Gastric contents..................................... 9
Examinations of cerebro-spinal fluid................. 5
pathological report."
Post-mortem examinations............................... 295
Paraffin sections, post-mortem............................ 2,070
Paraffin sections, operative................^............. 233
Examinations of pus from eyes (pneumococci)............ 2
Microscopical examinations of tissue:
Post-mortem........................................ 77
Operative........................................... 58
Examinations of pleural exudates (pneumococcus)........ 3
Lumbar punctures (pneumococcus)...................... 2
Embalming............................................ 2
Blood cultures.................... -...................... 75
Examinations for cerebro-spinal fluids..................... 7
Examinations of smears for B. Leprae (positive 3)......... 28
Examination of smears for gonococci..................... 2
Examinations of pus......................-............. 2
Examinations of catgut................................... 2
Inoculation of guinea pig................................. 1
Examinations of exudates, smears, etc..................- - 37
Wright's stain made, grams.............�................. 10
Frozen sections, from operations.......................... 57
Agglutination tests...................................... 83
Examination of dog for rabies (positive 1)................ 3
Miscellaneous........................................... 24
a Additional work performed of this nature appears under heading "Board of Health Laboratory."
�

40
Ancon Hospital.
Ke-i Lain-
Ing
Doc. SI,i 1907.
I
Ad-Litted.
Died
Isthmian Canal Commission employees.......................
Panama Railroad employees____!
Pay patients....................
Chanty patients................
Insane patients.................;
311 1 13,078 222
98 847 25
14 1,091 52
37 031 114
140 233 32
rotai
WM) 15,880
445
Discharged . '< Transferred. Remaining � Dec. 31. 1908.
11,077 | 1 1,507 583
817 48 55
969 25 59
503 15 36
123 218
13,489 1,595 951
15
Average number of days' treatment per patient..........
Average number of white employees constantly sick during year............................................. 245. 75
Average number of black employees constantly sick during year............................................. 244. 9S
Average number of white and black employees constantly sick.................................................. 190. 73
Number of days' relief furnished patients................ 251, 253
Cost of subsistence per patient per day.................. $0. 276
nationality.
Isthmian Canal Commission employees.
Panama Railroad employees..........
Pay patients..........................
Charity patients.......................
Insane patients........................
Total............................
Number treated. Americans.
White. Black.
13,389 1 945 j 1,105 1 668 373 2,495 86 4.50 106 9 1 28 I 1 2 2 3
i 16,480 < 3,146 35
Oilier nations
B1 ac k.
5. 112 71
331
126 33
5,673
5, 754
786 322
433 331
7,626
dispensary report.
Class. J 1 White. Black. Total.
Employees...................... 23 215 | 238
Nonemployees.................. > 3 41 44
Total.................... 26 1 256 I 282

41
OP E RATIONS.
(See Report of all Surgical Operations.)
laboratory rkport.
(See Consolidated Laboratory Report.)
Colon Hospital
Class. Re-I main-i ing Dec.31, 1907. Admitted. Died. Discharged. T rans-ferred. * Remaining Dec. 31, 1908.
Isthmian Canal Commission employees.................... Panama Railroad employees____ Pay patients (private).......... Pay patients (municipal)....... Zone charity................... Total..................... 181 1 75 15 33 13 4,874 1,450 610 454 304 102 j 40 ! 39 90 65 4,645 1.395 555 365 225 196 54 10 9 112 36 22 22 18
317 7,692 336 7,185 278 210
13
101. 25
Average number of days' treatment per patient..........
Average number of white employees constantly sick during year.............................................
Average number of black employees constantly sick
during year.......................................... 129. 08
Average number of white and black employees constantly sick........................................... 230. 33
Number of days' relief furnished patients................ 105, 651
Cost of subsistence per patient per day................... $0. 309
nationality.
Class.
Isthmian Canal Commission employees.
Panama Railroad employees..........
Pay patients (private)................
Pay patients (municipal).............
Zone charity..........................
Total...........................
Americans.
! White. j Black.
843 257 157 9 43 ii 1

2 2
| 1,309 15
O ther nations.
White
1,744 270 235 70 68
2.387
Black
2,457 998 233 406 204
4,298
Total.
5,055 1,525 625 487 317
8,009

42
DISPENSARY REPORT.
Class.
Employees____
Nonemployees
Total...
White.
4,697
3, 384 592
3, 976
Total
7, 806
867
8, 673
OPERATIONS.
(See Report of all Surgical Operations.)
LABORATORY REPORT
(See Consolidated Laboratory Report.)
Culebra Hospital.
Class.
Employees____
Nonemployees
Total
Remaining. Admitted. 1 Died. Discharged. Transferred .
1 8 2 79 2 x 68
3 11
9 81 3 70 11
Remaining Dec 31,1908
1
5
6
Average number of days' treatment per patient.......... 14. 51
Average number of white employees constantly sick.........25
Average number of black employees constantly sick.......07
Average number of white and black employees constantly
sick
.32
Number of days' relief furnished patients................. 1, 306
Cost of subsistence por patient por day.................. $0. 208

48
nationality.
Class
I
Nu
ber treated.
Employees................... 3
Nonemployees................ 87
Americans
White.
10
Total
90
10
Black.
Other nations.
White.
Black
2
27
1
50
29
51
dispensary report.
Class.
Employees____
Nonemployees
Total
34,885
19, 895 3, 597
23,492
Total.
47, 798 10,579
58,377
sick camp report.
1 Class. Remaining. Admitted. 1 Died.i Discharged. Transferred. Remaining Dec. 31,1908.
Employees.............. 15 2, 547 5 1, '": 2,059 482 1 16
Average number of days' treatment per patient............ 1. 48
Average number constantly sick: White, 6.95; black, 726____ 14. 21
Employees in quarters:
Days excused for quarters............................ 1, 778
New patients excused for quarters..................... 582
Average number of days' treatment per patient........ 3. 06
Average number constantly sick: White, 4.08; black,
0.71.............................................. 4.79

44
Palo Seco Leper Asylum
Class. � Remaining Dec. 31, 1907. Admitted. Died. Discharged. Transferred. Remaining Dec. 31, 1908.
Ex-employees.................. 1 � 1
Pav cases....................... 11 10 3 18
Isthmian Canal Commission employees.................... 2 2
Charity cases................... 2 2 4
Total..................... 14 14 i 6 22

Average nu
ii
ber of days' treatment per patient
221 0
Average number of white employees constantly sick......
Average number of black employees constantly sick....... 0. 83
Average number of white and black employees constantly
sick..................................................83
Number of days' relief furnished patients................. 6,186
Cost of subsistence per patient per day.................... $0. 344
nationality.
Class.
Ex-employees........................
Pay cases.............................
Isthm ian Canal Commission employees Charity cases..........................
Total...........................
Number treated.
Americans.
1
21 2 4
2S
White.
Colored.
Other nations.
White.
Colored
1
21
2
4
28

46
Taboga Sanitarium
Class.
Employees.....................
Fanilies of employees, pay
patients......................
Nonemployees, pay patients� Children under 4 years, no pay..
Total.....................
1 Remaining Dec. 31, 1907. Admitted. Died. j Discharged .
43 2,873 2,846
! 12 687 ! 690
6 6
1 ' 18 2 17
56 3,584 2 3,559
Transferred.
Remaining
Dec. 31, 1908.
70 9
79
Average number of days' treatment per patient............ 6.15
Average number of white employees constantly sick...... 54. 26
Number of days' relief furnished patients................. 22,407
Cost of subsistence per patient per day.................... $0. 645
nationality.
Class.
Employees.........................
Fa nilies of employees, pay patients
Nonemployees, pay patients.......
Children under 4 years, no pay.....
Total
Number treated. Americans. Other nations.
White. Black. White. Black.
2,916 699 6 19 � 2,107 692 6 19 809 7

3,640 2,824 816

Santo Tomas Hospital.
('lass.
Pay cases......................
Charity cases..................
Isthmian Canal Commission
employees.................
Panama Railroad employees
Total
Remaining Dec. 31, 1907.
Admitted
27 160
964 3,417
187
10
5
4,396
Dis-
ch arged.
953 3,106
10
5
4,074
Died
24 299
323
Trans ferred
Remaining Dec. 31,
1908.
14
172
186

46
Average number of days' treatment per patient............ 11.17
Average number of Commission employees constantly sick. . 13
Average number of patients constantly sick............... 194. 31
Number of days' relief furnished patients................. 73, 924
Cost of subsistence per patient per day (silver)............. $0. 75
nationality.
Class.
Number treated
Americans.
White. .Colored.
other nations.
Pay cases..............................
Charity cases...........................
Isthmian Canal Commission employees. Panama Railroad employees...........
Total............................
1
991 I 10 j 326 !
3,577 67 i 4 959
10 1 6
5 2 1
4,583 80 j 4 1,292 ! 1
White. ^Colored
655
2,547 3
2
3,207
OPERATIONS.
Major operations. Minor operations
444
675
Died.
25
dispensary report.
1 . \ Class. White. 15 lack. Total.
Natives......................... 272 764 1,036
Foreigners...................... 182 221 403
Total..................... 454 1 985 1,439

47
Fivoli Dispensary and Sick Camp, and Employees Kxcusbo
from Work for Quarters.
dispensary.
Class.
Employees----
Nonemployees
Total
white
Black
7, 552
Total.
11,951 2,041
13, 992
Class
Employees
sick camp.
� ^ ^
Reaming
Admitted .
Died.
Discharged
Trans-1 ferred.
Remaining
1907. 1 1908.
I 1 1 i 2,022 1,997 1 ^^^^ -19 7 [
Average number of days' treatment per patient............ 1. 50
Average number constantly sick, white, 4.03; black, 3.64... 7. 67
Excused for quarters:
Days excused for quarters............................. 504
New patients excused for quarters...................... 256
Average number of days' treatment per patient......... 1.96
Average number constantly sick, white, 1.16; black, 0.20. 1. 36
La Boca Dispensary and Sick Camp, and Employees Excused
from Work for Quarters.
dispensary.
Class. 1 White. Black. j Total. - - -
Employees..................... 11.763 12,553 ' 1 24,316
Nonemployees................... 589 646 1,235
Total.....................! 12, 352 13,199 25, 551

48
LrA Boca Dispensary and Sick Camp, and Employees Excused
prom Work for Quarters�Continued.
sick camp.
Class. 1 Re-1 main-in? Dec. 31, 1907. Admitted . 1 1 Died. Dis-charged. 1 Transferred.
Employees.............. 13 879 876 ^��BBBBBJ �BB� ^�BBBbbBBBB-� ^^BBBBBBBbB*-^^ ^BBvBABBBB* 16
Remaining Dec. 31, 1908.
Average number of days' treatment per patient............ 1. 82
Average number constantly sick, white, 3.63; black, 1.31___ 4.94
Excused for quarters:
Days excused for quarters............................. 428
New patients excused for quarters...................... 217
Average number days' treatment....................... 1. 97
Average number constantly sick, white, 1.13; black, 0.03. 1.16
Corozal Dispensary and Sick Camp, and Employees Excused
from Work for Quarters.
dispensary.
1 Class. White. Mack. Total.
Employees.....................! 9,145 5, 510 14, 655
Nonemplovees.................. 1,073 620 1, 693
Total.................... 10, 218 -^�BB*VBB> w *>BBb��BBBbBBBj*^ � �� *� V � ^ * � � � ^P�^��j 6,130 16, 348
sick camp.
('lass. Remaining Dec.31, 1907. Admitted. Died. �^�BBBP* BBf/ ** �B> ^�^^�TBBBBBi Discharged. Trans-f erred. I 4Jb) BBBBBfc^^BBBB^pBaB^^B^j^^B^B^jB^^jB^j^BBBB^ ^MBBBBBBB
Employees.............. 4 1 2 1 � BBBBBBBBBBBBBBBBB BBBBBBBB1 BBBBBBBBBBBBBP^P^BaB^pr � � 1,143 999 ' 146
Remaining Dec. 31 r 1908.

49
Average number of days' treatment per patient........... 2. 48
Average number constantly sick, white, 5.22; black, 2.94... 8.16 Excused for quarters:
Days excused for quarters...%........................ 398
New patients excused for quarters..................... 164
Average number of days' treatment per patient........ 2. 42
Average number constantly sick: White, 0.97; black, 0. .97
mlraflores dispensary and slck camp, and employees
Excused from Work for Quarters.
dispensary.
Class^ V - White. Black. Total.
Employees..................... 7,708 4, 634 12, 342
Nonemployees.................. 86 82 168
Total..................... 7, 794 j 4, 716 12,510
sick camp.
Class. Remaining Dec. 31, 1907. Admitted. Died. Discharged. Transferred. Remaining Dec. 31, 1908.
Employees.............. 2 1,155 .... 921 239 4
Average number of days' treatment per patient........... 2. 30
Average number constantly sick: White, 4.44; black, 2.38.. 6. 82 Excused for quarters:
Days excused for quarters............................ 104
New patients excused for quarters..................... 50
Average number of days' treatment per patient........ 2. 08
Average number constantly sick: White, 0.25; black, 0.01................................................26

50
%
Pedro Miguel Dispensary and Sick Camp, and Employees
Excused from Work for Quarters.
dispew sary".
Class. White. Black. Total.
Employees..................... 6,107 3,064 9,171
Nonemployees...................1 709 372 1,081
Total..................... 6, 816 3,436 ' 10,252
�
sick camp.
Class. Remaining Dec. 31, 1907. Admitted. Died. Discharged. Transferred. Remaining Dec. 31, 1908.
Employees.............. 13 994 815 188 4 1
Average number of days' treatment, per patient............ 3. 78
Average number constantly sick, white, 6.71; black, 4.59... 11.30 Excused for quarters:
Days excused for quarters............................ 545
New patients excused for quarters..................... 259
Average number of days' treatment, per patient........ 2.10
Average number constantly sick, white, 1.48; black, 0. 1.48
Paraiso Dispensary and Sick Camp, and Employees Excused
from Work for Quarters.
dispensary.
Class. White. Black. Total.
� Employees..................... 9,717 6,723 16, 440
Nonemployees................... 1,683 1,195 2, 878
Total.....................! 11,400 7,918 19,318

51
sick camp.
Class. Remaining Dec. 31, 1907. Admitted. Died. Discharged . Transferred. Remaining Doc. 31, 1908.
Employees.............. 11 1 1,736 1 ' 1,317 423 6
Average number of days' treatment, per patient............ 1. 59
Average number constantly sick, white, 5.23; black, 4.12... 9. 35 Excused for quarters:
Days excused for quarters�......................... 922
New patients excused for quarters..................... 373
Average number of days' treatment, per patient........ 2. 47
Average number constantly sick, white, 2.39; black,
0.09................................................ 2.47
Empire Dispensary and Sick Camp, and Employees Excused
from Work for Quarters.
dispensary.
Class. White. Black. I Total.
Employees..................... 45, 019 28,724 73, 743
Nonemployees................. i � 148 108 . 256
T otal..................... 45,167 28, 832 73,999
sick camp.
Class. Remaining Dec. 31, 1907. i Admitted. Died. 1 Discharged. Transferred. Remaining Dec. 31, 1908.
Employees.............. I 21 2,751 1 2,499 270 | r 1 2

52
Average number of days' treatment per patient............ 1.15
Average number constantly sick, white, 7. 13; black, 4. 70 . 11. 83 Excused for quarters:
Days excused for quarters............................ 2, 336
New patients excused for quarters..................... 930
Average number of days' treatment per patient...... 2. 51
Average number constantly sick, white, 5.99; black, 0.57. 6. 56
Las Cascadas Dispensary a^nd Sick Camp, and Employees
excused from work for quarters.
dispensary.
Total
20, 832
Class. White. I Black.
Employees..................... 17,039 6, 371
Nonemployees................. 3,793 2,275 j . .. '
8, 646
Total.
23, 410 6, 068
29, 478
sick camp.
Class.
Employees
Remaining Dec. 31,
1907.
Ad-
Litted.
9 1,692
Died.
8
Dis- Trans charged, ferred
1,330
354
Remain- ] ing
Dec. 31r
1908.
9
Average number of days' treatment per patient............ 2. 20
Average number constantly sick, white, 7. 87; black, 4. 09. 11. 96 Excused for quarters:
Days excused for quarters............................ 629
New patients excused for quarters..................... 238
Average number of days' treatment per patient........ 2. (54
Average number constantly sick, white, 1.48; black, 0.13. 1. 61

53
Bas Obispo Dispensary and Sick Camp, and Employees
Excused from Work for Quarters.
dispensary.
Class. White. Black. Total.
Employees................... Nonemployees................. � Total................... j 19, 448 1,541 13,266 676 32, 714 2, 217
20, 989 13,942 34,931
sick camp.
Class. Remaining Dec. 31, 1907. Admitted. Died. Discharged . Transferred . Remaining Dec. 31, 1908.
Employees.............. 9 2,254 i 1 1,795 444 23
Average number of days' treatment per patient............. 1. 95
Average number constantly sick: White, 8.38; black, 5.24.. 13. 62 Excused for quarters:
Days excused for quarters.......................... 487
New patients excused for quarters................... 228
Average number of days' treatment per patient........ 2.13
Average number constantly sick: White, 1. 27; black, 0. 1. 27
Gorgona Dispensary and Sick Camp, and Employees^Excused
from Work for Quarters.
dispensary.
Class. White. Black. Total.
Employees................... 21, 679 12,878 34, 557
Nonemployees................. 4,113 1,558 ; 5,671
Total................... 25, 792 14,436 40,228

54
4
Gokgona Dispensary and Sick Camp, and Employees Excused
from Work for Quarters�Continued.
sick camp.
Class. Remaining Dec. 31, 1907. Admitted. Died. Dis- | charged. Transferred. Remaining Dec. 31, 1908.
Employees.............. 10 2,305 i 1 1,919 387 : 1 8 1
Average number of days' treatment per patient............. 1.22
Average number constantly sick: White, 394; black, 6.07. . . 10.01 Excused for quarters:
Days excused for quarters............................ 2,170
New patients excused for quarters................... 755
Average number of days' treatment per patient........ 2. 87
Average number constantly sick: White,5.01; black,0.88. 5. 89
San Pablo Dispensary and Sick Camp, and Employees
Excused from Work for Quarters.
dispensary.
Class. i White. Black. Total.
Employees..................... 8, 284 7, 321 15, 605
Nonemployees................... 226 674 900
Total..................... 8, 510 7,995 16, 505
sick camp.
Class. Remaining Dec. 31, 1907. Admitted. Died. Discharged. Transferred . Remaining Dec. 31, 1908.
Employees.............. 2 949 1 706 173 11

55
Average number of days' treatment per patient............. 2. 20
Average number constantly sick: White, 3.51; black, 2.59... 6.10 Excused for quarters:
Days excused for quarters............................. 186
New patients excused for quarters...................... 92
Average number of days' treatment per patient......... 2. 02
Average number constantly sick: White, 0.50; black, 0. .50
Tabernilla Dispensary and Sick Camp, and Employees
Excused from Work for Quarters.
dispensary.
Class. White. I Black. i Total.
Employees..................... 7,490 8, 693 16,183
Nonemployees................... 739 745 1,484
Total..................... 8, 229 9. 438 17. 667
sick camp.
* Class. Remaining Dec. 31, 1907. Admitted. Died. � Dis-charged. Transferred. Remaining Dec. 31, 190S.
Employees.............. � 18 ! 1 1,644 � � � � j 1,360 299 3
Average number of days' treatment per patient............. 2. 01
Average number constantly sick: White, 2.77; black, 6.98... 9. 75 Excused for quarters:
Days excused for quarters............................. 330
New patients excused for quarters...................... 95
Average number of days' treatment per patient......... 3. 47
Average number constantly sick: White, 0.82; black, 0.08. . 90
�

56
Gatun Dispensary and Sick Camp, and Employees Excused
from Work for Quarters.
dispensary.
Class. White. Black. Total.
Employees..................... Nonemployees................... Total..................... 12, 419 2, 243 14, 524 373 26, 943 2, 616
14, 662 14, 897 29, 559
sick camp.
Class. Remaining Dec. 31, 1907. 1 j Admitted. Died. Discharged. Transferred. Remaining Dec. 31 1908.
Employees.............. 20 2,314 4 1,772 544 1 14 1
Average number of days' treatment per patient........... 2. 25
Average number constantly sick: White, 3.90; black, 12.54.. 16.44 Excused for quarters:
Days excused for quarters............................ 628
New patients excused for quarters..................... 282
Average number of days' treatment per patient........ 2. 22
Average number constantly sick: White, 1.69; black, 0. 1. 69
Spillway Sick Camp.
Class.
Employees
Re-
main-
ing Dec. 31, 1907.
5
Admitted.
Died
613
Dis- Trans-charged, f erred.
373
245
Remaining Dec. 31, 1908.

57
Average number of days' treatment per patient............ 3. 00
Average number constantly sick: White, 1.75; black, 1.63... 3.38
Excused for quarters:
Days excused for quarters............................. 8
New patients excused for quarters...................... 6
Average number of days' treatment per patient......... 1. 33
Average number constantly sick: White, 0.02; black, 0. .02
Cristobal Dispensary and Sick Camp, and Employees Excused
from Work for Quarters.
dispensary.
Class. White. 1 Black. t Total.
Employees................... Nonemployees................. Total................... 14, 286 3, 426 8,825 1,004 23, 111 4,430
17, 712 9,829 27,541
sick camp.
Class. Remaining Dec. 31, 1907. Admitted. Died. Discharged. Transferred. Remaining Dec. 31, 1908.
Employees.............. 7 � 682 546 | 137 6
Average number of days' treatment per patient............ 3. 49
Average number constantly sick: White, 3.87; black, 6.30.. 10.17 Excused for quarters:
Days excused for quarters..........................2,453
New patients excused for quarters...................1, 018
Average number of days' treatment per patient........ 2. 40
Average number constantly sick: White, 5.79; black,
0.88.............................................. 6.67

58
Porto Bello Dispensary and Sick Camp, and Employees Excused from Work for Quarters.
dispensary.
Class. White. Black. Total.
Employees................... 8, 610 7,061 15,671
Nonemployees................. 106 988 1,094
Total................... 8,716 8,049 16, 765
sick camp.
Class. Remaining Dec. 31, 1907. i 1 Admitted. Died. Discharged. Transferred. Remaining Dec. 31, 1908.
Employees.............. 6 1,848 1 1,386 1 461 6
Average number of days' treatment per patient............ 1. 82
Average number constantly sick: White, 5.33; black, 3.64.. 8. 97 Excused for quarters:
Days excused for quarters.......................... 281
New patients excused for quarters................... 142
Average number of days' treatment per patient........ 1. 97
Average number constantly sick: White, 0.78; black, 0.. . 78
Board of Health Laboratory.
Bacteriological examinations of�
Municipal water supplies.............................. 425
Water from condensers............................... 171
Water from demijohns................................. 25
Water from tank carts................................ 102
Water from rivers.................................... 64
Water from spring.................................... 2
Water from reservoirs and rivers...................... 15
Water from cold storage, Cristobal..................... 2
Aerated waters...................................... 44
Throat cultures (diphtheria suspects).................. 35

59
Bacteriological examinations of�Continued.
Blood cultures....................................... 370
Cultures from autopsies............................... 34
Charcoal filter....................................... 1
Glanders suspect (negative)........................... 1
Pus.................................................. 16
Cresilic acid.......................................... 1
Caramel (sarsaparilla)................................ 2
Exudates............................................ 4
Phenol sodique...................................... 1
Stools................................................ _8
Smears (diphtheria suspects).......................... 54
Urine............................................... 8
Sputum.............................................. 3
< /hemical analyses of�
Rock............................................... 1
"Meatox"............................................ 1
Flour............................................... 1
Rum................................................. 43
Sand................................................. 1
Water (brackish)...................................... 1
Baking powder...................................... 1
Can of squash........................................ 1
Water............................................... 6
Solution, 80 per cent crude carbolic acid.............. 1
Metallic zinc........................................ 1
Chemical examination of�
Wire screening....................................... 1
Paints..........................................- -. - 3
Mineral oil.......................................... 2
Gasoline............................................ 1
Bay rum............................................. 1
Urine............................................... 2
Milk................................................ 4
Turpentine.......................................... 1
Linseed oil.......................................... 1
Wine............................................... 7
Creosote oil........................................... 1
Breakfast sirup...................................... 1
Stomach contents..................................... 7
Powder.............................................. 1
Soil................................................. 5
Coffee................................................ 1
Car oil.............................................. 1
Flour............................................... 1
Phinotas oil......................................... 1

60
Chemical examination of�Continued.
Dynamite exploders................................. 1
Flavoring extracts.................................... 1
Kerosene............................................ 1
Benzine (naphtha)................................... 2
Foodstuffs........................................... 1
Examination of�
Leper suspects (positive,7)....................\...... 29
Pus.................................................. 42
Urine............................................... 19
Blood................................................ 13
Coffee................................................ 1
Quinine-urea tablets................................. 1
Sewage.............................................. 1
Phinotas oil......................................... 1
xPowder from district physician....................... 1
Aerated waters for preservatives...................... 7
Rock............................................... 8
Bean seedling3...................................lot.. 1
Sputum.............................................. 4
Stools.............................................. 6
Dogs, rabies suspects (positive, 3)..................... 19
Rat................................................... 1
Rat poison........................................... 1
Alkalinity and chlorine content in water............... 3
Cow (post-mortem)................................... 1
Faeces............................................... 2
Larvae............................................... 1
Rat virus............................................ 1
Determinations of�
Chlorine in water..................................... 299
Preservatives in aerated waters........................ 6
Total solids in water.................................. 82
Specific gravity of soils..........................----- 2
Alkalinity of condenser and tap water from Bas Obispo. 2
Manganese in drillings of steam-shovel parts............ 4
Assays of�
Kerosene............................................ 2
Crude oil............................................ 1
Magnesia cement................................lot.. 1
Sanitary analyses of water�
From Rio Grande..................................... 17
From Camacho....................................... � 16
From Brazos......................................... 16
From Gorgon a....................................... 16
From Paraiso........................................ 1
From Gatuncilla River................................ 2
Miscellaneous........................................ H

61
Agglutination reactions (positive, 34)...................... 950
Autopsies................................................ 352
Bodies embalmed........................................ 69
Tissue and neoplasms reported............................ 134
Sections of tissue prepared................................ 5,895
Frozen sections cut....................................... 35
Identification of mosquitoes..........................lots.. 2
Standardization of clinical thermometers..............do... 3
Preventive treatment of persons bitten by rabid dogs....... 22
Post-mortems of cows.................................... 2
Post-mortem of cat (rabies suspect)......................... 2
Positive............................................. 1
Post-mortem of calves..................................... 4
Post-mortem examination of dogs.......................... 2
Sections of tissue reported................................ 46
Analyses of wire screening................................ 2
Medico-legal post-mortem examinations................... 3
Surgical pathological tissue and neoplasms reported......... 67
Report op Vaccinations.
Cristobal................................................ 17
Bohio................................................... 58
Gorgona................................................ 93
Matachin................................................ 92
Empire................................................. 98
Culebra................................................. 364
Corozal................................................. 4
Panama................................................. 2, 588
Porto Bello............................................. 34
Colon................................................... 472
San Pablo............................................... 47
Pedro Miguel............................................ 10
Las Savannas........................................... 14
Gatun.................................................. 39
Vaccinations by quarantine officials at ports of Panama and
Colon, and vaccinations at ports of departure or en route. 32, 785
Total vaccinations................................ 36, 715

62
Statement of Issues of Quinine
[Kilo=2.2046 pounds avoirdupois.]
Total issues.
January................
February...............
March...................
April...................
May...................
June...................
July....................
August..................
September.............
October.................
November..............
December..............
Total.............
Average issue per month
Kilograms. Pounds avoirdupois.
274. 933 601. 416
57. 500 122.187
15. 225 32. 353
68. 871 150. 655
4S. 600 106. 312
36. 681 80.241
203. 900 446. 031
75. 675 165. 539
50. 400 110. 250
314. 050 686.184
55. 977 122. 449
23. 310 51. 350
1, 225.122 102. 093 2, 674. 967 222. 914
Sanitation�City of Panama.
Anopheles brigade:
Linear feet of ditches cleaned.................. 1, 860, 840
Square yards of land cleaned.................... 161, 444
Square feet of weeds and Holes filled................................... 489
Wells filled.................................... 21
Cubic yards of earth used....................... 4, 012
Closets oiled................................... 789
Closets cleaned................................ 137
Pools oiled.................................... 5,182
Cesspools oiled................................ 245
Pools disinfected............................... 22
Cesspools cleaned............................... 66
Cesspools disinfected.......................... 129
Tanks destroyed............................... 1
Tanks oiled................................... 17
Trenches oiled................................ 74
Linear feet of trenches oiled................... 401, 210
Linear feet of trenches disinfected.............. 5, 000
Wells oiled.................................... 193
Yards oiled................................... 3,919
Yards disinfected.............................. 22

Anopheles brigade�Continued.
Mosquito oil used........
Phinotos oil used.........
barrels.. ..do....
Loads of refuse removed from the city..........
Dailv average number of carts at work...........
Number of days carts worked...................
Linear feet of drains cleaned and disinfected----
Linear feet of ditches dug.......................
Number of drains oiled.........................
Loads of sand for tank and storehouse............
Loads of cinders hauled........................
Chloride of lime used.................pounds..
Disinfection brigade:
Number of houses disinfected and fumigated for
beriberi.....................................
Number of houses disinfected and fumigated for
diphtheria...................................
Number of houses disinfected and fumigated for
leprosy.....................................
Number of houses disinfected and fumigated for
rabies in dog................................
Number of houses disinfected and fumigated for
tuberculosis.................................
Number of houses disinfected and fumigated for
typhoid.....................................
Number of houses disinfected and fumigated for
pernicious malaria...........................
Rooms fumigated and disinfected for beriberi----
Rooms fumigated and disinfected for diphtheria Rooms fumigated and disinfected for tuberculosis Rooms fumigated and disinfected for typhoid
fever...................................
Rooms fumigated and disinfected for pernicious
malaria.....................................
Cubic feet disinfected and fumigated............ 5,
Cubic feet of walls, etc., whitewashed...........
Catch basins disinfected (52 times)..............
Cesspools cleaned by contract..................
Cesspools filled by contract.....................
Materials used�
Alcohol...............
Chloride of lime......
Bichloride of mercury
Phinotas oil..........
Crude oil.............
Flour................
Matches..............
Newspapers..........
Pyrethrum............
gallons.. pounds..
..do.... barrels..
do.... do....
packages.. .bundles.. . .pounds..

64
Disinfection brigade�Continued.
Materials used�Continued.
Sulphur..........................pounds.. 10, 351
Formaldehyde......................gallons.. 1�
Pyrol fume...........................do---- 20
Lime (unslaked)...................pounds.. 1,100
Nails...............................do.... 10
Soap chips............................do---- 10
Inspections of houses and yards:
Houses with water connections...........times.. 26, 873
Houses without water connections.........do---- 3, 200
Houses with sewer connections............do---- 23, 673
Houses without sewer connections........do---- 3, 017
Traps in yards connected with sewers......do---- 26, 567
Traps in yards not connected with sewers, .do---- 2, 834
Wells on premises.......................do---- 385
Tanks on premises........................do---- 157
Water-closets in good condition...........do---- 26, 041
Water-closets in bad condition............do---- 3, 014
Yards with drainage good.................do---- 26, 330
Yards with drainage bad..................do---- 3, 977
Number of water containers destroyed..........: 602
Sick inspection:
Average number of boarding houses and hotels
inspected (daily)............................
Number of persons reported ill..................
Urinary analyses made (positive 3)..............
New buildings:
Number of plans submitted to health officer and
approved.....................................
Destruction of dogs:
Number of dogs poisoned
2, 898
Persons notified to keep their premises in sanitary condition
Persons notified to connect with water and sewer. 57 Persons warned as to insanitary condition of yards I, 304
Places where mosquito larvae were found........ 5, 539
Persons warned for having mosquito larvae....... I, 617
Persons notified as to conditions governing the renewal of lease of Panama Railroad lands..... 27
26 156 41
130
973
Poison used (strychnine).................grams.. 347
Bait used............................".pounds.. 187
Destruction of rats:
Number of rats caught and cremated............ 11,086
Rat traps distributed............................ 173
Average number of rat traps in use............... 354
Live rats caught and sent to laboratory.......... 730
Bait used (cheese, ham, bread, etc.) - � .pounds.. 1, 367
Rat poison used.........................do.... 626

05
Sax it atio n �Co lo n .
[Including Cristobal and Mount Hope.]
Medical inspection:
White employees reported to health office.......r 42
White employees inspected by health office physi-
cian
42
Cases reported by Colon medical inspectors........ 313
Cases reported by health office physician......... 199
Cases sent to hospital............................ 68
Quinine {prophylactic) dispensed to laborers:
Total number of 5-grain tablets dispensed......... 223, 716
Total doses solution dispensed................... 87,120
Average number of doses of tablets dispensed daily 729
303
Average number of doses of solution dispensed
daily..................
Sanitation�Colon city:
Cans of garbage removed.. Cans of night soil removed Night-soil buckets retired.
.................... 1,107, 321
..................... 192,539
................... 1,215
Loads of vard garbage removed................... 2, 785
.................. 117
Miscellaneous loads removed
Tanks removed----:......
Tanks remaining...........
Loads of old lumber carted
Tanks oiled..............
Yards cleaned.............
Buildings cleaned.........
Passages cleaned..........
Water-closets cleaned......
Cesspools cleaned
17 6 162 7
122 2 78 80 9
Square yards of streets cleaned................... 11, 597, 238
Notices to abate nuisances sent out................ 1, 243
Number of nuisances abated �
Vacant lots cleaned.............
Rats caught and killed.........
Houses cleaned................
Private properties cleaned......
Cubic yards of ditches made...
Dogs killed....................
Cats killed.....................
Care fumigated................
Houses fumigated..............
Cubic feet fumigated...........
Ninth street dump maintained.
848 7
5, 624 23 648 75 389 28 1 1
15, 000

66
Mosquito work�Colon:
Square yards of vegetation removed............... 2, 997, 481
Number of water receptacles overturned......... 743
Water receptacles collected....................... 25, 978
Square yards of pools oiled....................... 117, 297
Linear feet of gutters removed----................ 6, 968
Number of persons fined for breeding mosquitoes . 5
Linear feet of drains made....................... 117, 279
Linear feet of drainage cleaned and maintained... 1, 293,173
Crab holes worked.............................. 11, 913
Crabs killed..................................... 9,494
Water receptacles treated......................... 302, 018
Houses:
Number of plans approved...................... 118
Permits issued to occupy........................ 62
Houses condemned............................. 68
Houses demolished.............................. 1
Water and sewers:
Number of connections made..................... 260
Number of houses remaining without connections. 97
.Total number of connections completed to date... 456
Number of outstanding permits................... 38
Sanitation � Cristobal:
Number of cans of garbage remove 1............. 114,154
Loads of yard garbage removed................... 1, 659
Miscellaneous loads carted....................... 85
Square yards of street cleaned.................. 7, 058, 000
Square yards of street sprinkled................. 3, 446, 752
Rats caught and killed.......................... 1, 915
Dogs killed..................................... 3
Mosquito work�Cristobal:
Square yards of vegetation removed............... 26, 733
Water receptacles collet ted..................... 5, 885
Crab holes oiled................................ 44,070
Breeding places eradicated...................... 3
Square yards of pools oiled...................- - - - ^8, 395
Number of feet of drainage cleaned and maintained 6,494
Crab holes worked.............................. 2,540
Crabs killed..................................... 397
Water receptacles treated....................... 73, 439
Fumigation�Cristobal: -
Tug fumigated.................................. 1
Cubic feet fumigated............................ 43,100
Vessel fumigated............................... 1
Screenin g� Cris tobal:
.Screening of wards repaired...................... 18
Screening of houses repaired (times).............. 418

67
Sanita t ion� Mount Hope:
Number of cans of garbage removed.............. 24, 701
Cans of night soil removed...................... 20, 634
Miscellaneous loads carted....................... 292
Square yards of streets cleaned................... 23, 874
Loads of yard garbage removed................... 349
Closets disinfected............................... 215
House fumigated............................... 1
Mosquito work�Mount Hope:
Square yards of vegetation removed............. 805, 916
Water receptacles overturned.................... 5, 087
Water receptacles collected....................... 10, 039
Tanks oiled.................................... 3,115
Breeding places eradicated...................... 44
Square yards of pools oiled....................... 77, 460
Barrels spigoted................................ 67
Barrels covered.................................. 67
Water receptacles treated....................... 55, 541
Drainage�Mount Hope:
Linear feet of drains made and ditches dug....... 28, 937
Linear feet of drains cleaned and maintained..... 81, 767
Mount Hope cemetery:
Square yards of vegetation removed............... 113, 931
Square yards of grading made................... 7, 961
Linear feet of new drainage made................. 1, 536
Linear feet of drainage cleaned.................. 291
Grave markers painted.......................... 2, 045
Interments..................................... 200
Disinterments.................................. 3
Sanitation�Canal Zone.
ancon.
Grass cut and removed................square yards
Swamp filled in........................cubic yards
Tile drain laid...........................linear feet
New stone, cement, and concrete ditches laid. .do..
Old ditches cleaned and graded...............do..
Closets cared for (daily)...........................
Closets erected....................................
Garbage cans emptied (daily)......................
Night-soil cans emptied (daily)....................
Houses fumigated (10)..................cubic yards
Metallic screen repaired (houses)...................
Ground prepared for use of mower.....square yards
New ditches dug........................linear feet
Closet pits dug (14)....................cubic yards
Closet pits filled in (1).........................do..
917,773 12,927 16,479 8, 650 191, 886
23 2
151 78 7, 841 328 104,393 1,430 54 5

68
LA BOCA.
Grass cut and removed................square yards.. 318, 634
Swamps filled in.......................cubic yards.. 4, 630
Old ditches cleaned and graded..........linear feet.. 52, 722
Closet pits dug (7)......................cubic yards... 23
Closet pits filled in (6)........................
Closets cared for (daily).............................
Garbage cans emptied (daily)........................
Night-soil cans emptied (daily)......................
Metallic screen repaired (houses).................----
New stone, cement, and concrete ditches laid, linear feet...............................................
do.... 9
34
204
82
131
403
Houses fumigated (5)...................cubic yards.. 2, 961
New ditches dug........................linear feet.. 6, 014
Ground prepared for use of mower.....square yards.. 22, 000
corozal.
Grass cut and removed................square yards.. 2, 855, 537
New ditches dug........................linear feet.. 13, 411
Old ditches cleaned and graded...............do---- 95, 488
Closets cared for (daily)................,............. 30
Garbage cans emptied (daily)........................ 90
Closets erected...................................... 18
Night-soil cans emptied (daily)...................... 4
Houses fumigated (23)..................cubic yards.. 22, 503
Metallic screen repaired (houses)..................... 477
Swamp filled in........................cubic yards.. ' 158
Tile drain laid...........................linear feet.. 11, 419
Closet pits dug (24).....................cubic yards.. 133
Closet pits filled in (3)
do.... 15
miraflores.
Grass cut and removed................square yards.. 226, 219
Old ditches cleaned and graded..........linear feet.. 110, 294
...................... 30
....................... 28
________............... 73
Closets cared for (daily) Closets erected
Garbage cans emptied (daily)........................
Night-soil cans emptied (daily)...................... 26
New ditches dug........................linear feet.. 3, 213
Tile drain laid................................do.... 7,507
Closet pits dug (76).....................cubic yards.. 265
Houses fumigated (42).........................do---- 4,037
Metallic screen repaired (houses)..................... 22

69
pedro miguel.
Grass cut and removed.................square yards.. 330, 502
New ditches dug........................linear feet.. 2,589
Old ditches cleaned and graded................do---- 105,171
Closet pits dug (134)....................cubic yards.. 359
Closet pits filled in (64).......................do.... 164
.................... 94
...................... 310
................... 73
.................... 251
.................... 14
Closets cared for (daily) Garbage cans emptied (daily) � Night-soil cans emptied (daily) . Metallic screen repaired (houses) Closets erected..................
Houses fumigated (24)..................cubic yards.. 3, 930
Swamp filled in...............................do---- 247
Tile drain laid...........................linear feet.. 161
paraiso.
Grass cut and removed.................square yards.. 903,044
New ditches dug........................linear feet.. 2, 468
Old ditches cleaned and graded................do---- 147,073
Closets cared for (daily)............................. 74
Garbage cans emptied (daily)........................ 257
Night-soil cans emptied (daily)...................... 50
Houses fumigated (9)...................cubic yards.. 2, 818
Metallic screen repaired (houses)..................... 272
Closet pits dug (97).....................cubic yards.. 469
Swamps filled in..............................do---- 879
Tile drain laid...........................linear feet.. 5,179
Closet pits filled in (24)..................cubic yards.. 88
cucaracha.
Grass cut and removed.................square yards.. 7, 384
Old ditches cleaned and graded...........linear feet.. 35, 470
....................... 82
........................ 210
Closets cared for (daily) Garbage cans emptied (daily)
Tile drain laid...........................linear feet.. 756
culebra.
Grass cut and removed.................square yards.. 1,485, 862
Swamp filled in........................cubic yards.. 1, 306
New ditches dug........................linear feet.. 10, 585
Tile drain laid............................... .do.... 8, 617
New stone, cement, and concrete ditches laid, .do---- 5, 591
Old ditches cleaned and graded................do---- 127, 020
Closets cared for (daily)............................ 28
Garbage cans emptied (daily)....................... 812
Night-soil cans emptied (daily)..................... 56

70
Metallic screen repaired (houses).................... 507
Houses fumigated (8)...................cubic yards.. 5, 737
Ground prepared for use of mower......square yards.. 140,331
Closet pits dug (2)......................cubic yards.. 25
Closet pits filled in (1)........................do____ 8
empire.
Grass cut and removed..................square yards.. 2, 232, 723
Old ditches cleaned and graded...........linear feet.. 214,728
Clostet pits dug (27)....................cubic yards.. 171
Closet pits filled in (23).......................do.... 96
...................... 117
...................... 1,033
...................... 102
Closets cared for (daily) Garbage cans emptied (daily).. Night-soil cans emptied (daily)
Houses fumigated (6)...................cubic yards.. 68, 223
Metallic screen repaired (houses)..................... 324
Ground prepared for use of mower.....square yards.. 17, 340
Swamp filled in........................cubic yards.. 11, 612
Closets erected
11
New ditches dug........................linear feet.. 1,197
las cascadas.
Grass cut and removed.................square yards.. 1, 425, 854
Brush cut and removed........................do---- 8,180
Swamps filled in.......................cubic yards.. 934
New ditches dug........................linear feet.. 3,130
Tile drain laid............................... .do.... 13, 345
New stone, cement, and concrete ditches laid.. .do---- 2, 869
Old ditches cleaned and graded............! -. - do---- 118, 837
Closet pits dug (68).....................cubic yards.. 345
Closet pits filled in (19).......................do.... 19
..................... 78
...................... 398
................... 133
Closets cared for (daily) Garbage cans emptied (daily).. Night-soil cans emptied (daily)
Houses fumigated (16)..................cubic yards.. 8,160
Metallic screen repaired (houses)..................... 516
Swamp drained........................square yards.. 900
bas obispo.
Grass cut and removed.................square yards.. 1, 260, 692
Old ditches cleaned and graded...........linear feet.. 87, 540
Closet pits dug (86).....................cubic yards.. 297
Closet pits filled in (92).......................do.... 159
" ' * _________................... So
Closets cared for (daily)
Garbage cans emptied (daily)----
Metallic screens repaired (houses)
265 222

�
71
New stone, cement, and concrete ditches laid,
linear feet.........................................
Houses fumigated (33)..................cubic yards..
New ditches dug........................linear feet..
Tile drain laid................................do----
Swamps filled in.......................cubic yards..
matachin.
Grass cut and removed.................square yards..
New ditches dug........................linear feet..
Old ditches cleaned and graded................do----
Ctasnt pits dug (28).....................cubic yards..
Closets cared for (daily).............................
Closets erected......................................
Garbage cans emptied (daily)........................
Night-soil cans emptied (daily)......................
Metallic screen repaired (houses)....................
Swamp filled in........................cubic yards..
Houses fumigated (12).........................do....
Closet pits filled in (3)........................do....
New stone, cement, and concrete ditches laid, linear feet.........................................
gorgona..
091 9, 893
872 1,872 81
162, 959 12, 266 119, 865
105 65 29 155 46 35 998 4,483
3
33
' [Including Mampi.]
Grass cut and removed.................square yards.. 1,071, 338
New ditches dug........................linear feet..
New stone, cement and concrete ditches laid.. .do----
Old ditches cleaned and graded................do----
Closets cared for (daily).............................
Garbage cans emptied (daily)........................
Night soil cans emptied (daily)
Metallic screen repaired (houses)....................
Swamps filled in.......................cubic yards..
Tile drain laid...........................linear feet..
Closet pits dug (21).....................cubic yards..
Houses fumigated (4)..........,...............do----
Closet pits filled in (14).......................do....
16, 558 338 100,950
70 475 151 384
13, 999 1, 565 84
4, 700 20
san pablo.
Grass cut and removed.................square yards
Swamp filled in........................cubic yards
New ditches dug........................linear feet
Old ditches cleaned and graded................do..
Closet pits dug (57).....................cubic yards
Closet pits filled in (43).......................do..
Closets cared for (daily)...........................
1,013, 753
2,108 3, 884
58, 337 163 85 50

72
Garbage cans emptied (daily) ... Night soil cans emptied (daily). Metallic screen repaired (houses) Closets erected..................
Closets cared for (daily) Garbage cans emptied (daily).. Night soil cans emptied (daily).. Metallic screen repaired (houses)
BOHIO.
Closets erected
Garbage cans emptied (daily).. Night soil cans emptied (daily) Metallic screen repaired (houses)
129 54
193 12
Houses fumigated (11)..................cubic yards.. 11,434
tabernilla.
Grass cut and removed.................square yards.. 966, 561
Swamp filled in........................cubic yards.. 1, 673
New ditches dug........................linear feet.. 9, 495
Tile drain laid................................do.... 1, 307
New stone, cement and concrete ditches laid.. .do---- 839
Old ditches cleaned and graded................do---- 161, 551
Closet pits dug (45).....................cubic yards.. 129
Closet pits filled in (27).......................do.... 46
.................... 40
.................... 290
.................... 49
.................... 89
Houses fumigated (29)................. .cubic yards.. 57, 539
Grass cut and removed..............'.. .square yards.. 166, 356
Old ditches cleaned and graded...........linear feet.. 135, 043
Closet pits dug (30).....................cubic yards.. 145
Closets cared for (daily)............................. 64
Closet pits filled in (21)..................cubic yards.. 59
6 69 11 40
Houses fumigated (18)..................cubic yards.. 7,193
GATUN.
Grass cut and removed................square yards.. 1, 022,144
Swamp filled in.......................cubic yards.. 11, 873
New ditches dug........................linear feet.. 7,001
Tile drain laid..............................do.... 6,029
Old ditches cleaned and graded..............do---- 44, 0*10
Closet pits dug (112)..................cubic yards.. 387
Closet pits filled in (59).....................do.... 131
Closets cared for (ddlv)............................. 77
Garbage cans emptied (daily)....................... 359
Metallic screens repaired (houses)................... 305
Closets erected.................................... 4
Houses fumigated (3).................cubic yards.. 968
ft

73
porto bello.
Grass cut and removed..............square yards.. 401, 323
New ditches dug......................linear feet.. 1, 289
Tile drain laid..............................do.... 1,647
Old ditches cleaned and graded..............do---- 20, 449
Closets cared for (daily)............................
Closets erected
13 10
58
Garbage cans emptied (daily).......................
Swamp filled in......................cubic yards.. 85
Night-soil cans emptied (daily)............- - - ------ 18
New stone, cement, and concrete ditches laid, linear
.................... 355
................... 24
feet
Metallic screen repaired (houses)
recapitulation.
Grass cut and removed...............square yards.. 16, 777, 658
Swamp filled in......................cubic yards.. 63, 510
New ditches dug......................linear feet.. 95, 402
Tile drain laid............................. .do.... 75, 883
New stone, cement, and concrete ditches laid.. .do---- 20, 769
Old ditches cleaned and graded..............do---- 1, 926, 464
Ground prepared for use of mower.....square yards.. 284,064
5, 338 933 1,054
Closet pits dug (828). ~"................cubic yards.. 3,154
Closet pits filled in (400)....................do.... 907
Closets erected....................................
Garbage cans emptied (daily) Night-soil cans emptied (daily) Closets cared for (daily)
134
Houses fumigated (253)...............cubic yards.. 161,019
Metallic screen repaired (houses)
4,120
Brush cut and removed.............square yards.. 8,180
Swamp drained.............................do---- � 900
Note.�Beginning September 1, 1908, most
i
department
quartermaster's department performed on account for the
General cleaning:
Number of square yards of streets cleaned............ 165, 550
Water-closets cleaned... Water-closets disinfected
9 46 4
Water-closets condemned...........................
Yards inspected (times)............................. 1, 770
Yards cleaned......................................
810
Barrels of garbage removed.......................... 204, 630
Loads of yard garbage carted........................ 1,161

74
'General cleaning�Continued.
Loads of street sweepings removed.
Loads of sand carted..............
Loads of grass removed and burned
Loads of cinders carted............
Loads of old lumber carted........
Loads of tree trunks removed......
Miscellaneous loads carted.........
Cesspools cleaned.................
Cesspools disinfected...............
Cesspools filled....................
Cesspools oiled....................
Houses torn down..............
Houses condemned...............
Houses inspected (times)..........
Houses cleaned...................
Nuisances reported................
Nuisances abated..................
Trees cut down...................
Tree trunks and stumps removed..
Buildings cleaned.................
Linear feet of board walk made ...
28 1,016
82
46 205 89 441 6 33 20 50 9 5
919
3
433 243 173
423 4
281
Linear feet of board walk repaired.................. 250
Square yards of street repaired...................... 632
Linear yards of water front cleaned................. 4,080
____________................ 122
Vacant lots cleaned
Linear feet of drainpipe laid-----
Linear feet of drainpipe removed
Loads of coral carted............
Closets oiled....................
Olosets disinfected...............
Closets filled....................
Plans for closets approved
Loads of earth carted............
Sewers cleaned..............
Average number of carts at work
Passageways cleaned............
Patios inspected...............
Patios cleaned..............
Mosquito brigade:
Barrels repaired (old and new Barrel covers made Barrels spigoted... Barrels overturned.
Barrels oiled.......
Barrels destroyed..
66 22 302 39 10 3 23
Persons notified to keep yards in sanitary condition.. 611
...................... 78
1
2 95 60 25
Number of square yards of vegetation removed....... 8, 000
1,962
1,500 2, 023 1, 901 260 473

75
Mosquito brigade�Continued.
Tanks spigoted..................................... 12
Tanks repaired..................................... 290
Tanks covered..................................... 18
Tanks oiled....................................... 40
Tanks destroyed................................... 12
Wells covered...................................... 5
Wells cleaned..................................... 4
Wells oiled........................................ 211
Wells dug.......................................... 1
Wells filled............:........................... 41
Crabs killed........................................ 1,705
Crab holes worked................................. 2, 900
Crab holes filled................................... 4,155
Crab holes oiled................................... 1, 755
Mosquito-breeding places eradicated............... 422
Linear feet of drains made........................... 2, 285
Linear feet of drains oiled........................... 2, 690
Linear feet of drains repaired....................... 1, 650
Linear feet of drains cleaned............^............ 7, 523
Persons fined for violating sanitary ordinances...... 66
Square yards of swamp filled....................... 722
New drains made................................... 8
Daily average number of men at work................ 13
Square yards of grass cut and burned................. 210, 400
Square yards of brush cut and burned................ 43, 000
Catch basins oiled................................. 266
Catch basins cleaned................................ 31
Gutters repaired.................................... 116
Gutters removed................................... 8
Water receptacles collected.......................... 5, 415
Water receptacles overturned....................... 1, 836
Holes filled......................................... 412
Cubic yards of earth used........................... 1,155
Cubic yards of coral used............................ 144
Square yards of pools oiled..........,............... 14, 650
Square yards of swamp drained...................... 293, 990
Drains oiled...................................#---- 22
Persons warned for having mosquito larvae on premises. 315
Destruction of rats:
Number of rats caught and cremated................. 52
Average number of rat-traps used................... 12
Dead rats found.................................... 87
Material used in work:
Spigots............................................. 2,007
Copper cloth (screening).......................feet.. 6, 237
Mosquito oil................................barrels.. 77
Chloride of lime............................pounds.. 204

76
Material used in work�Continued.
Bichloride of mercury.....................pounds.. 8
Sulphur.....................................do____ 50
Lime.....................................barrels.. 3
Turpentine...............................gallons.. 3
Paint.......................................do____ 1
Arsenic....................................pounds.. 4
Wire staples.............................packages.. 30
Tacks....................................pounds.. 64
Tar........................................gallons.. 35
Lumber..............................square feet.. 5,850
Nails......................................pounds.. 475
Quarantine Service.
[Ports of Panama, Ancon, Colon, and Cristobal.]
Number of vessels inspected and passed.................. 1, 001
Number of vessels detained in quarantine................ 4
Number of vessels fumigated on arrival
7
Number of vessels fumigated prior to sailing............. 48
Total number of pieces of baggage disinfected............ 1, 627
Total number of crew inspected
73, 942
Total number of passengers inspected................... 58, 799
Total number of persons inspected...................... 132, 741
Total number of persons vaccinated at ports of arrival
because of compulsory vaccination law................. 13, 621
Total number of persons vaccinated at ports of departure
or en route, because of the compulsory vaccination law.. 19, 205
Total number of persons vaccinated because of compulsory vaccination law.......................................
Total number of persons held in quarantine at the detention stations to complete period of incubation of yellow fever and plague.....................................
Total number of persons held in quarantine on board vessels to complete period of incubation of yellow fever and
plague
32,826
3, 806
1,597
Total number of persons held in quarantine............. 5,403
Total number of passengers landed from foreign ports:
Cabin....................................... 16,993
Steerage.................................... 26,605
Total number of passengers embarked for foreign ports:
Cabin....................................... 15,344
Steerage.................................... 16,679
43,598
Total apparent increase for the year from foreign ports:
Cabin....................................... 1,649
Steerage.................................... 9,926
32,023
11,575

77
Total number of persons arriving from coast towns on
small launches and sailing craft....................... 19, 884
Total number of persons leaving for coast towns on small
launches and sailing craft............................. 15, 993
Total apparent increase for the year from coast towns..... 3, 891
Total number of persons landed......................... 63, 482
Total number of persons embarked....................... 48, 016
Total apparent increase for the year..................... 15, 466
Number of immigrants recommended for rejection....... 141
Number of certificates issued to outgoing passengers...... 538
Number of persons refused certificates because of trachoma 42
Total number of bills of health issued.................... 50
Total number of bills of health viseed.................... 368
Total number of circulars relative to malarial fever distributed.............................................. 22,000
Quarantine Service�Bocas del Toro.
Number of vessels inspected and passed.................. 474
Number of crew inspected.............................. 8, 677
Number of passengers inspected......................... 5, 565
Total number of persons held to complete period of incubation for yellow fever................................. 373
Number of vessels sailing during the year................. 462
Number of vessels entering during the year.............. 484
Number of persons vaccinated........................... 43
Personnel Report.
[Average number of emyloyees per month for the year.]
Chief sanitary office......
Property division, sanitary department.....
Quarantine service.......
33
Health office, Panama____
Health office, Colon...... 137
Director of hospitals...... 18
Empire Dispensary.......
Las Cascadas Dispensary. 10 Bas Obispo Dispensary...
31 Gorgona Dispensary......
90 j San Pablo Dispensary____
Ancon hospital.......... 489
Colon Hospital........... 242
15 3 5 3 3 4 9
Culebra Hospital
Ancon Dispensary........
La Boca Dispensary......
Corozal Dispensary.......
Miraflores Dispensary.....
Pedro Miguel Dispensary. Paraiso Dispensary.......
Tabernilla Dispensary____
Gatun Dispensary
Cristobal Dispensary.....
Porto Bello Dispensary... Taboga Sanitarium.......
Palo Seco Leper Asylum.. Zone sanitation..........
Santo Tomas Hospital____
13 9
10
12 4 5
13 7 4
29 9
779 6
Total.............. 1,929

78
Malarial
with Averages, etc., 1908.
Employees, in Hospitals
Months
January... February..
March.....
A pi il......
May.......
June.......
July.......
August____
September.
October____
November. December..
Total
Discharged.
325 341 304 270 251 358 787 769 643 912 732 626
6,318
5
317
232
220 137 1<3 269 933 747 760 904 722 611
5,995
Died.
05
1 a
2 0 8
0
2
3 3 5 4 2 4 1
34
o
5
2 1 1 0 1 0 2 4
3 4 2 5
25
Total
died.
4 1
9 0 3 3
5 9
7 6 6 6
59
Total cases.
12,372
a cs o
646
574 533 407 397 630 1,725 1,525 1,410 1,822
1,460 1,243
1.10 .27 2.49
.00 .80 .78 1.33 2.44 1,86
1.65 1.72 1.74
1.34
>
I* CO
o o
3 C 3 *
<5
178 156 147 109 106 165 460 413 375 501 420 362
2S2
If
3 3
43,390 44,039 43,276 44,753 44,816 45,662 44,938 44,225 45,058 43,593 41,713 41,219
43,890
O
�

7: O.W

UNIVERSITY OF FLORIDA
3 1262 08229 053 6
43

	Front Cover
	Title Page
	Table of Contents
	Letter of transmittal
	Main
	Back Cover

MILLISECOND	CLASS.METHOD	MESSAGE
0	sobekcm_page_globals.constructor
0	sobekcm_page_globals.constructor	Application State validated or built
0	sobekcm_database.verify_item_lookup_object
0	sobekcm_page_globals.constructor	Navigation Object created from URI query string
0	sobekcm_database.verify_item_lookup_object
0	sobekcm_page_globals.display_item	Retrieving item or group information
0	sobekcm_page_globals.get_entire_collection_hierarchy	Retrieving hierarchy information
0	sobekcm_assistant.get_entire_collection_hierarchy
0	cached_data_manager.retrieve_item_aggregation
0	cached_data_manager.retrieve_item_aggregation	Found item aggregation on local cache
0	item_aggregation_builder.get_item_aggregation	Found 'all' item aggregation in cache
0	system.web.ui.page.page_load (ufdc.page_load)
0	sobekcm_page_globals.constructor.on_page_load
0	html_echo_mainwriter.add_style_references	Adding style references to HTML
0	html_echo_mainwriter.add_text_to_page	Reading the text from the file and echoing back to the output stream
37	html_echo_mainwriter.add_text_to_page	Finished reading and writing the file