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

UNIVERSITY OF FLORIDA LIBRARY

ANNUAL REPORT
OF THE
DEPARTMENT OF SANITATION
OF THE
ISTHMIAN CANAL COMMISSION
FOR THE
YEAR 1909
W. C. GORGAS
Colonel, Medical Corps, U. S. Army Chief Sanitary Officer, Ancon, Canal Zone
WASHINGTON
GOVERNMENT PRINTING OFFICE
1910
4
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(CXNTE^TS.
Page.
Letter of transmittal...................................... 5
Vital statistics:
Deaths of employees of the Isthmian Canal Commission
and the Panama Railroad Company................. 9
Deaths in the cities of Panama and Colon, and the Canal
Zone.............................................. 9
Deaths by age, color, and sex.......................... 10
Deaths by nationality................................. 10
Causes of death of Isthmian Canal Commission and
Panama Railroad employees......................... 12
Deaths of white employees from the United States.... 14 Deaths of white women and children from the United
States............................................. 16
Death rate among Americans on the Isthmus........... 17
Causes of death.......................................... 18
Discharges and deaths in hospitals of commission.......... 22
Consolidated hospital report.............................. 26
Consolidated dispensary report........................... 27
Consolidated sick camp report............................ 27
Consolidated hospital, sick camp, and sick-in-quarters report ................................................... 28
Total admissions to hospitals and sick camps for the year .. 28
Subsistence and operating expenses........................ 29
Average number of employees constantly sick in hospitals,
sick camps, and quarters............................... 29
Outside patients treated in hospitals, and amounts collected
for their treatment...................�.................. 31
Surgical operations performed in hospitals................. 31
Operations and work performed in eye, ear, nose, and throat
clinics................................................. 35
Consolidated ward laboratory report of all hospitals......... 36
Report of:
Ancon Hospital...................................... 38
Colon Hospital....................................... 39
Culebra Hospital..................................... 41
Palo Seco Leper Asylum.............................. 42
Taboga Sanitarium.................................... 43
Santo Tomas Hospital................................. 43
Ancon dispensary, sick camp, and employees sick in
quarters........................................... 45
(3)
7703$

I
Page.
Report of�Continued.
Balboa dispensary and employees excused for quarters.. 46
Corozal dispensary and sick camp, and employees excused for quarters.................................. 46
Miraflores dispensary and sick camp, and employees
excused for quarters................................ 47
Pedro Miguel dispensary and sick camp, and employees excused for quarters................................ 48
Paraiso dispensary and sick camp, and employees excused for quarters.................................. 49
Culebra dispensary and sick camp, and employees excused for quarters.................................. 50
Empire dispensary and sick camp, and employees excused for quarters.................................. 51
Las Cascadas dispensary and sick camp, and employees
excused for quarters................................ 52
Bas Obispo dispensary and sick camp, and employees excused for quarters................................ 53
Gorgona dispensary and sick camp, and employees excused for quarters.................................. 54
San Pablo dispensary and sick camp, and employees
excused for quarters................................ 55
Tabernilla dispensary and sick camp, and employees
excused for quarters................................ 56
Frijoles dispensary and sick camp, and employees excused for quarters.................................. 57
Bohio dispensary and sick camp, and employees excused for quarters.................................. 58
Gatun dispensary and sick camp, and employees excused for quarters.................................. 59
Gatun Spillway dispensary and sick camp............. 60
Cristobal dispensary and sick camp, and employees excused for quarters.................................. 60
Porto Bello dispensary and sick camp, and employees excused for quarters................................ 61
Nombre de Dios dispensary and sick camp, and employees excused for quarters........................ 62
Board of health laboratory............................ 63
issues of quinine..................................... 65
Sanitation:
Panama.............................................. 65
Colon (including Cristobal and Mount Hope).......... 67
Bocas del Toro....................................... 68
Quarantine service...................................�---- 69
Ancon-Panama and Colon-Cristobal.................... 69
Bocas del Toro....................................... 70
Personnel report......................................... 71
Hospital cases of malaria among employees................. 72

LETTER OF TRANSMITTAL.
Isthmian (anal Commission,
Department of Sanitation, Ancon, Canal Zone. January 18, 1910.
Chairman and Chief Engineer
' Isthmian Canal Commission,
Culebra, Canal Zone.
Sir: Inclosed I forward you herewith report of the sanitary department for the calendar year 1909.
In comparing the vital statistics with previous years we can see considerable improvement.
| Number of employees. 1 Deaths. Rate.
1904............................... � 6,213 16,512 26.547 | 39,238 43. 891 47,167 82 1 427 | 1,105 ! 1,131 571 i . 502 13. 26 25. 86 41. 73 28. 74 13. 01 10. 64
L905
L906...................................
1907...............................
L908...............................
L909...............................1

There were fewer white employees than in 1908. This is the smallest death rate we have had in our laboring force. The total tiumber of deaths in the year 1909 in a force of 47.167 men was very little more than it was in 1905 in a force of 16,512 men.
The death rate among our white employees from the United States from disease was 3.88 per thousand. The death rate in our irmy for the calendar year 1908 from disease was 3.20 per thousand; practically the same as ours. If we include American women and children, it will raise the death rate of Americans from disease to 1.05 per thousand. It would seem from these figures that the women and children stand the climatic conditions very much better than the men do. Among 3,240 white women and children from the United States we had a death rate from disease of 4.32. The rate among women and children in any of the cities at home would be very much higher than this.

6
Taking special diseases, the deaths from typhoid fever among our
employees have been:
1905 1906 1907 1908 1909
Deaths.
12 .. 42
98 .. 19 .. 13
This is an excellent rate�about 0.27 per thousand. That of the whole army for the calendar year 1908 was 0.31 per thousand; for the State of Pennsylvania for the calendar year 1907, 5.03 per thousand.
Considering dysentery, we have had among our employees from this disease the following deaths:
1905 1906 1907 1908 1909
Deaths. 14
.. 69
.. 48 ..16
.. 8
Among our J 1.662 white employees we had not a single death from this disease.
Considering pneumonia, we had a smaller death rate than has occurred any previous vear.
1905.....................................................
1906.....................................................
1907.....................................................
1908.....................................................
1909.....................................................
Peat hs.
.. 95 .. 413 .. 328 .. 93
i)
This would be about the same rate that would occur in New York City from this disease.
Considering deaths from malaria among employees, we see the following figures:
Deaths.
1905.......................................................
1906.......................................................
1907...........................................................
1908.......................................................
1909.......................................................
liOO
154
73 52
The death rate from malaria is probably the best measure of the success of sanitary work in the Tropics. The admission rate to our hospitals was:

1904 1905 1906 1907 1908 1909
Per thousand
125
514 821 424 282 215
This means that in 1906, when malaria was at its highest, out of every thousand employees we had 821 admitted to our hospitals with malaria. In 1909 we had only 215 out of every thousand admitted to our hospitals. That is, 606 men out of every thousand escaped malaria in 1909 who would have had it had the conditions remained the same as in 1906.
If we consider the death rate of the total population, including the cities of Panama and Colon and the country on the Zone between them, we find the rates for the different years to be as follows:
Death rate.
1905..................................................... 49.94
1906..................................................... 48.37
1907..................................................... 33.63
1908..................................................... 24.83
1909................................................... 18.19
That is, out of every thousand people living on the Zone in 1909 we had 31 deaths less than we had out of this same thousand people living on the Isthmus in 1905. This means a saving of over 4,000 lives.
During the year no cases of yellow fever, plague, or smallpox occurred on the Isthmus.
Very respectfully, W. C. Gorgas,
Chief Sanitary Officer.

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ANNUAL REPORT
op the < /.'
DEPARTMENT OF HEALTH, ISTHMIAN CANAL COMMISSION,
FOR THE YEAR 1909.
VITAL STATISTICS.
Deaths op Employees of the Isthmian Canal Commission and
the Panama Railroad.
Color. � Average i number of employees. Total number of deaths from� Annual death rate per 1,000.
Disease. Vio-lence.; All. Disease. Violence. All.
White.......................... Black........................... Total..................... 11,662 35,505 75 281 40 106 ! 115 387 6. 43 7.91 3.43 2.99 9.86 10.90
47,167 356 146 502 7.55 3.09 10.64
Deaths in the Cities of Panama and Colon and the Canal
Zone.
Place. Average population. Total deaths. Annual death rate per 1,000.
Panama............................ � 40, 801 17,479 76, 900 1,038 396 1,025 25. 44 22. 65 13. 33
Colon..............................
Canal Zone.........................
� Total.........................
135,180 ! 2,459 18.19

Note.�Figures relating to the number of employees are compiled from the pay rolls of the different months of the year. The population and deaths as given for the cities of Panama and Colon | and for the Canal Zone in the table above include employees and civil population.
30613�10-2 (9)

10
Total number of admissions of employees to hospitals and sick camps, including those sick in "quarters............41, 849
Average per thousand of admissions of employees to hospitals and sick camps, including those sick in quarters.. 887
Deaths by Age, Color, and Sex.
Age.
Under 1 year.
i to 4 years... 5 to 10 years..
ii to 20 years. 21 to 30 years. 31 to 40 years. 41 to 50 years. 51 to 00 years. 01 to 70 years. 71 to 80 years. 81 to 90 years. 91 to 100 years Unknown____
\ V h i te.
m.
72 10 5 12 60 74 53 18 6 5 1
F.
6
Total................... 828
47 18 2 6 13 13 9 9 6
4 1
1
129
Black.
m
303 55 29 70 340 199 159 67 36 7 6
27
1,298
F
215 46 26 32 117 106 48 33 17 14 7 I 6
�iuX
Yellow.
m
2
2 2
10 7
5
6
1
$5
F.
1
1
Total.
m.
377 71 34 84 402 283 219 90 48 12
34
1.661
F
263 64 28 38
130
119 57 42
23 18 8 1
798
Deaths by Nationality
Nations.
Antigua.........
Bahama Islands.
Barbados........
Bolivia..........,
Bermuda Islands Bulgaria.........
Chile............
Employees.
China.....
Colombia.. Costa Rica Cuba.....
Dutch West Indies
Dominica.........
Ecuador...........
England...........
10 1
150 I
1
11 4
1
1
2
Nonem-ployees.
Total
9 19
1
125 275
1 2
1 1
1
6 6
36 36
126 1 137
16 20
6 6
1 2
2 3
3 4
8 10

11
Deaths by Nationality�Continued.
Nations.
Fortune Island France........
Germany Greece...
Grenada____
Guadeloupe
Guatemala.....
Guiana, British Haiti...........
Honduras, British
Holland...........
India.............
Italv.............
Jamaica Liberia.
Martinique Mexico____
Montserrat
Nicaragua
Panama Peru____
Porto Rico Portugal -..
St. Kitts... St. Lucia... St, Thomas St. Vincent
Spain......
Svria.......
Trinidad Turkey..
Turks Island
United State
LTruguay..'..
Venezuela...
West Indies.
Wales.......
L^nknown...
3
3 2
24
Total
2 2
6
108 1
25 3 4
18 1
1
6
2 59
7 1 1
35
1
2
2
10
3 1 13 8 1
4 2 7 1 1 5
388
47 8 7 4
920 4 4 2 2 42 4 4
36 3 18
44 1
2
14 1
6
Total
3 10
3 4
15 32 1 6 4 7 1 1
11
496 1
72
11 11 4
938 5 4 2 3
48 4 6
95 3
25 1 1
79 1 3
16 1 8
2, 459

12
Causes of Death of Isthmian Canal Commission and Panama
Railroad Employees.
Diseases.
Apoplexy.....................-----
Aneurism, ruptured, into pericardial
ac
Aneurism of abdominal aorta (rup-
tured
Alcoholism, acute and chronic Aortic insufficiency...........
White.
Asphyxia, chloroform
Calculi, renal Cancer of gall bladder
Cancer of stomach..............
Cancer of tongue (inoperable).. Cholecystitis, acute gangrenous Colitis, acute and chronic......
Congestion
and
hemorrhage
of the
brain
Dislocation eleventh and twelfth dorsal vertebrae, trophic ulcers on back,
broncho-pneumonia................
1 )ropsy Dysentery
Embolism and thrombosis Emphysema, pulmonary..
Empyema.....................
Encephalitis, acute hemorrhagic Encephalomalacia, acute4........
Encephalon, abscess of..........
Endocarditis....................
Entero-colitis, acute.............
Fever:
Hemoglobinuria............
Malarial Typhoid
Heart, acute rupture of.. Heart, organic diseases of
Hemorrhage, cerebral____
Influenza................
Leukemia................
Liver:
Abscess of...........
Abscess of, multiple Cyst of.............
(-irrhosis of..........
4
1
3
1 1
1
1
12 14
1 1 1 1
1
4 1 1 1
Black.
1
1
s
1
3 1 1 l
2 1
1
25
13
1
3
Total.
2 2
1 1
1 1
4
1 1
1 1
1
1 | 1
1 4
1 1
1 1
2 2
2 2
1 1
8 2 1
3 2 1 1
3 1
13
39 13
1
10 1
2 1
7 I
1 1

13
Causes of Death of Isthmian Canal Commission and Panama
Railroad Employees�Continued.
Diseases.
Lungs:
Abscess of.. Edema of... Gangrene of
Meningitis:
Acute................�
Epidemic cerebrospinal
Pneumococcic...........
Tuberculous...........
Mitral regurgitation Myocarditis
Neck, cellulitis of Nephritis:
Acute........
Chronic......
Pericarditis.......
Peritonitis.......
Pneumonia.....
Psychosis, toxic Puerperal sepsis
Pyelonephritis................
Pyemia.......................
Sarcoma of femur.............
Senility�myocarditis..........
Septicemia, purulent infection Tuberculosis:
General...........
Of spine (cervical) Pulmonary
Tumor of abdomen, malignant Uremia.......................
Undiagnosed Violence:
White.
Accidental traumatisms, various...
scalds
Burns and Drowning, accidental
Dynamite explosions.
Electric shock........
Fractures...........
Homicides...........
Railroad accidents...
Shock by lighting----
Total..............
1
1 1
1
3
2 1 1
8 1
1
1
2
19 1
115
Black.
1
1
3
2 2
3 1
18 31 5 6 59 1 1
1 1
3
3 1
48
2
20 1 14 13
3
2
53
387
Total.
2
2 1 1
1
3 2 2 1 3 1
19 32 6 6 70 1 1 1 1 1 1 6
3 1 50 1 1 2
28 2
21 13 4
1 4
72 1
502

14
Deaths of White Employees from the United States.
JANUARY.
Name.
Gamble, Bert Nelson, R. J..
Petry, J. H
Department.
Time on Isthmus.
Engineering____
Panama Railroad. Engineering____
44 months 3 years...
Age.
do
35 31
(>1
Cause of death.
Liver abscess. Hemorrhage, cerebral.
Multiple abscess of liver.
FEBRLTARY.
Murphy, James P Putnam, James L
Rodman, Willis J.
Engineering ....do......
Panama Railroad.
10 months. 23 months.
42 months.
31 46
Railroad accident. Tumor of abdomen,
malignant. Uremia, complicating
amebic dysentery.
Aldrich, L. E
MARCH.
8 months..
APRIL.
Liver abscess
Higgins, II. H.......J Lamb, William...... Whiteman, P. M____ Waldron, Fred A.... Engineering____ Panama Railroad. Disbursing...... Sanitation....... 2 years____ 28 months. 2 years____ 58 months. 1 37 39 70 Delirium tremens, hyperpyrexia. Fracture, struck on head by lever of hand car. Shock, incident to burns. Senility, myocarditis.
MAY. �
Abbott, Charles M... Barbour, John II____ Kealy, Daniel....... Miller, Robert....... McFarland, A. Y.... Mechanical...... Engineering..... Quartermaster.. Engineering..... Quartermaster.. 30 months. 54 months. 33 months. 4S months. 42 months. 22 42 32 28 38 Homicide, fractured 3d cervical vertebra. Alcoholism. Accidental drowning. Fell from veranda. Abscess of liver.

15
Deaths of "White Employees from the United States�Con,
JUNE.
Name. 1 Department. Time on Isthmus. Age. Cause of death.
Barbour, James W .. Debardeleben, M. V. Howland, F. C...... Kingsley, Eugen H Morris. John R...... Panama Railroad. .....do........... Engineering..... .....do........... .....do........... 9 39 months. 48 months. 18 months. 48 months. 9 months.. 27 31 28 28 38 Struck by flying emery wheel. Nephritis, acute. Septicemia, acute. Homicide, pistol. Railroad accident.
JULY.
Hague, Joseph Ryan, John...
Engineering Mechanical.
2 months.. 11 months.
41
33
Heart disease. Lobar pneumonia
AUGUST.
Coogan, Michael.. Green, William B.
Smith, Gordon E____
Williams, Edward R.
Engineering
____do._____
Panama Rail
road. Engineering____
3 years____
28 months.
20 months.
4 months..
39 40
22 23
Pyelonephritis. Chronic endocarditis
with pericarditis. Accidental drowning.
Do.
SEPTEMBER.
Ball, H. C.....
Lythgow, A. G
Quartermaste Engineering..
3 years
4 years
Cerebral hemorrhage. Hemoglobinuric fever
OCTOBER.
Worrall, James C
9 months..
25
Edema of lungs
NOVEMBER.
Edwards, Charles Hawley, G. I
Hill, George
Snyder, William
Engineering do
8 months.. 4 years____
27 years...
6 months..
Alcoholism.
Endocarditis, aortic regurgitation.
Influenza, bronchopneumonia.
Accidental traumatisi (railroad).

16
Deaths of White Employees from the United States�Con.
DECEMBER.
Name. Department. Time on Isthmus. Age. Cause of death.
Hennigh, George A.. Engineering..... 34 months. 22 i Accidental drowning. 1
Deaths
of White Women and Children from the United
States.
Name.
MARCH.
I Time on Isthmus.
Kennady, Mary E..... 1 day
Price, Lily............. 10 days
Smith, Leroy..........
Age.
1 day.. 10 days. 14 years
APRIL.
Cause of death
Congenital debility. Asphyxiation-overlying Railroad injuries.
Rogers, Mrs. W. 1)..... 2 years...... 32 years..... Septic endocardit
JUNE.
k'ranz, Elizabeth......
Nugent, Margaret......
Kosen, child of Harry...
4 months...
10 days.....
'.\ hours.....
2 years...... Acute entero-colitis.
10 days 3 hours.
Basilar meningitis. Diseases peculiar to infancy.
early
july.
Hogan, Andrew........ 5J months... U months... Intussusception, intestinal.
Roark, Jane............ 10 months... 10 months... Malarial fever.
\v < \ ust.
Conner, Olive..........
Gutberlet (infant)......
Humphrey, Harriet A .. McKay, John..........
17 months... 2\ years.....
w months____ 9 months____
l\ months... 71 years.....
2$ years..... 2� years.....
Malarial fever. Pernicious fever. Senility.
Chronic pachymeningitis.

17
Deaths of White Wo
and Children from the United
States�Continued.
OCTOBER.
Name.
Tanner, Harold
Time on Isthmus. Age.
2 months____ 7 years......
Cause of death.
Accidental traumatism (fell from veranda).
NOVEMBER.
Bowers, Agnes
3* months...
Cook, Nathan, jr....... 2 years
Purcell, James J
4 months____
3h months... 12 years.....
3 years......
Chronic enteritis.
Acute gangrenous appendicitis with perforation.
Accidental traumatism (burns).
DECEMBER.
Marsh (infant)
Pemphigus.
Death Rate Among Americans on the Isthmus.
Number of deaths. 1 Annual average per 1,000.
White employees from the United States (average number, 5,146): Disease.................................................. 20 3.88
Violence................................................. 15 2.92

All causes............................................. 35 6. 80

White women and children from the United States (average number, 3,240): Disease.................................................. 14 4.32
Violence................................................. � ' ..,,.-4 1. 23

All causes............................................. � 18 5. 55

White employees and their families from the United States (average number, 8,386): Disease .............................................. 34 4.05
Violence ............................................ 19 2.27

All causes............................................. 53 6.32

30613�10
3

18
Causes of Death.
among the civil population, and among ommission and the Panama Railroad I
Diseases.
i
n
o
9 3
i
GO
0
I. General diseases.
Typhoid fever (abdominal typhus)
Malarial fever.....................
Estivo-autumnal malaria.........
Tertian malaria...................
Malarial cachexia..................
Hemoglobinuric fever.............
Measles............................
Whooping cough..................
Diphtheria........................
Influenza..........................
12
2 33
~5
�J
1
12
4
3 7
Dysentery........................
Bacillary dysentery..............
Amebic dysentery................
Leprosy..........................
Erysipelas........................
Beriberi..........................
Purulent infection and septicemia
Pellagra..........................
Tuberculosis of the larynx........
Tuberculosis of the lungs.........
Tuberculosis of the meninges.....
Abdominal tuberculosis..........
I'ott's disease.....................
General tuberculosis..............
1
3 1 4 1
Syphilis...................................
(ionorrhea (5 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 and other malignant tumors of the female genital organs....................
Cancer and other malignant tumors of the
skin.....................................
Cancer and ot her malignant tumors of other organs or of organs not specified.........
Other tumors (tumors of the female genital organs excepted)........................
Acute articular rheumatism...............
Rheumatism, articular, subacute, and
chronic.................................
Anemia, chlorosis........................
Other general diseases.....................
Acute and chronic alcoholism.............
Chronic lead poisoning...................
Surgical shock............................
7 1 1 43 1 3 1
.1 I I
1 1
1
2
2
1
4
7
10
47 1
1
1
1
I
2
2
I
5
-
Si
-
1
103 25
5 1 1
4 1
7
28 1
1
21
3
I
150
6 1
2
9 1
4
I 1
4
2
r.
5
1
19
9
I
1
2 1
17
1
IS 2
I
I
O
tiO 17 1
2
1
11
1 1
1
23
2
I
1
1
2
18 187 84 1
8 15 1 4 1
10
47
2
13 2 1
23
22
~3
280
2
6 1
13 10 1
3
s I
12
1
2 1
I
1
L2 1 1

19
Causes of Death�Continued.
Diseases.
II. Diseases of the nervous system and the
organs of special sense.
t
Encephalitis..............................
Simple meningitis........................
Epidemic cerebrospinal meningitis.......
Pneumococcus meningitis................
Other diseases of the spinal cord..........
Congestion and hemorrhage of the brain..
Softening of the brain....................
Paralysis without specified cause.........
Other forms of mental alienation.........
i
0
7l
i
0
<
71
1
4
2 1 1
s
Epilepsy.................................
Convulsions (nonpuerperal, 5 years and
over)...................................
Convulsions (under 5 years)...............
Tetanus..................................
Chorea...................................
Diseases of the ear........................
4 1
III. Diseases of the circulatory system.
Pericarditis............:...................
Pneumococcus pericarditis................
Acute endocarditis........................
Septic endocarditis........................
Organic diseases of the heart...............
Angina pectoris...........................
Diseases of the arteries (atheroma, aneurism, etc.)..........................
Embolism and thrombosis.................
Diseases of the lymphatic system (lymphangitis, etc.)..........................
Hemorrhages..............................
Other diseases of the circulatory system..
IV. Diseases of the respiratory system.
1
1
6 1
1
1
2
2 2
Diseases of the larynx....................
Acute bronchitis.........................
Chronic bronchitis........................
Broncho-pneumonia......................
Pneumonia...............................
Pleurisy..................................
Congestion and apoplexy of the lungs.....
Gangrene of the lungs....................
Asthma..................................
Other diseases of the respiratory system
(phthisis excepted).....................
Empyema................................
1
3 2
1 1
2
2
2 9
3
1
7 71
3 18
3 1
�2
4
1 I
71 g
03
"o
10
1
3 4
31 16
1
5
2
9 1 8
2 1
2
4
1
2 1 4
2 4 8
12 1 2
1 1

2

10

12
2
1
1 ______ 1
4 2 1 9
1 4
1 , 1
21 4 4 29
4 3 7
25 11 21 67
57 13 27 180
3 3 6
10 13
1
2 1 3
; 1 | 2 9
1
r.
o
1
18 9
3 3
20 2
3 9 2
14
18 1 1
10 1
10
3
76 2
<
2

20
Causes of Death�Continued
Diseases.
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 obstruction........
Other diseases of the intestines...........
Cirrhosis of the liver......................
Other diseases of the liver................
Abscess of the liver.......................
CO
o
I
c
8 "S
5
<
09
o
1
Diseases of the spleen.....................
Simple peritonitis........................
Other diseases of the digestive system (cancer and tuberculosis excepted)..........
Appendicitis and abscess of the iliac fossa.. Colic.....................................
VI. Diseases of the genito-urinary system
and its adnexa.
Acute nephritis............................
Chronic nephritis..........................
Other diseases of the kidneys and their
adnexa..................................
Calculi of the urinary tract................
Diseases of the bladder....................
Diseases of the urethra, urinary abscess, etc.
Uterine tumors (noncancerous)............
Other diseases of the uterus................
Other diseases of the female genital organs..
Uremia....................................
1 1
2
1 1
6
2
4 8 1 4
1
2
4
3
3 1
c3
CJ
a
2
2 143
2 19 1
8 3 8 3 2
6
a 9
V1L The puerperaI state.
Accidents of pregnancy.
Puerperal hemorrhage.. Other accidents of labor
Pu er peral septicemia...................
Puerperal albuminuria and convulsions
VIII. Diseases of the shin and cellular tissue.
Gangrene..................................
Acute abscess, phlegmon..................
Other diseases of the skin and its adnexa____
14 3
51 31
2 2
i
1 .....
9
.50
1 1
1 1
3 1
1
5
4
3
2 1
4 1
1 1
1
o
o
2 44
0
1 1
2 0 1
1
3
6
1
4
2
OP
a
o s:
1
2 25
5
1
7 2
0 2
1
4
9
1
1
2 2 2
1
o
1
2 1
6 215
8 30 2
1
9 14 13 14
1 20
4 4 1
33 147
5 1 2 1 3 1 4 1
4
2 2 19
8
1 1
2

21
Causes of Death�Continued
Diseases.
IX. Diseases of the organs of locomotion
Nontuberculous diseases of the bones
1 i
T.
o o
� �
a$ 33 g
0 X � *~

o 03
< 1
X. Malformations.
Congenital malformations (stillbirths excepted)...............................
XI. 2?arZj/ infancy.
Congenital debility, icterus, and sclerema..
Prematurity..............................
Other diseases peculiar to early infancy----
Lack of care...............................
XII. Old age.
Senile debility
3 3 1
4
2
3
XIII. External causes
Suicide by firearms........................
Fractures.................................
Other accidental traumatisms.............
Dynamite explosion.......................
Railroad accidents........................
Burns and scalds..........................
Electric shock.............................
Accidental drowning......................
Inanition (starvation).....................
Absorption of deleterious gases (nonsuicidal)
Other acute poisoning.....................
Other external violence....................
Homicide.................................
Judicial execution.........................
1
2 5
5 8
1
12 15
5 2
1
1
2
XIV. Ill-defined cases.
Dropsy.......
Sudden death
2
1
20 I
11 i
2
3
6
2
3
2 6 1
1
Causes unspecified or ill-defined
3
2
1 1 21
Total................................| 425
Stillbirths....................\............
Grand total
z
425
17
3
3
5
1
2
3
5
3
= z
56 17 14 2
10
1
29 9
39 9 5
38
1 1
2
8 2
3
9
7i
a
2
1
100
36 23 5
17
3 9 52 13 66 19 5 41 6 5 1 4 13 2
9 1
38
254 979 250 551 2,459
61 � 55 104 220
254 1.040 305 655 2,679
Note.�The deaths occurring in Ancon and Colon hospitals result from cases taken from the cities of Panama and Colon and the Canal Zone, and in the table of vital statistics are properly credited to either Panama, Colon, or the Canal Zone.
\

22
Discharges and Deaths of Employees in the Hospitals of
the Isthmian Canal Commission, from all Causes.
Diseases
I. General diseases.
Discharged.
Typhoid fever (abdominal typhus)
Relapsing fever....................
Malarial fever.....................
Estivo-autumnal malaria..........
Tertian malaria...................
Quartan malaria..................
Mixed malaria.....................
Malarial cachexia..................
Hemoglobinuric fever.............
Vaccinia..........................
Measles............................
Influenza..............................
Dysentery.............................
Bacillary dysentery...................
Amebic dysentery.....................
Leprosy...............................
Erysipelas.............................
Other epidemic diseases...............
Beriberi...............................
Purulent infection and septicemia.....
Tuberculosis of the lungs..............
Tuberculosis of the meninges..........
Abdominal tuberculosis...............
Pott's disease.........................
Cold abscess and abscess by congestion
White swelling........................
Tuberculosis of other organs...........
General tuberculosis...................
Syphilis........................................................
Gonorrhea (5 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 and other malignant tumors of the skin.................
Cancer and other malignant tumors of other organs, or of organs
not specified..................................................
Other tumors (tumors of'the female genital organs excepted)----
Acute articular rheumatism....................................
Rheumatism, articular, subacute, and chronic..................
Gout...........................................................
Diabetes.......................................................
Anemia, chlorosis..............................................
Other general diseases...........................
Acute and chronic alcoholism..........i..........
Chronic lead poisoning..........................
Other chronic poisoning.........................
IliS 312 1 1
4
3
16 (il
1
1
27
57
2 1
Died.
12
3 24 1
12
3
5 44 2 1
2 2
4
1
3
3

23
Discharges and Deaths of Employees in the Hospitals of the Isthmian Canal Commission, from all Causes�Con.
Diseases.
Discharged.
II. Diseases of the nervous system and the organs of special sense.
Simple meningitis......................
Epidemic cerebrospinal meningitis.....
Pneumococcus meningitis..............
Progressive locomotor ataxia...........
Other diseases of the spinal cord........
Congestion and hemorrhage of the brain
Paralysis without specified cause.......
Other forms of mental alienation.......
Epilepsy............................
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.......................................
Organic diseases 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..............
Gangrene of the lungs Asthma..............
Pulmonary emphysema....................................
Other diseases of the respiratory system (phthisis excepted)
1 1
3 6 11 35 13 212 612 130
12
4
30 2
28 1
121 242 4
17
147
22
1
287 29 17
142 89 2 24 37 18
Died.
2 2 1 1
1
4 1
1
12
2 1
4
2
1
64 3 1
1
2
\

24
Discharges and Deaths of Employees in the Hospitals of the Isthmian Canal Commission, from all Causes�Con.
Diseases.
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 (2 years and over).......................
Intestinal parasites...........................................
Uncinariasis....................................................
Hernia and intestinal obstruction..............................
Other diseases of the intestines.................................
Cirrhosis of the liver............................................
Biliary calculi..................................................
Other diseases of the liver......................................
Abscess of liver.....i............................................
Diseases of the spleen...........................................
Simple peritonitis..............................................
Other diseases of the digestive system (cancer and tuberculosis
excepted)....................................................
Appendicitis and abscess of the iliac fossa.......................
Discharged.
VI. Diseases of the genito-urinary system and its adnexa.
Acute nephritis.............................................
Chronic nephritis...........................................
Other diseases of the kidneys and their adnexa.............
Calculi of the urinary tract.................................
Diseases of the bladder.....................................
Diseases of the urethra, urinary abscess, etc.................
Chancroids.................................................
Chancroidal buboe..........................................
Nonvenereal diseases of the male genital organs.............
Uterine tumors (noncancerous).............................
Other diseases of the uterus.................................
Other diseases of the female genital organs..................
Nonpuerperal diseases of the breast (cancer excepted).......
VII. The puerperal state.
Accidents of pregnancy Puerperal septicemia.. Childbirth.............
VIII. Diseases of the skin and cellular tissue.
Gangrene................................
Furuncle................................
Acute abscess, plegmon..................
Other diseases of the skin and its adnexa
59 104 1
62
133 14
35
218 116
38 2
55 11
3 2
10
92
50 157 10 4 44
66
308 25
279 1 1 6
1
1 1 1
9 116 192
296
Died
1
1
6 4 1
5
1
9 42
2
1
1

25
[scharges and deaths of employees in the hospitals i
the Isthmian Canal Commission, from all Causes�Con.
Diseases.
IX. Diseases of the organs of locomotion.
Died
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. Old age.
Senile debility
XIII. External causes
Fractures...................................
Dislocations................................
Other accidental traumatisms..............
Dynamite explosions.......................
Railroad accidents..........................
Burns and scalds...............'............
Burns by corrosive substances..............
Sunstroke..................................
Electric shock..............................
Inanition (starvation)......................
Absorption of deleterious gases (nonsuicidal)
Other acute poisoning......................
Other external violence.....................
XIV. Ill-defined causes.
Sudden death..................
Causes unspecified or ill defined Not sick........................
30 !
98 115 344
Total
30613�10
4
3
1

26
' Consolidated Hospital Report.
Hospitals.
Ancon Hospital
Employees____
Nonemployees Insane........
Total
Colon Hospital.
Employees____
Nonemployees
Total
Culebra Hospital.
Employees____
Nonemployees
Total...
Palo Seco Leper Asylum.
Employees____
N'onemployees
Total
Remaining Jan. 1.
W.
299 50 20
309
B
339 45 198
582
09 27
90
79 35
114
1 . 1
4
Taboga Sanitarium
Employees____
Nonemployees
Total
Employees____
Nonemployees. Insane.........
2
4
22
22
70 .. 9 ..
79 ..
Total
Admitted. I Died.
W.
B. W.
7,090 1,004 41
8, 74'
9,008 839 172
10,019
01 31 2
Discharged.
185
94
1,7681 1,723 590l 073
331
20
99
24 111
2,3041 2,390
44
2 0
4
70
74
I
11 192
203
7
10
I
2, 700
057 3,303
23
439 4'8 11,574 87 100 2,928
20 I OS; 4'
540 722 14,543
'0,7-10 1,720 172
- 2,04
H'
55
2
3
2
5
1
I
i 3,x
2S7
237 23
547
Transferred.
W.
5,074
R.
W.
B
8,880 123 1,5031 099 231 29l 120
2,010 00 2
8 8 9
0,006 9,705] 2,084 25
1,477
551
1,50$
524
2,028 2,032
237 12 9 23
240 35
3
04
4 173
1 3 3 14
Remaining Dec. 31
W.B.
07
17
4
4 17
4
2,703
001 3,304
9,257 !0,402
2. 770
29
1,300 12()
12,005 11,918
16
10
5
<
2,270 7.X
2
2:. 50 0
2,350 84
244 208 54 54 28 218
320 540
103 183 39 50
142 233
1 4
1
i
s
I
57
5
112
40.'. i ()3 2s
I
32 33
453
'43 2!K
M4

Consolidated Dispensary Report
Class. White. Black. Total.
Employees....................... 220, 320 213,947 434,267
Nonemployees..................... 49,486 30,016 79, 502
'Total....................... 269,806 243, 963 : 513,769
Consolidated Sick Camp Report.
Station/
Ancon..........
Corozal.........
Mirafiores......
Pedro Miguel...
Paraiso.........
Culebra.........
Empire.........
Las Cascadas...
Bas Obispo.....
Gorgona........
San Pablo......
Tabernilla......
Frijoles.........
Bohio..........
Gatun..........
Gatun Spillway.
Cristobal.......
Porto Bello.....
N ombre de Dios
Total.....
Re main-
ing Jan. 1.
W.
7
B.
4
1
2
(i
(i 17 1
3
3 4 10 2 3 6 7
8 3
Admitted.
W.
4
51
14
6
2
08
1.299 110 503 383 293 493 218 519 891 213 442 303
12 517 380
00 341 1
B
7,044
459 125 487 468 370 729 589 521 035 401 585 797 20 90 3,205 295 709 442 5
11,058
Died.
W. B.

1 3 2
1 1 2 1

.... 1

1 1

4 10
Discharged.
W.
1,237 85 464 316 240 312 171 307 702
148
320
234
4
202 245 53 274 1
5. 441
B.
449 98 407
391
300
381 399 379 544 339 423 030 12 43 1.341 198 537 343 4
7,230
Transferred
\V.
01
30 101
05
54 186
47 154 203
00 118
C.4
8 251 135
7 02
B.
1,012
7
27 77 73 03 353 184 139 � 91 129 158 100 10 45 1,858 97 228 90
Remain
ing Dec.
31.
W.
3,795
8
1
2
3
i
3
2
1
5
4
8
38
91

28
Consolidated Hospital, Sick Camp, and Sick in Quarters
Report. '
Remaining Jan. 1. Admitted. Died. Discharged., Transferred . 1 Remaining Dec. 31.
W. B. j 1 w- B. W. B. w. B. | w. B. w. B.
Hospitals........i Sick camps......! Total...... 0 540 51 722 68 14,543 7,044 12,041 11,058 138 4 547 10 12,065: 5,441 11,918 7,230 2,350 1,012: 1 84 3,795 \ 536 38 814 91
597 790 21,587 23,099 142 557 17,500 19,148 3,962 3,879 574 905
TOTAL ADMISSIONS TO HOSPITALS AND SICK CAMPS FOR THE
YEAR.
White. Black. Total.
Total admissions to hospitals and sick camps........ Less number of patients transferred from hospitals to sanitarium and from sick camps to hospitals whose admissions are duplicated in above figures......... Number of employees sick in quarters............... Net admissions to hospitals and sick camps, including employees sick in quarters........ 21,587 j 3,962 23,699 3,879 45,286 7,841
17,625 7,841 19,820 1,307 37,445 9,148
25,400 21,127 40,593

29
Subsistence and Operating Expenses.
subsistence expenses.
Number of days' rations issued to patients .................................
Total cost of rations issued to patients... Cost of subsistence per patient per day..
operating expenses.
Number of days' relief furnished patients.
Total cost of operation..................
Cost per capita per day..................
Total cost of operation, with amounts received from outside patients deducted................................
Cost per capita per day with above deduction...............................
Total cost of dispensaries................
479,682 $131,985.68 SO. 275
44,104 S11,810. 26 SO. 268
479,682 $625,401.40
81.30
�527,319. 68
81.10 $170,040.01
44,104 S22.269.38
$o. 5C
$22.269.38 SO. 50
Total.
523,786 $143,795.94
SO. 274
523,7SG $647,670.78
SI. 24
$549,589.06
SI. 05
Note.�This per capita cost includes all expenses of the hospitals except original construction and extensive repairs.
Average Number of Employees Constantly Sick During
the Year in Hospitals, Sick Camps, and Quarters.
Hospitals.
Ancon hospital.......
Colon hospital........
Culebra hospital.......
Palo Seco lep�r asylum Taboga sanitarium_____
Total
White. Black. Total.
� ! 265.29 341.09 600.38
i 69.51 115.80 185.37
.14 .28 .42
1.04
J 59.78 j 1.04 1 59.78
394. 72 458.27 852.99

30
Average Number of Employees Constantly Sick During the Year in Hospitals, Sick Camps, and Quarters-
Con.
Ancon...........
Balboa..........
Corozal..........
Miraf lores........
Pedro Miguel____
Maraiso..........
Culebra..........
Empire..........
Las Cascadas�
Bas Obispo......
Gorgona........,
San Pablo......
Tabernilla......
Frijoles.........
Bohio..........
Gatun..........
Gatun Spillway.
Cristobal.......
Porto Bello.....
Nombre de Dios
Total
Sick camps.
White. Black.
8.23
1.94
Sick in quarters.
Total. White. Black.
.58 3.26 3.35
2. 30
3. 41 2.07 3.90 5. 74 1.47 2.95 2.20
.05 2.82 2. 10
.41
3.99 . 13
.87 2.77
3. 77 2.77 4.00 4.61 4.22
4. 73 3.77 4. 50 7.18
. 11
.20 13.70 1.75 0.02 4. 19 .20
10.17
1.45
6.03 7. 12
5.07
7.41
6.68
8.12
10. 47
5.24
7.51
9.38 . 11
.31
10.58
3.91
7.03
8.18
.33
121.10
2.35 1.82 1.42
.16 2. 49 1.02 3.65 5.98 2.28 2.01 6.48
.28 1. 14
.08
. 12
3.40
13. 00 1.03
. 19
50. 10
0.01 .20 .03 .02
.03 .22 1.32 .24 . 10
. 70 .03 .01 .20 . 14 .04
Total
.01 .58
10.;�
2.30 2. 02 1.45
. 18 2.52
1.84
4.97
0. 22
2. 44 2.01 7.27
.31
1. 15
.28
. 20
3. 44
19.41 1.04 .77
�50.54
St' MM A RY.
Hospitals. Sick camps. Quarters. Total.
Average number of employees sick daily: 394.72 458.27 1 49.02 72.08 1 50.10 � 10.38 493.90 540. ?:*
852.99 121.10 60.54 J 1,034.63
Average number of employees sick dailv, per thousand: 83.85 12.91 4.20 2.03 4.30 .29 42. 35 15.23
18.08 2.57 1.28 21.93 -

Outside Patients Treated in Hospitals and Amounts Col
lected for their treatment.
Patients for whom the Republic of Panama pays
75 cents per day..............................
Patients for whom the Canal Zone government
pays 30 cents per day.........................
Patients pa3Ting 30 cents per day for themselves... Patients from the Republic of Panama paying
other prices...................................
Patients from the Canal Zone paying other prices. Patients from the Republic of Panama not
paying........................................
Patients from the Canal Zone not paying........
Total.....................................
Number' cases treated. Number days' relief. Amount.
2,107 59,349 $44,511.75
408 9,575 2,872.50
1,170 13,470 4,041.00
917 8,591 19,485. 70
2,356 i8,o:e 27,170. 77
483 7,423 !
2,107 42.607
9,548 159,031 98,081.72
Note.�Patients carried from one month to another are considered as separate cases in above table.
Surgical Operations Performed in Hospitals.
Abscess of lung......................
Accouchement force.................
Adenectomy:
Axillary.........................
Inguinal, single.................
Inguinal, double................
Cervical.........................
Femoral.........................
Inguinal and femoral............
Amputation:
Arm............................
Arm and leg....................
Arm and both legs..............
Breast..........................
Cervix..........................
Digits...........................
Foot............................
Hip.............................
Leg.............................
Legs, both, and thigh...........
Legs, both......................
Leg and trephine..........*......
Metacarpus.....................
Metacarpus and metatarsus.....
Thigh...........................
Thigh, double...................
Died.
2 2
8 368 31 25 19 3
12
2
1
10 " 1
00 3 4
19 2
2 1 1
2 10
3
1
2
2 1 1
3 2

32
Surgical Operations Performed in Hospitals�Continued.
Arthrectomy, knee............
Arthrotomy, knee.............
Cholecystectomy...............
Cancer of breast (Halstead's)..
Craniotomy...................
Castration.....................
Curettage, uteri...............
Curettage and trachelorrhaphy
Cystotomy, suprapubic.......
Endometrectomy.............
Excision:
Adenoma of breast........
Breast....................
Bunion (Mayo's operation)
Epithelioma of face........
Varicose veins.............
Fistula in ano.................
Fracture:
Patella, repaired..........
Skull......................
Skull, trephine.............
Various, wired.............
Various,compound, wired. Hemorrhoids:
Clamp and ligature.........
Whitehead's operation.....
Herniotomy, inguinal:
Single......................
Double.....................
Strangulated...............
And umbilical.............
And femoral, double.......
Single, and varicocele......
Single, and appendectomy.
Double, and appendectomy
Double, and ventral........
Single, and ventral.........
Herniotomy:
Femoral....................
Ventral.....................
Hydrocele....................................
Hydrocele:
Single....................................
Double...................................
Radical...................................
Incision of abscess (septic pneumonia)........
Laminectomy................................
Laminectomy, cervical.......................
Laparotomies:
Abscess of liver...........................
Abscess of liver, multiple, with peritonitis
Abscess, paranephritic......................
Abscess, pel vie..............................
Abscess, subphrenic, with general peritonitis Appendectomy..............................
1 1 1 1
10
8
100 2 1 1
1
0
3 0 4
4
9
28
15
82 33
127 108
19 1
2 3 2 1 1 1
3 7 54
17 9
14 1 7 1
36 1 1
12 1
115
Died
1
1
I
3
1
I
1
1
3 1
8 1
1

33
Surgical Operations Performed in Hospitals�Continued.
Laparotomies-? Con tin ued. A ppendectomy�
Acute gangrenous........................
And round ligament suspension of uterus
And salpingectomy......................
With pelvic peritonitis..................
And ovarian cystectomy.................
And localized peritonitis.................
And nephropexy........................
And general peritonitis..................
Appendecostomy............................
Carcinoma of colon..........................
Carcinoma of ovaries, peritoneum............
Cecostomy...................................
Cecostomy and ventral herniotomy.........:
Cholelithiasis................................
Cholecystectomy................................
Do..........................................
Cholecystostomy, cholelithiasis, and cholecystitis
Cholecystitis, gangrenous........................
Cyst of liver, eehinococcus.......................
Ectopic gestation................................
Enterorrhaphy..................................
Exploratory.....................................
Exploratory-Abscess of liver..............................
Carcinoma...................................
Hemorrhage.................................
Hepatic neoplasm...........................
Sarcoma.....................................
Stab wound.................................
Gastroenterostomy..............................
Hematoperi toneum..............................
Hysterectomy...................................
Hysterectomy-
Supravaginal..........................
With appendectomy...................
Hysteromyomectomy......................
Hysteromyomectomy, with appendectomy
Hypernephroma...........................
Intestinal obstruction......................
Mvomectomv..............................
Number.
Nephrotomy...............................................
Oophorcystectomy, amputation of cervix, perineorrhaphy.
Ovariotomy...............................................
Ovariotomy and appendectomy...........................
Perihepatitis, chronic......................................
Peritonitis�
General appendix......................
Diverticulitis...........................
Rupture of intestine....................
Tuberculous............................
General.................................
General, stab wounds...................
Appendectomy and ventral herniotomy
Chronic hemorrhagic...................
Chronic.................................
Oriein unknown........................
3 23 4
7
2
4 1 4 4
2 1 3 2 1 3
2
2
1 1 1 1
8
1 2 1 1 2 1 2 1 14
2 4 1
3 1 1 1 3 1
5 1
2
4
1 2 3 3 1 1 1 1 1
I
Died.
2 2
3
1
1 1
1
1 1
1
i
l
l
2
2 1 1
30613�10-5

34
Surgical Operations Performed in Hospitals�Continued
Number.
Laparotomies�Continued.
Resection, intestinal, for intussusception...................
Round ligament suspension of uterus......................
Round ligament suspension of uterus, appendectomy and
myomectomy............................................
Round ligament suspension of uterus, and salpingectomy.. Rupture of liver, traumatic................................
salpingectomy............................................
Salpingectomy, double....................................
Salpingo-oophorectomy and appendectomy................
salpingo-ooporectomy, appendectomy, trachelorrhaphy,
and perineorrhaphy.....................................
Salpingo-oophorectomy....................................
Sigmoidopexy.............................................
Stab wound...............................................
Perineorrhaphy...............................................
Perineorrhaphy and trachelorrhaphy..........................
Perineoplasty (Ilolden's operation)............................
Plastic for severe injuries......................................
Prolapsus rectum..............................................
Removal of fragment of hone from fractured femur.............
Resection of knee, tubercular..................................
Resection of humerus..........................................
Resection of metatarsals.......................................
Retroflexion of uterus.........................................
Sarcoma of elbow..............................................
Shortening round ligaments..................................
Skin graft....................................................
Spina-bifidia, meningomyelocele..............................
Stricture of urethra...........................................
Stricture4 of urethra and external urethrotomy................
Tenorrhaphy.................................................
Thoracotomy, exploratory....................................
Trachelorrhaphy..............................�...............
Trephine, cerebellar tumor...................................
Tuberculosis, cervical spine...................................
Urethrotomy:
Internal........................^.......................
Perineal..................................................
Vaginal sections...............
Varicocele.....................
Various other major operations Various other minor operations
1 7
1
3 1
9 1 9
2 1
2 2
72 11
6
3 2
1
4 1
1 1 1
39 1
1 1 1
."> 1 1
32
KM)
3. :>s:<
Pied.
1
1
1
1
1
1
3
Total
5. Wi7

:>5 �
oi kuations am) work performed in' eve, ear, nose, a ni*
Throat Clinics.
Operations.
Number.
Adenectomy...........................
Adenectomy and tonsillectomy.........
Adenectomy and tonsillotomy.........
Advancement of internal rectus........
Abscess of nasal septum................
Amputation of uvula...................
Curetage of ear.........................
Cut throat treated......................
Dilation of lachrymal stricture..........
Drainage of:
Antrum............................
Frontal sinus.......................
Maxillary sinus.....................
� Sphenoid sinus----..................
Enucleation............................
Evisceration............................
Excision of alveolar process.............
Excision of growth under tongue.......
Excision of lymphoid angioma.........
Exploratory, mastoid..................
Expression for follicular conjunctivitis..
Expression for trachoma................
Extraction of cataract..................
G rat t age...............................
Incision of:
Abscess back ol ear.................
Abscess of nasal septum.........
Alveolar abscess....................
Peritonsillar abscess................
Nasal sinusitis......................
Dacryocystitis......................
Furuncle, auditory meatus.........
Iridectomy.............................
Killian's operation�frontal sinus.......
Mastoid:
Radical, and ligation of jugular vein
Simple.............................
Radical............................
Needling cataract..................
Snaring nasal polypoid tumor.....
Snaring tonsillar polypoid tumor...
Opening lachrymal tube...........
Pterygium........................
Pterygium, double................
Paracentesis.......................
Paracentesis of cornea.............
Paracentesis of membrana tympani
Plastic on:
Ear...........................
Eyelid........................
Face..........................
Lip............................
Nose..........................
Plastic and skin graft..............
Ptosis, operation for...............
45 9
1
2
1 1 1 1
] 1
3 12 1
3
9
Died.
22 1
1
6 6 8
2 1 1
63 1 8 9
18
3 8 1 1 5 1
9
3 1
4 i
19
1 1 1 1
70
2
10
1 I
1

36
Operations and Work Performed in Eye, Ear, Xose, and
Throat Clinics�Continued.
Operations.
Removal of:
Bullet from jaw........................
Nasal spur.............................
Nasal rhinolith.........................,
Necrossed turbinal.....................
Necrossed vomer.......................
Polyp..................................
Retropharyngeal abscess....................
Rolling operation for follicular conjunctivitis Submucous resection of nasal septu: Submucous resection of spur of nose
Straightening of nose...............
Tenotomy..........................
Tonsillotomy.......................
Tonsillectomy......................
Tonsillotomy and tonsillectomy----
Trichiasis, double..................
Turbinectomy.....................:
Various other minor operations.....
fotal
Examination of school children..................
Examination of employees for vision and hearing
Refractions......................................
Number. Died.
1
1 1 7 i 5 65 6 1 4 34 4 4 456

1,149 | 1
509 219 1.902 10,839

�Consolidated Ward Laboratory Report of all Hospitals. Blood examinations...................................... 20,272
Est ivo-aut umnal.................................... 5, 395
Ten inn
Singh'. Double
2
181 01
Mixed tertian and estivo-aut umnal................... 126
1 1
Quartan............................................
Lepra bacilli........................................
Differential blood counts............................. L
Leucocyte counts................................... L SJ>1|
Red blood counts................................... 77
Red and white blood counts......................... 50
Hemoglobin estimations.............................. 1,130
Filaria.............................................. {)
Spirilla obermeierii..................................
1 - .................. 1
................ 45
................ 33
Spirochete of relapsing lever........................
Blood cultures......................................
Widals.............................................
Guaiac and turpentine tests for invisible blood...... 5o

37
Stool examinations....................................... 7, G67
Ascaris lumbricoides................................. 370
Uncinaria ova...................................... 1> 319
Uncinaria worms.................................... 39
Trichocephalus dispar............................... 999
Strongyloides intestinalis............................. 229
Tenia.............................................. 9
Tenia saginata....................................... 2
Ameba............................................. 22/
Ameba coli......................................... 13
Ameba dysenteria.................................. 15
Ciliated monads..................................... 271
Flagellated monads................................. 10
Bilharzia.................................... ...... 12
Pus and blood...................................... 764
Pus and epithelial cells............................. 59
Balantidium coli.................................... 3
Tubercular bacilli.................................. 5
Lepra bacilli........................................ 1
Urine examinations..................................... 26, 366
Albumen............................................ 9,251
Albumen and casts.................................. 4, 952
Sugar............................................... 38
Pus and blood...................................... 581
Gonococci.............^......,...................... 5
Indican............................................ 4 �
Epithelium......................................... 148
Hemoglobin........................................ 10
Bile............................................... 2
Hyaline and granular................................ 1
Cylindroids......................................... 1
Diazo reactions...................................... 9
Microscopical examinations.......................... 412
Specific gravity estimations.......................... 311
Urea estimations.................................... 20
Sputum examinations.................................... 1, 896
Tubercular bacilli.................................. 220
Pneumococci....................................... 8
Miscellaneous:
Examinations of�
Pleural effusions................................. 9
Spinal fluid..................................... 14
Vaginal and urethral discharges................... 156
Chancre scrapings................................ 1
Pus, blood, and tissue.......................... 259
Various smears and discharges.................... 107

3S
ANCON HOSPITAL.
Class.
Isthmian Canal Commission employees ..........
Panama Railroad employees.......
Pay patients......
Charity patients...
Insane patients____
Total
Remaining Jan. 1. Admit ted.
w. B. \Y. B.
291 292 0,855 6,981
S 41 9 1 20 47 27 19s 241 2.027 l.Htio u\s 244 371 41 172
3<�9 582 8,741 10,019
Pied.
Discharged
T
i J(
ferred.
Remaining 1 >ec. 31
W.
57 4
23 8
2
b. \v.
152 4.9'!0
94
33
42
81
23
174
1.2(H) 237
�>o
� �
331
I!
w.
B.
(i.9lC> 1.9-45
1.979 40N
291 120
9.705
71
s
3
2,084
2 6
9 25
\Y.
B.
244 197
71
34 20
49
5
320
2S 21 s
540
Average number of days' treatment per employee for the year:
White............................................
IJ lack
13. 54 13. 71
Total
13. 64
Average number of employees constantly sick during the year: ' \ White............................................
........................................... 265. 2f>
Black.............................................. 341.05)
Total........................................... 606. 38
Number of days' relief furnished patients................ 346, 260
Cost of subsistence per patient ]><>r day.................. $0. 248

:}<)
Nationality.
Class.
Isthmian ('anal Commission employees____
Panama Railroad employees
Pay patients. .. Charity patients Insane patients
Number Americans. Other nations.
treated. White. Black. White. Black.
14,419 2, 888 17 4,258 | 7,256
2, 323 1,887 651 431 165 954 146 12 2 2 1 1. 84 447 107 49 1 2,072 484 397 �370
�
19. 711 4, 165 22 4,945 i 10,579
Operations.
(See report of all surgical operations.)
Laboratory Report
'See consolidated ward laboratory report.)
COLON HOSPITAL.
Class
Isthmian Canal Commission employees.
Panama Railroad employees............,
Pay, private.........
Pay, municipal......
Zone, eharitv........
Total..........
Remaining Jan. 1.
Admitted.
\Y.
b.
til
8 IS
7
51
28
7 17 11
W.
% 114
1.402
366 456
8 132
2.364
Died
b.
\v. b.
1.021 Hi 58
702
311
53
::09
4
12
41
41 14
5(i
Discharged
\v.
1.181
29(> 427 12
112
b.
Trans forred
Remaining
AY.
SS4
B24 200
46 212
177
B0
9
3
1 1
2,390 44 210 2,028 2.032
24(5
1
3 19
Dec .31.
B.
' 89 121
14 r.2
25 1(1
7
14 33
142 23:;

40
Average number of days' treatment per employee for the
vear: White
14. 63
Black............................................... 26. 12
Total............................................ 20. 18
Average number of employees constantly sick during the
year: / M 1
White............................................. 69. 51
Black............................................... 115.86
Total............................................ 185.37
Number of days' relief furnished all patients............... 95,456
Cost of subsistence per patient per day................... $0. 263
Nationality.
Class.
Isthmian Canal Commission employees
Panama Railroad employees
Pay, private... Pay, municipal Zone, charity. .
Total
Number treated. | Americans.
White. 1 Black.
2, 535 1, 104 789 83 459 � 774 274 257 1 49 8 1

1
4. 970 0 1 ' J 1, 355 10 1 1
Other nations.
White.
689
100 214 12 90
1, 105
B1 ae k
1,064
729 318
70 319
2, 500
Operations.
(See rejjort of all surgical operations.)
Laboratory Rki'okt
(Sec consolidated ward laboratory report.;

I
41
CULEBRA HOSPITAL.
Class.
Employees____
Nonemployees.
Total....
Re" Ad-
ffftf mined.
Died
Discharged.
Sed" lining leirea. �dqc.si.
W., B.
W.l B. W. B
W. B.
1 1
4
2 4
4
70
74
11
192
203
3
2
5
W
3
B. W
4
64 il73
1 3 3 14
1
4
67 177
4
17
r,
B.
1 7
Average number of days' treatment per employee for the
year: iL White
13. 25
Black............................................... 10. 20
Total.............................................. 11.07
Average number of employees constantly sick during the year: '�''<
White..........:....................................
Black Total.
.........;.................................... 0.14
.............................................. 0.28
............................................. 0.42
Number of days' relief furnished all patients............... 2, 997
Cost of subsistence per patient per day................... $0. 247
Nationality.
Class. Number treated. Americans. ! Other nations.
White. Black. 1 White. | Black.
Employees................. .......... 16 : 267 s 1 i 11
Nonemployees.........................i Total............................ 19 1 3 52 : 193
283 19 3 57 204
�
Operations.
(See report of all surgical operations.)
Laboratory Report. (See consolidated ward laboratory report.)

42
PALO SECO LEPER ASYLUM.
Class. Remaining Jan. 1. | Admitted. Died. 1 Discharged.] Transferred. Remaining Dec. 31.
w. B. W. B. W. B. \Y. B. W. B. 1 W. B.
Employees................. 7 7 9 23 f 4 2 i 3 2 7 .... 1 1 21 11 33
Pay cases................... 18 4 22 1 1 .... i
Charity cases...............
Total................. ---- i .... 4 ----
Average number of days' treatment per employee for the
year, black............................................ 03. 17
Average number of employees constantly sick during the
year, black............................................ 1. 04
Number of days' relief furnished all patients.............. 9, 883
Cost of subsistence per patient per day................... $0. 287
Nationality.
Employees......
Pay patients____
Charity patients
Total.....
Class
Other nations
treated. White. Black.
7 7
20 1 25
13 13
40 1 45

4:;
TAIiOGA SANITARIUM.
# Class. Remaining Jan. 1. Admit-mitted. Discharged. Transferred. Remaining Dec. 31.
Employees................... Families of employees....... 70 9 2,706 657 2,703 661 16 57 5
Total..................
79 3.363 3,364 16 62
Average number of days' treatment per employee for the
year
8. 02
Average number of employees constantly sick during, the
year
59. 78
Number of days' relief furnished all patients.............. 25, 086
Cost of subsistence per patient per day................... $0. 713
Nationality.
Class Number Class- treated. Americans. Other nations.
Employees...................................... Families of employees........................... 2,776 666 1,855 628 921 38
Total..................................... 3.442 2,483 959

Note.�No colored patients treated at Taboga Sanitariui
SANTO TOMAS HOSPITAL
Class. � Remaining Jan.1. Admitted. Died. Discharged . � � i^^v _i � w - �r - �-- Remaining Dec. 31.
Fay patients................... Charity patients............... Total.................... 26 208 1,231 4,109 13 273 1,230 3,824 14 220
234 5.340 286 5,054 234
Average number of days' treatment per patient........... 15.18
Average number of patients constantly sick............... 222. 02
Number of days' relief furnished patients................. 81,038
Cost of subsistence per patient per day................... SO. 36

44
SANTO TOM AS HOSPITAL�Continued.
Nationality.
Class. Number Other nations.
treated. White. Black.
Pay patients...................................... 1,257 4,317 239 900 1,018 3,417
Charity patients..................................
Total.......................................
5,574 1.139 1 4.435

Operations.
Number. Died.
� Mai or......................................... 636 | 1,174 18
Minor.........................................
Total..................................
1,810 18

Dispensary.
Class. White. Black. Total.
Natives............................... 220 161 813 93 1,033 254
Foreigners............................
Total...........................
381 906 1, 287

45
ANCON DISPENSARY, SICK CAMP, AND EMPLOYEES SICK
IN QUARTERS.
DISPENSARY.
Class. ; White. Black. Total.
Employees........................... | 11,670 10,181 21,851
Nonemployees......................... l 1,769 1, 243 3; 012
Total........................... 13, 439 11,424 1 J 24,863
SICK CAMP.
Remaining January 1................
Admitted...........................
Discharged...........................
Transferred........................
Remaining December 31.............
Average number constantly sick......
Average number of days' treatment per
patient...........................
Number of days' relief...............
7 7
1, 299 459 1, 758
1, 237 449 1, 686
61 7 68
8 3 * 11
8. 23 1. 94 10.17
2. 32 1.56 2.12
3, 005 710 | 3, 715
EMPLOYEES SICK IN QUARTERS.
Days excused for quarters.............. 860 3 863
New patients excused for quarters..... 359 1 360
Average number constantly sick....... 2. 35 0. 01 2. 36
Average number of days' treatment per
patient............................. 2.39 3. 00 2.40

46
BALBOA DISPENSARY, AND EMPLOYEES SICK IN
QUARTERS.
DISPENSARY.
Class. White. Black. Total.
I Employees........................... 12, 650 15,183 27, 833
Nonemployees......................... 1,265 i 734 � 1,999
Total......!.................... 13, 915 15,917 29, 832
, EMPLOYEES SICK IN QUARTERS.
Days excused for quarters.............. 663 71 734
New patients excused for quarters..... 431 41 472
Average number constantly sick....... 1.82 0. 20 2.02
Average number of days' treatment per
patient............................. � I . 1. 54 1.73 1. 56 0
COROZAL DISPENSARY, SICK CAMP, AN 11 EMPLOY! ES
SICK IN QUARTERS.
DISPENSARY.
Class. White. Black. Total.
Employees........................... 7, 921 5,356 13, 277
Nonemployees......................... 2,108 595 2, 703
Total........................... 10, 029 5, 951 15, 980
SICK CAMP.
Admitted............................ 116 I 125 241
Discharged............................ 85 98 183
Transferred........................... 30 27 57
Remaining December 31.............
Average number constantly sick......
Average number of days' treatment per
patient
Number of days' relief furnished
1
1.45
2. 21 530

47
COROZAL DISPENSARY, SICK CAMP, AND EMPLOYEES
SICK IN QUARTERS�Continued.
EMPLOYEES SICK IN QUARTERS.
Class.
Days excused for quarters.........
New patients excused for quarters Average number constantly sick..
Average number of days' treatment per
patient
Total.
531 263 1.45
2. 02
MIRAFLORES DISPENSARY, SICK CAMP, AND EMPLOYEES SICK IN QUARTERS.
DISPENSARY.
Class. White. t 1 Black. Total. �
Employees........................... 7,956 6, 527 14,483
Nonemployees......................... 232 308 540
Total........................... 8,188 6,835 ! 15, 023
SICK CAMP.
Remaining January 1
4
Admitted............................ 563 487 ! 1, 050
Discharged............................ ! 464 | 407 ! ! 871
Transferred........................... 101 i i 77 ; 178
Remaining December 31.............. 2 | 3 5
Average number constantly sick....... 3. 26 , 2.77 | i 6.03
Average number of days' treatment per
patient............................. 2. 11 | 2.09 1 2. 10
Number of days' relief furnished....... � 1.191 ! | 1,010 i 2,201
EMPLOYEES SICK IN QUARTERS. �
Days excused for quarters.............. 58 6 64
New patients excused for quarters..... 44 6 50
Average number constantlv sick....... 1 0. 16 0. 02 0. 18
Average number of days' treatment per
patient............................. 1. 32 1.00 1.28

4S
PEDRO MIGUEL DISPENSARY, SICK CAMP, AND EMPLOYEES SICK IN QUARTERS.
DISPENSARY.
(lass.
White.
Black.
Total.
Employees........................... 9, 205
Nonemployees....................... 1,478
Total......................... 10, 683
SICK CAMP.
Remaining January 1 Admitted...........
Discharged..........................
o
Transferred...........................
Remaining December 31..............
Average number constantly sick......
Average number of days' treatment per
patient.............................
Number of days' relief furnished........
9, 205 1,478 7, 767 802 16, 972 2,280
10,683 8, 569 19,252

1 3 4
383 468 851
316 391 1 707
65 73 138
3 7 ' 10
3.35 3. 77 1 7.12
3.21 ' 2.98 3.08
1,223 1,385 � 2,608
EMPLOYEES SICK IN QUARTERS.
Days excused for quarters............
New patients excused for quarters.....
Average number constantly sick.......
Average number of days' treatment per patient.............................
910 13 923
392 1 4 396
2.49 1 .03 2.52
�2. 32 3. 25 2.33

49
PARAISO DISPENSARY, SICK CAMP, AND EMPLOYEES
SICK IN QUARTERS.
DISPENSARY.
Class. White. Black. j Total.
Employees........................... 5,834 4, 898 10, 732
Nonemployees......................... 2,037 1,403 3,440
Total......................... 7,871 6.301 14,172
SICK CAMP.
Remaining January 1 Admitted...........
Died...............................
Discharged.........................
Transferred..........................
Remaining December 31.............
Average number constantly sick.....
Average number of days' treatment per patient
Number of days' relief furnished
2 4 . 6
293 370 663
1 3 4
240 306 546
54 63 117
2 2
2. 30 2. 77 5.07
2.85 2. 72 2. 77
839 1,011 1,850
EMPLOYEES SICK IN QUARTERS
Days excused for quarters...........
New patients excused for quarters____
Average number constantly sick.....
Average number of days' treatment per patient............................
1
592 82
243 45
1.62 . .22
2. 44 0 1. 82
674 288 1.84
2. 34

50
CULEBRA DISPENSARY, SICK CAMP, AND EMPLOYEES
SICK IN QUARTERS.
DISPENSARY.
Class. AVhite. Black. Total.
Employees........................... 28,451 27,088 55, 539
Nonemployees....................... 9,451 6, 323 15,774
Total......................... 37, 902 33,411 71,313
SICK CAMP.
Remaining January 1 Admitted...........
Died...............................
Discharged.........................
Transferred..........................
Remaining December 31.............
Average number constantly sick.....
Average number of days' treatment per
patient............................
Number of days' relief furnished......
6 10 16
493 729 1,222
� 2 2
312 381 693
186 353 539
1 3 4
3.41 4.00 7.41
2.50 1. 98 2.19
1,244 1,458 2, 702
EMPLOYEES SICK IN QUARTERS.
Days excused for quarters
New patients excused for quarters Vverage number constantly sick
Average number of days' treatment per patient............................
1,815 740 4. 97
2. 45

51
EMPIRE DISPENSARY, SICK CAMP, AND EMPLOYEES
SICK IN QUARTERS.
DISPENSARY.
Class.
Employees........................... 20,141
XonempL >yees....................... 6, 578
Total
White. Black.
20,141 6, 578 17, 500 3, 858
26, 719 21, 358
Total.
37, 641 10,436
48, 077
SICK CAMP
Remaining January 1 Admitted...........
Discharged.........................
Transferred..........................
Remaining December 31.............
Average number constantly sick.....
Average number of days' treatment per
patient
Number of days' relief furnished
2 2
218 589 807
171' 399 570
47 184 231
8 8
2. 07 4.61 6. 68
3. 47 2. 88 3. 04
756 1, 683 2,439
EMPLOYEES SICK IN QUARTERS
Days excused for quarters............ 2,184 89 2, 273
New patients excused for quarters..... 1,096 58 1,154
Average number constantly sick...... 5. 98 .24 6. 22
Average number of days' treatment per
patient............................. 1. 99 1. 53 1. 97

52
LAS CASCADAS DISPENSARY, SICK CAMP, AND
EMPLOYEES SICK IN QUARTERS.
DISPENSARY.
1 Class. White. Black. Total.
Employees...........................* �- 12,555 8,850 ' 21.405
Nonemployees....................... 5,103 3,528 8, 631
Total........................... 17,658 12, 378 30, 036
SICK CAMP
Remaining January 1
Admitted Died
Discharged.........................
Transferred..........................
Remaining December 31.............
Average number constantly sick.....
Average number of days' treatment per
patient............................
Number of days' relief furnished......
6 if) 3
519 521
1 2
367 379
154 139
3 4
3. 90 4. 22
2.73 2.97 1
1,424 1,542
9
1.040
3
746 293
8. 12
2. 85 2. 966
EMPLOYEES SICK IN QUARTERS
Days'excused for quarters.......
New patients excused for quarters
833 2S9
Average number constantly sick......| 2. 28
Average number of days' treatment per patient............................. 2.88
57 12 0. 16
4. 75
890 301 2. 44
2. 96

' 53
BAS OBISPO DISPENSARY, SICK CAMP, AND
EMPLOYEES SICK IN QUARTERS.
DISPENSARY.
% Class. White. Black. Total.
Employees........................... 19,809 14,631 34,440
Nonemployees....................... 2,424 1,487 3, 911
Total........................... 22, 233 16,118 38,351
SICK CAMP.
Remaining January 1 Admitted...........
Died...............................
Discharged.........................
Transferred..........................
Remaining December 31.............
Average number constantly sick.....
Average number of days' treatment per
patient
Number of days' relief furnished
17 6 23
891 635 1,526
1 1 2
702 544 1,246
203 91 294
2 5 7
5. 74 1 4. 73 10. 47
2.31 ! 2. 71 2. 48
2,094 1,726 3, 820
EMPLOYEES SICK IN QUARTERS.
Days excused for quarters.......
New patients excused for quarters Average number constantly sick
Average number of days' treatment per patient............................
734 251 2. 01
2. 92
734 251 2. 01
2. 92

54
GORGON A DISPENSARY, SICK CAMP, AND EMPLOYEES
SICK IN QUARTERS.
DISPENSARY.
, . . Class. White. Black. Total.
Employees........................... 21,312 16,103 37, 415
Nonemployees....................... 6, 726 2,739 9, 465
Total........................... 28,038 18, 842 46, 880
SICK CAMP.
Remaining January 1 Admitted...........
Discharged.........................
Transferred..........................
Average number constantly sick.....
Average number of days' treatment per
patient
Number of days' relief furnished
1 8
2L3 461 674
148 339 487
66 129 195
1.47 3. 77 5. 24
2.51 2. 94 2. 81
537 1,377 1, 914
EMPLOYEES SICK IX QUARTERS.
Days excused for quarters.......
New patients excused for quarters Average number constantly sick
Average number of days' treatment per patient............................
2,364 288 2, 652
938 70 1,008
6. 48 0. 79 7. 27
2.52 1 4. 11 2. 63

5 o
SAN PABLO DISPENSARY, SICK CAMP, AND EMPLOYEES IN SICK QUARTERS.
DISPENSARY.
Class. White. Black. Total.
Employees........................... 5,730 5, 666 11, 396
Nonemployees....................... 225 393 618
Total........................... 5, 955 6,059 12,014
SICK CAMP.
Remaining January 1 Admitted...........
Discharged.........................
Transferred..........................
Remaining December 31.............
Average number constantly sick.....
Average number of days' treatment per
patient............................
Number of days' relief furnished......
3 8 11
442 585 1, 027
326 423 749
118 158 276
1 12
2. 95 4. 56 7. 51
2. 43 2. 86 2.67
1,078 1,663 2, 741
EMPLOYEES SICK IN QUARTERS.
Days excused for quarters.......
New patients excused for quarters Average number constantly sick
Average number of days treatment per patient............................
101 12 113
50 7 57
0. 28 0. 03 0. 31
2. 02 1. 71 1. 9S

56
TABERNILLA DISPENSARY, SICK CAMP, AND EMPLOYEES SICK IN QUARTERS. Lfe&feJKlfl
DISPENSARY.
Class. White. Black. J Total.
Employees........................... 7, 302 6, 650 13,952
Nonemployees......................... 1,214 1,163 2, 377
Total........................... 8, 516 7,813 | 16, 329
SICK CAMP.
Remaining January 1 Admitted...........
Discharged............................
Transferred...........................
Remaining December 31..............
Average number constantly sick....... 2. 20
Average number of days' treatment per
patient
Number of days' relief furnished
2. 70 804
3
797 636 160 4
7.18
3. 29 2, 639
EMPLOYEES SICK IN QUARTERS.
Days excused for quarters.........
New patients excused for quarters Average number constantly sick
Average number of days' treatment per patient............................
415 3
137 1
1. 14 0. 01
3. 03 3. 00
3
1,100
870 224
9
9. 38
3.13 3,423
418 138 1.15
3. 03

57
FRIJOLES DISPENSARY, SICK ( AMP, AND EMPLOYEES
SICK IN QUARTERS.
DISPENSARY.
SICK CAMP.
Admitted.. Discharged Transferred
Remaining December 31.............
Average number constantly sick......
Average number of days' treatment per
patient............................
Number of days' relief furnished......
EMPLOYEES SICK IN QUARTERS
Class. White. 1 Black. Total.
Employees........................... 1,134 6,057 . 7,191
Nonemployees......................... 16 22 38
Total........................... 1,150 6,079 1 7,229
26 26
12 12
10 10
4 4
0.11 0.11
1.82 1.82
40 40
Days excused for quarters.........
New patients excused for quarters Average number constantly sick..
Average number of days' treatment per patient............................
29 72 101
21 58 79
0.08 0. 20 0.28
1. 38 1.24 1.28
�

58
BOHIO DISPENSARY, SICK CAMP, AND EMPLOYEES
SICK IN QUARTERS.
DISPENSARY.
Employees
Nonemployees
Total
Class.
White.
799 225
1,024
Mack.
4,354 1,023
5, 377
Total.
5,153 1,248
6, 401
SICK GAMP.
Admitted...........................
Discharged...........................
Transferred..........................
Remaining December 31.............
Average number constantly sick,......
Average number of days' treatment per
patient............................
Number of days' relief furnished......
12 90 102
4 1 43 47
8 45 ' 53
2 2
0. 05 0.26 0. 31
1. 58 1.08 1.14
19 95 114
EMPLOYEES SICK IX QUARTERS
Day8 excused for quarters
I
New patients excused for quarters Average number constantly sick
Average number of days' treatment per
patient
i 42 50 92
19 j 29 48
0.12 ! 0. 14 0. 26
2.21 ! 1.72 1. 92

59
GATUN DISPENSARY, SICK CAMP, AND EMPLOYEES
SICK IN QUARTERS.
DISPENSARY.
Class. White. Black. # Total.
Employees........................... 17,992 29,635 47,627
3,072 941 4,013
Total........................... 21,064 30,576 51,640
SICK CAMP.
Remaining January ] Admitted...........
Died...............................
Discharged...........................
Transferred..........................
Remaining December 31.............
Average number constantly sick......
Average number of days' treatment per
patient............................
Number of days' relief furnished......
EMPLOYEES SICK IN QUARTERS.
Days excused for quarters.........
New patients excused for quarters Average number constantly sick
Average number of days' treatment per patient............................
1,240 14 1, 254
620 3 623
3.40 0.04 3. 44
2. 00 4. 67 2.01
; 14 14
517 3,205 3, 722
1 1
262 1,341 1,603
251 1,858 i 2,109
4 19 23
2.82 13.76 16. 58
2.00 1.57 1.63
1,028 5,021 6,049 �

60
GATUN SPILLWAY DISPENSARY AND SICK CAMP.
DISPENSARY.
Class. White. Black. Total.
Employees_____ 3, 930 3,218 7, 148
Total 3, 930 3,218 7,148
Admitted
SICK CAMP.
Discharged...........................
Transferred..........................
Average number constantly sick......
Average number of days' treatment per
patient....................�........
Number of days' relief furnished......
380 295 675
245 1 198 443
135 97 232
2.16 1. 75 3.91
2. 07 2.17 2.11
787 640 1,427
CRISTOBAL DISPENSARY, SICK CAMP, AND EMPLOYEES
SICK IN QUARTERS.
DISPF.N'SAKV.
Class. . White. Black. Total.
Employees........................... 19,152 16. 989 36,141
Nonemployees......................... 5,108 3,068 8,176
Total........................... 24, 260 ! 1 | 20,057 44, 317
SICK CAMP.
Remaining January 1................. I � 9
Admitted............................ 60 769 826
Discharged............................ 53 537 590
Transferred........................... 7 228 235
Remaining December 3 1.............. L0 10
Average number constantly sick.......i 0.41 7. 03
Average number of days' treatment per
patient............................. 2. 48 3. 16 . 3. 11
Number of days' relief furnished....... 149 1 2,418 2, 567

61
CRISTOBAL DISPENSARY, SICK CAMP, AND EMPLOYEES
SICK IN QUARTERS�Continued.
EMPLOYEES SICK IN QUARTERS.
Class. White, i [ % Black. Total.
Davs excused for quarters.............. 4, 768 1 2, 319 7,087
New patients excused for quarters..... 1, 843 784 2, 627
Average number constantly sick....... 13. 06 6. 35 19.41
Average number of days' treatment per
patient............................. 1 2.59 2. 96 2. 70
PORTO BELLO DISPENSARY, SICK CAMP, AND EMPLOY
EES SICK IN QUARTERS.
DISPENSARY.
Class. WJiite. Black. Total.
4 -Employees........................... 6, 663 7,023 13, 686
Nonemployees......................... 431 231 662
Total........................... 7,094 1 7, 254 14, 348
SICK C A MP.
Remaining January 1 Admitted...........
Died.................................
Discharged...........................
Transferred..........................
Remaining December 31.............
Average number constantly sick......
Average number of days' treatment per
patient............................
Number of days' relief furnished......
i 4 2 6
I 341 442 783
1 1 2
i 274 343 617
62 96 158
8 4 12
3.99 4.19 8.18
j 4.32 3. 48 3. 85
1,457 1,531 2, 988

62
PORTO BELLO DISPENSARY, SICK CAMP, AND EMPLOYEES SICK IN QUARTERS-Continued.
EMPLOYEES SICK IN QUARTERS.
Class. White. Black. Total.
Days excused for quarters.............. 595 2 597
New patients excused for quarters..... 277 2 279
Average number constantly sick....... 1. 63 0.01 1.64
Average number of days' treatment per
patient............................. 2.15 1.00 f 2.14
NOMBRE DE DIOS DISPENSARY, SICK CAMP, AND
EMPLOYEES SICK IN QUARTERS.
DISPENSARY.
Class. White. Black. Total.
Employees........................... 114 271 385
Nonemployees......................... 24 155 179
Total...........................1 138 426 564
V SICK CAMP.
Admitted............................ 1 5 6
Discharged............................ 1 4 5
Remaining December 31.............. 1 1
Average number constantly sick....... 0. 13 0.20 0. 33
Average number of days' treatment per
patient............................. 4.00 1.80 3. 00
Number of davs' relief furnished....... 4 6 10
EMPLOYKKS SICK IN QUARTERS.
1 G 5 18 24
New patients excused for quarters..... 10 14
Average number constantly sick....... 0. 1!� 0. 58 0. 77
Average number of days' treatment per
patient............................. 1. 50 1.80 1. 71
Xote.�Nombre de Dios dispensary and sick cum.' � nblished December 1, 1wj.

63
HOARD OK HEALTH LABORATORY.
Bacteriological examinations:
Municipal water supplies
Water from�
Springs.............
Condensers..........
193
..................................... 11
..................................... 226
The Colon Steam Bottling Works.................. 3
Tank carts......................................
Creeks..............
Reservoirs and rivers, Demijohns and filters
Ice plant, Colon.....
Gatun storage tank...
Mess hall at Gatun...
Coolers at Gatun.....
Ancon filter.........
Blood cultures...........
58 7 74 37
l
i
3 1
425
Throat cultures (diphtheria suspects).................. 189
Nose cultures (diphtheria suspects).................... 1
.'.................... 24
..................... 5
..................... 325
..................... 368
..................... 21
..................... 37
..................... 1
..................... 1
..................... 2
..................... 6
..................... 1
..................... 1
..................... 1
..................... 1
...................... 45
2
'............'. 1
..................... 1
..................... 1
..................... 12
Cultures from autopsies..........
Cultures from conjunctiva.......
Stools...........................
Urine.........................
Sputum.........................
Pus............................
Testicle........................
Bile...........................
Hydrocele fluid.................
Kneejoint fluid................
Gall-bladder fluid...............
Spleen pulp...................
Spinal fluid.....................
Surgical tissue..................
Various smears and specimens...
Kola champagne and soda water
Catgut sutures.................
Glanders suspect................
Milk for tubercular bacilli......
Soil for B. coli.................
"Tuberculo-kill" for telephone mouthpiece............ 1
Bacteriological and microscopical examination of urine. 1
Determinations:
Carbon dioxide in air of wards
:
Manganese in drillings of steam-shovel parts............ 2
Alkalinity in condensed and tap water----............ 2
Chlorine content in water B. coli, using lactose bile
126
85

64
Examinations:
Dogs, rabies suspects (post-mortems)................... 24
Calves (post-mortems)................................ 9
Rabbits (post-mortems).............................. 21
Rats (post-mortems).................................. 32
Monkey (post-mortem)................................ 1
Goat (post-mortem).................................. 1
Leper suspects........................................ 23
Quinine and urea.................................... 5
Typhoid-fever carrier suspect.......................... 1
Chemical examinations:
Candy............................................... 1
Cementing material.................................. 2
Crude carbolic acid.................................. 4
Crude oil............................................ 3
Fermented cane sirup................................. 1
Gasoline............................................ I
Ham, for preservatives................................ 1
Hatchet, for blood stains.............................. ]
Iron clay.......-.................................... 1
Lard................................................. 1
Liquid from Palo Seco................................ ]
Liquid from alcalde of Panama....................... 1
Metal, babbitt........................................ 1
Milk, Blue-label brand.............................. 1
Mother's milk........................................ 4
Methyl alcohol...................................... 6
Lignites............................................. 3
"Pynamine"......................................... 1
Paint............................................... 5
Rum................................................. 4
Stomach contents..................................... 13
Sand from Panama beach............................. 1
Urine............................................... 2
Vanilla extract....................................... 1
Water, reservoir..................................... 50
Wood alcohol......................................... 43
Agglutination reactions.................................... 79
Autopsies................................................ 285
Medico-legal post-mortems................................. 6
Sections of tissue prepared (parafiin)....................... 8,248
Sections of lissue prepared (frozen)......................... 103
Surgical pathological tissue and neoplasms reported........ 122
Bodies embalmed........................................ 59
Preventive treatment for hydrophobia completed.......... 11
Sanitary analyses of water................................ 314
Toxicologic^ examination................................ 1
Qualitative analysis of cylinder oil........................ 1
Microscopical examinations of water........................ 86

65
ISSUES OF QUININE
Months.
Kilograms.
January..................
February...............
March...................
April...................
May.....................
June.....................
July....................
August..................
September...............
October.................
November................
December................
Total.............
Average per month
230. 555 60.100
221. 200 29. 805 16. 061
172. 552 54.675 87. 600
184.600
61. 675 46. 225 262. 900
1,427.948 118. 995
Pounds avoir dupois.
508. 28J
132. 496 487. 658 65. 708 35. 408 380. 408 120.537 193.123 406. 969 135. 968 101. 907 579.590
3,148. 053
262.337
SANITATION�PANAMA.
Anopheles brigade:
Linear feet of ditches cleaned.................... 2, 075, 810
Linear feet of ditches dug......................... 5, 650
Square feet of weeds and grass cut and removed____ 1, 961, 395
Cesspools cleaned................................ 264
Loads of refuse removed from the city............ 3, 932
Disinfection brigade:
Houses disinfected and fumigated�
For beriberi.................................. 24
For diphtheria.............................. 4
For hemoglobinuria fever.................... 1
For typhoid fever............................ 1
For blackwater fever......................... 1
For pernicious fever.......................... 71
For tuberculosis.............................. 84
Number of cubic feet disinfected and fumigated____ 4, 902, 700
Houses fumigated for chicken pox................ 9
Material used:
Alcohol, wood...........................gallons.. 53
Axle grease.............................pounds.. 10
Brooms................................number.. 24
Bichloride of mercury....................pounds.. 15
Chloride of lime............................do.... 2,697

66
Material used�Continued.
Crude oil................................barrels.. 17,500
Flour.....................................do---- 5
Kerosene oil............................gallons.. 338
Larvacide.................................do---- 1, 495
Matches...............................packages.. 82
Mops...................................number.. 24
Nails....................................pounds.. 47
Newspapers........................____bundles.. 17
Paper, manila..............................rolls.. 1
Pyrethrum.............................pounds.. 523
Sulphur
do.... 3,860
Sulphur, flowers of.......................barrels.. 3
Tacks..................................papers.. 64
Destruction of dogs:
Number of dogs poisoned
........................ 673
Strychnine used~.........................grams.. 144
Beef used...............................pounds.. 62
Destruction of rats:
Number of rats eaught and killed................. 17, 004
Average number of rat traps in use............... 347
Poison used...............................boxes.. 341
Bread used.............................pounds.. 362
..................do.... 412
.......*...........do.... 160
Cheese used. Sausage used
Inspection of houses and yards:
Houses with no water connection. times inspected.. 1, 026
Houses with no sewer connection...........do---- 971
Traps in yards not connected with sewer----do---- 385
Water-rlosets, bad condition.................do---- 716
Houses with no water-closets................do.... 855
Houses with open cesspool closets...........do---- 95
Yards with bad drainage....................do.... 928
Houses and yards inspected...................... 32, 860
Houses and yards found in good condition-----: - - - 29,197
Persons notified to keep premises in good condition. 1, 641
Yards not cemented
Persons warned for having mosquito larvie on premises............................................ 665
Places where mosquito larvae were found......... 667
Number of inspection reports of defective sewer and water connections forwarded to superintendent
of public works................................. U>
New buildings: Number of plans submitted to health officer and approved................................ :*35

67
SANITATION�COLON.
[Including Cristobal and Mount Hope,]
Medical inspection:
Number of cases reported by medical inspectors---- 110
Number of cases inspected........................ 110
Number of cases sent to hospital.................. 69
Water and sewers:
Number of connections made during the year...... 90
Total number of connections made to date......... 546
Number of houses remaining to be connected...... 8
Number of outstanding permits.................... 23
Houses:
Plans approved................................... 77
Permits to repair issued.......................... 202
Permits to occupy issued......................... 48
Temporary permits to occupy issued............... 17
Number of houses in which defective plumbing fixtures were found and reported to the superintendent of public works......................... 1,181
Sanitation of Colon:
Number of load- of yard garbage removed----.---- 2,164
Average number of cans of garbage removed daily.. 3, 433 Number of�
Acres of vegetation removed............�....... 460
Acres of streets cleaned....................... 2, 622
Acres of streets sprinkled...................... 416
Private properties cleaned.................... 2, 284
Square yards of pools oiled.................... 60, 612
Crab holes oiled............................. 7, 600
( rab holes worked........................... 224, 220
Mosquito-breeding places found............... 2, 776
Dogs killed.................................. 66
Rats killed.................................. 7,284
Horses cremated............................. 22
Water receptacles treated.................... 1, 319, 514
Linear feet of ditches constructed............. 25, 250
Cubic yards of ditches constructed............. 6, 554
Linear feet of ditches maintained............. 366, 528
Notices to abate nuisances served.................. 4, 677
Number of nuisances abated....................... 3, 617
Sanitation of Cristobal:
Number of�
Square yards of pools oiled.................... 22, 851
Water receptacles treated...................... 129, 210
Mosquito-breeding places found............... 398
Crab holes worked........................... 43, 200
Linear feet of ditches maintained............. 2, 467
Linear feet of ditcher constructed............. 15

68
Sanitation of Mount Hope:
Number of�
Square yards of pools oiled.................... 53, 658
Water receptacles treated...................... 118. 895
Linear feet of ditches maintained............. 155, 414
Crab holes worked........................... 73, 229
Mosquito-breeding places found............... 1, 741
Linear feet of ditches constructed............. 2, 265
Cubic feet of fumigation...................... 156, 400
Mount Hope cemetery maintained.
SANITATION�BOCAS DEL TORO.
General cleaning:
Square yards of streets cleaned.................... 10, 300
Linear yards of water front cleaned................ 1, 700
Yards cleaned.................................... 254
Yards inspected.................................. 1,400
Houses inspected....................�............ 1,020
Barrels of garbage removed........................ 42, 880
Loads of garbage removed........................ 701
Loads of old lumber removed..................... 91
Loads of sand carted............................. 303
Loads of grass removed............................ 32
Persons notified to keep yard in sanitary condition. 255
Persons warned for breeding mosquitoes............ 108
Persons fined for breeding mosquitoes............. 20
Persons fined for other sanitary violations......... 7
Nuisances reported............................... 48
Nuisances abated................................. 15
Plans for closets a] >proved......................... 2
Mosquito brigade:
Square yards of swamp filled..................... 90
Square yards of swamp drained.................... 6, 960
Cubic yards of sand used.......................... 119
Square yards of pools oiled........................ 900
Square yards of grass cut and burned.............. 340
Linear feet of drain made......................... 991
Linear feet of drain cleaned........................ 690
Roof gutters repaired.............................. 43
Water receptacles overturned..................... 554
Breeding places found in barrels, tubs, etc........ 158
Catch basins of sewers oiled....................... 36
Wells oiled...................................... 34
Wells filled...................................... 8
Wells re-covered................................. 2
Barrels covered................................... 883
Barrel covers made.............................. 863

69
Mosquito brigade�Continued.
Barrels repaired
Barrels broken up...........
Barrels overturned...........
Barrels supplied with spigots Tanks screened and repaired
Tanks cleaned.............
Tanks oiled................
Tanks covered..............
920 56
74 663 286 3 2 4
Minimum number of men at work for one day...... 7
Maximum number of men at work for one day..... 16
Average number of men at work for one day....... 14
Material used:
Spigots................................number.. 453
Copper cloth (screening)...................rolls.. 18, 4
Wire netting (^-inch).......................do---- 10. 6
Mosquito oil............................barrels.. 8
Lumber.............................square feet.. 2, 200
Tacks, copper............................pounds.. 80
Staples, wire
do.... 27
Nails, wire................................kegs.. 3. 25
Solder..................................pounds.. 4
Acid, muriatic..........................ounces.. 4
Turpentine.............................gallons.. 3
Scrubbing brushes.......................number.. 2
.Note.�This office was closed March 27, 1909.
QUARANTINE SERVICE.
Panama-Ancon and Colon-Cristobal
Number of vessels inspected and passed.................. 1, 000'
Number of vessels passed on certificate of medical officer
(Pacific Squadron)................................. 8
Number of:
Vessels detained in quarantine.....................
Vessels fumigated on arrival.........................
Vessels fumigated prior to sailing..................
Pieces of baggage disinfected......................
Crew inspected...................................
Crew not examined (Pacific Squadron)............ 7, 500
17 45 19
2, 833 75, 275
Passengers inspected
54, 439
Total number of persons inspected.................... 129, 714
Number of persons vaccinated at ports of arrival because
of compulsory-vaccination law Number of persons vaccinated at ports of departure or en
13, 674
route because of compulsory-vaccination law.......... 16,180

70
Number of persons held in quarantine at the detention stations to complete period of incubation of yellow fever
and plague......................................... 4, 799
Number of persons detained at quarantine stations to complete period of incubation of smallpox................. 15
Number of persons held under observation on board vessels to complete period of incubation xof yellow fever
and plague......................................... 8, 023
Number of persons held in quarantine on board vessels to
complete period of incubation of smallpox........... 66
Total number of persons held under observation........ 12, 903
Number of persons landed from foreign ports:
Cabin..................................... 18,930
Steerage.................................. 22,851
- 41,781
Number of persons embarked for foreign ports:
Cabin..................................... 15,316
Steerage.................................. 13, 445
- 28,761
Apparent increase for the year from foreign ports:
Cabin..................................... 3,614
Steerage.................................. 9, 406
- 13,020
Number of persons arriving from coast towns on small
craft............................................... 23,799
Number of persons embarked for coast towns on small
craft. . ............................................ 19,002
Apparent increase for the year from coast towns........... 4, 797
Number of:
Immigrants recommended for rejection.............. 75
Certificates issued to outgoing passengers............ 413
Persons refused certificates because of trachoma..... 26
Hills of health viseed.............................. 478
Circulars relative to malaria distributed........... 2, 900
Total number of persons landed....................... 65, 580
Total number of persons embarked..................... 47, 763
Total apparent increase for the year..................... 17, 817
Bocas del Toro.
Number of vessels inspected and passed................ 453
Number of crew inspected.............................. 10, 059
Number of passengers inspected....................... -1, 861
Number of persons held to complete period of incubation
of vol low fever..................................... 60

71
PERSONNEL REPORT.
[Average number of employees at work during the year.]
Chief sanitary office..................................... 33
Property division...................................... 9
Quarantine service....................................... 35
Health office: i
Panama............................................ 55
Colon.............................................. 95
Director of hospitals.................................... 31
Ancon hospital......................................... 509
Colon hospital.......................................... 125
Santos To mas hospital................................... 5
Taboga sanitarium...................................... 26
Palo Seco leper asylum.................................. 11
Zone sanitation......................................... 189
Dispensaries:
Ancon............................................. 4
Balboa............................................. 4
Bas Obispo......................................... 10
Bohio.............................................. 4
Corozal................................'............ 3
Cristobal........................................... 9
Culebra............................................ 14
Empire............................................ 11
Gatun............................................. 15
Gorgona........................................... 9
Las Cascadas....................................... 8
Miraflores.......................................... 4
Nombre de Dios................................... 3
Paraiso............................................ 6
Pedro Miguel....................................... 5
Porto Bello........................................ 4
San Pablo.......................................... 4
Tabernilla.......................................... 4
Total............................................. 1,244
I

72
Hospital Cases of Malaria Among Employees.
Months
Discharged.
January.....
February...
March.......
April........
May........
June........
July........
August......
September..
October.....
November.. December...
Total .4,325
5,804
w. B. ! W.
688 564 5
505 343 2
369 293
241 292 2
271 313 1
275 467 1
326 ! 619 1
296 611 1
329 | 634 4
329 740 m m + m
371 485 i
325 443 i
22
Died. 1 B. J Total. Total cases. Annual average per 1,000 of deaths. Annual average per 1,000 of cases. Number of employees.
1 6 1,258 1.69 354 42,007
2 4 852 1.11 236 43,267
1 4 666 1.09 182 43,825
____ 2 535 .52 139 46,221
m � m u 1 585 .26 149 46,974
____ 1 743 . 25 188 47,493
1 946 .26 247 45,875
1 2 909 .48 222 49,020
3 7 970 1.72 238 48,888
5 5 1,074 1.18 254 50,641
2 3 859 .68 196 52,643
3 4 772 .99 191 48,544
18 40 10,169 .85 215 47,167

UNIVERSITY OF FLORIDA
3 1262 08229 054 4

�

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

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