Citation
Report of the Department of Health of the Panama Canal

Material Information

Title:
Report of the Department of Health of the Panama Canal
Alternate Title:
Report of the Health Department of the Panama Canal
Creator:
Canal Zone -- Board of Health
Mason, Charles F
Place of Publication:
Washington, DC
Publisher:
U.S. G.P.O.
Creation Date:
July 1916
Publication Date:
Frequency:
Monthly
regular
Language:
English
Physical Description:
v. : ill. ; 20 cm.

Subjects

Subjects / Keywords:
Public health -- Panama -- Canal Zone ( lcsh )
Panama Canal (Panama) -- Sanitary affairs ( lcsh )
Genre:
serial ( sobekcm )
federal government publication ( marcgt )
periodical ( marcgt )

Notes

Dates or Sequential Designation:
Began with: Apr. 1914; Ceased with: Dec. 1917.

Record Information

Source Institution:
University of Florida
Rights Management:
This item is a work of the U.S. federal government and not protected by copyright pursuant to 17 U.S.C. §105
Resource Identifier:
642828894 ( OCLC )
020307785 ( ALEPH )
AA00006090_00001 ( sobekcm )
Classification:
W 79. 12/5 ( sudocs )

Related Items

Preceded by:
Report of the Department of Sanitation of the Isthmian Canal Commission.

Downloads

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Full Text

PAGE 3

*A REPORT^ OF THE DEARTMENT OF HEALTH OF THE PANAMA CANAL FOR THE MONTH OF JULY, 1916 Mt. Colonel, Medical Corps, United States Army, Chief Health Officer, Balboa Heights, Canal Zone WAS"INGTON' d16

PAGE 4

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PAGE 5

CONTENTS. Page. Letterof transmittal .5 General remarks. 5 Vital statistics: Health of employees. 6 Health of residents of the Canal Zone. 6 Health of residents of the city of Panama. 7 Health of residents of the city of Colon. 7 Hospital division: A ncon Hospital. 7 Chronic ward. 7 Board of health laboratory. 8 Insane department. 8 Colon Hospital .8 Palo Seco Leper Asylum. 8 Santo Tomas Hospital. 9 District dispensaries. 9 Sanitary division: Canal Zone.9 Panama.;. 10 Colon. 10 QuarAntine division. 11 Statistical tables: Table I. Admissions, deaths, and noneffective rates for employees; deaths of residents of Panama, Colon, and the Canal Zone. 12 II. Deaths by age, color, and sex. 13 III. Deaths by nationality. 14 IV. Deaths of white Americans. 14 V. Causes of deaths of employees. 15 VI. Causes of deaths of civil population (employees and nonemployees) and military, and places where chargeable .15 VII. Admissions and deaths in the hospitals of the Panama Canal. 18 VIII. Consolidated hospital report. 28 IX. Consolidated dispensary and admission report. 30 X. Employees: Constantly sick and noneffective rates per 1,000. 31 XI. Employees: Days' treatment per admission, hospital and quarters. 32 XII. Financial statement .32 XIII. Ancon Hospital. 33 XIV. Colon Hospital. 38 XV. Palo Seco Leper Asylum. 39 XVI. Santo Tomas Hospital. 40 XVII. Sanitary work done in the Canal Zone, Panama, and Colon. 42 XVIII. Quarantine transactions. 45 XIX. Issues of quinine. .46 XX. Personnel report .0 ..47 M N:

PAGE 6

4= 50I si ;. U--1. .-.Ls, H. A 4 I oA1.0 4 'A. No Ito 44 A* .~~ ~ ~~ ~ ~ ~ ........ lo in--Sm o l~ila-UAV % --oo. .M -I v oll11 ,n aa. 'a

PAGE 7

LETTER OF TRANSMITTAL. THE PANAMA CANAL, CANAL ZONE, HEALTH DEPARTMENT, Balboa Heights, August 11, 1916. Col. CHESTER HARDING, Acting Governor The Panama Canal, Balboa Heights, Canal Zone. SIR: I have the honor to submit the following report of the operations of the department of health for the month of July, 1916. Very respectfully, D. C. HOWARD, Chief Health Officer. GENERAL REMARKS. No case of yellow fever, smallpox, or plague originated on or was brought to the Isthmus during the month. VITAL STATISTICS OF EMPLOYEES. The health. of the employees remained good during the month. The following statistics are based upon the number of names appearing on the rolls for the preceding month, which was 33,787. The total number of admissions to hospitals and quarters was 738, a rate of 262.11,1 as compared with 287.99 for the preceding month, and 389.22 for the corresponding month last year. The total number of deaths from all causes was 12. Of these, 7 died from disease, giving a death rate of 2.49, as compared with 8.48 for the preceding month and 3.34 for the corresponding period oV last year. The constantly noneffective rate was 8.35, as compared with 9.48 for the preceding month and 10.71 for the corresponding period of last year. The total admission rate for malaria, hospitals and quarters, was 42.26, as compared with 23.61 for the preceding month and 101.39 for July, 1915. The total noneffective rate was 1.41, as compared with 0.70 for last month and 1.94 for the month of July, 1915. The increase in admission rate for malaria, as compared with the preedig month, is due chiefly to a seasonal outbreak occurring among silver employees living in unscreened houses in New Gatun and the Folks River district of Colon. The malaria rate in other districts is low. .1All morbidity and mortality rates are computed as' equivalent annual per 1,000. (5)

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6 The diseases, next to malaria, causing the highest admission rtes to hospital, in the order of their numerical importance, were: Venereal diseases, diseases of the digestive system, nonvenoret. diseases of the genito-urinary system, and diseases of the circulatory system. These five classes of diseases caused 57 per cent of all admissions to hospitals. Twenty-seven per cent of all admissions to hospitals were caused by malaria. There were two admissions for typhoid fever during the month of July, giving an admission rate of 0.71. There were no admissions during the previous month and none in July, 1915. EFFECTS OF RACE. The admission rate to hospital and the death rate from disease for black employees, were 91.78 and 2.44, respectively, as compared with 83.07 and 7.55 for the last month and 199.57 and 2.68 for the corresponding month last year. For white employees the admission rate to hospital and the death rdte from disease were 283.09 and 2.83, respectively, as compared with 261.97 and 0.0 for the preceding month and 520.32 and 7.54 for the corresponding period last year. The admission rate to hospitals and quarters for malaria was 36.14 per thousand for blacks and 84.93 for whites, as compared with a rate of 16.88 for blacks and 64.15 for whites for last month, and 76.52 for blacks and 263.93 for whites for the corresponding month of last year. There was one death among American employees during the month, giving a death rate of 2.83, and none during the month of June; the death rate among Americans for July, 1915, was 5.63. The admission rate to hospitals from disease was 202.63, as compared with 195.03 for last month and 366.20 for the corresponding month of last year. DEPORTATIONS. There were 16 deportations accomplished during the month, 12 employees and 4 nonemployees, all for disease. CANAL ZONE. The population of the Canal Zone, as shown by a census taken by the police department during the month of June, 1916, was 31,048. This includes employees, nonemployees, and military garrisons, residing or stationed within the Canal Zone limits, Th were 39 deaths among the residents of the Canal Zone during t month of July, of which 32 were from disease, giving a deathrate 0 f 12.37, as compared with 8.12 for the preceding month and 11 for the corresponding month last year. Of the total deaths from disease the percentage under 5 yr Lr age was 53, as compared with 62 for last month. There were 45 births reported, giving a rate of 17.39; of then, were white and 29 colored.

PAGE 9

Tere were 10 deaths of children under 1 year of age, 2 white and 8 scored, giving an infant mortality rate, based upon the Mumber of births reported for the month, of 125 for white and 276 A, cosed, with a general average of 222. The percentage of stillto total births was 4. PANAMA CITY. The population of the city is 60,778, among whom there was a total of 157 deaths; of these, 150 deaths were from disease, giving a rate of 29.62, as compared with 30.01 for the preceding month and 25.24 for the corresponding period last year. Of the total deaths from disease the percentage under 5 years of age was 54, as against 53 for last month. The principal causes of death showing an increase as compared with last month were: Tuberculosis, 24, as compared with 20 for the preceding month; abscess of liver 3, as compared with none lastfmonth; arteriosclerosis 3, as compared with none last month. There were 250 births reported, giving a rate of 49.36. There were 56 deaths under 1 year of age, giving an infant mortality rate, based upon the number of births reported for the month, of 224. The percentage of stillbirths to total births was 10. COLON. The population of the city is 24,693, among whom there were 42 deaths from disease, giving a rate of 20.41 per thousand, as compared ~with 24.30 for the preceding month and 24.14 for the corresponding month of last year. Of the total deaths from disease the percentage under 5 years of age was 49, as compared with 40 for the preceding month. The principal causes of death showing an increase as compared with the preceding month, were: Tuberculosis 8, as compared with 5 acute bronchitis 5, as compared with 3; broncho-pneumonia 3, as compared with 2. There were 82 births reported, giving a rate of 39.85, with an infant mortality rate, based upon the number of births reported for the month, of 183. The percentage of stillbirths to total births was 7. DIVISION OF HOSPITALS. ANCON HOsprrAL. 'The average number of patients constantly in hospital during month was 725. The daily per capita cost per patient in the hospital proper was $1.61 gross for June, while for the insane sylum it was $0.445 for June. Chronic ward.-There were 2 admissions, 7 discharges, and 3 rafem during the month, and the number of chronic and incurble patients constantly cared for during the month was 22.55. The cost per patient was $0.2423 for June; AR

PAGE 10

Board of health laboratory.-In addition to the routineOrk the laboratory the mosquito census was continued during them There were sent to the laboratory for identification 50,83toes from various stations on the Zone and from the' cities. Numbers were as follows: Anopheles albimanus.-.-. .-.-. --------------Anopheles tarsimaculata.-. Anopheles damaged----------. .....-------------------------------1 Culex and allied genera .* 6. ...981 Mansonia titillans -------------------------------------------. 10? Stegomyia.---------.-------.-------------56 .des tarniorhynchus. All others.-----------------------------. ........50 The west side of the canal continues relatively free from Anmpheles albimanus and other malaria-carrying mosquito. In the Gatun and Cristobal Districts, however, the albimanus is relatively prevalent and malaria admissions are relatively higher than in other districts. Corozal Hospital (insane).--There were during the month 19 admissions, 12 discharges, and 8 deaths. Included in the discharges was one patient transferred to Ancon Hospital for surgv'Wtreatment. There were 5 deportations to the United States, 4 soldiers and 1 charity case. The general health of the patients and cripples remains good. Plans for the construction of a concrete addition to the piggery and reconstruction of a type 17 cottage for nurses' quarters were begun during the month; work on this construction will start shortly. The number of days relief furnished, insane department, was 8,969, at a net cost per patient day of $0.4256. COLON HOSPITAL. The average number of employees constantly sick in hospitaI was 27.59. The average number of day's treatment per employee was 7.19. The per capita cost of patients per day for June w' N $2.86 gross. Detailed statistics are shown in Table XIV. PALO SEcO LEPEiR ASYLUM. The number of patients at the end of the preceding month 65, and at the end of July 67. There were 2 admissions, no d4 and no discharges. The water supply for the asylum, which came from a well the hospital grounds, began to fail to furnish the required about the middle of July; since then the supply has grown less and it was decided to sink another well farther bak n higher elevation. The municipal engineer is now making n boring. It will be necessaryto haul water for drinking and purposes by boat from Balboa while the change in supply ing effected. KRA!A

PAGE 11

9 Wor on the new ward for patients is progressing well. The :r -i' being done by patients' labor under special authority of the gvernor. SANTO ToxAs HOSPITAL. rig the month 1,339 patients were treated in the hospital, a compared with 1,345 for the preceding month. The daily average number of patients was 456, as compared with 441 for June, and the total number of day's treatment was 14,134, as compared with 13,632 for the preceding month. The number of deaths was 94, with pulmonary tuberculosis, congenital debility, diarrhea, and enteritis (in infants) the chief causes in the order named. There were 5 cases of typhoid fever treated, with no deaths, and 6 cases of pneumonia, with 4 deaths. The necessity for providing separate accommodations for the large number of tuberculosis patients which are now treated in this hospital at a great menace to other patients, has again been taken up with the Panama Government, and it is hoped that some assurance may be obtained from the Government that appropriate action will be taken. Detailed statistics are shown in Table XVI. DISTRICT DISPENSARIES. The dispensary having the highest admission rate for malaria was. Gatit, with a percentage of 0.61. The lowest rate was in the Ancon-Corozal district, with a percentage of 0.03. A new motor ambulance was received and placed in service in the Balboa District during the month. This provides transportation for the district physician in making,, professional calls, as well as transportation for patients transferred to and from Ancon Hospital. Work on the construction of the new Ancon Dispensary began August 1. tailed statistics are shown in Table IX. SANITATION. CANAL ZONE. The usual sanitary work has been carried on during the month. The districts in general are in a very satisfactory condition. Work has been begun on hydraulic fills in the Balboa flats and at Paraiso. Many old insanitary quarters at New Gatun were condemned and demolished during the month. Steps have also been taken toward the condemnation and removal of insanitary dwelling in Paraiso. ,he following communicable diseases were reported during the DysLn7ry. 6 Malaria. 126 eum .2 Measles. 3 W pIng cough. 4 Mumps. 1 .7 Typhoid fever .2 .2 Opthlamia neonatorum. 1 I hth r .2 5&W02-16--2

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10 PANAMA CITY. During the month of July there were 11 admissions to Ancon Hospital and 24 to Santo Tomas Hospital for malaria, a total ot 35 cases as compared with 71 cases during the same period last year. One death occurred, in the case of a Spanish child eight years f age, living in the suburbs. Antimosquito work was carried on in all the districts of the division, and the total number of mosquito-breeding places encountered during the month by all inspectors was slightly less tNan for the previous month, 311 as against 350. Most of the lot owners at Bella Vista finished removing the vegetation from their lots, and work of a similar nature was commenced in the exposition grounds and will be completed during the present month. On Government-owned lots, vegetation has been cut by squads of city prisoners, thus aiding considerably the forces of the health office. Panama Railroad piers.-Several months ago the question of ratproofing the old piers belonging to the Panama Railroad in Panamaa, Bay, was considered, and it was found impracticable to make these piers rat proof and their destruction was decided upon. Durin the month of July the work of demolishing the "American wharf was begun and will be completed during the present month. Vaccination.-At the opening of the schools in Panama during July, arrangements were made for vaccinating all children in need of it, and this work was started during the last few days of the month. A total of 295 vaccinations were performed during the last five days of July. The work is much easier this year than last, owin to te fact that records have been kept in the schools showing what children were vaccinated, and when the inspector goes to a school ow, the children are prepared for his coming, and a great deal of time is saved that was lost in the preliminaries last year. The following communicable diseases were reported during the month: Dysentery. I Chickenpox. A4 Malaria. 35 Diphtheria. 8 Measles. 11 Leprosy. .2 Tuberculosis. 26 Pellagra. Typhoid fever .3 COLON. The antimosquito work for the district has been extended ding the month so as to cover a wider area on Mindi Island tha d been previously contemplated. As a consequence, the mar areas have been rendered dry, a number of anopheles-br places eliminated, the daily anopheles catch for Camp Bierd Mount Hope decreased and the malaria rate for the cities reduced. Quite extensive filling operations are planned for immediate com.pletion at Mount Hope. These include swamp 7, 7A, and 7 swamps 3B, 30, and 3D, and the IUnion Oil section. This w will reduce the expense of maintenance of some of our worst and should bring about a considerable reduction in them incidence.

PAGE 13

11 A concrete, rat-proofed pier for handling the cayuca and small boat trade in coconuts, ivory nuts, etc., is undergoing erection at Folks River. The following communicable diseases were reported during the month: Malaria---------------. 40 Whooping cough. 1 eumoa. 3 Tuberculosis.-. 3 Mea e .3 Typhoid fever. 1 QUARANTINE. No disease of a quarantinable nature arrived at or occurred on the Isthmus during the month. The plague situation on the west coast of South America shows no marked changes. Passengers, state that this disease is very prevalent at Manta, Ecuador, though it is not officially reported as existing in this port. Returning passengers from Buenaventura, Colombia, advise that the town is not in a very good sanitary condition, that refuse is being allowed to accumulate, awd that the locality is slipping back into its former unclean condition. On the Atlantic side the quarantine officer has had some difficulty in enforcing antiplague regulations on vessels working at the docks. This matter will be investigated for the purpose of having this condition corrected. No mosquito breeding was found on sailing vessels at Cristobal-Colon during the month referred to. The anthrax situation in the supply department pastures, Colon, shows little improvement. There were 19 deaths from the disease during the month. The disease appeared in three pastures that had been previously used as quarantine pastures. Steps have been taken to vaccinate all incoming cattle which are intended for fattening in noninfected pastures. About 300 cattle have been vaccinated and are now in the Miraflores pastures. As anthrax spores persist in swampy parts, steps have been taken to clear and drain the water holes and swampy areas in infected pastures, and these will later be fenced off from the pasture proper and artificial watering places provided. New pastures are being prepared and it is estimated that pasture provisions for a reserve of 3,300 cattle will be ready by September 1. All cattle in these patiures will be vaccinated. The services of an expert from the Bureau of Animal Industry, Department of Agriculture, have been asked for to assist in the control of the disease. 4,!.p '.P

PAGE 14

12 TABLE I.-ADMISSIONS, DEATHS, AND NONEFFECTIVE RATEK 11' EMPLOYEES; DEATHS OF RESIDENTS OF PANAMA, COLJN, AND THE CANAL ZONE. ABSOLUTE NUMBERS. NoneffeCAdmissions to Deaths. tive from hospitals. 0 to w 0s EP rA E4 4 r July, 1916. White. 4,239 126 100 26 1 1 .2,409 77.72 Colored. 29,548 293 226 67 11 6 5 6,337204.4 Total. 33,787 419' 326 93 12 7 5 8,746282.12 June, 1916. White. 4,489 117 98 19 ..2,575 85.82 Colored. 27,012 258 187 71 20 17 3 6,380212.66 Total. 31,501 375 285 90 20 17 3 8, 955298.4 July, 1915.White. 4,774 207 183 24 3 3. 3,1811024.) Colored. 31,207 519 400 119 14 7 7 8,771282 Total. 35,981 726 583 143 17 10 711,952 PRoPouTIoNATE NUMBERS.1' July, 1916. White. 4,2391356.69283.09 73.60 2.83 2.83. .18.,4 Colored. .29,5481118.99 91.78 27.21 4.47 2.44 2.03 .8. Total. 33,787148.81115.78 33.03 4.26 2.49 1.78. June, 1916. White. 4, 489 312.76 261.97 50.79 ....AM Colored. 27,012114.61 83.07 31.54 8.88 7.55 1.33. Total. 31,501142.81108.54 34.27 7.62 6.48 1.14. July, 1915. White. 4,774 520.32460.00 60.32 7.54 7.54 Colored. 31,207199.57153.81 45.76 5.37 2.68 .2 Total. 35,981242.12194.44 47.69 5.67 3.34 2.33. 'Annual average per 1,000.

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13 TLME I.-ADMISSIONS DEATHS, AND NONEFFECTIVE RATES FOR EMPLOYEES; DEATHS OF RESIDENTS OF PANAMA, COLON, AND THE CANAL ZONE-Continued. Annual average per DeNtho.thousand. Popu*. lationxterExterTotal. nal Total. Disal ease. causes. ease. causes. July, 1916. Paama. 60,778 157 150 7 31.00 29.62 1.38 Con. 24,693 47 42 5 22.84 20.41 2.43 Canal Zone. 31,048 39 32 7 15.07 12.37 2.71 Total.116,519 243 224 19 25.03 23.07 1.95 Jwne, 1916. anama. 60,778 154 152 2 30.40 30.01 .39 Colon. 24,693 52 50 2 25.27 24.30 .97 CanJl Zone. 31,048 27 21 6 10.44 8.12 2.32 Total. 116,519 233 223 10 24.00 22.97 1.03 JVly, 1915. Panama. 60,373 129 127 2 25.64 25.24 .40 C1o.-. 29,331 61 59 2 24.95 24.14 .81 Canal Zone. 30,057 37 29 8 14.77 11.58 3.19 Total. 119,761 227 215 12 22.74 21.54 1.20 TABLE I.-DEATHS BY AGE, COLOR, AND SEX, JULY, 1916. White. Colored. Yellow. Total. U year.4 4 8 38 35 73 ..42 39 81 16o4 yer.1 1 2 21 15 36 ...22 16 38 olyears. .1 1 4 1 5 ...4 2 6 years. 1 1 1 3 4 ..1 4 5 M1 J3 years. 2 1 3 22 19 41 1 .1 25 20 45 5! Yews. 4 5 9 12 10 22 1 .1 17 15 32 -. 2 1 3 8 4 12 1 .1 11 5 16 51t 0yewrs. 2 .2 4 4 8 ...6 4 10 7yers. 1 .1 2 .2 ...3 .3 80 yars1 2 .2 1 1 .1 1 ...2 2 To a. .......... NoAsatedi. ...3 .3 ...3 .3 Toal.6 115 31 11 2 28 .4 1361 1071 243

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14 TABLE III.-DEATHS BY NATIONALITY, JULY, 1916. Em NonE'NEn-m Nation. ployemTotal. Nation. ploye m-Tees.ployploytal, ees. eam. Antigua. 2 2 Italy.------. ---3 3 Antilla. .1 1 Jamaica------------4 00 64 Argentina ..1 1 Martinique--------1 45 Barbados. 5 36 41 Montserrat. 1 2 3 British Guiana. .1 1 Panama. .0) 0 Colombia. .11 11 Peru. .3 China. .4 4 St. Lucia. ..9 9 Cuba. 1 1 St. Vincent -----------1 1 Costa Rica. .1 1 Spain .------------------3 Domni. .1 1 Trinidad. ..4 4 England. 1 1 United States. 1 11 12 France. .1 1 Unknown.5 5 Grenada. 2 2 Guadeloupe. .2 2 Total .-. 12 231 24 Haiti. .1 1 TABLE IV.-DEATH RATE AMONG AMERICANS ON THE 1STHM1U CONNECTED WITH THE PANAMA CANAL. Number A of deaths., av rag pel L,05 White employees from the United States (4,027): Disease.1 2.98 External causes. 0 Total.1 2.98 White women and children from the United States (3,267): Disease.4 14. External causes. 0 Total.4 14 9 White employees and their families from the United States (7,294): FDsease.5 External causes. 0.Total .. Total number of Americans on the Canal Zone, including soldiers and their families (15,481): External causes. s3. A .3 Total ...862

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15 TABL Y.-CAUSES OF DEATHS OF EMPLOYEES OF THE PANAMA CANAL AND PANAMA RAILROAD CO. Causes of death. White. Colored. Total. Disease. Tuberculosis, pulmonary .1 1 Cancer and other malignant tumors of the peritoneum, intestines, rectum1. .1 A1cohohsm (acute or chronic).1 .1 Cerebral hemorrhage. .1 1 Lobar pneumonma.1 1 Appendicitis.1 1 Diseases of the urethra, urinary abscess, etc .1 1 Tot .1 6 7 External causes. Acidental drowning. 2 2 Fractures (cause not specified).1 1 Traumatism by crushings (vehicles, etc.). ..2 2 Total. 5 5 Total from all causes. 1 11 12 TABLE VI.-CAUSES OF DEATHS OF CIVIL POPULATION (EMPLOYEES AND NONEMPLOYEES) AND MILITARY, AND PLACES WHERE CHARGEABLE. Disease. PanaColon. Canal Total. ma. Zone. General diseases. Typhoid fever.1 1 Malarial fever, estivo-autumnal. 2 3 6 Diphtheria and eroup.1 C. .ro.p. ....1 ..1 Purulent infection and septicemia. 1 ..1 8epticma.1 1 P 11gra. ...2 1 .3 Beriberi. ..2 2 Tuberculosis of the lungs. 18 6 .24 Tuberculosis of other organs. 1 ..1 Disseminated tuberculosis. 5 2 3 10 Syphilis. tertiary .2 ..2 cancer and other malignant tumors of the stomach and liver. 1 .1 2 Cancer and other malignant tumors of the peritoneum, intestines, rectum ...1 1 % t e gen ra d* e ses;. 1 ., o m,acute or chronic. ....2 As chronic .2 ..2 see of the nervous system and of the organs of special sense. imple meningitis. .2 ..2 bra hemorrhage, apoplexy. 1 I .2 of the brai. .1 1 eral paralysis of the insane. ..I I .1 .2 Convulsonsofinfants (under 5 years of age). 2 2

PAGE 18

1a :X TABLE Vt.-CAUSES OF DEATHS O~F CIVIL POPULATION (EMPXY EE8 AND NON EMPLOYEES) AND MILITARY, AND PLACESWER CHARGEABLE-Continued.PanaClon. Ca Disease. Zone. Diseases of the circulatorij system. Pericarditis.1. Acute endocarditis. .1 .. Aneurysm.1.. Arteriosclerosis. .3 .......3 Embolism and thrombosis.--.1 2 Diseases of the Te pzratory 81ystem. Acute bronchitis.2 5 .7 Broncho-pneumonia. 6 3 3 12 Pneumonia (unqualified). 4ee.e. 4 Lobar pneumonia. 4 1 i GEngyene.he ..1. Pulmonary congestion, pulmonary apoplexy. 1. 1 Diseases of the digestive system. Diarrhea and enteritis (under 2years).44 1 2 47 Colitis 6 1 7 Chronic appendicitis. -.1e. I Cirrhosis of the liver. 1-.-. 1 Abscess of liver (unqualified). -3. .3 Simple peritonitis (nonpuerperal).2 .-.2 Nonvenereal diseases of the genito-urinary system and anneCa. Bright's disease (chronic nephritis).-. 2 1 3> Otherdiseases ofthekidneyandanne .-. 1 3 4 Diseases of the urethra, urinary abscess, etc. -. -. 2 2 Stricture of the urethra, nonvenereal. -1 .-.Salpingitis and other diseases of the female geni1.~ tal organs. I The puerperal state. Purper lhemorrhage. .1 Other accidents of te hr -. 1 Puerperal septicema. 1 ..N Dseases of early infancy. Congenital debility, icterus, and sclerema. -. 1 1 2 Premature birth. 6 Congenital debility. 2 2-----anutrition.3 2 1 Other causes peculiar to early infancy (including various consequences of labor). .2 .4 014 0ge. SeiLobaro. 2 E m ye a ................I ...

PAGE 19

17 TABLE VI.-CAUSE OF DEATHS OF CIVIL POPULATION (EMPLOYAND NONEMPLOYEES) AND MILITARY, AND PLACES WHERE ARGEABLE-Continued. PanaCanal Disease. Colon. Total. ma. Zone. Affections produced by external cause. Sfticidoebyfirearms. 3 ..3 Acute poisonings. 1 .1 olagration. .5 5 Accidental drowning.1 2 3 Traumatism by firearms. ..1 1 Trauxatism by fall. 1 ..1 Traumatisms by crushings (vehicles, railroads, landslides, etc.). 1 2 Honmcide by other means. ..1 1 Frac e (causenot specified). ..2 2 -Ill-defined di8ease8. Cause of death not specified or ill defined. 3 1 .4 Total. 157 47 39 243 Stillbirths. 25 6 2 33 Grand total. 182 53 41 276 Died from disease. 150 42 32 224 Died from external causes. 7 5 7 19 Total. 157 47 39 243 DEATHS OF NONRESIDENTS.' Residence. Nationality. Color. Sex. Age. Diagnosis. Interior of Panama. Panaman. Black. Male. 70 Fever, undetermined. Do.do.do. .Female. 44 Chronic nephritis. Do.do. .-.do. Male. 43 Cardiac iyertrop~hy and dilain Do. Colombian. .do. .do. .43 Chronic nephritis. Do. Panaman.do. Female. 60 Arteriosclerosis. Do. Colombian. -.do. Male. 28 Traumatism by firearms. Do. Panaman. do .do. 68 Strangulatedhernia. Do. Cuban. .do. .do. 33 Myocardial insufficiency. Do. Panaman. .White. Female. 25 Pulmonary tuberculosis. fiteamship AlSpanish ..do. Male. 19 Heat exhaustion. inerior of Panama. Panaman. Black. .do. 22 Chronic diffused nephritis. Do. Zolombian. .do. .do. 50 Chronic nephritis. Do. Panaman. .do. .do. 49 Softening of brain. Do. Chinese. Yellow.do. 40 Carbuncle. Deaths of nonresidents are not included in the statistical charts relating to the t.e.'of Panama and Colon or of the Canal Zone. 58302-16---3

PAGE 20

18 TABLE VII.-ADMISSIONS AND DEA R Employees. Admissions. Deaths. Diseases. White. White. Black. AmernEuroAmernEurocans. peans. cans. peans. M. F. M. F. M. F. M. F. M. F.M. F. General diseases. Typhoid fever. 1 ...1 ..... Malarial fever, estivo-antumnal. 10 .10 .75 1 ...... Malarial fever, tertian. 3 .1 .8 ..... Malarial fever, quartan. ...I ....... Malarial fever, clinical.2 Measles. ...2 ...... Whooping cough. .........-. Diphtheria and croup. ....--. ..... Influenza. 1 1 .1 ....... Cholera nostras. ...1 ..... Dysentery. ........ Dysentery, entemoebic. ..-. ..... Dysentery, bacillary. ........... Chicken pox. ....2 ..... F'iariasis. ...1 ..... Beriberi. .......... Tuberculosis of the lungs. 1 .1 .5 ... Pott's disease. ....... Tuberculosis of the lymph glands .2 ... Tuberculosis of the genitourinary organs. ........ Disseminated tuberculosis. ....1 ...... Syphilis, secondary. ....2 ---------..---.-Syphilis, tertiary. 2 2 .17 ..... Syphilis, period not stated ....4 ..... Gonorrhea.1 ...7 ....... Gonorrheal orchitis and epididymitis. ...5. ...... Soft chancre.6. ..6 ..... Adenitis chancroidal. 1. ........ Cancer and other malignant tumors of the peritoneum, intestines, rectum ..........1 Cancer and other malignant tumors of the female genital organs.-....-....... Cancer and other malignant 1. tumors of the skin. ........... Other tumors (tumors of the female genital organs excepted). ..... Acute articular rheumatism ....1 ..... Chronic rheumatism and .C gout .......

PAGE 21

19 HOSPITALS OF THE PANAMA CANAL. Nonemployees. Nonresidents. Admissions. Deaths. Admissions. Deaths. W. U B. B. W. B. W. B. *Others. Others. KM F. M.F. M. M.F.M.FF.M.MF. .F. M.F.M. F.O 40 -40 3 .1. 3. ..1. ..----. ----.---.---.---.---.--.--.--.20--. R9 1 3. 1 5. ..3.-.-.-.2--1.4. -----------------*------------20 -a -~~~~* ------------------ee---e----* -----+ ---------1 S5 1. .-. ...5 ..---------. -------x ~ ~ ~ ~~ -----+:-:+ ----:+-:+ :-::.:-+::: :----::-::::: ::---..-..-----.21. ........1. .1 ......----.-------------------------^-----------------------------. .1. .--------------------1 ........a ----= -------.-------------1 -------------. .------------~ ~ ~ -----------------------* ---------2 *.~ 3. 3. ............1 ...1. .....1 *. .... ....... -x ---: ::-:::::: ::: :::::...........::: :-:: .:-. ::.: ...........8. .1 ....2 ......3 2 ............8 10 1. 4. .1. .1. ............... 10 ............19 .........1. ...2 9. .........21. ............... ........2. ...........1. ....* .......1. .............. .......-.^

PAGE 22

20 TABLE VIL-ADMISSIONS AND DEATHS IN .HE EMplo1yees. Admissions. Deaths. White. White. Diseases. Black. Blok AmernEuroAmernEurocans. peans. cans. peans. -M. F. M. F. M. F. M. F. M. F. i. F. General diseases-Contd. Anemia secondary, cause not determined. ........... Other general diseases. ......... Alcoholism, acute or chronic 1 .....1 .... Alcoholism, acute. ........ Alcoholism, chronic. ......... Alcoholic psychosis. ........ Diseases of the nervous system and of the organs of special sense. Softening of the brain. .......... Paralysis without specified cause .-. ....1 ......A General paralysis of the insane. ...-.-. .......... Other forms of mental alienation ......... Dementia precox. ......... Hysteria. ......... Neuritis.-. ...1 ....... Other diseases of the nervous system. ....1. ... Neurasthenia. I ........ Diseases of the eyes and their annexa. 1 ..1 4 ..... Diseases of the ears. 1 ... Diseases of the circulatory system. Organic diseases of the heart ...1 ..... Aneurysm. ........ Arteriosclerosis. ....1. .... Embolism and thrombosis. ....... Diseases of the veins (varices, hemorrhoids, phlebitis, etc.). .1 .1 ........ Hemorrhoids .1. .2 ... Diseases of the lymphatic system (lyinphangitis, etc.) ................ Lymphadenitis (nonvene-. real). 1 1 1 .1 ..

PAGE 23

21 0EP'ALS OF THE PANAMA CANAL-Continued. Nonemployees. Nonresidents. Adm1iiss s. Deaths. Admissions. Deaths. .W. W. B. B. W. B. W. B. Others. Others. X. M. K. M. F. M. M. F. M. F. I. F.M. F.M. F. M. F. ----------------1. ......1 1 ....................... ................. 41 ................. ...........1 1. ............ ............... 1 ..1 ............. .-.4 .1. ...9. ........... ..1 ........... ...4 ...........31 ...3. .... 8.-..I. ......... .2 ................5 .. 1. 1. ..........3 .1. ......5.1 1 ....3. ................. ......... w 0. ...0 ..........2 .......*. .. .....................

PAGE 24

22 TABLE VII.-ADMISSIONS AND DEATHS IN Employees. Admissions. Desths. Diseases. White. White. Black. AmernEuroAmernEu rocans. peans. cans. pens. M. F. M. F. M. F. M. F. M. F. M. Diseasev of the respiratory system. Diseases of the nasal fossm. 2 Adenoid vegetations--------------Acute bronchitis ----------2 ... Chronic bronchitis-.-. ....2 Broncho-pneumonia. ... Lobar pneumonia. ..3 --Pleurisy. 1 ...1 Asthm a ............... Diseases of the digestive system. Diseases of the teeth and gums. 1 ... Diseases of the pharynx. 1 1 2 .2----------------------Follicular tonsillitis. ..1 Acute gastritis ---------------------2---------------------Chronic gastritis.----------------. .... Acute indigestion. Diarrhea and enteritis (under 2 years). Diarrhea and enteritis (2 years and over). 1 .1------------------------Colitis. Ankylostomiasis. .1----------. .. Acute appendictis .4 ...1 Chronic appendicitis. 2 ....--1 Inguinal hrna---I g i a h rn .....3 .1 ..3 ....... Other diseases of the intestines. .----------------1 1 .3 .Constipation-------------. ... Duodenal ulcer. .----------1 Cirrhosis of the liver------------.------------------Other diseases of the liver. .1 Simple peritonitis (nonpuerperal)------------. .-.-. ---------------------Nonvenereal diseases of the genito-urinary system and annexa. Acute nephritis .* .. Bright's disease (chronic nephritis)-.-----. ...6 ... Other diseases of the kidney and annexa. 1 ...

PAGE 25

23 49EPITALS OF THE PANAMA CANAL-Continued. Nonemployee. Nonresidents. Adnissions. Deaths. Admissions. Deaths. .1wI B. B. W. B. W. B. o Others. Others. Wirs d rs. ).M. F. M. F. M. M. F.M. F. M.F. M. F. M. F. M. F. 6 1. .9 .-------------------------1 .-.1 ....... S. 1 1. ..1 .5 2 1. 1. .....4---.-. -------------------------..........3. .2 .1----------------------10 1 3 1. .4.10 .................23 1. ..1. ...2--1 12 2. 1 .4 1 1. 1 3 5.12. S1 1. 2.4. 2. ...............12 .....1.-.7--. 1 2 ---3.1. .14 ..2 ..5-.--4. 1. ....12 1. ....1 ..........I. .41 -1. ..........1. ............11 1 1 1 2 3. .1 1. .13 2 4. .1. ..1 1. .9 4 ...............................

PAGE 26

24 TABLE VII.-ADMISSIONS AND DEATH IN Tj Employees. Admissions. Deaths. Diseases. White. White. Black. Black. AmernEuroAmernEuro-. cans. peas. cans. pens. M. F. M. F. M. F. M. F. M. F. M. F. Nonvenereal diseases of the genito-urinary system and annexa-Continued. Pyelonepbrosis .. Calculi of the urinary passages. Cystitis.-.1. Diseases of the urethra, urinary abscess, etc. ...1. ..1 Stricture of the urethra,nonvenereal. ....2 Hypertrophy of prostate .. Nonvenereal diseases of the male genital organs. ..2. Hematocele. ... Hydrocele. .2. Uterine tumor, noncancerous. .1 Other diseases of the uterus. .. Cysts and other tumors of the ovary. Salpingitis and other diseases of the female genital organs. Benign tumor of breast. .. The puerperal state. Normal labor. Accidents of pregnancy. Extra-uterine pregnancy ... Hyperemesisgravidarum. .-. Abortion Puerperal hemorrhage. Other accidents of labor. Puerperal septicemia .-. Puerperal diseases of the breast. Diseases of ths skin and of the cellular tissue. Furuncle. Acute abscess. ....1. Phlegmon and celluitis., 2 ...2 Ulcerof the skin. .. Impetigo contagiosa. ...... Ingrowmg nail. 1 ..... Other diseases of the skin and annexa. ..1 .2

PAGE 27

25
PAGE 28

26 TABLE VII.-ADMISSIONS AND DEAT H IN Employees. Admissions. Deaths. Diseases White. White. Black. Black. AmernEuroAmeriEurocans. peans. cans. peans. M. F.M. F. M. F. M. F. M. F.IM. Diseases of the bones and of the organs of locomotion. Diseases of the bones (tuberculosis excepted). .2 .1 Arthritis. ..1 2 Amputations. .1 ..2. Other diseases of the organs of locomotion.1. Malformations. Congenital malformations (stillbirth not included). ..... Diseases of early infancy. Newborn child. Premature birth. Affections produced by external causes. Poisoning by food. 2 ... Other acute poisonmgs. .. Conflagration. Burns (conflagration excepted). ...4. 4 Traumatism by firearms. .2. 2 .-.. Traumatism by cutting or piercing instruments. 2 .4 .7.-.-.--. Traumatism by fall. 1 .2 .7 ....Traumatism by machines. .1 .4 ... Traumatism by other crushings (vehicles, railroads, landslides, etc.). ..1 14. .. Injuries by animals. ..... Electricity (lightning excepted). .1. 1 ... Fractures (cause not specifed). ...2 Sprains. 2 .Other external violence. 5 .4 .24 ..Ill-defined diseases, Ill-defined organic disease. ..... Infections of undetermined origin.2. ...... No disease. ....... Total. 76 6 43 1 291 2 ....

PAGE 29

27 4XQ$IALS OF THE PANAMA CANAL-Continued. Nonemployees. Nonresidents. Ad1missions. Deaths. Admissions. Deaths. B. B. WI. B. WS. B 8o1Oter. oOthers. dfi. thrs d'rs. So' ----M, M,. F. M, F. M.M. F. If. F. M. F&.M. F. M. F. M. F..1. ......3. 2 ---.-.-----------------------1~~~ ..-. .-..-.-. -.-----.4~113. ........19 il 1-3------19 ..1 ..1 ....-.3 -. .-. ..--.-.-.--.---.-..1. ........ 2 *. .......... -. .. nw-a ...11. ......153. ......6 16 1. .........1 I. ..............1 .... 8. ..... -. ..-.---------* --........ 3 2. ..3. ZF ~. 4. ...........143 4. ...1.8 --** --478-801 -714 ---6 -.-.1 930 38 '4 9 8 117 1 4 -5 7' 14 -26 .2

PAGE 30

28, TABLE VIII.-CONSOLIDATE A-White Americans. FRemaining Admitted. DIed. July 1. A. F. B.A. F. BA. .B ANCON HOSPITAL. Panama Canal employees. 15 17 118 57 25 147 1 Panama Railroad employees. 2 7 55 10 5 59 .. Panama pay patients. ...2 .. Other pay patients. 106 28 49 213 30 141 5 3 8 Charity patients. 5 2 35 18 3 18-. A Total.128 54 258 298 63 367 6 3 -W Insane department. Panama Canal employees. .5 10 .-------------Panama Railroad employees.&. .5 ..2 .--Panama pay patients. 2 31 172 2 10 2 6V Other pay patients. 5 3 1 1 1 2 .. Charity patients. 4 5 48 ..... Total. 11 44 236 1 3 15 .2 6 Grand total. 139 98 494 299 66 382 6 5 21 Corozalfarm. ~ Panama Canal employees. .10 44 .4 10 Chronic ward. Charity patients. 22 COLON HOSPITAL. Panama Canal employees. 5 2 2 13 11 33.1 Panama Railroad employees. 1 1 11 2 3 52 Panama pay patients. 1 2 2 13 .1 1 Other pay patients. 5 2 3 14 19 9.2 Charity patients. .3 2 5 .. Total. 11 6 16 34 37 112 1 > PALO SECO LEPER ASYLUM. Panama Canal employees. 3 .. Panama Railroad employees. .... Panama pay patients. ..2 37 .I Other pay patients. ..... Charity patients. 2 21 .. Total. .4 61 ..2 GRAND TOTAL. Panama Canal employees. 20 34 177 70 40 191 1. Panama Railroad employees. 3 8 71 12 8 113 Panama pay patients. 2 34 210 2 4 26 .3 Other pay patients. 116 33 53 228 50 152 5 3 Charity patients. 9 9 132 21 5 26. Total.150 118 64333 107 5O8j 8 8 Number of employees remaining in hospitals: White. Black. Tota ...

PAGE 31

29 .O ITA1 REPORT. r4 Wr. B =Blacks. Average number constantly sick. D charged. Transferred. July 31. Black. Total. A. F. B. A. F. B. A. F. B. American. Foreign. 54 25 146 .1 3 17 16 114 21.90 16.29 111.42 149.61 7 4 58 ..2 5 8 53 3.52 5.90 55.97 65.39 .--. .3 .1.58 1.58 224 38 108 .1 3 90 16 71 97.65 21.22 64.84 183.71 16 4 22 ..5 7 1 22 4.22 1.72 30.25 36.19 301 71 334 .2 13 119 41 263 127.29 45.13 264.06 436.48 .5 10 .---. 5.00 10.00 15.00 7 .-. .5.55 5.55 2 1. .2 2 29 173 2.00 31.19 172.29 205.48 5 1 ....1 3 3 1.71 2.81 2.32 6.84 1 1. ..3 5 48 3.64 6.00 46.81 56.45 6 3 2. .2 6 42 241 7.35 45.00 236.97 289.32 ----2 -6 -i -473 307 74 336 .2 15 125 83 1504 134.64 90.13 501.03 725.80 2 1. ..12 53 -.---. 10.74 48.71 59.45 7 ..3 ..20 ..22.55 22.55 15 10 22 .2 1 3 1 11 4.51 2.48 6.80 13.79 2 1 47 .1 11 1 2 5 1.00 1.32 11.48 13.80 1 2 4 1 .7 -1 .12 .03 1.19 1.34 12 15 2 2 .6. 6 2 2.32 6.41 2.03 10.76 1 1 1 3 2 1. .29 .48 .25 1.02 30 28 76 4 4 28 11 10 19 8.24 10.72 21.75 40.71 4 ..3.71 3.71 2 38 .2.00 37.58 39.58 -2 21. 2.00 21.00 23.00 4 63 .4.00 62.29 66.29 69 37 169 .3 4 20 34 192 26.41 34.51 180.64 241.56 9 5 105 .1 13 6 10 65 4.52 7.22 73.00 84.74 1, 4 5 1 .9 2 31 215 2.12 33.22 212.64 247.98 .41 54 110 2 1 9 96 25 76 101.68 30.44 69.19 201.31 17 4 31 1 1 11 12 9 111 8.15 10.20 120.86 139.21 Z7 104 420 4 6 46 136 109 1659 142.88 115.59 656.33 914.80

PAGE 32

30' TABLE IX.-CONSOLIDATED DISPENSARY REPORT. EMPLOYEES TREATED IN QUARTERS. RemainAdmitDisTrans Remain jng ted. Died.charged. feared ing Days lost. June 1. June 30. W. B. W. B. W. B. W. B. W. B. W. B. W. B. Tota. Ancon. ..88 ..85 .2 .1 .164 184 Balboa. 3 .85 4 .82 4 2. 4 .209 2 221 Pedro Miguel. ..8 ...6 .1 .1 .23 Paraiso. .19 3 ..19 3 .--. -------29 4 3 Gamboa. 1 .1 3 ..1 3 1 ...4 2 Gatun. 2 1 9 5 .10 6 .1 .24 22 46 Colon. 6 17 86 34 ..87 40 .5 11 192 426 18 Total. 12 18 296 49 ..290 56 6 .12 11 645 466 1,111 ALL CASES TREATED, BUT NOT EXCUSED. Employees. Nonemployees. Total. White. Black. Total. White. Black. Total. White. Black. Total. Ancon. 2, 475 3,891 6, 366 1,779 2,628 4,407 4, 254 6, 519 10, 773 Balboa. 3,382 3,684 7,066 929 840 1, 769 4, 311 4, 524 8, 83 PedroMiguel. 525 591 1,116. 463 510 973 988 1,11 2,089 Paraiso. 811 2,658 3,469 512 731 1,243 1,323 3,389 4,712 Gamboa. .49 178 227 49 347. 396 98 525 623 Gatun. 541 1,560 2,101 666 1,445 2,111 1,207 3,005 4 21M Colon. 863 2,953 3,816 726 755 1,481 1,589 3,7)8 5,297 Total. 8,646 15,515 24,161 5,124 7,256 12, 380 13, 770 22,771 36,541 CONSOLIDATED ADMIssIONs REPORT. White. Black. Total. Total admissions. to hospitals, excluding Corozal farm and chronic ward. 436 504 940 Total admissions of employees to quarters. 296 49 Total. 732 553 Less number of patients transferred between hospitals and from quarters to hospitals, whose admissions are duplicated in above figures. 16 43 Net admissions to hospitals and quarters. 716 5101,2 Net admissions of employees to hospitals and quarters. 412 326 M Annual average per thousand of admissions of employees to hospitals and quarters. 1,166.30 182.39 2Z!.11

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31 TAME IX.--CONSOLIDATED DISPENSARY REPORT-Continued. CONTAGIOUS AND INFECTIOUS DISEASES REPORTED. Disease. Panama. Colon. Canal Total. Zone. Dysentery. .1 ..6 7 NMaa. 35 4 126 201 Pneumoia. 3 3 17 Measles Whooping cough. .1 4 5 Mumps. ..1 1 TIuberculosis.37 36 Ty hoid fever. 3 1 2 6 -Uhicken pox. 14 .2 16 Opthahmia neonatorium. ..1 1 Dhtheria. 6 .2 8 Leposy .2. .2 Pe~gr.2. .2 Total. 100 51 156 307 ~TABLE X%-NUMBERS OF EMPLOYEES CONSTANTLY SICK IN HOSPITALS AND QUARTERS. White. Colored. Total. Thspitals: Anco -Hospital. .47.61 167.39 215.00 Colon ital. 9.31 18.28 27.59 PoSeciLeper Asylum. .3.71 3.71 TI'otasl. .56. 92 189.38 246.30 parter-: Ancon. .5.29 Balboa. 6. 74 .39 7. 13 PedroMiguel. ..74 .iarakiso. ..94 ...13 1.07 Ga nboa. ..13 .06 .19 Gat .77 .70 1.47 C o ..6.19 13.74 19.93 Total. 20.8So 15.02 35.82 Quarters. Total. Aver number of employees constantly sick: :5. 26.92 20.80 77.72 Colre.2. 189.38 15.02 204.40 Tlotal. 246.30 35.82 282.12 4 raenumber of employees constantly sick per Wht. ..13.43 4.91 18.34 Colred ..64.51 6.92 Total. .7 29 1.06 8.35

PAGE 34

32 TABLE XI.-AVERAGE LENGTH OF STAY IN HOSPITALS QR QUARTERS FOR EACH ADMISSION OF SICK EMPLOYEE. White. Black. TotaL Hospitals: Ancon Hospital. .12.10 22.48 19.34 Colon Hospital. 9.49 6.80. Quarters: Ancon. 2.18 Balboa. 2.43 3.00 Pedro Miguel. 3 .. Paraiso. 1.53 1.33 Gamboa. 2.50 .66 .4) Gatun. 2.60 3.83 Colon .2.25 14.05 TABLE XII.-FINANCIAL STATEMENT. June, 1916. May, 1916. June, 1915. Administration: Chief health office. $566.43 $695.35 $747. 66 Hospital division: Ancon Hospital. 26,075.79 26,744.97 25,244. Board of Health Laboratory. 2,107.05 1, 875.32 1,670.27 Corozal farm. 6, 024.47 5,586.15 5,625.79 Chroniceward. 229.08 249.61 248.93 Colon Hospital. .4,316.32 4,494.36 3,398.71 Palo Seco Leper Asylum. 1,508.86 1,708.31 2,46.5 Santo Tomas Hospital. 805.50 785.83 969.45 Medical storehouse. 1,595.41 1,762.73 820. C' Depreciation. 834.15 823.94. 43,496.63 44,031.22 40, 441.71 District dentists. 249.48 .6.98 Dispensaries: Naos Island. Balboa .1,061.40 1,181.66 1,5.21 Corozal .... Pedro Miguel. 448.99 446.33 Paraiso. 600.97 594.02 Culebra. .. Gamboa. 260.44 215.88 140.08 Gatun. .577.24 692.69 744. Toro Point. .... 3,198.52 3.130.58 4,. Sanitary division: General inspector. .50.00 Health office, Panama. 3,630.77 3, 605.57 3, Street cleaning. 4,128.26 3,909.94 Health office, Colon. 3,007.35 3,292.49 Street cleaning. 2,327.39 1,711.72 2 13,i143.77 12,569.72 Zone sanitation: Ancon. 2,584.37 1,417.51 Balboa. 2,215.55 1,138.11, Corozal. 2,772.26 2,094.87 Pedro Miguel. 4, 043.61 2, 341.01 2,1Z .5

PAGE 35

33 TABLE XII-FINANCIAL STATEMENT-Continued. June, 1916. May, 1916. June, 1915. sazItation-Continued. Sr. .$381.26 .70.22 $62.70 100.41 aun;. .4,437.65 3,770.25 2,188.19 Vr*Itoba-Mount Hope. 2,374.31 2,017.85 1,963.75 31,641.74 25, 412.02 25,546.28 Q -antine division: qUaG office .117.23 .181.75 3 -. 2,188.81 1,922.03 1,888.74 Colen-Cristobal. 3,172.94 3,022.05 2,889.24 5,478.98 4,944.08 4,959.73 RECAPITULATION. health of ice. 566.43 695.35 747.66 001:4w division ..43, 496.63 44,031.22 40,441.71 iesaries. 3,198.52 3,130.58 4,009.48 ary division. 31,641.74 25,412.02 25,546.28 juarajtne division. 5,478.98 4,944.08 4,959.73 Total. 84,382.30 78,213.25 57,704.86 TABLE XII.-ANCON HOSPITAL. REPORT OF NATIONALITY OF PATIENTs TREATED. Total American. Other nations. number treatWhite. Black. White. Black. ed. Puama Canalemployees. 379 72 2 42 263 Panama Railroad employees. .112 114 Panama Government patients -3. 3 Other pay patients. .567 19 1 58 189 arzty patients. 81 23 .5 53 .1,168 426 3 117 622 piama Canal employees. 15 ..5 10 'Railroad employees. 7 .7 PanamaGovernment patients. 217 2 .33 182 pay patients. 13 6 .4 3 ty patients. 58 4 .5 49 T 0.s .$10 t2 .47 251 Grand total. 1,478 48 3 164 873 227 227 ..30 .,. ..14 30 Famerple). 68 .141 54

PAGE 36

TABLK XII--ANCON HOSPITAI~-ontinued. REPORT OF DAYS LOST Il HOSPITAL. Tod AmernOther Bak Total.ite. Hospital: Panama Canal employees. 4, 638 679 505 3, 454 Panama Railroad employees. 2,027 109 183 ,3 Panama Government patients.49 .4 Other pay patients. ,9 ,2 5 ,1 Charity patients. 1,122 131 53 3 Total. 13,531 3,946 1,399 8,18G A sylum: Panama Canal employees. 465. 15531 Panama Railroad employees. 172 ..17 Panama Government patients.6, 370 62 967 5, 341 Otlier pay patients. .212 53 87 7 Charity patients. 1,750 113 186 1,451 Total. 8,969 228 1,395 7,4Grand total. 22,500 4,174 2,794 15,53 Soldiers. 2, 247 2,247. Chronics. 9 .9 Farm (cripples). ,43. 331,1 Average cost of subsistence per day, $0.2629. W~nn LABORATORY REPORT. Blood examinations, total number. .7 Estivo-autuxmnal. .15 Quartan. TLertian. .1 Differential counts. Leucocyte counts. .13 Hemoglobin estimations. .7 Red blood counts. Tool examinations, total numuber. .68 Amneba. Ascaris lumbroinocides ..U1 Cercomonas intestinalis. .2 Ciliated nomads. .8 Entameba (hystolitica and tetragena) ...1 Guaiac tests. .2 Pus and blood. .9 Strongloides. .1 Tricocephalus dispar. .3 Uincinaria (ova). ..1 Urine examinations, total number. .1 4 Albumen. .............................9 Albumen estimations, quantitative. Bile VI .. Epithela. (iuaiac tests. docan. Pus and blood. ....... Sugar (all negative). 1 39

PAGE 37

35 TABLE XIII.-ANCON HOSPITAL-Continued. WARD LABORATORY REPORT-Continued. SParexaminations, total number. 20 iive for tubercle bacilli. 20 A.r exanations, total number ..41 V Agr al. 20 Uri .0. 7 .ial. .4 in u .3 Aoft tu .:.3 N tasal. ..1 REPORT OF SURGICAL OPERATIONS. Number. Died. Amptations: Shoulder. 1 Thigh. A L og ...... Digits, multiple. Leg, double. Operations on bones: Ostiectomy. 4 Wiring of fractures, simple. 2 Wiring of fractures, compound.1. .Aay. brng ......................1 Artuopiasty hip. 1 Artroplast y knee. 1 Adenectomy: Aervical. 2 Axillary. 1 -ngui-al, single.-. .17 Iginal, double. .1. Feuioral. .5 Rerniotomy: Inguinal, single. Ing inal, double. .3 H.entral.1. 4denito-urinary tract: Urtrotomy,internal. .1 1 Urethrotomy, external. .3. Varicocele, radical cure.3. Hydrocele, single, radical cure.3. Uyrocele, double, radical cure.1. lechi.d.ctomy ..2. Epididymotomy. .8. Amputation of scrotun ..1. Curetage uteri.4.4 Perieoplasty.3 Trachlorrhaphy ... A.asection, abdominal. 2 %eineorrhaphy. Remorrhoids, radical cure .3 1 Fituta in anus, excision of.1. Genral: Varicose veins excisio .1 Tenorrhai y. .I Myor utery. surface neopiasls. .2. Plastic operation for severe injuries. 1 in anu ,e cso f. ..0.1 vins x iino ...

PAGE 38

36 TABLE X-I.-ANCON HOSPITAL-Continued. REPORT OF SURGICAL OPERATION-Continued. Numbe.i Ded Laparotomy: General peritonitis (not traumatic or appendicial) .1 Gastro-enterostomy Appendectomy.13 Appendectomy with local peritonitis-.5 Colostomy. 2 Sigrmoidopexy----.4 Supravagina hysterectomy .5 Hysteremyomectomy .4 Salpingectomy, single---------------------------------......I1 "MI Salpingectomy, double---------------------------------. Ovarian cystectomy. Suspensio-uteri. -. Major operations, various other. Minor operations, various-. .118 Total. 257 5 REPORT OF OPERATIONS, EYE AND EAR CLINIC. Submucous resection of nasalseptum. Tonsillectomy. 4 Adenoidectomy. 4 Pterygiumn transplantation. Turbinectomy. 1 Magnet removal of steel from eyeball. Minor operations: Eye. 2 Ear----. Throat. 2 Total. Refractions. All REPORT Or OUT-PATIENT DEPARTMENT. Clinic. Total New Pay visits. cases. cae, Medical. 250 16 33 Surgical. 232 92 Eye and Ear. 689 290 1 Total. 1, 171 548 1 MONTHLY VACCINATION REPORT. Number of adults vaccinated. .... Children. .. Total. 7x

PAGE 39

37 TABLE XIII.-ANCON HOSPITAL-Continued. BOARD OF HEALTH LABORATOY-MONTHLY REPORT. .,ologial examinations ofB_6o ctrs. 23 Throat cultures.r. 59 Urin s. ----------------o. ..30 S-----. ..a. 19 Z t' m .-.6 B7 00hra, for trypanosomar. 1 Pathological fluids, exudates, etc.o. 8 Cultures of autopsies. 1 Ice cream. 4 Milk.1 Wasserman reactions. 605 Leper suspects. 1 Agglutination reactions. .5 Autogenous vaccines prepared. 2 Autityphoid vaccinations. 6 Animal inoculations .11 Diry milk from Corozal farm. 26 Dark-lield examinations .-. .2 Blood for malaria. 3 Vaccine points (smallpox) manufactured. 2,300 Chemical examinations ofMother's milk. 3 USines. .18 Fat determinations of milk from Corozal dairy. 20 Butyric acid tests. .10 Colloidal gold. 5 '"Vergrout". 1 Concentrol". 1 "Zest". ..1 Beef. 2 Patological tissues prepared, paraflin. 228 Pathological tissues prepared, frozen. 4 Surgical tissues reported. 33 Autopsies performed. 29 Animals autopsied .30 Rats examined: M us m usculus..-..-.522 Mus norwegicus .904 Mus alexandrinus. .14 Mus rattus. .163 1, 603 Bodies embalmed ..4 Interments at Corozal. 10 Taken to Panama .-. 7 Cremations. .22 COROZAL HOSPITAL. STATEMENT OF COMMITMENTS, DISCHARGES, AND DEATHS, JULY, 1916. COMMITMENTS. Male. Female. r Canal Zone, first admission. 5 2 Paniama Government, first admission. 8 4 T ..13 6 "A

PAGE 40

438 COROZAL HOSPITAL-Continued. DISCHARGES. Well. Improved. Unrp-vd. Male. Female. Male. Female. Male. emale. Costa Rica. Jamaica. Panama. ... Portugal. .. St. Vincent. .. United States. ...2 5 Total. 2. 2 2 6 11 transferred to Ancon Hospital for surgical treatment. 2 5 deported to the United States. DEATHS. Medical diagnosis. Mental diagnosis. Male. Feme. Pyonephritis; cystitis; urethral stricPsychosis undetermined. 1 tures; leprosy. Arteriosclerosis. P s yc h o s i s associated 1 with arteriosclerosis. Psychosis; syphilis. P s ye h o s i s associated with cerebral syphilis. Disseminated tuberculosis; cyst of Ps yc ho s i s associated brain; epilepsy. with epilepsy. Syphilis, tertiary; pellagra. P s yc h o s i s associated with cerebral syphilis. Generalparalysis of Insane; gangrene General paralysis of the 1 of lungs; dysentery, insane. Softening of brain; syphilis ..do. 1 Disseminated tuberculosis; epilepsy. P s yc h 6 s i s associated. with epilepsy. TABLE XIV.-COLON HOSPITAL. NATIONALITY. White White Black. Total, Amerforeign. ican. Panama Canal employees. 18 13 Panama Railroad employees. 3 4 Panama pay. 23 Other pay. 19 21 Charity cases. .3 2 451 43 1.214

PAGE 41

39 TABLE XIV.-COLON HOSPITAL-Continued. LABORATORY REPORT. ex11si-a---ns -------------------------------------------------164 Blood exa.t. ...164 Estv-------a---------s--.----------.-.-.-. -1 Teta .6 Q uaan .w. White blood counts. ----------------------------7 Red blood counts.---.---.-------.2 Differential counts.-------. 8 dtool examinations.---.--.--. 15 U ncinaia.-.-. 1 A caris. -.2 Oxy ris vermiculosis. 4 Tricocephalus dispar. 6 Urine examinations. .w. 141 Albumen.-. 61 Sugar. .--.-. 5 Casts. .......---------------------------------------------------25 E pithelia cells.---.-. 65 R blood counts.-.--.--. 2 te blood co ts. 15 Triple phosphate. 5 Calcin oxalate.---. 6 A putum examinations .9 Positive for tubercle bacilli.w. 2 8mear examinations. 3 Positive for gonorrhea. 1 SURGICAL OPERATIONS. Amprtions: For arm .. Digits, multiple. 1 Operations on bones: Craniectomy, exploratory. 1 Merniotomy: Inguinal, single. 5 Genito-urinary tract: Urethrotomy, external. 1 Cyretage uteri.-. A Obstetrical: 01ig forceps.-V. a. -gb forceps --------------------------Version. I Perineorrhaphy. 1 General: Extensive injuries to soft parts, operation for. 2 Lap:rotomy: Appendectomy. 1 Appendectomy with local peritonitis. 1 Minor operations, various. 7 2Lbior operations, various (dispensary). 126 TABLE XV.-PALO SECO LEPER ASYLUM. NATIONALITY or PATENTS. N be .Americans. Others. Class. White. Black. White. Black. White. Black. P anal employees.-. 4 ...4 ..38 ..2 38 2 21 ..2 21 Tota. 4 63 ..4 63 aet of subsistence, per patient, per day, $0.26

PAGE 42

441 TABLE XVI.--SANTO TOMAS HOSPITAL. Remin-AdmitDIsYted. charged. *d1 Pa y. ...14 4 33Charity cases. 429 832 736 Total. 443 896 769 9 7 Average number ofpatients constantlyslck.~. Total numbers of days' treatment. .14,13 Average number of days' treatment for each patient. 1 NA TIONALITY. Americans. Other nAL* n Number___________ __ Class. treated. White. Black. White. k Pay cases. .78 2 25 Charity cases. .14 26 31. .103 1,147 Total.1,339 13.128 ,198 DISPENSARY REPORT. Class. White. Black. Total. Natives. 48 632 Foreigners. 71 335 0 Total. 4119 967 1,086 DIsEASES TREATED. Typhoid fever. Malaria-. 7 Measles. Diphtheria and croup. I Influenza. .NI Dysentery. Leprosy. Other epidemic diseases. Purulent infection and septicemia.~. Pellegra. Beriberi. Tuberculosis of the lungs.'. 1 Syphilis. Soft chancre. Gonococcus infection. .N.--. Cancer and other malignant tumors of the buccal cavity.Cancer and other malignant tumors of the female geia organs.Cancer and other malignant tumors of the organs not specified.

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41 TALE XVI.-SANTO TOMAS HOSPITAL-Continued. DISEASES TRZATED-Continued. Um. ataxio;.r. O forms of mental alienations. 9 .9 .5 diseases of the nervous system. 5 diseases of the eyes and the-Mr. n .exa .2 b hear. 1 r diseases of the heart. 8 On.e AM. of the arteries. 9 D' ofthe Veas. 4 of the y hatic system. 3 of the na ios r. .2 ibbronch itsn.en i.W. 1 n oma. 2 p .6 Diseases of the teeth and n .2 iiasy te .cunx. 1 Oter diseaseofth .13 Diathe andese teis ides2 ears .ne .1 Dlarrhea'and enteritis 2 yas and over ..10 Ankylostomiasis. w. 60 2 ep eths addtyphts. .6 07 intestinal obstructions. 10 oeses of the anus and fecal fistula .4 terieases of the intestines._ o .2 Mary .1 Ot h s disease. .11 .Other diseases of the kidneys and annexa .1 Diseases of the bladder. 2 NISeaSM of the urethra. 9 ANonvenereal diseases of the malr gctal organs. 4 Uterine tumor, noncancerous. 2 Fetrinl. 1 Otherdiseases of the uterus. 2 Salingitis and other diseases of the female genital organs. 9 Diseases of the breast. 2 S o .71 AN. cideats of pregnancy .28 Ganr .I le1 ..o. An abscess .12 hr diseases of the skm and annexat. 32 Diess of the bones. o. 2 te oin s. 3 Ote iessof the organs of locomotion. o. 3 ii maformations. 5 discharge from hospital without disease. 69 poisonings. 3 t .3 by firearms. 24 S b cutting or piercing Instrument. 1 Y. 8 ......*.0. Diessnot specified or ill defined. ..I 8 ......4.*.-.

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42 TABLE XVLANTO TOMAS HOSPITAL-Continued. SURGICAL OPEBRATIONS. Numberi id Amputation of arm. Amputation of digits, multiple. Craniectomy, decompressive. Ostiectomy. Excision of maxilla. Union by nail. Adenectomy, cervical. Adenectomy, iguinal, single. Adenectomy, iguinal, double .3 Herniotomy, iguinal, single. Herniotomy, iguinal, double.3, Herniotomy, strangulated.I I Urethrotomy, internal. 4 Urethrotomy, external.2 2 Hydrocele, single, radical cure.2 Curetage, uteri.7 Perineoplasty.1 Excision of breast and axilla.1 Hemorrhoids, radical cure.4 Fistula in anus, excision of.2 Gunshot wound of soft parts, operation for.I Plastic operation for effects of disease. 27 Skin graft.12 Laparatomy, for general peritonitis.1 Laparatomy, for tuberculous peritonitis.1 Appendectomy. ..41 Appendectomy with local peritonitis.2 Abscess of liver, paparo-hepatotomy. 1 Pan-hysterectomy. I Supravaginal hysterectomy.2 Salpingo-oophorectomy. Suspensio-uteri.1 For ectopic gestation.2 Minor operations, various.36 Tonsillectomy.7 Mastoidectomy.I Enucleation eye.1 Needling of eye.1 Pterygium. Total. .160 Aim U TABLE XVII.-SUMMARY OF SANITARY WORK PERFORMED AjD MATERIAL EXPENDED IN THE CANAL ZONE. Work requests, supply department: Grass cutting. Screening. Miscellaneous. Work requests, municipal engineering department. Work requests, other departments. Notices served to abate nuisances. Arrests and convictions. Closets, inspection of. Stores, inspection of.:. Shops, inspection of. Garbage cans emptied. Closets disinfected. Rat traps in use. 4 Rats destroyed.

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43 IT-SUMMARY OF SANITARY WORK PERFORMED AND ATERIAL EXPENDED IN THE CANAL ZONE-Continued. t es caught .23 629 t 4estroyed. 31 .e.used ...gallons. 548 Crude oi .sed.do. 15,047 eneused .do. 869 SUMMARY OF ROUTINE WORK DONE BY PANAMA HEALTH OFFICE. General sanitation: Linear feet of ditches cleaned and maintained. 18,960 Linear feet of new ditches dug. 675 Gallons of larvacide used .600 Gaollns of crude oil used. .4,673 Square yards of pools oiled. .355,870 Water containers treated. 16, 377 Mosquito-breeding places found (Stegomyia, 108). 311 Fly-breeding places found. 51 Flies trapped (13,000 per quart).quarts 114 Number of rats killed. 1,324 Number of room disinfections. 13 Square feet of vegetation removed.,.345,700 garbage collection: Number of loads of garbage removed to dump. 5, 329* Number of cubic yards of garbage removed to dump. 9,236 Total number of cans garbage emptied. 42,443 Bu ldings: Number of buildings inspected ..4,573 Number of plans for new buildings approved. 23 Number of permits issued for repairs to old buildings.95 Total number of building permits issued. 118 Number of buildings condemned. 18 Number of stables condemned.1 Number of buildings demolished. 6 Street cleaning: Average number of square yards of streets cleaned daily. 600,000 Average number of square yards of streets sprinkled daily. 45,000 Number of private properties cleaned during month. .1 Number of notices served and nuisances abated. 366 Vaccination: oNumber of vaccinations performed during month. 295 Total number of vaccinations since Apr. 1, 1914. 23,539 WORK REPORT FOR COLON AND CRISTOBAL AND MOUNT HOPE. sanitation, Colon and Cristobal: square yards street cleaned. 3,895,800 Square yards alleys maintained. 655,000 N omber of private properties cleaned. 772 Dosesof qunme issued .7,555 NuIber of rats caught. 150 Number of dogs caught. 39 Number of dogs killed. 22 Loadsof yard garbage disposed of. 604 Number of cans garbage (cubic yards, 2,389). 67,072 Lear yards ditches main ed .110 Acrs o veetation removed: Panama Railroad properties. 34 Washington Hotel.11 Panama Railroad Reservation, Colon. 6 Square yards oiled. ...70,525 Nube f receptacles treated ., .40,495 er of mosquitoes caught on Colon Hospital screens: Anopheles. .129 Culex. .1,119

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TABLE XVIL-SUMMARY OF SANITARY WORK PERFD MATERIAL EXPENDED IN THE CANAL ZONEWORK REPORT FOE COLON AND CRIsTOBAL AND MOUNT H Sanitation, Colon and Cristobal-Continued. Number of mosquito-breeding places destroyed. Number of fly-breeding places destroyed. .-----------------Number of buildings inspected. Gallons of larvacide used in Colon. Gallons of crude oil used in Colon----------------------Number of nuisances abated. Building Colon: Number of building plans approved. Number of permits to occupy issued. Number of permits to repair issued. 44 Number of bills collected.146 Sewers, Colon: Number of new connections made during the month.-7 Total number of connections made to date.-----------1,3&1 Number of houses in which connecthons were made-----------Outstanding permits. .4 Sanitation, Cristobal: Number of cans garbage (cubic yards, 745). 14,17 Loads of yard garbage handled. 1" Number of receptacles treated. Square yards oiled --Number of mosquito-breeding places destroyed. 9 Number of fly-breeding places destroyed. Gallons of larvacide used. Gallons of crude oil used. Number of buildings inspected. --.7 Number of nuisances abated.52 Sanitation, Mount Hope: Number of cans garbage (cubic yards, 137). 1,4 Square yards oiled. 232 twNumber of receptacles treated. .W. Number of mosquitoes caught in barracksAnopheles. 491 Culex .-.-.-.-.-. .__ 1.1. Number of mosquitoes caught in cars, in swamps, and Camp BAnopheles. F 4 Culex. Number of mosquitoes caught in silver married quartersAnopheles. Culex. Number of mosquitoes caught in steamshipsAnopheles.Culex. Number of mosquitoes caught in Mount Hope villageAnopheles. ,. CU1ex. Total anopheles. .I Totalculex. Gallons of larvacide used. Gallons of crude oil used.-. Mount Hope Cemetery maintained. Linear yards of ditches constructed, Mindi Island. Linear yards of ditches constructed, Mount Hope. Linear yards of ditches maintained. ... Square yards of vegetation removed. ,73. Number of burials during the month.-4Number of mosquito-breeding places destroyed. .7

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45 T.-CONSOLIDATED REPORT OF QUARANTINE TRANS, T AT THE PORTS OF BALBOA-PANAMA AND COLON-T BAL. r vessels inspected and passed. 220 beroivesseisheld in quarantine. 16 numberof vessels entered. 236 of special inspections made to enforce compliance with antiplague wn mosquito-breeding regulations. 109 ber of vessels fumigated on arrival. 18 ber of vessels fumigated on departure. 4 ~niber of vessels detained, but sailed in quarantine. 6 Somber of stowaways inspected. 10 Number of crew examined. .12,573 number of passengers examined.4,030 16,613 Number of supplementary inspections. 2,210 Number of persons vaccinated at port of arrival because of compulsory ,Vaceinatlon law. 420 ~nuber of persons vaccinated at port of departure or en route because of compulsory vaccination law. 1,255 1,675 N~nber of persons held in quarantine at the detention houses to complete prE Id of incubation of yellow fever or pague. 298 W umber of persons held in quarantine on oard vessels to complete period of icubation of yellow fever or plague. .1,921 2,219 Total number of persons landed from foreign ports: Cabin .1661 Steerage. 1,617 3,278 Total number of persons embarked for foreign ports: Cabin. 1,844 teerage. 1,805 3,649 number of persons arriving4rom coast towns on small launches and craft .1,665 number of persons sailing for coast towns on small launches and raft. .1,233 tincreasefor month from coast towns. 432 t decrease for month from foreign ports: 1)1rg. .183 371 sons rejected and deported. 25 r241s of health issued or visded. 212 of inspections of docks. .4 of inspections of vessels at docks. 17

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47 TABLE XX.-PERSONNEL REPORT. l 1916. June, July, 1916. 1915. Gold Silver Total Total Total employemployemployemployemployees. ees. ees. ees. ees. lefihealth office. 5 .5 4 4 medical storehouse.4 4 8 8 10 Quarantine division. 12 34 46 45 42 Health offico, Panama. 11 153 164 155 160 Health office, Colon-Mount .9 185 194 181 159 -. Hospital. 118 253 371 359 341 Cr von H. 15 26 41 40 34 A ant. Tomas Hospital. 6 .6 6 5 PalSeco Leper Asylum 2 34 36 19 32 Zone sAnitation. 7 128 135 139 113 Hospital farm, Corozal. 2 56 58 59 50 .5 2 7 7 6 borozal. ..........4 GambIL. ..4 4 Gatun.22444 Naos Island.1 Paraiso.2 2 4 4 4 PedroMigue. 3 1 4 3 3 204 880 1,084 1,034 973 4. ..0 tj UW L 6. R4'&

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UNIVERSITY OF FLORIDA 3 1262 08520 1019