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 1914
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_00018 ( sobekcm )
Classification:
W 79. 12/5 ( sudocs )

Related Items

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

Downloads

This item has the following downloads:


Full Text



























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Th Pa A.. : :
I*... PDiARTMENTOOF REAATJTI1,
-Amton, C(bal Zone August v 914
:4M TH PANAMAA OANAL., '
O. .ebra,. Candy. Zone,
S0 -honor to submit- the following, report of the
d pmentof health for the month of July 1914.
:f '* AIkAsa. F. MASON,
:0 h Chief Health Officer.



B .. :,: ..o, .a:4x .:pl d. : .

V.'.,. TAL STATISTICS. .
ieU elorague onateoo




SIoveme t of6mpldyees rom the Canal Zone to



oi'er'" e-half of the enployeeslive nethese tie#.
i n:n.t ..i;ue. very good.. The nm. o0 .

4 qpcgiig mouth 46t616.
a fbmnisio# fo hioTpitale and quarters a
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,166U deaths were from disease, gyving a rate.c. 39.14
rer ainum, as i compared ,with 26.10 for the preced-
l '3.72 for the %corrsonding iorith of la0st year.
ie.death rate in Colon is, ho doubt,: largely due to an
*latiodn,. which has undergone no revision for the
pa.ft of the increase was in children under A5 year of,
irge of wjeos6e deaths to the t6tal aths from disease
S6inJu, t d 7 in..July. .. ..
pid eat)h 6owing .thelargest increase e bronchitis
ai..malaria, an4 malnu.tritio .
H.e HOSPITAL DIVI 0N .
| ,i:. .. ; ;"t" *^ :... '. .
A'.rn:n' .. H...n n." .. ....o *' .... ... .;

i:l. a decided eerease in the umb.e of pa tie'
l.sinmne the ew .r'eg-hatiobnsgovetdng tre~jauo t
sgong io efI::. The. :numer of adisisi hsa to
in IJ j wieres Employees, 5; otj (i0, ~.a
5., axd 584 otherY in Ray1 and -uto notwitfr
paW sh~wa the highest ~4*isaioni ntaC of any

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prcd`niiuant disease treated, the rate beinron-
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S n in Table





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jxyg tha. largest adm rate for, nialania a-

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SThe unewqiit d4j euii 41
-ax4 :vibe se up siud t;.M'idxwv
W "ith the'is. nc equipment cT e '
raising of dust cuds whih are conon where
.* : :;GARBAGE n n. fnlnr 44::. -I., :
:Garbage-colection Jarvice wa atihatoiily mu
-Athe ionth, and all refuse matter received at the dumft
SA.start .wa made on erecting.an incinerator for :c
and will be. placed in.operation d rng the c. m
incinerator all. manure collected in the city :.-W'&Y
wil.l llow a more rapid. cremation of garbage at d.ii4
4-VBUILDING INSPECTIONS. *
It was" foundinecesar to condemn 179 bhild
month, and of this :number 23 Lwere demoliaied,.21
nd .2 by the forces of.thisoffide. :A6ttabiof ~i 13perm
for new buildings and repairs to old buildings. The 4s
ing construction work since April 1 is shown belowf::

o of p mof
", ." -:. ":. N u..ber N I :
issued. Vt
April....- .. ... .... ..... .................... .... .. 131.. :,:i.
June -------......... ................ 0
.- : 0.7 .

S ,.. Aangements have been nmae so that property j :
hligh-grade graveL for -their cement work,. This awil
able benefit to all concerned, as it wil allow it l
work than was possible under the old plan ofusg
which 'was the only kind obtaina le in thi ciy
tion. is being gi ven to the ra.proofing feat re
h city -. ..: .. .. : ...
L" J :: :' :* ':" o *B
M6SQU*OPrLo A,.. fl... .WOW. '
: ewer mosquito-breeding p laces ers~e V U.LL
thinr bha been reported for the two previi.os moih

ini the niber of fly-breeding place Autiidthei
.... ..... ...... ..
e;locatfed du ..J
E were. .ent to h la ratory e: "...'
.. e ...par.- .da i is, ..U. ..i .




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i: contagion. s d ea s w ere. re .pod urg the.



Sees we isolated 'as soonA fomnd, and pre-
., r w e. w. .... ,.
to tei the pread of the disease w each case.
hidecasees reported,.one was contracted in? Chrirea
eable to tina distrct; the other case iwas presufm-
Shis city. Iag.osis of both cases :wa ma:de
lWi~kh atgglutination test; Widal'8 in both cases
' blood-: ctitures: were m.iade. ..The M i s ere
lii; W .' ir'...*..'.|* I .: .. I, :. .. ; ... .
e: .in. the' .hospital.


ip ... a for- cleanliess ha.s been i ugurated
pteTa the slogan being Clean up for

sient has been made with the municipatiity for the"




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ipgred ie m u end
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TABnE :IV.-DAT A AMNG AMERICA NS 06
ON. NEEDD WITH TH PANAMA .,OCA



S...'. .: .. C... *ases. Cause of uea .h




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TE O f-ATHS O F EMP.L.OYE-ES A..._ ..VL w .
;AN .JA WHE_ HARGE 1..
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.i s e nf af .szesr.a we 'ttoffje VrgSR of
Speea2 e s

SIe hettriage apol'exy. ---... .... ---



S. y is without speo ed nuse ..... .... .
*oiivulsions of infants (under 5 years of age),..-. 2

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(angroe Ofthe ungs-------------------------.
S Other dsiasBes erespi"tory system (ttaber-
S:, closis except )..... .. .....,-. -

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Sam ....- .... .... ,
' gland -.. .:.....,,.. .
larlados........ .... .
S ortarie Island.... .
Antigua~...... -....... .
Panama..,;. .s. -....
Doemrara.. .............
' S. A.......... .......
J amaica .... ;.......
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Mental diagn
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Psychoses accom-
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diseases:


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ann ".e railroad oe. .:---.-.--.
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-&NATIO;LITY OF PATIENTS.
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Emihgnai tumors. Other diseases of the utrgsans 0n-
7 sceidists of preogniancy- --- -




S e oion.... .......- .........





"b. heart'-.-.". ." 7 :Traumats., b.y other iii

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p .!a*laf tenition/ ... 6. AOther diseases of the. sMn' .' ..



.. Newbo hil.... R .. .... ....... 0
5 Congnltal ebiity.
'tt.m-heart 7 TVraun.tiam, b .other orushinga
5 (Vehicles, railroads, landslidesi,


...: ': -.--:-.. 1 Feigneddisease -: 5 .


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Sp*atomy for inteitinal DbbautionL ..
q.to.y eplorary :. ,. .'..." .': .. .. ----- --- -- :
i :4. 4 *li artmyf iit li
.pen etom .. .. ., ... .
Abscess of liver:
La.. ro-h patotomjeo.. ... .. .:.. .. ,..
Hora o-hepatolomy f6r...L ... .-L..... .
an-h ter t :'.. ; :.. ... ...6. .... .

H. yst.. .omyo eet y .. ..... .. ..O...... ..
.. g l e .... ... ... : .' ...... : ..... .. '. .. :
ou b le .. '.. ".., ... ... '.: -. .. ..'..... .,. .
B.. alpi igf. ophorecto y....... ..... .. ... ..
,m -O.,.~.m ---------i'~' ~ i~~'~:
S spensio- te .. .... ...... ... ....... .....
Majoor operations various other. ......e.. ......
inof operations, various. ... .... .... .....

,Total.... ... .. .. ..... .... ... .... ....
S. .. Te eo ma ......... ... ......................, ............ ..,. 1


*l TABLE. XV...II.-SANoITATX IONe. .
The following is a summary of sanitary work perfonned an4aii
during themonthin the CnariZone:- ---- .. -. ... .:

Gr.es.uting ..........

.." Miseig Ia .eousr i .a.-roe -.........r..-,,"". ........... .. 3
6'rbim. Mg. .:- -. -------
,, ...io ot rs ..,...... ..............
Work requests-on engineering department...
Work requitso on other departments .. ....- '.,... .. "..,.
SNoties served to ....ate nuisances.... ..............- .....
SArrests for aviation otf an.itay iegi.... ..... ....... ,-.,:
Convict is. ...- ...'o..... .. ..;..
__ es dignnper it "a..ved.. -..s. -.-- -. .... .... ..
S, sp ope s so e.....tio of close.ts'-..:..,.
Inspections of restaurants...,...; -,- ..--.-.
*'*. ..* ."ji s p e c t n :sb a p. -; .. .-. '.J.. -"- -. : .'. :
oar a.ge Ie I.. ........ ..

S r...a:d. oil ed a.... ..-........ .. ..
S* es. feeted. .... ... ...... ..... .- -
Sat tr&sm'used daily.-... .in ;
Adutn.Anophetes destroyed in houses-.-'..;..: : a:;,: iiP

*; C on ia.ers found' with .t.go. .yia la a ....... .. I .. :



., .. .l .u .e s. .....-. ".... .._-.. -' .,- .. ...... .,.,-.a
. ,. .. -. ... .. .
,:. ; i!,II^













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S... .. .. ... .... ... ... N. ` y:
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. ne...-... .. ....- -. ...4 .. .. "1. .





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: ._- .-..:....:. ...... .... -.. .. ..." 8

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-" 1 ....... ... .....


..." ". .... ....'. .. .. .







.. .... .. ....

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,. ,, ,; ,. ....., :,. L,. : .~~~~. t:...,.. ,.., ., ::,,,.. ..,,,,: .: .. .. .........
ii ... ,, ,... ....... .' .,.. ... .,. .....,
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L .E.' .. .. .. : D [. :.'E' E ..:-'.' :;. EE :: .. ... :" :E.':: .
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= :. .:.. s?. "' .... :t:sm' (.'".'" E. '.:.: :"I ":.:: :.. "K. ':. : :':." ". ." 'E:EE :
?,,e; a a. ;".,.. .. ...T ,. i,.,..,. .... !... .... .. ... ..... ,...
... g:r .. ....~; ; r... .:... ,: .. .,: .t .. ., ..: .... :: ..
: : : :: .": : ; ':i: 3 ,: ":: .:':... ": '.:":.,:i;:, :: ',.















LinevaryarsdisTaMi Wnl"ainm .: ,.-.
.. loanss larvacidelse.,d ... .
S.Gallons rude oil used... ....
Sanitation, Mount Hope: : .: ;;
Square yard-.oiled--;-.-... .. .... .: .

... ".. "" "es killed m
Receptacles t .reated.;-. .--:-.- ..... -:- ---:.-- I
., -.Number mosquito-breeding places dstr.yed .... ;- ,..
Number mosquitoes kled i bar (Ariph. i201, C u. s
Number mosquitoes ksi d in cars (Anoph. 0,0. Cut i .0 i
Linear feet ditches .. mata .. ...-... .---..
Gallons laracid used.................. ......... .--------------
Gallons crude oil. sed- ...... ......---- :
General sanitation Mindi Island (Jfly 21 to Slinclusive)
SSquare yards lliMng in low places-..--...--.....-- ....... .--
'Square yards removing vegetation.. -..-...-. ..--.... -. -:..',
;*-. Ditching (cubic yards 3034), linear yards, ....... ........
Vaccinations:
From July o to 17; .......... .....
Number of patients examined and passed., .. .. ..,:
TAuLE XVII.-QUARANTINE TRANSACTIONS AT-T!i
BALBOA AND PANAMA FOR THE MONTHS OF3-
Number of vessels inspected and passed ........ ... -; :.- -i- .
Number of vessels inspected and held in quarantine......: .
Total number of vessels inspected ..... ....- ........ -
Number of vessels fumigated on arrival.... ... ........ ....,
Number of vessels fumigated on departure....-------
Totl numberof vessels fmigted...... ........, -
Number of crew xamind---..---...-----------......-.-...-......... :.:
Number of passengers from foreign ports examined and landed::%.
Cabin......-.. ................ .... ...-----.---..
S. Sterage..... ..................-....... .....--

Total umler- of person examined -..
lumber ofpei s vaccinated atports ofarrivalbecauqeotom
*vacfCiaton law ...-..-...... ...-..... : '---
aNumber of persons vacinatedi at ports o departuFre:oreo
of copulsoy vaccination law.. ..----...-------.
Total mnmberofl persons accinated .. .--
Numb*r of peronie ih il.quarantine at the detentionhou t ''e.
:iplte .pezo of incubation for fever or plamue-...--. -.... ::.,
Number of persons'held i quarantine board vie
per; iod of m baton i yellow fever ot pl0agute.. :


Ca in-.-. o a y *. .. .. .


Sraft...... ..........:. ..--


ttin A----
Number of persons aelirnig o f ,.: ,,


S. .. : .. ...
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., plague-.. .,.. ..... :......... .
on. .eselss........ e ...... .-, k:^ .
9Z1*,oeld under obUservato. .. 9
nladed frib foruigi-ports: : ..
I .- .
-V





emilfred for foreign ports: 9
S .:-....-....- -.. ..... -... -. .. I, O79 *
... s.. ...... .. ... ,.

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T- a t ,oni .....
S otal nm er of pros embared or f o f:..g o: .... '
,i .. .. ... ... ... .-. .. .. ... .. .-'. '. -

S Totl number of ersonsa ...... .. ...from coast tons o s. ... l
: : m .e t: -:.. p s. : .. .. :. -. .. .. :.-- 7- .i-------

Totali.n' ber of persons sailing for coast towns on small. '
** a d sailing 'r a ............ r.. .... .. ..


Apparent crease fr month from foreign ports:







-- P--
... Steerae:(d eae..-.

Nnmbier iifirant commended for deportation
-. Number.ofcerificates issued. tooutgoingpassngers...
Ninber ofee feo lth issued or vis"d. -1 '. ,^5fi : .. .
S.l .berofi persons landed .....-.. ... _-.."-----
*LesE number far Lacrnc ports-.'---------------------a
STotal number of persons sPaiimgn.g: or--.t------. m.i
.. ..* ... ...... .'. .. .:.' .

Totaparent res# -...
M RATIONN POT,. FO s0OW
....-. L 5
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Full Text

PAGE 3

99 ( I +

PAGE 4

x .-..----: : -: .: ..--:: -:: -: : -: -: :. .x -:: :: .:f .-:7-

PAGE 5

REPORT OF THE DEPARTMENT OF HEALTH OF THE PANAMA CANAL FOR THE MONTH OF JULY, 1914 CHAS. F. MASON Lieut. Colonel, Medical Corps, United States Arnu Chief Health Officer, Ancon, Canal Zode WASHINGTON 1914

PAGE 6

4 .x 4.-x u -In/2W Mn & \\C -R Iinti u-uu --g -.s x-:. ,* -3 -y t -x

PAGE 7

CONTENTS, Page. Letter of transmittal. 5 General remarks. 5 Vital statistics: Health of employees. 5 Health of residents of Canal Zone. 6 Health of residents of the city of Panama. 6 Health of residents of the city of Colon. 7 Hospital division: Ancon Hospital. 7 Board of health laboratory. 7 Farm for disabled. 8 Insane department. 8 Colon Hospital--------.-----------------------------------8 Chronic department. 8 Palo Seco Leper Asylum. 9 Santo Tomas Hospital. 9 District dispensaries. 9 Sanitary division: Canal Zone. 9 Panama. .........------------------------------------------------10 Colon.-.---------------. 11 Quarantine division: Panam a. ..11 Colon. 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 employees and civil population and places where chargeable. 15 VII. Admissions and deaths in the hospitals of the Panama Canal. 18 VIII. Consolidated hospital report. 32 IX. Consolidated dispensary and admission report. 34 X. Employees: Constantly sick and noneffective rates per 1,000. 35 XI. Employees: Days' treatment per admission, hospitals and quarters. 36 XII. Financial statement.-. 36 XIII. Ancon Hospital. 36 XIV. Colon Hospital. 42 XV. Palo Seco Leper Asylum. 43 XVI. Santo Tomas Hospital. 44 XVII. Sanitary work done in Canal Zone, Panama, and Colon. 46. XVIII. Quarantine transactions. 48 XIX. Issues of quinine. 51 XX. Personnelreport. 51

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-x:49

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LETTER OF TRANSITTAL. THE PANAMA CANAL, DEPARTMENT OF HEALTH, Ancon, Canal Zone, August 11, 1914. To the GOVERNOR OF THE PANAMA CANAL, Culebra, Canal Zone. Sm: I have the honor to submit the following report of the operations of the department of health for the month of July, 1914. Very respectfully, CHAS. F. MASON, Chief Health Officer. GENERAL REMARKS. No cases of yellow fever, smallpox, or plague originated on or were brought to the Isthmus during the month. VITAL STATISTICS. EMPLOYEES. The very large movement of employees from the Canal Zone to Panama and Colon, which has recently taken place, will no doubt affect their vital statistics, though this effect is not apparent. When the last zone census was taken in February, 1912, only about 9,872 employees out of 42,174 were living in the terminal cities, while now over one-half of the employees live in these cities. The health of the employees continues very good. The number of names on the rolls for the preceding month was 46,616. The total number of admissions to hospitals and quarters was 1,424, or a rate of 366.57 per thousand per annum, as compared with 381.09 for the preceding month, and 513.87 for the corresponding month of last year. The total number of deaths from all causes was 27. Of these 16 died from disease, or 4.12 per thousand per annum, as compared with 3.28 for the preceding month, and 5.38 for the corresponding month of last year. The diseases causing the largest number of deaths were as follows: Lobar pneumonia 3, and tuberculosis 3. No other disease caused more than 1 death. The number of employees per thousand constantly sick was 11, compared with 11.69 for the preceding month, and 15.19 for the corresponding month of last year. The disease causing the highest admission and noneffective rates in hospitals was malaria, with rates of 87 per thousand per annum (5)

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6 and 1.66 per thousand, respectively. The corresponding admission rates for last month and the same month of last year were 62 and 69; 35 per cent of all admissions were due to this cause. The next highest admission rates were for venereal diseases, diseases of the digestive system, nervous system, and respiratory system. These five classes of diseases caused 62 per cent of all admissions. The admission rate for typhoid fever per thousand per annum was 0.51, as compaied with 0.00 for the preceding month, and 0.83 for the corresponding period of last year. EFFECTS OF RACE. The admission rate to hospitals and death rate for disease for black employees were 151.58 and 4.56 per thousand per annum, as compared with 386.33 and 1.69 for white employees. The noneffective rate for disease and injuries for black employees per thousand was 9.78, as compared with 17.76 for white employees. The admission rate to hospitals for malaria was 78.68 per thousand per annum for blacks, as compared with 134.96 for whites. DEPORTATIONS. There were 20 deportations accomplished during the month, divided as follows: Employees, 13; nonemployees, 7; for disease, 15; and injury, 5. CANAL ZONE. A census of the Canal Zone taken by the police department between the 16th and 30th of June shows that there were 37,702 people living in the zone, of whom 18,548 were employees, 2,154 soldiers, 7,247 women, and 7,059 children. The estimated population for the preceding month was.54,655. The result of the census confirms the opinion expressed in former reports that the estimated population of the zone was much too high. The ratios in the present and future reports will be based on the new census. The total number of deaths for the month was 54; of these, 46 deaths were from disease, giving a rate of 14.64 per thousand per annum, as compared with 9.22 for the preceding month, and 16.47 for the corresponding month of last year. Of the total deaths from disease the percentage under 5 years of age was 35, compared with 35 last month. There were 63 births, giving a rate of 20.32 per thousand per annum. There were 15 deaths of children under 1 year of age, giving an infant mortality of 238 per thousand. For colored children under 1 year of age, the rate was 286. PANAMA CITY. The population of this city, which has been carried at 47,172 since July, 1912, has been increased this month by 15,000 people. This is an estimate based partly upon the number of employees and others who have emigrated from the Zone to the terminal cities, as shown by the recent census, and partly upon the estimates of

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'7 our health officers and sanitary inspectors, who have noted the great influx of people overcrowding all available houses in Panama. These figures will be checked by a census to be taken as soon as possible. During the month there were a total of 176 deaths; of these, 172 deaths were from disease, giving a rate of 33.20 per thousand per annum, as compared with 38.16 for the preceding month, and 31.03 for the corresponding month of last year. Of the total deaths from disease the percentage under 5 years of age was 47, compared with 55 last month. The principal causes of death showing an increase were tuberculosis, pneumonia, heart disease, and malaria. COLON. In Colon, with an estimated population of 20,232, there were 68 deaths; of these, 66 deaths were from disease, giving a rate of 39.14 per thousand per annum, as compared with 26.10 for the preceding month, and 23.72 for the corresponding month of last year. The increase death rate in Colon is, no doubt, largely due to an increased population, which has undergone no revision for the last two years. The greater part of the increase was in children under 5 years of age, the percentage of whose deaths to the total deaths from disease increased from 36 in June to 47 in July. The causes of death showing the largest increase are bronchitis and pneumonia, malaria, and malnutrition. HOSPITAL DIVISION. ANcON HOSPITAL. There has been a decided decrease in the number of patients admitted to hospital since the new regulations governing treatment in hospitals has gone into effect. The number of admissions to Ancon Hospital in July were: Employees, 805; others, 509, as against 859 employees and 584 others in May, and this notwithstanding July usually shows the highest admission rate of any month in the year. There has been a large increase in the revenues of the hospital, the total receipts being $27,346.53 in July as compared with $15,169.99 in April. This increased revenue has resulted in a decrease in the net per capita cost per patient from $0.90 in April to $0.396 in July, and this notwithstanding an increase in the cost of the ration from $0.241 to $0.277 in the same period. During the month two of the old French wards (11 and 12) were found to be unsafe, and were evacuated with a view to their destruction and replacement. Board of health laboratory.-The following special work was done: Bionomics of Stegomyia scutellaris. Breeding of citrus tree moths. Observations on the relation of Anopheles albimanus to Anopheles tarsimaculata. Preparation of suitable mounting media for mounting pathological specimens for exhibit. Preparing and mounting specimens for exhibit. 65448-13---2

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8 Flea observations. Susceptibility of sloth and deer to Trypanosoma hippicum. Collection of data on syphilitic aortitis. Examination of smears from placentas with relation to the diagnosis of malaria. A study of the deteriorating effect of certain constituents in the atmosphere on larvacide. Examination on the nonvolatile constituents of crude carbolic acid and the relation of these substances to the complete emulsification of the crude carbolic acid with resin soap. An attempt to determine the slight amount of acid substances occurring in some hydrocarbon lubricating oils. In addition, tha bacteriologist is preparing the proceedings of the Canal Zone Medical Association for publication, and the chief of laboratory is collecting material and data for the San Francisco exhibit. Farm for disabled.-During the month there were planted out 6,500 pineapple plants, 375 coconuts, 300 papayas, and 8 acres of Para grass; built 4,480 feet of wire fence and cleaned off site for cow barns. Cultivated corn, yams, bananas, yucca, Kaffir corn, sorghum, and vegetable garden. Insane departrnent.-During the month there were 22 admissions to the observation ward, and 2 patients were returned from the hospital proper where they had been transferred for surgical reasons. Of the 18 discharges from the institution there were 11 recoveries, 1 was improved, and 6 were unimproved, the latter being deported to Barbados 2, England 1, Holland 2, and Spain 1. Two deaths occurred within the month, 1 being an acute case and the other of a chronic nature. The government of Jamaica has recently authorized the repatristion of 10 male and 10 female Jamaicans at present in the asylum, and it is expected that they will be deported in the next few weeks. Negotiations have been initiated with the representatives in 'Panama of several foreign Governments with a view to the repatriation of their respective nationals also. The health of the insane population was unusually good. No cases of malaria were admitted, nor did any develop either among the patients or employees. The manual occupations of the patients, both at the Corozal farm and asylum, are making satisfactory progress, and the beneficial effects to'them, as well as the economic value to the institution, are steadily becoming manifest. Detailed statistics are shown in Table XIII. COLON HOSPITAL. The highest number of patients treated on any one day during the month was 57, the lowest number 41, the daily average beirg 48.16. The average number of employees constantly sick was 33.70. The average number of days' treatment per employee was 6.64. Chronic ward.-There were 25.19 chronic and incurable patients constantly cared for during the month. Detailed statistics are shown in Table XIV.

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9 PALO SEco LEPER AsyLum. The number of patients under treatment at the end of the month was 51, an increase of 2 over the previous month. Detailed statistics are shown in Table XV. SANTO ToMAs HOSPITAL. During the month a total of 1,307 cases were treated in the different wards, showing an increase over the preceding month. The daily average for the month was 362, a decrease of 6 from the preceding month. The total number of hospital days was 11,231; the per capita cost was $0.8428 United States currency per day, and the subsistence cost $0.235 per day. The deaths for the month totaled 77, an increase of 14 over the preceding month. The births were 80, a decrease of 7 from the preceding month. Malaria was the predominant disease treated, the rate being considerably higher than for the month preceding. For the first time in many months the hospital was entirely free from typhoid fever, pneumonia, or dysentery on the first day of the month. Scarlet fever seems to be slightly on the increase, as does diphtheria and varicella. During the month the new home for the pupil nurses was completed and at once occupied. Preparations for converting the former dormitory of the maternity pupils into an additional ward have been made, and this new ward should be ready for occupancy before the end of August. Detailed statistics are shown in Table XVI. DISTRICT DISPENSARIES. The district having the largest admission rate for malaria was Toro Point, with an average weekly percentage of 1.24; that having the lowest admission rate for malaria was Culebra, with a percentage of .11. Detailed statistics are shown in Table IX. SANITATION DIVISION. CANAL ZONE. The malaria rate has been maintained at an exceptionally low level, considering the season and the fact that percentages are figured on a new, careful, and considerably lowered census. As foreseen last month, very extensive Anopheles breeding areas developed back of San Miguel, but as work was undertaken eacly for the control of this, it is thought that serious harm will not result. One case of typhoid fever developed in the zone in June. Malaria carriers are now being brought under treatment to a greater extent than formerly, but not nearly all yet receive it. The negro towns are in even better condition than last 'month. The expenses of mosquito-prevention work are less in most towns than in any previous July, while the catches and the malaria rate indicate that the results are good. Detailed statistics are shown in Table XVII.

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10 PANAMA. STREET CLEANING. The new equipment for the street-cleaning service has arrived and will be set up and placed in operation as soon as practicable. With this new equipment we expect to be able to overcome the raising of dust clouds which are common where street brooms are used. GARBAGE COLLECTION. Garbage-collection service was satisfactorily maintained during the month, and all refuse matter received at the dump was cremated. A start was made on erecting an incinerator for cremating manure and will be placed in operation during the coming month. At this incinerator all manure collected in the city will be handled; this will allow a more rapid cremation of garbage at dump No. 2. BUILDING INSPECTION. It was found 'necessary to condemn 179 buildings during the month, and of this number 23 were demolished, 21 by the owners and 2 by the forces of this office. A total of 153 permits were issued for new buildings and repairs to old buildings. The status of building construction work since April 1 is shown below: Number Number of permits comPer cent. issued. pleted. April------.----------------------------------131 86 66 May-------------------. .-----------------------175 75 42 June--------. .-----------------207 70 31 Arrangements have been made so that property owners can secure high-grade gravel for their cement work. This will be of considerable benefit to all concerned, as it will allow of a better class of work than was possible under the old plan of using a low-grade sand which was the only kind obtainable in this city. Special attention is being given to the rat-proofing feature of all buildings in the city. MOSQUITO, FLY, AND RAT WORK. Fewer mosquito-breeding places were found during the month than: has been reported for the two previous months, as shown by May, 1,400; June, 1,185; July, 752. There is also a slight reduction in the number of fly-breeding places found, there being 1,209 such areas located during July, as against 1,336 for the month of June. There was a total catch of 714 rats for the month; of this number 669 were sent to the laboratory for examination for plague. No plague-infected rats were found or reported during the month. SCORE CARDS. Hotels, restaurants, aerated water factories, breweries, ice cream parlors, dairies, and bakeries were regularly inspected during the month, and conditions found in these several places noted on the score card.

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1I VACCINATIONS. The work of vaccinating children was completed during the month, when 342 children were vaccinated, making a grand total of 5,186 children vaccinated. The work of vaccinating adults will be started during the coming month. CONTAGIOUS DISEASES. The following contagious diseases were reported during the month: Cases. Diphtheria. 4 Scarlet fever.--. 3 Typhoid fever. ..2 All of the above cases were isolated as soon as found, and precautions taken to prevent the spread of the disease in each case. Of the two typhoid cases reported, one was contracted in Chorrea and is not chargeable to this district; the other case was presumably contracted in this city. Diagnosis of both cases was made on the Bass-Watkins agglutination test; Widal's in both cases was negative; no blood cultures were made. These cases were isolated and treated in the hospital. Detailed statistics are shown in Table XVII COLON. A special propaganda for cleanliness has been inaugurated through the press and posters, the slogan being "Clean up for opening day." An arrangement has been made with the municipality for the collection and destruction of all unlicensed dogs in the city, and the work is already in progress. A special effort is being made to keep the sidewalks clean and in good repair. The antirat campaign has been maintained. The Panama Railroad freight office has been made rat-proof, and the condition of the docks has been greatly improved. The progress of vaccination has been temporaily suspended, until -the arrival of additional vaccine. Three cases of diphtheria. have been the only communicable diseases reported during the month. Detailed statistics are shown in Table XVII. QUARANTINE SERVICE. The plague situation in Havana, Cuba, appears to show an improvement, doubtless due to the active measures being taken. No report of any additional cases occurring at Santiago has been received. Measures for plague eradication are being actively taken in New Orleans, and ships arriving from that port have complied with our regulations and are not being detained. The situation regarding plague and yellow fever in South America remains about the same. No quarantinable disease has arrived at any of the Isthmian ports during the past month Detailed statistics are shown in Table XVIII.

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12 TABLE I.-ADMISSIONS, DEATHS, AND NONEFFECTIVE RATES FOR EMPLOYEES: DEATHS OF RESIDENTS OF PANAMA, COLON, AND THE CANAL ZONE. ABSOLUTE NUMBERS. Admissions to hospitals. Died. Noneffective from sickness. Number Color. of emExter.ExterConployees Total. Disnal Total. Disnal Days stantly ease' causes. ease. causes. treated. noneffective. July,1914. White. 7,113 267 229 38 5 1 4 3,916 126.33 Colored.39,503 688 499 189 22 15 7 11,983 386.56 Total 46,616 955 728 227 27 16 11 15,899 512.89 June,1914. White. 8,350 304 244 60 2 1 1 4,676 155.88 Colored. .39,229 622 457 165 18 12 6 12,008 400.27 Total 47,579 926 701 225 20 13 7 16,684 556.15 July,1913. White. 12,317 717 595 122 4 2 2 11,428 368.64 Colored. 45,643 1,004 626 378 33 24 9 15,868 511.88 Total 57,960 1,721 1,221 500 37 26 11 27,296 880.52 PROPORTIONATE NUMBERS.1 Admissions to hospitals. Died. NumMalaria Color. emExterExterto hosTotal. ployees. Total. nal Total. Disnal pital. ease. causes. causes. July,1914. White. 7,113 450.44 386.33 64.11 8.44 1.69 6. 75 2.83 17.76 Colored. 39,503 208. 99 151.58 57.41 6.68 4.56 2.12 1.44 9.78 Total 46,616 245.84 187. 40 58.44 6.95 4.12 2.83 1.66 11.00 June,1914. White. 8,350 436.89 350.66 86.23 2.86 1. 43 1.43 3.15 18.67 Colored. .39,229 190.27 139.79 50.48 5.50 3.67 1.83 1.29 10.20 Total 47,579 233.55 176.80 56.75 5.04 3.28 1.76 1.62 11.69 July,1913. White. 12,317 698.55 579.69 118.86 3.90 1.95 1.95 (2) 29.93 Colored. 45,643 263.96 164.58 99.38 8.68 6.31 2.37 (2) 11. 21 Total 57,960 356.31 252. 79 103.52 7.66 5.38 2.28 .15.19 I Annual average per 1,000. 2 No record.

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13 TABLE I.-ADMISSIONS, DEATHS, AND NONEFFECTIVE RATES FOIL EMPLOYEES: DEATHS OF RESIDENTS OF PANAMA, COLON, AND THE CANAL ZONE-Continued. Deaths. Annual average per 1,009. Place. PopuPlc.lation. DiExDiExTotal. Dasternal Total. eternal ee.causes. ae.causes. Jul, 1914. Panama-----------62,172 176 172 4 33.97 33.20 0.77 Colon--------------20,232 68 66 2 40.33 39.14 1.19 CanalZone. 37,702 54 46 8 17.19 14.64 2.55 Total. 120,106 298 281 14 29.77 28.37 1.40 June, 1914. Panama. 47,172 156 150 6 39.68 38.16 1.52 Colon. 20,232 48 44 4 28.47 26.10 2.37 CanalZone. 5 ,655 44 42 2 9.66 9.22 .44 Total. 122,059 248 236 12 24.38 23.20 L18. July, 1913. Panama. 47,172 130 122 8 33.07 31.03 2.04 Colon-----------20,232 43 40 3 25.50 23.72 1.78 CanalZone. 63,390 98 87 11 18.55 16.47 2.08 Total. 130,794 271 249 22 24.86 22.84 2.02 TABLE II.-DEATHS BY AGE, COLOR, AND SEX. White. Colored. Yellow. Total. Agre. Under one year.4 2 6 55 37 92 ...59 39 98. -1to 4years. 1. 1 18 9 27 .1 1 19 10 29 5 tol10years. 2 2 1 .1. ..1 2 3 11 to 20years. 1 .1 2 9 11. ..3 9 12 21 to 30years. 4 1 5 38 18 56. ..42 19 61 31 to40 years. 3 4 7 20 10 30 ...23 14 37 41 to 50years. 3. 3 12 10 22 1 .1 16 10 2O6 51 to 60years. 1 2 3 4 4 8. ..5 6 11 61 to70 years.2 1 3 2 2 4. ..4 3 7 <71 to 8O years. .1 1, 1 4 5. ..1 5 0 91 to00 years. ...1 1 2. ..1 1 2 Not stated. ...5 1 6. ..5 1 0 .Total.19 13 32159 105 264 1 1 2 179 119 298

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14 TABLE III.-DEATHS, BY NATIONALITY. Nation. Employees. NonemTotal. ployees. Antigua. .3 3 Barbados. 8 26 34 Chile. .1 1 -China. 1 1 Colombia. 1 3 4 Costa Rica. 1 1 Cuba. :. .1 1 Demerara. .1 1 Etuador. .1 1 England. 1 1 Guadeloupe-. 1 .1 Haita. 1 1 2 Jamaica. 7 53 60 Martinique. 2 5 7 Mexico .-1 --1 Panama. 1 140 141 Spain. .7 7 St. Kitts. .1 1 St. Lucia. .7 7 St. Thomas. .1 1 St. Vincent. ...1 1 Trinidad .-. 1 2 3 United States. 5 10 Venezuela. .3 3 West Indies. ..4 4 Unnon. ..1 U nkno-,n 1----------------1---Total. 27 271 298 TABLE IV.-DEATH RATE AMONG AMERICANS ON THE ISTHMUS. CONNECTED WITH THE PANAMA CANAL. Number Annual Cases. Cause of death. of deaths. average per 1,000. White employees from the 2 Disease. 1 2.29 the 24 Vilnc._ 4 9.14 United States .f All causes. 5 11.43 white women and childrenfrom Disease. 1 3.16 the United States. 3,796 Violence. ..-. th UAll causes. 1 3.16 White employees and their Disease. 2 2.65 families from the United 9,044 Violence. 4 5.31 States. 1All causes. 6 7.96 Total number of Americans on Disease .2 2.09 the Canal Zone 1.lces5 5.21 th .anlZo.) IAl causes---*. 7 7.30

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15 TABLE V.-CAUSES OF DEATHS OF EMPLOYEES OF THE PANAMK CANAL AND PANAMA RAILROAD. Causes of death. White. Colored. *Total. Disease: Apoplexy.1 Dysentery, unclassified ..1 1 Infection, undetermined ..1 Leuchemia, lymphatic.-.,. .1 Lobar pneumonia. ..---------------------------------3 3 Malignant endocarditis-----------------------------1 1 Purulent infection and septicaemia-. .1 1 Stricture of the urethra .-----------------------------1 1 Sudden death. .1 1 Tetanus. .....----------------------------------------1 1 Tuberculosis, acute miliary.-. .I I Tuberculosis, disseminated. .2 2 Uremia. .....-----------------------------------------1 1 Violence: Accidental drowning. .3 3 Dynamite traumatism. 4 2 6 Railroad traujmatism. .2 2 Total. 5 22 27 TABLE'VI.-CAUSES OF DEATHS OF EMPLOYEES AND CIVIL POPULATION AND PLACES WHERE CHARGEABLE. Disease. PanaColon. Canal Total. ma. Zone. General diseases. Typhoid fever1. .----------Malarial fever: Estivo-autumnal. .2 1 3 Tertian.------------------------------------1 Quartan. 1 ..1 Undetermined-. 6 ------------. Clinical. ---------2 .2 Diphtheria and croup. 1 ..1 D ysentery.-. .....1 ..1 Unclassified. ..2 1 .3 Hemoglobinuric fever unqualified. ..1 Purulent infection and septicemia. ..1 Septicemia. 1 1 1 Tetanus. 1 -----1 2 Pellagra. 2 2 .4 Beriberi ..1 ..1 Tuberculosis of the lungs. .26 .7 3 36 Acute military tuberculosis .1 .2 3 Tuberculous meningitis. 1 ..1 Disseminated tuberculosis. ..3 3 Syphilis: Tertiary. .-.1 2 Period not stated. 1 ..1 Cancer and other malignant tumors of theBuccal cavity.-. 1 1. 2 Stomach and liver.-.-. I ..1 Peritoneum, intestines, rectum. .1 .1 65448-14--3

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16 TABLE VI.-CAUSES OF DEATHS OF EMPLOYEES AND CIVIL POPULATION AND PLACES WHERE CHARGEABLE-Continued. Disease. Pa Colon. n Total.General diseases-Continued. Diabetes. .....---------------------------------1 .1 Leuchem ia lym phatic. ....--.-. 22 Alcholism: Acute or chronic .---------------.1 -------Chronic-------------------------------1 ----------------1 Diseases of the nervous system and of the organs of special sense. Cerebral hemorrhage, apoplexy ----------------1 1 1 3 Paralysis without specified cause ----------------------------I Convulsions of infants (under 5 years of age) --. 2 --------------2 Diseases of the circulatory system. Acute endocarditis.--------------------------1 -------1 2 Malignant endocarditis .1 .., I Organic diseases of the heart.------------------9 3 4 16 Arteriosclerosis. 1 ------------Diseases of the respiratory system. Acute bronchitis.4 8. 1 Act rnhts--------------------------4 8 ---12 Chronic bronchitis .-------------------------------1 1 Broncho-pneumonia. 7 2 .9 Pneumonia (unqualified).---------------------3 ...3 Lobar pneumonia. .--------------------------2 5 3 10 Pleurisy. .---------------------------------1 --------------1 Gangrene of the lungs .-----------------------------------1 1 Other diseases of the respiratory system (tuberculosis excepted) .-------------------------------1------Diseases of the digestive system. Ulcer of thestomach. -.---------------------1 -------. 1 Acute gastritis.-----------------------------.--3 3 Chronic gastritis.------------------------------.--. 1 --------1 Acute indigestion. ...--------------------------------1 1 2 Diarrhea and enteritis (under 2 years)----------36 1 4 41 Diarrhea and enteritis (2 years and over)--------2 1 .3 Appendicitis and typhlitis. 1 .1 Otherhernias------....1---------------1 Intestinal obstruction. -------------------------1 -----------1 Other diseases of the intestines--.-.-.--1 .---------------1 Cirrhosisof theliver.-------------------------3 2 ----.5 Other diseases of theliver.-------------------1 --------------1 Abscess of liver (unqualified)----------------2--------------2 Nonvenereal diseases of the genito-urinary system and annexa. Acute nephritis----------. .------------------1 --------------1 Bright's disease (chronic nephritis). 13 3 1 17 Other diseases of the kidney and annexa--------1 --------------1 Diseases of the urethra, urinary abscess, etc -----------.--------1 1 Uterine tumor (noncancerous) -----------------1 ..I Salpingitis and other diseases of the -female genital organs. ----------------------------1 .1 2

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17 TABLE VI.-CAUSES OF DEATHS OF EMPLOYEE ES AND CIVIL POPULATION AND PLACES WHERE CHARGEABLE--Continued. Disease. PanaColon. Canal Total. ma. Zone. The puerperal state. Hyperemesis gravidarum. 1 ..1 Puerperal septicemia .------------------------. 2 --------------2 Diseases of the bones and of the organs oj locomotion. Osteomyelitis. 1 --------------1 Malformations. Congenital malformations (stillbirths not included)-------------------------. ------.-. 1 Diseases of early infancy. Congenital debility, icterus, and sclerema. 1 ..1 Premature birth------------------------. 4 .4 8 Inc. congenital debility .----------------------1 2 .3 Malnutrition. ...-----------------------------5 9 6 20 Other causes peculiar to early infancy (including various consequences of labor)----------------1 ..1 Old age. Senility. .1 2 3 Affections produced by external causes. Suicide by drowning. .I .1 Accidental drowning. 2 .1 3 Traumatism by machines-----. 1 ..I Railroad traumatism.-----------------------------1 2 3 Dynamite traumatism. 1 .5 6 Ill-defined diseases. Sudden death. 1 .-------1 Cause of death not specified or ill defined. 3 2 .5 Infections of undetermined origin .1 .-------1 Total. 176 68 54 298 Stillbirths. 10 8 4 22 Grand total. 186 76 58 320

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18 TABLE VII.-TABLE SHOWING ADMISSIONS AND DEATHS IN JULY, Ancon H ospital. Employees. Nonemployees. Admissions. Deaths. Admissions. Deaths. Diseases, White. White. White. White. 3O General diseases. Typhoid fever. 1. Typhoid prophylaxis. Malarial fever: Estivoautumnal. 15 7 129 ...15 9 23 --------1 Tertian.----. 1 11 12 816. -Quartan. -.-----. -. .6 ..1 .1 Clinical-. 16 15 52 --------23 10 16 .. Cachexia. .1 ........ Measles.-. ........1 ... Diphtheria and croup. .......4 1 ..I Croup.--r --------------------------------------1 ------------Influenza. 7 .....1 1 ... Dysentery. ........... Entemebic ...3 ........-. Unclassified. 1 .6 ..1 .1 ... Leprosy. ........1 ... Dengue. .......1. .. Hemoglobinuric fever, unqualified .....1 ..1 Filariasis .1-. ....... Purulent infection and septicemia .-. ....1 ..-.. Septicemia .-. .-. 1 ........ Tetanus. ..1. .1. ..... Pellagra. .1 .....2 .. Tuberculosis of the lungs. ..5 ....1 2 ..1 Acute miliary tuberculosis. ..1 ..1 ...1 1 Tuberculous meningitis ........1 ..1 Abdominal tuberculosis. .......... Tuberculosis of other organs ..1 ........-. Tuberculous abscess. ..1 ......... Disseminated tuberculosis. .2 ..2 .1 ..1 Syphilis: Secondary. 5 1 8 ...1. 2 .. Tertiary. .1 4 ...1 5 6 ..1 Period not stated. 3 .19 ...4 1 1. Gonorrhea. 4 3 22 ...10 3 1 .. Gonorrheal arthritis. 1 1 1 ...1 1 ...-Gonorrheal bubo..1 5 ....----..----Gonorrheal orchitis and epididymitis. 1. 1 ...1 -. .-. Gonorrheal ophthalmia. ...1 1.--. -.--

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19 THE HOSPITALS OF THE PANAMA CANAL FOR THE MONTH OF 1914. Colon Hospital. Total. Employees. Nonemployees. Employees. Nonemployees. AdmisDeaths. AdmisDeaths. Admis Deaths. Deaths. sions. sions. sons. sons. White White White White White White White White ro r c5 4f ....... 1 9.39 .1 3 6. .16 16,168 16 12 29 -1 1 11 8 1 ............1 11 14 ..1 6' ..1971.2118. .......1. ........1. -.1 ..........-1. ............1 ---. 71 1 .......... .....-. ...............-..6 ..1 .... ...................1 .-................1 ..........1 .....3 ... ......4 .. ......2 ....1 ....1 ....1 ..1.1 .................1 6 ;. .......11. ..1. .........1 1. ... ............2 .2. ..1. 5 1 .. 1 4. 1 5" 6. ......3. .19 .2 .4 1. 3. ......43225 8. .1031. 2. ....2. ..3.11 ...1 1 ....1. .g 1. ...1. *. ....11

PAGE 24

20 TABLE VII.-TABLE SHOWING ADMISSIONS AND DEATHS IN OF JULY, Ancon Hospital. Employees. Nonemployees. Admissions. Deaths. Admissions. Deaths. Diseases. White. White. White. White. &4 C4 .f 00 P;0 General diseases-Contd. Soft chancer. .3 1 8 ...7 2. .. Adenitis chancroidal.1 -.-. 5 -------------1-.-.-. Cancer and other malignant tumors of theStomach and liver -------------------1. Female genital organs .------------.---------1 2-.-. Other organs and of organs not specified --------------. .1 1---Other tumors (tumors of the female genital organs excepted).-------------2 1 1 --------------.-. Acute articular rheumatism 1 ....-------1. Diabetes. .-------------------.-. .....-1-. 1 Leuchawmia lymphatic ---------i ---------1. Hodgkin's disease----------.---. --2 ......... Anemia secondary, cause not determined---------1------..---.---..--. .---Purpura hemorrhagica-. ........1 .. Alcoholism: Acute. ---------------1 .........-. Chronic. 1. ...--------------1 1 Alcoholic psychosis -------------2 ..... Other chronic poisonings.-.-.-.-.-.-.2-.-.-.--. Diseases of the nervous system and of the organs of special sense. Cerebral hemorrhage apoplexy.----------------1 .1 1 --------------------. Other forms of mental alienation-.-.-. .2.---------------8. Dementia precox.-. .2-----------. .3 ... Epilepsy --------------------1-2------------I----. Ep le sy ........1 ....) I Hysteria -.-----------------------------2 1 Neuritis.-.-1 1-.-.-.1.-----------------1 Other diseases of the nervous system----------.---.---.---1 ------------2 Neurasthenia.-------------2 ...1 3 Diseases of the eyes and their annexa.-----------1 .2 9 ---------1 4 10 Follicular conjunctivitis-.-.-.--.-.-.-.-.-.1 Diseases of the ears--------5 3 2 ...--1 3-.

PAGE 25

21 THE HOSPITALS OF THE PANAMA CANAL FOR THE MONTH 1914-ContinuEd. -Colon Hospital. Total. Employees. Nonemployees. Employees. Nonemployees. AdmisDeaths. AdmisDeaths. AdmisDeaths. AdmisDeaths. sions. sons. sions. sions. White White White White White White White White 9s Di ce C6 Di &4c3 C3 C1 c r -~ -C6Q3 ; ....4 SCS 03 ca 2. .1 8 .5. 21----------.....3. .....2. --.-....1. .......12. 2 1 1 .......-I--.1 ...1. .1. ..12--------..1. ....--------.-.-.------.--.------.--.-. 1. 2i.-.-.--.---. ..iiK ...3.11--. ..... 2 ........I .2. ........2. -. ....1. 2 ...8 3 ...1 .......2 .......2. .1. ..1.2. .... ..2. ....3 .. ..2 ....1 .........1 ...1 1 .... 1 .............2 11 ...1 4 10 .... ..3 .. 1 1~~~~~~~~~. .......5,33'. ..

PAGE 26

TABLE VII-TABLE SHOWING ADMISSIONS AND DEATHS IN OF JULY, Ancon Hospital. Employees. Nonemployees. Admissions. Deaths. Admissions. Deaths. Diseases. White. White. White. White. Diseases of the circulatory system. Malignant endocarditis.----.-.---1 ------------------------Organic diseases of the heart -.-. .6 .-.----..-.2 ---.---.--.-A neurysm .---.--. -. ----. -------.------.----1 .-----------Arteriosclerosis --.---.-1 ---------. -----.------------. -------S Embolism and thrombosis.-----.----.-.------------o---------Diseases of the veins (varices, hemorrhoids, phlebitis, etc.).-.--.---. 1 ...------1 ---------------H em orrhoids.1 o-. 5 -. .---. 1 3 1 --..--. .-V aricocele.-.---.4 -----------.-------------o ---------Diseases of the lymphatic system (lymphangitis, M t n). e.doc.t .--.-----------------1 ------------Lymnhadenitis (nonvenereal).--------------------. 1 2 ---.----------.-I -----.--Hemorrhage; other diseases of the circulatory system. ------------------------------------Diseases of the respiratory system. Diseases of the nasal fossm,.5 .4 ..-.1 .2 -.--. .-..-.--. Adenoid vegetation ---------------------1 Myiasis of nasal fossae and sinuses.-----------. ....----1 -----------------------Diseases of the larynx.-. .o-------.-------I ------w------Laryngitis--------------------------------------------Diseases of the thyroid body-------------.-------------------1 Acutebronchitis.---. 2 1 7 -------.-----------------Chronie bronchitis.---------------------------Broneho-pneumonia..-.--1 -------------1 ------2 Lobar pneum onia.-.--.-. ..-3 ..1 .--.---3 ----.-I Pleurisy. system.-.-. .----.------. ----------Pulmonary congestion, pulionary apoplexy --------1 ----------.--------------------Gngrene of the lungs-. -...----------1 -. .1 Asthma.-----------------------------------------

PAGE 27

23 THE HOSPITALS OF THE PANAMA CANAL FOR -THE MONTH 194-Continued. Colon Hospital. Total. Employees. Nonemployees. Employees. Nonemployees. AdmisAdmisAdmisAdm*s -Deaths. Aatsss. deaths. sDeaths. Sions. sions. sions. sions. White White White White White White White White 5 ..2 i4. 0 $4 E 0A P. 0 *P 0 A ------........6.-.2. 1 ---------------------------------------------.1---------------------.-----1.----. -. -..-----.--..-..-1------------1. ........ .~~~~~. ..-------.131. ... -------------------------------......... ..-.-.-.---------...-1 ... 4 .4. 12. 1v 2 .1. ..... ---------221. .....-:: .... ............ ............. ..1 S. ....... ....-1. .....13. .1. ..3. 18. .11 ........1. 1 ..... .... .2 ..1 -. ..3 .3 .....1 .....-. ...... 5 .I. *654 48-14---4

PAGE 28

24 TABLE VIL-TABLE SHOWING ADMISSIONS AND DEATHS IN OF JULY, Ancon Hospital. Emplo-yees. Nonemnployees. Admissions. Deaths. Admissions. Deaths. Diseases. White. White. White. White. 40 PQ Q Diseases of the digestive system. Diseases of the teeth and gums.---2 ....1. .. Stomatitis.-.-.-.-.-.----------.1. Diseases of the pharynx. .1 4 ...1 3 4 ..-Pharyngitis.---------------1 1 ......... Follicular tonsilitis -. 4 ---3 ...4 11 .... Ulcer of the stomach. .......1 .... Other diseases of the stomach (cancer excepted). 2 .....-..-.. Gastrectasis. ........... A cute gastritis. .......... Chronic gastritis. 2 ..--. -. -. .1 .... Acute indigestion. ..1 ....2 6 ... Diarrhea and enteritis (mader 2 years). .......3 7 .1 2 Colitis. 1 ........... Diarrhea and enteritis (2 years and over). 1 .....1 2 .. Colitis. 1 .1 ....... Ankylostomiasis. ..2 ......... Intestinal parasites. .......1 .... Ascariasis .....1 .... Appendicitis and typhlitis. ......1 .... Acute appendicitis. ..1 .2 5 .... Chronic appendicitis. 1 .....3 ....Inguinal hernia. 2 .4 ....3. --. Other diseases of the intestines.2. ......4 1 .. Constipation. 7 .1 .-. ..1 1 ... Cirrhosis of the liver. ....2 ...--. Biliary calculi. 1 .....3 .. Other diseases of the liver. ..1 ...1 .... Abscess of the liver: Unqualified. ............. Entamoebic ...1 .... Cholecystitis .2 1 .... Simple peritonitis (nonpuerperal). ......1 .... Other diseases of the digestive system (cancer and tuberculosis excepted). .2 1 ...1 1 ....

PAGE 29

25 THE HOSPITALS OF THE PANAMA CANAL FOR THE -MONTH 114-Continued. Colon Hospital. Total. Employees. Nonemployees. Employees. Nonemployees. Adms-AdmisAdmis AdmisAd-SDeaths. Deaths. isDeaths. Deaths, sions. sons. sions. sions. White White White White White White White White 1 ..-. 2 S -S ---. -... ;41 ;4 P 4 ...;A ;3 4 ... 0. ....... -4 ---------4 --0.-q .......1 ---------------..---. S ......3 4 ----------------1 4--------1 3--------------------1--------2 ---1------------1. ------------------------4--.4----------------------------------------. -1 -----------------------1----------------------------------------------------------------------1 3-t1' ----------1 --------------------------2---------------------1 2 --------------------------------------------------------. ---1* 1 1-------------..----------------1---2----------------------------1 ... S--------------1----------2 .---. ------------------------------------.-----------------1 .--.--.-.-..-.--. .....1. .. ---------------------------.----.---.---.2. ---------------------------. ----. .-. .5 ---. ..--------...----. 1 ----1------------.--.-----1--.-.-------.-------------------------------------------------------------1-----7 -1 ... *--------------------1-----------21---------------. -----------------------1----------------21 --------11---------..............2 1 .... .~~ ~ ~ .......2 ....----...............2 1 ...1 1 ------

PAGE 30

26 TABLE VII.-TABLE SHOWING ADMISSIONS AND DEATHS IN OF JULY, Ancon Hospital. Employees. Nonemployees. Admissions. Deaths. Admissions. Deaths. Diseases. White. White. White'. White. Ce C 3 -~1 0~ A ~ r C) Pq Nonvenereal diseases of the genito-urinary system and annexa. Acute nephritis. ......1 Bright's disease (chronic nephritis). 2 .3 ....4 3. Chyluria. ........1 Other diseases of the kidney and annexa. 1 .1 ..1 2. Bilharziasis of urinary tract. ....---....1 Pyelo-nephrosis. .1. Calculi of the urinary passages. .2. Diseases of the bladder. ..1 .... Cystitis.-. 1 .1 ....1 Diseases pf the urethra, urinary abscess, etc. .1 --.-. 1 .1 .-Stricture of the urethra, nonvenereal. 4 .2 ...2 Diseases of the prostate. ..... Nonvenereal diseases of the male genital organs. .1 ...2 1. lHydrocele. 1 ........ Uterine tumor (noncancerous). .......--. Other diseases of the uterus. ....: .5 1 Metritis.1. ...1 Salpingitis and other diseases of the female genital organs. ......--.2 6 1 1 Nonpuerperal diseases of the breast (cancer excepted). .....1. The puerperal state. Normal labor.--. ......12 2 Accidents of pregnancy. .......4 1 Extra-uterine pregnancy. ........I. Hyperemesis gravidarum. ...1 1 Abortion. ....1 1 ---------Other accidents of labor. ....-------3 2. Puerperal diseases of the breast. .1.

PAGE 31

27 THE HOSPITALS OF THE PANAMA CANAL FOR THE MONTH 1914-Continued. -Colon Hospital. Total. Employees. Nonemployees. Employees. Nonemployees. AdmisDeaths. AdmisDeaths. AdmisDeaths. AdmisDeaths. sions. sions. sions. sions. White White White White White White White White cI) Ca S$:? C ) ad 4 adc 0 ;z 73 00 A qPq 0 PqA wP ----------------"----* ---------..... -2 ..--------5 5 3 ----------------------------------1 ..-. -. ...-------------.----1 2 ----------------------------*------------------------------...... ....-------....---------------..2 ..-.------I ---------.--. .------. -4 ----*----2 ---*-~1 1--. ------------------------*--1 ------.......-. ..............-----......I. .......3. .-. .-.....--* ...........5 2 ..... ....I. .......2. ....8.1 .......1. -. -. .....2 .1 ------------.-----,1 3 -..I. .......I. ..41. ....1 .i. .......21. .. .......32. 3 ..................1. ... 44

PAGE 32

28 TABLE VII.-TABLE SHOWING ADMISSIONS AND DEATHS IN OF JULY, Ancon Hospital. Employees. Nonemployees. Admissions. Deaths. Admissions. Deaths. Diseases. White. White. White White. C 3 Diseases of the skin and of the cellular tissue. Gangrene.:. ..-----------------------Furuncle.--.---------------1 2 1 ...Carbuncle.----. .----------------1 Acute abscess-----------4 1 5 ...2 2 6 Phlegmon and cellulitis.1 1 2 .---------1 Pemphigus contagious. .1 Ulcer of the skin. .1 .. Tropical ulcer. 1 ---. Impetigo contagiosa.-------.....2 Ingrowing nail. 1 .....1 Other diseases of the skin and annexa.----. ..2 ...1 5 2. Diseases of the bones and of the organs of locomotion. Diseases of the bones (tuberculosis excepted). 1 ......1. Diseases of the joints (tuberculosis and rheumatism excepted)1. 1 .....1 Arthritis. .....1 Synovitis. I Amputations. ........Other diseases of the organs of locomotion. 1 1 2 ...1 2. Malformations. Congenital malformations (stillbirth not included). .....1 1 .1 Diseases of early infancy. Newborn child ...-. ..15 2. Premature birth. ......1. ..2 Malnutrition. ....... Old age. Senility. ...1.

PAGE 33

29 THE HOSPITALS OF THE PANAMA CANAL FOR THE MONTH 1914-Continued. Colon Hospital. Total. Employees. Nonemployees. Employees. Nonemployees. AdmisDeaths. AdmsDeaths. Deaths. Deaths. .sio-is. sons. si White White White White White White White White ---------------------------------------------------------------------------1---------------------; -** *C -4 2 z &6 2 2 .12 ...11-----------------------------------------1 2 ----------------------------------------2 ----. .-.--------.-S-1 ----.--------....-I ---1 -------1-.--.--.----------1-. .. .1.------1 2 .. .1.12--------------. .. .....1.--.--.---------.--.-.-.-.-.---1.-.--.--.---3 .1 3------------1--------I .. .........2. .1.2. .. .............. ......3 1 -1-.--.--. --. .18. .. ..1. ............1 --

PAGE 34

30 TABLE VI.---'IABLE SHOWING ADMISSIONS AND DEATHS IN OF JULY, Ancon HospitaL Employees. Nonemployees. Admissions. Deaths. Admissions, Deaths. Diseases. White. White. White. White. rn rJ U) U ~; o o C Affections produced by external causes. Poisoning jy food.-. 1 3 2Other acute poisonings-----. 1 .-. Burns (conflagration excepted)---------------------3 ----------------2 1. Traumatism by firearms&-----------1-. ..-----. Traumatism by cutting or piercing instruments---------26. Traumatism by fall-------1 2 5 ------------1 1------------Traumatism by machines. 1 1 9. Traumatism byother crushings (vehicles, railroads, landslides, etc.). -2 9 9------------------------Railroad trauniatism ------.-. 1 3-----------1. Dynamite traumatism.2 --. 9 1. Traumatism by landslides. ..1. Starvation-------------.--.-. .---..-----------1. Homicide by cutting or piercing instruments -----------1. Fractures (cause not specified)-------.----------2 2 5 ------------1 1 1. Sprains.----------------1. 9. Other external violence. -2 6 76 ------------3 4 Ill-deoned diseases. Ill-defined organic disease .----------------------1. Infections of undetermined origin .....-...-..1 1 1 1 1 -No diseas6.-----------------1 2--------------23 6 -Feigned disease ------------. 1 Total-----------146 91 "74 2 1 10 106 240 181 .7 17 I

PAGE 35

31t THE HOSPITALS OF THE PANAMA CANAL FOR TILE MONTH 1914-Continued. Colon Hospital. Total. Employees. Nonemployees. Employees. Nonemployees. AdmisAdmisDeaths AdmisDeats AdmisDe sns. et sions ets. s1onsets s10fis. Dets White White White White White White White White cz G4 cz C4 a z 3 '5 3 2 1 -------.----------------------..----...1 3. ...3 1. S-. ......1-------------------------.-------.----. .---.------.....2 I S ......1. .---------------------1 .~. 2 2---------------2----------1 2 7. --. -1 1 2 -.1 6.---1 2 15 ....... 1216 -. .--13 ----------3 11 251 .1 3 .. S---1. .10 1 .1 ........10. ...1 ... -2 .1.2.-.24.--------------------------------------1 .........1 ......... .4 4--------.2 2 5 ...1 1 7 1 --.---.1.10 .......2 676.--3 43------.............1. .... .......i ..--. 1 .. ...1 2 ....1 2 ....24 8 .. ..... -------------------------------------822114. 33.215138 14108270219. 918 8 4 30 8 ..21 115 1113688 2 114

PAGE 36

TABLE VIII.-CONSOLIDATED HOSPITAL REPORT. Remaining DisTransRemaining Average number conJuly 1. charged. ferred. July 31. stantly sick. Hospitals. W. C. W. C. W. C. W. C. W. C. W. C. White. Colored. Total. A ncon Hospital. Panama Canal employees. 82 228 198 461 2 10 204 431 .10 74 238 76.54 243.19 319. 73 Panama Railroad employees .15 55 39 107 ..37 93 1 .16 69 15.19 58.16 73.35 Pay patients (Republic of Panama) .2 .......1 .1. 1.61 1.61 Other pay patients. 180 69 322 130 4 10 377 143 1 1 120 45 142.15 44.88 187.03 Charity patients. 25 4 22 35 3 6 28 8 .3 16 22 14.00 31.22 45.22 Total. 302 358 581 733 9 26 646 675 2 15 226 375 247.88 379.06 626.94 Insane department. Panama Canal employees. 7 22 .4 .1 1 3 1 2 5 20 6.29 22.03 28.32 Panama Railroad employees-----------10 2------------------1. .-11 ...11.06 11.06 Republicof Panamapay patients. 13 157 .14 ...3 2 .11 168 12.10 168.25 180.35 Other pay patients. 4 6 1 ...1 .4 6 4.74 6.00 10.74 Charity patients. 9 75 1 2 .1 .3 1 1 9 72 8.87 68.29 77.16 Total .33 270 2 22 .2 2 10 4 3 29 277 32.00 275.63 307.63 Grand total .335 628 583 755 9 28 648 685 6 18 255 652 279.88 654.69 934.57 Corozalfarm. Panama Canal employees. 7 43 1 3 ------------1 1 .3 7 42 7.00 41.77 48.77

PAGE 37

Colon Hospital. Panama Canal employees -----------21 22 81 .3 12 59 2 19 8 21 3.22 20.58 21,80 Panama Railroad employees. 3 13 8 33 .1 10 21 .16 1 8 1.64 8.25 9.89 Private pay patients .3 1 19 20 ..13 10 5 8 4 3 4.06 3.51 7.57 Republic.of Panama pay patients. 1 1 5 12 1 .5 3 9 1 1.51 2.54 4.0 Charity patients. 1 8 6 1 1 6 2 4 1 2.32 .48 2.80 Total.v. 7 37 262 152. 2 5 46 95 7 56 14 33 12.75 35.36 48.11 CHROME WARD'. Charity patients,.26 3. .24. 25.19 25.19 Palo Seco Leper A sylum. Republic of Panama pay patients. 2 30 2 1. ...2 31 2.00 33.87 35.87 Charity patients. 2 15 1. ..2 16 2.00 15.18 17.18 Total.4 45 3 .1 ..4 47 4.00 49.05 53 05 Grand totals. Panama Canal employees. 96 314 221 549 2 14 218 494 3 34 94 321 93.05 327.57 420.62 Panama Railroad employees. 18 78 47 142 .1 47 115 1 16 17 88 16 83 77.47 94.30 Republicof Panama pay patients. 16 190 5 28 1 1 5 6 2 10 13 201 15.61 206.27 221.88 Other pay patients. 187 76 342 150 4 10 391 153 6 9 128 54 150.95 54.39 205.34 Charity patients. 36 121 31 47 -4 8 34 18 1 8 28 134 27.19 140.36 167.55 Total.353 779 646 916 11 34 695 786 13 77 280 798 303.63 806.06 1,109.09 Number of employees remaining in hospitals: White. 111 Colored. 409 Total. 520

PAGE 38

34 TABLE IX---CONSOLIDATED DISPENSARY REPORT OF EMPLOYEES TREATtD IN QUARTERS AND ALL CASES TREATED BUT NOT EXCUSED. Employees treated in quarters. ReRemainAdDisTransmaint g mitted. charged. ferred. ing July 1. July31. W. C. W. C. W. C. W. C. W. C. W. C. W. C. Total. Naos Island. .2 1 26 .1 24 .2 .2 2 37 39 Balboa. 1 1 50 35. 35 24 414 11 2 1 76 51 127 Corozal. 1 .90 ..82 .3 6 .151 .151 Pedro Miguel. 1 .16 ..15 .2 --...-. 31 .31 Paraiso. ..16 ..12. 1. 3 ..-. 50 Culebra. 1 3 1 28 ..2 29 ...2 4 55 59 Bmpire. 1 3 29 7 ..30 9 ..-. 1 62 66 128 Gamboa. .......... Gatun. 2 2 32 12 .30 14 3 1 .86 48 134 Cristobal. 14 29 103 110 .108 118 ..9 21 265 463 728 Margarita Point. ...4 .....4 ...2 2 Total. 21 40 338 222 315 218 23 17 21 27 1727 '722 1, 449 All cases treated but not excused. Stations. Employees. Nonemployees. Total. W. C. Total. W. C. Total. W. C. Total. Naos Island. 123 1,288 1,411 ...123 1,288 1,411 Balboa. 3,696 4,028 7,724 --115 138 253 3,811 4,166 7,977 Corozal. 1,808 1,183 2,991 486 69 555 2,294 1,252 3,546 Pedro Miguel 475 1,021 1,496 423 58 481 898 1,079 1,977 Paraiso. 681 1,356 2,037 432 652 1,084 1,113 2,008 3,121 Culebra. 346 898 1,244 226 369 595 5721,267 1,839 Empire. 689 977 1,666 420 388 808 1,109 1,365 2,474 Gamboa. 58 190 248 58 372 430 116 562 678 Gatun. 830 1,212 2,042 713 421 1,134 1,543 1,633 3,176 Cristobal. 1,031 2,576 3,607 471 361 832 1,502 2,937 4,439 Margarita Point. .74 479 553 -------. 74 479 553 Total. 9,811 15,208 25,019 3,344 2,828 6,172 13,155 18,036 31,191.

PAGE 39

35 CONSOLIDATED ADMISSION REPORT. White. Colored. Total. Total admissions to hospitals, excluding Corozal Farm and Colon chronic ward. 645 910 1,555 Total admissions of employees to quarters. 338 222 560 Total.-. 983 1,132 2,115 Less number of patients transferred between hospitals and from quarters to hospitals, whose admissions are duplicated in above figures .36 91 127 Net admissions to hospitals and quarters. -947 1,041 1,988 Net admissions of employees to hospitals and quarters. 578 846 1,424 Annual average per thousand of admissions of employees to hospitals and quarters. 975.12 256.99 366.57 TABLE X.-AVERAGE NUMBER OF EMPLOYEES CONSTANTLY SICK IN HOSPITALS AND QUARTERS. White. Colored. Total. Hospitals: Ancon Hospital. .98.03 334.45 432.48 Colon Hospital. 4.86 28.83 33.69 Total. 102.89 363.28 466.17 Quarters: Naos Island. .06 1.19 1.25 Balboa. 2.45 1.65 4.10 Corozal. 4.87 .4.87 Pedro Miguel. 1.00 .1.00 Paraiso. 1.61 .1.61 Culebra. .13 1.77 1.90 Empire. 2.00 2.13 4.13 Gatun. 2.77 1.55 4.32 Cristobal. 8.55 14.93 23.48 Margarita Point. ..06 .06 Total. 23.44 23.28 46.72 Hospitals. Quarters. Total. Average number of employees constantly sick: White.---. 102.89 23.44 126.33 Colored .363.28 23.28 386.56 Total. 466.17 46.72 512.89 Average number of employees constantly sick per 1,000: White. .14.46 3.30 17.76 Colored. .9.19 .59 9.78 Total. 10.00 1.00 11.00

PAGE 40

36 TABLE KI.-AVERAGE NUMBER OF DAYS' TREATMENT PER EMPLOYEE IN HOSPITALS AND QUARTERS. White. Colored. Total. Hospitals: Ancon Hospital ----. 23. 45 16.04 18.32 Colon Hospital. ..---------------------------4.75 7.02 6.64 Quarters: Naos Island. ...-----------------------------2.00 1.62 1.63 Pedroa ---g--e-----------------------------1.94 1.4 1.9 Paro g........9---------------------------1.4 .1.84 Culebra.-. 2.50 2.03 2.06 Empire. .....--------------------------------2.10 10.11 3.95 Gatun. 2.67 3.57 2.94 Cristobal.-------------------------------3.06 4.68 3.91 Margarita Point. ..50 .50 TABLE XII.-FINANCIAL STATEMENT. May, 1914. April, 1914. May, 1913. Administration, chief health oflice. $1,958.88 $2, 264.34 $3,020.67 Hospital division: Ancon Hospital. 41,894.99 41,497.16 44,577.65 Corozal farm. 1,391. 77 2,019.52 763. 24 Colon Hospital. 2,404.81 2,073.81 15,961.78 Chronic ward .248.80 288.59 Taboga Sanitarium-. .-..2,444.10 Palo Seco Leper Asylum .1,159. 32 1, 182.40 1,186.01 Santo Tomas Hospital. 925.00 924.00 860.00 Medical-storehouse. ..724.77 Construction and repairs to buildings. 1,800.41 587.85 848.39 Total.:..49,825.10 48,573.33 67,365. 4 Dispensaries: Naos Island. 260.89 247.80 201.56 Balboa .821.49 954.48 585.05 Tivoi. .742.79 664.29 Corozal. 535.40 727.76 610.37 Miraflores. ..413.36 Pedro Miguel. 417.69 407. 79 562.54 Paraiso. 612.28 595. 45 459. 44 Culebra. 660.83 745.41 866.43 Empire. 703.75 902.87 979.89 Las Cascadas. ...503.76 Gamboa. 131.04 121.45 .,. Bas Obispo. .641.14 Gorgona. ..732.33 Gatun. .664.43 922.16 1,601.31 Cristobal. 995.29 987.20 937.02 Margarita Point. 119.84 109.11 152.04 Toro Point. 241. 57 242.42 401.27 Porto Bello ..288.59 458.09 Total.'.-. 6,164.50 7,995.28 10,769.89

PAGE 41

37 TABLE XII.-FINANCIAL STATEMENT-Continued. May,1914. April, 1914. May, 1913. Sanitary division:* General inspector -----------------------880.00 $315.00 $525.00 Health office, Panama.----------------2,981.54 3,275.28 3,472.90 Street eleiwing .4,416.01 4;132.73 833. 33 Health office, Colon. 2,y348.70 1,386.97 2,665.21 Street cleaning. 1,758.32 2,014.65 1, 489.26 Zone sanitationAncon. 2, 258.74 1,195.98 1,840.28 Balboa. 1,266.83 1,128.53 1,540.26 Corozal. 1,410.94 1,320.11 1,059.63 Miraflores. ..4,286.49 Pedro Miguel. 1,369.91 2,752.30 1,890.65 Paraiso-. 1,342:42 1,446.92 1,585.40 Culebra.-. 1,082.41 955.24 1,564.03 Empire. 1,887.13 2,019.47 3 542.10 Las Cascadas-. ..1 660. 13 Bas Obispo.-. ..785.00 Matachin. ..1,117.15 Gorgona. ...1,318.80 Frijoles-. 65.00 119.30 452.20 Gatun. 2,192.57 2,233.23 6,602.07 Cristobal and Mount Hope. 2,383.06 2, 174.06 2,299.47 Porto Bello--. 236.33 321.45 Total-. 26,843.58 26,706.10 40,850.81 Quarantine division. 4,251.20 3,941.45 4,576.47 Recapitulation. Chief health office. 1,958.88 2,264.34 3,020.67 Hospital division. 49,825. 10 48,573.33 67,365.94 Dispensaries. 6,164.50 7,995.28 10,769.89 Sanitary division. 26,843. 58 26,706. 10 40,850.81 Quarantine division. .-.-.-. 4,251. 20 3,941.45 4,576.47 Grand total. 89,043.26 89,480.50 126,583.78 TABLE XIII.-ANCON HOSPITAL. NATIONALITY OF PATIENTS TREATED. Total Americans. Other nations. numClass. ber treated. W. B. W. B. Hospital: Panama Canal employees. 969 168 1 112 688 Panama Railroad employees. .216 27 .27 162 Panama pay patients. .2 ...2 Other pay patients.701 353 .149 199 Charity patients. 86 35 .12 39 Total. 1,974 583 1 insane asylum: ~8-0--Panama Canal employees. 33 2 .-. 5 26 Panama Railroad employees. 12 .12 Panama pay patients .184 ..13 171 Other pay patients. 11 5 .6 Charity patients.87 5 77 Total. 327 12 .23 292 Grand total. 2,301 .595 1 323 1 382

PAGE 42

38 REPORT OF DAYS LOST IN HOSPITAL. AmerForClass. eign Black. Total. white. Hospital: Panama Canal employees. 1,115 1,258 7,539 9,912 Panama Railroad employees. 319 152 1,803 2,274 Panama pay patients. ...51 -51 Other pay patients. 2,875 1,532 1,391 5,798 Charity patients. 298 136 968 1,402 Total .4,607 3,078 11,752 19,437 Inane asylum: Panama Canal employees. 40 155 683 878 Panama Railroad Co. .343 343 'Panama pay patients. .375 5,216 5,591 Other pay patients. 147 .186 333 Charity patients. 148 127 2,117 2,392 Total. 335 657 8,545 9,537 Grand total. 4,942 3,735 20,297 28,974 Cost of subsistence per patient per day, 27.75 cents. WARD LABORATORY REPORT. Blood examinations. 1,006 Urine examinations----------1,846 Estivo-autumnal. 299 Albumen .596 Quartan. 11 Bile. 6 Tertian. .------------------42 Casts. 504 Mixed. ..---------------------0 Epithelia.:. 131 Differential counts. 59 Guaiac tests. 9 Hemoglobin estimations. 109 Hemin crystals. 1 Leuco3yte counts. 133 Indican. 42 Red-blood counts. 7 Pus and blood. 412 Stool examinations. 883 Sugar (positive 12; negative Ameba. 6 33). 45 Ascaria lumbroicoides. 53 Trichomonas vaginalis. .1 Balailtidium coli. 2 Sputum examinations. 118 Bilha zia. 2 Positive for tubercle bacilli. 18 Cercomonas intestinalis. .1 Smear examinations. .31 Ciliated monads. 13 Urethral (2 positive for gonoEntameba (hystolytica and coi). 16 tetragena). 6 Vaginal. 5 Guaiac test. 11 Spinal fluid. 1 Pus and blood .119 Mouth, throat, etc .9 Strongyloids intestinalis. 46 Tricocephalus dispar .*. 98 Uncinaria ova. 120

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39 REPORT OF SURGICAL OPERATIONS. Number. Died. Amputations: Leg. 2 Foot-. .----------------------------------1 Digits, multiple .3Operations on bones: Laminectomy. 1 1 Ostiectomy. .....--------------------------------------2 Fractures, simple. ....---------------------------------25. Fractures, compound-------------------------------3-------Adenectomy: Ingainal, single. --------------22 Inguinal, double. ..-------------------------------------4 Femoral. ....-------------------------------------------2 Herniotomy: Inguinal, single. ..-------------------------------------9 Inguinal, double. ...-----------------------------------2 Ventral. .....------------------------------------------1 Strangulated. ...--------------------------------------1 Genito-urinary tract: Nephrotomy --------------------------------------1--------Urethrotomy, internal. .------------------------------Urethrotomy, external ------------------------------3-------Varicocele, radical cure------------------------------3-------Hydrocele, single, radical cure.--------------------------6 Hydrocele, double, radical cure.-------------------------2 Epididymotomy-----------------------------------6-------Amputation of scrotum-------------------------------1 -----Curettage uteri-------------------------------------.8 .--Perineoplasty. ....-------------------------------------1. Trachelorrhaphy. ...-----------------------------------1 Obstretrical, Cesarian section, abdomnial--------------------1 Thorax, thoracotomy. .----------------------------------2 1 Rectum, hemorrhoids, radical cure ------------------------13 General: Varicose veins, excision of.----------------------------2 Excision of surface neoplasms-. 6---Plastic operation for severe injuries .1-------Skin graft ----------------------------------------3-------Laparotomy: Exploratory. ....--------------------------------------1 Appendectomy ------------------------------------4. With local peritonitis. 1 Cecostomy-. 1 Celostomy. 1 Cholecystostomy.-. 1 Abscess of liverLaparo-hepaotomy for. 1. Thoraco-hepatotomy for. 1. Pan-hysterectomy. 1 Supravaginal hysterectomy. 4 1 Hysteromyomectomy. 1. Myomectomy. ..-----------------------------2. Salpingectomy, double. .I--Salpingo-oophorectomy. 2. Suspensio uteri. 6. Various other major operations. 4-------Minor operations, various. 198. Total. 373 4

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40 REPORT OF SURGICAL OPERATIONS IN EYE AND EAR DEPART MENT. Adenoidectomy ..--. .---------------------------------------9 Enucleation .----------------------------------------------1 Expression .-----------------------------------------------1 Pterygium excision ----------.-------------------------------1 Pterygium transplantation. ..-----------------------------------1 Submucous resection of nasal septum .....---------------------------8 Tonsillectomy. ..........---------------------------------------------15 Ossiclectomy. .--------------------------------------------. 1 Excision lachrymal gland .-.-------------------------------------1 Plastic on nose ......---------------------------------------------1 Excision of sarcoma of nose .------------------------------------1 -_ 40 Various minor operations: Ear. ...........--------------------------------------------------10 Eye.-------------------------------------------------16 Nose and throat .-.-----------------------------------------8 34 74 Total number of outside cases treated. ...: .------------------------------768 Refractions .------------------------------------------------.-.-.169 OUTPATIENT DEPARTMENT, JULY, 1914. Clinic. vsts. New cases. Pay cases. tncs.Medical -----------------------357 292 79 356 Surgical-----------------------355 199 37 77 Eye and ear-------------------768 236 27 385 Admitting physician----------6,325 4,764 10 2,347 Total-------------------7,805 5,491 153 3,165 REPORT OF THE BOARD OF HEALTH LABORATORY. Bacteriological examinations ofBlood cultures ---------------------------------------------14 Throat cultures. ..........--------------------------------------------49 Urine cultures. ........---------------------------------------------10 Stool cultures.:. .---------------------------.------------------36 Pus. ..-----------------------------------------------------1 Sputum-.........-----------------------------------------------1 Cultures from autopsies. .......---------------------------------------3 Blood. ........---------------------------------------------------1 Smears. .......-------------------.--------------------------------2 Spinal fluid .-----------------------------------------------4 Autogenic vaccines prepared. .....--------------------------------------5 Antityphoid vaccinations. .......----------------------------------------4 Wassermann reactions. .........-----------------------------------------274 Agglutination reactions. .......------------------------------------------1 Pathological tissues prepared, paraffin .-----------------------------157 Bacteriological examinations for quarantine officer ...---------------------2 Chemical analysis ofHospital dairy milk .........-----------------------------------------1 Milk from private dairies supplying cities of Panama and Colon.------27 Mother's milk. .........----------------------------------------------3 Stomach& contents .........-------------------------------------------1 Urine. ..........-------------------.---------------------------------4 Beer, Panama Brewing & Refrigerating Co. --------------. 1 Liquid substance (poison) for division of police. ..---------------------1

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41 Surgical tissues and neoplasms reported. .19 Autopsies performed ..------------------------------------.------27 Bodies embalmed .........---------------------------------------------5 Animals examined or under observation -.4. 4 Leper suspects examined (1 positive). 3 Rats examined--------------------------------------------1,331 REPORT OF -OPERATIONS OF HOSPITAL FARM, COROZAL. EXPENDITURES. Supervision. 2 00 Labor. --.------------------------. 476.27 Subsistence of labor. ...---------------------------------362.66 Quartermaster team service ...----------------------------65.30 Electric lights. .......--------------------------------------3.90 Ic. ...........-----------------------------------------------.90 Material and supplies. .......--------------------------------23.90 Total --------------------------------------------$1,132.93 PECEIPTS. Transfer and services rendered. 53.62 Products sold: 688 heads lettuce. .--------------------------$15.90 995 bunches radishes. ...------------------------45.78 288 bunches spinach. ....-------------------------5.30 29 bunches bananas. .....-------------------------6.85 218k dozen eggs. ....---------------------------114.53 251 dozen ears corn .4.01 5 dozen roses. .....------------------------------2.75 1,281 pounds string beans ....--------------------187.35 249 pounds papayas. .....-------------------------5.61 1,454 mangoes----. ..-------------------------26.75 6.565 okras. .......-------------------------------30.31 670 limes .---------------------------------3.16 30 guinea pigs. ......-----------------------------15.00 6 hogs-. ........---------------------------------150.00 54 loads grass. ...-----------------------------54.00 I small coffin. ......------------------------------1.20 1palm. ......-----------------------------------1.00 Burial permit. ...------------------------------2.00 Pasturage. .......--------------------------------24.70 696.20 Total. ........-------------------------------------------749.82 Net running expenses .-------------------------------383.11 Number of days' treatment. .......-----------------------------------1,512 Net cost per patient per day. .....---------------------------------$0.2469 STATEMENTS OF COMMITMENTS, DEATHS AND DISCHARGES, ANCON HOSPITAL INSANE AgYLUM. Commitments. Male. Female. From Zone Government: Received on first commitment.-. 110. From Panama GovernmentReceived on first commitment------.-. -6 Received on second commitment---.-. 1 1 Received on fifth commitment-.-. 1. 18 6 I Returned to asylum from hospital, 1.

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42 STATEMENTS OF COMMITMENTS, DEATHS AND DISCHARGES, ANCON HOSPITAL INSANE ASYLUM. Discharges. Well. Improved. Unimproved. Nationality. Male. Female. Male. Female. Male. Female. Holland-----------. .-----------------12. Spain---. -.-...-.-.1 England ...........-Eglad----------------------------------------1----------Barbados. -. .1 .I---------12. Fortune Island. -1. Antigua ----------------1. Panama----------------1 1. Demerara ---------------1 --------------------------2 1. U. S. A -----------------2. -amaica----------------Jam aica.i. 1 --------------------Grenada ----------------1. Martinique --------------1 10 1 1 7 1 Deported. 2 Transferred to hospital. D ths. Mental diagnosis. Physical diagnosis. Psychoses accompanying other Infective-exhaustbrain or nervous ive psychoses. diseases. Tertiary syphilis-----------. .-------------------1 Infection of, undetermined origin ---------------------------11 I Male. C. H. 0., 4; Asylum, 1; A. H., 1. TABLE XIV.-COLON HOSPITAL. White WhiteTotal American. foreign. Panama Canal employees. 4 18 103 125 Panama Railroad employees.5 6 46 57 Pay, private. 10 12 21 43 Panama pay. 1 5 13 19 Zone charity. 5 3 7 15 Total. 25 44 1901 25 Cost of subsistence per patient per day, 30 cents.

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43 LABORATORY REPORT. Blood examinations. .104 Estiv6 autumnal. 55 Tertian. --.--. 4 White blood counts. 6 Differential counts-. 8 Stool examinations. 6 Negative. 6 Urine examinations. 110 Casts.-. 37 Albumin. 48 Pus and blood-.-. 18 Sputum examinations. 2 Negative.-. 2 SURGICAL OPERATIONS. Amputations, digit (single). I Operations on bones, bone plate .1 Adenectomy, inguinal, double .-.-. 1 Herniotomy, strangulated .2 Genito-urinary tract: Urethrotomy, external. 3 Hydrocele, single, radical cure. 1 General, ingrowing nails .1 Laparotomy: For tuberculous peritonitis. 1 Cholecystostomy. 1 Salpingo-cophorectomy. 2 Suspensio-uter .1 Minor operations, various:. 8 TABLE XV.-PALO SECO LEPER ASYLUM. NATIONALITY OF PATIENTS. Number Americans. Other nations. treated. White. Black. White. Black. White. Black. Panmma Canal employees. ... Panama Railroad employees. .. P ay cases. 2 31 -. ...--Charity cases. 2 16 ..2 16 Total. 4 ,471 .-. .4 47 Cost of subsistence, per patient, per day, 25 cents.

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44 TABLE XVI.-SANTO TOMAS HOSPITAL. Remain-,. AdDisremain, Class. ing mitted. charged. De. ing July 1. July 31. Pay cases. 44 122 133 3 30 Charity cases.;. .318 823 37 74 330 Total. .362 945 870 77 360 Average number of patients constantly sick. -----.-----..362 Total number of days' treatment --------.----------------------11,231 Average number of days' treatment per patient..8 Cost of subsistence per patient per day --.-. .-----------------. --NATIONALITY. Americans. Other nations. Number Class. treated. White. Colored. White. Colored. Pay cases. 166 ..65 101 Charity cases. 1,141 ---------------100 1,041 Total. 1,307 .----------. ..--.165 1,142 DISPENSARY REPORT. Class. White. Colored. Total. Natives. 82 306 388 Foreigners. ...----------------------------------153 288 441 Total .235 594 82D

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45 DISEASES TREATED. Typhoid fever--------------. 3 Diarrhea and enteritis, 2 years and Malarial fever. 112 over. ..-------------------.-.--21 Estivo-autumnal. 28 Intestinal parasites. 24 Mixed. ..--------------------1 Appendicitis and typhlitis--------9 Clinical ....------------------89 Hernia, intestinal obstructions----14 Scarlet fever. ..------------------3 Cirrhosis of the liver. 9 Influenza. .-------------------24 Simple peritonitis, nonpuerperal-. I Dysentery.---------------.----4 Other diseases of the digestive sysLeprosy------..--------------I tem, cancer and tuberculosis exErysipelas ..-------------------2 cepted -. ..---------------------2 Purulent infection and septicemia .21 Acute nephritis. ..---------------25 Pellagra. ...---------------------3 Other diseases of the kidney and Tuberculosis of the lungs--------26 annexa. 1 Syphilis. .--------------------59 Diseases of the bladder.----------Gonorrhea. .-------------------11 Diseases of the prostate.----------3 Cancer and other malignanL tumors Other diseases of the uterus. 10 of-Normal labor. ..-----------------83 The breast. ..----------------7 Accidents of pregnancy ----------9 Other organs and of organs not Abortion.--------------------6 specified. ..----------------2 Eclampsia. ....-------------------2 Acute articular rheumatism------15 Gangrene-. ..--------------------2 Diabetes. 1 Furuncle. ..--------------------6 Alcoholism, acute or chronic ------10 Acute abscess. ..----------------13 Other forms of mental alienation--6 Other diseases of the skin and anEpilepsy. ...---------------------2 nexa. ..---------------------20 Other diseases of the nervous system 8 Other diseases of the organs of locoDiseases of the eyes and their anmotion. ...--------------------5 nexa. ....----------------------2 Newborn child .---------------80 Acute endocarditis----------. 5 Congenital debility.-------------1 Organic diseases of the heart ------7 Traumatism, by other crushings Arteriosclerosis .5 vehiclee, railroads, landslides, Hemorrhoids.-----------------2 etc.).----------------------38 Chronic bronchitis .19 Fractures, cause not specified. 8 Lobar pneumonia. 12 Feigned disease. 56 Asthma ----------------------1 Diseases of the mouth and annexa. 1 Total.-----------------947 SURGICAL OPERATIONS. Number. Died. Amputations, thigh. 3 Ostiectomy. 3 Excision of maxilla. 1. Adenectomy, inguinal: Single. 3. Double. 1 Herniotomy, inguinal: Single. 4 Double. .1. Urethrotomy: Internal.-------------. ----------------7 External. 2 Epididymotoy. 1. Curetage uteri. 2. Excision of breast and axilla-.-. 2--Fistuia in anus, excision of. ;-. 1Prolapsus rectum, radical excision of. 1. Extensive injuries to soft parts, operation for. 1. Plastic operations forCongeni al defect-. 9. Severe injuries. .1. Effects of disease. 8.

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46 SURGICAL OPERATIONS-Continued. Number. Died. Laparotomyfor general peritonitis, not traumatic or appendicial. ......-----------------------------------------------2 2 Laparotomy for intestinal obstruction----------------------1 1 Laparotomy exploratory.1. I :. Appendectomy. ....-----------------------------------------4 Abscess of liver: Laparo-hepatotomy for.-. 2 Thoraco-hepatotomy for.--------------------.-1-. Pan-hysterectomy--------------------------------------3. Supravaginal hysterectomy. 2 Hysteromyomectomy.,. -. Salpingectomy: Single. 1 Double--. 1 Salpingd-cophorectomy .---------------------------------10 Suspensio-uteri. .-----------------------------I----1 Major operations, various other. 2 Minor operations, various7. 7 Total. ......-----------------------------------------140 3 TABLE XVII.-SANITATION. The following is a summary of sanitary work performed and material expended during the month in the Canal Zone: Work requests on quartermaster's department: Grass cutting .----------------------------------------------19 Screening. ..........------------------------------------------------17 Miscellaneous. ---------8 Work requests on engineering department. 23 Work requests on other departments-------------------------------Notices served to abate nuisances .,.-.--.35 Arrests for violation of sanitary regulations. 1 Convictions. .........---------------------------------------------------1 Building permits approved .---------------------------------------1 Inspections of closets------------------------------------------. 2,697 Inspections of stores .---------136 Inspections of restaurants--------------------------------------. 11 Inspections of shops. ........-------------------------------------------156 Garbage cani emptied. ........--------------------------------------137,644 Closets di infected.---------------------------------------. 5,476 Houses diiinfected. ---------2 Rat traps used daily .-----------------------------------------1,514 Adult Anopheles destroyed in houses. ,--------------2580 Adult Culices destroyed in houses. .------------------.-----------10,504 Containers found with Stegomyia larvoa Larvacide used. .......-------------------------------------gallons. -3,921 Crude oil used. ...----------------------------------------do ..20,638 R ats destroyed ..-. .-. .1,072

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47 SUMMARY OF ROUTINE WORK DONE BY THE HEALTH OFFICE, PANAMA, DURING JULY, 1914 Mosquito work: Linear feet of ditches cleaned and maintained. 43,230 Linear feet of new ditches dug. 0 Number of cubic yards earth used in filling.--------------0. Gallons larvacide used. ......-------------------------------------653 Gallons crude oil used. .......--------------------------------------140 Square yards pools oiled. .....:.----------------------------------60,940 V ater containers treated. .......----------------------------------76,880 Mosquito breeding places found. ...-------------------------------752 Fly breeding places found. 1,209 Gargage collections: Number of loads garbage removed to dump. ...---------------------4,142 Total number of cans garbage emptied. ....-----------------------106,437 Buildings: Number of buildings inspected. .....------------------------------6,605 Number of plans for new buildings approved. 54 Number of permits granted for repairs to old buildings--------------99 Total number of permits granted. ....------------------------------153 Number of buildings condemned. ..------------------------------119 Number of buildings demolished. 23 Street cleaning: Average number of square yards cleaned daily. ..-----------------600,000 Average number of square yards streets sprinkled daily. .-----------90,000 Number of private properties cleaned during month.----------------13 .Number of notices served and nuisances abated----------:. 191 Vaccinations: Number of vaccinations during month. 342 Total vaccinations since Apr. 1, 1914. 5,186 GENERAL WORK REPORT FOR COLON, CRISTOBAL, MOUNT HOPE, AND TORO POINT. HEALTH OFFICE, Cristobal, July 31, 1914. General sanitation, Colon: Square yards street cleaned. 4,123,178 Square yards street sprinkled. .----------------------------------0 Square yards alleys maintained. ......----------------------------715,367 Loads, garbage, ctbic yards. ..---------------------------------472 Private properties cleaned. ....-----------------------------------94 Number of rats killed. ......--------------------------------------152 Number of cans, garbage (2,152 cubic yards). ..-------------------67,587 Number of doses quinine issued. ...------------------------------982 Square yards oiled. .......--------------------------------------19,800 Number of receptacles treated. .....------------------------------26,709 Number of mosquito breeding places destroyed ------------------. ., 115 Number of fly breeding places destroyed .------------------------114 Number of buildings inspected. 3,675 Gallons larvacide used-. 646 Gallons crude oil used. 0 Number of nuisances abated-. 304 Colon dump maintained. Buildings, Colon: Number of plans approved. 2 Number of permits to occupy issued. 2 Number of permits to repair issued. 48 Number of temporary permits to occupy issued .1 Sewers, Colon (reported by division of municipal engineering): Number of new connections made during month. 1 Total number of connections made to date. 1,149 Number of houses in which extensions were made. 6 Number of outstanding permits. 36 Sanitation, Cristobal: Square yards pools oiled------------------------------. 4,400 Number of receptacles treated. 3,709 Number of mosquito-breeding places destroyed. 23 Number of fly-breeding places destroyed.-. 11 Number of buildings inspected. 360 Gallons larvacide used. 44 Gallons of crude oil used. 0

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48 Sanitation, Toro Point (from 1st to 20th, inclusive): Square yards oiled .---------------------------------------15, 150 Number receptacles treated.-.----------------------------------2,660 Number of mosquito-breeding places destroyed------------------11 Number of fly-breeding places destroyed.--------------------------I Number of mosquitoes killed (Anoph. 1,240, Cul. 171) --------------1,411Cubic yards ditching (old ditches redug) ------------------------649 Linear yards ditches maintained.-------------------------------1,193 Gallons larvacide used .---------------------------------------27 Gallons crude oil used. .......------------------------------------284 Sanitation, Mount Hope: Square yards oiled -.-----------------.---------------------101,800 Receptacles treated. .......--------------------------------------23,550 Number mosquito-breeding places destroyed ---------------------104 Number mosquitoes killed in bar (Anoph. 2401, Cul. 3,066).-.-5,467 Number mosquitoes killed in cars (Anoph. 10,098, Cul. 1,502)-------11,600 Linear feet ditches maintained. ....------------------------------.19,919 Gallons larvacide used. .....--------------------------------------520 Gallons crude oil used. ......-------------------------------------1,830 General sanitation Mindi Island (July 21 to 31, inclusive): Square yards filling in low places .----------------------------3,271 Square yards removing vegetation. ..-----------------------------582 Ditching (cubic yards 303;), linear yards ..------------------------184 Vaccinations: From July 1 to 17. .....------------------------------------78 Number of patients examined and passed.------------------------512 TABLE XVII.-QUARANTINE TRANSACTIONS AT THE PORTS OF BALBOA AND PANAMA FOR THE MONTHS OF JULY, 1914. Number of vessels inspected and passed. ..------------------------15 Number of vessels inspected and held in quarantine.--------------12 Total number of vessels inspected. ..-----------------------------27 Number of vessels fumigated on arrival. ..-------------------------9 Number of vessels fumigated on departure. ...----------------------0 Total number of vessels fumigated.------------------------Number of crew examined-------. .------------------.--2,171 Number of passengers from foreign ports examined and landed: Cabin. ........-----------------------------------------351 Steerage. .....---------------------------------------124 475 Total number of persons examined .-------------------------2,646 Number of persons vaccinated at ports of arrival because of compulsor y vaccination law.-----------------------------------------4 Number of persons vaccinated at ports of departure or en route because of compulsory vaccination law ---------------------------1,231 Total numberof persons vaccinated. .....--------------------------1, 23 Number of persons held in quarantine at the detention house to complete period of incubation for fever or plague.-. 85 Number of persons held in quarantine on board vessels to complete period of incubation of yellow fever or plague. ..----------------1,786 Total number of persons held under observation .----------------1,871 Number of persons embarked for foreign ports: Cabin. ...........---------------------------------------------348 Steerage --------------------------------------------195 543 Number of persons arriving from coast towns in small launches and sailing craft.-----------------------------------.------------1,642 Number of persons sailing for coast towns in small launches and sailing craft. .......--------------------------------------------1,754 Number of bills of health issued. ..----------------------------------25 Number of certificates issued to outgoing passengers .--------------------61 Number of certificates refused on account of trachoma-------------------2

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49 Number of persons recommended for deportation .0 Total number of persons landed. 2,117 Total number of persons sailing. 2,297 Apparent decrease for the month. 180 QUARANTINE TRANSACTIONS AT THE PORTS OF COLON AND CRISTOBAL FOR THE MONTH OF JULY, 1914. Number of vessels inspected and passed. 91 Number of vessels held in quarantine. 9 Total number of vessels inspected. 100 Number of vessels fumigated on arrival. 7 Number of vessels fumigated on departure. 7 Number of crew inspected .9 176' Number of passengers inspected, including 55 United States troops. 5,297 Total number of persons inspected. 14,473 Number of persons vaccinated in port on arrival. 912 Number of persons vaccinated in ports of departure or en route 872 Total number of persons vaccinated.-.-.-. 1,784 Number of persons detained in quarantine to complete period of incubation for yellow fever and plague. 332 Number of persons detained on vessels. 640 Total number of persons held under observation. 972 Total number of persons landed from foreign ports: Cabin .1,920 Steerage. 1,351 3,271 Total number of persons emisarked for foreign ports: Cabin.-. 1,779 Steerage. 1,829 3,60& Number of persons in transit. 1,482 Number of persons from coast towns: Inspected .-. :....544 Not inspected.-. 294 Number of persons leaving Colon for coast towns. 259 Number of persons landed during month: For immigration report. 3,805 For Pacific ports. 304 4,109 Number of bills of health issued .-.-. 10 Number of bills of health vised .41 Number of persons recommended for deportation. -2 Total number of persons landed. 4,109 LesspAumber for Pacific ports. 304 3,805 Total number of persons sailing. 3,867 Apparent decrease for month. 62 CONSOLIDATED REPORT OF QUARANTINE TRANSACTIONS AT THE PORTS OF BALBOA-PANAMA AND COLON-CRISTOBAL FOR THE MONTH OF JULY, 1914. Number of vessels inspected and passed .106 Number of vessels held in quarantine. 21 Total number of vessels entered ..127 Number of vessels fumigated on arrival. 16 Number of vessels fumigated on departure. T Total number of vessels fumigated. .23

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50 Number of crew examined. ..11,347 Number of passengers examined, including 55 United States troops. 5,772 Total number of persons examined.-.------------17,119 Number of persons vaccinated at ports of arrival because of compulsory vaccination law ----------. -------------------------916 Number of persons vaccinated at ports of departure or en route because of compulsory vaccination law ----------------------2,103 Total number of persons vaccinated .-.3,019 Number of persons held in quarantine at the detention houses to complete period of incubation of yellow fever and plague.-----------417 Number of persons held in quarantine on board vessels to complete period of incubation of yellow fever and plague. ..--------------2,426 Total number of persons held under observation .----------------2,843 Total number of persons landed from foreign ports: Cabin. ..---------------------------------------2,271 Steerage. ..........------------------------------------------1,475 3,476 Total number of persons embarked for foreign ports: Cabin. ....--------------------------------------------2,127 Steerage---. .........---------------------------------------2,024 4, 151 Total number of persons arriving from coast towns on small launches and sailing craft.-------------------------------------2,480 Total number of persons sailing for coast towns on small launches and sailing craft. .....-------------------------------------2,013 Apparent increase for month from coast towns.-----------------467 Apparent decrease for month from foreign ports: Cabin (increase) .-.-------------------------------------144 Steerage (decrease) .--.-----------------------------------549 405 Number of immigrants recommended for deportation -------------------Number of certificates issued to outgoing passengers-.--. --..---. 61 Number of persons refused certificates on account of trachoma--. ---------2 Number of bills of health issued or visded. ...---------------------------76 Total number of persons landed. ..----------------------6,226 Less number for Pacific ports .-.-------------------------304 5,922 Total number of persons sailing. .....----------------------------6,164 Total apparent decrease for month. ....---------------------------242 IMMIGRATION REPORT FOR COLON, JULY, 1914. FromCabin. Steerage. Europe.-40 33 U nited States. ........-. .1,179 18 Jamaica and West Indies. ..------------------------------181 925 Venezuela. ......------------------------------------------20 17 Colombia. ......-------------------------------------------77 121 Cuba .......----------------------------------------------50 46 Guatemala. ......------------------------------------------4 18 Costa Rica. ......-----------------------------------------125 113 Bocas del Toro ...---------------------------------------66 478 Coast towns. .......------------------------------------------------294 Total ........--------------------------------------1,742 .2,063 Men. ...........-----------------------------------------------------2,364 Women. ....-------------------I6--------------------------------760 Children. ..---------------------------------------------------387 Unclassified ........------------------------------------------------294 Total .-----------------------------------------------3,805

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51 QUARANTINE, BOCAS DEL TORO. Number of vessels inspected and passed. 37 Number of crew inspected and passed.----------------------------1,873 Number of passengers inspected and passed-.---. 547 Number of passengers, in transit inspected and passed. 274 Number of persons held to complete period of incubation of yellow fever .1 Number of persons held to complete period of incubation of plague. 1 Number of vessels fumigated (Greenbrier, direct from New Orleans). 1 No quarantinable disease has appeared in this port, and the health conditions of the port and surrounding territory are good. TABLE XIX.-STATEMENT OF QUININE ISSUED. Kilos. Quinine sulphate. 18 Quinine sulphate tablets. 2 Total. 20 Pounds avoirdupois, 44.09. TABLE XX.-PERSONNEL REPORT. July, 1914. Total. Skilled Officers and Total. Juine, JAly, and e mskilled 1914. 1913. ployees. labor. Chief health ofice. 16 .16 15 34 Medical storeho se. 4 4 8 .9 Q -arantine division. 21 19 40 39 40 Health office: Panama. 22 152 174 161 53 Colon. 19 120 139 139 139 Ancon Hospital. 265 107 372 476 550 Colon Hospital. 22 11 33 32 192 Santo Tomas Hospital. 6 .6 6 5 Taboga Sanitari nm. ....20 Palo Seco Leper Asyl -m. 10 8 18 18 14 Zone sanitation. 24 102 126 126 264 Hospital farm. 1 48 49 48 16 Dispensaries: Ancon ...5 Balboa. 5 .5 6 4 Bas Obispo. .6 Corozal. 4 .4 4 5 Cristobal. 6 .6 6 6 C .ebra. 4 .4 5 6 Empire. 4 .4 4 6 Gamboa. Gat -n. 4 .4 4 9 Gorgona. ...4 Las Cascadas. 4 Margarita Point.1. 1i 1 Miraflores. ..3 Naos Island. 2 .2 2 2 Paraiso. 4 .4 4 4 Pedro Mig'iel. 3 .3 3 4 Porto Bello. .....4 Toro Point. .-. .3 Total. 448 571 1,019 1,099 1,412 0

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