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HIDE
 Front Cover
 Notice
 Title Page
 Table of Contents
 Letter of transmittal
 General remarks
 Vital statistics
 Division of hospitals
 Division of sanitation
 Quarantine transactions
 Deportations
 Statistical tables
 Back Cover


PCANAL



Report of the Health Department of the Panama Canal for the calendar year ...
ALL VOLUMES CITATION THUMBNAILS PAGE IMAGE ZOOMABLE
Full Citation
STANDARD VIEW MARC VIEW
Permanent Link: http://ufdc.ufl.edu/AA00006092/00001
 Material Information
Title: Report of the Health Department of the Panama Canal for the calendar year ...
Physical Description: v. : ; 20 cm.
Language: English
Creator: Canal Zone -- Health Dept
Publisher: U.S. G.P.O.
Place of Publication: Washington
Creation Date: 1917
Publication Date: 1918-
Frequency: annual
regular
 Subjects
Subjects / Keywords: Public health -- Periodicals -- Panama -- Canal Zone   ( lcsh )
Sanitation -- Periodicals -- Panama -- Canal Zone   ( lcsh )
Genre: federal government publication   ( marcgt )
serial   ( sobekcm )
 Notes
Dates or Sequential Designation: 1917-
General Note: From 1918 published: Mount Hope, C.Z. : Panama Canal Press.
 Record Information
Source Institution: University of Florida
Rights Management: All rights reserved by the source institution and holding location.
Resource Identifier: oclc - 225670417
ocn225670417
System ID: AA00006092:00001
 Related Items
Preceded by: Report of the Department of Health of the Panama Canal for the year ...

Table of Contents
    Front Cover
        Front Cover 1
        Front Cover 2
    Notice
        Page i
        Page ii
        Page iii
        Page iv
    Title Page
        Page 1
        Page 2
    Table of Contents
        Page 3
        Page 4
    Letter of transmittal
        Page 5
    General remarks
        Page 6
        Page 7
        Page 8
    Vital statistics
        Page 9
        Page 10
        Page 11
        Page 12
    Division of hospitals
        Page 13
        Page 14
        Page 15
        Page 16
        Page 17
        Page 18
        Page 19
        Page 20
        Page 21
        Page 22
        Page 23
        Page 24
        Page 25
        Page 26
    Division of sanitation
        Page 27
        Page 28
        Page 29
        Page 30
        Page 31
        Page 32
        Page 33
        Page 34
        Page 35
        Page 36
    Quarantine transactions
        Page 37
        Page 38
    Deportations
        Page 39
        Page 40
        Page 41
        Page 42
        Page 43
        Page 44
        Page 45
    Statistical tables
        Page 46
        Page 47
        Page 48
        Page 49
        Page 50
        Page 51
        Page 52
        Page 53
        Page 54
        Page 55
        Page 56
        Page 57
        Page 58
        Page 59
        Page 60
        Page 61
        Page 62
        Page 63
        Page 64
        Page 65
        Page 66
        Page 67
        Page 68
        Page 69
        Page 70
        Page 71
        Page 72
        Page 73
        Page 74
        Page 75
        Page 76
        Page 77
        Page 78
        Page 79
        Page 80
        Page 81
        Page 82
        Page 83
        Page 84
        Page 85
        Page 86
        Page 87
        Page 88
        Page 89
        Page 90
        Page 91
        Page 92
        Page 93
        Page 94
        Page 95
        Page 96
        Page 97
        Page 98
    Back Cover
        Back Cover
Full Text








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REPORT


OF THE


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THE


PANA


CANAL


FOR THE


CALENDAR-


1917


ALBERT


TRUBY


Colonel, Medical Corps, United States Army
Chief Health Officer


II. .,* HI
I ,i-.


YEAR




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Santo Tor
District d
vivixi of samm


employees. ... ......
residents of the Canal Z
residents of the city of:
residents of the city of I
spitals;
lspital ,...........

I of health laboratory .
pital..................
Leper Asylum ........
nas Hospital.........
Lrepsariez.- .........---------
nitation:


na. one...........
"0 .t C i -- Pa*.... *.,..

quarantine Trausetions
hanne==6n@@p


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Chart
hCMoart
Chart
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orne--...
Panama..

Colo0....


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I.-Admission rate per 1,000 employees................
II.-Death rate per 1,000 emplovees.....................
III.-Noneffetive rate per 1,000 employees .... ........-.
IV.--Malarial fever, admission rate per 1,000 employees..
V.--Malasrial fever, death rate per 1;000 employees.. -...
VI.-Death rate per 1,000 population, employees and
_ ployees.................. .....................


Statisticaltables:
Table No, I.


Admissions, deaths, and noneffective rates for e
deaths of residents of Panama, Colon, and the C
Deaths of infants by cause, sex, color, age, an
residence.....................................
Deaths among children under 1 year of age, in
Zone and the cities of Panama and Colon, by
month of death..-.---...m.m.........-....


NBUB...-

* ...a*. ..
*... .....S
,O i n
,ilIliD


nonem-


employees;
anal Zone.
d place of

the Canal
cause and
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* .1


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IV.. Deaths by nationality....................................
V. Deaths of employees, arranged with reference to cause,
color, age, and length of residence on Isthmus...........
VI. Death rates among Americans on the Isthmus............
VII. Deaths of civil population (employees and nonemployees)


VIII.


IX.


XI.
Xli.

DIn.


and military, by cause, sex, color, age, and place of
residence ... ..... .............
Deaths among civil population (employees and nonem-
ployees) and military, in the Canal Zone and the cities of
Panama and Colon, by cause and month of death......
Discharges of employees from hospitals, showing cause of
admission and month of discharge ... ...............
Consolidated hospital report .. . ...........................
Consolidated report of employees treated in quarters......
Consolidated hospital and employees treated in quarters
reIport. ..... .. .............. .. ..... ........ ....
Number of employees constantly sick in hospitals and
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4 .
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TTER


TRANSMITTAL.


BALBOA


HEIGHTS,


CANAL ZONE,

January 28 1918.


IWNG,

'anama Canal.

nor to submit the following report of the opera-

Lepartment for the calendar year 1917.


ALBERT E. TRUBY,

Chief Health Officer.





PERSONNEL.


S' There have been many changes in the organization of the depart-

ment during the year. Before the declaration of war in April, 1917,
there were 12 officers of the Medical Corps of the Army on duty

with the health department. All but the present chief health

officer have been relieved by War Department orders, and in addi-

tion four civilian physicians and three other employees of the

department were commissioned in the reserve corps and ordered
i:. t the United States. The medical officers relieved were:
S' .- Col. Deane C. Howard, chief health officer.

SMaj. E. E. Persons, assistant chief health officer.

i Maj. F. F. Russell, chief of laboratory.

Maj. Wm. A. Duncan, chief of X-ray clinic, Ancon Hospital.

1. Maj. Guy L. Quails, surgical staff, Ancon Hospital.

Maj. Thomas D. Woodson, superintendent, Corozal Hospital.
Capt. T. J.-Leary, superintendent, Colon ,Hospital.
i .:. Capt. Win. E. Hall, chief eye and ear clinic, Ancon Hospital.
"-: OCapt. Charles E. McBrayer, health officer, Colon-Cristobal.

Capt. D. W. Harmon, chief sanitary inspector.
('Jpt. H. P. Carter, health officer, Panama.
ti,..---------------------------------------------------- I I iA it y fl' I *




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'well as all other "contagious disease of childhood are in variab ly
.m~ld'i. on the Isathmous, and recovery israpid and practically without
I:P ..
.:: ;." ;*. .%7
:***:.: *0
--well as all other contagious disease of childhood, are invariably
unild on the Tetlirue, and recovery is rapi n rcial ih u
complicationctandllyequtlae.


complication and sequelse.
S.. In the tertninal cities the death rates for
momnia in the colored race, also the high in
matters for careful consideration. The cau
rates are mainly economic-high, cost of
The cost of food has advanced greatly since t


Cited in great hardships,
are usually small, and th
>le and insufficient. The
particularly noticeable
The high rates charged
making these people sec
unsanitary; it also prod
often have but one sm


especially
e food the
results of
in cases
in Panan


ek quar
luces o
all rooI


te


has resu
incomes
unsuitab
food are
babies.
result in
usually
families


tuberculosis and pneu-
fant niortality rate, are
ses for these high death
food and high rentals.
he war started, and this
y for the blacks; their
?y are able to buy often
deficient and improper
of tuberculosis and in
la and Colon for rooms
rs which are small and


vercrowd
n becauE


afford to rent more or better ones. This depart
measures to improve the sanitary condition
requiring the owners of the buildings to incr
windows and ventilating spaces, and making
An educational campaign on tuberculosis
visiting nurse has been assigned to assist in
cases of tuberculosis. It is urgently recoj
quarters for silver employees be constructed
relieve the overcrowded conditions of Colon


* were done it would improve c
overcrowded condition of the
charged for rent.
The Panama Red Cross has d
zation, and is doing splendid
welfare work. The chief health
organization, and is therefore ,
are most urgent and important.


,ment
n of
3ase t


oti
has
this
mm
on
an


conditions in two
cities and rzduc


ing, and
e they cs
has taken
such plac
he size of


'a
4
C
.1


whole
Ln not
active
es, by
lattice


ler i m proveme
been started.
work and to v
ended that n
the Canal Zon
d Panama; if
ways-relieve
e the high pr


nts.
A
rsit
lore
e to
this
the
ices


developed into a very active organi-.
work along economic lines in baby
h officer is one of the directors of the'
ible to indicate what lines of work


CENSUS.


A census of
in June, 1917
forces-) of 24,03
and Colon, sho
these being sli
of December.


the Canal Zone was taken b3
, and showed a population
(8. Censuses were also taken
)wing a population of 61,074 a
ght increases over the numb
Q1.Di


-t .r. A -


* the police department
(exclusive of military
of the cities of Panama
nd 25,386, respectively,
er shown by the census




















Tubereulosis in its various forms caused 468 deaths amon aii&:'.
population of the Canal Zone aad the cities of Panama and Coloua
in 1917, giving a rate of 4.11 1 per 1,000, as compared with a rAte ...
1.41 in the registration area of the United States in 1916. .
Pneumonia (including broncho-pneumonia) was responsible ferr;.
343 deaths in 1917, giving a rate of 3.01, as compared with 137 ini
the registration area bf the United States in 1916. 4.. f
Diarrhea and enieritis caused 425 deaths in 1917, giving a rate 0ii
3.73, as compared with 0.79 in the registration area of the -Uiftd.r
States in 1916. .
Diseases of the heart.-The deaths from heart diseases (ozanic
diseases of the heart and endocarditis) numbered 161 or 1.41 per
1,000 population, as compared with 1.59, the rate. for the registation.
area of the United States in 1916.
Bright's disease (acute and chronic nephritis) caused 178 dethu
in 1917, giving a rate of 1.56, as compared with a rate of 1.05 for the
registration district of the United States in 1916.
Cancer and other maliqnant tumors were responsible for 39 death
in 1917, giving a rate of 0.34, as compared with the rate of 0.8. iw
the registration district of the United States in 1916.
INFANT MORTATIr'Y. "'".
The high infant mortality rate noted in last year's report
continued. That this excessive rate is chiefly caused by.por;i
ignorance, inadequate housing facilities, etc., may be seen
comparison of deaths among children of American families on
Isthmus with those of natives and West Indians for the year 191'
..... ..* "" i i. M:.:
i:






!''
.ini
.3!' ..



Ii!
I:r


S9

Of the 9 deaths occurring among American children, it is a
significant fact that in 5 instances (the mother in 3 of these cases
was Latin-American) the parents resided in Panama City or Colon.
Of the four remaining deaths, where the parents resided in the
Canal Zone, all were due to causes of early infancy, the oldest of
the four children being only 2 days of age at time of death. Such
a record speaks well for health conditions on the Isthmus for chil-
dren, where they have proper nourishment and care.


BIRTHS.


Births and stillbirths together
rate of 41.06 per 1,000 population
preceding year. Of the total bi
stillbirths, the same percentage as


numbered 4,681, giving a
, as compared with 37.65 fo
rths reported, 7 per cent
for the preceding year.


birth
r the
were


PERMANENT BUILDINGS.

Construction work on the new buildings for Ancon Hospital is
progressing rapidly. Two large ward groups and quarters for the
superintendent will be erected in 1918 the plans for these buildings
are practically finished. This will complete the building program
and will provide this community with a thoroughly modern con-
crete hospital. It will have a bed capacity of about 700, and will
compare in every respect with the best of such institutions in the
United States.
VITAL STATISTICS.
EMPLOYEES.


The average
Canal, the Pan
Panama Canal,
for 1916, and 34
The total ad]
as compared wi
alone the admi
103.72 in 1916,
hospitals only
186.17 in 1915.
The total de:


number of employees on the rolls of the Panama
ama Railroad, and contractors doing work for the
for the year was 32,589. as compared with 33,176
L.785 for 1915.


[

i



a


mission rate to hospitals and quarters was 356.75.
th 282.76 in 1916 and 320.20 in 1915. For disease


ssioi
anc
was

Lth


I


1 rate t.o hospitals was 124.80, as compared with
143.82 in 1915. The total admission rate to
160.85, as compared with 140.43 in 1916, and


rate was 7.09, as against 6.03 in


1916, 5.77 in


1915. and 7.04 in 1914. The death rate for


r disease alone was 5.74.































lenra mes. were zs 0ows: a'


1916. 19127.

**
-i :






Tuberoulosis (various organs)............. 36 LO 36 H
LobarDeaths. Rate. Deaths. Rat


Organcdiseases oftbeart....... 12
Nephritis (acute and cbronic)........... 20 .60 21 .6.
Cerebral hemorrhage.............. ... 9 27 .24


There were 36 deaths from tuberculosis among employees, being

the same number as in 1916, as compared with 27 in 1915. Fom H
pneumonia 29 deaths occurred among employees in 1917, as corn-
H biii
pared with 31 in 1916 and 25 in 1915.
I m I l .ll
E R . . .
EFFECTS OF RACE. .. ..
.. H
*,,,,,
mmI mm,,m

The admrnissionrate to hospitals .and' death rate from disease, for
white employees, was 280.02 and 4.57, as compared with 97.89 and
5.94 for black employees. ."
The admission rate to hospitals and quarters for malaria wa,
26.80 for whites, as compared with 12.39 for blacks.. .




Hr:.

I:
ii i : "t .
H.. 4.
* .: . * .
:.. ., *.:.. ..
*.. i .
......"
I" :::":::


CANAL ZONE


EMPLOYEES AND NONEMPLOYEES.


From an average population of 27.543 in the Canal Zone. there


was a total of 313 deaths during the year.


Of these. 273 deaths


were from disease, giving a rate of 9.91. as compared with 9.22 for
1916, and 11.30 for 1915.
The death rate for tuberculosis was 1.31. as compared with 1 .30


for 1916.
all deaths.


Deaths from tuberculosis this year were 11. per cent of


There were 669 births reported during the year, giving a birth
rate of 24.29. Of these, 225 were white, and 444 black.
There were 85 deaths which occurred among children under 1
year of age, 4 white and 80 black, giving an infant mortality rate,
based on the number of births reported for the year, of 17.77 for
white, and 180.80 for black children, with a general average of


125.56 per 1,000 births.
Of the total deaths, '_


per cent occurred among children under


1 year of age, and 37 per cent among children under 5 years of age.


Of the total births reported, 6 per cent were stillbirths.
Below is a table showing the death rates for the Canal Zone from


91 05 to 1917, inclusive,


including deaths from all


causes among


both


employees and


nonemployees:


Year.


1905.
1906.
1907.
1908.
1909.
1910.
. 1911.


I

- . . I
- . I
m n nm-m
ammmnmm


Popula-
tion.


Deaths.


Rate
per
1,000.


35.29
49.86
31.60
18.95
13.33
14.47
15.32


Year.


1912........
1913........
1914 .. .. ...
1915. .......
1916.......
1917. .. .


Popula-
tion.


Deaths.


Rate
per
1,000.


14.1
16.
15.3
12.
10.


1 Average population for the year, excluding the military for the last six months,


PANAMA

EMPLOYEES AND


CITY.

NONEMPLOYEES.


- A


-- -- -






































both employees and nonemployees: pr


u rRate ioivriet s.rs




Ood6.....c... o, 51t hat .. 44. 5 .. ... .... ..' ... ...7

1907...-.... 33 548 1,186 34. 45 1914.......-. 1,, i4 18,
The..... deat rate fro tuerulsi was.8 531.22. as comar i:







H OYeth. topulda-teahs. per Yeteccr.e Pmopul cidrentuhde








1 rf....... 40, d801. .0 er ce a.o,4 4191e........ 47,$0 15 e a I of.i
1925,5817 1,142ivn 44.75in 1913..th.. 47,172l 1,507s 31n.6




1908....... 215484 1,156 34.83 19125....... 0,373 i,103 .

1O5t....... 40',801. .1,48 ..25.44 .1916........ 80,778 1,765 ..
1910........ 456591 1,446 31.72 1017........ 61,074 1,714
1911.......... 46, 555 1,456 31.27 ..

CO...
: *:i iiii
.. .
CoWN.*










. 1916 1917
i. *


I*Tuberculosis (various orgnas)........ ......... ......... ..... 91 113
l Pneumonia lobarr and broncho). ..-.... ..... -- -. ...- 117 95
.. Diarrhea and enteritis (including colitis).. 48 74
SNerphritis (acute and chronic) .... .........--*.---... 80 61
Bronchitis (acute and chronic). .........., ... . -. ----. .. .-.- 61 55


The


deatb


3.69 for 1916


Irate from tuberculosis was 4.45, as compare
, being 17 per cent of the total deaths this year,


pared with 13 per cent for
There were 908 births r
rate of 35.77.


There
giving a


were zz
m infant


deaths
mortality


d


with


as com-


1916.


reportedd


among
rate,


during the year


children


based


reported for the year, of 244.49.
Of the total deaths, 33 per c(


1 year of age, and 43 per cent among cl
Of the total births reported, 7 per cen
Below is a table showing the death


19Th"


inclusive


, including


deaths


under


on the


giving a birth


year


number


ent occurred among children


I age,
births

under


children under 5 years of age.
t were stillbirths.


rate


from


in Colon
1 causes


from


among


1905


both


employees


and


nonemployees:


Year.


* S -
* S S
* Si *
- S S -
- -- S- S*


Popula-
tion.


Deaths.


Rate
per
1,000.


Year.


Popula-
tion.


* - . .
* . S -
- . . .
* - S *
* . - S I
* S - - S


Deaths.


Rate
per
1,000.


DIVISION


ANCON


HOSPITALS.


HOSPITAL.


The


total admissions to


the hospital


10,880, as compared with 9,116 for
average num her of nat.ients ennsts


1916


Lmt.lv in


during the year numbered
. and 10.652 for 1915. The


thet hosnital during t.he


i




























e emn anto mess in ing Is .Irapi y approach
tion., -
The isolation building for contagious diseases is also
completion. and
The passageways connecting section "A" and section "B i with ..
the administration building, were practically completed. e"n
The nurses' quarters was ready to receive roof. ..
Work was commenced on site to receive section "C-" of the new
hospital.
OLD BUILDINGS EVACUATED.. ."
*E
.. w.. ..-..ereautdnMrha
Building 237, wards 5 and 6, were evacuated in March and t.rne
over to the building division, which used same as field office, ta-
room, and carpenter shop, in connection with construeotino :1
the administration and clinics building and kitchen and mess
Building 238, section "B," wards 8, 9, 10, were evacus. ...,
in April and turned over to the supply department for razing a4
reerection at Pedro Miguel a silver quarters. The new kite 1
is being erected on this site.. iii"
Building 246 was also evacuated, cut in two, and moved ont th
4-n1 nl nn nn ,4,n 1A 5 c 4A wl ,n 4s InnmnaA .In- .-.t..- ... :m1:.







15

Building 2U5, section "C," wards 11 and 12, was evacuated in
September; building razed; site to be used for new nurses' quarters,
active construction of which has progressed as before mentioned.
Building 224, ward 15, was turned over to the building division
for use as storeroom and field office. Building 237, wards 5 and 6,
at present so used, to be razed in the immediate future.
As soon as building 240, operating room, can be evacuated, the
permanent ground improvements, such as walks, roads, lawns, etc.,
will be immediately undertaken.


SURGICAL CLINIC.


During the year 1,668 major operations and 1,775 minor opera-
tions were performed. There were 301 obstetrical cases delivered.
Three thousand one hundred and eighty-four cases visited the out-
patient department, for whom 560 prescriptions were written.


MEDICAL


CLINIC.


There were 3,184 cases treated in the out-patient department, for
whom 2,806 prescriptions were written.


EYE


AND


EAR


CLINIC.


There were 856 operations performed, 1,108 refractions done,
and 5,426 treated in the out-patient department, for whom 522
prescriptions were written.


X-RAY


CLINIC.


There were 2,205 cases treated during the year,
340 dental films taken, and 57 treatments given.


4,930 plates used,


DISEASES.


No new cases of sma
the latter part of 1916.
nated with 410 know
known "takes."
In January there wau
undetermined (with c
adenitis and neritvehl


llpox developed from the three cases treated
During the year 1,699 adults were vacci-
n "takes," and 62 school children with 37

3 an epidemic of an acute intestinal infection,
,r without as the case may be) mesenteric
itis.
























'emovetom car oo. o, e nr wit a earm
rebuilt from surveyed horse-drawn conveyance. The parent
hearse U. S. No. 301 is to be refitted with ambulance body and-
transferred to a line station for district physician's use.
-* H:r i.
COROZAL HOSPITAL I-NSANE)...
Hil.
During the year, 193 patients were admitted, 30 died, and 129 .
were discharged. Among the discharges are included 8 patients
who were deported or transferred to other institutions for further
treatment. .
The average number of patients constantly under treatment .i.
during the ,ear was 343, as compared to 290 for 1916.
Buitldins.-.-During the year the following changes were made in .
the buildings: The old Ancon admitting office was reerected in-!
the garden at the farm, and will be used as an office for the farin
manager and sleeping quarters for the watchman. A new vegetable
:and implement house and a breeding house for guinea pigs :and.
rabbits were built at the garden.A dipping vat, 1,590- ao
capacity, was built at the dairy to eradicate ticks. Thre:,AM
Proved a great success in getting the cows in better physical ....
S-tion and increasing their milk production. The fire exit. on te .: H~
wards were fixed by parmis3ion of the fire department so tt
they can be of more use during a fire.
Hospital department.-The hospital has shown a.gradual increa
Sn ;nn 0 .,C i# +La Unn+ .aran ianf A anarnl+oan fib -.:.




ii *!.. v'
:i. '*:.


I! -. 17
hii



II
.t:.' ?
*


3r,
H'7""
H:
3em4
H


to th
of th
been
from
larly,
test.
Wa M


e hospital
e stock,
increased
good mill
and one
The aua


a. 11"


i t is practically
1.5 to 2 per cei
Piggeel.-A
immunized pe
we will save
enable us to r
worked out wi
is hoped this w
Poultry yard
States were fo
fected were se;
this disease am


s of
)ut
. A
king
cow
lity


--- --


the department.
by more careful
n effort has been
mothers. The
was condemned
of the milk coni


y free from
nt above tl
process is
rmanently
the expen


aise ma


bacteria


he
un
ag
se


legal
der w
ainst
of a


a, :
rec
ray
ho
Im


ny more pigs


Iereby hog cholera se
rill make the piggery*
.-The Rhode Island
und .to be suffering
)arated and are being
long the healthy chic


Garden.--The garden has e
income, although the expense
granted cripples, and increase
General.--With increase of
crowded, and steps will have
room. Several cripples have


ihown


more interest in the occupation ward. Aside
they are being taught to crochet, and to make
the patients to distract their attention from the
Some of the male patients are allowed to cultiv
within the hospital inclosure under the supervisi
This has proved successful, producing about $
attempt is being made to teach some of the mal
rug making as done by the female patients. Alth
in not having a hydrotherapeutic room, an eff<
to carry out this treatment on the wards. In
patients' surroundings more pleasant, several
been added to the lawns, providing cut flow
A neurological clinic has been established a
where cases not requiring hospital treatment
staff of Corozal Hospital.
Farm department .-Dairy.-The demand for I
has increased so that at present we are s,upplyin
daily to sick adults and children, aside from t


Corozal farm milk
g about 200 quarts
;he regular suDnlv


There has been no increase
feeding the milk output has
made to raise all heifer calves
tuberculin test is made regu-
after positive reaction at last
tinues to be of high standard.
and the fat content runs about
luirement.
whereby all our pigs will be
g cholera. With this method
ministering serum, and it will
than before. A plan is being
;rum will be manufactured; it


pay for itse
Red hens
from tuber
killed off t


kens.
an increase


If.
imported
culosis.
Prevent


pro<


!has increased due to incr
d number of cripples.
patients the wards are
Sto be taken to provide a
had their claims settled


from the
Those in-
spreading


duce and
eased" pay


becoming
Additional
and have


from making hats,
rugs. This helps
ir morbid feelings.
ate a truck garden
on of an attendant.
125 monthly. An
e patients hat and
rough handicapped
ort has been made
order to make the
flower beds have
ers for the wards.
t Ancon Hospital
may consult the


-- I -- --























5.
adult
addit
of thE
An
sites,
wild
lecte(
of th
labor
Th
estab
in NT
were
cattl
Film!
* ined




Brain.
Marrow'

Th
brain


The focal degenerative arthritis found at autopsy in yfrng .
a offers the gross pathologist, in the opinion of the writer, somfe
ional presumptive evidence of syphilis and the application .
Laboratory tests for the disease are indicated.
attempt has been made to enlarge our knowledge of the psra
particularly those occurring in the blood and muscles, otf both
and domestic aniinals in Panama. The pathologist has col-
d for publication in the Proceedings of the Medical Association
SIsthmian Canal Zone the observations thus far made at the
atory on this subject.
e presence of Texas fever in this locality was first definitely
lished by the finding of B. bigeriina in the blood of sick cattle.
november, 1916. During 1917 further studies on this disease e
carried .out. Twenty-nine poorly nourished, tick-infested
from the Miraflores pasture were submitted for autopsy. .
s from the blood, spleen, bone marrow, and brain were exam-
for the piroplasma with the following results:

I..,
S Positife. Negative. Positive. Neptive. i.
," ,," e*.,t v

10 19 Bd.3 .


us it is seen that films made from crushed graj matter of the.
yielded far better results than blood films. An examination
L n n..n at 10K a i i,11... 1, nt an,.4d-1 ni. -' nln uun, 1 mi 4.ae.*






I
Il!!'"
j..n
'i.:


ii.


show a high mortality. Experiments ]
immunizing imported nonimmune cattle
large dose (20 cubic centimeters) of the I
after their arrival and not turning them
have passed through their mild attack of
By cultural methods it was shown ti
Panamanian beef cattle carry in their bl
The morphology of the trypanosome wa
and, as ordinary blood films were unife
method was developed to demonstrate t
in the peripheral blood. The freshly dra'
laked with distilled water and centric
sediment usually showed a few trypano
cattle inoculated into laboratory animal
young calf showed numerous trypanoso
inoculation. The trvpanosome agrecs


mes
with


s4


Trypanosoma thcileri in morphology, in size,
multiply in other hosts than cattle, and in thi
readily grown in artificial culture media. W
that the trypanosome of Panamanian cattle
organism is regarded by most authorities as b<
During the examination of the sediment of lak
centrifugation, filaria were frequently encounth


were practically always
Spirochaetes were enc
fore, that Panamania
dium; that most of th
them have filariasis;
th.ir blood.
Murrina has caused
the Sabanas between
conducted some field
in a few horses; life \
the treated horses surn


in carrying
examination
mat.a were
equine piro
Canal Zone
site occurs i


* out fourth
n of the bl
encounter


s present
rounterec
1 cattle a
Lem are
and that


even days after the
the descriptions of
in its inability to


e fac
e th
is Tr
?ing
ed c:
?red.


in films made from tl
in two instances.
I1 harbor B. bigrmina
barrierss of Tr. thIcicr
a few of them have


t that it can be
erefore decided
. thicleri. This
nonpathogenic.
battle blood after
Sarcosporidia
he heart muscle.
It seems, there-
and sarcospori-
i, and many of
spirochneles in


heavy losses during 1917 among the horses in
Panama City and Chepo. The laboratory
experiments on the treatment of the disease
ras prolonged in most instances, but none of
rived. The experience gained will be useful
er experiments in the future. During the
ood of the horses for trypanosomes, piroplas-
ed in several instances. An acute case of


plasmosis in an American horse was encountered in the
by Darling in 1913. It has been shown that the para-
.n Peruvian and Panamanian horses in this locality, and


it is probably quite prevalent.
Hog cholera has continued during 1917 at Corazal farm in spite
of the useof ho-rcholera serum It. has been established byv autnnsv


have been begun toward
by injecting them with a
)lood of native cattle soon
out to pasture until they
the disease.
hat a large percentage of
ood a large trypanosome.
s variable in the cultures
)rmly negative, a special
*he trypanosomes directly
wn blood was defibrinated,
fugated; smears from the
somes. The blood of the
s yielded negative, but a


























Blacks and mulattoes:
aemales.. .......................... a 1 238 2,44 3174 1
Irlaems~e.,.. ... ...~- 191 558 749 4
Children... ....................... .. 10 1 174 .

1,4t39 3, s2. 4,109) ]. r
(IsS, IIIs.* - 4 9 13 1
Grand total..-..... ........... 2,1 078 7,483 9,561 *

In addition Wassermann tests were made on 214 spinal nuid. fro d
many individuals, and of these, 47, or 22.8 per cent, were poi-
tive.l1
B. typhosus has been recovered in blood culture 25 times. Seven
of these cases came from shipboard (six different ships, two case
were recent arrivals from the United States, and the rest w#e0
sporadic cases from six different towns. None of the paaypi.i
oanism were encountered during the year. ".i- .:.
The following were also recovered in blood culture: t. Bee
sBctxrentocotos..,.n..... -..-... .. -- ---. --. N.on.. o th--e- .. ptI..
Stamp. rylochclus aurenus....e....-.- ...... .-....-....- .. ..-..-...e--.-.... .. ... .. -...
Staheyloiooges eblreo........i...............e....... ...-.
B.Sta loos us....... ......... .................. o.................. .
. dsenter (Feotype).... .. ......,






a 21


tions made of insects belon


pal lines of investigation that ]
ment were in connection with
tidns have also been made alor
and general entomology, as thk
There were 240 lots of mosqi
and identified. Several samp]
attacking stored products. O
position habits of Culex and A
made on the house fly, Musca
interesting data regarding the
secured which will be report
tions on the life history and
calcilrans, are also being made
on regarding the insect transm
disease of horses, to determine
hosts. A number of adult r


received during th
Anopheles previous
covered this year.
which undoubtedly
of Bromeliaceous pi
have been foumd on
reported from this
humerale, was found


man as a hosi
Work on tU
hand catches
military post
completed in
ent year thai
examined an<


Anopheles
Anopheles
Anopheles
Anopheles
Anopheles
Anopheles
Mansonia
Mansonia
Mansonia


ants
the
local
on a


as well as
te census ol
in quarters
s, etc., wh
February,
t this work


g to a


. Specimens
Isthmus, whi
Ility-one of
tortoise; the
various wild
f the adult m


i
1


identified


albimanus..
tarsimaculant
punctipenni
malefactor..
s apicimaoula
eiseni.......
citillans.....
ni ricans....
fasciolatus...


a..
s...


11 orders. Although the princi-
been conducted in this depart-
.cal entomology, many observa-
lines of agricultural, economic,
s o'n the laboratory demand.
arvae received during the year
flour were examined for insects


observations were made on the ovi-
edes mosquitoes. Studies are being
domestic, in Panama, and new and


hal
ful
,bit
In


e year for iden
y unreported fr(


)its of oviposition have been
ly at a later date. Observa-
3 of the biting fly, Stomoxys
vestigations are being carried
of Murrina, the trypanosomal
ng insects act as intermediate
toes of various species were
Ltification. An adult female
m the Canal Zone, was dis-


of two new species of ticks
ch have not been previously
these species, Amblyomma
other, Ixodes ricinus, accepts
and domestic animals.
mosquitoes taken in the daily


and barracks at the various line stat
ch was continued throughout 1916,
917. During the two months of the
was carried on. 20.835 mosquitoes


Of thi number there were:
Of this number there were:


* * * ..I* ** * ~ . . *


- .. ... .. ...... . .. .. .. .. ... ...
. . ... .. .... ..... ... ..... ..... ..... .....
*.. ........ *. m********-**** ***.****s-****
.. .. . .. . .... . .. .- . .. ..


Aedes (Stegomyia) calopus.
A edeomira squanmipennis. -
Lutzia allostigma...........
I esticocampa................
U' frnAm nn


ions,
was
pres-
were


1,108
2
53
10
1
4
5,021
342
916
14
4
1
16
An


This is Anopheles hylephilus, the larvae of
live in the water held at the bases of the leaves


1111111111111111
I














IH










on the water lettuce explain the history and ibution qf the
plant, a description of the plant, information regarding its pmp
gation and development, suggestions for its control, and notes ..
the insect enemies of the plant. Additional studies on the watr .
lettuce will be carried on from time to time with the view i;
discovering an economical and practical method of eradicating
a g g a"EE:....EEEEEi
the plant and its associated mosquito. s..t.. i
Evidence has been received which leads tothe suspicion t: t
ticks are possibly concerned in the distribution of the eggs of D...er
matobia hominis XDermatobia cyaniventris). Studies have been :'
made in connection with this infestation of the larvae of tlif n 's
and a report has been prepared for publication which contain the .ii
evidence submitted and the finding- of our observations. .
Extensive studies on the i uana tick, Amblyomma dissimile, ..
common ecto-parasite of snakes toads, and iguanas min Paj~s. 4
were completed during the year and an article on the subject
pared for publication. This pa er deals with tire descnptioi l4 ..
the diterent stage of the tick, te periods of attscihment, moltb
preoviposition, oviposition, and its attacks. on reptiles and ba. ..
chians. .. **
Pi 1m " ..... : ':H.
The study of the snakes found in the Canalr Zonpe and t
was continued during the year and a number of specimens w ..




















:: :: ::

...........H..


. .....:....





...- ..
..................





TX



H..
.!, ... "


1q1 ..
HH
.11 i.
I:::rii:


.. uI . .... ...
..r-1 Hi..
.... "*:" : ..* .**
:. :. .... **. ** ..
* : : .. .. *
T :*:*:.. i . .
. I*..::*.
. H


"."' ..'..f.. 'Ydtlow-bellied sea snake," Hydrus ploturus,
. '"" .."c": ... measured 26 inches in length, ra inches
:j* t:t!. ...i. *r n 1 inch wide doteally, was allowed to bite a
I pgrug weighing 425 prams. Its action in biting was very sim-
.I': th* ctsaln- ake,n E9laps fulvius. 'The act of biting lasted
j Iijondap and :a -chewing motion of the jaws occurred throughout
iHHttftt od mThe: pig evidenced no symptoms until four. minutes
teriithfe bite, when it suddenly fel over on its side, the respiration
": g33 to short weak gasps, and two minutes later the pig was
.Sm .. i Inexperiments with thevenom it was found that0.0015 gm.
.:: liquid venomnd iluted with 1 c. c. of normal saline solution and
c-ected .iubcutaneously. into a guinea pig weighing 508 grams,
aud paralysis in 10 minutes and death in 14 minutes. One ex-
Staction of venom from this snake produced 0.0038 gm. of liquid
veonm. While securing the venom it was noted that as soon as
te. snake began biting on the edge of the extraction dish the venom
was ejected from the fangs in fine streams of minute volume. The
fresh venom is quite viscid, but entirely colorless like water. It is
neurotoxic in effect. Animals that were bitten by this snake or
Received injections of the venom manifested no swelling, discolora-
tion, or other changes at the.site of the bite or infection, and the
autopsies showed no gross pathological changes. We find that the
Hydrus platurus is the most highly poisonous of any of the Panama
Smsnakes we have studied' to date. This species lives in the Pacific
and Indian Oceans, where it may be encountered in large numbers,
s sometimes being found in schools numbering thousands of indi-
viduals. It is commonly known among the natives of Panama as
the "Toboba" and is very common along the Pacific coast of
Panama and the adjacent islands. It is rather sluggish in dispo-
.tion and does not appear to be very vicious.
. Experiments were also made with the venom of the "Fer-ce-
; lance,'' Bothrops atrox. This snake was 4 feet and 2 inches in length;
the body was rather stout, being about 11 inches in diameter and
with a ridge along the median dorsal line which gave somewhat of
.. a triangular appearance. The head was 2 inches long, 1I inches
.' ide at its broadest part, and rather flattened, being about three-
-.fonrth- of an inch thick and ending in a pointed snout. The tail
Shich was about 7 inches in length, tapered finely to a small tip.
This snake was allowed to bite a guinea pig weighing 410 grams.
It struck the pig with great rapidity and the bite lasted less than
Sthire seconds. Owing to being confined in small quarters the snake
was handicapped in its striking and but one of the fangs entered the
.i*L tnt in nert trnfntn. Thin wan a.t. thP rvioht fnrn anlldn1r Thn


:'




I~





S*. .. . ... .2 ... .-.
S:: :*X : :*w* *. ". ... **** .. .* * P a n *.

: .. .. ..... .....A. . ... .. .
I ... .. .. -. -. i *. ... .. .. ..:a
e.... ... ... .t ntantly cared for during.te
S.' .tei. were 66 patients under treatment at the
i.-...lpya ;.f '. were admitted, 7 died, and 3 were dis-
.^ j7 ,6 remaining in the asylum at the end of the
Mcon story hit, 28 by 72 feet, containing 6
IBi.by lI feet, an 2 bathrooms, 2 toilet, and front and
t.i.disa. the length of the structure, was completed
H1,, ,,trA the -work on this building,'with the excep-
'41S0 ee riering, was done by patients of the institution.
iig is ued as quarters for6 male Wert Indian patients,
A 4 ~relieve he present congested conditions. The chapel
wuitrnved a distance of 35 feet and placed on a direct line with
Sbt ilding.. The space formerly occupied by the chapel was
reaaidd planted with grass and flowers.
p'.ahc- year the municipal engineering division made water
'..:..; *..t.. from.. the asylum pump to the military substation and
Swas erected by the forticationdivisionof 50-barrel capacity
|Hf the use f the'military substation. Water was supplied to this
....tBo commencig mi May, continuously, with the exception
Mubou.. thrw, weeks when the well at the asylum appeared to be
.iiU dry. The plunger and casing were lowered 50 feet,
*ni.i midg the total lift of the pump 138 feet:
S A foundation of rock and stones was laid during the year as a
.:w sate for the laundry, placing this building on a direct line
i ;:other buildings. Minor repairs were made on all buildings
. ".I..i. .the year by patient labor, who also built tables and benches
::a::. o aasylum-use. .
:bout 35 acres of land were under cultivation during the year
: patients; and all products were sold by them to the asylum.
i wimste 9,000 pounds of yam3, -1,400 pounds of yucca, 800
Sdd .pumpk, 500 pounds cucumbers, 600 pounds tomatoes,
o pounds okra, 500 doze ears of green corn, 12,000 plantains,
weeen ddgs were purchased from the patients at a total cost

'......ls. to theamount of $1,509.48 were sold from the commissary
..... ..ent during the year. All articles are sold at cost, and at a
t to .ithe_ department, as the cost of transportation and handling
..ti.l. extra supplies required to be-carried in stock amount to
II per cent, and it is recommended that authority be obh
.BeEfinsI e4a timar in. aif nI knn nmn nar, wn aflo *nU-t ntabn an 1enhe
'":' :10 pe ent d. d that a thority :c it.is recommende e .ob-







*H H 4... .... =::: :.. ..*:.. . *.. : :*. .:*
S'*' = ": *.... .. A* ; *
*H*.. .. *. . ':".
.. : .:W. *
::::: ..: *..i *Hi. ..

.. ...
. : : '. . .r .. :' *
** "'d....'.*l" * *
:'.:...'* :'.: 'E*:. *..': "': : : *. P: .:".: ..

B ,... .
HI : :.. *

,.--, . -
.:I I i i ii. . j H** *


27


*: ": mi~hi. ll' ,:**** i~ : .:. .'.- .=" " ". " "-
:gqi..B. .- *-thin thoe of teeth mly 58
~ iC;k; s. : &.l )i-i,-.! .ili..i i .i m Il i.; ..... ...i:1.... i !ii !!!iii!
S............... .................
:.1** 79
*." *...*. *. .... .... g aa **Fa.. ***: ...: .*.*.. .* a.
*H* H*.Au :0*:: .I*** ** a7

~ij~...:..:: ..il;:i#i ., .. .. .. .i.... IlIIi! ,i I iIIIIIlIi
*::**,****:. v. ..* :-:::. Pm. : .4 ***.n 3
H*** *., g
ii .. H 1**-I ** s.

H... ... 1 3 1 1.a .... .......................... .....-............. 167
H ,,,H:" ,, S ,, X ,
.*:. .*. .i....- .. .. *. *.,.
:.: 14* .... *.-*......* -*..... ---. *-- -- *
:*....s ... ................... -................... *.eaa.............. .


i.E~? "*3:*"..i. gla ds _.p
.* .* : :I H. . *


**~~ ~ ~ raed n ramn ::.ri***,....*m*wammmeeempored..gammmmmemmmmmemmmmmmmmmme 16
::: T ,;. ..... li" gi,..:.." .*-
iF..... .. .................................
."H" ..... ' .




litiC



gvn were ..~s m istmpe.t "1i
,. ,...,* ...** ...-. . .... .* -*..-..--- -.. ..... .. .. .- - - - -- -
** :...... :*: .*...s e ee *e e e m m m mmdm m mm m1.emm m mm m
.. . .. I '." ".s.
T at',i h i o s ul 9 1sae m raton me nrep e.
*. .. *
... .. H.... ...


-, =.,. ......--s u a i a io so t d8
". nh umber found, needing treatment includes all children in
there was even a suspicion of a diseased condition. The
*.:: .~.. . Xzg ds a ..gax~s ....-.-.-.... -.-........2
rI'I.........n*~ 't"eated tonde fac



stiP: mber of cases reported as treated is not complete,dutohefc
~that many notices were.. ignored .by. parents, and many slips to be
..." etuned tm the exam tngrphyam can, showing that treatment was

+;( iven, were lost or misplaced.
I:. -- Th




,. H $h .children in the colored schools were also examined. and
*.*"- rentment recommended where necessary.


.. i "*.

a.".
* : ::

IH ':
". "
HI H
:9....*


HI.


- I


DIVISION


ZONEs


SANITATION


SANITATION,


The zone sanitation activities have been directed chiefly toward
malaria control and antimcsquito work. The infrequency of other
diseasesn of a communicable nature, within the limits of the zone,
has been such that no extra effort has been required of this depart-
::meot during the past year.
: .. iThe extensive activities of the supply department in clearing
eand for pastures.and plantations which-have made necessary the
establishment of numerous camps outside of the regular seanitated
areas has been responsible for 173 of 473 cases of malaria among
: employees reported during the year 1917. Of the remaining 300,
177 -were from Colon-Cristolal and Panama, leaving 36 for dredges,
-.etc and 87 for.the zone proper.
* 7 presence of the cattle in pastures which have limits extend-
btowithin the distance of maximum flights as determined for
tnn hAel mnsnaitn a, intrndrne a n w nrnhl nm in mnanuitn enn-


L::"i




I~




I..: *...;
.. .. ...;
I.H:. i H
.. .7


d~:~l~n T.1:::


unt aove-ll Rothem, poverty and the
.Iff lntitatin in the tenement houses of
: te.d.ang is due, of course, ti both low wages
-" . : ....: ." ,


.. rs whae been taken to improve the living condi-
e n -eent houses by notifying owners to install lattice
t ot dark roomb, and ae such other changes as .are
iri pt" rove the preset poor system- of lighting and'
Sorty-fur different houses had undergone such
nte up to December 81, 1917.
better antitabereuloeje measure would be the building
mk an silver quarters on the Zone for the housing of the
owbtea. iding infantma. This would reduce the popu-
e.ity .greatly and there would then be room enough to
overcrowding among the remainder of the inhabitants.
ent"s would also result.
.Iovember and December several educational articles on
. :r .J . .
entio of tuberculoi" .were published in the local press,
A :' 'pbds were completed whereby, beginning with the New Year,
cot tuberculosis in the city would be visited and instructed
a b.ic-health nurse attached to this office.
H' H;H:i..I we;are work.--Late in 1916, because of the high infant
..:.'.:....r. ate, -a public-health nurse was added to the porFonnel of
.Pauna m|halt l.Pfice, and by the beginning of 1917 her work
.::well underway. During the year she made 14,165 visits and
'*ii instructions to 700 mothere in the care of their babies.
* : -the. firsthalf of the year there was no appreciable difference
E +, the ubual number of infant deaths, but in the latter months the
....:,etse ..was efficiently marked to indicate that results were
! :....i.. : areOd. -
...e-.a.tma National Red Cross Society, a native organization,
"- ""ok u.p this Work early in 1917 and conducted it along the
bjB linea as or iginally outlined by the visiting nurse attached to
4 Ti. iBy t re end of the year .their work was so well organ-
:..at it was decided to turn over to the National Reod Cross
Somety all intfut-welfare activities in Panama, which was done
,*. DOewer .31, 1917.
'Tlaagh the infant mortality rate is slightly higher than it was
.' ago it would doubess have been very much higher if no
St Welfare work had been done because of the increased cost
im Mi lk as well as practically all foods.












which is then burned. However, during the
of heavy rains, these fires die out and many
to finish their cycle of development in the
I, the1 manure piles.
Milk, dairies, bakeries, bottling works, can
restaurants, etc.--After the resignation of the
spector in August the inspections of these
carried on by district inspectors 'and the v
the circumstances it is not possible to make a
this work, or to give tables, but an effort w'
keep the hotels, restaurants, and bakeries in
at all times.
Building inspection.-Because of the increase
the number of new buildings has not been la
of old buildings and the work of supervising ri
on regularly. During November and Decem
unusual activity in this branch of our work d
of an extensive antituberculosis campaign.
Sanitary nuisances abated.-The total nu


abated for the year was 3,440. Fines amou
imposed. As many nuisances were commi
a policy of great leniency was followed, and
were minimum. A very effective way was
of $5 and then suspend it pending the subs
of the offender, and it was seldom found nc
fine.
Street cleaning.-This work has been carri,
by street sweepers with push carts under th
foremen in the various districts. By the prei
are kept in excellent condition.
Garbage collection and disposal.-Practical
elected during the morning, and throughout
been disposed of at the city dump. However
the new year all this material will be burned
which is now completed. No special comic
posal are necessary, as the work has been c1
way as for the previous year.


nt


night,
of the
ground


or in times
larva- escape
surrounding


idy kitchens, hotels,
food and dairy in-
various places were
veterinarian. Under
t complete report of
as made to at least
a sanitary condition


ed


cost


of materials


rge, but inspections
epair work has gone
ber there was most
ue to the beginning

mber of nuisances
;ing to $497.55 were


tted b
fines,
to imp
;equent
Scessar*


y poor people,
when imposed,
'ose a fine, say,
; good behavior


Y


to collect


ed on, as in the past,
e supervision of street
sent system the streets


ly all garbage is col-
the entire year it has
, after the beginning of
at the new incinerator,
nents on garbage dis-
arried on in the same


CO LON-CRISTOBAL.


Large permanent
during the past ye
LT a- 1 -


improvements ha
Sar. The principal
--1-t-- .. LI U. ..


ve been made in the district
1 one was the completion of
-- - nLnaJ. - tie .C AL..


I


I



















bull
01
been
on t
Mou
Th
atati
the
cond
will
local
long
lapi(
poli<
01
for t
furti
TI
and
elim
from
Be
Rivi
stati
nece
vici
in tl
press
effec


111


..................................................................................................il
ding sites.
her of the swamps farther south toward Gatun have dtl""
killed or drained until the radius of filing extends.
lie average at least one-half mile from the setth pt
nt Hope. ...H
e Ponton Beach water front in Colon, west of the ra
on, has been filled in and is being used as a-railroad
buildings adjoining the beach on the north side have gl bl
Iemned and removed, with the exception of one group whieh.'.:
soon be demolished likewise. Other improvement in h H **--
lity are expected to eliminate the rat infstation
centered there. The buildings had become old nd
dated and were not built in conformity with the rat proiH
nv of our present re'ulations.- ..
Ld Pier No. 4 of the Panama Railroad has been demoliubedH.
he most part and reconstructed for the remainder, h
her reduces the rat problem. ,,,
he beach at Battery Morgan has been completely trmnsf i:n*4.
the long-standing unsatisfactory conditions there en tw a ld
inated by filling in and building a sea wall there exeJ
the battery up to Fifth Street. .
because of the crease of population on the east saide of
er, the development of Fort Randolph, the plans for an H
on, and the submarine base at Coco Solo, it has beenh i
sssry to grapple with the problem of mosquito breeding in a.
nity. Work was commenced on draining some of the a
he latter art of the calendar year and is being continued at
ent. Hydraulic filling of a large part of these swamps isb i
ted now. .. .....






33

I side of glass plates coated with gum and placed on the west shore
of Folks River.
It was established by repeated inspection that the anopheles
Were not breeding anywhere in Colon or on Manzanillo Island. It
IH was proved that the mosqi itoes flew across the Folks River and the
necessity of eliminating the breeding grounds around Coco Solo
was demonstrated.
SOn the initiative of the chief health officer, persons living in un-
screened houses in Colon were reqp ired to be provided with mos-
[ quito nets, which m st be r-sed under penalty to isolate all infected
cases not being treated in the hospital.
Tuberculosis.-There has been an increase over 1916 in both the
I number of cases reported and deaths resulting from tuberculosis.
This high incidence is suggestive of conditions demanding im-
provement. One of these is the overcrowding in the old wooden
tenement ho-ses of Colon, many of them three stories high, on
, both sides of an alley only 3 feet wide. This office is engaged
in plans for a graded scale for widening alleys in proportion to the
height of b. ildings, which it is proposed to put into effect when
these bt ildings are condemned and replaced. It is believed that
the poorer classes of the population are not getting eno: gh of fats
and oils in their food, and a campaign of publicity on the subject is
intended.
The dampness of the lower p trts of these tenement ho--ses during
the rainy season is also a contributory ca'- se, and this will in part bo
remedied by better drainage of certain alleys and the raising of the
floors of these older buildings. The g neral cong. stion in the tene-
ments will be hard to relieve under existing economic conditions,
since the laboring classes are oblig d to pay between $4 and $10 for
a single room and consequently cl b tog other to reduce the expenses.
The best measure to remove these conditions permanently wo: ld
be the opening of a good road from Colon into the interior east-
wards, to enco rage the population to live out in the open and so
remove the congestion due to the limited b-ilding area on Man-
i zanillo Island, while this road wo-Id be a means of improving the
general business conditions of Colon, of increasing the prodt action
of food, of raising the standard, and lowering the cost of living. It
is recommended that the construction of this road through t.he
Canal Zone territory to the Panama boundary line be included in
plans for the Atlantic Terminal of the canal as soon as practicable.
Diphtheria.-There were 23 cases of diphtheria during the year,
a decrease of one as compared to the preceding year. A diphtheria
E carrier was located and kent in the hospital for several weeks until








































lies.--The close of the year witnesses an almost i
minimum in fly incidence in Colon. In the early partlof .
an effort was made to economize in the use of lanroaeci ck*e.
custom of using a mall quantity of larvacide on mnecesibteiq
and crevices in the cleaning of patios and premiisswas t
discontinued, with the result of an increase in the numbr i
to the extent that it was decided to resume the use of
before, which soon got rid of the ithe again. This use of
both destroyed adult flies and prevents fly breedapg in is i
d c e t rise i- s
before, which econ got rid..of the Sim again. This us of
both detroys adult flim and*prevents fly breeding in plus M
*9 "W a 41 wr *Me i Aiush .h *.h



An::.: .1
1:3'


35.


course of the year. The elimination of the old buildings on the
water front, the filling in of holes in the coral rock on other beaches,
which are a harboring place for rats, and the constant killing and
poisoning have reduced the rat infestation in the district, and it is
believed that the reduction is much faster than the increase, with
the probable outcome that Colon and Cristobal may be completely
free from rats when the prospective improvements are completed.
On the completion of the modern cold storage plant at Mount
Hope, the rat-infested plant now in operation at Cristobal will be
eliminated and the building used for other purposes, after it has
been freed from rats by the demolition of Dock 11, which is the
source of rodent breeding in Cristobal. The new cold storage plants
will probably be completed within the next eight months.
Hotels, cafes, and markets.--A new and modern concrete hotel was
built and put into commission in Cristobal during the year, replac-
ing the old wooden building which has been a subject of frequent
complaint of late years. A large new concrete hotel for Colon is
nearing completion at Bolivar and Eighth Streets, which will be a
decided improvement in the accommodations of that sort in the
city.
Continuing the policy of bringing cafes and restaurants up to a
high standard, upon which the health office has been working
steadily since the completion of the canal, several of them were
closed and others made to conform with the regulations. A num-
ber of improvements were made in the public market in Colon, but
it is probable that additional market facilities will have to be pro-
vided for that city before long, and it is desirable that this should
be located on a water front.
Piers and docks.--Pier No. 7 was completed and put into com-
mission during the calendar year. Pier No. 6 is well on the way
toward completion. Pier No. 11 is in the same unsatisfactory con-
dition as previously reported, but it will doubtless be remodeled
as soon as conditions permit. Pier No. 4 has been remodeled and
made available for the use of the schooner trade.
The docks are inspected thrice weekly, and the work of catching
rats is carried on daily, although the improved condition of the
piers has reduced the rat catch to almost a negligible point.
Building operations.-The three large areas devastated by fire
within the last two and one-half years have been almost completely
rebuilt with concrete structures, with the exception of a part of
one block,in front of the Government Palace. In addition to this
many vacant lots in various parts of the city have been improved
.2J, a 4,.., - an j. L, a, n, A. -, a, 4 1\ A na C rrt alq S a n a i











PH ii
I:


tH
f: == :*


QUARANTINE


TRANSACTIONS.


A r6sum6 of the quarantine operations for the year just ended
shows that the quarantinable diseases of plague and yellow fever
have not materially changed, with particular reference to Central
and South American ports. Along the west coast the first part of
the year plague conditions were bad, particularly in Guayaquil,
with a high mortality rate. An ,extension of the disease has
occurred in Ecuadorean ports north of Guayaquil, which has been
made the subject of reports from time to time, and requires very
careful consideration from the standpoint of a farther northward
extension to Colombian ports, which would make the disease
relatively a very short distance from the Canal Zone. So far as
we are aware, however, this disease has not made its appearance
in Colombian ports up to the present time.
In Peru and Chile, general plague conditions have shown little
variation. The infection is very generally disseminated, and no
measures of any special benefit have been carried out for its eradi-
cation.
Yellow fever on the west coast has been more prevalent in
Guayaquil, Ecuador, than elsewhere, though the seasonal increase
of this disease at that port, looked for in the last few months, has
not been as extensive as expected.
In Buenaventura, Colombia, toward the latter part of the year
a consular representative, who also looks after the matter of fumi-
gating ships, has been stationed, which arrangement will be more
satisfactory from the standpoint of shipping between the canal
and this port.
Smallpox has been quite prevalent in Chile and Peru, and has
been reported as having a higher virulence than usual. Since
the first of the year, and even earlier, considerable trade has
developed between Ecuadorean ports and Panama, carried on in
small schooners. Careful watch is being maintained of this traffic,
in order to guard against yellow fever, smallpox, and plague, and
when considered necessary these vessels are detained and fumi-
gated.
On the Atlantic side plague is reported in Brazil, and we suspect
its presence in Venezuelan ports also.
Yellow fever is reported from time to time as being endemic in
certain places in Venezuela, and the shipping calling at Venezuelan
ports is watched on account of both this disease and the possibility
of plague being present. Yellow fever has also been reported in
Brazil and from some of the West Indian Islands. This disease


















forces of the canal have given material assitace in the p1 .

able class were rejected and deported.
of the law. During the year 360 U migmants falling in the m d ..................................................

The work of the veterinarians in connection with quarantine *~j'
ante and post mortem inspection of food animals, has been eid..
out in a very careful mainer, with particular reference to tnat.
During the month of March, 1917, a total of 15 deaths from mntihrn 'z'.
occurred among cattle belonging to'the supply department. Oun
of these cases occurred on the Ioor of the Cristobal abattoir 4n
was made the subject of special report. The statistical reports ..
the quarantine and ante and post mortem inspection of food a- .i H
male, and disinfection of hides by immersion in 1-1,000 biehloride ...
.... iii#





solution for 24 hours, are as follows: :" ..
Quarantine inspections:
Cattle. - -- -....-..-.. -. ... -.-- ...-.-.--. ....-.-. .. I-.. *. -. 28. 675
Swine ......,,, -- -- -- --- -- -- -- ,...,-,, -,,.,,, - -
Sbeep .. V" .".ijjlJ.





-- -p ,,. - a -- ---. a--- ,, -. - -- .. ... .- -.. ,--- a-.... -
0 oats. ...... .. - .. .. .. ....-. ... -..-....*.a. -. *... I ..
ante and post mortem inspections:
Cattle. *-*. -.. -*. - ...-** **- *- - -----.- -. ... -- .- .. -. -.. ---- .. 17, clI
Swine.. ---- . - - - - .... - .. . - ... 531..
Hides d isin fcted..- -.. .. .... -. ..- ...- -- --- -..... -" .. ...... .... ,
The supervision of veterinary work was transferred to the health.ix .
officer of Cristobal-Colon on December 5, 1917, in order to conhWi iH
date this work under one head. On November 21, 1917, governor t
circular 700-1 was issued, requiring application of tuberculn tat .ii!
to all cattle and hogs imported into the Canl Zone for d atr a m....
breeding purposes, and to such animals arriving in Canal r onrts. O
ports for transhipment to other points when considered neesry,.i
unless such animuale are accompanied by a health cert
including tuberculin test chart executed byan inspector of -th
United States Bureau of Animal Industry. This req uremeutzwsu.
H.........








for the purpose of preventing the introduction of tuberculos@is 1.
uamonti domestic animals on the Cn...al Zone. Th..e.ex.ami..ti.....
amog omstc nial o te anl on. heexmiaton h





HiI.!.u
ibi!!'
ll '/ DEOTTOS

"iiH""" "I:iiil.

H::*
~39
*:, ,,, *.



H *..i



.:1, DEPORTATIONS



|| Sixty-six employees were repatriated to their homes during the

Year, 57 of whom were incapacitated by mental or other diseases,

and the remaining from injuries received in the course of their

: employment. Thirty-four nonemployees were also repatriated, all

| of whom were suffering from disease excepting 2.
In addition to the above deportations accomplished by the

hospitals, 360 passengers on incoming vessels were detained and

fl deported by the quarantine authorities.
I *. 43016-18---6
Ii..






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DEATH 7


.RATE


ALL


PER


/ 000oo EPL O YES.


CAUSES


/906 26S47 4/. 7J
m-i...... D



/907 93S38 *&.74








/,09 47/67 /0.64




/Oc 60:08 /0.90



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DEATH


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cot. Ott


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Year 1916: -i
White..... 4, 552323. 59 67.35 56.23 5.27 3.29 ....... 17.76
Colored... 2417 0 33.61 6. 15 4.79 1. 3 ....."...3


Total.....3 54 ,7 ,1 31 187 447 11., 4.. 1
Year6 1140.














6n-1.. ".i

1 Annual average per 1,000 employees. . ... 2'..7........5.:8......7..




. :
.. .
h.43.62.... H. .....8'....
. ....*. ..,,,gi

-.. "... .'

i- ..G.. ..... ,..
** ~::* *




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==* = .: ii :i

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IIIIIIHIIII











TABLE I-A.-DEATHS


IN THE CANAL


ZONE


PANAMA AND COLON


AND THE CITIES OF


Year 1917:
Panama...
Colon.....


....g....
*.. J. .


CanalZone.. .


Total ...........

Year 1916:
Panama..... .....
Colon............
Canal Zone....... -

Total...-........


Aver-
age
popu-
lation.


61,074
25, 386
127,543

114,003


60,778
24,693
31,447

116,918


Deaths.


Total.




1,714
667
'313


2,694

1,765
696
343


Dis-
ease.



1,661
642
273


2,576


1,702
662
290


Exter-
nal
causes.



53
25
40


Annual average per
1,000.


Total.


. Dis-


ease.


-~-- 2


28.06
26.27
11.36


23.63


29.04
28.19
10.91

23.98


27.19
25.29
9.91


22.60


28.00
26.81
9.22


22.70


1 Military forces stationed on Isthmus not taken up in population,
among same not included for last six months of year.


and deaths


43016-18--7


Exter-
nal
causes.


























S1IIeroulot xeziiiiitis ........ .....a ii:! 7 *
Abominl tuberculosis .................-. I.- 1 1 .. - ...*.... -.
Disseminated tuberculas.. .......... ...... 81 3 ...- 4 ...-. -
4,~..
Syphilis, hereditary .................. ....... 1 1 8 5 2 -iH
Soiiv 5 ...... ........ .......**...- ......- I.- ii.
Stcarvy.".'".".. ... ""..... ". "... "".. .".--.'. "'i" 1 .... 1 ...... 1.
A nemu ....................................... 1 ... .... -.............. :
S. .... H.
1mpleme...net...... H........................ 2" .. .
Cerebro-spinal fever."". 1'"""" "" ["" ........ ..
Pneumococce eningitis ............ ........ . 1
-- "" -" "" """ "" "". """"a"". """ "H, ". =
epileagV --..-._ _...... ......................... 2- 1- 1 ---...... -..... ..,
Eopilsopa p1.............................. 2 1 ". .
ConvalsionspfDZ mfants,..-.,,,,.,,,,. 11 1 2 10 6 1-
Acute endoArditis 2 1 2 1 ........ 1
Organic diseases of the heart....... ......... 1 4 I--..1 5 .....
D- 4A
~.sraixoejsoteasoy n pheat-nsy stem -.. . . . . 1 .*. --. ......... . .
Diseases of the yymphatic system............ 3 1 1 3 ..." .....
Acute bronchitis.............................. 24 25 4 45 3 3
SChronic bronchilis:...-...... .......... 13 11 1 23 ..-...
BronCho-pneumo -...... ......... 70 54 15 1109 1 1
Pneumonia (unqualified)................... 8 7 3 12 ........ ........
aO pnemoma. . ..... ,,, . . .. .. 5 '58 2 11. H..
Ple1yr ........................................ ... .". ."'....a *.a. '" ... *
~11m
Bmpyerna. -. ... .,,, .. * ..***.*
Pilmonarj y con gesti ......................... 1 ... 1.1
Aoute somuatitis... ......................a...... .4 - "'....-..- -
.A.c31e g .stritis. *.......- .".. .5- 4 3 1
Acteo indigestion. .. ............ .... ... .... 2 .-.. 5...... ..
Diarrhea and enteritis. 1................. ..... 50 122 28 2344 7 1 1
cities. ................. ........ .......... ... 3. 37 65 1 ....
intestil obstructions....:- ....-..........- I..... 5 7 ... t.
Other iseeses of the intestines ....... ...... ... 2 I 1 .. .
Congestion of liver................. ...... ..-....... 2 2- .... 4 ..... ... ... .
Peritonitis............ ....... ................ 1 21.-.. 3 1
A,.t. nep.ritis -.. .. ....... ....... . . 8 2. ... .. ..
Chrom.ic nephritis .... ... ............-.. 1 1 ....-- 2 ................
Other diseases of the kidney and annexa....... 1 1.... 3 ...............
Pyelonephrosis................................ 4 ..... 4 ...............
Altti.nonitn 1 t I








tin





;1*.





hi
SEX, COLOR, AGE, AND PLACE OF RESIDENCE.

SAge by months. Place of residence.
__________-_______----__ ---~ ----i.,I. IT o

S1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 Pa Colon. Zoanal tale





i ... "'" ..... .. 1 4
1... .. .. .. .. .. .1. i ..2.. .. . 1 3


.... 1 ... I .... ... 1 1 1 I ...... 3 ....... 4 7
2 .... 1.... 2 ........ 1 1 2 10 1 .... .... 11
.... 1 2 1 .... .... 1 1 ..... 3 1 7 1 2 10
.... 1 1 .... 3 1 .... 2 ..... 1 1 9 1 ....... 10


1





1
.... -


2



5"
1
12
3
*







2"

"40"
6
4
1



2
.... C

2
*.a. C
..3.
4..


1
1







1
1

2

19

2



19


30
12
12


1
*i"


1
3
6
2
2


i.. .
.ma e D


1


2

1
1


..~....


1
1
8
4
* -C


1
16
4


2
3
9


.9
1

3
1



9


4
34
1
70
1

15
8




8
2
205
64
6
1
4
2
7

2
1


. i..
--....


12
21
43

4'
1


1


1
1
2


2

















+++I.








Abdominal tubersulou sr-;..:.-: : :c:: :z:::: :::: :: : :z .- -- :: zx zz:
Diss.... ted tuberculosis........ ++.............. , I

Syphilis, hereditary -..-... --....-.......-. .. -...- -.-- ---.... ...* 2 --. -...-.
S* ***.*-- .. --. .- -
Anzerriia, primrxwv, Ter11131J31J5 ---- -.~..- .-...I.-. -a--.. a.- d.:
Simple meningitis... ,:::::::::::11
Pneumococcus meningitis.......-...-...-.... 1 I-.**..... ....
Cerebral hemorrae, apopexy..........-...- .-...-.--- --..- -..--. 1
Epile asv. -. - - .........-- ..... ........ . .. -- -. '.. --"-
Convulsions of infants (under 5 years of sge)........ ........ 2
Hi.*



Acute endocarditis. .- .. ..... .............. - - - - ..H
Organic diseases of the heart.................. 1...........
Lymphadenitis (nonvenereal).... .......... .......
Acute bronchihts .......... . ... ....... .-... 4 6. 6 1'"H'."
Cehrone bronchitis... po.. ... ........... ......! .... 1i" ....
C i lr~~ e broncl.lti .. - -. -. - * *. - - I 1 .. 1 . - . -.. -. . ... *!. i


Broncho-pneumoa ......n.nde a.. ... ..... 12 11 2 7
Pneumoia un usli.ea.... .--..... .. ..... - I.........
Lobar pneumonis ... ....... ....... --..... .. .. ...--- ----- -- .-
letprisy.. ...... -.. ...................... .....
EA yema ... - -
Diseases of the mouth and an.exam ... .... ..-.- - ....-.-..-... 2
Sto .tite. ...... ...-.- ....... .. .......... .. ....-a........... .-
Chroniutec gastritis. 1I. .:
ABcute digeston.. 12.... ....

Diarrhea and enteritis (under 2 years)...-..... 20 12 .13
Colitis ... . ... ..... ..... .... ..... ..... 1.6
Hernm'.,mintestinal obuctions.... .... ....q ... m. m... ..m. -----
eIntisiainal obstructions.. .... .. . .-. . I ..
Duoenal ulcer..... -- -.- .- -- - .- - ---- i

Acute yellow atrophy of the liver.......-.. I ---!-
Other diseases of the iver ..... ....... ... .----.i 1 -. .- -.-...-.....aa... . ...
Diseases of the suleen d.............,............. .......... ..... ................
Simple peritonitis.......... ..... ...... 2
Acute nepristis. . . ....i.-.. . . . -. - -. .
Chronic nephritis.-...- ............. ....... ...H.. .... 6.1.......
Other disease of the kidney and anexa.... 1 ........ .













51



IN THE CANAL ZONE AND THE CITIES OF PANAMA AND COLON,
MONTH OF DEATH.


May.


..a....
*..... -
..... a
-..- -


... .. a
... ...


.- i -


..i i.-





*Wia ai*
* a
* .. .a
* a-

- --
* --


me.aa en
in- -mia a


June.


a.i a
i*a. a


.i. .a


July.


a... a...
II IBIl





iil~Iliil
*...a .. -
* a... .- a
* aa --


*......*
..a- -
-.a .na
*i-iaato
- a aaia


13
3
2


... .. -
* -e a










-.. .a a



...a a..
* .aa -
Sa a.- a


August.


i..a-i


ii.aai

..aa .a*i



..l i.i
- anaa ai
wiain- *


* iD.Dea
* a -- ai


iio....


1


- 1


Septem-
ber.


1



1
1





2


..a...- a


- -. -a *

Sa.a a


.....* a


- a a- -i
* .- -i


1
m -a- e
i a a B


October.


2


* ina i


-i ia i a


* *-*
* a- Sa


. .. ... .


a a ..n
i lii- a i


*wa i-w -i
ia in i- li


Novem-
ber.


iam i.m.a


-.a.-. a
- -.a a

















* a .


.. -...a




* a a a



- -- a


I.-.* *

..a.a -


* a.. -


-I



*.....


15

4
. .... a a


1
1


2
U i m i


1


eem- Totl.
ber. Total.


3
4
1
1
I
1
I


II
10
10
2
4
9
1
I
5


3

2
2



12



124
15


I


1


1


272
67
1
5
I
1
1
5
1


11
2
3


:(:::::::::I~ ::


[ -


I


I


m




























Colomba '-; _..:::"::: " ii 1: 761 90 61. m1.
Costa Rica........... ... ...8 4 8 4 A ,
CubIa... ..... ......... 2... --.-.-1 a 1 7 1 S,
Curacao ... .......... .......... ....- 4 1 4 1 5 !r
Demerara.........a. 1 -....-... 7 4 8 4 13 H.
*Dominioa...... .. ... 2 . -- ..- -- .. 3 2 3- '5
Employms. Naepo s. Toa .








Fnte isa. .............. .. --...a..... ...... 1 ..... .. 1
Brbai:.....: ......:1 47 .... 1..:5...- i 15. i :

French ooias.............. 1 ......... 7 61 W 61.. 1,:
German.................... ........ 1 1
Gree e -...a.. .. . .. . . -- --. -.- .-- 9 3 9 3. *..
Grenada. -...--...-.-.. 4 ........! 281 19 32 19 ';
Guadeloupe........ .. 6 ......I 13 4 19 4 3 ,iii
Haei........ ......... 1......... 1 2 4-,
Iollandi.... ....... ........ ........ ........ ....... 2
Honduras. d 1---- ---1-..- ... ..--- .......- .... 1 .....
India...............- 1 31...................... 7 .....9..... 1
Italy ...----------- .--- 11 3 11 3 U4 }
Jamaica......-...-. -.. 76 ..a*a...318 301 394 301 05 .
O .. ~i~



LBeria.......-.......................l.......- I : 2....-..- 1 a! .-i
Martinique............ ......... 38 47 501
Hexico................ 1........ 4 3 5 3 8 :
H 13O".



Montserrat.:..-........ 1........I 7 5 8 5 1-:Hi
Nasssul.. I I I... I!i I I iii IIi ," i","..i_ I 1 1 1 "' ..dal
Nie:i2sP. ..a.- ....:7 : *.aa i '- i I 1.- 1i

Peru.....-.-.-........ 1........2 10 1 11 .. 2 .
.oPnulra. ............ ........... 1 "........ I .....-.. 1 "
Iodio m.o.................. ........, 4 ........ 7 ........ 7 ..,,-






Siaeia Leon............ ..... ........ ..... 1 ........ .'.
Salvadora -q........-.... 1.2 ..-.-.....-... 7 10 -...-.. I







~1
it
b.












ii.


I:

U:
I..





















Alcoholism, acute and chronic...,...
Aneurysm..... ...... .............. ...
Apoplexy (cerebral hemorrhage)......
Arterio-sclerosis ................ ...
Brain, abscess of ......-..... --, .....
Brain, softening of.....-.............-
Caroinoma of the stomach...........
Dysentery ...................-.-... .
Endocarditis-....-.....-..- ......
Fever, malarial, estivo-autumnal......
Gangrene. ..........................
Gastroenteritis, chronic...............
Heart, organic disease of..............
Hemorrhage, pulmonary..............
Hemorrhage, due to ectopic pregnancy
Hemorrhage ........ ......---......
Hernia, strangulated ................
Hodgk 's disease................ .. ..
Intestinal obstruction.................
Intestines, other diseases...............
Liver, abscess of ... .................
Liver, cirrhosis of........--..--.. -.. -
Lungs, abscess of............. ......
Lymphosarcomatosis-.................
eenimgitis, pneumococcic.............
Meningitis, streptococcus...... ........
Nephritis, acute-.. ....................
Nephritis, chronic...-..........-.......
Oesophagus, epithelioma of...........
Pancreatitis, acute gangrenous ........
Peritonitis, simple..-----.......--....-- ..
Pericarditis... ........ .....-.......
Pneumonia, lobar... ....... .......... .
Pleurisy ....................----.........
Pyemia -.........-----------------..
Prostate gland, hypertrophy of........
Rheumatism, acute, articular.........
Sarcomatosis. general ......-.....-...-


! 7
8
1
1
1
1
I

*
1
2
2
1
1
1
1
1
--i.
I
1
1I
1
3
3
1
I
1

16
2
1
2
.29
1
1
1
1
.- -.


.. I..!


1
4I


[:1 .. '"A
I -
I..r: Cii
?~111 ."H:.I
1. ...
.:: jf j.
tH
---


I


111





I'U5


WITH REFERENCE
ISTHMUS.


TO COLOR, AGE, AND LENGTH OF RESI-


Age in years-Con.


Length of residence on Isthmus (in years).


t-
,I
R e^




II
. .I -
.. ...

'i' '."


I
Grand
total.





I
1
\ 1
8
8
2
1
2
2
1
3
3
2
1
22
2
1
1
1
1
3
1
1
3
II3
1
1
1
20
2
1
1
'~2
29
1
1
1
1
1
1
20
2
1
I
2
29
I
I
1
1
1










































*e e* s .... ...C..S... -.. ... ....*.- .a.....a**-- b *:..

rnnn tiarn ais 11 2 t l*:*..
va ous. .... .... .... .... .... .... .. .. . .!..


Suicide by firearms.............
Suicide by railroad traumatism
Other external violence........


.....

.....
meimi
riOQi


a......-.

-in.....i
immieilmmm


a.TotaLs. .. m.m.. ...a.-..-. . ....a m....-a a m.*. ....


IE











*.. 4..:1




H.:


- ... H H::




..%



5'

WITH REFERENCE TO COLOR, AGE, AND LENGTH OF RESI-
I STHMUS-Continued.


Age in years--Con. Length of residence on Isthmus (in years).




--- -- - --- --_ ---- --- --
SGrand
1 a s so a total.













2 1 1 1 1 ,
<6 1 1 1



6 3 1 .. . ... 1 .. . 1 .. ... 1 1 3... 1 .. .. ... 312 15
--
I... ... .. .. ... ... .. ... ... .. ... .. . .. .. .... .... .. ....





TABLE VI.-DEATH RATES AMONG AMERICANS ON THE ISTHMUS.

Annual
average
per 1,000
popula-
tion.
White employees from the United States:
Disease............................................................. *.31
External causes1.........-. ....................... ....... .. 91

Total............................................................. 6.22
White women and children from the United States:
Disease............................................................. 4. 25
External causes ............ .................... ................. ......... .67

Total .....................................................********... .......... 4.92

White employees and their families from the United States:
Disease. ................................. ......................... 4. 28
External causes.................................................... 1.27
STotal............................................................ 5.55
i..
I ,
H! '.


















*. .."* .... .= =..:*:: M..
I I I

Cause of death. - Les.........
m. F. W. B. Y. than 1i -4 54 0 .
1 year.
*.....


i*j
Hii






4jj







H.
''
I'H'



A
H H




'i

. I ".


General diseases.

Typhcrid fever...-.-. -- ...-- .
Malaria .-------------.-----.
Malarial fever, estivoautumnal


M leasles...........
Whooping cough..
Diphtheria and crc
Dysentery........
Entamebic ....
Bacillary......
Unclassified...-
Purulent infection


S..n

ulp
. .-S.
-m -


and septi


n0


Pyemia. ............... .
Septicemia. ----. -...-..
Pyemia and septicemia, pi
coccic-- - - - -
Tetanus-. -----... .. .-.
Pellagra ...................
Beriberi..- ...............
Tuberculosis of the lungs..
Aiute mniliarv tulhberplnosis


.... -. ..
-..-.-. -.
*. -....- .
* - .
* - .m
* mm- m -
* -.- -. -
cemia.
.. -. -
* S *
eumo-
*m- m- mm. -
- . *m m
- . -
* - -


Tuberculous meningitis .......-...
Abdominal tuberculosis.. ..... ...
Pott's disease -...-...............
Tuberculosis of bones and joints..
Tuberculosis of other organs......
Tuberculosis of the genito-urinary
organs ..-..... .. -- ........
Disseminated tuberculosis........
Syphilis:
Tertiary -......... ...........
Hereditary --.. -----..-.-..--
Period not stated............
Gonorrheal arthritis .....-.........
Cancer and other malignan
tumors:
Of the buccal cavity .........
Of the stomach and liver.....
Of the peritoneum, intestines,
rectum........-...-.-......-..
Of the female genital organs.
Of the breast .. .... ........
Of other organs and of organs
not specified......... ..,..
Other tumors (tumors of the


t


1
22

8
12
4




3
6

1


4 . .
4


- -. -
2
. .


4
19
3
133
12
7
5
1
1






2
1

1
1



5

4
11
4

* . -


2
27
2..
7


1
3


5


1


--- 1
1
1
I


----..


. ...
..-.-. -


*. .....-
* S ..-.


- . -


-. a
.


....-..
-.- --
.....
S....t
* -.


.A. -
* --


I.x
H.i H~lII


|


* I


i I I


I


I


*


I




H.:::. *:
*1":
Hr
ii!:



!ii*"* :.
.911


:: *
vs.: EE 59


SEE8 AND NONEMPLOYEES) AND MILITARY,' BY SEX, COLOR, AGE,
OF RESIDENCE.


11-20





2

. ...


1
1
1
I8
32

S2

1


S.i


.....
*m -


21-30


I
- -




I 3

I 1





- . . -
1
1


1
15
1
127
8

1i
iI




)mmemm
""7"




I *~ ~ .



1

1
"'4'




i-



- -


31


Age (by years).



1-40 41-50 51-6-


"3'
I




2
"~ T




1

" '3
3



101
5
"i1,


3


2 .


1


2
1



. I
* - *I
- *


0 61-75 76--160


2'



-i


'2

i 1

49 22


11
1 ;
S. -1 .


*-


::1.
- -


SS -i -I --


- S .*
I

II
1



i
6 i




I
I
-I

'I


..'.I

I
.
* S *


- *i*


2


5


- -


Il


---- s


..-.-I
iii~ii


I
I
2 1


. S....
-am m



---------------


.. -


Pan-
Colon.
amal


I--


2
2
9 0


Illij


I ij


*


.


(32

I
3


.


.


1


11



1


1
10

2
1
1




I
4



1
2

2


I .,

rri



) ..
(


Irl



/..~....~/

Iir


3






1


I


Place olresidence.


A ge
UI1
kPo\~n.


2



1
1




1

2

1

1

1

19
3
2

1


Total.


Canal
Zone.


Ilj

I
II

1



2


d












































Other diseases of the spinal cord... 1 4 1 4 I....-........ H
Cerebra 1 hemorrhage, apoplexy.... 33 30 7 55 1 2 ...-. E 1
softeuing ofthe brain.... ........ 3 2 1 4 ... *.... *. h'
S.W . **bS ..a1 *

Paralysis without specified cause. 3 5 3 ..... .H. E.
General paallysis of the insane.... 5 1 1 5 .. .... ......-
Other forms of mentelalienation.. 1 1 2 ....... -. -.. ....
Ch oni ... ... .... ... ... ..a 3- . . . ..


Epilepsy....--------------....: :.
Convulsions of infants (under 5
years of age)...--- ,-.-....-...
Choreas... ... . .... ........ .
Other diseases of the nervous sys-
tem .- ...... .-..-.-.. .........
rericaraditis -...........---..-....
Acute endoosarditis...............
Malignant endocarditis............
Organic diseases of the heart......-
Angina pectoris..................
Diseases of the arteries, atheroma,
aneurysm, etc...................
Aneurysm.-. ...................
Arterio-sclerosis.....-..-........
Embolism and thrombosis....-...
Diseases of the lypiphatic system
(Iymphadenitis, etc.)............
Hemorrhage; other diseases of the
circulatory system.. -...........

Diseases of the respiratoJry yatem.

Diseases of the nasal fossae.......


1
13

1

3

2




1


1
1


"2'

-6
3
46
2

1
.2
4
2

1

1


I.. .I..


2

m ea


3

1
16
--. ..

- *.. .
1
1


2
.6
14
6
122
3

2
14
11
3

3

2




1


3

"""5
I~II Il


I .-ii

- -


4


---U-


1



3






--
.....
.....
.....







S S

-* a -
.. .
....~i



. ...


.- -S -
*1


:.


* ::ii:.i*.i
H.:. ..y
* :.:y*
* .*......*
x.: :::: :: :.
. *..:* *:: :* ::::
Hi...........
Hi: : hi! :
... .
.. :!::: .: .
E
...........................................................................................I*H

...* 1. ..
.... .
T "**. J.. -----


* "

.*1.

i .H ii
..
: H... i

.** II


.. :


3


II


L


I













EES AND NONEMPLOYEES) AND MILITARY, BY SEX, COLOR, AGE,
OF RESIDENCE-Continued.


Age (by years).


11-20


1






1
1
1
1
.C i
- C -
1"i
1


2
*1
... -


gagmm

* C -


21-30






1




i





1
- C * C












5

1





1



2
2
2
19



1
....- -
- mm -

- n -


31-40 41-50 I 51-60


2
2


1
1




22
1
2
21
2






1
amm m


2
3
a


3
2


1
"2"










'"2'
13
1
2
1
1


1
1
1
30
1


7


1


I......


- -




* wI
nI w
-I


1
3
1
24
* -


61-75


-..- C
-n. .
* C C


C....C.C



26
1I


1 1
4 --...

C Cw C -W

n - C n I . -


76-100


1


4

2
- C *








* S
* n -


*
- -. C


6
* nwC


..CC .. .
* .. .. C
3
. -..C.C -

* m.. m- C

* - m. C


Age
un-
known.


* CC *
* CC -


1


* ..C-. C
. . .- . C

C .C w. n-


Place of residence.


Pan-
ama.






2
2
3




1
9
2
5
4

34
3
6
5
1
5

9
1

2
3
13
4
80
3

1
3
8
2


mrmmmage
-mC - m -I
* C *W .


1
1


Colon.









2




1


1


1
23
2


. ... .


3
. n -


3
4I

46





2
- C



* C *


* C m -


Canal
Zone.


1






2




6
2




1
1
I





1







3
17


1



21







1 !
1
i
--1

-~ -


Total


1


i .


















































+- -
Duodenalue ...
Acute yellow atrophy of tbeliver.. 1 J 1 ... 2 .*.. .I... ..


Cirrhosis of the liver-.. .......-...--
Other diseases of the liver .....- -.
Abscess ofliver (unqualified)... ...
Abeess of liver, entamebic. .....- -.


Diseases of the spleen..
Abcess of spleen... -----
Simple peritonitis......
Other diseases of the
system...............


digestive
- m .. 0.


NoIanenereal diseases of the genito-
orinary system and annera.

Acute nephritis......... ... -....-..
Bright's disease (chronic nephritis)
Other diseases of the kidney and
annexa.. ..............-..--- ....
pyelo-nephrsis......-----...---
dfT..L.J.!"..5-


12






19
52

2
1
1


4







1


2
*. -


II
.
11
3

3
3
I II


---


t


I


*


rr
2






I'U..:"..

.iiP.. 63 -




" EES AND NONEMPLOYEES) AND MILITARY, BY SEX, COLOR, AGE,
:. OF RESIDENCE-Continued.


11-20


a i2
* ....


* a....





-.-.-.. a
2

*.S....
-......


21-301 31-401 41-50


... .-. I..
......- ...
i g ii i i DID
BaIa
Iillr m


1
1
1




am






1
2











ii-Y







13
20
3


*.a.... -


1
1
1
1
1
*..... .






5
1
* a*. a a
2

2
7


,.... -
1...a..


2










""4"
2
.....a.a
... ...




1
*......



4











4
28








1
1
1
*..a....
*......


*......




4
28


1
1


51-60




















"2"


""2

""2





""3'
1
2











2
26
....-.-a
*.-.a.. -
a..a .. a







2
*....a.a

*.... -
2a





a 3 a
1


a..... -



..... i






2
20


78-100


61-75
































""6'















"'5'


i
i
......
..... a
.-.a.a a
*..... a
-a...-.. -








*....a. -





*.... ..
- -6 a

* a.- a
*..a.-.. -
* -~ a
*..a.a. a


*..a.... a




- .1.


Age
un-
known.


i- i. - -
fiBae *


.iiiiiiii






..iiii....



... .....


Pan-
ama.


1
1

2
10
2
3

244
80

2
6


9
1
6


1
2



2

146
.7







3
2
2
""14"







31
61

8
5


Colon.






3




1

1

65
3

3
3










'"4"
3
1
1
"'2'
10
4


1



10


15
46

4
1
2


Canal
Zone.


1
1
1


1
1


1

2


2




1


3
22


2


Total.








3
1
2


Ago (by years).


Place of residence.


*O a a -
- a a
----4-


I I


|











I


Puerperal albuminuria and cnm- ....
-- H....'am --., ........ EL..
nEclampsia-r ...n7........... 16..... 7 1 6 ...
Puerperal inseanity3 .....-.... -- -- .- --,, I ..- --.. --....-.. .
Diseases of the kin and of the celiZu-
sr tissue.,,,
angrene. -- ..-...- .. .. .... 3 ---. 1 2 -- -....-.---.. -, N,,,,
Phlengom and calllltis------ 1 .1 .. ---......-.-..-. .,,,,
ElepbazLtiasii- -................... .. .-.. 1 0.....* 1 *- -.****- *-- *
Other diseases of the skin -and
annexa. ..............- .. 2 -""
Mizlformatiosa.
Congenital malformations (still- |
birth not iclded). ....... 6 es. ,, ,,,H H



Diseases of early infancy. .n ..-...
Newbo................. ........ 1 1......... 1 ....... ,
COngenital debility, icterus, and
sclerema. ..... 7 4 3 8. 11
Premature birth..*..-*..** 39 37 3 71 2 76 .-.. **-.,
Congenital debility-- ..., 19 11 3 27.... 30 ..
A trophy ofinfats..-............ 1 ..... .... 1 *1 ---. '- *- *
M442 32 1 3 65 9 .
inanly (Incluing various c(snl- l




birthot nf larde 1 1 1 8 0 L i
ODe age. e.
snity ...................... ..... 4 3 ... .......... ....
j ,... E ..".. : .i:i .i
Oterfue ipii ii ii ir to iiq mrly i i i..i "ii i i .














EE8 AND NONEMPLOYEES) AND MILITARY, BY SEX, COLOR, AGE
OF RESIDENCE--Contnued.


11-20 121-30131-40


S.....l 1

* ...i

1 4

i i
1 5


I....IIII


* ***a
* .-.



a..a.


.... a


a.---I
IIIIII



a.---I


1
I I






1



1











aa

-a .e.



..... a
I ae* -I
...i. a


* -a


41-50


III.I*
1










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










*......
Iiiill

II iro
IOa aoa


* a a



* a aa a
* a.a om

* i.a -e



* a Ia.i


51-60


61-75







ni. a a
aaima a
-wie- i
*ia a o a
Iia a-i-


a..... a.a....


IIIaIa I




* aI-II-


... a a
a--...


I IIII




* a -- a


- ...
a..--.



I


76-100
I


iiIII


Iiirii
.Iaa a









a. ....
- -. i.


ea le


a.a....


Age
un-
known.


..aIa aI
-I- III


IIIIaIaa





IIIIaaII




IIIIIIII


*.... ....
IIIIIII
IIliiII


Place of residence.


Pan-
ama.


1





5







6
47
24

45



30




5


Colon. Canal


2







1
25
3
1
12
1 1


8
1


1
2
- aI I. a~


1





2




1

4
4
3

I 17
*
I

6
a--a-.


'Total.


Age (by years).


I


I


I

























om i: ,:N "



Iins .ii.ts.- ----.- 4 2 .- ..:....




Ho umsism by oteurtl oe...-... .. 2 .. .................. 2...il


Frahictes, "ce n .. 4 ....... ... .. 4 1 1 .
ere te m al v le e*........*. 5 .5:.. :.: --- *.....-... .:: .-..*
Affeciious produced hr alerzi -.. .
Ilausee-Continued. t HF




S "," H ::::
ramajMtISm by macSBrhin es.. .a. ............. ...e... n. i=
Traumatism by cutting or piero- 2
S Istru.. ................... ........ 2
-* i lH.i ".1
Traamatism byf all...... ....... 1 2 131. 1 1 ..... ......
Traumatism by machines 31

Traumatism bn ther crushing * . 1 2 *:..
vehicless, etc.). ... .......... .. -95 3 4 8 .. .1 ..t 1...
RIroad tra Iaumatisn. 5 .... 1 4 ...I. i *. 1.i i. .1 ...
Electricity (lightning excepted)... 2 1 1 H.... .H-H
o 1 1 H..........

Homicide by cutting or piercing .i.



Oiier external violence..". i


I
*t *


Ill-defiHed organic disease.........
Sudden death.-.-........-..-- .........
Cause of death not specified or ill-
defined ....-....................
Infections of undetermined origin.

Total- .. .... .. .. ...-- .....
Stillbirths...... ---..-.........

Grand total.............-...


1
1

9


1,.587
182

1,709


13 5
...- -....
-I
1,107 329
150 40

1.2571 369


-i
1

2,921
292

2,013


--S.--
.......


......



Ir~~
.ee at

-....n-


:i "
I \ I
III;
* I

**.." ...
S ..:
.1




Hli
-3
: H H




x ...:: :.
* :
* i S.'
rfV *:H


I

..I
.




p :.*


.

67


EES AND NONEMPLOYEES) AND MILITARY, BY SEX, COLOR, AGE,
OF RESIDENCE-Continued.


11-20 I91-30


s.-.-
-ia..

----a
Iiiig


..... a
..... a

....... -
a.... a

87
..... .8

87


1
* a a. -


31-40


2
a. a- a


1
a a i a -


2
a a - i i


380 377


380 377


41-50 51-60


3
1

2


1
I* a a -


1
1









1


245


215


. .. . *


2
.*. .* .a


*. a - .-.
2
BI ii



i-a i ii
. - a .
* *a ai


1


1


176
m. a a a a


61-75


.a.. a a- .
t a a .e
i* a a -
i a aai-


105


78-100


i .ii-I
iI.. .i
ii. .i .


Iliil
- a a a .
Sa. a a a -


Age
un-
known.


i a a a a ii
i a a a -


......
S- a a .e
e ai*a -e


3


Place of residence.


Pan-
ama.


1
5


2
2
5
3



1
1

15


1,714
216

1,930


Colcn.


S i i .


2
1


42


ilim
* n d i a





. a a .
* a -


5


667
73

740


Canal
Zone.


2

1
3
1

3
3
1

2


2
1

313
43

356


Total.


1
1

22
1

2,694
332

3,026


Ago (by years).
























Whoopin-. cH EEh 1 1.
WDjiph)fflh r iC indiao . ... .................. *.a..... N.. . * .....I *.***. :apa.. r.. r
Diphtheri. and croup ................ .... ...
i Senitenry nm - - -- -n-- ....- - - I. I- h
Dysernterv::
_: ..n. -,- v- ,., ,...... ,....:4:4,

Flurr lout hifeetion and eepticeuuiia...,...... 1 1 ***.,,I.:,,,
iii*i : 4:m44
Fl 10mbi W WHUB.,.... ........ ...... .... .. '. .. :.:44444

Pveimis and septicemif upnnooic *n.. .... .......
T e t sn u s. .m -e m-e- -*--e m- m--m- -mm m me m mm mm-mm- a-- - -- I .
P ...,,...........2...2................ . 21 2
UPer macemem mmmmmmmmm emmmm emme memmesemm ese .m .5.. ,
Tuberulteis o -- .1. .ndsp e 40 25 32 oil
**: ....: : .:lllllll
# W m m m m m mEEmm m m ,:M.EE::EEEN



Aeute mil'ry tuberculosis ....................... 3 3 1 .
Tuberer bmus pneniwcitis1 3 2 2 '44
--* -*- -*- -S *--: -H'El
.. .H. EE.E
Abdominal tubercu loss '-. --....... -.. -- - 1
Pott's dissanH
ltrtiar hb .... ""


Hereiar .. on e ,.,, ..... ...,. . ... . . .......
Tuberlosi of other orrens. -- 1* *
'uberel isj of the enito-urlaz.y organs.

Byphilis:
'T1ertioei... iii-iii 1 - -ii ai. ..



--------- --- -eioem --cum -.. .... .,. .... .. 2 -- -- a,.
Of ~~~~~~~~~~ ~ ~ ~ ~ :, ,,:4, :4:4:4:4 :n. ...,,.,, .,,..,..., .,.,..
HE..:.:EEEEE






Pl er o ... st....... 1 1
Gonorrieai u.liiti . . -. .- . -.--s a a .--. * a - a .- - - - -. -.II
Cancer and other manlinant tumors: H
O~f thebIu ocalcayvity a---------------------- -H



Ofhe theor fem91e nit seal geia.ogn
Oe f the r 1oxr1h and f er...... ........... ......a ..............
raerromos etcaumo-rsof- o. em- ail. r--a-a4 :4-.


pt-d) 1-H H
0 iieibeiit.:4.:4










Acute otiul *ry.:. reuHatis 1 "

0 urv. jbl..................a......a...*..... a...s.. a....... ai .~..a.;.
Ao csl ar io hr rho. uiratis .. xi - - . . . - . .-.- .-. .- . - .- . *.1. ..
1 a a..iii~ ii. 'iiii
1:4d4 1:1: 44












Anemia:I4
Thior os l xiso- the bones------ -n oi t. .. -- .......... ...::.:44.4.:::4-444....1 ..











i * * * H
Pbrmary I%.r uof other o,- 4.




L I"











fc AND NONEMPLOYEES) AND MILITARY,! IN THE CANAL ZONE,
B CUSE AND MONT OF DEAT.














I1' ay, June. July. Aug. Sept. Oct. N'ov. Dec. Total.
'" *
*.69


...AND NONEMPLOYEES) AND MILITARY,' IN THE CANAL ZONE
6-BY CAUSE AND MONTH OF DEATH.




.. May. June. July. Aug. Sept. Oct. Nov. Dec. Total.


1


....a a.a a





1













3
1
24
........ .








1














I6



2
is. ...... -

















1












2

"""2'
....aa i"
.a...a.... .






24




1





2


S a .


1


....--a.... a
* a S a sa-
..aa...-a ...
* a a a1 aa aa


a -*- a


........
....... -


2


*.n..a.








*.. |.. a



NO- a a


* a a a a -


a.....


a.....

*.-...
a
OQrri


1



1
a.... ... -
.........-



2
-.. ... a

3

2
4






2


""'4'

... .....
aa aa1


-.-..a....
....*. a a
-.aa . aa
....... a
.a .aa a a


..a .aa. -a









1


1










"""2'
1











"""28'

4

"""3'

1




"""3'










2


1
1
2
1
r.......- -





1









1
1





1


I

5

. a-i
a..a.


- a a -
....a ... -


-.-.-a.a -



-.a.a..a a


...... -


1.


1
Sa a a a aaa



a-- i 1 a


* --.......
- -a a -a

- aaa.a3


2



.... ...


2










1


4
....a ..a.-. -
-.a.a a .a a


-.a.a. -

-.a... -

-..a *



-..- a

- ---..
- *. a


2
2





2
1
1
*.-. -.a-.a
..a. a a-.a


.....


* a a aa -


-ac-a....
- a a .. a.
n - - .~ -


a..a..


1
* a a a


--a---a-
st


I











































Other diseases of the nervous system ..-" .. .
Oter csdits...- ............-.....-.-2

'lil
4 .:...........
.... .



















+Dtezeaaaof the eu.tog a-f.. .
I ..........
4-":'- "i ... ..... .
4 *
Dianaea of" the circstnfory system '



Acuitis O'e"c''dt
------
.: .' * ...
Angii~a ectois. ... 1. *** -F







Iiessraesoftoather iseasher oma anerysmlete.1 ------- -..
An teurym....--- 1 ... ...
A .L........ n
Jkru.lmccrala. 7,.q E
Mbols-i s tm end thrdm sb. eui". ........*... . 1. ""."1........ .. ".=...:.
eOrganic do ease of the heart ... ........ ...... 6- 1 "H
Angina pectoris ..........-.. .............. 1 .



isse of tmateries.,theom...... ......... aneurysmet. ...... i......
Henouraygeot.e .......................-..--.. 11

leysemo.. -----...-.. .... ....,,,....... -
nitl. etc.)....-..........---...-.....I............ 1. 1. 1. ..

y........ ........ ,...
* .. .


,et'" "
Diaecea of the respiratorn agemate
.*
S-S 3~*Eb~~3 .. . .. *... H .
luernso..hens..................................... ..... -. ..
r isease.-- of thec thyrozu body ..

t j. .* .H --H

Broneho-pn umoniach. .:..-....... --.-.-...- 29 14 13 .. .
Pneum.iiiruiia (unqualified)- ... . ...- m m m m I i 3 1 2. ii.
Lobar neum noa...I ..................o 7 12 a>.
ij~ si iiurii~i.- -- -* **- -* -** .'r--
P~leur nsyeu. on. ........f d..................... ......... .-. .... ......H.... .H

-my m - -..... -a -.-.-.-.-...-........ ..- 1 .. :..Y.. .
Gangrene of the lungs....... ... ............-. ........ 1 2 ......
m *" . iiiii

Phil I YtW~hPW Pm95 fWlR a ...H:*.
.. ......
I n wrtc wm, mnh nR " i ',,,",,' "
.... ,, .:EE'E: .... ....




lH.. H : .*:: ': *:.. ....:.. .. . *."
,, .* .:*. .. *. ? ....


. *** * i** * i ** -. _
..* ...... * ..... ....
:. .ah . ,. . .. .. 1 i
." :: ...: .. .... : .. .

. : ... .* . .

..: i ... .. ..... "4 *
...ir...... ....... . :..-
:. .. .ii : . H .

i B" AND MILITARY IN THE CANAL ZONE

*K M E AN3 MC f OF DEATH-Continued.


Yuiyg


m.. .a


*




#.
a.....
mamman




.a-aaa
a.....


I I
I .*..... .. 1

S*..' 11 10 13
1 ......... ........
* .........i. ...... .. 1
. .1 2 3





| i. .........
I : ..

H.! 1m
..... .




i!"i:: .
" | 1 "
I. 4
. 9 4



-.. I 1 17 20
r::.* * 7. m4 20'


18 12
*:::**i ..m 1 2
*' .. a.

fl . r : 7 .a* I
--. .1 1

i *..


Ang.


* .

* ---


*i mBea i
ime..a


2
18
*ia m. -
i a mii .i


* memme.. -
* ....e ..


I ........


a.-...-
a.-----
* .. i
semenem


Sept.


. *


-a a a
* ... .


* ia*
a I e


me-m.m-m-


a. -i*"


*a
ma.mm.. -
-a *..13 -
.- a .. e *


oo.. a. -..
alii. ia a
messe*Wee


*iai.i
* a a.
|| |iai
meemm I


I


Oct.


-a.-..

















meem-a *


2








I




ma ...... .















10
68
22
2
12
sam-aasei


Wa. - a
- e a -m* a
I1


Nov.


3







7
* .. .a. *
* am.m* a
* a -m. --


1











1
15
* a * .
* aseme .


*..a.a....-
* aeame a *
am* mama


iwmillie


111111
* e ..
...m...
m..e...


Dsc.


O
*.-.. ..
C


a


i a


1







1




1









*23


- ..aa
* ea


* a.sa


* a a


seemen



1



1





* -.. i


-m*m..


Total.


i
i


I










!'j '.': HE "i..*
Al~:b V .. .. .a.
Mn:. ~ ..V. k. ll.1 . *-
~:91! I' :. .J.




A F..

i.:.


:s.WD I T TARY- IN THE CANAL ZONE

OF PDEATl-Oontited.


..~ -
H.-
N ..k 4
~ Vlll*14..


ixlb"
ViX..







*V.. *..
4i ..














I::.' ,
















N; ..:'...
LHi-



Ic'




Pt..

S.a::


ri~.ii~qU i

I.I


r;::P *





*. . ~X





I.


*;:~


ii'.1
i.:n ai



11





III

,2
4i


VlI~CI


K
C
*
mw-n



ItII


*
L.




.,*a -


1 W
M


'Sr
--a,.A


~rim


r '*











U .- -.


--S.r

|06|||


i l l. i i i


-


JRw.


W *IWW-i.


a. -a

* ... S

-a--.




1*5**S


5**S**

S...--

.... a


*


1


1
.1

.. .
l "


f Aug.


I. I i i
*--. -

-a---.


----S.

* .. -


WWWiWi
.. i--

- S..-


o -. de

*mm ii

* |.- O


.--- m mm


-I


Sept.


- ......
- S * -

* . ..



....i .














4


* i n- i


.m. w imnm
g m ll C


Oct.


iii.i-



* .

-----


-i-i-




11111

...-



-S...
S....

S..-.


Nov.


..i .


, eS-5
* .

* i i


.......*. **......


a.. S...**. 25t* S


.i ...I.I-


---- --- 1


Dec.


Total.


i


I


i


Fr~iJrr









H:"'!^ ir::* HillI:.*:.' **
S . :.. :: *. :. :. .:. *:
."". **. .
i.8f::. .'" .::" **. * *
P i*. ..* .. q.
: :... :* *. ** .. ,


i..i..i i..j..i.x. ...


hr


4..
-.5.


:1:

ii:. HI














Bn.1



A.,:












Hii..-.


.n:


1.

Ii



.3


-"p.- -.


a...1


1
1







1.........

1


h~1)S...
p.i-
I.r lr
li* *.r S


it111
Si
8
2
.OS


1.
1




1
-5.-C----i



2
1

*.... .i.


a-..-.

.. -S.
U
a*
---S.

*5 r a


,-.".. S..
a


? MILITARY, I N THE CANAL ZONE


~7a1ti~


12



4

2
I.'i



-C p-nSn


* *a C
~a*5aS*
- .
* .. C-


- ..... i.
- S h ......
... ......

.... -5- .
a a S. ... .
1*
- a . a ...


"""3'


*.a- ..- *-S1*
...i!~' CI .0 5 1.qa


*5
-a


Aug.


a








1


......-.S
""3'
Hi D I


"'"2'
- .*5 -*


II I



iIII
.i..-.-

[*".. -


. .g .,


Sept.


..... p...a
-m
2
4
......... -

8"

7




K 1


1



1


5



1
...a...i"


* .. --
- .. ..5-
. S ** S -
- U i- i -
* a- SS
* .....
. ..--

* .... ..


\ 220


Oct.


1
4
2

11


5


a
i.i ..i i


2


Nov.


1
2
6




4
Ce a ..


.. a


""'"5"

....... _
-. ... a

1


5

*.r.. B.
......- -


253


Dec.


........
5
3


7


a
S* ... S


* ....
* .. S
- S a *


1
1








..a .a i. "







.... ..1


Total.


1
22
1
1

2. G4


A.


till Lrll


)rYr
rrrC




I~




S. h M. . .... . .. .... .. * m
..* H* H...* . .
*** *:
..... ..H ... .. : .. -
- .. . ..
.n .
C. **
..... .... .. :... . ...
N .. I .. ..H ... .
NIH.... *
.. .. .*.. ..
--" :--s j -




:: : : :
"E ,: 1 "i ....** **. : : *. ..
.... .. .4.. .... .... .
II.. .....E..E1 ."::-E : E:... .... "-p. ...- E . '.. .E:... .. . -. .. .
.. .. . .: .. . .. " -
t.....-- ept. Oc..

i .*. .. *.. :
=. *.n ,. .** .. .. *........


.-.





lH I.m* *
: :.. ..: V.
***.. 5 : : :* :










i i i i=.: ... ... --
:::. E.-." ". .: . -








3 .4 IS 4 24 6 7 7 36 9 47







11 2
::::.:.....: .. ._ 1 7.... . ..


..r::. : :." ." :. " 2 1
.* ** *.. ... 1 1 2 1
r 11' 8 2 6 56 812 4 7







fl 14





il .~~ .-.. 2 11 2; i-. 2.. 2.. -:. ... .... I.
HI.. .-. ..:*2 2
E. 3l .z ': ... : ...E . .. . 1 1." .. I















*.1: 1. h* C *.. .....





*.. * .
i. In .I ii ...... .. . .n i~ i. :. . i . i.I i. i i i ii. i .























. .... 6..."


...*:. ...." : "- . 1..
: : -




















", ..I I : /I
.. i .5- .
.. : . .
tr









S * III
. . ... ... /
". .. IM w # #1W W w 1a me m e mee 1 a I 1
.:



,.. e .- "-.1- -- ]t/t,

L, *-: .. "

: iA pd ... "W~ i m lI imu mem m I I iml mII I Im l e I
...... :.I II .11 11 2
p .::: *:

.-.! .I -/. l*! .. ....


8 ,- 5..--7 7...I.3-.1 318


ag,,,: i\ .1[: I i* 1 "1---i /-I I l /-


** * ** .,. 1, ... .. .. .... . .. ... .. .. .. .. 1 .


I I / l. I
. _. .....
I" ,] n,:[ lsl
,,
III III II III i ii iI I ii I II n i


.aNaB OF DISCHARGE.


Nov.


D.c,


II-I I- I 3 i -


Total.


5
* - -

31
1
2
3


3

i2
3


"47"

6
13
1
1
1
1
1
4
48
1
1
2
8
6
4
1


Grand
total.










H, 79
,: '79


ING CAUSE OF ADMISSION AND MONTH OF DISCHARGE-Ccntinucd.


May.


W. B.
-


June.


I


July.


Aug.


B.I W.


Sept.


Oct.


Nov.


Dec.


Total.


5



8
2



1

3
40

23


2

3
6


4

1
1




1
2
3
2
9
1
6

-2
13
4
4

7
--.




1
G8


1
3
4

2
32

6
-


Grand
total.


1


I








II


rmuu nopzeizzozia. a...... .. -. . . - - . . . . . . . . . -s . . TI ....
WWflrmeem.Ibemawt..am im w tat wa..nmumfli.Am MA 1
Lobar peummia.. -...-......-.- .. ...-. .. .. 2 .. 2 - .... - -
..... .. .

Other diseases of the respiratory system...--. .... .... ... .--. -. .


bScess f luns..,.. ........ .............~..... I.... .-... 1..-. .-...... 1 .... .
Diseases of the digeatine agatem. 2 :
Diseases of tb e th and enexa. -. .- ... .. ... 1. .
Diseases of hie teth ud grim-....-.......... 1 1 1 *.. .a w
Btiatii . . - . -. . . . . . . .-.. ... - -- - . . .- - . .-. . ... . ...
Diseases of the pharyni.......:.....:. .... .... : : .: : -: -...- -. ... -
rbharynlgitis..- .- --.. ..a..-. .... ... ..... . .-. .. ... 1 -..--. .
Policular tonsilltis. ........--....---.. :3 1 1 - 1 3 6 1.
lIcer of the stomach.......... ..-.-.......-... 1 1 .... 1 L ...
Other diseases of the stomach (cancer ex-"
canted)..... -.....(....f... ...-.... .. 1 .. .! 1 ...- ..|. .
Acu te ge3stritis -. -.... -.... -..-- .-..- --.. -
Chouial gastritI -....- ........- .......... -... .. - ...-. ... .... .- .. ..-. ....
":""": E: F "








Diarrhea and enteritis (2 years and over)..... .... 1 .... 2 1 2 A.... .
lob war lm em m e mm m e meemmeumomla s Ie mam m I emm /m I | g [ 8| ....
V IL :":EEE:








I . I / -......-
In teost ialpaasits .. ... .........., ....... ..... .... ..... ... ... ... .
Inrosss.io .apn...e.i..i . . - - - . -. 1 . 1 . . 1 --.
Ienuiisya ..r.ia-... -.--- .... .. *....... 6
Appendicitisand typhtis. .......... 1,,.,,,,
Sn .". l "
Ocute rsndestss ....ei..t...t........ .....s I 1 1 .. I 6 -. 1 1
Chronic apendicitis .....,................... 1 .. 1 1....1 I 1 2 ..
bu rsllun 6. -......... . .TI ........ - .
therhernigS ............... .......... 1 .... .. ...... ........ ....
Other dineass of the intestines............. 8: 3 3~ 2I 6~ 2 11-1 ~il i i Ill- f:-
C'ira ion .oe......i..v...................... .... .... :

DOther disen es of the hliv d ner ... . . . .- .-*. .... ..-. 1 1 1 1 .
Abseosse of liow te (unqu ieI). ........... .... -.. ....... -.-. ..*.. ... :.
T'horyn sitis F....,, I..,., I,.1,,.-1 /. !~ 1.1 /11 I I -! b'









r.mple peritonitis I31(nonpueper/I)......... .. i i :j 1 ..
Ulcer ofthestomath II I011 1/ I 1/ 1.! .I..' l.*."


Other diseases of the digestive sttemner .e.... .. .I.I./. I I. I .-








81 .

ING CAUSE OF ADMISSION AND MONTH OF DISCHARGE-Continued.


May.


June.


B. W.


July.


132W


Aug.


131W) ~


Sept.


W. IB.


Oct.


Nov.


W.A B.I


Dec.


W. B.


Total.


38
6
1
2
4
9
5
1
2



5

3
2
33
9

7
5
3
9
10
7
5
3
4
1
24
10
41
3
1
51
5
G
1
2
7
1
3
1
1


__ Grand
total.
B.




49 87
11 17
2 3
1 3
45 49
37 40
2i 31
2 3
..... 2


4 4
10 15
2 2
4 7
1 3
35 68
2 11
H
3 10
4 9
3
..... 3
2 11
3. 48
10 17
16 21
1 4
4
..... 4
..... 1
4 28
2 12
89 130
8 6
1
..... 1
42 93
12 17
2 8
..... 1
..... 2
5 12
2 3
2 5
..... 1
1 2



































Metsntis her tilmore o.....h..o.... ............ .... .... .... .... .... .... ..
Cysts and other tumors o the o 'arv".....
Balpinaitis and other diseases of the female ... '
gem"t.l organs ... .......... .............. .... ........... ..................... i ...
*t

The ptLerperal shte. " "

a -
: . : :EEEE"
Extra-uterine pregnancy - -
.... *......-*. .. . ..... ..
Abortion .- 1
tt
.H *=
Dieamst of the skirt and of the cellular tissue. 9 .

,Furuncle 1, 4 1 1 1F
,I,. .. 1'
Acute abscess EH 2 3 I 4 1 5 8
Phlenon oe.nd clulitis s ....... ............ 4 7 3 3 3 6. L 5H


Dhobie itch.."-.- -. .--..--- 1 1 2 1 "' 1"
IlUcer of the siin 2....... ...... ...... .. 1.. 2 2.... 2 1 3 H 1

i mpe tino ......o................... .... .. 1 ..... *. ..*. ............
UrboticeIiai 1 "ninn
....... ..* ...-.
SH......... ,




Other disems of the skin and annexa........ .... 1 2 4 5 .5-

Diseases of the bones and of the oTgIms of mo- -. : >::L.H
motion..
Wt t2, ,,,,L:,::HN:::,,,,






*. ..: 1
Dseasesofthe bones(tuberculosisexceptod).. 2 1 *...* f." ..* '.....
Caries (non tu berculous).. .... 1 .. ... .. . .-.
Ostoomyeithis ........ .........."1 .
Periostils .... .. .. ................. .. .. *...... ... ...-
Diseases oT the joins (tuberoniosis and rh .......
- A a iI I ." .. ... ,











ING CAUSE OF ADMISSION AND MONTH OF DISCHARGE-Continued.


May. June.


W. B.I W. B.


. .-


July.


Aug.


W. B.


- I - -


Sept.


Oct.


W. IB. IW.


Nov.


Dec.


2
1
3
1
2

10
3

6
1
1





1


7
1
21
32

5
6

3
1I
11
33



17
1
.... .


B.





10
25



26
32
2
2
1
1

5


2



12
1
39
50
1
1
5
34
1
2

1
32



16
1
3
5


Grand
total.


Total.



















Aooncio prbyeod.by ...na. cau.s........,
ii::::::::::* : ..:::::i=
Buieide by poisoning........................ .... .. ... ........
Poisoning by food......................... ..... 1"" 4 3"1 1" 1
Venomonsb*sanftingu:n...:..n:n.. ::: :::: cx: :::: .: ::i:z : ...2


tion ercpteosnd) .... ................ .. ..... .. I.I:..::. ..'. ::.. .'.:*
Ao mldental drownin ..... ...... .............. ." '. . .. 1... ... .
raumatsmbyfirearms................I 1. H.



'lraumatism by cutting or piercing iqstnru-:
S a ire usbites . a a . - a a - . a a * - - - -. - - - . * * I .a *


me1ts.:..... ... 1 1 10 11.
Traumatsm b wationerllept)............... 2 I 8 .... 5 1 'IH'
Absorption or deleterious gas(oes nfiagra- .
. s* *S*****.* S *::*:*:
Aecideznital. dro wning -. . - - - . . -. ... - 1. ......................

Traumatism by marear hmes.. . .... ..... ."-". "... "" T1 . -. 2 1
Traumatism by other r crush pier g gs.....i.... 1 10 st 1 r -
Raii1road trau1m0tism......... .......... 2 1
unamite tram by falml.............. 2 8.... 4 5 1
T raurmatismninmines an d qunarrih. ... ... . ... . . . . ................... 1

Traumatism by landslines.................. 1 1 1 5 1 II 2 4


Effects ofheat........... .......... .............'....,..... ['"';::' ''
Treat euhatisn by other crushing........................... 1 1 0 1 6 4 5 .... 7.
RaElectrociad trau(iahtnin ex. t . . . . .. .. .. 1 3 . . . . 1 ... 1


Homicide by euttinp: or pieremng instruments, .1""t "i
Fractures (cause not speei ed).. ....I....... 4 11 [1 6
pn rase amalis:...h....s.................. ...... 1 2 I. .. .*
erexternal volene..................... 9 35' 10...
Heat echaUStiOn .. *.* .... ......** * .... 1 .... .... .~....... *-.. ....





IL .fiem 3 discrrses. ,
Electricity (IIb tning excepted) ........ ... ......... ....
H omicide by cuttmns or piercing instruments. .... ... -.. ... n.... fl** *... .e--:


FrIna cturions (aof ndetermnet d o i. ....... 4 1 16 3 1 .. 3 3 8'
D~islocationis......... ................b.* a... 1 .... *i.... A 1 ..


No dise.se........-.......... ...... .....--.....-. 3 .. -. ... .. 9 -1H
Otherexternalviolence.................... 5 34 945 35 10 42

l-2eflned diatasee. diiHI
)I-de~ined ortnacadouse.........a-..--.... .... .... 1 ... .... .-. a.... *.. .
Inlect ions ofunmdetermined origIn............. 2 2 .... 3 ....4 1 1 .

*.* .: ..............


139 ZI [lii AJV lSj i4~...::it[l
IT I 1 W 1..*- .. -.II#
.;!!!1.11








85


ING CAUSE OF ADMISSION AND MONTH OF DISCHARGE--Continued.


May.


3 7
2 10


.5.27
11*2S2
150 272'


June.


July.


3 134


2 4 ....
2 2 1

144243 122
1


Aug.


W. B.


3 34


111 309


Sept.


4 134


126,330


Oct.


7 150


Nov.


W.




1

1







2
1




1











8



"4
2
... -
-.. -
1~m
*ge S




1 S


1

8



4
2


127355 123


Dec.


W. IB.


I...
1

1



2



3
1


3
*.-.. S
*mu -
* -m-


102 267
I.- ;


Total.


2

1

16
12

10
13
3
- S -


28
1
4
74



1
18
12

1,488


25

2
1
"37'



10

123
79
1
29
53
16
1
2
5

1
1
1.
56
11
18
438



39
14

3,325


Grand
total.




1


1


2
1
11

139
91
1
39
66
19

2
7
1
1
1
1
84
12
22
512



1
57
26

4,813


















iADTii
.I :l a:I..
W. C. W. C. W. c. W. O. W. C. W
a wa.-. . .... :*

::
AxNcox HosPrrALa. ..
I"E....n:*:* EE

Panama Canal employ- a
ees..-.................. 42 1301,0371,852 16 751,061,800 3 41 :6
Panama Railroad em- 1 21
ployee...... 1 52 1911, 124 3 53 1831 21
Panama pay cases r..... 1I.. 5 1.-... ..-. ... 5 0 .'
Other pay cases....... 9 564,17 620 37 1564,1131,415 8 ..
Charity cases.......... 12 3 485 391 5 32 452 327 4 30 36 25

Total.... ... ...... .154 2625, 888 4, 992 61 317 5, 7844, 562 3012 l1a .25

(inane). t ..Ir
:" m* m:.



Panama Canal employ- 0
0s3.... .. .- -- .... i7 ... -. .. . 8 .. _. -
Panama Railroad em-
ployees ...... ......... 1.... 6-.... -.. ....- . 4.. ., .... a H.
Panama paycases...... 37 188 2 64 3 1 9 28.... 5 5.
Other pay cases......... 7 2 35 17 1 6 33 7 2.... .
Charity cases........... 13 62 4 32.... 1 9 23 .... 1 .

........... 57 259 67 126 4 26 51 70 2 6- 67
Co0221 5778.

. -. . ... ....- .- .. ........ 9H... --- "-
ChrTo ic ward. *
II



COLON HOSPITAL. .
Panama Canal employ-
ees..... ......... 6 8 19 341 2 13 164 253 31 78 9 5 .:
Panama Railroad em- -I
a ......

ployees............... 1 8 125 359 2 14 106 242 15 107 2 .L
Panama pay cases.m.... 1 27 101 5 12 8 25 14. 6I .*
Other pay cases......... 12 1 620 159 10 11 507 100 44 5 ii
Charity cases......... 1 0 65 34 1 4 57 16 7 12 1..:
__. ___ ____ ________ __ ___ ___ __ _____ ____. ...
Total.............. 20 181,042 994 20 54 842 636 165 2991 5:3 M
PALIO 8ECO LEPER :
ASYLUM..
S H Hi i l i










TABLE XI.-CONSOLIDATED REPORT OF
IN QUARTERS.


EMPLOYEES


TREATED


Stations.


Ancon.......
Balboa.......
Pedro Miguel.
Paraiso.......
Gamboa......
Gatun........
Colon... .....


Remain-
ing Jan.
1, 1917.


5
1


2

.9


Admitted. Di
I

W. B. W.


1 004 7....
1,804 125....
168 13.....
94 131.....
12 13....
146 59....
1,104 2, 140.....

4,3322,488'....
I,1


ed.


Dis-
charged.


W. B.


996 7
1,776 72
153 11
86 116
11 10
1391 57
1, 105 2, 142

4, 266 2, 415


Trans-.
ferred.


Remain-
ing Dec.
31, 1917.


CONSOLIDATED REPORT OF DAYS LOST IN QUARTERS BY EMPLOYEES.


Station.


Ancon......
.A.xlcon .. . . .
Balbo......
Pedro Miguel
Paraiso......
Gamboa.....
Gatun.......
Colon........


White.


10,132


Colored.


10,934


Total.


21,056


Total. ..........


Total. ...... .. ....
I:































--*-: :
TotalD.... l -- .. *-.' .A'Lj 70001fl ai .4 d ID 1 M .,
.-.... H...
.* ...:* ...:


White. Colored. H"..
il : l


Total admimsionn to hos itals, excluding Corosal --
farm and chronic warJ r. ... .. .. .... .. .. ... 6, iB 6, 12 1 4 i
Total'-ndinaiasns of employees to quarters........ 4,M32 2,4188 6, W0
S* ............
A. * .E



Total admissimtio mpoye to hos itals, exldn Cbrozal H,52 ,8 5 8

Total admissions employees to qarter&.......... 4,332 .2,488 6 .EE.E
3 8 610 :.

.Lep Lun er of ipaiients brred from 1,3 8q6ar0 es
t to hospitals, and between hospitals, whoe
admissions are duplicated in the above Agure.. 327 .0 73TEE

Net admissions to hospitals and quartort.. 11,057 8,10 .P1C

EMPWOYES8...

Total admiionsofemployeesto hospitals....... 1, 552, 68 5.241 .
Total 0 admissions of employees to quter.-.... 4, 332 2,48 6,) M..... ...
I~ tai... - - * - - -....,12 I,.......










Lss number employees transferred from
teo to hospitals, nod between hospitals, wose ali
nadmissions are duplicated in the above figures.. 116 319 43
1...E:I"H8E..
H: ."EEE.J:
A m e m e m m m m m e ama m e m mi....me m m.: :J..:E














't.i


CONSOLIDATED DISPENSAEY REPORT OF ALL CASES TREATED BUT NOT ExCusn. ..
.....*-. .t


i Employees. Nonemployose. TotaL .
S.t a t 1 -.
Station I ,a I es I I ... 1. ... I











TABLE


XIII.-AVERAGE NUMBER OF EMPLOYEES
SICK IN HOSPITALS AND QUARTERS.


CONSTANTLY


Hospitals:
Ancon Ho
Colon Hos


Total -.


spital ............... ....... ... .....
pItal -'..-.---- -..-..-..-....a ..-


Quarters:
Ancon ....-...-
Balboa..........
Pedro Miguel..
Paraiso.... ....
'GOi.boa...-..--
Gatun.. --.......
Colon-..........

Total ........


n.-.-..


Average number of employees constantly
Hospitals ..... .........-....-...-..
Quarters..........- .......-. ......


y
- -
a-


ick:
..-. .. -


Total.....


Average number of employees constantly
1,000:
Hospitals ---- .----.a---- a-
Quarters ..'am- m-- --- -..a .* a


ck per


*..... -
*m-m-e -


Total. -.......0.. ...--.........------


White.


49.99
7.54

57.53


5.55
11.55
1.12
.92
.09
1.34
7.19

27. 76


57.53
27.76

85. 29



11.95
7.17


Colored.


181.45
17.76


199.21


.07
1.10
.17
.91
.07
.57
27.07

29.96


199.21
29.96


229.17


Total.


231.44
25.30

256.74


57.72


256.74
57.52


314.46


17.72
8.25


TABLE XIV.-AVERAGE NUMBER OF DAYS STAY IN HOSPITALS OR
QUARTERS FOR EACH ADMISSION OF SICK EMPLOYEE.


SHosital ospals:
Ancon Hospital.-. -....-.-..-....-.---... -.-
Colon Hospital.........................-.....
Quarters:
Ancon..... ....~ .............................
Balboa ...... ............ -....-..........
Pedro Miguei .- ....... ......-..... ---.....-- .--...-
Paraiso .......... .... ..- ........-.. ......
Gam boa .................. -.....-..........
Gatun ..... .........-. ..-...... .....-. ......


White.


14.65
8.60


.- -.


Colored.


21.75
9.23


.i -


Total.


19.74
9.02



































ies o emp ayee ', I...,i...:.
Army and Na. patients 2, 604 35,2942 69,IOI$, H: I. "
Pubc-health ser e patientsVA........TO......... .26,..1 5,216 ....

rai tl..-.-....- ....-....-.--....- ........ 5,Z4 I4,8 w." ..

r Grand toty p. .. ....... ............. 2,a W 5s, 2,.02557 5 4
-H- H.
"" .:i i" "
..... ...' "" q4. .


TABLE XVI.-SURGICAL OPERATIONS PERFORMED IN ThOON ADH:
COLON HOSPITALS. + ..
H!".
Ia ,. . .;,:i--



Ancon Hoe- Colon Hom- Total. ...I*. NH:
pita!. pita!. i;


:- *: :I q*:j. :..
m iHi
**.**:**: :::*



.*, *** ,, *,IH
,, ,,,:"








.po. .*Ancn **os- ....Colon Hos-" .". 1 a....
.... ....................... ....... .. .........
" I .. i.
Nigi.-.- D .. N 2- . .....
I~eg * * - ** ** ** ** -* *5 H --* MiH.



......................................................................._....... ... 1r.. ............................................
.. .1 5*
S,, ,i,,

.Foot .


d: ::,.... r EE....,......:. : .

I * -:* H*
.*"*.*Ili ii:iW







...ni .to ...ex por.toY... 1 -. -.... 1 .. *



Tam innh do.m w1 .
Operations on"bon.s:"",,,,,,
Grnetm, eomrs-- -'"j
I I = I "1 " "I I I i> i l . ,
Hranieto e'lrao1+
Ta miwarwam w1 1' ? 1 1 i.: :=I














TABLE) XVI.-SURGICAL OPERATIONS PERFORMED IN ANCON
COLON HOSPITALS-Continued.


AND


Ancon Hos-
pital.


Num-
ber.


Herniotomy:
Inguinal-
Single ......... .......
Double ............
Ventral .
VentLraI.... ............... -

Strangulated...... .....
Genito-urmnnary tract:
Nephrotomy .... ......-....
Nephrectomy... ....
Nephropexy........ .......
( ystotomy .... ......-..-
Urethrotomy-
Internal. .-.. .
Extertil ............. I
Prostatectomy............. -
Varicocele, radical cure....
Hydrocele-
Single, radical cure ....
Double, radical cure.. -.
Orchidectomy........
Epididymotomy........
Amputation of the scrotum:
Amputation of the penis...
Curettage uteri ....
Perineoplasty..... ..... ....
Trachelorrhaphy.........
Vaginal punctures.. ......
* Undescended testicle,
double.........
Obstetrical:
Caesarian section, abdomi-
nal . .................. .
Accouchment force. .......
High forceps... .........-. .
Low forceps ...............
Version....-.......... ......
Perineovrhaphy ...........
thorax:
Thoracotomy.... ..........
Pneumothoracotomy --...--
Excision of breast -........
Excision of breast and
.axilla- ... ..


1


,Died.


rrii
.....





. -
. *-
1iil
iilm
Iirii
1ii.
*i-. i


1 .


.a. ..
a... -
S...a
* -...a
a.a.-. -




* -... -


Num-
ber.


2
1


. . 2
2


Died.


....i


.mime
...me
...i.
.Ri.e
. - .
- -
* a
* -
- .-

- --


'I


. . .
--.....


Num-
ber.


Died.


..a. .*
. .....



.......

- ..-
- -. .
. a .

* - .


. a .


3

i.ii-...
..i.. l..

* a ..
a. ~ a a .


."a i*ai


Colon Hos-
pital.


Total.


I I




















+ U.- - a a .+ - -+-a+
















Appendectoumy -. .5- 104 .. .""". 50 ".---- 154I .. .
Appendectomy with local:
peritoxtis.i .-.-- 20 - -7--.. 27 H:
Appendectomy with gen:
eral peritonitis. 2
Cholecystotomyp f... ........ A3 A....... 3
Cholecystostomy .-..... 1 .. .-... ....-. I
Cholecystectony.......... 5---...... - .-..-- 6
Abscess of Liver-- o"
Lpartohepatiotomyfor 1 1 1 2 1 -
Thoraco-hepatotomy
Exlraoy15,~.. 6.... 2.... 1 6





Pan-hysterectomy- ......- 1 ....... 1 .
. .+" .. .."






''"upravaginahyttm y 82 1 2 .. w 84 1 H
Hystero omycomeouy ...... 42 1 2 **.... 44 . . ....1>Il.
Adpohetomy............ .1......... .......-..... .. 1 ......
Salpmgo-o:"
Rvhniaannrw-.* .'..






Bin slw.....J. ........ 7 -....... 27 ....
)ouble -- ~- ..- --- - -1,... --... :x:: :8
SAlpingo-dophorectony. -n- 30 -...... 2 a 32
*- - -- - - - -- -". *
Ovarian cysteontomy..... ... .- - 1 3 .. .:. HT.
pholetotomy.... 1 ......-.. .. 1........ .,. ..a.-
Ioaoo- oheationt fr f
Sspen- io-sterecom......3 ....... --
uPrast ginal hopera t omny 0 r ......... 84



Ovarian cysteetomy....... 8 ........ 3 ........ 11 ........
Oophorectomy............. 2 ........ 3 ......... 5 ........
ii" ...Hill
I ""I "iii'""
Plastic operation for .




I





93


TABLE XVII.-OPERATIONS PERFORMED IN EYE, EAR, NOSE, AND
THROAT CLINIC--ANCON HOSPITAL.


Adenoidectomy........
Adenoidectomy and
tomy................
Cataract needling......
Chalazion ..............
Evisceration ....
Excision of chalazion...
Expression, both eyes..
Extraction of cataract..
Fracture of nose, reduct
Iridectomy. ...........
Lachrymal sac, inci
drainage -. .........-
Mastoidectomy .......


Number.
..... 145
tonsillec-
......... 90
... . ... 1


nion


and
- .. .. -


Plastic on eyeball.........
Plastic, nose..........-....
Pteryglum, transplantation
Removal of nasal polyp...
Submucous resection of
septumi... ...-.......
Tonsillectomy. .............
Turbinectomy .............
Trephine of schlera.........
Urlectomy ..........-......
Various minor operations..


Number.

. .... 3
... .. 71

nasal
209
.....- 183
...... 47
... . 5


-I -


Total- - -. .. -.
Refractions......................


43

856
1,108


TABLE XVIII.-WARD LABORATORY REPORT-ANCON
HOSPITALS.


AND COLON


Blood examinations..........
Estivoautumnal......
Tertian ------ -......-- ...-
Mixed tertian and estivoa
Quartan ................
Differential blood counts.
Leucocyte counts. .. .-..
Red-blood counts ......
White-blood counts......
Hemoglobein estimations


Filaria......... ..........
Stool examinations...........
Uncinaria ova............
Ascaris lumbricoides .....
Trichocephalus dispar....
Strongyloides intestinalis.
Ameba ...... .... -....
Entameba -
Ciliated monads..........
Bilharzia.m..-.- --m-..
Pus and blood...........
Bilantidium coli .-......
Entameba, histolytica, an
Guaiac tests-.. . ....-..
Cercomonas, intestinalis..
Tenia saginata dispar .....
Oxyuris, vermicularis. ...
Uncinaria (parasites) (ova
Trrin. n xn.minntinne


*. . i . i .
utumnal.
i . S i i -
. . . . *.

- --. *. . .


*. .. S .
.. . .


S.. ... ......


.... ...
* .


.....m....


ragena..
- . . . .



.m.......
.....r..
* . . . -
*.-. ..S.-.* -


Illil
a-mmi"
*. .. .

i l .. *


Aneon.


8,251
447
188
2
15
345
1,085.
92
116
2,867
12
7, 151
347
98
233
249
51
3
67
3
704
8
14
252
28
12

119
on inl


Colon.


....


- . .



.. I.


....


1,468
204
39

1
48

31
141
62

483
8


33
2

38

'134

1


I


Total.


9,719
651
227
2
16
393
1,085
123
257
2,929
12
7, 634
355
98
233
282
53
3
105
3
838
8
15
252
28
12
16
120
"7 iea






































































SD ie ". :*: .S ." ..........

ingmJin- I Ad-SS zi DHi....

LIJ mitted. charged. 31
I i.H "E..
: ... ........
1 1917: ,..ii P-
.. "* .... .i: .
g

I H.
H-...
-.H E J


" .. ..: ...
Pa :p ~i~t. ." ::::: 115 1,451101 341 1,451052' 3!O: "I ".JIHi

Chantyp tients........ .. 416 9,450 990n 8e.. 14c..


umoiotal. ... ..431 101551 190 .........'



N r.o.,.. rel.. f.n ....int ... ... ........ .. 4 .
*j.i. ""*





Aveagenuberof ay' teaten r atentad~itsd~ -- .- .- --. 13 H .:5|
Nb od sefr hd* .. H... .*
vr fi--..et-. e..
.& "* -*::;= .. .... :



ilaiets -.-.- *- -10 646 =-4.-:
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