Front Cover
        Front Cover
    Title Page
        Page 1
        Page 2
    Table of Contents
        Page 3
    Letter of transmittal
        Page 4
    Main
        Page 5
        Page 6
        Page 7
        Page 8
        Page 9
        Page 10
        Page 11
        Page 12
        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
        Page 27
        Page 28
        Page 29
        Page 30
        Page 31
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        Page 33
        Page 34
        Page 35
        Page 36
        Page 37
        Page 38
        Page 39
        Page 40
        Page 41
        Page 42
        Page 43
        Page 44
        Page 45
        Page 46
    Tables
        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
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        Page 62
        Page 63
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        Page 67
        Page 68
    Back Cover
        Back Cover 1
        Back Cover 2

i. ii.4;..
;r"'
..,."..


REPORT


OF THE


art


:eI ~
i;:Y.,.h.
hiI.


ent


l'k:::.: 1
I.


:1:


Panama


Canal


FOR THe


CALENDAR


YEAR


1926


I::''.:


I..i ."
. A:
Si L.. H .l
H.i*
?n.E

Ai.
-I

MMIII.' i


ii.r *ii '. S



1..iit~l.
H".. :l" i s~~

I' :::. H


CHAMBERLAIN
ial Corps, United States Army,
hieF Health Oficer


D. P. CURRY


iat Chief Health Officer,


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For additional copies of this publication addlrcs Thw:.Panama C:

or Balboa Heights. Canal Zone. " .,


5. .4 .4...






anal. WGashiutlns. ?W;fl










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Page.


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P S^ ^ ^ '. "i .i. ". : I

H isii: ett rgardig employees on y-------..-..---------

g 1 f j:t| statitics .for the Canal Zone,employees and nonemployees..
... ,.u,, -.- -- -- --......... ... .-.. .. ....-*.......... ..*.... ..............
, ji(..f.. statistics fr .Pa.nan.a City-" **-



BWqMJMM i.* .*--* .- *^ V9 ^f
t tfC..:--- -.-. -

I Ji tt 1 ..* ** *mX m. ..-m i- Wl-w-. -um--mmpagem*m muma -mm mw -m-m- mm- - m-m- m m -mmmmm - - -m- -

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a r I""" H I *K 3 f r- * iH
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--... .... . . ....-. ..-.--.. -.. --..... --



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g .l *. .- .-.--.-.-- ----.........-- .----- .- ---.------- -.....-.. .. .. .-..-. -. ---- ........--...

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. . ..i. i . _. .. .... . . . . . . . ..

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. .rg fr.om . ats noneffective rates for em-
D[scharges f om hospitals, deaths, and noneffective rates for em-


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

..Causes of deaths of employees, arranged with reference to color,


I'1~


S.age, a:;. legth of residence on Isthmus .........................

tDeaths.of.reeiaeantsand death rates, of the Canal Zone and the cities


oa. Pi Iaia .ra d Colon....-. ........-.....-... -.-..... .-...-..-. ...-....-


I.,


I:


.De;aths of residents of the Canal Zone and the cities of Panama and

....::i6Oa,.,by cause, sex, color, age, and place of residence. .......

Deaths of nonresidents.by cause, sex, color, and age .....................


1 rStati.ptics .egarding- American employees ard their families...........

,' Birts and. birth rates in the Canal Zone and the cities of Panama
ft :: ..... .. :V ; *' \


tt,"'i?: **i; ij* .*jlorI ^^^, -, ...,-^-j -., ^-- ...', ....,--..-- -- ...-.-......-
H . .. S 1 d - i. i -1 -- -. -- A i------i-i---.-i- i.. i-l.i - -i

..ii. md"lity tes in the Cant Zone and. the cities of Panama

,,..ii-- i ... - ..i-..-... m|u ijmai- -i .m -w .mm ->m .m .. -- .mm- .. .. -.-- --- --- ---.....

Deaths i hospitals of The Panama Canal...........


CI.


":91


il.~q*P;i;;irsr~;rr rrr~rrnrurrrnrrr.rrrrrrr,,,,,,,,,


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erATION


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DEPARTMENT.


ORGANIZATION.


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FE ~II14
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VI.
ng~e


the operation


and


organization


* PERSONNEL.


iange in the higher supervisory personnel except


iom, Medical Corps, U


-*0 fl


; lesner, Medical torps,


~ctivie


Army


relieved Capt.


S. Army, as Superintendent of


1926.


December


* :: white and .69:" loredempoyees -a total of 1, 000
&l|Sere: were.231 white and 769 colored employees-a total of 1,000.
*:^ .. .*:"1 am


raiH::.


hi force was divided as follows:
C 'H, ,. 1 -


jeanss. medical officers of the


li Hi. S my:: (3 o

|tfi|:t:i^^ Detdeinber,
l. ..,whO. lef t short
:,A :*. ,. : *. * ,,

~7Yi^iti cia Surgeop
. :. '. .. ...i E s "i... . .. .

)';iK iviiian
* *:* .** p*: u 1 ** .. : .
1i - - - ". -


"'we.

-
~- -~


f these arrived
to. relieve offi-.
ly after the end
.


,, U.


Public


." .. ,- .. . .,


12 sanitary inspectors.
2 quarantine inspectors.
5 veterinarians.


7 technicians.
.6 dispensary assistants.
'3 pharmacists.
15 miscellaneou--storekeepers, chem-
ists, stewardesses, carpenter, fore-


men,


mechanic


, embalmer,


vac-


cinator, student sanitary inspector,


sanitary assistant.


. I


;J ** ::iU 'I h
|"^: !B^-:. l iiB:!.




:: : S
:I.*
,,,, LI, N E:


ividuals filling" the high" positions on December

esrpective duties were as follows:


**
.- : .*..
.: . :.- ..- . .. .. *


CHIE HEALT*I OFFICE.


, 1926,


S. -


November


i .**


XII


" rl~J










111~






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A
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* ,',, ,,


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. .^ ..* iys v. **** .. ... k .
S:' .::::" ..'..:. :* '": : 65 ,422
:h.'rQ::. .. : .
^sif3S~ " ^..;: .=. ''* *' s uc~^A
Jay IIIIII, I :., v"? I iTI AIA"I ..:I II"II .II i: ~ : II i I ll I


"i* .v" h"


* :" 4 - a...... -


pic Fb~.,,-- ;- ,,---,




wae.... -m.-e.-..i..-.--.- ,m i .. ". -m... ..


** I

-' =:l i S...:- l-- : - *-- -g. -. - -. - a e -

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



Storehouse operatjon--.--.-.-.-..---.---.-.-..
"i i "M .." i ..





t'! ": :h "
Ui.M..."l. ..0..I




S.. * .I ,.

... 1 ". ...... .............
a d. i st. .. .. .. I. a -- .,




iof ,g-,,'i:aa g ie ""ator-.- .... .. -
*A J ** :. .:* . .
ii:.' .lu,(prpqa.*

||I. gOS C incinerator, Colon IOH,........-... .. -............. .....-.
I"i *(:Iklxt^*' " .....*.* . .. "" ".
"oo o erfor hospitals, quarantine stations,
BiiI RsNfM .s .iK-l s I m I' .n I* I I i I i 4s na i< I a ina = mmH


!! ". .. ...:"A'r. '. - : npr
. .... A.... ." " ".n-" *, " *
- : .- - -- - S - -- - - - a - -
) J.. .... ..n... .... .. ....


|.ffiM f ts ..chi ges. fOr.services- of'oQther Panama Canal depart-
i..:. ":- *.hi .*" -"-" . .. ::. : : - - . .
:I Nf. .. : ... ... .*

: ... :.J.tal ordinary b.er.ating e.penhe................--. ........-....-....-..
. :. i- .. : -

B..t at Palo Seo Leper Colony........,... .......
..:" *: *." .... " " -



SW. Sj * : - :: .. d *: -
. . .
: .*: :. .:: "U-- .... .. .. "... ..... .....
... :-: -":.: *a".* t l e t g Se L -o-
.. ...* ..... .. .: .


4la vr


5.607.00


$583,096.59'

363,628.9

178.266,5S


5.505.43


56 .865


52,514.01

75,112.00

28,630.01'

12 066.68

1,929.97

7,593.03

6,559.39

10,289A46

11,823.07

9,354 50

26.419.06


56,1947.92


5.299.


19.052


510,953.25

9.245.87


520.199


.4i1i4u1J^ Iroa Ar my medical officers for rental trom
' " 25, 9 64
I t. ..e. ... .e r. s A, ...589
......... .... .. i .'I"-" f
...f. l c A y niedical officers paift from Army ap-.
"-' 112,067 .31
: a::l l--- - - - - - - -- -------------------------- ---- 11 0 1

f. V.nit ,.Sta.tes PyblUe Health Service officer,
- / ,, H ... :. .... .-. : : .. .- .


? "'~, /g:':lic :i


*...,..




11111]
































































































































































32,589


9.65


A:'i. .


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-


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id :..


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|BE. . * :: ":* ". f .


S* iB


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a.


PxdfMaAkf; EMkoYntns ONLY.


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:. 1
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::... .:.E .:* :'i.: :... *
I.lD:ll om is P* tar onitt'e. S p. 16,Repwt of H. far calendar year 1925.

.. :I..::- I .!" . I
*4 4. H .


.4

. -i ; ... . * : .


1.090.


EMPLOYEES ONLY.


. .. , ;; *
H r...H*: :.'.Is!:: :.::. .: '.:.


4,
.i!I~I


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II


.H::::Ig*. 4..


~~', twi I:i.


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i.;


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...* .. ...*. .
..". ." .,a, ,, ,, ,, .* .

i ,
i : ... "". . .
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;,
: *I .= .* *.: "..*.. .* :: ..** i "* .. .. ..
." ... ...." :M. ... ." ...


. .' : :
:*" 2 |4:* *


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t


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c.


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* :: :** ** ***. : *:
En .: * ::*E
MH. *..:' N *. x*.
A*
.:::..:* 't :* *. N:1. :. ::
H:*: H..:s.4 H: a


%eit~n~ :~j
I *.:f i


: r .i:


IttrIiY). ry rt during the ear,

I'44 fo|r.' bl .ebidressC. and .a general
.. .....
nn*" .... .. .. .. . .... \ s. *
m: .* :*" * *. '.
:i:. ..; .: : :..:,.: ... .. T ..: .


ges 20 per ent ocrSed among.children


I per ct amag. children under 5 years of


*i t*:iA


rH:... *1 .n.,.


I


JROM ALL CAUSES, CANAL ZONE ONLY, EMPLOYEES


AND NONEMPLOYEES.


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'sVO.43
#947
HN ~[i[i~[~[i
N'.
~~ ~1,46
b n: IV "~






I,~


Li!273


S1,251 2
1.385
1J29
1 047
Io.., ;,10....
410
343
328
286
241
242:.
236
: 254
S253
305


284


MKatp
per
L.OOO.


49..86
31.60
18.95.


I 13.33 -
14 .47 m
15 32 i
14?24 m
16.97 -
...1.5.31
12.83 m
10.91 I
'9.93 t
8.49 -
7 .63
'8.81 l
7.52 M
8.17 m
7.96' -
9.05 i
3853 U
r 7.79 M
.IR 1 : *


----

.. . O

^ *estma
mm mm mA
mHmy mmmm m a


i ..


VITAL


itd population of
Of:th ese. ,152ji


'* .. :- ." . : *.: "! * "aO
tahesgthii

',' f ",: ': ... .*. ..


* .


59,635,


FOR


CITY


1,188 deaths


, giving a rate of


.d 18.92 for 1924.


iumnber of deaths, with their rates,
! ..


S ,k


I.,.


r ~1r


*.::'.'. '
a .. *:..
. jy. .


'up.


-


I U An w ..' t 11 % deaA nka


STATISTICS


PANAMA


there were


from disease


"mA.


;" Qul;:


I
.
I


~i~i~i~l


c


,,


*


























































": :1.


I: l


SUMMARY OF VITAL


c~i:;I.. *7 ~ ...jj.......
?..4ii,:.
FGRR OtO
.1~ . a


an estimated


ti


population. ::*, ,.th.:.
iese, 427 wer far disease,


during the year


The 6 diseases causing the highest number of deaths,
...


*' ... .: ".W .:
*i*njC '
i..,
". :" :" : ':::i*"
**. :': :..": .:h "* : .::'i:.:.Lc


From


13.65


as compared with 12.12 for. 92S' "it. for







111111








H Hi: ii ... i;


'.b:TI..
". ..X ..


-. nX
'I.


iii


iE$A t f adaltetet fn long observata
"i... neralin lesto Miraflores Lake
S. "" . S ..". : ... .. "
: .:: .. , X*:,"


-"astI


4B9h bes. accompliahe4at.t regular intervals,
rojr tint between :oiBags,; aliough longer


In
:i $9
nI~Hgflowi~t. o


ne sections of this lake,


notably


smaLl rivers, might seem especial.


means of Paris green


bi Barber- and' Hayne
"


but conditions


. Cd' -se ae the use of oil for this purp

.r. e, . be diluted
....... ..... .... arsgre.demands that it be diluted


)ose the


with a


in h..jih popbartions of about 1 part of the poison to


perfect dryness being a prerequisite.


In most


i. 6ie;td as the diluent,


although sand,


ashes


flour


:i. tot, nd other materials are also mentioned as satis-
.1 .si be'reanermbeedm that outside the tropics the'period of


* . ..... .. .


.galls in the short warm season of the year which is
by the relatively excessive rainfall that occurs during


* .* *** *** ** * * *
I::
1. State, ",
^fl Ite!
&te;


breeding on the Isthmus.


doe. nrot


exist


here,


"'Road dust"


does .any


as it is


other


especially during the long rainy season.


dry


Even


i 4hS. provided, special and expensive precautions- must
4.g^the wet. aaon toikeep it in a condition of proper dry-


astup UJ3O tlie Water.


And not only. must the nmterials


Sarenicv.is used in areas covered with dense grass


. the vegetation itself must be dry


or else the.


tt Iil the powder will adhere to the moist surfaces of the leaves
itat. he. lt that but little of it will reach the surface of
'rcuI n ie, during the long tropical rainy
iu .:.i. ":: im., : i ,. ,. ,C .* w


the.timi


able..for the application of Paris
The use of :oil is dependent on


.* IP"** ". F .
cn W. applied at any time rega4lesp qf
itis treen is said to' be mainly, effective


A4uA^ sonlyand not soxnuchsoagainst
",'M* .. 4 'v ^
"m mmmm mm .. <:* m r a m .. ? - .' a _A S. .- *- __ -.- -


r~~j


r1i,


.


rY


p.'


~_~ i PL


:P:L~X~;in.:T;:


nr>


"i'ji


..




LII~













1.H;

.lM..... j
i!'A :i: .


'art less.


ie more recent extent


*1


-'.. ':ete communities


in a:t! j
,s'nff
LL *l:":J


.ways 'than


* 1.. ;Jt .ft ubratinns: te made both at night-
i .I g what mosquitesre on
.. :it "... .!!!.!..." I ."" q. . ..."
4i.:. ... "r "suct h efforts usually resulted in
S l i tispecies within the town. sites,
.,Snor.u. t.h m u;. oe are only rarelyop caught,


.&fr the .lgh.al.ways be found are now prac-
iT ihei.O cou.rsethis has not been a sudden occurrence,
".. .. . .


MAr'S work, but is the cumulative result of


P. ..
.E .* *L : *. .. * '. *


w.:HltwO..


i .-4 4 .:':





^jinl dthitrlf 1reed
.. .. .: ..: : *:3 . ..

ai
"l .i.:.A* a thf ar
.::3.. S':" "x ...::. < a


S :4 *i ..... t h e '


oulid


"Ini.fact,.were: it not for the presence


though


Baliadi,


very


. realize


annoying


now


that


species


i mosquito
.iorhynchus,
a mosquito


on casual examination but of very different


:e voracious


ing places.
pparently
Isthmus.


biters and


finds'j


both


plenty


Bt Ini


fly very


breeding


ruins


long


places


Old


-


H. ..side and extndding 30 miles or more to the east,
-aB."s Waaps form a continuous band from 1 to 2 miles
MH H. t


i : ,:
"i.'4,. ",a .: id e a: i


Teat of the Canal, on the Pacific side are several


ianwps.


withibh


5 miles


terminal cities.


Sunmreasured :miles of brackish swamp


. .
..
Asstance of teensokhynchus,


land


which is believed


Hi$: "' Yet:it must be confessed that fairly exhaus-
Kt:'^sa4 *'pa hadi icnbvred noi breeding places of these
tt AI.ti .for t t valence at certain seasons of'the
A- 4 ~aKrTrf


i::nC::.'2.
1.


~1'1


.cbpos e Fpoi Fpumitped .from the Canal or
: .. ". X4. i .1
. "". ' ."' " "o
tji. 'Mtkeznt dr y seasons and present me
e bri ^Aesd c'iorthycru whena the early rains
i . . ". . .
bH& afep fisr-e. with rack ihh water.
S H .. . .. . .


. M. . .


.1. *.*


wo mosquitoes are Ates taen
quito; anrd the Mansonia titillans,


:4I


r:i:n


i :IC'?IY I''
~i~ti


k


== = m l i


!











































memorandum stating that, following a period of uuual





i ..


H': 'i ..::?i


!.i. . :4. .. .. .. *.
H U.*
,4,, "4 ,,i ,,,, ,i:,,.4 .4 ,: ""
X* ** * ::. I .:. A *
* *:' *i H:3 : "::::. :i. .:: ...A : :. .. : *
,,,, ,,, . ,,, *. , , ,


,, , ,


.:
." "'.E'
.."
.. li .
*," ,


N. i .
4 ... "


Va.


. .. .. *** . : **
|44At. see kaPwn.t as s050ssat hutous darnszti-
Ia a it hai been. desribed in European
piak distasa although they, eem to have been
., ", "


as
w


Ie
*:::: .. .
u ih:-t.-j


.._. ..... C:M'al
i, .:a . ". " .
,hJ ,, ,: :4"" ,* ... j*:: :* :, ,,, : ,

,, .4 t .. .: .'"" "





.. ,, *.:" .. .* -*
..... e.a bo
r H


. ." ." .. B.:. .
!iShegir visii
k~~~~~~s


;an


. specimens,


a similar


insect,


known as the cause of .outbreaks


has been discovered in the Canal

ceding habits, and no more than


lave been taken here, nor has the characteristic
mized here, yet the presence and performance of
borne in mind as, a possible- source of such an

Zone.in the .future.


DISTRICT NURSE.


tfng or district nurse was continued throughout
d the physicians in the annual examination .of


di~


sides of


Isthmus.


ts to the Canal Zone Schools,


Pacific


conducted


side


baby


:iiB... I tfahomne op infants and expectant mothers. She

SW 4& e rai bl Woman's Club free clinic, the Panama Red
f4'i" and the Mothers' Association of Balboa. Her work
H** H
|ili d both parents and children, and cooperation was
ib e..very class of persons with whom she came in contact.


j.......jF .,F ",. ... .:l U* i* *
(" ,," .::* . ,, H" ,

.*, j c ,*:4*,::": : i C *x .
i : . ........ .


*. :* .* ..* i .... *. .; .
:.....::.. X .' .l. " .: .* .

I, r : *:
. **:.i.. ...

T I deathE T of clildren- under 1 year
;iv ii: t;lhe pas s has been:
.* i :..
.:. ": :

... "* i*** .. .*. .
*: : .. : "- :*.: . :. ".. .:. *
D.:.;*. .. HOLTWATH at "* fi
d::: HS
~i~li~~i~j'U


141.95
138,06


117.12


'IL..:'


p^' yl J q .r ,, ^****. v.M~
plWicaon writers.
' i|St :iici O!er
vitte4Ealipaottlso
let.one rn Ecpad%,
.. .. -
jiwnc here of its br
N' H H b -


Ii"!.'.


It


il


*- *^ '


,, n
,,,,,
e:4":' :4




1111~




































































































































- .~ 4*t





I H.i
NH I' -
1~ ji~nIk~
1i h. cm' ..

ilt ti -.i
.1.
15B .
Nr. H..r ... H
III.;,.*i
I::::N


ir
-in jji..i ~ 'h~

NH H ..- i.
'4*'*Ni' .. H'q-:7
4 .


i, : .
* i, B. .


.:. ^ |.:iA. -..i
.:- ..[ i:. k.:"
A H ,* :, ::


. ... .
4 /'


fihtf iutotHRtv rate per


1,000


been as follows:


*H


139
140,
~ai


1924-............ _................ ....-.-...
1924 -
1925.-.... ._...... .............. .........
126.... --. -1.-.-. .--..-- ......~. ..-. .-....-.~-


tSeandi enteritis continue to rank high as the causes of


tSrunder 1 year of age, acute respiratory diseases
the cause of a large number of 'deaths in 1926.


were


j'7v


.-Garbage


A ..i.: ., . r: .. -
.'
H r

H .': .. H.t' !
:::: *" .. : *** :: :* .:...:.. .::
. 1 :..i .i : . .:.*u* .J


i.. .
IHNiD ** **, Ii *



......... i1 Ii1 1 1i xf-pi


*i*" "


........ 3:. .i "". . " lk .
I.p' .Hssswo*rk.--At t
re and of these
S4 edition,. 2 on a
. .... .. .. s : .
.* : ". .* .
1'HN. Vrcent'of -gaungrene.
.1 onna.y1- on:- acco
'. .... ..a. a a d1 .n ac
feig ,.baiig"1 on ac<
1Ntsd~mad because of ex
. .S: (livers heads

... rty: turtles w..


and


and


disposal


eighty-six


there are over


but


maintenance


persons


owing to


Incinerator,


12,000 graves with


unmarked graves.


:he Mount Hope abattoir


4 were condemned.
count of anthrax,


10.704 cattle were


were


vac-


proved


the excessive


Health


metritis,


1 on account of external bruises, 2 .on account


unt of emaciation, 1


count of actinomycosis.


on account of


pus con-


Nine quartets


were


tensive bruises and two because of abscesses.
i, hearts. ftr..were condemned to the number
ire.slaui eAl, one of. which was condemned
* m .- t


tie


were


because


slaug htered.


external


these


bruises,


Fr -n


live births


~ft~,c~ri~ housalid
- KFar
8tt~nsac


from a sanitarystandpoint,


by incineration


is preparing to use the much cheaper burial method
r used in Panama City for some years past.


e Cemetery.-The gross receipts for burials was 83,801,


Ssae of flowers $1,487.


50 acres,


sand a large number of


in. which


The cemetery occupies an area of


on account of being in a


2 on account of


..o its dying condition.
S ... 5 .* 3? .. . *
WfW on .abattoir.-: 5,048. cat
. :*'.*: . :" : .
. *.i... :.. i"... **.. .:lli" .. ." :.. .Ii* . ** m .


-
... a
"""


...". "- :--


. i "


"ijr, ,;-.


J




I~






























































ileg ne relon is, .osary, or:n pastc v :.r Ht
koce eshalb idn and pads i sta tiorn, bu a, ........ .,.....





operation, ncludng .itraveou ijic.iisHofir..h
ifre;383 ae iie th [u-pten dprt
















,, ,i, ,

I *r,,, ,r,:. ,nH i
.."S "+i i" ,':" ..... i'.
,,, ,+u,







KS~~~~~ *H..E r .,:rC :~i~ .

i;;n4.; K. ... *.* L a S
ri:'i i"f: ~~S=EZ
Es. '' ^;i:'; .." ..
'CEC.*C Ic K. .~r~X~
I~ ":. "ii aC KCE :':: i'

UEKi~.xjl .E r..hi. 4:t: .
"5 1e~n ..tk."... ;i

~~j::.3j.~ji edia Cporps, Ub S. Armyy
K, :
.2 :1'.


.,K "",


f@:.A lWitt
K 'Ci.t
Hi .4


"E" :. < I "


!theRbt at the fixed rate -of


noan c


ares- tor.


Superintendent.


r


the Canal Zone


.$0.75


per day


W alie. eniploycesb of the Canal Zone disabled


ironic diasease.and who desire to enter the institution.


I:te aii. --A new concrete dam was built in the hills


I.

.~j~i. ~iggerytor~i~
I,:l liI'
~~'~I"(ER~~


enlarged thereby.


tese at me. aairy
w '." "a n ,:.


and kitchen


r. MC
'A


IL i"' 2H
.i':
';I~r I
Hi.
'C"


for females, the partitions on


lower floor were


S.eliminating the small individual rooms which were


dt ad ventilated.
tha ard was re a
better lxinfmation,


Small windows were reptaced by full


vir -d
with


reducing


number


lights


amount


*,it' consumed .
iorki was commenced by the Constructing Quartermaster


Pat Cnal on the erection of a two-story concrete building,
itd 140,000, with a capacity of 120 beds. This is to
:-- :IJ*-- : U e a .


ryu~r?
*~4~ji
K.~a I


atulidil


Female in ne. patients.


October work was


cotis auction. of a new kitchen and dining hall,


~estli
K


U


atd. cost.of


including


also of


equipment.


. I."
. 'Cf '" .. .: : .. : .
lA':" '" ":. .t ^ i Yxtlf- ""~y


.K K.,


r' i~n


s fr all the patients and em-
Jf-- K -


'r.e .expected.. to


.tbiu ...cotVructi onit was. pecessa
.: .: u* 0 fe .al
--at..100 alsO t


be ready for use


to move .building.


boiler


:o move


F~i~a tn**wm iai4-44nn 9 noW tin~llr hniiCP


Uis u mvn id-ni rh


S.1K-,


the insane, of


.Panama, being reimbursed for the latter class


V.
K


by reason


place a smaller one, the capacity of the reser-


This reservoir,


for cooling the condensing coils of


during the


the re-


and for washing down


a .decrease


$110,000,


i:. :::


I I


I


1










U! m KJHH *W*jf I jlH :: il -, *Bir ig..- .
,y ,l i :4 *, : *:, ,
. 4 , *:," *, .: : H .:4" ,, '
E :.. .f.H*. .. ..* .:
.... j * .... .. ..::*::**. .* ..
H*.....: : .. *H..... ... .. *.*.. AE .....
I |.. .. t *.* ... **
S. :::. ....::. .. . n ..... .
,, ,:,,:,:4 , 4 "% , ,


t:ib


..i.. Hid... 40
p:4..*'," :* i .' : ,. '. .
is tir t'" hta z :e ,
ir f i
,, , , ,
ih ete, taught capei
.:. -. -i : .:"l, <.. .


-t":


. ...... .....
* .. *.. ..': f :: .
. ii **
, *h -
" .: . '* "
~ ~ "."E ""i :.: ""


S-. "
4. .
./


was


given


patients


hese being about 20 per cent of the
d.ed and six doses of arsnhenamin


51t0z1*n
V


timber punctures were made.


e year..there


were


18 male


in ie occupational therapy


entry,


weaving,


bag


making,


"ae taught to make rugs and baskets,


and


V
I
IhdAP


... ish-r.. ... ..
t8, 1,ornam


The articles produced and sold were:


mental


baskets,


card


table


covers,


px:~neces,


toys,


small


boats


and


S,,, ", *


l .:4 .. .
x:llH?.


Ii li:.


. . .
ti ab tients engaged in various lines of work in the
.... '.mle: insane who are strong physically but
rinodated in the occupational ward on account of


.. ... .. . i: .


. '..... .i: .' .. ...:
4 ," ,,4* *: :" .. . .... ,,,

..... : ... .


\t
of


o't


,


1 -


to, the fields and employed, in agri
the produce taken from the patients'


amounted to $3,000.71


a ini. the laundry


cultural
garden


The more vigorous


sewing room,


or in


As :result of .these various undertakings, be-
en:t .f the'patients are engaged in some form of


ierng,
'wtmor


with the exception of bed sheets, pillow


orms, is done by the patients.


. the occupational ward amounted to $2,045.48,


.and :brushes manufactured
.. . . . F *" *" .


by the


This money is utilized


chroniccs"
for material


activites in these departments, and for tobacco,.
rn ief


f4 e aihmen ts, etc I
.i.. W. .Maih, 19 ,.1
.: . '.: .:.",
" a : ..i .. wa
..:itlpg p r'a.. *n J* '



*)Irtflarti'4' end. of" t
,,. , Ji t i-n

.... ..lfl ^jf ti! .. : r


for the patients.
he position of farm manager was


played instead
Cs.


to supervise the


account of the increase in


to assist


the veterinarian.


ate of repair d pastures


were


h tr y *eason. ,
:h. fkr at the close of the year.


Mm


i







1





















...iii i
3G::::::::i
. 1**
-:-: i


4 .xr.p



*. *: flI.f ..' r
d. *:ri1 H .. p
H.::..
:


Ir. 1.l


.4.


titi
~g~* .1...


I:


A ..-.-4,bs. .-.-.
---, -- - --- ------------- w ..... -. --. --. - -... ----C----


o .r...a t r. --.------- ----
....-.m ._..............-.. . ....... ............ .. ..-.. ..............
* * .
* ** ,

C z 1uipaiims .m. *.. *-. -imm- --. n g-i- m- n. .i- m -mmm--.nmum--um- -m ni.nm-m-gn-mmm ip.---. --m-m -mnn.min---- .---m

.. . .. . .
....... . .. . ...: *- .. *- --- *:.*.-. .. . .


---a a niina--m-imni--nk4---im n -nmim---m ---.--mmmm- -m-...q --m-mAm mm--q--.-m...*-- -----. i ii. ---ii- ---.i-- m


* ..- -- -. -.. --4 .m-m -- -C- - -m .- - -- ----. ----*m--... .- .. --- --- -m- m- - -. -----.--- -----


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

.. ". -i- ... -.. "E:.'. ..-. -


S. c ni men, s. g. am-- i- ---a nM U, m- m-m--- m .-- ,.ii. .-n -,i m,- -- n --.- imm i ---- m .-.--ii - i. ina-.* i -am-.-------wi-....i--ia -m ...-i--
...ii...i:


I m* --- --- *- *--*
. ... ." "" "' " .. .

.. ........ _-.... ...... ....... ...... ........ ..-..... -------.-..............................................


" .--'.- -. -...'- -. . . -
...... ...... .'. T .H.. .. ... * /





i " "' & : I l ...4 ,. 1.
I g
... (ugmwmaimsummma.rhp,,L w = ., i . ...-. .m-.. ........... ..m.m.m........i.............. ... .... .......... ..........




I'in ?: .:" .. "<. '.: : .




natu.. .......... ...-....... -...-. .. . ..... ... ...-- ..


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




*_' mm o .. ..m..mm..m.m... ..m..m .. *... ....... ... .. ...m m ..... ......... ....




n u w "... .. .- c"- "-- *.. -"- .-..-
mileumlliBmSmmema _._.m............m.
.Ai .' . ...: ... ......-... -. ......-.... ........ ..... .-;... ........ -.......... ....................
":: .. . ... ": .: .. : ....- .-
.* ', -
imSmmmn--mwocqmhama, -m- 4*~.s ---. --..-- -- -- -- -- .--.-. .a- -mm ....... -m-m- -.....- ....m......
ts .-.-. -..-M .. . ..-

.. ..*. ...


i* : == "*


.1.. .
b i~r.. .kij.:


.,,,. .-.. .-- ... ...-. ........... .. .
*. . * ** . *:, *:....,:.". ...
** ~".- * '*** -.~~ *. .- -


wei data denpistrate t venomous


4,ni& but that at least 4 dangerous sp<


S.

ot is-be


. .... .: ( *: . ... : :s n a
.....* .E : :. l: .
.. . -- .. .. ... *. j ..
i ,, ,,, : S sl


snakes


rare


ecies are encountered


lig made to instruct the public of the


Sit bite for capturing the snake


neces-


that caused


El


ri~i


: "..
:v, *%Za


Li&.


.;'::


,


ii, I II r r~ ( r,(


, ,M:"


w i




I~

















......... .::, :r:: -,,". :" "i:: ,,, - -
H.H:**.: :. , H .... I i ...*......*
. ::.i... *, *, * ,: * *." *.. ,
3^ .. ...:": ::: ... ....... .. ... :*.. *:*. .
:*.::*... g: .... ...* :" . ....... :
. : **:. .. ...5 * : ** , :, ,.,,,, ., ,
." ."*: .:" , .: *, : ," ... . . .
.. .* t 3** .:.* *. ". .:. . :" -: .. : : .*. .. .* , ": .* .

E~l"1; ..:aei^ '.. .MM;EXAMINA
: *. -. .... .. .. . .. .*-
."-', : "" .'. 2: S: T d v .' 'l '"A u l' ,
". .. '.-.. . . .. .. ., ., .


yhaWaliandred. and eighty-two
KW.. H. .4
Er.. .. f i
i1 H h JI: I* '


p~ra"ri
I HL.
EN
AE~
.4HEEEH..
H


Iwith Laboratory.


ithe


LTIONS.


autopsies were performed

causes 'of death were as


Hfel'i .' "*^-' *
. H :: '*-i ^:'' .
H:- r |"'i "



i ~ ~ 4H' ^


H HE.: :* x: J-* H.i
:?Sf ft.....:;*.: E.......*
i-ui i... ....iP~
-- & *'" "'.H* "


mafi:;;...:J . **. . * ''

t .. *a.a
.. *
k :iffgB. .... ....... ... .
:uta ...a . -


* * .
.. .m *. . t i * . i
i,, .. .. . ......
o

* s | |


Diseasns of the diguestive system:
SEsophageal hemorrage........ ...........
SUlcer of the duodenum. .. . . ...............
Enteritis and colitis (under 2 year of age)...
Enteriti and colitis (2 years and over)..... .
Acute appendiiets .......... ..............
Ie rma. .. . . .. . . . . . . . . . . . .
Inteatmnal obltruction..... ..... ..........
IScioreotal asc~ess .......................
Ulcerafive protta..........................

Fatty degeneration of the hliver............
Hepatic 0irrhofs ................... .......
Abcessn of the liver. ....... ...............
Chronic interstitial pancreatitis...... ......
Acute peritof iti e, ....... .... . . . . . ..
Gangene of the meooeolon.................


utei .. .. . . . .


S *. *.* *..*.. a*.. *..- * ..
qiup:U^ U I E * *:. * *: -* *- * -


*^^cc'ff~c^^Q. it4- *. -* * * *. .- * * . .
.... .. "- - - -

hj: -dis of thie newborn,.......
. . *..E . N. . . . .
..... "..H .:Ig". *U .
............... I j A *h .
E::|.:"w .:::" ^-: .' "W Aif *
-. . i .. ... .. .

.... . ..B i
"m:.emnd "" :!: e: ." gu .zo
wt astenand eof the ogans of
..... .....* : ,:.x .* : .
.: di4":....x:*:: itm nds jfmMh..riA- &j


H-
~L


Nonvenereal diueaes of the genito-urinary system
and anness:
Ac te neDphritis.,...... ..................,
Chronic nephritis................. .......
lyelonephros .. ...... .. ...... .. .......
Caleui.of the urinary pasages ...... . ....
Stricture of the urethra. .... ............
SAcute suppurative epididymitis and orchitis..
Cervical amputation and uterine suspension..


21


The puerperal state:
Rupture of uterus..........
Puerperal septicemia .....


uumemnirgitis... . q.. ..
gmai me. ingiti. .. .
. i . a *. : *. * .
h*e *tane. * ....i....
.. . . . .. .X .


: .:..Kv JW fU.x?- :..^ W .* ,'< * . . .. ,. . . ,. .
H..... ... st. d B .. . .. .. .
S .,... .....,............


.aft.
H...." .&.". .:,'

.. ..' a. ..
S- .. -, ./.,....... .........
EH.. .... ., .,,....... ....
k si:,.-.-..'.,. L...."...... ..
.. H H. . .--.,..-.,,...-.. .. .. C


i:... i i -- ciency......
^^BlE^plifet onifth^elsert'.......
....l J.I ... We. .oB-BlF a .. ...i ....


~* a. ** t-JI


~UI*tES1I 3N WU~.IU*n**I~n rfl~rw .. .. -


21


Diseases of the skin and of the cellular tissue:
Gangrenous stomatitis... . . . . . .
Furuncle..... . ... . . . . . . . ..
Celulitis.. .. .. ... . .. . . . .. . . .


Milformationa:
Congenital hydrocephalus.............
genital malformatsion of the heart..


...... .T.o.
H *|: *.-. : Total...........................
.*rOlBS"^ Of 881 *~a~ P
..Ift!'lhiearna of earjy infancy:
*. -a Iterus neonatrm..................
SMalnutrition............ ............
.1 em ature rth.....................
Injiry at lirth.. .............. .... .
2
1 Total...... .. ........ . ....... .


I
I


Aaeotions produced by external uses:


16




1111


































V.




:tg.:4t.t:+~&..:. 80
rr. .:b:..~ *. *


.91

. ~ 875

325

dud... Es ~123
.334
259

.119
201
* SOS
I.. 1306
Hi.
Hill
,qi. ,.. ..
N . .

t*1i~~
HE
HH


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p.. ~.. ...U
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.


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il I~ ***


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p .


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1
m1 .

3
4
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4
1
2
1
3
2
3

1
2
3



1


* i
* . .i
I; "i


S. . . i


".**3


hundred and twenty-two bodies


(not


passed through: the laboratory; 282 or 66.82


I.


i..
*.q *b U'~ *. '- *. l St * * . --S S S * U S * * U * * .U *S U S * * * U * i S *

S** . 'i 4t ** j ** .. i' . . .^ Y * :* S * U ** * * . . U U * S S * * . F *
m m* f -' aai fa a a fa a a. aa a 99m


H. ..... H ...L .
.,,.++ :+~.1 :,:? -:+.:. .


alsi fnd at -Thirty-three cases in the 282
*... .. *"u "p ... .. ** *h*e.

HI the4 a or 117 per cent, showed 1
: .. ..... . . .." .n .. .. 4 . M. M "


flr rnu'nr..c
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.. as flUuS....t I,
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1
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1
11

.1

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"ir-f.i....... .. ........
F ) :: ..W""i ,a -.... . '. . .
.B oU *iw* . . ., U .


?ft1ix ;Ut (telangiectatlu type).,..
'ags .. .. . . . -..-... y
I ... A . .A .
*It J *S *r * U** ,'" * * *
.:.. .iii .:.....h .." ... .. -.
H.. n .


tblonis: **'
.* :. -. A . . . .

Jgki^ctabl J i nodea,..., ^ ....


a !,".' ".. .." 9 J :* 4'. .. coat ': i.Eum .. .. ..

".R .**'. .. *"" "" 1'" : * "
H.. .t...ess and ovaries.. :.....
1. .;-' .J.i~-lr ~ :.^^ j.... ...-.. - .. -1 .- ..

I.. ...<.,.;. ..._ .B............
H



B.L : i ....-.' -
-.ab ... ..; ,d.l......... ^..........

.. . |ed' S.D L ....h... ..--..... ... ... ". ,...

....... . e, fmoral.................. ..
."K .:" *" ." "E:..* .*" :h : ":" ""
".:E ."..+ LA JI1":hf * 1 l t fl .. . .."

,,, .... . ... ..*... . ..... .
S. .




aL*. .1 ". -- "* '' IL"W .....* I*I >ri" 4i 1 > -
S "m- :. ".'.. .. :*. .:.'" I. L.. - A N
.'* .. :: .. .. .. .i* 4:*.



,+l .: *. ..
-. .a H



*iHa -, H ** '' d ejuMEn~e n> p-t
..R p1.. ..f O ow..........."


:"....... (..a.)..-.. ... .......... ....
.... . .of.. ",tle eaa fore o f s a fw,... ,..
Cuts 6Eh Sbooeeeon foreleg of mmle........
.*, B (roa dog esawined for paradta.......

.:: :.k" *: *" .. ': E.. :'.E. ". ": h : : .l ."*
-"::: E: : : . ... . .

HH|. i *


. .h -
**...:y s ., I..... ..... ... ... ... ... .. ..
sS.". -" y .. Sp-VM M '
.. "'-'. ....::: *H D O g.^. .^.. ... . . .. ... .. .. .. ... .
'.. " : ". "" . .
Ii.I


a.A~*C *,W. *h .. *BJ *'M *. *."* *. U U U :Ufi


EBnifHs 6.41'.. :*" : ' "* *
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... . -



H .. .. "%uH:". .
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-i: .. .ii". .= . . .... ..a .w


. .. ..* *I. * i


Other infrequent lesions encountered:
Goiter (toxie).. .........................
Goiter (nontoac)........

Hydatid cyst of liver...... . . ...... . ..,
Foreign body in stomach wall surrounded by
giant cells.. ,...... ........... ...
Duodenal ulcer .........................
Syphilis of jejunum.. .. .. ... ...........
Amebic uiceration of inteatine..... . .
Tubal pregnancy (ruptured ectopic).......
Eatopio pregnancy (tubal abortion).........
Endometrial hyperplasia suggestive of extra-
uterine pregnancy......... ...........
Hypertrophy of labia (syphilitic ?)..........
Lymphangiectasis of vuliva.................
Inclusion 'of endometrial tissues in ovary....
Elephantiasis of prepuce ........ ...
Calcification of connective tissue of prepuce..
Ulceration and gangrene of penis...........
Leprosy nodule ............ .......... .
Ulcer of heel with fungus infection of mucor
type . . . . .... .. . . . . . . . .
Fungus infection of ulcer ........ ........ ..

.T otal.. ..... . . . . . . . . . . . ..

Miscellaneous human examinations:
Placenta (2 positive for malarial parasites)..
Examination of seminal fluid.... ...........
Examinination for fungus....................


341


rD DOMESTIC ANIMALS.


Histological examinations-Continued:
Dog's appendix...................
Skin sections from dIcers of cow....
Tumor from penis of dog ......... .
Tumbr from tongue of mule........

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


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

. .. . ...
. .

. .. .. .. .


MiEcel'aneous examination:


Identification of cat Jouse.................
Blood filns examined from domestic animals.
Smears from ulcers of bull........ .. .......
Smears from ulcers of cow.. .................


1ft -;,. Rats eamzized:
.'.- Hn
:+ ."..: Mnu imwcu us.......

S :Mua norwrgo e....'..
MU rUaftus..........


V U.-.S*. * *i S. * j .~ . S


nH*Hdn * j .


S: .*:&:..: ... MICROSCOPC SLIDES PREPARED.
A I:%: .- .j" V


................. 5,213


i------


:4 *















































S)j~1


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TABLES.


DEATHS, AND NONEFFECTIVE RATES

,OYEES.


AUBSOJUr NMaxmS.a


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SI


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Deaths.


13
96


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'I-


16.488
39,640

56.128


16.266
44,957

61,223


45.17
108.60

153.77


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Total.


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2,220
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114
43
34

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Birth rate per 1,000 population.


a~otal.


35,50
24.13
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27.72


39.23
25.57
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30.14


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26.30


28.67


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aK CANAL ZONf AND THE CITIES OF
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Total.


U1 I


Deaths among
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N Number.


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Im


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5.21
1.20


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40 U .fl. U(.OfT:Z.i OF THE.PANAMA CANAL, 1926.-Continued.
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TTRNIBREP AND AVERAGE NUMBER IN
CLASSES OF PATIENTS, 1926.


I'~" L:jdrt.. ....:~


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--1,:8Uq
* I
11

1,448
21,672

i. 1"033 -


209,158
S-.690
4,646


i .~~-


Black.


233,46


I '9,682
I 28,594

S. 1,9.600
i1 ---9 _


87,618
10,110
14.924


I 1,2q4


S,985 f


S. 2 ;,9


* -- -. ** i-


31,815
26,505
389
13,623
55.408

127,690


5,600
S1,156
116,777
S12,800
19.761


10,089
13.563


2,059
3,101
10,083

18,059


26,263
10,163

36.426


40,231
29,720
143,379

63,339
85,252

361,921k


BhcaIc.


63.96


.93
26.53


leg .76


14.27

240'05


322.91

23.70
34.15


17.07

28.81


63.77
27.84


83.78

304.75


Total.



87.16
72.62
.93
37.38
151.80
*' _


349.84


15.34


319.94
35.07
54.15

427.67

27.64
37.16


49.47


27.84

99.79


110.21
81.43
392.82

173.54
233.57


991.57


k.11 !y:

ui:?. Sr
II-.,-


Average number.in hospital ealc day.


3S6,859 117, 60 1156,094


12,465


2,026


10,515


23.283~
AO1ic3


5.55~


80.580


111,.34





244,892


32,145

6,801
17,600

58,9067


146.11
136.30

670.94


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747

2,849


3,596


44


3,553


1.138.10


4,631



6,079



279


5,800



1,126
1,448


2,574


97


2,477


257.73


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4.297


S14.250



466


S13,790



1,873
4,297


6,170

141


6,029
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I White.



15.15
6.43


13.64



2.03
3.58
2.81

2.86
3.28


Black.



28.98
7 96


24.65


Total,


23.32


20.25


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TAM.s XV.-FORCE REPORT OF HEAL DSPAP t


*--'~ .~.

H.:.:
HEN::.!!
-:
4 .H~ .s


(sipf Health Office....,
Quarantme Bavrie......
Healh Offle, Panamsa..
Reafh fonE, Colon....
Aixoon Hlespital...,...
C6Ion "oupit..........
'Palo BeSo Leper Colony.
ZEne Banitation....... .
OovoslNroe p .al....,..
Line dipenarimes. .....


i * . -


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I







UNIVERSITY OF FLORIDA
II uIInInllllllilllI II
3 1262 08896 2252