Report of the Health Department of the Panama Canal for the calendar year ...

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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:
1929
Publication Date:
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 applicable rights reserved by the source institution and holding location.
Resource Identifier:
oclc - 225670417
ocn225670417
sobekcm - AA00006092_00015
System ID:
AA00006092:00015

Related Items

Preceded by:
Report of the Department of Health of the Panama Canal for the year ...

Full Text











PORTI
-F THE *


Dear tment.
OF

anmana cane'
IR THE
CALENDAR YEAR.
1,929

low









iWiei, Medical Cotrps, United States Army
Chief Moath officer


W00j" CANA ZONE






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CONTENTS..
7- -

Pa gt
HL
--------------------- ------- ------- ------- ...... ................ ...
---------- ...... ...... 1: --------- ........ 5',
statement,-' '__ ---- ------------------ ...... -------------
of*vital statistics regarding eniployees ....... ------ 10
of viul statistics for the Canal Zone, employees, and n6nemploye 13
at statiatics for Panama City_.._".- ......... ------------------------- 14
Y, of Vital 9tatistics for Colon ----- ------- --- ---
------ ----------- --------------------- 15:1
the'Isthmus of Panama ----------------- -------------- ------------ j .. .... 17'
h Office, Panarna City... -------------- --, --------------------------------- ^ --------------------- ------- 37_
--------------------- -------- I-~ ------------ ----------------------- 38
C
------ ------------ --------- ---------------------------------------- -------- 41
of Quar`axqioe_.__
----------- ------- ........ ---------------------------------
Vial Hospital___ ------- --------- --- ----------------- 149
------ --------------- -------- ----------- --------- 52
OLeper Colon ------- kl-_.r ----------- jw ......... w --- -------- -1 -------------------- 54
*6f Udaltfi Laboratory,--. --- ------------- --- -------------- ---------- -
N,
1, Discharges from ho
spitals, deaths, a d noneffectivc,, rates for em-
ployees, --- -_-------------------------- ------------ ........ 67
Utauses of deaths of employees, arranged with rOerence to color,
age, and length of residence gn ------------ -- ........ 68
I'll. Deaths* and death rates of residents, of the Canai Zone and the A:
ci ties of Panama and Colork-_- -------- -- --------------
IV Deaths of presidents the Canal Zone and the cities of Panama and,
Colon, byteause, isex, color, age, and plaie ofxesidence_, --------- .72
deaths of nonresident by cause, sex, color, arid ------- #78
't an their 80
ta istic regarding American employees
*j3irths. anA birth rates in'the Canal Zone and the citiles of Pan
@Lma .
-------- ----------------------------- ? ------------ '80
rnfantmortality rates in the Canal Zone and the cities of Panama
,7- '1, and ------ I ----------- I --------- ------------- --------- --------- -- ----- -------
-1)&bat06' AnId deaths in hospitals of The Panama Canal.t.- ---------- 81
",Watedb6spital and colony report.. ----- ..... ------- ------------- 87
hospital treah'nent furnished, average number
ihho-Vital each day, of the various classes of patients ------- -------- 88
--- -_ -------------------- ------------ ----------- ."88
rt,,.,hospitals and dispens4rics-_
89,
admission ripo
tof I cootAiotsand infectious distas-es reported ---- --------
----- --------------- -------------------- 71 .......

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77

iA


HEUH DEPARTMENTT.

PERSONNEL.
ne15, 09291 Col. Weston P. Chamberlain, Medical Corps,
Armly, Chief Health Offwer, was relied from duty withTh
Canal, and Col, Joseph F Siler, Medical Corps,,U. S. -Army,
,ppointed, Chief Health Officer.- January 24, 1929,, Maij. Hertel
1,Medical Coprps, U. S. Army, was appointed Superintendent,
-.lospithl, vice Adaj. John Wallace, Mediwal Corps, U. S. Army,
jr onduty with The Panama Capil August 19, 1,929, Mai...
".L'Chaipepll 'was appointed Superintendent, Corozal Hospital,
Cleve C -Odom, reliever from duty with The Panama Cnl
eemnber 31, 1929, there were 282. white and ,891 colored em-
-jg,, os7a ptal of -1,17 3. The white force was divided as follows:
m; medical officers of the 13 sanitary inspectors.
47 .Aomy. quarantine inspectors.
t fnisti- dental officer of- the 6 veterinarians.
'AL S. Army.. 7 technicians,
man, surgeons of, the U. S. W 9 dispensary assistants.
Fubliic wal~th Service. a- pharmiatists.
sicas civilian. 14, miscellneous---storekeeper, chem-
er~ns .ists, stewardesses, carpenter,.
of s.foremen, mechanics, unde~rtak-
le n Ur _ess4 er, vaccinator, plumber, ,dexital
Hygienist, and dietist,

v0.4yidixals filling the higher positions on December 31, 1029,
spective duties, were as follows.

CHIEF HEALTHf OFFICE.

Bblboa Heights,

-Y" Sar*edical Vorps, U.-S. Army, Chief'Health Officer.
V, A04sstant Chief Health Officer.
J1t Ve, ,S- P. MLS Chidf Qtiarautine Officer.
e eA 4t
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HI hi-
DrVIODS F IRwoIi
r mm t ----
tt
__--t
Co.Gore k-zl;Mdca bp
Johit W Shrwoo, Meica Vop% 1. S7f~w t
Mr. mer OhsonExottivi "itapt
Dr ToyW.EahatChleofSugi~lrvte
Dr-oar .Tute Assat hx t$riaiSmm
Ma.HnyC oln;MdclCrs i .Am,'he fUda o"
.Cp.'oretR sradr tialCrsLt .A"y
Medca Sevie.4
Dr v| .Hx he fEe Er co n hotSrie
MaLuetL aRce eialCr .S rLA5s=
Noe n hotSrie
De eo .TwsnChe fXRySrie

Ma' Hnr W Gady MdialCopsV.S.Ary,(,ie o Pyso,
Maj Pec ugns- ia ops l ,ry Oserca,
Ma.E J tvs ia m ,U .Ary adooit 4
Ma.Rbr.E/hms edcl op' .S ry
MaCrtn .VnebgtMdclCrs .S ry
Ma' a .SokoMdclCrs .S ry
Ma.Jh '.WolnMdclCrs .S-ALy
Cat Wlia .DitMdia orsU ry
Cat mr .AlnMdelCrs .S ry
Capt Alin L Goby, edial Crps, U.S. rmy
Cat atrS esn edclCrs .S ry
Capt Wil~hmKras, edicl Crps tT.S. rmy

CatArhu B.MBrik EJna ops .S ry





4,
4j1
iiiiiA:

-hppelq Meia oiaU .AmSprnenLt
t,?4nr, M 4-ops .S ry
K ma'opUS ry
Conirs, teriaria andDair Miiiir
'M kQ edcl ops1. .Ary ipritdet
Chief o Medicliiiie
W. Bilii~l Medcal CrpsU.iS.Armi
.D sh bl ~ ca o p ,U .S r y

/ /ik DoLn eia ors .S ry
d .Witer Mdcl op,V.S ny
ALA
- -1 l
PaoIIwLp; y

r.................. Supeinte dent

qa nDses"
ACieDsrc h aro
Pe roMgdDiksr!
tgAi Smsn isrc hsca
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MriCogeL
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Ir.T o fk edn, e elna
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D rie s .B r ,He lh Of c r'
Mr. omasA.-LeatleySant~y L[]
Mr CaresH:BahSaitryI
Mr E reerc Qimy Sniay nseto.
1 rFrdrik .DodVeein"ad va lsietI.



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01


O'GF,*bigRIVISIONS OF THE tMALTH DEPARTMENT,
CALENDA4 VEAR 1929.
Percent_'Gro4scogi
bp6rat;ng Earn self per
wgs
support- patient
ing'. per

i7 --------------- ------ '$947,72701 -$486,057.30 52 z $5,08
159,461.78 $3,214.88 52 5.18
t 213,830.50 88 .90
4.
45,679.35 20,925.75 41i
ati"W, SeVN*e ----- _A 80,385.94 42.,665.34:, 49
4,4'_.6a6s-of Manama 4
----------- 5 71015.09' 11,586,53 16 -------- --- ---
and garbage cot-
114,'disposal, CitieS L of
hnd Coloii---.. --- ------ 140,996.86' :9 115,117.72 82 ----
rotm 1hltiwlw -------------- I ----- 139,017,00 51,684.51 37
--------------
------------ 6.5,986.66 23,372.48 35 _- ------------
----------------------- 8,028.$5 ------------ ----------- ------- ------ ----------------
ii&f"nd miscel-
4
-------- -4 34,092.63 447.60 1
i 1,902 222. 1,022,940.76 54
-------- ----------
YLv( Army mediwJ officers, which amounted tw ......... ............ ........ $113
w4ef operation dBo&d of health Ubaratory and Anson Dispensary.
ynf Amy hwdical officem, which amou to. ....... ....................... 22,265J9
Non Dispensary.
stof opbrxfing
4y"Of'Arnu4cal offieers whic4 amountecrto.. 14,066.69
car4'4 oripplm and chroni m and-operation off arm,- and dwy 1: .................
Health Hervibe pay_ of U. S. P. H. S. officer, whi ch amounted to i .................... 6,444.90
thS arvice pay of U i S. P. H. S. offioer, which 3nowkW to .......... 116.49
untedto.- ............. ...... 7,045.89
au41YUbhq frealth dervico pay, which amounted to, .. ............ 162,289,40
4`*0 P& Cent of total expense. plus la pr cent is to the RA-

ING EXPENSES OF TEW, UEAYTH DEPARTMENT, CALENDAR YEAR.
1A-',,AUOUNT CIFAftEU TO THE VARIOUS AC(XWNTS.

pay -------------- ------- $64 A.73
--------------- --------- 156,728.02
Ae'alth SPfiwe paY_______ ------ --------- ---------- 5,561.38,

------- ----------- L --------- I ------- 419T691.65
4,
SU oi__ ------ 244,034.16,
------------ ------------- ----------
----- ---- --------- -------------- ------------------- ---- 6,093.81
7
---------------------------------------- ------ ------------ 878,022.72
-------------------------- --------- 9 -------------- ----------- ------ 50,256.40
------------ *
--------------------------------
---- ------------- -------- -------------------- 44,619,58
------- -- ------------------------- 15,07&28,
Wly disabled--.,-. -------- 493--68
'br, n1en -
------------ 8,102&9S

------------- ------------ 6,738.80
7
t.498.34_
fW
0' 1 AA
-------- ------- I V t.93 :7.
gnA
1 5 0,535,92,
v" 6
V
44











Rlor",- to motor, traftsp(gtatkaw

7W
Wntal
1glif on -------
g repairs and tiunor canstrwt6rt
'Miscellaneous direct charg:eahd tbth6r P4aama Coi!
par,"

Total operating ----------- lo
Salaries of Army medicaL officers, zndUnlt'ed Sit4,
Servic"e-officers,, paid from

Total operating expenses 'as charged agaiiiit De-
A
partment funds.---
-------------------
Construction iterns charged against Healt bepartffient fumb-

Total, amount charged against He'aith 15o.patdh 'ftWds- 1,

"SUMATARY OF VITAL STA-r1ST1JCS!t
EMPLOYEES ONLY.,,,--,,
The five fottowing chartr, are for.the ota_,k
foe the year 1929 averaged ,50'5 whites a-42,08,q
CHARTNO..,LADmissioN"RATS' TWii0S'F'lTA.L9 AND, QVARTURS FWW%,
A EAmLoyas ONLV,
Average "Rate
War. number per
employed. 1.000.
1W 26,,547 1, 179
1907 39,238 f, 419
1908 43,890 1,132
1909 47,167 887 a
191b SO -t 802 905
1911 48,876 896
1912 50-,893 727
1913 56,654 5-0
iqi'4 44 329 `A
*1W 34:795 24,
1916 .33,176 183''
1017 32,589 3 5, t '4
1918 25,520 406*
IM 24,204 55b"
1920 20,673 6721.1so
1-921 14,389 620 r
1922 10,447 490
1923 10,976 485
1924 11,625 513
1925 12,180. 519
1926 12,732 *474
1927 13,561 502
1928 14,260 595,
192%, 16,193 602
All rates tbxoughout this report am 0*maea is 7,
-Includes all employees of T nALMd#WV 0*0*
"in the Canaj Zone and cities of Cofft "aA
P, 601ttiti
Activ saitary work in the Canal K
States soon after
b$ th'e Un.4 the conttbl Nf
takeri over M May, 1904, Tables are,= 'skrvie:
available to give a comparison ts
The admission rate* to,"
q'th' 176.72 in 1928, and 1'46.15 in' 1927.'






in 4n


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mom


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B9.10
6'89
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9 00




!|.4 i
iA
Ap
Sl
clplW
I L0.
|1
90|11,28 4 ,
'99 4,80 2,
J99 4,6|11
5080 1
1911 8,876 184 A
1912 O, 83 I!
1913 56 54 7
1944,29 P w
195A,75I
1916 $,17 16
197 3159 1
1918 5,52 is

199 2,0 3 4














.... .' .: ...... .. 1929.


*24 b7. 164 8 `
1S5 266' 16.43
+.251 184 11.36 ..


U &W.. 4.40 109 642
S :.:.: 1 "3 f.. "
ti + w t numbe+f c.a ths among em,


.. .. i 1 929 .

Ar ....... De1as. Deats. i .o .
: : .. ..: .:70 10 .



ne p+pati[ ...(h 38,45 n' ..the .Cantl Zmone, there












A,,. .7J ibese were from disease,
*itt Z fS l28,m and 7.20 for 1927.
pt .....o.. $.26, and ,1925. Ti.s.berculosis














1#tls.front disease dirting the "year; as .cor-
i9et in 1 lper cent in 10926
...... .. .. U. ..






-dis "eOf- the year, giving a birtf











ppe .2puge 8 '0 Of these, 176 were white,
d 9.:::te. tt ptt.tl, 6 per cent" e., .ere -
Syer ae frn sestotaled






.... .porte.dut .the year, 44 .45
sh e ind e eral average aro her

...1 : .. .. ..
... .. ,.. ...~ :: ,~ ~ :: :i: :i .. .... ... .. ..






M I r E'a pr oiv
...flE,!o ..9E, da E ti" ee



: 9i 2 :W a 4i9 Vo 09" ... i



...... .... ...... ......
hI&- + up, gv w re


... .... .2 .







4 W ; :: :+=' :.:, :..ii. : : +i .+
.. ..: ..,*" .-.. + :+.;. : : ':', i.b:.N: .'
,: .;u .:": "...:7::, .". ::: )m : SY.+ : 4" ':
<"" : ..." .::#:i+.. ":E:+: :+:.. "...': t::+E: "!e...:." ,... ..
:. o"::. z;' ::" .. :." "+ ; i lI
'++ + ": : : :... .. .::.'. ""i "' ::./;i":" :: :...:. :" ,. ..::, i:[ i':Y ::.."; .:: : .;.:. : .:".s:n" ..r::: '. :

















4
V
106 34 W5 A "706
1,001 47036' l';7,ox
1 67,14-0 1,49 JAI W
t*-A04., -769,C0
194d, 86',p 465 1,
191' 911.414-,, 1,111 15.3"
41
79,279 1,1,29 144,4k,
61, 706 1 F'047
1914 46, 3-79,' 1 t5, 31
31,496 *410 11A
19 14 31,447 343 10,.91
1191i .3 34W,, 42, &N 1, 4.Wl:
19419 33,803 ,2$:0ti ;401
1919 32,3,66 247
1920 2,7,4$9 2424-6-o
1921- 31,317- 236 1. Zii
1922 31,098 254
1923 31.,793 253 'I,,96
1924 33,723 305 9 0$,t lwNpxjNw,,
1925 34'840 297 tt I
1926 .36:480, 284, 7'. 7-9,- N
1927 36,794 298 1, 10 =0
1928 37,056 *316
1929 38 lt,825 298 LOT

SUMMARY OF VITAL*SITIATII FOR,,
e 4, 73,
Trom an estiradt d iOlil4diow the&
Of these, 1,370 were from dtV* ate%*4&t-
as compared with 19,44in 19aWIN
A r In the previous anfi"
V "t,
'have been based 'on the yo, r-",L
"-A
port gliows'reirised figureg,
*t
*tak-en early in 1930 WH4,`-04
'a, 66
order to record the gradu.4:j,!eA$e-
were revii
*%he figures sed,, tWug tbe 10 W
bases, andfillitigi theiA
Ak The 6 diseases oausing I 11A*
rates, as follows
were



brditcho and lahar. ...........
Cng win9 001W
Oro= dimewas of th lioaA-.
phdU sioLte sad cha .... ......
sa drpm), ..........





F4

. .......


Fwas 2.79, as, compared with 3.17
ut
a.V2 f f 19' 6- "'46berculosis Vaused.15 per
A8,,ftoni, disease, as compared with .16 e-r cent in 192 8,
8-Per omt in .1926, and 19 ber-cenf in 19251.
0,10 li*eUrths., rv'orted during'the year g a,. birt
6h'totalbirthls re orted,,5 per cent weie stillbiirt4g.
"I P
39- eaths amoft, hfldwn under 1 yearofage, giving an
number of, I': births
ive reported
IF

-0ta at forFi geg2A4,'Fper ce'nt oomrred among children
age,, and 34 iET c I e t ipiong childen. under 5 years of %
14 h
T 4ft FS,Ctff OF PANAMA..

t)eath8. per I ,
J 1,000,
J-
iF9`84 47 --65 -'82
I's 1, 142 44 75
4548 1 1,56 34.45,
34 -
',,'ROI 1*,038 '25-44
45,,,, 31.72
591 1,446
'46 ,,53 5 '1 '456 31.27
-057, 1,380 29 P
'1 -507' 31 45,
S; 948 1 863 34.53
60:33,, 1,810 29-98
,+VJ50,178 1,765 29.04
06
7J4 28 Now

458 i '29'7 21781
L, 36 1'.
3,1279, "20:46
4 lob- 17 2&
0-,$ i-500 1,468 17.83, ANNEOWN
_1 I I I



0, '1413 z I

OkOFyITALSTATISTICS FORCOLON,
ted" pppula jio'n of ",29,850, there vV e 492':de fis
_,Wthee-` 4,67 wtre, fro"m d1i8easo, giving a rate of 15.64,
-'Klo fop-1928, aad 13.46 for 1927.
,qual reports" t116, population figures since 1920
that, year. 1,
Chart No. 8 of
-off the, censu' of this
020 to date. Acensus
"h"Amwd''the Population to-be 29,765,
43t) 11
grii.dual, decr,6ase iii, Poputation,,wIl'Oitwk, 4-T
Pevit'ej, ihXJ920, and 119,30 A6
J


Y





Wi

11 16
censuses as bases, ad filn the intervtningyer y
clprqgression.
The 6 diseases; causing ,the highest number of deaths, 'tk
rates, were as follows:
llog



Tuberculosis various orsans.............. ... 63 2.10 64
Pneumonia, broncho and lobar. .. ....... 68 2,27 63
Didrrhea and enteritis. ........ 27 M9 31


........................
Kephritis, acute and chronic. .... ....... ... w 23 .17 30
Apoplezy.............. ........ ...... A 19 29 S
Orgn "e dsese of the heart. ..................... ...... 14 47 2


for 1081 2.65 for 1927, and 2.54. for .192.6.- Tuberculosis.
approximately 14 per cent of all deaths Ifromn disease, as'c
iWth 15 per cent in 1928, 19 per cent in 1927, 18 per cent in 192,"
17. per cent in 1925.
Thbgre were 822 live births reported during the year, giving a
rate of 27.54. Of the total births reported, 5 per ceint were stll,
There were 05 deaths among children under I year of age, gp
infant mortality rate, bae n th ubro ive births
during the year, of 115-57.
Of the total deaths for all ages, 19 per cent occurred among '
under 1 yeWr of age, and 27 per cent among children under S yeat4
agT.
Rate
Vear, oug Deaths. per
tPIO
1905 11, 176 553 49. 48
1906 13,651 703 51.42
1907 44,549 571 39.24 M
'1908 15, 878 418 26.32
1909 17,479 396 22.65
1910 19,535 514 26.31
1911 19,947 527 26.42

1914 23,265 590 25.36
1915 29,331 640 21.82
1916 24,693 696 28.19
1917 25,386 667 26.27
1918 26,078 616 23.62
1919 26,078 573 21.97
1920 31,203 554 17.75
1921 31,050 497 16.01
1922 30,900 4-45 14.40
1923 30,750 393 12.78
1924 30,600 475, 15.52
1925 30,450 401 13.17
1926: 30,300 452 14.92
1927 A0, 150 423 14.03
1983,00 42L47

1929 9,85 49216.4





ANNUAL DEATH RATE PER 1,000 FROM SMALLPOX
PANAMA CITY YEAR FRENCH EMPLOYEES
U.: a nn. 0.05 0.00 a0 i o So I.a MI


5.00


-- -


ofe qrap
'ee logar
0.01 toO.
0.10 to I.
1.00 toZi


icolly lowest and h
ithmic .cales are <
10 inch base.
V0 -lirnch base.
.00 3 inch ba.e


- I -


20.00


JIo,


I .g 0


,u urv


mmomms m


Note
To indic
rales ihl


- ---


II


mm

mm


1881
1882
1883
1884
1885
1886
1887
1888
1889
1890
1891
1892
1893
1894
1895
1896
1897
1898
1899
1900
1901
1902
1903
1904
f905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929


-i.U-


CANAL ZONE RESIDENTS




54


VE IT11CS O"PA//A

Y ...


,viule-tepiemc o sallox avng ccrre i
the ollof 929,it s oportne o rvie
Ae ithms ofPanma n. tis nnua reor 1


"I k
"b-cntrct* mllpo
Jon bythe, rench --npa












4j,%,
Th sui Pr W
'the-
Aar,
P M 0Kim
V
kA lion* the Frndj coxiip"mr,
7
C:a itit er
rrw Q 00ect 40
"fly
Sipce 190476peel of -W.
livijRg the Canal1i
In one
PoPuL-Ition ofthe two ttr-
PlAced on vacdnationof soho Smallpox mof%4ity riteA-for fbij'
MR ity, CI
I.A-uPma'-, Ct
100 to 1,929, inclusive, aAZl 'are, incorporao'd
grapbocally in the diart following.
STATEMENT OF 3MA"M CISES GCOMI"Vi T"
AMONO IEarxzj?(D saNAIMM1071t,

P"Kma CitY.
.Year.
PIUPU- Rate pop *t 'OPA-,
lation- per M. WQU.
241,548 :,7
21,984 A" L 0%,
25,518 40 J-i:iw
33149 ... ...... 14,549' 1 at;m
37
"aw ......... 40801 11479, ...
45,H)
1', 7 4A
47,07 220
0,171 ....... AIM
1013 ...... 47,112
5,3,948 '2` 23565 2.". 40:141
$31, 4% ,
41 ........ 60,778 -0 3', 24',43
61,074 ...... ..... U,3%,
1918 61 360 102 1.66 24,01s,
1,35 61:369 0 .86 U',07B 114 ;31 -,424",4
Ji
.,01 1926,. ... ...... 159,458 1,4 -24 M W 27,4* J#
1921. 61,1*0 5 4 89 144 3
1922, .......... 62,5N 3
192
65,w 6w 33
A
-1925,- .......... 67,000 *14SO ....... *V1. 34,W
17, .... 70,000
2S .............. 71,500 30,00 1
......... 73,000 339 4.64", 29, W"I
1930-- ........ 74AW ...... K 14
TOW- $67 ...... 187

TheVapukdon figuresakwa fat for4w Ik
the A" e&6uw 0 06 PNa 'An
fr6m Ot tl* 1EU10d,
'TIke To ixkkid
of




Air







414

Ifv4











I, f

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






i --
1_ 4
TmemioatffcsAv *
(4 h no te 4
#bu-iv7ote e"


an ---a a n t ep p ltog -no mnl
Thrug a~ntonp tee~cs41
ye e th pedo tedsae-
prLo h
(v helw rdefviueneLfe
excedinly lw dath ate, du-, o th -wde
Vacnainintetemnl iis Cln .n
inrviwn vcinto rqirmns nth s
berinmrd ht w rop o ii r
reienso teCna oe nth n hn ndti-pBu
'totemna iie n h th .1*E entoghte, It
"ig h..to rop, r patialy ieti4
machnvyexitentin he one or crryng he rgultios'.
is geaty sperir t tht exstig i, th tw tatki
,hee i nottheshif' o ljoulaion*-inthe Zon 04
c ni nu ul int e-ri a' iis n ,patclryi
(adtontte ouato rm h utynp|vne
Cosdeig frt cniios.i h CnlZoe'he d
be ai: ine niiaio o costucio ude A ercaef
has eenthe racice hatallindiiduls krnetca
coin toteItmsfr-sdnms rsn ai41c oy
Ofrcetsucssu aciato, filn hih vcinto
reii i rd 'Frmn -ershat e 4toshy
nebonicidrimutbevccnae treiiitsafe




_tiii IbaiIi h ai-nprnnn
jhl bydsHt'hscas lbrh
A' strd-C
iiWt
Ki a ofedsrtpyiai.cncernd
liyi rpr 'acn'to'cr orec hl
td t t ecidivciae he'ot
ieqd- ekdfo r tm-otreb'h he
A-1aino vr col hl nteCnlZn
ato h mtin-nulpyialeaiaino
Aon Ih eurn acnto ae eerd oad.7

- by;1tlAN4in
reacnto a:$ya nerashsbe
P-iocd-oln steidvdulJ nsho u ntecs
i t-ht o ,e ytmtclr ple.i h cs f
& nt aiis oeeivciain t
R,,-il~elacopihdla ot ftednlyb
i hUie ttsfrmtm otm n h
neswoae rsetv
-ii-Al nomtkpas





1 11
Am I I I
mm C
00;r P !


fal int,4, t a c hscw
th|aia ria f le~t,"t le
'Uii"Satstergtad4 riyt' e "
Une!h j~wfet'vC
gov~ffin proectin trm sL
as adecrt b thePreidenof her c 4
Suc.29.Ev~ey" on livig f~r te ctie df oloal|
h asntbe ucsfll ~cntd*0nMoYr rw
iifi sm allpox..........
ciaint h aifat! fteHat'Of~r ,x i W b~t~
P~sn4vn h ae utdo o aymn r iNqi
the otf fae ocue utmnro nlvd b
vacnte_ Cetfct fscesu|ati~invP~e~s O
or by* tl~er person dsignate by tht',offiial.* Te 4"jik00i6*o
N%
vacpto rts
S[.3.I hl etedt fprsdns rnias aa r
iin rhiia o
haigcag fayedctoa ntt g





o'


34
qlt,-i4144 the traiasportation facilities into
.*4604VVY'coastwise steamers and sailboats,
0*tly speaking, btit little contact'between the
'676dtlying, provinces and the, two terQain*al cities. *7
P(,npd,'no national health arganitation for the
And g0erdl, periodic vaccihation was not pt'W.ticed.
11 in the outl7ing p nctsfrom time
POX qcc rqvi
t e
PanamaCanal authorities became'aware of them
`pltaftltce of tbe'Pa'n'ama Canal stealth Department in co-
0
thw Gdvernment of the Republic of Panama to send
012 mits to carry out general vaccination in the areas in
e, wasikn6wn to exist.
ed I Novem-
f1flomimg,",ex,amples-of such cooperation are cit n
as, -he gult ofan -epidemic of sinallpox prevailing in
,t_Wjh* of Los Santos, a vaccinating unit :consisting of two.
P"'An'd a, vacqinator of the Canal health service and.. a repre:
4of' the Government of Panania. was sent to: various towes
k" -1 CS*i I fTie' province -where they vaccinated 1, 145 persons.
Y ing Vionth a unit visited Aguadulce, Chiriqui, San. Felipe
er, towns, where 229 individuals were vaccinated. On the occur-
jn'e-pidernicin San Carlos, a unit was dispatched to that arei.
and abou't 1,000 persons were- vaccinated. Theprav
in Chiriqui province. (Davi4d) in April, 1909,.
,'in the d* atch of a vaceinating unit to that area *here 4, 100
Mitre v4cCmated in 27 villages. 'Anothe"'r widespread epidemic,
'41hany pdrt' of the Republic during the peribd 1918-1921
at'Mg units were sent out to various parts of the R ublic.
'Ihf.-Or'ganizatowof a national health service fourth RepubliL**
64 1" Is service has began gradually to practice..general vaccination
_'" 1141 W -h sma0ox has been reported. T e Directorof
.'991 frPiii hic
b"K tbeRepublic has been'unable to secure funds in his
lor the initiation of a general vaccination program
the poutitry, In 1929, as the result of waa. epidemic in
a v-,arious pointsi elsewhere in the Republic, the
(It madt, availablea special fund of $$0,000, for the
vaccination program throughout the
d,'for t1iefimt time $M'cefhe foundation of the Republic an
:*Ldeto vac6nate the entire population. As a result
PrQ Tam initiated in, 1929, and ontjnuedin
blic, -of Panarna4 at the present, tim, o
fr 'llpox than has ever before, been,
'Vp m, ed orjalsma the









moving -recent, yeare tlrqelk
developed a tiw factor' of. the' t
spreatdi of smallpox. The GovermAift g
Sltious roactdevelopment prjects kanditt* Jir
surfaced roads, a're available. on the,,ifi swi U
east) *id to Sona (196 Mcie ws) t 1,4nicp
ye .ar or so'gitod rpads, wff be available' as fat as Davird
province (358 miles,, west). This- province bp 0
The opening 4 these highyWays has bogttf lt
4.City and the -provincial districtss into, inatiatt,
A: private and public automobile service whickllas,
Rapidly during recent years and will coatique tgrAc
,The recent epidemics of smallpox in. Panama Citydith* l
1918-1921, and'in 1929, were due to6*th6i i4troductioni ot,
from sources %outside the areas controlled by the Ilealth
6f the Panama Canal; with -the continuing- impfovenjtedintb
station facilities by land, it can be anticipated that -the0(4
of the-introduction: of smallpox into thestwo terminal'cities ViW,
enormously unless..systematic vaccination throughut fhe
well as in the two terminal cities is continuously carried on, a a,
and unvarying. policy.
.*Another important factor governing the occeurrence of
Pananta City has been tile rapid increase in its population (194
19114$ 54,000 1924, 65,500; 1929, 73,000). The additonal
consists, mainly of individuals, andamlemoigkt
cit from the various provinces of the Republic, aloge ppp
whom bave never been vaccinated.
The increase in, popul-ation in Colon has been smaH as Oq y
Panama City (1904, 23,500; 1929, 29,850) due to its ina
land and restricted area suitable for build&hg Purpoe
The vaccination policy .hjeretofore carried, out In Panamia
'Colon Jhas been to vaccintate the new born, And tb dAvs ,
each year, vaccinating those requiring it. In alddition, it
policy to vaccinate contacts on the occurrence of soa
Extend vaccinations to wider areas on the ,occurreWte b
cases, and to undertake general vaccination, whenepititi
With' the rapid increase in population and ease lc s
improved roads,. additional protective rieasures wt*U be-,
the future. .p
If and when -the Panamanian Governmeft ntige
health program periodic vaccination 61 its entir oe.1PP.
with vaccinati-on of the new born and ynadention *~
chlrn h agro ocrec feioi




4,

ryuAee-lvccntonpormi
fie emt splmn h
sc qdra
mi-r tia a curdi
91hlolwn erssne10:Pw a
USII n 96,91wfd199
ti ;,q
'V t ,i & -9 1 'eg n i u e 91 ,
enclet6 niae ht h ies
i| yeviiiyb
e esnwiilvdiIf
o-b iiiih ptef gae ha tee
L, A=hr ,em ri. Tf eodr ae
4-I M uyW xoe otepiaycs eerd
et ofcsr eotdfo Pnm iydrn,
wa s S ,1
uC folw 11,12;199 3 9
wa no iuet sol n ain id
prga a ntae ntermrsidcf
i eedn i 01.D
JMbiir hepro 98
ya pdri om vics1 i nu:poIv_ h
prbbeta.tedffclyeprecdi
th:dsaefo anfn iwsdei ag atN
_4_nesv'pdui h weigoe h eulG

pe d ltte aaaingvrnetl uhr
"Oietdefr osa iottruhwoeae









17X

X t4
"InA
tfo
vim

th r W
h 0'
had, "Asited this*bavm,,,44 A
HiLin road runni"
Ikepitblic., Two
Uy- Recom
sniaupox -gituation at C hLVO, Pat-Ora,
sout4West as 5-",Carlos 40specially 4 -ChoAreral.
and Panama City busses, ply at hmrly int&vwr",
'On June 17, 19,291 a smallpx suspect Was 4
116*1W, a positiveZI nosi's
CaLsv Was the firstt reported cas of a, widesp4&, e
viruleni smallpox in Vanaxna City, Which'4adled 01
the epidemic, 339, cases, withw t dmt4,, ommirod.,a
Thi fatality, t4oughreportdas stp4pox, wa
pneumonia.
FWm *available data, the epidentic appeAg to have
an-unrecognized case. The wife and daughter of lho
'admitted'Awthe hospital orx June,17 had'viike(I 't,
Republic of Panama several weel% pre-viom-ly'., A
their return to Panama Cityf the 4aughter
an eruption which, persisted for about
think it nece&s4ry to call adoctoK,4s, the, tli,
very ill, Following thv- child's recovery, aWivil"If
I A
$e'riod, the f9ther became ill and wa:s tt;eated,-io
sm- allpox.
No other case occ4rtd during Ae'xnbn
Occurred in jufy prior to the 25th,'in 4,415tri
trved to the original focus of, lnfvruion Tbf-J40,
no tipprehension of any *spread of the d'tse
additional -cases were roodrted.
The usual Health Pepartmend'outine 6f
followed in connectim with thecW,'reVp'"t
this date, general v4ccinatioujpf the,
d*trl'Ct was instituted. Thjswas, bqim'poi,
AIL being employed fr the-pti '686,
rp








2
7,
'iiteaded, to joverschools in the threaten, -
4, ,,,(jay.s the program was further extended to
44he, city. General vacci4ations -along these*
'Ab,fhe month of August aind for the first
4)1Anj this periodabout 1.-0,000 persons were
i -p-uffyschoot children and children of pre'-school age.,
Ar!t vwk of Sep" bc+, when occasional cases began
_iwothtrdigtriots iri-Panama'City, it was decided tha6
dnd imit 16 spread it would be necessary to institute
on pr6gram for the citie of Pampa and Colon,
4br',the on was
you4lation of the Canal Zone. This decisi
tekeat tive samples of the population of the two ter-
hiid'been surveyed to determine their' vaccination status...
hidicatod that between 15 per cent and 25 per cent o&the
04" h4d ther never been vaccinated or had not been vaccim
-hiany-years.,
vac*nnation for Pariama. City had been in 19-18,
61,'I- va6cinations, were performed. In 1921 a similiar po-
iiuted in Colon, 19,824 vaccinations having been done.
'F' the,- general Vaccination program was decided upon, Dr.
'de Paredes Director. af, H 'giene. and Public Health for
li,,of jVanarna, offered the full assistance of his department.
U on, planned aod developed, utilized all available medical
Wthe two health departments (Canad Zone andTanama),
Oble nnMberof vaccinating unitsaw ere secured from other.
IOfth favorable, n6wspaper public-y and health depart'
th 'population of the two cities as well as the residents
nehverle advised of the necessity for being protected
'OX by -vaccination.
IN plaiis. followed are incorporated 'in the following,.perti,7,
att letters of instructiQns,
September 4,1,929.
UALTHOFFIMP, PANAMA.
oui'cbnVersA ion of yesterday relative to the vaccination pro-
Qky, tho fdllb,%ing draft, of my understanding of the, plan is sub-
4PPM#41" T* plan should be adhered to as closely as'possible and

into two eatative divisions, on division being the
c- 'liounded by Calte 16-Waterfront-Central Ave. to
f *' 'ity,
Ave,.! IA6 Calle B-26th St.-Waterfront, and the other section'

ef&AV t Pat,ph 1, to follow, The line frvm ater-,
,,t6si'tol*r et'tI4 e, _Jo,4tJTvf juy L St.-toVentral Ave.-to'
to, the Waterfront.






philm ndt.ine
-oth itune t aVA ea
]]aaIuseVl
Thsho bAe*wl lioee*
toprto n cuts f!r


II
Itis ,9 ute nIsodta a&-om
4IId
ThIeoddvsono h iy* budrtLd
It spandt nraetioc fvcntrj ee




4,i X
L"
ins a oicmn h usewl sit
so htalidvd0Iso ahhueo lc
jn h-6et fterfslo n'niiul
th aeadadiswl. 6eoddadrpre
rvpoibe otecik acnto ftedsrc
wmed mlt eod y ae ftesrebok
M1Vjit 'Oltiiomto ne h.haig
bowlb frihd
exric nth l acntin n i'
Arsolfrtbe6rful lase ihachl n
Aiaaoq fv civsolb 'lidadtevct
40jilpe ucr
mehd n eiu eanno
4tivcnain ibr oe'ihcto ygnl lt
apfilto ob acu, sfiinamutiotiedin
'w tlattI niiulCuto l esn gis hIs
bemtdfo acnto nes iulvdneo eetvci
-o hi oliy sson(r epand olsi iess
U*4qetwsaiermtm t ie'hyw4btknu
Mo .HAASN
IgiA0 MRMS, Z, etebt 3199
*W1 0
Itio'iudeommlpxi tewgbrn eulco aa
4? 1 I -'s t t a tt a h r sa hep e e tt m n e i e i
-4
-ct,,aira tbcmsncsayt hc h, ere&
fira h q'hc ie acnto4o hs eiigi h aa











OA_
IVIV



I-It ',A' "4r
Ot
4r
V"t


'A#

q,




4

t
TYPES 6FIK AND T ,

1. When an iqdi#id ual is properly Vaccinatid vgthi, i
reaction whlc follows is depen4entupon thii ieso_ 4,'
StanCeS in the tft nal. AAY
'SUCS Of the Pne_ Of th
after Vace'ination and the interpftta,41641 'tiO64, igAt4t
(a) Vaccinia (rjvi4Ty vaccinikY If divi4,
by an attack of smallpok or by
Clnl oft tjje
fest itself as a pTmvy va4 a.
papule appears at the
"*r14 A
a veticle; as e ves1cle, whlaeg'es it
VX
is surrounded y a red s*mUewarea WkWh I I I I
Mlowi nd theL SUjTo Ing*a"
a and
maximum Aout 7the n in th or tenth t,
leaving a brownish cu5t, whicb-funns an,'enj
hot be-rertioved. Thistypef reaction I4W"to',
and will be rec6r&d oja 6 ordbt
(b) Vacinoid regaion
ual has had stnalipox or a surcessfI U "lit.
degree of -the im;nunity Aquired ther,,
-4 JeSS SeVere than Wiyiary4 V'

papuk will ippeaecarfer, tfit-vg*jc,
4 rednessv4fl be !Auch
terisity, wh1cli will betpt"'n ijw,4 60-0h
1*actift indk#bes-i'14't,
W

or a successfulvacc, 1 4, ftt"
*'t* tedctibu, fall Wid fib*I *WiJt be
g ,
consists of An &O-a of 1 01
sj;rf6 Odin
,gr boeweob 12 aw houm




:k+
I4
t6,vemie~dto~ffueAe-frde&Tt
-tnm in!ci
_P hta gvnrato
niti n" f' Ag ereo mmun
zeoeaafcaIxmrsA"muerato,
r6MMA~ R thpe~s, o rect'iiiifithipapueiand
rU01 O golbeadtee n eiuain ri h
I iiiiiiAi
r'ett1otoiit'n o h he ye ecie
on"a t ucsfu"adwllb'-s eoddo om A
61et[os]uld, thimnt f=h niiult h
tye[ atmidiae]htimntyarayeitd
e-ocr acntowll-ergre sNcesu.
Ak tw ecin. bo c bvocrte acnto
f,4to n r~acrajiiwl eprore toc ithrwt
'A rviet rwihipoe eh
io| sdissetdo en
,b evmee htcopeesneo nyrato snal
io. ra~ u itofut ncliin
Ib~~a go ers,,d grn cradohtudsrbPcm







Arl

W;
o v
f-
J

'to b
'fiulb. Then breal
with tje fiiget egpet tht
'oii
H. Multiple V
agrface of the wLxm ls AA
m order to
unt es -A
WitliA4 Tot haud WIP&*040W
fiftem oblique pricks
poin_ of theaedk'throuO thc di; Vwus.
mw Mon one-eigA4 Ut*) Vf ag i in,
tocauK tht tieedle pointVw mW, d1w t*-
when the proced*g is comA bA nQ or
Suffiieat virus to producea.
4 W,e
beaeath the superficial player of
virusremaming on the surface of the sku 94 6ege YY,
Y, Y
mvng a single siuke. NO SHIELDor other drespi,
49 W
nation site should not be exposed to k4gc-sunlightj* foo
12. No perwn will be vaccinatedwben "hq a b 6 TUv ,
Trotect against recent exp0sUre to smallpox_-

RD Otr VACCRWiT

13. A Smallpox Vaccination Recor(j (Form 06), *W* 0
person vaccinated in fhe Canal Zone, it, e"*q:as0,4M&!,
:wa I vaccinate4butno smr
represent 41previous y ", "$A ,
A
nator will take the necessary.steps fo sectuwr0 an e
on the, 2 d and 5 th day after vaccination ia, order owgv iL
(a), (b), (c), and Sd), The results -abserved,-will betropa)bfi tkop
tion"Record in the spaec provided therefore. In casei't a
before" the observation Otthe Tesultwill be'thl4do on tfie"45
14.' If the vacdnation res*g in a reaction sutfi;ks Is
(c), the vaccinator will sign, 4nd diliver 'to the vi,w;
VACCINATION CERT-lFIt_'ATF_ (Fom,-4078
person vaccinated and such othef data aa.a're'in4jxated *51_
Smallpox Yaociiiation Record (Form 8996) 01 be
WL
ranged alphabetically, in Lbeofficesof di5#wt,0 J
permanent records.' If the, vaq%
1; (d), the individual will
successful
results un, uliyi no further
cotnpl'eted by,-Proper eltries idha f4v,&WQ
15. It is oi distinct adwImtagtOlw- I ebAth,
_4 _', tf -
that untneqessary revaecinatiblibe and it is, to
reasonable effoitg,'be tirade y 44 ibr to secure tvi,
dates, or if this is imp6mgi at:'ApproXVdy, the
include the maintenan of, a'al list of
r*ord card',c e ual"ft&, Vurpose) Ad a da
whether or not t e port-Ing as irri6qui




A





iiif
osV,&n f wl nome y1e ae a
eratona prspbe naagah13aoe
re a faitean 144arvciai4'ilbe
OY AC
FR 3rIAIN
-:oi ed riacN.5 prvdj ur 6
A
W ohsntbense:C!lyvciae
ymim, "h o- a natc f9alpx(Wh atsalb
hkleci#Hat fie)salsumtt acnto otests
thtooe nhsopnotepro o i'u o


1ll wilW c ae nsibadb h.Qa Cne
u a e fie
vv fgcesu aciainwti pro f iey rsalni
-4 t~rfltimtbet h elhDprtek,6 yadg la fasa
-.hc iscniee yte e hDpatett niaeimnt

ml41
ouk oi taimp ftePnm alod .rpna pf s:rci
10lgNwYrwl acnt ac asne nwoe aeacnat
'ghe~p andig, lid th proisins o Paagrah 1. Thse urgens i ll
Ol pxVmato C tfct Fr'98 oesoitoeo h
4w*4 bd aael () ban cadi dto ilctoeezn
W iwfHai0:cr mlpxVciain eod(fu81,)



r 9,
BABAi~rs .Z, etme 6 $2.
6 Orsoh br csso salpxi aina drn h at
retrcton agans th ot'f






Dontlo rni psee oLhA'
evdeceofd uoewu~vo 1 io wmi l-
beoe n "tre A
Do 4 lo eme fiemwt oa
-o sgesfu vciato jspro t h
onbordbeor oiga~oe. I
U
Bmb A]EGHS .
To AL CO~t'ERNEZ "4
1.Rfrnei aet h irIlro etme 4 ,rUrn
natin wihin30 dys f evry analandRailoadIMP1y--
2.Pyollsswl b etoLntena;ftr ohaso
sios orus i cnnctonwih nsrig copfaae, 4 a
-, l 1
Thes art etre vrt odsuevsl9ofrmn h .
naincrifcts(or 98o ohrfr o acaio-"fcIebutg
ee proa fa elhDprmqtpyict)pesne y ~e IA
uprvsona idira ethirvccntin ttu n h 41
plye hoenmsd o jperonti ls hul eade h'e
acintin tausshw
3."s tte.inte icua o etebr 5hep~ytIw6'+'
saifatr evdne4fascesu aeilainwti h ps iv
vacnhd ntecs ftoewopeetsalo acntp
-srie inprgah2aoe|h oea rgl uevsrsol hc
on th ar>.ls.lu:4 aigetr hro looftedtno h
nai n criiae w sis e f h r p o e 'sa sn r m A s ixl,
reue t eV~cntd,. sae et otatefc soJ b ae
nae h iiil o h dprio o oeansolt p~ronec mk










5, jj itaJ9.and dispensaries 'were available
f''1 tit Zone resifents. Immediate and whole-'
.xf)xep-alyin responding to -the vaccination
c ktigeyond, most sanguine, expectations. All
W'Aupea~with appfied~nts for Vaccination. Within
ly'approxiptately 50 per cent of the entire popu-
abeiida. After the initial. rush, vaccination units,
A-6 ,-ne or mrpte vbtccmnators, onie or. more assistants,.
of the Panamrianian police force, covered the cities:

daod June 18,',1929, to October '31, 1.929., a total of
tions -ere dofie in Ah Zone aad in the. terminal cities.
AS&that the- residts accomplished in this capig p
earty 100 per cent as in any general vaccination program
q~anyherein the same period of time'e.
me, time the health department of the Republic of Panama a
,XenetaI,va-ccination campaign throughout the Republic.
"Uatts were sent to all sections of the country, and large
gepe were, vaccinated. There, is no doubt that the popu-
z~Puic of Pa 'nama is at thle resent time more thorough Ily.
Aginst smallpkx than at any time during its history'.
Se-1$09P -0 capillary tube%. of. vaccine ordered for health
1husel 4,550 of which were sold- to*-outside agencies. The.
Vpp u sed,4c*eu by* the health department amou nted to,46.,273.50.
4d06ount 'expended by thQ Health Department o~f The Panama
%evacMination prqgcam in the terminal cities and the Canal
-idto $8,676.3 1, distributed as follows:
--t --- --- --- --- --- --- --- --------- --- --- --- --- --- $ 1,9 0 2 A8
---------- ------m--- ------ 6'2 73.50
-------- -------- ...... 500A0

-- --------....... --- ------ --- $8,676 .3 1
ettojnote that the total expenditure for vaccinations,
*uAie of regular health department person.Vel, oh6
"k' additib to their re lar duties, was at the rateo
c ~ ~ f tse.aciatd Of*
".ir t obs~rvations Aftade during the accidatio

C interitig point, was, -the extraordinarilywoe
tio~diki sone to this vaccination program, on




4r
Y*
A 4
4L
WANU


fii iebrqM ov,
(d),te'aqwa dmo~trudthjf'i
vaciaton,a ig ter s sh ota-
fu ...................... ae,6L4
Itwsfeosayt|osrv ~ca
an Wwsacmlsidb snt*s6~
J.m
iiuUWoni sdsie of
Pir11c PO.
iniertie o- av te rm ofWlin~da L
-tanousy fo th aplicaionof he vmne'a'
vrst cofteskproswtotrMVnIg
the exrsinbl, ftett
Th xclen duloNane ee triuedt
Art h aoal n xlntr e p
waosd-h ouaint h ee~t o feia tLL'"
loalppes arid evrl ituv4 f Oos q
smalpo i Gogast~l~tl.
Sion: Te vacin wt~ ofexcllen 4ulityandJ~!
at H, a,,iiii HiiiiiH loep rtr r m te i e t a hp e lo
laoaoisi h nieSttsuttafiniw'
Whe tae u frfieain o itiuin t





7



ewemvc t4,e conO- fusion
Of rml rallbo
04 as W,

thi,, 649e of it',*ild 8Wlpox-
IIUWOty #Ot Arery ill,
s, Ore r if 86; only
i, il**ey low, and in, this seriles
"akomAlc41ng l6bar pneUMOM
"in-higleonvalesten't pierio(
8 ciortaift ehraeteristic le',ions which
th4n, is ui-uallyqbserved in smallpox,
-4t
Optr,41, *pox ma'rks remain but pigmen t loss,
'14-rllv4tying ds of iitse, which usually return

*n aga- Pt, tfie'dise"e but the immunii
AIOeribd of three Weeks afer a su(cessful
necessary before an 'great degree of immun'ity
patlent with'smallpox wete act-
a s wing -yac ation results, in all stages;
d" having-b'een successfully vacci
o, ree 6ks, bilt th e were very few who
a 'ft -Ving be,6 successfully vac inated one
r hA CA to
eossful vaceinat-iods of three br more,
rv!6t'gn*ttdck but seem'ingly dtd lesseti lits,,

iv-45, shown to b&gfeatest in the age group from
4 e to, 'cases Under A year ofage and 3 cases


01R' CITY oF PANAmA

"*'-Suroeba, 'tjL S. R-A.' 'S Health lbfficer'.

1j, ZObuildin pi!rn As issued as,

11-9
tt ...... --*
---------------

------------------
TIOP_ ftirl,`ap.d, hi,8taAatjoj;sI'-WOPe,
It o' re4 ired, Pat-proofirig, :w;,#
A





6Wd,* irtY M, '
IG A cityof i
Lxazn 14t ,oo*
an l tjmasw i ot
fon obkecorsW-er
Vabg ipsL Th,'rbkh,
,Bto, otA adr idQat
INod[up nteCli a f"O
of gkraewr olce adbre t 0pr
pe o 3 ui'yr
Veenr wok -tte m nciaaaii n
1452 ctl ee4 -,L M
xig tre~oo wiaJ wre p I
fi, fomod'nAcon fte
an initain,1;mchetbc
101
ixa~in ; agrnu ondM
unknwn cuse,2; nd prexi; 1
Of1,7 ossagtrda h tiiaA
codme asuftfrfo o c-utpte
Exasin. 42" yt),-oi',68 co 3
grfeIspieha,-;emyoe n
Inpcinmeemd f1,5 atead5,
thdaii oteAlnicsd.Criia* ee

Aix
saiayrlsan euain.




i 'v
i4ii_.itvc'i apointey4,0 ,w eiv
swmqiyinwtoog rtce
Clni.Ti lnci'oeae a.toe
t,pyI eia teiin Tewr
orm ldi
se ev ea;nsadtra ae etl
'r aisad, hlie
_,etr lhcf .e ,er
e' ae o ei olwn sdMa r-r a
A h er 99
6I I rV------ -------- ------------------- 332
-------------I I---- ---- ----
-- -- -- .
I I o t-- ---7 ------ --- ---- ----------- 5
-- "' U fo a is ---------- ------- ,1
dit'fieisdrc-rothclnc
i h, nat otliyrtepr ,0' i -e :its
OfI 'oi.'frth a 8yerhaebeasflo .
------ 4 9 6 -- __ -------------- I
--- ------------ ------------------ 0
-- -- -- -- -- 1 4 1 2 --- -- -- -- -
------ 1 7 1 -- --- ----- --------






-q
M-7 4,
?
4k

s-i -





CUW JR V
T

9POSal, Pe ba
-A&
Cast of diS66s*A, I; Per ------
4
A104nt Yope ceoteery.7--Th=-e, wer-O 4115* V141
aed, to $i,'72. Sal`* of 00*10vs *6
and miscellaneous reompvq fpr ve 11
were $165.35.
t;_mb et
Colin v,&iMir.-Arite and pos' "rt
-4,716 cattle. Foijr carcasses were, condonned I
on 'because .,P, ic'.
&ndid' at tim,6 of shtughter4 I 'because, epta,
because ot extensive bruises. Twelve q o
account of bruises'and septic wounds, 329'liye
infestation, and, 8,335 polands, of raeat, because a br 11
condition.
There were 7,705 hogfr inspected,;'56, were cc)
fo4 on account of the following ''coliditiol4q**
cholera, 23; emaciation, 10; pjrnift', 25; hq ,sii
1,; licterus 1; p'leuritis", I dying condition, 1.
Mount Hope (Panama Can4 abatWr-Aii **kd
inspections were made on 8,169 cattlel'36 'It
O"Wr 4
Ot the follow-Ing cond,tions: Hem' orrha C 56p C
.1fition, 0; emaciation, *10; 4ptinomyco
pyemia, t; septic wounds, 4; tuberculosisA. N
'WO 'carcasse*s were found, s4ktly'iAfec Vi
cosis,.but were passed for food afftr rp 4 iti
peribd of 30 days. TwOnty-three quarti
6f bruises and septic'wounds, Whe*ajs on 4ce*11t A",
t ,
and 412 liyers dh account 4 pafa4tic-infeAa-09*.
Dairies.--Fourteen dairies located Onthe 'AtIl"
Zone a`nd the Republic of Partana prod6*_A", i
'7
of milk annually. AA' this rtilk, is
modern plants, Zof which aretloca"'W in
How in the Canal Zone. One of the, P,4st A
dur Ing the yeF with n,w milk-hand n"ina4_ 'i






14






lA

-wtw-aliewihghslnns
'44,44tz e ubati otln a hiewr
plmi t'on oe elcn l
`l a ie s mal mligpis
ni'atuzdml r eevddiyfo

1i sod'nC'o.beclnts a
6PAI d e ,n
'ctl; cfde'aepo o adwr
nh npcin fdiis ikpatbtl
"pmi"ai"edrmres etuatsf rn
Ak,'n goey,,soe Weemd, eualy net
" ,16 |6* ,utns fultadsn rcniin
- bUi ofpcaeo etdiypoutadohr
mae aswl sfeun npetoo h lcsi
Ver nnfcuehnld trd n od
wee'am sflo s:B kr,23'ar,5-m
01o tu- 0 c ra ln n elr 4;'akt
16-mkdae,38
, odpmut od mnd ad etoe sun
nwioionwr s olw-





'bidig V1
passnger; ths bildin, 4i
todafs4per;qn IT obe
f o r h e s e t s e e r g e p a s e I = 1 '
4 ,
Fou meia fiesa dooLa "
of t h b a r i n s a t O 31 t g e h e W Ii tE,
pesne toprfr hent
Thnl chnei otqiiie dV
w a t e i n t i t o n o f u r a t i ~ n ~ o o l
The ai-rnpr ie av o'i~u~rtd
Zoe h is r riigarlaewsio me
Duigtescedn- ots b'evm a
an a oa f26pae a ie uFwiej
of heyer.Atprset a trie--wekehduei
bqh orh ndSot&
Rotie n~eqon o ariin vsslswa m a
r
th grae f n~uaatnal'is~einot
ulr tentinwa gvn ovesesarivn,-
Itisfet htofal uaantnb
..Port e dse~ ii

plgu inoteCnlZn sth raetpbnil
voskocag a aaJ7v~otsae dure w
frj he es i ob poelyrtgare lL
bulig ~uatoso: h ara oe n ofPtml
that sruct 0
reure eer ue euitt af J'i imtit










''Ie been brought to Panama Ci*ty
Tbere was a total Of 399 cases
ic-" 330*,froni Panama City, 24 from Colon
-IPA6amk*aiid 5cds." from Ae Canal Zone..
ti at alboa was utilized for the detention of
fit pdtiWt8 after their discharge from G(:wgas
-wer*,-1,11- Tbig grou
treated. p. was Garedfb aiad
tot`8,j-,,O-f 1,,70, detention days.
yesels wa INer ormed promptly and efficie 1:and
6dit-Od-as mich aspo*ssible.' The4egular hours for'board'
CanatZone ports are extremely. liberal, extending from
bp. m. January Z to June 13, boarding hours were.:.#
whole of the 24 ho-tirg of edch day. This was
'61144co-unt of the petiodir overha!'bf: the locks at the Pacific
s of: locks to used at a:
fhe Canal,'which allowed but one et
41
all, fimi atioti of vessels during: the year was done with
se is fumigant has continued to prove very
has, esulted in the savii)g of both time and expense
'c6rhmerce and The Panama Canal.
toti'df Quv'antine continues to'supervise the fumigation
pdsti&'hnporteO'I from regioas of :South America where'
"outhdisease of caftle prevails. unring the year, 153 boX-
-Qf- su4h, igated with formo in.
aniiQ foods were fum
Of -& ,division "are also the immigration offic0s'for the,:,
'CA-441. Thed' sion'cqoperates with ihe Immigration service
Wic ef Panam, a in the enfqrcement oftheir immigrption
n iduty. Since
officers perform this addition, al
Ar,& the arincipat ports of entry for the Republic..
"Pta iealIV jniv L iduals destincd for Panama enter'at
P6rt!6" Al per8onswhojn the opinion of the quarantine
cessar ciedentials are allowed to enter Panama
ixr -lity 'hose who, have-not coniplied ith.allthe.
tlg Panamaulan imFIigration laws are detained ..Aempo-
Panamanian authorities for final disposition'.
14114011'ty,,which the'division perfotins is becoming
Ftime.-i,--oftsitiiaing in viewof the increasing nuniber of
44 ne Id the Republic of
*k'fo Ae Canal Z6 an
'Iq 'th" 1 O4 persons were'detained at the Balboa
v thei*imigratiou laws for a total of 9,599
4, 1


I



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












41-1




t74
in 44
44-
Wand pmmed, T i
'Y rV
on cor4ficateo of wA
01 -


W
inWedtl =d wwd-,
get sed W radio
Qft e Or tifiC-at, n, iera.
1 I 1 11 '' f X

Vesstls detained in quarantine.
PPIMerdary inspewoa Ofve-V04. ......
. . .. ... .


'Crew detained ia quar3ntine on bwdsW
Persons ad'm'itted t o statiob Account iA immigration JaW3.
Niftber of detention day3 fbr rrkoath....
Porooias beld or detaiqed for investigtion and riAeaspd. ......
Perons deported under immigration law&...., I .............


Ntiww imed:
Cabin pakjerlgel't-
8teragt paasenors (i naluding sjAij:'
Gold ewplobes. ........ .........

TOW .............. fit
ToUO cost of rat' ......
Aver3ge daily e

GORGA -40VI-TAL.,-, ,
(Capac'ity' 8M, pabefft-,)''
COI.'GF-0. M. EYWtRZF-L- M-OdiOal "Cof PS, tJ, S. AtUj,*#, J- i

Admi'wistration.-Mr m any years theh a, W"44 ilit
combined with the dispensary serwing he djstsjct,,;A
Of the distance of the dis4jeasdry from _t,e
with'continued, ijcrease -of h64tal popglatioplt'
bring the ad itting office closer to th,
effecqd in the month of.-Nov'embet,by Mdi
office and emergency station onthe ground floor
-clinics buildings. At the same i
district physician, was made an in'4"'Ve"
toAe*Chief Health Officer.
1,4
M




A

I JA441'
W

U'
.4 14
4
00,- 1 hei remodelitig of ward 4,, qection "'A
Al"private rooms was completed in ApriL Ea6h
a Merent color skheW'and'the rooms tore
hospital 'beds and furniture. The total' cost
vfteats, was approximately $30,000.
4 11 aarsing sta5i' necessitated by increase of hospital
adOitionali housing facilities for nUrses. to
he work of construction of an addition to the
teks:Lt An estimatd :ost of'about $90,000. This addijion,
tdand occupied in 1930, will contain 28bedrooms,
card, room, a rece0tion room, 'and a.' small kitchen, aTAI
ily a total of 00,female' #
,,the'hopjtal to quarter satisfa6to; 1

c',conditions alone requive considerable Owork to prevent
ok-buildings and equipment. Te routine. work of
c6l. .,a&d repair thereof, including- repainting of rooms and
ee'-,throughout the hospital, and the Fepair of all elevators, was
IT the hospital artisans. Jif addition a large amount, of new
a zomp eted and many articles of furnitu. equipmT
d forlthe hospital and other units of the Health Depart
x4l
'serViee-There'were'2,0 t 9 majot-operations (with 26 deaths),
ioiqoropOrations (with I death), and 4,258 intravenous injections
Ar hoamin (with "I death); 7,626 cases visited tfie. out-patient
'44 obAetrical cases were delivered, in whi' h there vvere
IObiiths and 30 stillbirihs. Medical service,,-There were 8 849
'in the out-patient department, of whom t,610 were not
14% with The Panama Canal or the Pan Ama Railroad, or other
-There were
0- setvices. DeAtal seA)ice. 3,759 sittings
Th, 1252 -oral examieations!- 829 teetlP extracted; 498
494141554 partiaYdental X-ray examinations weremade during
P:we4r, nose, and, throat service.-There were 14,643 visits
06h department,, 2 j485 operations performed, -and 1*, 395 -
01, i*,de., Radsograohic service.-There- were 5,479 cases
gus sizes were
"VbAAA!889 films of van spd and'in whict
tc --eXanunationa were, made. Physio-therdpy serv*fce.-
and 19,hlf.v-oncout-pat-ientsand'9,31in-patientsrecived
JOAbji alinle during the year. Nonresients-Sixhundred
`T$I ces were -outside of the Canal *Zone
whose r
I
_4pla, an& Coton', were treated in Gorgas Ho'spital

A




















Amputations:

Forearm. ....... .. ... ....... ...g

Leg .... .. ...- ..... .. x ....... ..
F o .. .... ... ..... .... -r. e'. -k... .
Digte oajiif... ,........... .. ......... I P.
Operations on IFnaw:
Osico y ., ......... .. .... .. .
'W9iring, dimplefraetufte.................. .....
Plaing~implfra ...., ........... .......
Ploking, ompoundfrsti*....-. .. ... ... ...
SReduction of frpeture, imple.., ..... .. .
Reducton of frcture, 4mrpound.. .......... ........
W Boregraft ..... .

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

In i single .. .... .. ..
I g i double .. ... ..
Femtoral. .......... . .
Strangufited...... ... .... ....I ....
Hlerniotomy.
IngURina, single ........... ......
Inginmal, doule ..... ...
... ... ..... .. .... .... ..... .... .... .. .
Ventral. .. .. .. .. ... .... ..... ... .. .
.....lte .. ... .. k 6 .. .. ........ ... .
Nephrotomy. ... ...... ... .. .. ... .
...... ....... ... .. .. ........ .......... .
S N el opezy.. .. .... ......................
Cystotomy .... ..... ..... ... ...
Urethrotomy, internal. .. ...........I. ..........
Urethrotomy, external.. .... ... .... ..... .. ... ..
Prostatectomy* ...... ............ .. .
Varicocele, radical cure ........ ...... A.'. .. .
flydrocele, ingle radical cure. ....... .. ... ................... .
Orcidetoy................ .....
........y.. .............. .
Amputtion of scrotum.... ... ....... ...........
..es ge t r ... .. .. ........... ... .
Trachel......................
Vagm lp Mun ue .......... ........ ...
R wymotomy. .. .... ... ... .....
Obstetrical:4
Oesareamse&*ion.admn AS........ ....
Bigh forcepe ........ ... ... .. ... ..
Low forcep. .........
Version ..... ... ..
Thfrti:
Thoracotomy.. ....... .. .. .
Excision of breast .............
Excision .f breast an z ill .... .... ..... ....
Rectum: -
Hemorrhoids radical cure for ....sm
Fistula in ano, eeidaionof .... ..... ...... ......
General:
ThyroildeconW ... ......
S Stabwound qdNof v*t i0p~a'rts loprati for ... .. .... .... .... ..
Congenital defect, plastic operation for ...... .... .......
Effects of disease, plantic operation for .. ..... ....... ......
..ng af ....... ....... i ...... ..... .
Valicose veins, exciosion f ... .. .. ...
Laparotomy:
For general peritonitis. .. ...... M ... ..- .. ... ......
For intestinal obstruefion. ...... ............ .......
E lo atory. ........ .. .. ... .. .
................... ...........
Gustroenterostomy .... ......... ... .
Grastrectomy ..... .. ... ..... .. ....
Gastrectomy (atxbtotal). .....i........
R tero-enterostomy ...... .... .... ....
If tere tomy ..... ....... ........... .
........ ........ .... .
WAE














21
42
ira1
3


......991
..... .....33 1
m1
.............. .. .
..96.......... ....
3

i11
... ... .... 19 .. .. .
..................39 .. ... .....
4,5 1.
.. .. .. .. .. .. .. ..11 26
.. ... .. .. 1 ,911 1
.. .. .. ... .. 4 ,258 1



X 6AE RHOAT14ERVIk- REORTF OPERATIONS.

)?G rmoal of .......... ......... .1
ape.......
........ Slum, etheoid, simpe ... .. 7
.n o... .
183 iumxilr,5ml
.... i 1,Inxtay uZ r a'I''nag' 7
.... iiS~kDiUP6

.. .. .. 5 eu tino rooo. .. .. ... .
Spw rmfvl








T u b n e t n l ............ .......
Minornos-bpersio .





%





21 A
lmm40
PH&OTAto []R UQ
9'"Ww
45I
ouptet.. ii
-it f ramet..
0%siato ofWA
Mainn ...3
Roenten thrapy
Hoelw p~tieto ....... '-13 P,*tu[w
Outr~ ietg ......... .... 32
Numbr ofresmtnt.. .... 1,84 ot[o
.. .. ..7
l 5
Pbmohtay

- fo1 wptinq ... 9 mne
Oupde ......43
Nub[o retet.
S k i . .I4e d
!e.ooial... 4
.. 60
Tubeculois ........ ..... 2







.. 14,6...3,117.0 ..
.. .. 2 6 3
.. .... 1, 3
.. 9
r 71 .5
CIOA-HOPTL
(C 'ciy,1 paint)
-N
T elTPFLMdia opU rySprne~et
-Ths nsittin ar'sfo te nsneofth Cna Zn
eIbi f aaa en embre,~ h at- ls
I I 6 Reulca h ie aeof$.5prdJ.I lo
alien npo softeCnlZnedsbe y esno n
"yic diesswodsr!oene h nttto.
P" n I an%-- wd oceeapoahfrtul.t
iatoma icea ela ieak edn oti
laid CoceesdwlsbtWenwr_H n I
',,ad afse"lreeog ohos 0o 0cle
o
ctdi ls rxmt o h ar anb optl_
Ah oftfnwludybidn n olrhue n o
'Cnacigiicen wt ad#bilig,-wr -pitd a
T..0 se s'fV u tio ae ee ntle t rn n
s to hs xen
pia grud.As arofodF aer
"sl er g rv'~gsHoptl a e patrsm
A"--inrac. wr K. h opta.ra a
in*dyte ui pal Enicrn:'iin otn










Chronically ill or crippled,
blA:k and 3 white 6f these dasses' Ai
.teen were admitted, $3Vied, .2dihiesan
wag Ytansferred to insane status.Sgtl %
Aospital- for -treatm-eit, and o liilWt
HoMspital, 3,dieid while in Ggore Hospitl ng3
ment at CGorgas Hospital at-the enid 4b tho~ea
performing work were enNqurgew to do, mo Sitep
the payrolls, employed as brootn andi brushx yaker,61
ward& attendants, janitor, laborers, and helpers;
brooms- per week wer iiufcurd
Recratin.-,eekl y picture shows and bd.oet
continued;"and the-patients derive considermble pea
entertainments.,c Picuics .were held twice month, df
season in a grove. back of the hospital, and during the r
the basement of the new ward building; luntche*. are sMv
ball,;*handball., and other games are played on thersemocslons,A
sevies were .held weekly for the Cathotic and Protsat
Th e former are held in tht, chapel near enitranme to hosp ia
the latter Are conducted in the basement of the new ward biiid
Treatment.-Intensive specific ,treatment was, give
suffering fromn syphilitic psychoses.' Eight huna.e
doses of arsphenamnin were administered intraa~e ld
lumbar punctures were made. At the'end of the, year, t apre,
patients suffering from neuro-syphilis or tertdary syphi)W
form, M1 of these weremale 'and 36 female,-
O0ccupational therapy,--n December 41,, 1929, 41ia
Sand 30 female patients ,under treatment in the occ
department. The men "were taught jar-pentryl ev
rush-work, etc.; the women were taught .to makers a
sew, knit, *embroider., crgchet, and do rush-wor*. ls
duced and sold weft 142 rugs, 98 1bpgs, III ornamotat
A6ard-table covers, doifies and other embroidered piecs, 57
320 Pieces of furniture,. 14 *6oat in bottles, 42 knitted,
pieces of ruqsh-work;, 30 pieces of furniture were polite'
In -addition- to the parties engaged in, vgrios of
occupational wrard, other male insane who verej~ c
but could. not be: accommodated hi the occupatitonal.
of limited space,'-Were sdnt to the fie'ls ftnJ es~ig
activities. The value of the, -nmcheefromm.th
hopia cnumtinamute t $1W7,






















xed; '1 was dVorted, and 1 discharged. These- men
in the garden, dairy, .piggery: steam plant, cemetery,
ite.$ing plotg of landin the farm reservation, which they
telk garden.and are paid orq an actual-production basis.
:; liper tonth amptted to $45.57. Subsistence ,
e tien ree of- charge. The receipts for produce sold
Ift441, and for manure $635.85.. '
i-iW.. Lwswere purchased.in Lopisiana and added to the
-ir b-lls w bought from Mindi Dairy. During the
i4it 'nd beqa mi k producers. Two bows died, and
At. theend of the year the herd consisted of 89
Site i;3talves,' andA 4 bulls. There-were 158,0581
S jrted :and 'ilk sales- duriiig the year amounted

4 6*l 1- hoi-iand 3 boars on hand December 31, 1929.
a" e :bagatn been restored as a source of revenue,
~I: year I.ouitin g to .$2,167.31, gross, revenue

iarease in imAb ei of tieits treated and the:
h w~ti erefithe umberof gold employees
ai: fttzn of 1i additional -male nurse,. I
...... .: ..... .:... .; :
S tdng to replace some of the obsolete
ig il fruthi id, and that actual work
`1d w i be tated about Novetul ai
td*.~~.i villassist. greatly inrelief f ...,
i: M s-i P. jpate^'a i ov Ng. R.





AN, .. .:
E ..E: :E" : > ".: :.:V" ::: : .[g3 .!! ...:.: ;'r ..,. :. : !" ": :" E ." .
























CO
(Capacity, IOG pg W s);'
U'aj'. HE P. MARRL Medk' &j U,,
#,,,olon Hospiulaltho h.ppeMted'ta
h6s ital aslx I* fwwtio ed dunng the%
kpspital, giviAg defini-6v-,-, treatmeot,-A 'o#'*",ew
ve*real'and infoctious-dis4psies'.
During'tfic past year thebedoapga, 4"
5 rJi, s and 12 detts This"j,
A ing numerous al tkr4u.' oxj'r" oo
Bij7iJd in K, of new torek?' Oin iA, UR
offers enought spacekw qII_-sqOp4Ivji
lation rooms, one of I e&aqd W 4*44,
of 2-small former iwrerooiOs,, .4)
1aa concrete room ia tear ofh t4l't'L
Removal of dining toot wq lxwtkwp
"4r used ascomniissa'ry' nd EtWi';O,d
capacity pf ward E by, 16 beds,',(,'
ouuused porch sp.-im ng,
more spacifffls diet, Wtdeu.
Oildren's section inward P9
a-, 6-bed'ward established& (g), IF
giving more space for the-,q
for colored new
reartIA -d tt ofter
ge bett faq!U'























































































































..::i


:..: .::. .. .. :: :..
.. ...::: :/ .: : ...i; : ...





dolivred~y-,Cesl
pornewt ekbletdit
Bye eame n hw mik
duhi helatr .-tofOc-4m T
vioucodtos1,4 mi- ramt ad
X-a.'-h fcltelf-tmoig
bengUtasmllprtbl ui aaidkfo- h,I!*
1,11 flmsforfratur ap Ij,, ,~et deitaqu
.teya.*
Eaoaky-h lartr ftIshsi u a.
labraoy th oe|g~ s~ijzdw
of HelhIbrtr prte t4im-eVfk
Miai fVt lew*ii'
toae 2,7 x
= ptrs 4os ti otetadohrr~tn-
PAL SVC EE OOY
`)I, zA Uvhz Sperjtedpt,

Ox ecmerS 12, hrewre97.pt
we nl oe hriycae, n 7 anm
re ea P
27wmeind7iinClsifeiccrin o ai
ii omi ReulcoiPnm .Cirqi2iice5 oon Ls* t











SPresented definite psychopathic syptoms for several
st~nuently "et to Ihe Corozal, Hospital for the insane,
I drecly o tei- homes., ComplIete follow up evc
is tct osible, but..they were.-direted to report twic
tihe board, of, health laboratory at Ancon for examination.
PA'ilrM*' CONDITIONALLY DIS CHARGED DITRING 1029.
Length of period of
,-Age. ngth of time under noninfecti-vity before
treatment. discharge.
...... 13 years, 4 m thas 2 years. 3 months, 21 days. 2 years.
1D yekst, 6 montbb5. 6 years, 1 months 12 days. 3 years, 9 months.
41-eas,6 years, 5 months, 23.days. 3 years, 2 months.
,-,5S Yeas 8 years,. 2 months, 9 1ayu. 4 years.
14 years. *8 years, 2 months, 19 days. 1 year, 7 months.
.4 eas 9 years, months, 2,days. 3 years, 10 months
.39kyears. 9 years, 10 months, 20 days. 3 years, 5 months.
~ ~ ~ ~ Y3 yer.1 er,6m hs, 16 days. I year, 4 months.
I ..... 20 yearsA 12 Xears, Ikumouths, I day. 7 years.

experimentall work was. done: @at the institution during the
hode treatment consisted of intramuscular injection of the
-eO ,erg of -hau~lmoogric cisin dqses of 3 to 6 cc. given twice a
di dof' ail surica dressings of leprous ulcers pca
pfgic 'rvc for 3 cases was secured from Gorgas Hospital.
re dm t'h'e nasal mtacosa and fromn skin lesions of, all 'patients
I~ad or ci-fat acilieach month, and in 'those' patients,
Jii~ apparently bbcome noninfective this examination was made

otwas made to improve the hygienic. and dietetic standards:
ladby with- noticeable resultst, in..spite of set habits and tastes
;alhogha geaernumber of, patint were permitted
rtnsand prepare, their o'wn food.
chstrueltioni of the old kitcheax-messz hall has given the colony
utit recreation hall. The 2 pool tlesaeIn lotcn
OigAe'day, motion pictures are shown~ 3 times a week at
10 tio e patients attend, and there was dancing with refresh-
thoe fiestas. Religious services were held regularly
40l; n T uesdays they- were conducted, by the Rt. Rev.,
44 of 'the, Prcotestant Episcopal Church, and .onx.
Y ,:he Rev: Father A. E. Gay, of ..the Roman Catholic

tietetts were- employed about the colony, An were. paid
_e to a: value ol $1,146.71 was bought from 31
,Tbi pkkctice of Mikthholdi~ng allotment from' those
W _f 4 '0lars the' previous moqth bas taken the
Wat of itis deficit, and, as the practice per its, a mnore-







iqt l r~ pk*''l
!' api u fteaft~


gg A
B a ci l u s ty ~ h s u s R e c v e r & 'i h b l
and romstol spcj~ensof 1 oters Oftb~,1|
Paa a 5fo oo,4dretfo i4ad ,,
In ad iin aayiomB w sr ,4
1 1
pain nCrzlHsiafrteism.
Tyhii;rir. uDcrfe 1 9tee,
caresude aiaytuelac, .B''u
CiyI.B ~nie oiiv ha fottf-y~

wett h neifo etteciuiy w ti-
IZ n Rbt fPaaaCtweedtce
Thywllh -ajie fi ie otrq_ Tei ls
tyh osu care neIaiay uvilne61
1H ,ofPnma iy













6" we yas bittens at 12.30 p. m., and died. at abouJt
prelp ronihing- a town., No antivenin was, gi-gen him.
1,-as held. The snalts wa's killed by the hunater .at the

biftteiifand sent to the laboratory by *the Canal Zone
iectday for identification. It measured 5 feet -and I inch
_tOf weighedd '3 pound i-ts' intestinal tract* was: -empty;
case was repredb Maj. Allen R. Howard, Medical'
SS, Aray. XTe patient, a soldier, was bitten, pn the right
Ax-earing j~un'gle around an observation tower some
6 r1 t Fort Randolph., His hand and arm: became swollen
mere slightly delirious. The wound was opened by the man
mditely after it: was received, and he was given bothropic
-,several hours later. The man, recovered. in. the course of
s. The snake was killed but not recovered-. The patient.
t 6 feels sure it was a &shmaster' (Lachesis mulis), but hi's
e aons totratmnt ithbohropic. antivenin suggests the

rdf its having been ajferde-lance.

liApproximately 52,127: reports, not including duplicated,,
re n ade.

STEI.OLOGICAL PROTOZOAL4 AND MISCELLANEOUS EXAMINATIONS.
.. .... ...................................... 1
B ~t ph n e .. ... ............ ... ............. ........ 7
pla occ sa k s. .. ... .. ... ... ... .. ..* .. ... .................
d r c o c c uea c a l b u em e l t . A
COCO.............
fn` N igoeena ur 'ge ....i........ --.. .. . . .
B~c li( ac erhi p r ru nh i) ............................ .
r B h oengotid s( bethlla poens) ......................... ........... .
(h tr w ate di i eo cu .. .. ............. ... ........... ...........
Puentmorocci (type twdetermiued);,.r... .. ... ................. m......
P nit af pelu.. ....... .. ........ .. ........ .
Ior, tv dfx dcrysetery group .... ........I... ... .. ...... 1,557
0 i 4N ... .. .. ............................,...... 47
B na'*Ufroja carriers t .. .. ............. ...... 19
M rRe e ty h sh .. ............. t.... ....................... I ....... 2
fEd & -d eriqt Group 1l. ....... ............ I ............. .I....... 8
#for a cateraegfou lil.. ...... ..... ........ ......... ..n....8
fo typh ld group .. .. .. .. ... ...... .. .... .. ... 749
f pther thaxityphoid gtouo-........ 464

rt t ... .... .... ... ......... .. ..... ..... ... 4 70
e ro ca rie s. .. ........ .... : ........ .... 40A.

*WUia ..............
other hsnB ~ iph......,..... ..... ...... ... ... ....
. . . . .. ... 1 3



cut ... .... .1
. 1




17






4-
A
7C,
spu &A
or
pod4ve AOUmoMt*" 7*j
It Aoa%Wcww ftpe 111'. 1, i,
s- -,g
..........

PoMiveforrPnsi ......
pleiit4ftuid owtaw ...... ..................


Wtutefromajdahmions .............. ........
............ ......
Culture of pugfrom Vanous 80111wa ... If., ....... I. ......
PosiNeforStaphigocaams aurw, hemaytia. ....... I

PNOQM B. dAW"iae, #1
MiNcultuied for ..........
"Frezo" oulturedforbacterial ownt_._ .... .........
Darkfieldexaminations ........... ......
Positive for Tmponema pallidum- ............
Phritfield examination for yaws.,:. ..........
coojunctivalBmem. .......... ij44 ....... :A_
Positive for Gram nejwioci;li M.'i ....... .......
Throat Hmesr8.. ........ .......
P03itiVe for fusiform bacillus and spkilluviq( VinqnexaWing .......
Urethral smem ..., .......... .......
Positive for Gram naga*t inframllular di ......
......................... .......
Positive for Gram neuative intrarAular diplo6occi_
Sputum for R. f u5mvuloais.. ........ ...... ............. 4... ......
PositiVe for Br. fu&-r-
......................
Spinal fluid for B. lubi7rmlosiz_ ............ ......
Positive for 9, tuberculosis- ............
Urine for B. tuberculosis... _: ........ _-;- ..............
Positive for BtuberculoeiB .... ........................
Cell cauntof spinal flaids ............
Examoation of leper
Positivefor B.leprav_ ................. I ....... ......
Examination of lepers previous to parole .......... ...... ....... .........
,pers, .... ..............
Faamination of paroled 1 .......
Autogenous vaccines prej*.d.. ...... .................
j;;es examined f or pAxasite,8 and ova. .......... ........
Po2itive for Tric"cepWu8 ditpar ova .... ............ _.__ .........
Poeitivefo4Amebahigiolytica, ....... ___ ..........
Urines examined for ova ....... ......................... .......... ......
Differentialcounts .... ...................
Red blood count& ......
........................
White blood counts. ....... I .......
Hemoglobin estimation ........... W- ............
Blood smeal(myelogencps leukemia)-., ...............
Blood films examined for malarial parasiteo. .
PoAtive'for TeFlian mdarialparw4r. .......
PositiveforE.A. malarial
Po3itiveforQuartan mdarialpari&iW. ........ k,
Positive for E.44. and Talian malarial pararileN comb&M
Culture's of bile_ ............. ...
JJulture of contents from gall bladder ......
Cultares of duodeiialfluid ........... ........ .......
Culture otcyst of i aw.. ....... ..............
Culture of ulcer of ......
Smear of pusfromri
Scrapiw, fingernail, Eaicrosco* elimination.. ...............
Pau.1 testfor smallpoikinoodlation ofrabWtffye) .........
Waterfrom Balboa Cl&houjge 8wkwAing pool. .... .. .......
Waterfrom Balboa Army and Navf Y_ M, C. A. pool.
Waterfiom Peclro Miguelswiroming pool-, ......
WaterfromUrtio C1 s*immingpool.-_ .........
Water from Fort =or Owimming pool'.
Waterfram. Corozalswimming pod. ..........
Waterfrom Fort Clayton swimming pool. ....... ........
Water from Hotel Washington owimmin pool ......
0r
,WaterfromPanam InstituteswinimingpooL .......
Watarf rom. Fort Amador. % ....... .......
Wdr from U.846-0,vehmd ...... ......
Wwh water from Fteezing rnwhines.. ......
Waterkom. Health ftpe-Panama

'Ilk

Jr-

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.. ... ... .. .




"I:L .Xl' ..: I i i I I 1 l l i
* ,. ..:,HH.. .. ..... .. ..
i ..: .. .* ..... .. .
-, .. .. ...,.; ...




1:. i ." i '" Oi ..- .. "
a ... .. ...


: .. ..
246 2,440 2,686 9.12 "*
63. 383 446 14.13


309 2,823 8,132 9.87


S 1,065 3,114 .4,179 25.48
6 00 2,518 3,018 16.57
19 285 31021 .29

1,884 5919 7,499 -.21.12

,16 8 2 97 ..15.46


.....
" 9 ^ *. *
..2:.. '. ".: .... 1A 1.

.:- ... .maade on .796 spinal fluids take.



Svidals .positie. .






.... .. ..






r 'l": [[[x x ;; : : ..- K'
i:. 4 .. ;


'( :i i :~/ii :i::" .'i:..::.:: :, :... : ."
p .:,,.,. ,,...', .:,,.,...... .


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.S .


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.. .. .. .
.. ., : .. *:;::*.l:.....













at theo Disease of early infancy,--Continued:
ther on ed:Injury in del'vr ................. I
da ... .. ... 1. Atelectawis of thenewborn.............
pite hiw ..... .. ...... 1 *I
.1... ...... .3 Affleetions produeedby external cau-ses.:
t10 ....... ....... Suicide bybhangin~g. ..... 3
6prostat r-,.... 3 Suicide by firearms ........... .......
Mldil~f oadligament. Snakebite (Fer-de-lance) ............ 1
hoi biatra.... 1 NovarseuobenzolpMisoning....... ....... 2
da .. ..... ...... 114 Asphyxiation by f.3lling eoal...... I
7.. ......1 Accidental drowning ..................... 8
Traum tism by fall it1o ocks.......
Traumuatisma by fall from building ... .. 2
...... Traumatismn by fall from dock. ......
...e.on 1I j r by diving ........ .
tig ......... 1 Tram atism byfall..... .. .. ...
04b ce-1- Accidental crushing b.y lock valve. .... -
aiam....... ..... .2 Traumiatism by bursting cap onrelay barge.1
Traumantism by falling valv casting on
a etinpabd of the cellular tis'se: suctioadradge. .....
ageeraise... .. 1 Traumiatism~byautomobile.... ..... 6
ce 19 1liia1 Aeroplane accident ..................... 3
s ......... Traumatism byfallinglumber .........


Perforation of sigmnoid by fishbone......... I
tolcenitogasoloo-Infectedlaceration of right thumb ........ I
04- ~~Traumatism, of unknolyni causation. .... I
tive "Gfroyelitis, right Il-defined diseaaes:
%- -..1. --. .... *., 1 Malnutrition (overlIyear*f age) ......... I
Undetermined............... 4,
Infection of undetermined origin- ......
lextermilbydrocephahus....... 16
formation of the-triauspid Appedx
... .... 1 tilbrth, accidents of pregnancy ......... 5
gew afirormation.oftheb n ... .. 1 Stillbirth, accidents of labor ............. 3
Stillbirth, syphilitic fetus. ............... I
-bainfAney' Stillbirth, resulting from disease of mother. 5
a ........ ..... a Stillbirth, cause undetermined .....,....... 11
11lit.....10. Stillbirth premature nonviable fetus ...... 2



MORE FREQUENT CAUSES 01 DEATH FOUND AT AUTOPSY IN BOARD OF HEALTH
LABORATORY, 1929..

Per cent,
Qause of death.. Cases. Of
autopsies.



a hoa w d 1 W) ............... a.. m . ..... 40 8.83
gg paresis).......... ...... ............. ........ 37 8.17
-. I .. ...... ..... ....... ......... 23 5 .07
(aute and cbronic nephritis). .... ..... ....... ........ ........ 22 4,85
d e (acute and .... ............... to. 102.20
hages.. ... .* ... ........... ........8 1.76























* -c


*Includes 32 asee of influena. ::

* NUMBER OF AUTOPSIES PERFORMED REVEPADIN Tim FOtLO TK I::wpI
BOARD OF A R B LABORATORY..1 TOA2s,2


Year.*


0 ... .. ...... 9 1 .
1907........................... ..... .
1908 ................... ......... 4 "
190. .......................... 5004
1909 ..... .. ... ... .. ... ..
100 .............................. 6 .....
1910 ..... ...... ................ ... X I ..
1913........ .................... .... 4 ..
1911. I 460 .....
1 92.......................... .. 5 I....
1913...... ... .... .. .. ....... 4 ....
1f14..: ........................... -375 .
1915 .............................. 338 3 .
1916 .............................. 323 .1 .
.1917....... ........... ......... 0
S1918................. .......... .....
1919..... ...... ......... ..... 324 ..
1920........... .. .. ......
...... ................. 1
19221.............................. ..
192 ............... ............. .
1924 ......................... 26
1925............................. ..
192 ........................ .... 3 ,, .,

193 ............................ 1 8 .
199 ............................ .:.
9........8 ..

: To l .............. ............ 85,1 1 ... :


.7. r .1.... ..:.. ..
c All nasesGce 1908 lwfetiug tedaru i



; -i : *... .. .... .:
'";"':''"~ *'iL.














.4-l.ix dred and ten bodies' (not including 13

and' 1 disinterred)' pissed thirough-the laboratory.;-

A'e 6t were autopsied,



.. .. .. .. ... 3

a~sies fudat ,autopsy,. Thirty-seyen cases in 453

,o 'A per cen showed one or more parasites or their ova,


I rcv ft ................1.oow rm .. 2
.A m bs ........... .. . .
.. .... .. .. .. .. 10 nx uris ....... ......... ....... 1
3 Ro3uAd worms and their ova .. .. ... .... I

kie infections occurred as foReows:
anduncnara_ .. ..... .. 4 Trichurio and uncinaria. .. .... .. ... I
.... .. ....... 3 Trichuris, oxyuris and uncinaria ........ ...
I. 1 ifUnindria and strougyloides..... ...... ..... I

l,;$i'Ft IoNl)AT AUTOPSY OF, LEPERS IN BOARD OF HEALTH LABORATORY, 1929,


Causd leth.Contributory cause.

.... Aqute nephritis.
by halling L eprosy.
y s... .... Chronicenephritis.
t*30, bassivesoftening offfie brain,
by ......... ..Chronic glomerulonepihritis. Cardiac hypertrophy and decompensation.


ROCESCOPIC EXAMINATIONS AND REPORTS ON SURGICAL SPECIMENS.
from.p 1 Prostate. .......... .... .. ...... ...... 3
.... .. 3 Penis, specimens from .... ................... 2
. 4 T esticle ..... .. ...... ......... .. 3
....... .... .... 0.. 1 *E pididym is ..... ...*............... .. 2
.......3 U terus ........ ............ ... ... .. .. 5
'Al, .......5 -Uterus, specimen from ........... ... .....
ita re~ g .. .. ..t ... 2 Uterua and tubes ............. .............. 3
to .*5 Uterus and ovary............... ........ .. 3
600o mgpyuad s .. ....... 1 Uterus, tubes and ovaries ............. ... 45
ppt o frns...... I Uterus, tubes andovary ..................... 8
Irm .. Uterus, tube and ovary ......... ... v.. ..... 7
....... ..... 6 Uterus, tubes, oviriesand appendix .......... 55
rm .... ....... I Uterus, tube, ovary and appendix ............
........ 2 Uterus,tuben, ovaries, appendixsandcervix. .
qp ..... 1 Uterus, tubes, ovaries and cervix. ........... 2
Ry) from- ..... 4 Uterus, tube, appendix, and biopsy of cervit..
A. 11 Uterus, tubes, ovaries, fetus and placenta. .. ..
enI Uterus, tubes, ovary and appendix .......... 5
.. .. ... .. 2 Uterus and appendix. ...... ................ 6
2 Uterus, ovary and appendk .................
..... ..... I Uterine curettings.. ............... .. 27
If~k.. .... ... Uterine curettiug and tubpo ............. ..
.... .. 8 Uterine contp ts. ... .......... 22
ro .. .. .. 3 Uterine scraffga and cervix ... .. .. .. ... I
seem .. .. .. .. 1 .r3 .. W
.5 Gervix, specimens from .... 14 +
.21 T ubes....-........ 4:,ti......... .............
I Tubesasudappendix ............ ........ 6
3 v ry .. ................ *....... 8 W
of".~ ... .. .. 2 Ovazies8 ................... .............. I
2 O ar d app i 1.0
Irm T be and Mvaries ................
.... .10 Tube adovary. ............ 4
,44ovp and part of Tube, ovar and appendixx. .. ... .. .. a
I T Iubes. ov ary dappendii... i............ 5
3 N~b, ovary and biopsy cervix .. .. .. ... ....*
a pe d c s ......... A.... I..... n .. -.. 1M
S elvis,specien frmu....en...... .
..3 Vagin,,specimw fo ....... .














Vulva, specimenfo. .... .... ...90 esrm
Smallintegtine portion, resection of, .. 2 Mkin 3nd esutwgeouwiur
S Anualistula. ....... 5 Rib.,specimenestr(m.....,
Retdm and a=4s specimens fr~om.. 18 Bone, tumor from .........
Buttock, sinus from.... ...... .........ry Iosutfr
Perineal oinus, ._. ........ ...... Subroxaillary gad, issue ffyo .
Shoulder, specimens from.... .... ........ 2 Alatmor from.. .
Arm, amputated..... .. .....h.d..eciio o
Arm, specimens from. .. ..........t .
Forearmuspecimens from ............ ........ a e t~altsu..
Elbow, specimenfro .- w.I-~............. I Placentasascand fatus.
Wrist, tumor from tendon sheath... I Fetus aid placental tiaeue- .
. Rand, amputated ........... I Sputum ......
Finger, amputated.... .... ..... 3otiigfoea niso
Finger, specimens from_'... -l..... 3 Autopsyti;8WeromCQlonHuggtl
Thigh, amputation of mid-thid. ......... I es .... ... .
Thigh, tumor of ..... ... I ........ 1 Autopsy vtiwsus (vases esiates
Leg...:......... 5 forwardeA for microscopical
Leg, speimen-8from ..................... 5 nation)... ..
Knee, spedrmeas from..... .............. 2
Foot,amuttOof... Total ..........,i.

Lesions in surgical speci-mens.-The-principal lesions*

in surgical specimens other than inflammatory, were as foljo.

Maignant tumors (cancer): R *Beign tumnorontinued:
Scalp ............................1 Lymphangioma lip._ .
Ey. ... .. ... .. .. .. .. .. .. .. .. .. ... I Mixed cell tumor, salivary glWn
Nose .................................. 1Papilloma, v" caord... ...
TAP ....... I............. I......... .. I eNeurofibroma, neck... .
Tongue .................... ............ 5 Lymphangiomna, neck.
Nasopharynx. ........................... I Riedal's strama (thyroid)...... .
Neck ........................ 1 Axlenomja,thy'roid. ..- ;
Chest wall ............. ...... ........ 2 Adenomaxtouo goiter...
Breast. ...... ........... I...... I........ Fibeoadenoma, breast. .. .*
Pharynx .... .. ........ 2 Eutercanaliular adenofibrm b'9 res
Esophagus .................. 2 Lymphangioma back.
Omentum................... I............ I 'Adenoma, prostate,...
Stomach ............. ... ................. 2 Myomata. uterus. .
Abdominal wall. ................., 2 Polyp. Uterus..
Liver ..............L....................... 1 In..e.........
Bladder ........ *..................... I ... I ~ Teratoma, ovary .....
Prostate ................................... I Cyst,o ry .
Testis.. ................................... I Dernpid cyst, ovary, .. -
Uterus.................. .................. I 'Neurofibroma, wrist .. .. ....
Vagina ................. .............. Cavernous hemangiomla, mtid~lnger U
Ovary......... I............... ............ 1I forearm .... .
Chorion ................................ I Pigmented mole, thigh, .
Oervix .................................... 12: Hemangioma hypertrophictun,
Rectum .. ............................. 2 Neurolibroma, ankle .........
Anus ........................... ........ I Giant cell tumor of tendon iheta'0
Buttock . .......... Ia on uoe fo .
Forearm ................................... I Oateochondrorna, rib...
Thigh .......... ............ -............. 1 cyste,teratomatous. ..
Leg ....................................... 1Iy t~ piieil
Skin ................. I.................... 6 C)yet, Coccygea .. .. .. k
Bone... . .......... I Papilloma. 7.
Parotid gland.. 1............ Fibroma,iakin_. .. ......
*Cervical gland ............... I Lipoma. ........ ....
Cervical polyp .... ............... :......... I1
Axillary glands ............................ 2 Towal.... .
Bubmaxillary gland ......................... I 1
Lymph lans ...... ....... t ............... .3 Specimens showing tnbereolsu
,Peptic ulcer.. ..... ............ *......... 1 Tonsils .....
Hofdgkn'sdisease........... .... 1 Sinus (Chest)............. ..
Sputum ........ I.................. .. I Epididymis, ._ .... .7
Fallopian tubes and peritoneum.
Towa .............., .............. 75 Anus... .
Intestine and mese l;eric ode
Benign tumors: ULyph Wds ........
Nevus pilaris, forehead..., .......... I
4. Neurofibroma, eyelid ................... I Toth]l................. ..
Angiomn, eyelid ........................ I
SPapillomnaconjunctiva ........ f......... I Mieecelaneous human examination
Papillomna, sclera .............:........ 1 Blood smers ...
Gliomna, retina. ..... ............. lcn a .. .
Keloid,ecar .............................1
Lymphangioma, ose ................ 1 Total .........:......
























































A m .
.r -ii. F:... ..... r;.. .. .... ............ ....... ....................... 20




: ... ... .......... .............. ..... ........... .........
.. .... .................... ........ ........ ..... ...... 9
i"E 3. : .'..", .. ... .... ............................... ...... .... .
ai, ,.: .. :.. .... .................................. ...... 4



.. ........... ... .. ........ ......
........ .... ........ .......... .......
.... .- ,".. ........ ................ ..................
.. .... .... .......... .. .......


i,....... ..o. .:.... ... ....... ......... ....... 2,192


l ; .: ;:: ;...., ..... ......................................... 129
".... ... ........ .. .... 4........... 414


.. .. .... .. ........... ....... 1
... .. ... ... ....... .....
4 .1 ....... ................ ................ 2
.. .. ......... ..
... ;. .i... ................".... ........... ..

.. : ;' ,:. .;" .,i ; ,: Ti", .. .. .... .. : ........ .......... .. ... g ... .
:. ; ... .-. ......... ......... ... 2 0
: :... ....' .: : ". ". .. . ." ..
'' .. .. .............. .... .. ......

.~., I ; .l: :' :. -: ... ... .... ..............................



S......;:.I 'i ; ... : ... .. .. .. ..... .
1. .-


.; : : ... ......... .....:..... ... ..... .......... I

05. : % .'A:.'- ... L











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:"' ......................







i Ii ;:.l~:'~ O':. :: .. ........ .. :.. : i" .. 1




.... .,..
4L
4, .. .. .
C reMPo d~,"FNQ' ..........
z .... ....


4K...................
|omleyeoui~.
(31 M D 1 . .. ..
Clids ... .... I
TALllis-. ... .. .. ..


iiii'ii''iiiiiiIi ...... ..... .4
spna a
. .I.. .
$nwan o ...
<$ i ei .. .. .. .

de q to .. .. .
OWUM.,







































S 58 10 27 23 4 23,861 65.3.
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ieU .l.IAD. jAeDMISSION REPORT. HOSPITALS AND DISPENSARIES, 1929.
..:. ,. ... ... 7 .. .


Aft dainwI~f$fpatfrn.~


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7,125
3,208


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3,196


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51

4,248


145

5,507


i: A:IN.RO U .AND, QUA.ERS 'OB EACH ADIBON, lMS ONLY.
IN DAYS IN HOSP,, AND aSR S FO. EACH ADMISSON, EMPLOYEES ONLY.


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............ ,14.38 10B 6 17 .9?
.. ,. ::-
....... 2.07 3.85 3. .
......... 1.91 .39 2. 10
..... ... 2. ..... ... .73 8
........... 3.12 4.99 4. 20
.............. 3.75 8S. .6.. .06
...... ..
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New Itse m

Chickenpox .................. 17 n 88 1 SOJ
Diphtheria.......s... 291 -A 6 2 ....... 66 as
SysenteW, amebic ...,.....e.. r 3 21- 3 5 0,1
'Dysentery, Bacillary (;mclasai-2 2 5 2 5
Malaria.'....... '72 3 29 964 -6' #R
........... 222 5 0t go0 .. 4
Meningitisa menage oe. ..... .. .......
M m s ... ........... 21 .. 406 4 1 i
Pnetumonia (deaths onl4)-.- ...(r 231 (z) 3 ( () $
Poliomyelitis ........... 46 1 w... ...
Relipsingfever ............... I .......
Scarletfever ....... 0........ m.. ..... .... .......
Trachoma, .................. 2 ....... 1 ... ... ... .. 2 '
Tueruosa~etholy... () 204 (9a 64 ( 44 () 3
TyphoWdfever,.......... 411 3 5 1 4 e... 1
Paratyphoid fever4 ..... 2 1 ........... __3, ... e .
Whooping- ough.... ....... 4 :.... 36 ...... 48. ....... 3
Maritimequarantinablediseases
C holera ................. .... .. .. .. ,
Leprosy ...... .......... 3 .. 8 ...... ....... A
plague .........f j ....
Yellow fever..., . .< .. ..
Typhusfever...*e. .. .. .

As many cases of pneumonia and tuberdsi wre. not reported until 4vath ocme thim r
unuber of deaths onl f or thee two discuses.

TABLE XV.--FORCE REPORT OF HEALTH DEPARTMENT.

41December,31120
Gold. Silver. Tot&L
.Chief Health Office .............. .... :.. 7 .......
Gorgas Hospital .......... ....... 176 299 475 025
Colon Hospital..;....... ........ ......... 25 62 77 2
.Corozal Hospital............... .. ................. .... 19 14-4 163 147:
idne Dis~pemaries.. ...... f? ........... 10 1 27 2
Palo Seco Leper Coloo .......... ............ 2 36,
Quarantinesernlee ...q..................... 10 23 3
Health Offlce, Panama... j............. ..... 1. 1 128 9
HelhOffee, ......... .... .. 88,_ O
Zone banitution. .............. ......... 5 1U2, 117 Wl
Totl" .. ........... ............ 282 8011 9
.. .. .. .. .. .. .
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