Citation
Report of the Department of Health of the Panama Canal

Material Information

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

Subjects

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

Notes

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

Record Information

Source Institution:
University of Florida
Holding Location:
University of Florida
Rights Management:
This item is a work of the U.S. federal government and not protected by copyright pursuant to 17 U.S.C. §105
Resource Identifier:
642828894 ( OCLC )
020307785 ( ALEPH )
AA00006090_00008 ( sobekcm )
Classification:
W 79. 12/5 ( sudocs )

Related Items

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

Downloads

This item has the following downloads:


Full Text






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REPORT OF THE DEPARTMENT OF HEALTH OF THE PANAMA CANAL FOR THE MONTH OF AUGUST, 1916 D. C. HOWARD Lieutenant Colonel, Medical Corps, United States Army, Chief Health Officer, Balboa Heights, Canal Zone WASHINGTON 1916

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As 6A

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CONTENTS. Page. Letter of transmittal.P 5 General remarks. .5 Vital statistics. .5 Health of employees. 5 Health, of residents of the Canal Zone. 6 Health of residents of the city of Panama. 7 Health of residents of the city of Colon. 7 Hospital division: Ancon Hospital. 8 Insane department. 8 Chronic ward.:. 9 Board of health laboratory.:. 9 Colon Hospital. 9 Palo Seco Leper Asylum. .9 Santo Tomas Hospital. 9 District dispensaries. 10 Sanitary division: Canal Zone. 10 Panam a. 11 Colon. 12 Quarantin service. 12 Statistical tables: Table I. Admissions, deaths, and noneffective rates for employees; deaths of residents of Panama, Colon, and the Canal Zone. 13 I. -Deaths by age, color, and sex. 14 III. Deaths by nationality. 15 IV. Deaths of white Americans. 15 V. Causes of deaths of employees. 16 VI. Causes of deaths of civil population (employees and nonemployees) and military, and places where chargeable. 16 VII. Deaths of nonresidents. 19 VIII. Admissions and deaths in the hospitals of the Panama Canal. 20 IX. Consolidated hospital report. 32 X. Consolidated dispensary and admission report. 34 XI. Employees: Constantly sick and noneffective rates per 1,000. 35 XII. Employees: Days' treatment per admission, hospital and quarters. 36 XIII. Financial statement .36 XIV. Ancon Hospital. 38 XV. Colon Hospital. 43 XVI. Palo Seco Leper Asylum. 44 XVII. Santo Tomas Hospital. 45 XVIII. Sanitary work done in the Canal Zone, Panama, and Colon. 48 XIX. Quarantine transactions. .50 XX. Issues of quinine. 51 XXI. Personnel report. 52

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.4S 4

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LETTER OF TRANSMITTAL THE PANAMA CANAL, CANAL ZONE HEALTH DEPARTMENT, Balboa Heights, September 9, 1916. Maj. Gen. GEO. W. GOETHALS Governor the Panama Canai, Balboa Heights, Canal Zone. SIR: I have the honor to submit the following report of the operations of the Department of Health for the month of August, 1916. Very respectfully, D. C. HOWARD, Chief Health Officer. GENERAL REMARKS. No disease of a quarantinable nature originated on or was brought to the Isthmus during the month. The last case of yellow fever contracted on the Isthmus occurred in November, 1905. The last case brought to the Isthmus was on December 10, 1915. The last case of bubonic plague contracted on the Isthmus occurred in August, 1905. The last case brought to the Isthmus was in October, 1911. No case of smallpox has been contracted on the Isthmus since 1907. VITAL STATISTICS. EMPLOYEES. The health of the employees remained good during the month. The following statistics are based upon the number of names appearing on the rolls for the preceding month, which was 33,609. The total number of admissions to hospitals and quarters was 790, a rate of 282.06.1 as compared with 262.11 for the preceding month and 335.44 for the corresponding month of last year. The total number of deaths from all causes was 10; of these 8 died from disease 'giving a death rate of 2.86, as compared with 2.49 for the preceding month and 3.99 for the corresponding period of last year. The constantly noneffective rate was 8.06, as compared with 8.35 for the preceding month and 10.22 for the corresponding period of last year. The total admission rate for malaria, hospitals, and quarters was 29.99, as compared with 42.26 for the preceding month and 72.28 I All morbidity and mortality rates are computed as equivalent annual per thousand. (5)

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6 for August, 1915. The total noneffective rate was 1.13, as compared with 1.41 forlast month and 1.63 for the month of August, 1915. The diseases causing the highest admission rates to hospital, in the order of their numerical importance, were: Malaria, venereal diseases, diseases of the digestive system, diseases of the circulatory system, and diseases of the respiratory system. These five classes of diseases caused 50 per cent of all admissions to hospitals; 18 per cent of all admissions to hospitals were caused by malaria. There was one admission for typhoid fever during the month of August, giving an admission rate of 0.36, as compared with a rate of 0.71 for the preceding month and 0.33 for the corresponding month of last year. EFFECTS OF RACE. The admission rate to hospital and the death rate from disease were 99.98 and 3.31, respectively, for black employees, as compared with 91.78 and 2.44 for last month and 127.30 and 3.44 for the corresponding month of last year. For white employees the admission rate to hospital and the death rate from disease were 228.79 and 0.00, respectively, as compared with 283.09 and 2.83 for the preceding month and 367.71 and 7.77 for the corresponding period of last year. The admission rate to hospitals and quarters for malaria was 26.03 for blacks and 55.23 for whites, as compared with a rate of 36.14 for blacks and 84.93 for whites for last month and 55.81 for blacks and 183.86 for whites for the corresponding month of last year. There was one death from injury among American employees during the month, giving a death rate of 2.63, as compared with 2.83 for last month and 5.78 for the month of August last year. The admission rate to hospitals from diesase was 177.16 for Americans, as compared with 202.63 for last month and 291.91 for the corresponding month of last year. DEPORTATIONS. There were 11 deportations accomplished during the month, 2 employees (for disease 1, for injury 1), and 9 nonemployees (for disease 7, not sick 2). CANAL ZONE. EMPLOYEES AND NONEMPLOYEES. The population of the Canal Zone is 31,048, according to the last police census, taken in June, 1916. This includes employees, nonemployees, and military garrisons, residing or stationed within the Canal Zone limits. Among this population there were 25 deaths during the month of August, 21 of which were from disease, giving a death rate of 8.12, as compared with 12.37 for the preceding month and 18.26 for the corresponding month of last year. Of the total deaths from disease the percentage under 5 years of age was 48, as compared with 53 for last month.

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7 There were 60 births reported, giving a rate of 23.19; of these 15 were white and 45 colored. There were four deaths of children under 1 year of age, all colored, giving an infant mortality rate, based upon the number of births reported during the month, of 0.00 for white and 91 for colored children, with a general average of 67. The percentage of stillbirths to total births was 8. PANAMA CITY. EMPLOYEES AND NONEMPLOYEES. The population of the city is 60,778, among whom there were 148 deaths during the month of August; of these 144 deaths were from disease, giving a rate of 28.43, as compared with 29.62 for the preceding month and 29.02 for the corresponding month of last year. Of the total deaths from disease the percentage under 5 years of age was 61 as against 54 for last month. The principal causes of deaths, as compared with last month, were as follows: August. July. Diarrhea and enteritis (under 2 years). .35 44 Tuberculosis of the lungs. 19 18 Broncho-pneumonia. 9 6 There were 225 births reported, giving a rate of 44.42. There were 63 deaths under 1 year of age, giving an infant mortality rate, based upon the number of births reported for the month, of 280. The percentage of stillbirths to total births was 11. COLON. EMPLOYEES AND NONEMPLOYEES. The population of the city is 24,693 among whom there were 56 deaths during the month of August. 6f these 55 were from disease, giving a rate of 26.73, as compared with 20.41 for the preceding month, and 20.86 for the corresponding month of last year. Of the total deaths from disease the percentage under 5 years of age was 38, as compared with 49 for the preceding month. The principal causes of death, as compared with last month, were as follows: August. July. Tuberculosis of the lungs. 6 6 Organic disease of the heart. 4 2 Broncho-pneumnnia. 4 3

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There were 64 births reported, giving a rate of 31.10. There were 14 deaths under 1 year of age, giving an infant mortality rate, based on the number of births reported for the month, of 219. The percentage of stillbirths to total births was 9. DIVISION OF HOSPITALS. ANCON HOSPITAL. The average number of patients constantly in the hospital proper during the month was 453, as compared with 436 for last month and 470 for the corresponding month of last year. The average number of days' treatment for each employee was 23.82. The daily per capita cost per patient in the hospital proper was $1.51 gross for July. Complete removal of the board of health laboratory to building No. 222 (formerly ward 16) was effected and laboratory operations resumed with practically no interruption. Building No. 287, the former laboratory, was razed by the building division, the site to be used for the new concrete dispensary building, work on which was started. To relieve the present congestion in the colored women's wards a section of ward 17 was partitioned off and the tubercular patients (colored women) transferred thereto. Two additional mahogany handrails were installed on the stairways of section A, the new concrete section. A telephone booth was installed in the operating room. One hundred and twenty-four malaria cases were admitted, as against 143 for July. Influenza increased from 6 cases in July to 23 admissions in August, and acute bronchitis from 7 cases to 20. Twenty cases of follicular tonsillitis were admitted in August, against 11 in July. The number of cases treated in isolation increased considerably, diphtheria and diphtheria suspects accounting for the increase. COROZAL HOSPITAL (INsANE). The* average number of patients constantly cared for during August was 290, as compared with 289 for last month and 251 for the corresponding month of last year. During the month there were 20 admissions, 13 discharges, and 3 deaths. Of the adnilssions, three were cases that had been sent to Ancon Hospital for surgical treatment. The discharges included one case sent to Ancon Hospital for surgical treatment. Two soldiers were deported to the United States, one of whom had only been in the hospital a few days in transit from the Marine detachment, American legation, Nicaragua. Six cases were deported to Barbados and one case to Italy. The nurses' quarters were completed during the month. Work on the addition to the piggery has not yet commenced. The general health of the patients and cripples remains good. The daily per capita cost per patient was $0.42 in July. Detailed statistics of Ancon and Corozal Hospitals are shown in Table XIV.

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9 CHRONIC WARD. There were no admissions, discharges, deaths or transfers during the month. The average number of chronic and incurable patients constantly cared for was 20. The per capita cost per patient per day for July was $0.29. Detailed statistics are shown in Table XIV. BOARD OF HEALTH LABORATORY. During the month of August work outside of routine as follows was performed at the board of health laboratory: Five gallons of a disinfectant was prepared for use in the hospital, according to a formula proposed by the United States Public Health Service, in order to test the efficiency of this product as a bactericide in practice. It is prepared from pine oil and rosin, and while it is therefore noncresylic the preliminary tests have shown .it to compare very favorably with other saponaceous disinfectants of a cresylic origin. The physical properties of petroleum are being studied with the purpose of determining the possibility of improving its efficiency as a larvacide. The rate of change of anhydrous sodium sulphite to sulphate while stored in a dry atmosphere is being studied, and in connection with this study a comparison has been made of the different accepted methods of determining the sulphite radicle. COLON HOsPITAL. The average number of patients constantly in hospital was 34, as compared with 41 for the preceding month and the same number for the corresponding period of last year. The average number of days' treatment per employee was 6.89. The daily per capita cost per patient was S2.14 for July. Detailed statistics are shown in Table XV. PALO SEcO LEPER ASYLUM. The average number of patients constantly cared for during August was 67.58, as compared with 66 for the preceding month and 57 for the corresponding month of last year. During the month there was one admission, no deaths. no discharges. Work has been carried on continuously during the month on the new well for the water supply of the asylum. A good and ample supply has been obtained at a depth of 147 feet, and with the completion of the installation of a pump and connections will, it is hoped, solve the problem of water supply satisfactorily and permanently. The daily per capita cost per patient for July was $0.87. SANTO TOMAs HOSPIrAL. During the month 1,439 patients were treated in the hospital, as compared with .1,339 for the preceding month and 1,334 for August of last year. The daily average number of patients was 67709-16-2

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10 -440, as compared with 456 for the preceding month and 448 for the corresponding period of last year; the total number of days' treatment was 13,717, as compared with 14,134 for the month of July. The number of deaths was 93, with tuberculosis of the lungs, diarrhea, and enteritis (under 2 years), and congenital debility the chief causes in the order named. There were 13 cases of dysentery treated, with 1 death, and 9 cases of pneumonia treated, with 6 deaths. Detailed statistics are shown in Table XVII. DISTRICT DISPENSARIES. The dispensary having the highest admission rate for malaria was Gatun, with an average weekly percentage of 0.504; that having the lowest was Paraiso, with a percentage of 0.12. Detailed statistics are shown in Table X. SANITATION-CANAL ZONE. While the month has been one of heavy rainfall, antimosquito work has been carried on in the several districts with vigor and success. The mosquito catch and malaria rates in most of the districts are the lowest on record for August. A noticeable reduction in the malaria rate has been effected at Gatun, where an average weekly percentage of employees excused for malaria has been reduced from 1.06 in August, 1915, to 0.504 in August, 1916. The destruction and removal of quarters at New Gatun is in progress, and it is believed that with the elimination of these 1,000 or 2,000 nonemployees-a great many of whom are malaria carriers and allof whom have been residing in unscreened quarters-the health conditions of this community will be permanently improved. In addition to the routine antimalaria measures of ditch cleaning, oiling, grass cutting, and adult mosquito catching, a large amount of permanent work has been accomplished at Gatun, Corozal, Paraiso, and La Boca, including filling and grading of marshy lands and laying of subsoil drains. The construction of new quarters is in progress, and already better housing facilities have been afforded employees residing at Frijoles and Monte Lirio. The box cars at these places formerly occupied as quarters have been vacated and are now being demolished. Inspection of hotels and restaurants and the physical examin-a tion of their employees was made during the month. Two cases of contagious disease were discovered at these examinations, and the employees suspended from their employment until such time as they presented a medical certificate of recovery. Complete surveys have been made in each district of the permanent work required to reduce maintenance cost to a mimmum. This work, as outlined, will notbe undertaken comprehensively until the beginning of the dry season. The following communicable diseases were reported during the month:

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11 Chicken pox. 3 Measles 5. 5 Diphtheria. 10 Puerperal septicemia. 1 Malarial fever. 94 Tuberculosis. 13 SANITATION-PANAMA. During the month there were reported 7 admissions to Ancon Hospital and 15 to Santo Tomas Hospital for malaria from the city of Panama, making a total of 22 cases. During the same month of 1915 there were 36 admissions, and during August, 1914, 274 admissions to both hospitals for this disease. There were no deaths reported due to malaria. A survey was made of the outlying districts in which we carry on antimosquito work for the purpose of locating houses in which there were to be found cases of chronic malarial infection. Ten such houses were located and quinine, both in capsule and liquid form, was left with careful instructions to the occupants as to its use. These people are of the poorer class of Panamans and present marked anemia due to hookworm infection and chronic malaria. It is thought that this distribution of quinine will be of considerable aid in lessening the prevalence of malaria near the outer limits of the city. With the aid of the Panaman police an effort has been made to enforce stricter compliance with the sanitary regulation requiring that all chickens and other fowls or small animals be kept in sanitary rat-proof coops or cages. It was found necessary to raid a number of places in which birds and animals were being kept more or less secretly, with the result that a large number of such birds and animals were taken up andsent to the city pound. Considerable difficulty has been experienced in the past in this respect through the habit of some of the people of attempting to conduct a small poultry business in private houses and other thoroughly unsuitable places. Vaccination.-Th -vaccination of the school children of the city was practically completed during the month, a total of 1,324 vaccinations being performed. Total number of vaccinations since this work was instituted in April, 1914, is 24,863. During the month of August there were eight cases of diphtheria occurring in Panama city. Of this number there were two deaths. As a result of careful search for carriers in houses from which active cases had been removed six such bacillus carriers were detected and held in isolation until negative throat cultures were obtained. A total of 40 contacts were examined in this way by Santo Tomas Hospital Laboratory and the Board of Health Laboratory at Ancon, and the early detection of these cases made possible the control of the spread of the disease. Request was made on all physicians practicing in Panama city for the prompt reporting of all suspicious cases, similar instruction being sent to the heads of all schools. Very willing and prompt cooperation was received. It was necessary to impose a fine in one case where a house quarantine was violated.

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12 During August the following infectious diseases have been reported from all sources: Chicken pox-. 13 Mumps .1 Diphtheria. 8 Pellagra. 5 Diphtheria carriers-. 6 Tetanus. 1 Dysentery, amebic. 2 Tuberculosis, pulmonary.28. Leprosy .2 Typhoid fever.--.3 Malaria.--. 22 Whooping cough. 2 Measles. 12 SANITATION-COLON. The general health conditions of the city continue excellent. There has been a marked reduction in the number of malaria cases in Cristobal-Colon as compared with previous years. Building operations in the burned district of the city have commenced on certain of the lots. Preparations hat-e been made for the installation of dry fills in the Mount Hope section, and the work will be begun within a few days. One case of diphtheria in a Panaman was reported during the early part of the month; while there were 24 close contacts no secondary cases developed. Prophylactic immunization was employed on these contacts. One case of typhoid fever in a cook at the Cristobal Hotel appeared during the month. The last preceding case from this district occurred on February 5 last. The source of infection in this case could not be determined, but it is presumed that it was of carrier transmission. On this assumption a routine stool examination is being made of all the employees of the hotel handling food, not only in the effort to locate a particular carrier, but also as a measure of protection to the public. The following communicable diseases were reported during the month: Diphtheria ---. 1 Measles. 1 Malaria. 35 Tuberculosis. 3 Pneumonia. 1 Whooping cough. 2 Typhoid fever. 1 QUARANTINE SERVICE. The work of the quarantine division was conducted during the month without special incident. No mosquito breeding was found in small sailing or other coastwise vessels at Cristobal-Colon. The yellow fever and plague situation on the west coast remains practically unchanged. No new cases are reported from Buenaventure, Colombia, though there is no good reason to believe that the disease has been eradicated at this port. The plague situation. in Peru and northern Chile remains practically unchanged. The anthrax situation in the supply department pastures, coimented upon in last month's report, is improving, no deaths having occurred during the last week of August. New and stringent regulations have been put in force, and it is believed that the present epidemic is well under control. Infected pasture areas will probably remain for some years to come unless drainage is perfected. The disease may be expected to recur each year if animals are pastured in sucl a o

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13 TABLE I.-ADMISSIONS, DEATHS, AND NONEFFECTIVE RATES FOR EMPLOYEES; DEATHS OF RESIDENTS OF PANAMA, COLON, AND THE CANAL ZONE. ABSOLUTE NUMBERS. Admissions to hosDeaths Nonefrective pitals. -from sickness. Number of employees. Exter-ExterCon Total. Disease. nal Total. s nal Days stantly causes. ease, causes. treated.1 nonefcauses. afective. August,1916. White. 4,563 109 87 22 1 .1 2,135 68.88 Colored.29,046 317 242 75 9 8 1 6,266 202.13 Total,_ 33.609 426 329 97 10. 8 2 8, 401 271.01. July, 1916. White. 4,239 126 100 26 1 1 .2,409 77.72 Colored. 29,548 293 226 67 11 6 5 6,337 204.40 Total. .33,787 419 326 93 12 7 5 8,746 282.12 August, 1915. White-. 4,634 167 142 25 3 3 .3,141 101.32 Colored. 31,390 443 333 110 14 9 5 8,276 266.96 Total. .36,024 610 475 135 17 12 5 11,417 368.28 PROPORTIONATE NUMBERS.1 August,1916, White. 4,563 286.65 228.79 57.86 2.63 .2.63 .15.10 Colored. 29,046 130.96 99.98 30.98 3.72 3.31 .41 .6.96 Total. 33,609 152.10 117.47 34.63 3.57 2.86 .71 ..&06 July, 1916. White. 4,239 356.69 283.09 73.60 2.83 2.83 ..18.34 Colored. 29,548 118.99 91.78 27.21 4.47 2.44 2.03 .6.92 Total. 33,787 148.81 115.78 33.03 4.26 2.49 1.78 .8.35 August,1915. White. 4,634 432.45 367.71 67.74 7.77 7.77 .'. 21.87 Colored. 31,390 169.35 127.30 42.05 5.35 3.44 1.91 .8.50 Total. 36,024 203.19 158.22 44.97 5.66 3.99 1.67 .10.22 1 Annual average per 1,000.

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14 DEATHS OF RESIDENTS OF THE CITIES OF PANAMA, COLON, AND THE CANAL ZONE. Number. Per cent. Place. Population. DisExter.'ExterTotal. ease. nal Total. easnal causes. causes. August, 1916. Panama. 60,778 148 144 4 29.22 28.43 0.79 Colon. 24,693 56 55 1 27.21 26.73 .49 CanalZone.' 31,048 25 21 4 9.66 8.12 1.54 Total. 116,519 229 220 9 23.59 22.66 .93 July, 1916. Panama. 60,778 157 150 7 31.00 29.62 1.39 Colon. 24,693 47 42 5 22.84 20.41 2.43 Zone. 31,048 39 32 7 15.07 12.37 2.71 Total. 116,519 243 224 19 25.03 23.07 1.95 A ugust, 1915. Panama. 60,373 149 146 3 29.61 29.02 .59 Colon. 29,331 54 51 3 22.08 20.86 1.22 Zone. 30,219 50 46 4 19.85 18.26 1.59 Total. 119,923 253 243 10 25.31 24.31 L.G TABLE II.-DEATHS BY AGE, COLOR, AND SEX. White. Colored. Yellow. Total. M. F. Total. M. F. Total. M. F. Total. M. F. Total. Under 1 year. 2 1 3 42 35 77 .1 1 44 37 81 1 to 4 years. 1 2 3 20 15 35 ...21 17 39 5 to10years. 1 1 1 1 2 1 1 2 2 3 11 to 20 years. ...2 2 4 ...2 2 4 21 to 30 years. .1 1 20 12 32 ...20 13 33 31 to 40 years. ...13 11 24 1 .1 14 11 25 41 to 50 years. 4 1 5 12 2 14 .16 3 19 51 to 60 years. .2 2 5 2 7 2 .2 7 4 11 61 to 70 years. 2 1 3 3 2 5 1 .1 6 3 9 71 to 80 years. ..2 2 4 ...2 2 4 Total.9 9 18 120 84 204 5 2 7 134 95 229

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15 TABLE III.-DEATHS BY NATIONALITY. Employees. Nonemployees. Total. Male. Female. Male. Female. Male. Female. total. Antilles. ..1 .1 .1 Barbados. 1 .18 18 19 18 37 Colombia. ..8 8 8 8 16 China. ..4 2 4 2 6 Cuba. .2 .2 .2 Ecuador. ...2 .2 2 Fortune Island. 1 ..1 1 1 2 France. ...1 .1 I Germany. .I .1 .I Grenada. ..3 2 3 2 5 Guadeloupe. ...1 .-. 1 1 Guatemala. ..1 .1 1 Italy ..4. 4 .4 .4 Jamaica. 4 .36 31 40 31 71 Japan. ..I .I .1 Martinique. ..5 1 5 1 6 Mexico. ....1 1 Montserrat. 1 ...1 1 Nevis. ..5 1 1 Panama. ..30 18 30 18 48 Nicaragua. .1. .1 St. Thomas. ...1 1 St. Lucia. I .2 5 3 5 8 Spain ...2 .2 .2 St. Vincent ...I .-.-.-. 1 .1 St. K itts.I ...1 .1 Trinidad ...2 2 2 2 4 Turkey. ..1 .1 I 'United States.1 .1 .2 2 Total. 10 .124 95 134 95 229 TABLE IV.-DEATH RATE AMONG AMERICANS ON THE ISTHMUS CONNECTED WITH THE PANAMA CANAL. Number of Annual deaths. average per 1,000. White employees from the United States (4,335): Disease. 0.00 External causes .1 2.77 Total. 1 2.77 White women and children from the United States (3,500): Disease. .0.00 External causes. .0.00 Total. .0.00 White employees and their families from the United States (7,835): Disease ...0.00 External causes._1 1.53 Total. 1 1.53 Total number of Americans on the Canal Zone, including soldiers and their families (16,022): Disease .au.es. .0.00 External causes. 1 .75 Total .1 .75

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16 TABLE V.-CAUSES OF DEATHS OF EMPLOYEES OF THE PANAMA CANAL AND PANAMA RAILROAD CO. White. Colored. Total. Disease: Chronic nephritis ..-----------------------------------2 2 Disseminated tuberculosis ...4 4 Tuberculosis of the lungs----------------------------1 1 Organic heart disease.----------------.----------------1 External causes: Compound fracture, base of skull .-----------1 Fracture, simple, linear, concussion of brain ------------1 1 Total.-----------------1 9 10 TAB'LEVI.-CAUSES OF DEATHS OF CIVIL POPULATION (EMPLOYEES AND NONEMPLOYEES) AND MILITARY, AND PLACES WHERE CHARGEABLE. PanCanal Total. ama. Zone. I ----Grand, Disease. General diseases. Malarial fever, estivo-autumnal1. .... Whooping cough.-. .1 ....1 1 'Diphtheria and croup. .------------2 .1 ..-I 1 3 1 4 Dysentery1. ....-------I Dysentery, unclassified .----------1 --------------1 Septicemia. .1 --------------Tetanus1. I ------------1 Pellagra. 2 1 1 1 .1 3 3 6 Tuberculosis of the lungs. .---------12 7 4 2 2 ---18 9 27 Acute military tuberculosis1. .I -------------1 1 Tuberculosis meningitis. ..-------1 1 Disseminated tuberculosis. 4 .2 ---1 .7 .7 Syphilis, tertiary-----------.-.----.---I ...1 .1 Cancer and other malignant tumors of the stomach and liver. 1 1 ------------1 12 Cancer and other malignant tumors of the female genital organs. .1 --------------1 Cancer and other malignant tumors of other organs and of organs not specified. ....------------------------1 ---------.---1 Alcoholism (acute or chronic) ----------1 .---------------1 Alcoholism, acute. ..---------------1 .1.------2 -. 2 Diseases of the nervous system and of the organs of special sense. Simple meningitis -------------------..------1 .-1 Pneumococcus meningitis. .1 .....I Cerebral hemorrhage, apoplexy. .I .2 .---.---3 3 Epilepsy. .----------------------------1 1 ------1 1 2 Convulsions of infants (under 5 years of age). .---.---1 ..1 1 2 Neuritis.----------------------------------1 --I Other diseases of the nervous system. ..----------1 1

PAGE 19

17 TABLE VI.-CA USES OF DEATHS OF CIVIL POPULATION (EMPLOYEES AND NONEMPLOYEES) AND MILITARY, AND PLACES WHERE CHARGEABLE-Continued. P-Canal Ttl PanColon. n. Tot. ama. Zone. Disease.' Grand se 0 4 4 total. Diseases of the circulatory system. Acute endocarditis. .....1 1 Organic diseases of the heart. 6 1 3 1 2 .11 2 13 Aneurysm. .I .1 1 Arterio-sclerosis. .... Embolism and thrombosis. ....1 .1 Diseases of the lymphatic system (lymphangitis, etc.).1. ..1 .1 Diseases of the respiratory system. Acute bronchitis. 2 2 .2 ..2 4 6 Chronic bronchitis. 1 .1 1 ..2 1 3 Broncho-pneumonia. 5 4 1 3 .1 6 8 14 Pneumonia (unqualified). 2 .1 1 .1 3 4 Lobar pneumonia. 1 1 2 1 ..3 2 5 Pulmonary congestion, pulmonary apoplexy. 2 .1 ...3. 3 Asthma. ......1 .1 1 Diseases of the digestive system. Chronic gastritis. ..1 1 ..1 1 2 Diarrhea and enteritis (under 2 years). 23 12 2 2 1 1 26 15 41 Colitis. 5 2 ....5 2 7 Diarrhea and enteritis (2 years and over). .1. ..1. 1 Intestinal parasites. .1. ..1 .1 Acute appendicitis1. 1 .1 Other diseases of the liver1. 1 .1 Simple peritonitis (nonpuerperal). .1 1 .1 -1 2 Other diseases of the digestiN e system (cancer and tuberculosis excepted). 1 ..1 .1 Nonvenereal diseases of the genitourinary system and annexa. Acute nephritis. 3 1 ....3 1 4 Bright's disease (chronic nephritis). 3 3 .1 .7 .7 Pyelo-nephrosis. ....1 .1 Salpingitis and other diseases of the female genital organs. ..1. ..1 1 The puerperal state. Abortion .1. .....1 1 Eclampsia. ...2 ...2 2 Malformations. Congenital malformations (stillbirth not included). 1 I ..1 1 2 67709-16---3 1co

PAGE 20

18 TABLE VT.-CAUSES OF DEATHS OF CIVIL POPULATION (EMPLOYEES AND NONEMPLOYEES) AND MILITARY, AND PLACES WHERE CHARGEABLE-Continued. PanColon. Canal Total. ama. Zone. Disease. Grand 6 total. ~ @3 Diseases of early infancy. Congenital debility, icterus, and sclerema. .1. .1 .2 2 Premature birth. 3 1 .1 3 4 Congenital debility. 2 .....2 2 Atrophy of infants. .....1 Malnutritution. .2 1 1 1 1 .i 5 Other causes peculiar to early infancy (including x arious consequences of labor). 1 ...1 1 Old age. Senility. 1 .....1 1 AfJections produced by external causes. Suicidebydrowning.1 .1 1 Suicide by firearms.1 .1.2 .2 Accidental drowning. ....1 1 Traumatism by other crushings (v ehicles, railroads, landslides, etc.). ...2 _. 2 .2 Homicide by firearms. 2 .....2 2 Other external x iolence.1. ....1 .1 Ill-defined diseases. Cause-of death not specified or ill defined. 2 1 ..1 .3 1 4 Total. 88 60 31 25 15 10 134 95 229 Stillbirths.;. 16 8 5 1 3 2 24 11 35 -Total deaths, Including stillbirths.104 68 36 26 18 12 158 106 264

PAGE 21

19 TABLE VIL-DEATHS OF NONRESIDENTS. Residence. Nationality. Color. Sex. Age. Diagnosis. Steamship Ancon Sweden. White. Male. 47 DrownAing, accidental. Steamship PasUnited States. .do.do. 29 Suicide by firetores. arms. Interior of PanPanama. .do.do .26 Chronic nephritis. ama. Po. .do. Black. do. 30 Septicemia. Do. do. .do. Female .16 Amebic dysentery. Do. .do. .do. Male. 25 Lobar pneumonia. Do. .do. .do. do. 70 Arteriosclerosis. Do. Chinese. Yellow. .do. 30 Fever, undetermined. Do. .do. .do. .do. 51 Tuberculosis of the lungs. Do. Panama. Black. Female. 68 Acidosis. Do.do_. .do. Male. 20 Tuberculosis of the lungs. Do. Colombia. do. .do. 40 Septieemia following liver abscess. Do. Panama. .do. do. 60 Organic heart disease. Do.'. Jamaica. do. do. 21 Tuberculosis of the lungs. Do. Panama. .do. do. 40 Do.

PAGE 22

20 TABLE VIII.-SHOWING ADMISSIONS AND DEATHS Employees. Admissions. Deaths. Diseases. White. White. Black. Black. AmeriEuroAmeriEurocans. peans. cans. peans. M. F. M. F. M. F. M. F. M. F. M. F. General diseases. Typhoid fever. ..2. Malaria. .1 Estivo-awitumnal.5 .5 .57 .. Tertian.4. 5 .Quartan ..... Clinical. ..... Smallpox: Varioloid. ...2. .. Measles. ..1. .. Whooping cough ...... Dipht eria an croup. ..... Croup. ..2. .. Influenza.2. 2 .1 ----. Dysentery, entemebic. .. Unclassified. ..... Leprosy. ..1. .. Dengue. .. Chicken pox. .4. ..... German measles. 1 .. Mumps. ..1.Yaws. .. Filariasis. .1 .. Purulent infection and septicemia. 1 .. Septicemia. ... Pellagra. .... Tuberculosis of the lungs 1 .1 5 .. Acute miliary tuberculosis. .... Abdominal tuberculosis. ...... Tuberculosis of the lymph glands. ....-. Disseminated tuberculosis. .....4 .4 Rickets. .... Syphilis, primary. ...7 -. .. Sphilis, secondary.1 .... Syphilis, tertiary. ....9 1. Syphilis, period not stated. ..... Gonorrhea .....8 Gonorrheal orchitis and epididymitis. 1 ...4. Gonorrheal ophthalmia. .2. Soft chancre. 1 ..8 Adenitis chancroidal. 1 ..1.Cancer and other malignant tumors of the female genital organs. .......

PAGE 23

21 IN THE HOSPITALS OF THE PANAMA CANAL. Nonemployees. Nonresidents. Admissions. Deaths. Admissions. Deaths. White. White. Black. Black. White. Black. White. Black. Others. Others M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. 0 L. 1. ......2 ......5 .......1 -----------. .2 26 2 6 11 23 --.1 --4 ------------.-. 139 1 7 .1 1 1 -------.--------------------19 ---S .1 ...........219. .....---.---.-. -------------------2 ...2. .........3. .1 ....2 -.--. -----. .......3 .1 4 -. ....1 ----------------1. 4 1 2 .-. 1 --------------------------------4 -...............2 17 2 1 ...............25. 1 .............. ...........1 ------------I ------.--.--.4. ...........1. ...---------------------------------2 --. .--.-.----.-----------------------------2. ............. ............. ...............1. 1 ................-1. ....I ....I -----------------...1 3 ....I --.--------------5 3 .1 3 3 ......-17 1 ...........--.. ....--...---.--..---------.......3 .--....----. ----. .....1. .......2 1. ...-. ...-...-----.--------.-----..--. ..........-. 2 1 1 4 5 ...1 .2 .--. ..----.-25 ....2 .....-. .....--11 ...........21 2 ............5 -.-1. .............3 ..1. ....19 2 .--. .-. 2.-. --.-. -----.---. ---.............. .......3.,

PAGE 24

22 TABLE VIII.-SHOWING ADMISSIONS AND DEATHS Employees. Admissions. Deaths. Diseases. White. White. Black. Black. AmeriEuroAmeriEurocans. peans. cans. peans. M. F. M. F. M. F. M. F. M. F. M. F. General diseases-Contd. Cancer and other malignant tumors of other organs and of organs not specified. ........ Acute articular rheumatism ........ Diabetes.1. ...... Anemia secondary, cause not determined. ....... Alcoholism (acute or chronic). 1 ........ Alcoholism, acute. ..1. ..... Alcoholism, chronic. ....... Alcoholic psychosis. ....1 .... Diseases of the nervous system and of the organs of special sense. Simple meningitis. .. Paralysis without specified cause. ........ ther forms of mental Oalienation. ......... Dementia precox. .... Epilepsy. ...... Hysteria. .......... Neuralgia. ...1 ..... Neuritis.2. ........ Other diseases of. the nervous system. ......... Neurasthenia. .1. ..... Diseases of the eyes and their annexa. ...10 ....... Diseases of the ears. 2 ........ Diseases of the circulatory system. Organic diseases of the heart 1 ....1 .....-.Arteriosclerosis .....1 ...... Diseases of the veins (varices, hemorrhoids, phlebitis, etc. 2 ....... Hemorrhoids. 1 ...4 ...... Varices. .........

PAGE 25

23 IN THE HOSPITALS OF THE PANAMA CANA L-Continued. Nonemployee?. Nonresidents. Admissions. Deaths. Admissions. Deaths. White. White. Black. Black. White. Black. White. Black i Others. Others 0 F. M. F. M.F. M. F.M. F. M. F. M. F. M. F. 0 ------1 .............2 .11. .......2. ... .... .................... 1 .1 ............3 2 .2 1. .1 .........3 ...1 ..1. ......1 1 S. .........1. .1 7 .1. .9. .2. ..1. ....13 ..3. ............3 3 1,. 1. ........7. .1.3. S ...............5. .5. ..... 4 1 2 1. ....1. 21 1.~.1 ....5 2 .............2 1 .........3 ......,. .....2

PAGE 26

24 TABLE VIII.-SHOWING ADMISSIONS AND DEATHS Employees. Admissions. Deaths. Diseases. White. White. Black. Black. AmeriEuroAmeriEurocans. peans. cans. peans. M. F. M F. M. F. M. F. M. F. M. F, Diseases of the eirculatoTY system-Continued. Diseases of the lymphatic system (1ymphangitis, etc.) ...1. Lymphadenitis (nonve-ne)real) .-. .2 ........ Hemorrhage: other diseases of the circulatory system. ........... Diseases of the respiratory system. Diseases of the nasal foss,. 2 ...2 ...... Laryngitis. 2 ...1 ....... Diseases of the thyreoid body ......... Acute bronchitis .4. 2. Chronic bronchitis. ........... Broncho-pneumonia. ....2 ....... Lobar pneumonia. 2. ..... Pleurisy. .1 ...... Asthma .1.2. Diseases of the digestive system. Diseases of the teeth and gums.-. ....1 ...... Storm atitis ............. Diseases of the pharynx. ....1 ...... Follicular tonsillitis. 3 1 ..8 ...... Ulcer of the stomach. 1 .... Acute gastritis. 1 ....... Chronic gastritis. 3 ..2. Acute indigestion. 2 ..... Diarrhea and enteritis (under 2 years). .. Colitis. I .... Diarrhea and enteritis (2 years and over). .1 .2 ..-. Ankylostomiasis. ..... Teniasis .., ............ Acute appendicitis. .1 -. .... Chronic appendicitis.I Otherna hernia. ..7 ......

PAGE 27

25 N THE HOSPITALS OF THE PANAMA CANAL-Continued. Nonemployees. Nonresidents. Admissions. Deaths. Admissions. Deaths. White. White. Black. Black. White. Black. White. Black. Others. Others t45 M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. o o w E-4 E4 2 .......1 ........1. 2. 1 4 4 2 5 .....1. ...24 1. ..............1 ..............3 .3 1 .2 .1 .8 2 -. 1 2 .5 ...3 2. ..4. .1. 1. 1 7 .....11 7 2 4 .4 ...........29 .............2 1. 1. .........3 1. 1. ...........7 2 .1 .............5 1.1. .4 1 ..........2. ......2 .........................-.-..---e. .......2 6 1 1 .............. 4 1 1 .8 ..1 ...........1 67709-16--4

PAGE 28

26 TABLE VIIL--SHOWING ADMISSIONS AND DEATHS Employees. Admissions. Deaths. White. White. Diseases. Black. Black. AmeriEuroAmeriEurocans. peans. cans. peans. M. F. M. F. M. F. M. F. M. F. Mf. F. Diseases of the digestive s8ytem-Continued. Other diseases of the intestines.3. 1 .. Constipation. ............ Biliary calculi. ...... Other diseases of the liver. ........... Abscess of liver (unqualified). .. Diseases of the spleen.-1. ..... Nonvenereal diseases of the genito-urinal system and annuea. Acute nephritis. ....... Bright's disease (chronic nephritis).13 .....2 Other diseases of the kidney and annexa. ..1. ...... Pyelo-nephrosis. ... Calculi of the urinary passages.1. .... Diseases of the bladder. 1 ... Cystitis. ... Diseases of the urethra, urinary abscess, etc. ...1. Stricture of the urethra, nonvenereal. ...2-----------------------Diseases of the prostate. .. Nonvenereal diseases of the male genital organs. 1. 1. Uterine tumor (noncancerous). .1. Other diseases of the uterus. Metritis. Cysts and other tumors of the ovary. .. Salpingitis and other diseases of the female genital organs. Nonpuerperal diseases of the breast (cancer excepted).-. ...... Benign tumor of breast. ...........

PAGE 29

27 ]IN THE HOSPITALS OF THE PANAMA CANAL-Continued. NonemployeesNonresidents. Admissions. Deaths. Admissions. Deaths. White. White. Black. Black. White. Black. White. Black Others. Others M. F. M. F. M. F. M. F. M. F. M. F. M.F. M. F. b 0 E-4 Eq 1 ....1 I ...............2 .... 1 11. ~~~~. ...-. -. .-.---E --.1 ......2 .. .-----------.---.--. 1 .......2 15. .I .-.--.---------......2 .1. .7. ........ ----. ..-.-.-.----. .......4 ...-.---1 --........16 3 11. 8 1 1~~~~~~. ...-----...1 2 ......------..-. .................................I 2 -------. -..-. ..4 ......5 ........................................2 ---I .............7. ...I I .............I. ....4 1 .5 --...I ---..............2 .. .......I ..............1 1 ...---.--. ........2 .I ..............

PAGE 30

28. TABLE VIII.-SHOWING ADMISSIONS AND DEATHS Employees. Admissions. Deaths. Diseases. White. White. Black. Black. AmeriEuroAmeriEurocans. peans. cans. peans. M. F. M. F. M. F. M. F. M. F. M. F. The puerperal state. Normal labor. ............. Accidents of pregnancy. ......... Extra-uterine pregnancy. ............ Hyperemesisgravidarum. ............ Abortion. ........... Other accidents of labor. ...I. Puerperal septicemia. .. Puerperal albuminuria and convulsions. .. Eclampsia. Puerperal diseases of the breast. ... Diseases of the skin and of the cellular tissue. Gangrene. .. Furuncle.1 .. Acute abscess. ..1 .4. Phlegmon and cellulitis. ....1 Elephantiasis. ....1. Myiasis of skin. ..... Dhobie itch. .1. Ulcer of the skin. .2. Urticaria.' .... Ingrowing nail. 1 .1 Other diseases of the skin and annexa-. 1 ..2. Diseases of the bones and of the organs of locomotion. Diseases of the bones (tuberculosis excepted). 1 ...2. Caries (nontuberculous). .... Diseases of the joints (tuberculosis and rheumatism excepted). .-------1. -. ... Arthritis.1. 1 .-. Synovitis. .. Other diseases of the organs of locomotion. ..... Malformations. Congenital malformations (stillbirth not included). ....

PAGE 31

29 IN HEHOSPITALS OF THE PANAMA CANAL-Continued. Nonemployees. Nonresidents. .Admissions. Deaths. AdmIissions. Deaths. White. White. Black. Black. White. Black. White. Black. Others. Others '0 Mf. F. M. F. M. F. M. F. M.' F. M. F.M. F. M. F. ..16 ---6 ..........22 1 1 2. .........4. I .............. ..6. ...........1. .6. 8. ..........14. ...3. ......3 ....I. ..........1. S. .......1. ...1. ...1. S1 ...........2. ......1. ......1. 2 3. ...........6. ..2 5 ......../. .13. 3 1. .1 ...........6. .....................1. 1 ............1. ..................... ...1. ..........3. .........1 1I. ................3. 3 ;. ............8 .. 31. .3. ..........87. I ...1. ........... I. ..............12 ~3. 2 3 4 ....2. ......15 .I. ...1.1. ........ X.,

PAGE 32

30 TABLE VIII.-SHOWING ADMISSIONS AND DEATH Employees. Admissions. Deaths. Diseases. White. White. Black. lac AmeriEuroAmeriEurocans. peans. cans. peans. M. F. M. F. M. F. M. F. M. F. M. F. Diseases of early infancy. Newborn child-. .......... Premature birth. ...........Affections produced by external causes. Poisoning by food. 1 ...3 ..-. -...--. .-. Burns (conflagration excepted) .I .1 ......--..-. Traumatism by firearms. ......... Traumatism by cutting or piercing instruments.12. ..... Traumatism by fall. 4 ........... Traumatism in mines and quarries. ...1 ...... Traumatism by machines. ....2. .,. .. Traumatism by other crushings (vehicles, railroads, landslides, etc.). ....22 .1 ..--.1 Railroad traumatism .....1 ...-.-..Traumatism by landslides. ....1. 1 .--Heat exhaustion. ..1 ... Fractures (cause not specified).1 3 .11 -Sprains .....4 Other external violence .4 1 5 _. 18 .... Ill-deftned diseases. Ill-defined organic disease. .....-------Cause of death not specified or ill defined. .....Infections of undetermined origin. ...16. ... No disease. ...1 --Total. 73 3 33 .314 3 1 ..

PAGE 33

31 TN THE HOSPITALS OF THE PANAMA CANAIr-Continued. Nonemployees. Nonresidents. Admissions. Deaths. Admissions. Deaths. White. White. Black. Black. White. Black. White. Black. 4 Others. Others Z M. F. M. F. M. F. M. F. M. F. M. F. M. F. M. F. 3 .-. 8 8 4 4 ..........24 .......1 ......I .................5 ......... ........12 ..2 .1. ..........I .......1 ...4.2 1 2 1 ................I. .23 1 ... ......32 ....1. ..........21 ...I .............5 4 ............32. 3 1 2 2 .........24. 2 3 14 1 5. 32 .31. ~2035613 79 52.1.128 541.1,069 30

PAGE 34

32 TABLE IX.-CONSOLIDATED Remaining Admitted. Died. Aug. 1. A. F. B. A. F. B. A. F. B. ANCON HOSPITAL. Panama Canal employees. 17 16 114 51 23 193 1 .2 Panama Railroad employees. 5 8 53 6 2 55 ..3 Panama pay cases. ..--. .-. .. Other pay cases.90 i16 71 288 58 168 ..12 Charity cases. 7 1 22 17 2 30 ..3 Total. 119 41 263 362 85 446 1 .20 Insane department. Panama Canal employees. .5 10 ..1 ... Panama Railroad employees .7 ..7 .-. .1 ... Panamapay cases 1. 2 29 173 ..11 ..2 Other pay cases. 1 3 3 3 1 2 ... Charity cases. 3 5, 48 .4 15 ..1 Total. 6 42 241 3 5 30 ..3 Grand total. 125 83 504 365 90 476 1 .23 Corozal farm. Panama Canal employees. .12 53 .2 3. Chronic ward. Charity cases. 20. ... COLON HOSPITAL. Panama Canal employees. 3 1 11 14 7 27 ..1 Panama Railroad employees. 1 2 5 5 1 40 ..2 Panama pay cases. .1 .1 9 .1 2 Other pay cases.5 6 2 19 15 8 .. Charity cases. 2 1 .5 1 3 .. Total. 11 10 19 43 25 87 .1 5 PALO SECO LEPER ASYLUM. Panama Canal employees 1. 4 .. Panama pay cases.2 38. Charity cases.2 21. 5. Total.4 63. 5. GRAND TOTALS. Panama Canal employees. 20 34 192 65 32 224 1 .3 Panama Railroad employees. 6 10 65 11 3 96 ..5 Panama pay cases. 2 31 215 .1 20 .1 4 Other pay cases. 96 25 76 310 74 178 ..12 Charity cases. 12 9 111 22 7 53 ..4 Total.136 109 659 408 117 571 1 1 28 116 incurable insane and 5 lepers were dropped as Panama Canal and Panama Railroad employees and taken up as charity patients.

PAGE 35

HOSPITAL REPORT. Discharged. Transferred. Reman Average number constantly sick, A. F. B. A. F. B. A. F. B. AmerForeign. Black. Total. ican. 46 27 154 1 1 1 20 11 150 18.97 13.84 117.42 150.23 6 8 41 ...5 2 64 4.01 5.26 52.74 62.01 3 ....2.23 2.23 256 38 ,157 1 1 2 121 35 68 103.26 25.87 71.84 200.97 15 2 14 ..1 9 1 34 7.39 1.03 28.77 37.19 323 75 366 2 2 7 155 49 316 133.63 46.00 273.00 452.63 ....4 9 .1 2 .1.32 2.17 3.49 ..i. ...6 ..2 ...1.83 1.83 .3. ...2 26 182 2.00 27.81 176.10 205.91 1 .1 1 .1 2 4 3 1.19 3.55 2.13 6.87 -...1 3 3 8 59 3.00 9.23 59.83 72.06 1 3 1 1 5 19 7 39 248 6.19 41.91 242.06 290.16 324 78 367 3 7 26 162 88 564 139.82 87.91 515.06 742.79 3 5 1 ..10 51 .11.06 50.68 61.74 ...20 ..20.00 20.00 13 6 27 1 1 3 3 1 7 2.26 .77 7.42 10.45 6 3 27 .7 ..9 1.03 .29 7.74 9.06 2 ..6 ......03 .38 .41 19 17 6 1 2 2 4 2 2 4.78 4.77 1.74 11.29 5 2 2 .1 2 .1.48 1.00 .13 2.61 43 28 64 2 3 19 9 3 18 9.55 6.86 17.41 33.82 ...4 ..... .....238 .2.00 38.00 40.00 ..2 26 .2.00 25.58 27.58 .4 .4 64 .4.00 63.58 67.58 59 36 186 2 7 17 23 23 210 21.23 26.99 177.69 225.91 12 11 68 ..13 5 2 75 5.04 5.55 62.31 72.90 3 2 ..9 2 28 220 2.00 29.84 216.71 248.55 276 55 164 3 3 5 127 41 73 109.23 34.19 75.71 219.13 20 4 16 .1 5 14 11 139 11.87 13.26 134.31 159.44 367 109 436 5 11 49 171 105 717 149.37 109.83 666.73 925.93 Number of employees remaining in hospitals: White, 53; black, 285; total, 338. A.-White Americans; F.-White foreign; B.-Black.

PAGE 36

34 TABLE X.-CONSOLIDATED DISPENSARY REPORT. EMPLOYEES TREATED IN QUARTERS. ReRe-. mainAdmitDied DisTransmaining ted. charged. ferred. ing DayS last. Station. Aug. 1. Aug. 31. W. B. W. B. W. B. W. B. W. B. W. B. W. B. Total. Ancon. 1 .96 13 ..95 11 2 2 ..170 30 200 Balboa. 4 .93 3 ..93 2 .1 4 .204 4 208 PedroMiguel I .9 2 ..7 1 1 1 2 .25 4 29 Paraiso. ..12 4 ..11 4 ..1 .21 17 38 Gamboa. ..1 ...1 .....3 .3 Gatun. 1 .14 6 ..14 4 1 ..2 38 23 61 Colon. 5 11 89 47 .87 45 ..7 13 197 319 516 *J Total. 1 1 75 308 67 4 4 14 15 658 1397 1,055 ALL CASEs TREATED BUT NOT EXCUsED. Employees. Nonemployees. Total. Station. W. B. Total. W. B. Total. W. B. Total. Ancon. 2,613 3,980 6,593 1,882 2,709 4,591 4,495 6,689 11,184 Balboa.-3,436 3,899 7,335 1,006 940 1,946 4,442 4,839 9,281 Pedro Miguel 406 608 1,014 508 596 1,104 914 1,204 2,118 Paraiso. 869 2,883 3,752 556 869 1,425 1,425 3,752 5,177 Gamboa. 53 156 209 43 444 487 96 600 696 Gatun. 290 1,656 1,946 742 1,679 2,421 1,032 3,335 4,367 Colon. 727 3,109 3,836 723 798 1,521 1,450 3,907 5,357 Total. 8,394 16,291 24,685 15,460 8,035 13,495 13,854 24,326 38,180 CONSOLIDATED ADMISSION REPORT. White. Black. Total. Total admissions to hospitals, excluding Corozal Farm and Chronic Ward. 523 568 1,091 Total admissions of employees to quarters. 314 75 389 Total. .837 643 1,480 Less number of patients transferred between hos-pitals and from quarters to hospitals, whose admissions are duplicated in above figures. 19 53 72 Net admissions to hospitals and quarters. 818 590 1,408 Employees admitted to hospitals. 109 317 426 Employees admitted to quarters. 314 75 389 Total. 423 392 815

PAGE 37

35 TABLE X.-CONSOLIDATED DISPENSARY REPORT-Continued. CONSOLIDATED ADMISSIONS REPORT-Continued. White. Black. Total. Less number of patients transferred between hospitals and from quarters to hospitals, whose admissions are duplicated in above figures. 8 17 25 -Net admissions of employees to hospitals and quarters. 415 375 790 Annual average per thousand of admissions of employees to hospitals and quarters. 1,091.38 154.92 282.06 CONTAGIOUS AND INFEcTious DISEASES REPORTED DURING THE MONTH. Diseases. PanaColon. Canal Total. ma. Zone. Chicken pox.12 3 ,15 Diphtheria. 8 1 10 19 Dysentery. 1 ..1 Leprosy. 2 ..2 Malarial fever. 22 35 94 151 Measles. 12 1 5 18 Mumps.1 ..I Puerperal septicemia. ...1 Pneumonia. .1 1 Tetanus.:. I ..1 Tuberculosis (any organ). 21 3 13 37 Typhoid fever. 3 1 .4 Whooping cough. 2 2 .4 TABLE XI.-AVERAGE NUMBER OF EMPLOYEES CONSTANTLY SICK IN HOSPITALS AND QUARTERS. White. Colored. Total. Hospitals. Ancon Hospital. 43.40 174.16 217.56 Colon Hospital. 4.35 15.16 19.51 Total. -. 47.75 189.32 237.07 Quarters: Ancon. 5.48 .97 6.45 Balboa.%. 6.58 .13 6.71 Pedro Miguel. .81 .13 .94 Paraiso. .68 .55 1.23 Gamboa. .01 .01 Gatun..1.22 .74 1.96 Colon. 6.35 10.29 16.64 Total. 21.13 12.81 33.94

PAGE 38

36 TABLE XI.-AVERAGE NUMBER OF EMPLOYEES CONSTANTLY SICK IN HOSPITALS AND QUARTERS-Continued. Hospitals. Quarters. Total. Average number of employees constantly sick: White. 47.75 21.13 68.88 Colored. 189.32 12.81 202.13 Total. 237.07 33.94 271.01 Average number of employees constantly sick per 1,000: White. 10.47 4.63 15.10 Colored. 6.52 .44 6.96 Total. 7.05 1.01 8.06 TABLE XII.-AVERAGE LENGTH OF STAY IN HOSPITALS OR QUARTERS FOR EACH ADMISSION OF SICK EMPLOYEE. White. Black. Total. Hospitals: Ancon Hospital. 17.66 26.73 23.82, Colon Hospital. 6.10 6.95 6.89 Quarters: Ancon.:. 1.94 2.31 1.98 Balboa. 2.01 1.33 2.09 Pedro Miguel. 3.12 2.00 2.90 Paraiso. 1.91 4.25 2.53 Gamboa. 3.00 .3.00 Gatun. 2.60 5.75 3.26 Colon. 2.41 10.00 5.00 TABLE XIII.-FINANCIAL STATEMENT, DEPARTMENT OF HEALTH. July, 1916. June, 1916. July, 1915. Administration, chief health office. .$792.97 $566.43 $475.12 Hospital division: Ancon Hospital. 25,742.20 26,075.79 25,441. 84 Board of health laboratory. 1, 440. 96 2,107.05 1,551.67 Corozal farm. 6,143.71 6,024.47 5,553.60 Chronic ward .202.35 229.08 254.08 Colon Hospital. 3,803.60 4,316.32 3,042.33 Palo Seco Leper Asylum. 1,691.10 1,508.86 2,956.20 Santo Tomas Hospital. 866.63 805.50 1058.18 Medical storehouse. 930.17 1,595.41 1,031.69 Reserve for new tools (depreciation). 835.80 834.15 41,656.52 437496.63 40,889.5 District dentists. .91.21 294.48 445.52

PAGE 39

37 -TABE XI.-FINANCIAL STATEMENT DEPARTMENT OF HEALTHContinued. July, 1916. June, 1916. July, 1915. N a sIslan -...-.-. $126.95 Balboa.$1,028.61 $1,061.40 952.29 Corozal. ..........--.--------521.92 Pedro Miguel. .-. 500.47 448.99 416.18 Paraiso;.--.-.595.63 600.97 441.92 Gamboa.-----------------------------151.00 260.44 124.93 Gatun.623.07 577.24 465.16 2,989.99 3,198.52 3,494.87 Sanitary division: Generalinspector. 50.00 50.00 50.00 Health office, Panama. -. 3,338.25 3,630.77 3,185.35 Street cleaning. 4,254.49 4,128.26 4,202.74 Health-office, Colon-Cristobal. .2,680.64 3,007.35 2,225.22 Street cleaning. 2,101.29 2,327.39 2,087.92 12,424.67 13,143.77 11,749.23 Zone sanitationAncon.--.-.---.-.-.-. 2, 196.93 2,584.37 2,519.73 Balboa. 1,413.51 2,215.55 4,088.45 Corozal. 2,072.61 2,772.26 2,030.75 Pedro Miguel .3,965.59 4,043.61 2,563.72 Culebra. 24.58 Frijoles .2. .70.01 70.22 100.06 Gatun. 4130.88 4,437.65 2,736.93 Cristobal-Mount Hope. 2393.27 2,374.31 1,619.22 28,667.47 31,641.74 27,434.67 Quarantine division: Chief quarantine office. 170.87 117.23 209.55 Balboa-Panama. 1912.00 2,188.81 1,925.91 Colon-Cristobal. 3,182. 57 3,172.94 3,120.54 5,265.44 5,478.98 5,256.00 RECAPITULATION. Chief health office. 792.97 566.43 475.12 Hospital division. 41,656.52 43,496.63 40,889.59 D .2,989.99 3,198.52 3,494.87 division. 28,667.47 31,641.74 27,434.67 division. 5,265.44 5,478.98 5,256.00 79,372.39 84,382.30 77,550.25

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38 TABLE XIV.-ANCON HOSPITAL. REPORT OF NATIONALITY OF PATIENTS TREATED. Total American. Other nations. number treated.White. Black. White. Black. Hospital: Panama Canal employees. 414 68 2 39 305 Panama Railroad employees. 129 11 .10 108 Panama Government patients. 3 ...3 Other pay patients. 691 378 .74 239 Charity patients. 79 24 .3 52 Total. 1.316 481 2 126 707 AsylumPanama Canal employees 16 ..5 11 Panama Railroad employees. 8 ....8 Panama Government patents. 215 2 .29 184 Other pay patients. 13 4 -.-. 4 5 Charity patients. 58 3 .5 50 Total. 310 9 .43 258 Grand total. 1,626 490 2169 965 Soldiers .272 272 Chronics. 2Farm (eripples). 70 ..14 56 REPORT OF DAYS LOST IN HOSPITAL. Hospital: Panama Canal employees. 4,657 588 .429 3,64) Panama Railroad employees. 1,925 127 .163 1,635 Panama Government pa.tients. 69. .69 Other pay patients. 6,230 3,201 802 2,227 Charity patients. 1,153 229 .32 892 Total. 14,034 4,145 .1,426 8,463 Asylum: Panama Canal employees. 453 ..155 298 Panama Railroad employees. 231 ...231 Panama Government patients. 6,383 62 .862 5,459 Other pay patients. 213 37 .-. 110 66 Charity patients .1,715 93 .172 1,450 Total. 8,995 192 .1,299 7,504 Grand total. 23,029 4,337 .2,725 15,967 Soldiers. 2,398 2,398 Chronics ..620 .620 Farm (cripples). 1,914 ..343 1,571 Average cost per subsistence per day, S0.2589.

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39 TABLE XIV.-ANCON HOSPITAL-Continued. WARD LABORATORY REPORT. Blood examinations (total number). 703 Estivoaatumnal. 123 Quartan. 2 Tertian. .2 Differential counts. .20 Hemoglobein estimations. 170 Leucocyte counts. 128 Red-blood counts. 1 Stool examinations (total number). 695 Ascaris lumbroincoide. 19, Cercomonas intestinalis. 6 Ciliated nomads. 31 Entameba (hystolition and tetragena). 4 Guaiao tests .1 Pus and blood. 75 Strongloides. 23 -Tenia saginata dispar (ova). 2 Tricocephalus dispar. 38 Uncinaria (ova). 19. Urine examinations (total number). 2,009 Albumen. 454 Bile. 87 Casts. 441 Epitholia. .918 Guaac tests. 11 Indicon. 67 Pus 6. 6 Pus and blood. 96 Sugar-(positive 1, negative 176). 177 Sputum examinations (total number). 374 Positive for tubercle bacilli. 22 Smear examinations (total number). 30 Urethral. ..9 Vaginal. 9 Eye. 3 Prostatic. 1 Spinal fluid. 8 Albumin estimation. 1 REPORT OF SURGICAL OPERATIONS. Number. Died. Amputations: Digits, multiple. Operations on bones: Craniectomy, decompressive. 1 Ostiectomy. 2 Wiring of fracturesSimple. Compound. 1 Adenectomy: Cervical. IngninalSingle. .15 Compound. 5 Femoral. Herniotomy: Inguinal, single. 2 Genito-urinary tract: UrethrotomyInternal. .2 External. 1

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40 TABLE XIV.-ANCON HOSPITAL-Continued. REPORT OF SURGICAL OPERATIONS-Continued. Number. Died. Genito-urinary tract-Continued. -HydroceleSingle, radical cure------------------------------3. Double, radical cure.------------------------------1 Epididymotomy-.-. 8 .-. Curetage uteri. 13 Perineoplasty. ...-1 -------Trachelorrhaphy----.-. .1 Obstetrical: Cesarian section, vaginal1. I Low forceps. ....---------------------------------------2 -. Rectum: Hemorrhoids, radical cure-----------------------------6. Fistula in anus, excision of. 2 -------General: Thyroidectomy ------------------------------------1 -----.--Aneurismorrhaphy.--------------------------1 .------. Varicose veins, excision of.----------------. 4 .---Excision of surface neoplasms. 5 .-.---Plastic operation forSevere injuries --------------------------------------------Effects of disease. .--------------------------------1 .--Laparotomy: Exploratory. 1 -------.-. Castroenterostomy.-1 .---. Enterectomy.-----1.-------Appendectomy-------------------------------------16. Colostomy. 1 Supravaginal hysterectomy. .--------------------------4 .1 Hysteremyomectomy. ...-------------------------------5 -------SalpingectomySingle.---------.--1-------Double---------------------------------------2. Salpingo-oophorectomy. 5 -------Ovarian cystectomy. 1 ---------Oophorectomy.-------------1 ---------Suspensio-uteri. ...------------------------------------3 -------Plastic operation for chronic pelvis peritonitis. 1 --------Major operations.--. 3 Minor operations. 105 Total. 235 1 REPORT OF OPERATIONS, EYE AND EAR CLmrrc. Tonsillectomy. .----------------------------------------------------17 Adenoidectomy-------.-----------.--------------------------------13 Bubmucous resectory------------.----------------------------------9 Minor eye ..--.-----------.---------------------------------------3 Minor ear.-. ----------------------------------------------3 Turbinectomy-----------.-.---.------------------------------------3 Pterygium transplantations------------------------------------------2 Total -.--------------------------------------------------------------Refractions ----------------------------------------------------92

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41 TABLE XIV.-ANCON HOSPITAL-Continued. REPORT OF OUT-PATIENT DEPARTMENT. Clinic. Total New Pay Prescripvisits. cases. cases. tions. Medical. 288 224 45 252 Surgical. 236 105 8 34 Eye and ear. 659 212 3 61 Total. 1,183 541 56 347 MONTHLY VACCINATION REPORT. Number of adults vaccinated. 48 Number of "takes". 10 Number of school children vaccinated. 24 Number of "takes". 1 BOARD OF HEALTH LABORATORY. Bacteriological examinations ofBlood cultures. 16 Throat cultures. 111 Urines. 73 S tools.-.-. 101 Sputum.-. 4 Pathological fluids, exudated, etc. 14 Smears, gonococcus. 17 Culture of autopsies. 3 Leper suspects. 7 Milk. 7 Dairy milk from Corozal. 30 M iscellaneous. 1 Wassermann reactions. 847 Agglutination reactions. 5 Amebic pyorrhea. 11 Antityphoid vaccinations .1 A niM al inoculations.--.-.-. 10 Blood for m alaria. 28 Dark field examinations. 13 Chemical examinations ofM other's m ilk. 6 U rines. 6 B eer. 1 Fat determinations of milk from Corozal farm. 23 Spinal fluidsButyric acid test. 11 Ammonium sulphate. 11 Phenol test. 11 Colloidal gold. 9 Pathological tissues prepared-paraffin, 568; frozen, 2. 570 Surgical tissues reported. 73 Placental smears examined. 21 Autopsies performed. 21 Animals autopsied. 19 Rats examined: Mu8 m sculus .489 Mus norvegicus ..793 M s alexandrinus .12 JM us rattus. 153 -1,447 Bodies embalmed. 4 Interments at Corozal. 7 Taken to Panama. 2 Taken to Mount Hope. 1 ~a~tnn~.17

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42 TABLE XIV.-ANCON HOSPITAL-Continued. MOSQUITOES IDENTIFIED AT THE BOARD OF HEALTH LABORATORY DURING AUGUST, 1916. Stations. r Pedro, Mie rarrd 0 0 PAraio ......,3 5. 2 ......1347 Lorozald Cpost. .34 ..-. 1,2 ....7 ..-. .4,2 0 C o r a ds .....2, 419 ...._ 1. .2 42 Pedr TM i .g ...--------22122 .......70 .--1,2333 rdstationsr --.1 .1 64 21 .21 To ers ...6 .....1Y35 ..4 -.-. ......Y48 R G rb a.-------..--. 2 ,06 ........2,1412 Other places in Pedro Miguel district .2 ....2 229 ...20. 1 _. 254 Gatun.912 35-. 1 98 701 1 .1,748 New Gatun ..743 27-.-. 5 64 762 ........1,601 Frijoles.1,231 36 -.67 7, 563 ...I ..-. .8,898 Monte Lirio .350 1 ..50 4,927 ........5,'328 Barracks, Cristobal .102 69. .-. 1,297 21 2 1 2 .....1, 494 Silver Married Quarters, Cristobal .56 47-. .-.l,,083 16-. 8 1 .-. .1, 211 Mount Hope village .343 261.-.194 485 13 2_. 1 1_ .1, 300 Colon Hospital .91 71 -. 1 .1,)068 553 1 1 9 .-. .1,795 Other places, ColonCristobal district .129 W4 ...435 122 3 .1 1 a ..725 Fort Grant ......6 9 -. 85. .100 Camp Gaillard.2 ..1 2 89 7, 536 ...6 .7,63" Em pire. .............5 663 ...1 ...669 Camp E. .' 6tis. ..1 38 4,Y358 ...1 .4,398 Fort Randolph .1,590 704-.-. .103 385 .9 .1 .2,72 Fort Sherman .119 28 ..422 3,275 2. 5. 3 3,854 Total,. 584911313 2 10 5,758 49,7642313114139 2 1 1 363,039

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4 COROZAL HOSPITAL. STATEMENT OF COMMITMENTS, DISCHARGES, AND DEATHS. Male. Female. Commitments: From Canal Zone, first admission. 6 3 From Panama government, first admission .3 5 From Panama government (retransfer from Ancon Hospital). 13. Total-.--. 12 8 Well. Improved. Unimproved. Male. Female. Male. Female. Male. Female. Discharges: Barbados. .21 23 .22. Italy ....-. Panama ......-2 4 1 Spain. 1 .---. .. United States. .21 Total. 1 1 4 6 1 Deaths. Medical diagnosis. Mental diagnosis. Male. Female. 1. Tertiary syphilis. Psychosis associated with syphilis. 1. Lobar pneumonia; tertiary Psychosis undifferentiated. syphilis. 1. Arteriosclerosis; multiple abPsychosis associated with scesses of the lungs. arteriosclerosis. 1 Had been transferred A neon Hospital for surgical treatment. 2 6 deported to Barbados; 2 to United States; 1 to Italy. 8 1 transferred Ancon Hospital for surgical treatment. 41 eloped. TABLE XV.-COLON HOSPITAL. NATIONALITY OF PATIENTS. White White Black. Total. American. foreign. Panama Canal employeess. 17 8 38 63 Panama Railroad employees. 6 3 45 54 Panama pay. 1 10 1 Other pay. 24 21 10 55 Charity cases.7 2 3 12 Total. 54 35 106 195

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44 TABLE XV.-COLON HOSPITAL-Continued. LABORATORY REPORT. Blood examinations. .8& Estivo-autumnal.---------. 45 Tertian. 4 White-blood counts. 4 Differential counts. .9 Hemoglobin. ..2 Stool examinations-. --. 12 Tri.-ocephalus dispar .1 Strongyloides. 1 As-caris lumbricoides. 1 Urine examinations. ..191 Album en. 38 Pus. .19 Blood. 3 Sugar. ..2 Crystals. 29 Bile-. 1 Sputum examinations. 12 Positive for tubercle bacilli. 2 Smear examinations. 4 Urethral. 2 SURGICAL OPERATIONS. Amputations: Forearm. 1 Herniotomy: Inguinal, single. 5 Inguinal, double. & Genito-urinary tract: Curetage uteri. 2 Reetum: Hemorrhoids, radical cure. 1 General: Aneurismorrhaphy mitos obliterative, femoral. 1 Tenorrhaphy and myorrhaphy combined. 3 ExIsion of surface neoplasms. 1 Laparotomy: Gastro-enterostomy. 1 Appendeetomy. 2 Appendectomy with local peritonitis. 2 Minor operations, various. 11 Minor operations, various (dispensary). 133 Obstetrical: Deliveries. 7 TABLE XVI.-PALO SECO LEPER ASYLUM. NATIONALITY OF PATIENTS. Number Americans. Others. treated. Class. White. Black. White. Black. White. Black. Pay 6ases. 2 38 ..2 39 Charity cases .2 26 ..2 26 Total. 4 64 ..4 64 Cost of subsistence per patient per day, $0.23.

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45 TABLE XVII.-SANTO TOMAS HOSPITAL. RemainAdmitDisRemaining ted. charged. Died. ing. Aug. 1. Aug. 31. Pay cases. 44 52 76 3 17 Charity cases. 432 911 827 90 426 -Total. 474 963 903 93 443 Average number of patients constantly sick. 440 'Total number of days treatment. 13,717 Average number of days treatment for each patient. 9 NATIONALITY. Americans. Other nations. Number -Glass. treated. White. Black. White. Black. Pay cases. 96 15 .27 54 Charity cases. 1,343 ..155 1,188 Total. 1,439 15 .182 1,242 DISPENsARY REPORT. Class. White. Black. Total. Natives .50 679 729 Foreigners. 68 410 478 Total. 118 1,089 1,207 DIsEAsEs TREATED. M alaria. 30 -M easles. 7 Diphtheria and croup. 10 Influenza. 6 Dysentery. 12 Other epidemic diseases. 5 Purulent infection and septicemia. 15 Pellagra. 6 Tuberculosis of the lungs. 22 Abdominal tuberculosis. 1 Syphilis. .47 Soft chancre. 4 Gonococcus infection .44 Cancer and other malignant tumorsOf the buccal cavity. 1 Of the female genital organs. 2 Oftheskin. 1 Of other organs. 2 Leuchemia. 1 Alcoholism (acute or chronic) .12 Locom otor ataxia. .1 Other foims of mental alienation. 4 E epilepsy .4

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46 TABLE XVIL-SANTO TOMAS HOSPITAL-Continued. DISEASES TREATED-Continued. Hysteria. 5 Neuralgia and neuritis.5 Other diseases of the nervous system. 9 Other diseases of the eyes and their annexa. .11 Organic diseases of the heart .7 Diseases of the arteries. 4. Diseases of the veins. 6 Diseases of the lymphatic system. 22 Hemorrhage; other diseases of the circulatory system. 1 Chronic bronchitis.;. 14 Broncho-pneumonia.& Pleurisy. a Asthma. 1 Other diseases of the respiratory system. 1 Diseases of the teeth and gums.1 Diseases of the pharynx. 6 Other diseases of the stomach (cancer excepted). 2 Diarrhea and enteritis (under 2 years) .-. 8 Diarrhea and enteritis (2 years and over). 12 Ankylostomiasis. 67 Appendicitis and typhlitis. 5 Hernias, intestinal obstructions. 18 Diseases of the anus and fecal fistula. 2 Other diseases of the intestines. 5 Biliary calculi. 1 Other diseases of the liver. 4 Diseases of the spleen. 1 Simple peritonitis (nonpuerperal). 1 Pneumonia. 6 Bright's disease (chronic nephritis). 10 Other diseases of the kidney .2 Diseases of the bladder. 7 Diseases of the urethra. 11 Nonvenereal diseases of the female genital organs. 12 Uterine hemorrhage. 2 Uterine tumor (noncancerous). 3 Metritis. 9 Other diseases of the uterus. 12 Cysts and tumors of the ovary. .I Salpingitis and other diseases of the female genital organs. .8 Nonpuerperal diseases of the breast (cancer excepted). 1 Normal labor .80 Accidents of pregnancy. 24 Puerperal hemorrhage. 2 Puerperal albuminuria. 1 Furuncle .2 Acute abscess. 10 Other diseases of the skin and annexa. 34 Congenital malformations. 4 Diseases of the bones. 6 Diseases of the joints. 6 Amputations. 1 Other diseases of the organs of locomotion. 2 Nurslings discharged from hospital without disease. 85 Burns (conflagration excepted) .3 Traumatism by firearms. 9 Traumatism by cutting or piercing instruments. 12 Traumatism by other crushings. 1 Injuries by animals.I Dislocations. 4 ractures. 19 Other external violence. 17 Disease not specified or ill-defined. 3 No disease .2 Total. Deaths of patients. 93

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47 TABLE XVII.-SANTO TOMAS HOSPITAL-Continued. SURGICAL OPERATIONS. Number. Died. Amputation of thigh. 1 Amputation of foot. 2 Amputation of digits, multiple .6 Ostlectomy. ... Excision of maxilla. Resection of elbow. .1 Wiring of fractures, simple. .. Wiring of fractures, compound. 2 Adenectomy: Cervical. Inguinal, single. Herniotomy: Inguinal, single. 15 Inguinal, double. Femoral:. 1 Ventral. Combined (any two of the above). 1 Cystotomy. 1 Urethrotomy: Internal. 4 External. 3 Hydrocele, single, radical cure. 1 Orchidectomy. 1 Epididymotomy. 1 Curetage uteri. .8 Perineoplastic. 1 Vaginal sections. 5 Perineorrhaphy. 2 Hemorrhoids, radical cure. 4 Plastic operation for severe injuries. 1 Gunshot wound of soft parts, operation for. 1 Skin graft .13 Laparotomy exploratory. 1 Gastro-gnterostomy. Appendectomy. .10 Appendectomy, with local peritonitis. 1. Co ostomy. 1 Cholecystostomy. 2 Cholecystectomy. 1 Choledochotomy. 1 Spleenectomy.1. Panhysterectomy.1 Supravaginal hysterectomy. 4 Myomectomy. 2 Salpingectomy, single.2. Salpingo-oophorectomy.9. Suspensio-uteri.2. Minor various operations. 54. Total. 180 1

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48 TABLE XVIIL-SUMMARY OF SANITARY WORK PERFORMED AND MATERIAL EXPENDED DURING THE MONTH OF AUGUST IN THE CANAL ZONE. Work requests on supply department: Grass cutting-. 30 Screening. 8 Miscellaneous.-. 13 Work requests on municipal engineering department .18 Work requests on other departments. 1 Buildings inspected: For screening. 1,733 For mosquitoes. 4,438 For general sanitation. 2,260 Stores, inspections of. 24 Restaurants, inspections of. 16 Ships, inspection of. 82 Pit closets, inspections of. 552 Closets disinfected. 793 Garbage cans emptied. 2,912 Houses fumigated and disinfected. 5 Rat traps in use--.--. 425 Rats destroyed .637 Adult Anopheles caught. 3,043 Adult culices caught. 29,011 Stegomyia destroyed. 95 Fly-breeding places destroyed. 6 Larvacide used.gallons-589 Crude oil used.do. 17,061 Kerosene used.do. 918 SUMMARY OF ROUTINE WORK DoNE BY PANAMA HEALTH OFFICE. General sanitation: Linear feet of ditches cleaned and maintained .29,620 Linear feet of new ditches dug. 2,520 Number of cubic yards of earth used in filling. 0 Gallons of larvacide used. 600 Gallons of crude oil used.--. 5,805 Square yards of pools oiled.-. 439,650 Water containers treated .14,890 Mosquito-breeding places found (Stegomyia 108). -.--------327 Fly-breeding places found. 47 Flies trapped (13,000 per quart).-.quarts. 66 Number of rats killed. 979 Number of room disinfections. 18 Square feet of vegetation removed ..383,950 Garbage collection: Number of loads of garbage removed to dump .5,771 Number of cubic yards of garbage removed to dump. 8,756 Total number of cans garbage emptied. 42,509 Buildings: Number of buildings inspected .4,952 Number of plans for new buildings approved-. 18 Number of permits issued for repairs to old buildings. 79 Total number of building permits issued-. 97 Number of buildings condemned. 8 Number of stables condemned.-. 0 Number of buildings demolished. 5 Street cleaning: Average number of square yards of streets cleaned daily .600,000 Average number of square yards of streets sprinkled daily. 45,000 Number of private properties cleaned during month. 2 Number of notices served and nuisances abated .397 Vaccination: Number of vaccinations performed during month. 1,324 Total number of vaccinations since Apr. 1, 1914.--. 24,863

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49 TABLE XVIII.-SUMMARY OF SANITARY WORK, ETC.-Continued. MONTHLY WORK REPORT FOR COLON AND CRISTOBAL AND MOUNT HOPE. Sanitation, Colon-Cristobal: Streets cleaned .-.square yards. 4,200,604 Alleys maintained.do. 702,000 Private properties cleaned .777 Fumigated.cubic feet. Quinine issued .-.doses. 6,92& 1 ogs caught. 56 Dogs killed Rats caught .-. 236 Loads of yard garbage disposed of. 710 Cans garbage (cubic yards, 2,598). 67,722 Colon dump maintained. JL itches constructed (cubic yards, 92).linear yards. 850 Ditches maintained ..do. 898 Vegetation removedColon.acres. 2 Quarantine station .do. 3j Panama Railroad properties. do. 35 Colon.Hospital.do. 3j Panama Railroad reservation, Colon.do. 30 Parkway and E Street maintained. Square yards oiled .61,680 Receptacles treated. 45,630 Mosquitoes caught on Colon Hospital screensC u lex .--. 1,600 Anopheles. 118 Fly-breeding places destroyed. 3 Buildings inspected. 11,205 Larvacide used in Colon.gallons. 131.87 Crude oil used-in Colon .do. 1,375 Nuisances abated. 361 Building Colon: Building plans approved. 6 Permits to occupy issued. 8 Permits to repair issued. 41 Bills collected .164 Sewers, Colon: New connections made during the month. 7 Total number of connections made to date. 1,338 Houses to which connections were made .18 Outstanding permits.-. 42 Sanitation, Cristobal: Cans garbage (cubic yards, 740). 14,646 Loads of yard garbage handled. 231 Square yards oiled. 13,701 Receptacles treated. 10,320 Larvacide used .gallons. 19.5 Crude oil used .do. 525 Buildings inspected .2,250 Nuisances abated. 64 Sanitation, Mount Hope: Cans garbage (cubic yards, 178). .1,524 Square yards oiled. 193,000 Doses of quinine issued. 556 Receptacles treated. 28,700 Mosquito breeding places destroyed. 139 Mosquitoes caughtAnopheles Culex. Barracks..175 1,460 Sil. mar. quarters. 48 1,067 Steamships. .65 318 Mount Hope Village .239 457 Total. 527 3,302 Larvacide used .gallons. 200 Crude ollused.d. 2,930

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50 TABLE XVIII.-SUMMARY OF SANITARY WORK, ETC.-Continued. MONTHLY WORK REPORT, ETc.-Continued. Sanitation, Mount Hope-Continued. Mount Hope Cemetery maintainedDitches constructedMindi Islands (824 cubic yards).linear yards.' 4,732 Mount Hope (89 cubic yards).do. 400 Maintained. do.11,375 Vegetation removed .square yards. 254,350 Burials during the month. 54 TABLE XIX.-CONSOLIDATED REPORT OF QUARANTINE TRANSACTIONS AT THE PORTS OF BALBOA-PANAMA AND COLONCRISTOBAL. Vessels inspected and passed. 205 Vessels held in quarantine. 15 Total number of vessels entered .220 Special inspections made to enforce compliance with antiplague and mosquito-breeding regulations.-. 156 Vessels fumigated on arrival. .21 Vessels fumigated on departure .1 Vessels detained but sailed in quarantine. 6 Stowaways inspected .21 Crew examined. ..12,270 Passengers examined. .3,532 15,823 Supplementary inspections.-. 3,011 Persons vaccinated at port of arrival because of compulsory vaccination law. 320 Persons vaccinated at port of departure or en route because of compulsory vaccination law .1,290 1,610 Persons held in quarantine at the detention houses to complete period of incubation of yellow fever or plague. 37,4 Persons held in quarantine on board vessels to complete period of incubation of yellow fever or plague. 2,081 2,455 Total number of persons landed from foreign ports: Cabin.-. 1,652 Steerage. 1,124 ______2, 776 Total number of persons embarked for foreign ports: Cabin. 1,862 Steerage .1,474 3,336 Total number of persons arrivingfrom coast towns on small launches and sailing craft. 1,685 Total number of persons sailing fror coast towns on small launches and sailing craft .1,363 Apparent Increase for month from coast towns. .322 Apparent decrease for month from foreign ports: Cabin. 210 Steerage. 350 --560 Clearances issued. 53 Bills of health issued or vis6ed. 211 Inspection of docks. 10 Total number of persons landed. 4,461 Less number for Pacific ports .-226 Total number of persons sailing. 4,699 Total apparent decrease for month. 464

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51 TABLE XIX.-CONSOLIDATED REPORT OF QUARANTINE TRANSACTIONS, ETC.-Continued. IMMIGRATION REPORT FOR COLON AND CRISTOBAL. FromCabin. Steerage. Europe--. 9 9 United States .670 155 Jamaica and West Indies. 73 308 Venezuela. 11 4 Colombia. 70 145 Cuba. 27 16 Costa Rica. .89 14 Bocas del Toro. 28 134 Coast towns. .0 154 Total. 977 939 Grand total.1,916 M en. 864 W om en. 484 Children. 272 United States troops. 142 Unclassified. 154 1,808 QUARANTINE TRANSACTIONS AT THE PORT OF BOCOS DEL TORO, PANAMA. Vessels inspected and passed. 19 Crew inspected and passed. 1,332 Passengers inspected and passed. 238 Passengers, in transit, inspected and passed. 89 No quarantinable disease has appeared in this port, and the health conditions of the port and surrounding territory are good. TABLE XX.-STATEMENT OF QUININE ISSUED. Quinine sulphate.kilos. 22.00 Pounds avoirdupois. do. 48.50

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TABLE XXI.-PERSONNEL REPORT. August, 1916. July, August, .1916. 1915. Gold emSilver emTotal emTotal emTotal employees. ployees. ployees. ployees. ployees. Chief health officer. 5 .5 5 4 Medical storehouse----------4 4 8 8 8 Quarantine division---------15 34 49 46 43 Health office, Panama .-. 11 152 163 164 173 Health office, Colon-Mount Hope----------------------9 175 184 194 167 Ancon Hospital-------------125 250 375 371 323 Colon Hospital--------------15 25 40 41 34 Santo Tomas Hospital. 6 ------. 6 6 4 Palo Seco Leper Asylum ..2 3 40 36 35 Zone sanitation-------.-*7 132 139 135 12 Hospital farm.---------------2 63 65 58 45 Dispensaries: Balboa. 5 3 8 7 6Corozal.-----------------------------------------------4 Gamboa. 2 .2 1 1 Gatun. 2 2 4 4 4 Naos Island.------------------------------------------------1 Paraiso.-.-------2 2 4 4 4 Pedro Miguel. 3 1 4 4 3 Total2. 15 881 1,096 1,084 985

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UNIVERSITY OF FLORIDA 3 1262 08520 1167