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:
November 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_00011 ( 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:


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CONTENTS.


Page.
fte r or f transmittal. ...................................................... 5
b remarks .................. ........................................ 5
i statistics. .... .... ..... ......................... ... .............. 6



Huapi;Ai division:
~4con Hospital-----------------------8
'aici. Hospitalo..........................................................
.p; oard of health laboratory ......................................... 8
X':: :1 sdtnsane of d rtment ............................................... 8
SChraenic *Aid... o ..................................... .................. 9
Board of health laboratory---------------.-..---.--..-----.----. -8
bIesxe dopytrnent---------------------------.------------..... 8
Ironic w~rd-------------------------------------------...... 9
iton- H ospital......................................................... 9
ST Seco Leper Asylum............................................. 9
7 B'ito Tomas Hospital.................................................. 9
Strict dispensaries.................... .......................... 9
UflB.ary division:
Zone ................ ........................................... 10
;11............................................................... .......... 11
iiff division:
tJ1iboa-Panama...................................................... 12
o ba l ......................................................... 12
cN tables:
Ib I. Admissions, deaths, and noneffective rates for employees;

Deaths by nationality........................................... 15
4i [b fIV. rDeaths of white Americans.................................. 15
S::: Causes of deaths of employees............................... 16
VI. Causes of deaths of civil population (employees and nonem-
p1_rWs es) and military and places where hargeable.......... 16
SDs and deaths the hospitals of the anama Canal... 20
VII. Consbli ated hospital rept................................... 32
SIord- apslte4 dispensary and admission report................. 34
liR i Employees: Constantly sick and noneffective rates............ 36
XI.Employees: Days' treatment per admission, hospital and
quarters............................. ................ ....... 36
f I S Financial statement........................................... 37
Xin.. Afconm Hospital............................. ................... 38
XIV. ColonHospital................................................ 45
XV. Palo Beco Leper Asylum...................................... 46
,i Banto Tomas Hospital........................................ 46
3I. Sanitary work done in the Canal Zone, Panama, and Colon... 49
!VIIIn .Quarantine transactions...................................... 51
.I.; .Issues of quinine ................... ..................... .. 52
XX Personnef report.............................................. 53











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THE PANAMA CANAL,
CANAL ZONE HEALTH DEPARTMENT,
Balboa Heights, Canal Zone, December 9, 1916.
:;: :ieut. Col. CHESTER HARDING,
Acting Governor, The Panama Canal,
:: Balboa Heights, Canal Zone.
BSm: I have the honor to submit the following report of the opera-
tions of the department of health for the month of November, 1916.
Very respectfully,
D. C. HOWARD.
Chief Health Officer

S'.GENERAL REMARKS.

The general health of employees and nonemployees in the Canal
Z:: one and terminal cities has continued good.
: ..: .. A case of smallpox was admitted to Ancon Hospital on November
2,: 1916, from Panama City, in a West Indian sailor who was dis-
charged from the British steamship Coya on October 18, 1916.
The: disease was contracted before his arrival on the Isthmus.
This ship had called at Peruvian ports on her trip north, and took
an original bill of health at Salaverry, Peru; she sailed from that
Sort on October 11, 1916; called at Eten, Peru, and sailed on Octo-
er 13, 1916. The patient was isolated in Ancon Hospital and is
now convalescent. All known contacts were immediately vacci-
nated and isolated, and other usual precautions taken. The adult
contacts had been protected by vaccination, but there were three
C young children contacts who had never been vaccinated. The
first vaccinations were unsuccessful. On November 21 the second
c se appeared in a child "contact "-daughter of the first patient
..admitted. On November 23, a third case appeared in an infant
co:'" ': ntaort, living in an adjoining room of the same house. No
: further cases have developed. Of the three cases treated in Ancon
hospital, the first two are now convalescent, and the third (6
weeks old infant) died November 30. Previous to the above the
ast case of this disease brought to the Isthmus was in February,
S 1915; the last case originating on the Isthmus was in 1907.
.: :: ...:. The annual physical examination of gold employees was com-
S: enced during :the month. This year these examinations have
been made by a permanent personnel of physicians, clerks, and

; action to another as the work'requires. Formerly the examina-
S:ton were made by the district physicians in connection with their
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qpd 47.40 for whites for last month, and 17.41 for blacks and
whites for the corresponding month of last year.
as one death among American employees during the
giving a rate of 2.84, as compared with 2.85 for last month,
.i. for the month of November of last year.
....::-;:::, ..... ..
DEPORTATIONS.
~:ee were seven deportations accomplished during the month,
saployees (for injury 1, for disease 4) and two nonemployees.
CANAL ZONE.
.: EMPLOYEES AND NONEMPLOYEES.
hie population of the Canal Zone, according to the last police
ia taken in June, 1916, is 31,048. This includes employees,
a employees, and military garrisons residing or stationed within
lQanal Zone. Among this population there were 24 deaths
doetthe month of. November, 20 of which were from disease,
iu1 a death rate of 7.73, as compared with 9.66 for the preceding
and 11.14 for the corresponding month of last year.
l the total deaths from disease the percentage under 5 years
.ag was 20, as compared with 32 for last month.
ffiere were'54 births reported, giving a rate of 20.87; of these 14
Miliite and 40 colored.
I'here were three deaths of children under 1 year of age, all
'$i,: giving an infant mortality rate, based upon the number
A i s reported for the month, of 0 for white and 75 for colored
IliEi. 'with a general average of 56.
!tei percentage of stillbirths to total births was 7.
PANAMA CITY.
EMPLOYEES AND NONEMPLOYEES.
pe.i population of the city is 60,778, among whom there were
i-it.as during the month of November; of these 176 deaths were
k: isase, giving a rate of 34.75, as compared with 29.62 for the
4ing month and 27.63 for the corresponding month of last

:4the total deaths from disease the percentage under 5 years
was 52, as against 47 for last month.
ppncipal causes of death as compared with last month were


Novem
October. Noem-
her

(various organs).......................... 31 28
iadanteritis (uner 2 years)...................... 24
...1 tOWlamnia. ...'............................. 16 17
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gthe month there were 21 admissions, 7 deaths, 11 dis-
iand -no transfers. The daily per capital cost for October
ed statistics are shown in Table XIII.
-ihvard.-During the month there were 10 admissions, no
and 3 discharges. The average number of patients con-
:ly eared for was 21.77. The daily per capital cost for October

; COLON HOSPITAL.
.. Average number of patients constantly in hospital was
ed i ith 38 for the preceding month and 23 for the cor-
-Iifonth of last year. The average number of days'
.n pner employee was 9.25. The daily per capital cost per
agent icr October was'$2.27 gross.
;i~e4 d statistics are shown in Table XIV.

PALO SECO LEPER ASYLUM.
i Thie average number of patients constantly cared for during the
iitl ias.68.56, as compared with 67.67 for the preceding month
.!l44t for the corresponding month of last year. During No-
S r there was one admission and no deaths or discharges. The
i ,i capita cost per patient for October was $0.75 gross.
J- iliWflbd statistics are shown in Table XV.

..SANTO TOMAS HOSPITAL.
S.G Q thousand three hundred and seventy-one patients were
in the hospital during the month of November as compared
.1,4 14 for the preceding month and 1,388 for the corresponding
lat year. The daily average number of patients treated
*i/t9 as.compared with 440 for last month and 453 for the month
iyvember last year. The total number of days treatment wasE
;asI.& compared with 13,657 for last month.
iuimber .of deaths was 97, with tuberculosis of the lungs,
and enteritis (under 2 years), and congenital debility
causes in the order named.
ve cases of dysentery were treated during the month., with
S10 cases of pneumonia, with 1 death. There were no
for typhoid fever during the month.
i~tlil&d sttistics are shown in Table XVI.

DISTRICT DISPENSARIES.
ipenary .having the highest admission rate for malaria
with a anvetage weekly percentage of 0.11. There
,,admissions for malaria among the employees. of. the
: a pire district during the month.
Statistics are shown in Table IX.





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,The, 'ne
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are present, at a time'iln a th xic
placea h the, diA" t- la_
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There have been 4 cases of diphtheria reported during the month
S with 1 death. The same routine was employed as heretofore,
including hospitalization of cases, the taking of throat cultures
-from all contacts, their restriction for 10 days following expo*
sure, etc.
Two cases of typhoid fever were reported during the month
with no deaths. Both cases were in West Indians residing in the
section of the city known as Guachapali, but no connection could
be traced between them. In both cases the source of infection
was undetermined.
. A bureau of child hygiene was inaugurated under the direction
of this office during the month. One registered nurse was assigned
to the work and Santo Tomas Hospital was made a central head-
quarters for the time being. The plan is to take a certain number
., of infants from birth and by instruction of the mothers as to proper
'feeding, bathing, clothing, and general care trace them for an
indeterminate period. Visits are made to homes and one afternoon
per week an opportunity for consulting a hospital physician is
afforded. The goal sought is the lowering of the infant mortality
rate in this city which has for years been excessive.
The following is taken from the report of the registered nurse
in charge:
From the 11th, when the work commenced, to the end of the
month 61 babies' histories were taken and appropriate instruction
covering feeding, care of mouth, eyes, and general hygiene was
given to the mothers who in the main evinced considerable interest.
The first four days the attending nurse worked exclusively at the
station (Santo Tomas Hospital) but beginning on November 15
she began visits in the city in the follow-up campaign and from
then until November 30, 37 babies were visited in their homes.
On the weekly day for physician's inspection, 17 babies were
brought in; 2 it was deemed necessary to treat. Two infants who
were being artificially milk fed were returned to the breast.
Although in its beginning, the future outlook in this work is
encouraging.
SThe following communicable diseases were reported during the
month:
Beri-beri........................... 3 Smallpox ........................... 3
o: Cgickepox........................ 4 Syphilis............................. 7
S Diphteria......................... 4 Scarlet fever ...................... 1
S Dysentery-.......................... 2 Typhoid........................... 2-
M::. alaria.......................... 22 Tuberculosis....................... 28
S: easles ............................. 9 Tetanus............................. 2
::: nis.gitis........................ 3 Whooping cough.................... 3
Sll, agra............................. 1

COLON.
7.' : :7 ?
,';i. The activities of the health department have been along the
usual lines during the month. Good progress has been made in the
; permanent antimosquito work that has been under way in the
i:: s:: tobal and Mount Hope districts. Several large swamp areas
I:have been filled and the drainage facilities improved by laying tile
i:....and cementing ditches.


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. .-ADMIBSIONS, DEATHS, AND NONEFFECTIVE RATES FOR
.PFOYEES; DEATHS OF RESIDENTS OF PANAMA, COLON, AND
EI ONE.
:: ABSOLUTE NUMBERS.
.; "'.o **. '_________ ________


..r, 1916.

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.. Ne41c 1915.
o l."... ...........



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Num-
ber
of
em-
ploy-
ees.


4,703
30,328


Admissions to
hospitals.


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Deaths.







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Noneffec-
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2,459
5,945


81.98
198.15


35,031 376 264 112 13 9 4 8,404280.13


4,538 151 136 15 4 2 2 2 ,125 68.55
28,734 245 160 85 15 14 1 6, 292202.96

33,272 396 296 100 19 16 3 8,417271.51



4,593 140 119 21 2 0 2 2,362 78.72
29,631 329 234 95 21 17 4 7,692256.39


34,224


10,054


335:11


PROPORTIONATE NUMBERS.1


i mber, 1916.

................... 4,703298.53
:................ 30,328102.48


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

;Ocinoer, 1916.

J.. ................
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i. ..'..............



Muvember,' 1915.

.,. .............


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


250.05
65.68


48.48
36.79


2.55
4.75


17.43
6.53


35,031128.80 90.43 38.37 4.45.3.081.37 ...... 8.00



4,538399.29359.63 39.66 10.585.295.2 ...... 15.10
28,734102.32 66.82 35.50 6.265.84 .42...... 7.A0

33,272142.82106.76 36.06 6.855.771.08...... 8.16



4,59 365.77310.91 54.86 5.23 .... 5.23 ...... 17.14
29,631133.23 94.76 38.47 8.506.881.62...... 8.65


34,224


164.44


123.77 40.67


5.9612.10


9.79


1 Annual average per 1,000.


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Male.


,Antilles....... ........
Antigua ....... ........
Barbados....... 6
China........... ........
Colombia........ ........
Costa Rica..............
Demarara....... ........
Ecuador.............
England....... ........
Greece......... ........
Grenada....... ........
Guadeloupe...........
Hayti.......... ..1
HolIand......... ........
Italy............ ........
Jamaica......... 3
Martinique ...... 1
Montserrat..............
Nicaragua....... .....
Portugal........ ........
Panama......... ......
St. Kitts........ ........
St. Lucia........ ........
Spain........... ........
Russia......... ........
Trinidad........ 1
United States... 1
West Indies..... ........
Unknown....... ........
Peru............ ....


Total......


loyees.


Female.


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..........
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13 ..........


Nonemployees.


Male.


1
2
19
7
9


1
1




1
3
38
3
1


33
1
2
6
1
1
4
1

3


Female.


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2
11
1
13
1
3
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1
1


1


28
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28
2
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..........
35

1
2

1
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Male.


1
2
25
7
9



1


1
1


41
4
1


33
1
2
6
1
2
5
1

3


TABLE IV.-DEATH RATE AMONG AMERICANS ON THE ISTHMUS
CONNECTED WITH THE PANAMA CANAL.


Number Annual
of average
deaths. per 1,000.


l ;., White employees from the United States (4,221): External
::. .auses................................ ..................

ii': White women and children from the United.States (3,918)...

Ly: ',.iWhite employees and their families from the United States
(;:* (8,139): External causes ......... ...........................

l.j:otal number of Americans on the Canal Zone, including
S soldiers and their families (17,203):
,: Disease............ .... .......... ..........
xternal causes.......................... .................

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


1

..........


I. -


Totals.


~






'i "


;;


Female.


..........
2
11
1
13
1
3
..........
1
1


..........
1
28
2

1

35
..........
1
2
..........
1
..........
.......... .

..........


Grand
total.



1
4
36
8
22
1
3
1
2
1
1
1
1
1
4
69
6
1
1
1
68
1
3
8
1
3
5
1
1
3


S259


2.84

..........


_ ~~ ~


15


TABLE III.-DEATHS BY NATIONALITY.






J 14


4- J
......
- .Rnt
imummuuIYlt

t' --

tv '








17

ia nI, VT.-CAUSES OF DEATHS OF CIVIL POPULATION (EM-
P: PLOYEES AND NONEMPLOYEES) AND MILITARY AND PLACES
WHERE CHARGEABLE-Continued.


General diseases-Continued.
.Cancer and other malignant tumors of
; other organs and of organs not speci-
fled-...--...........................
Diabetes ... ........ ".................-
O their general diseases....................
I : Diseass of the nervous system and of the
i. organs of special sense.
: neplhalitis ...........................
Simple meningitis......................
L. ~ oomotor ataxia ............. ....
i'.: Other diseases of the spinal cord..........
Cerebral hemorrhage, apoplexy...........
fEpiepsy............ .......................
nv;:: i lsions of infants (under 5 years)....
Diseases of the circulatory system.
Po.ericarditis................ ..........
Ac,:..:0'pete endocarditis......................
S ganic diseases of the heart.............
Diseases of the arteries, atheroma, aneu-
I is4m, etc...........................
Arteriosclerosis ...........................
S Dfseases of the respiratory system.
'' e bronchitis. ........................
i:''.., anic bronchitis.......................
i-,. Broncho-pneumonia...................
S:,:: wLobar pneumonia .......... .........
i: th'" er diseases of the respiratory system
(tuberculosis excepted)...............
SDiseases of the digestive system.
o ute gastritis..........................
larrhea and enteritis (under 2 years)...
i s. ............................. .....
A, .i endicitis and typhlitis...............
4: i intestinal obstructions............
ii nstinal obstruction....................
: Ea-pl: peritonitis (nonpuerperal).......
i bovenereal diseases of the genito-urinary
system and annexa.
Ac;uifte nebphritis.........................
Snmoui::: n nephritis (Bright's disease)......
tw., lo-nophrosis.........................
.74084-17--3


Pana- Canal
Pa. Colon. Canal Totals.
ma. Zone.


n as l .
X l


3 ....


.... 1 ....... 5
5 2 2 .... 14
. i. .... 1 I....












19


DEATHS OF NONRESIDENTS.


no.--- '*' -----
of Panama.

p eo...........

Do ............

*t6n- del Toro,
B..P.
ftoBelo, R. P.,

. Quilue......
teari of Panama.

SS. S.Charleston.

of Panama.
Toro.....

erfor of Panama.

:, .......

i r of Panama.

irMnla R. P...
sMari, R. P..


Nationality.


Martinique..

Panama...

Barbados ...

Nicaragua..

Panama.....

Chiie.......
Mexico.....

United
States.
Jamaica .....
Panama.....

.....do......

China.......

Panama.....

Colombia...
Panama .....


Color.


Black...

...do....

...do....

...do....

...do....

White...
Black...

White...

Black...
...do....

...do....

Yellow..

Black...

...do....
...do....


Sex.


Male....

...do....

...do....

...do....

...do....

...do....
...do....

...do....

...do....
Female.

Male....

...do....

...do....

...do....
Female.


Age.


44

22

30

75

44

20
40

45

55
29

26

31

39

28
29


Diagnosis.


Pulmonary tuber-
culosis.
Broncho-pneumo-
nia.
Accidental drown-
ing.
SChronic myocardi-
Stis.
I Broncho-pneumo-
nia.
Lobar pneumonia.
SPulmonary tuber-
culosis.
SRailroad trauma-
tism.
SArteriosclerosis.
SPulmonary tuber-
culosis.
Chronic myocardi-
tis.
Estivoa u tumnal
malaria.
Pulmonary tuber-
culosis.
Do.
Chronic nephritis.


a2 r ...


;..... ..









ry
I,'..; ..: .

, .. ...:. o..










B i. -' 5" ,.:::..
..mE: "




"ai': :' :i,.: "
i ,::.:







:I .. !:.ii: =,( ,.


i:...

.:::iE. :.. r~;.~. ;;


L;-" '






Y
TA






TT


IT
210,w, te





B'la
Ameri-,
ns
4,W T!




Ocml* 4sea&x

oidlev-er
uJarw fever' v



----------


4Dghthdria, And TIM OUT)
D' 2,
1 *9 OACL5111 cataTOWO
3

ox-
=d
Wp
IT,

3"Of the
yfab,
Out .. .....
AzuWm erculom,

Tttbog ml
T

7
-T

hft te 3,

p-b"-


PI -4-

2=t,
TI,
Adoi*isbb cr -T., 3
'ant.
lowc iDf' tUO
d' jTjo

40 btW

"alt

1934,01"A
=Oof
-04
rtT
otub





tlj i] : i ,:, "



21


OF THE PANAMA CANAL FOR NOVEMBER, 1916.


SNonemployees. Nonresidents.


Discharges. Deaths. Discharges. Deaths.


White. White.

Black. Black. White. Black. White. Black. ; U
Sol- Oth-eOthers.

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


S .. F. 1. F. M... .. M. F. -M. F. -M. M.. -.








.... .... .... ... .. ... .. ... -
4 1 3 2 6 .... ...... ....... ... 1 1 ... ... ... ... ... ... ... 33 ...
S1.. ...... 1 2 ... ............ .... .... .... ... ... ... ... .. .. 12 ...

S1 2.... .... 1 1 ... ... ....... .... ... ... .. ..... ... ... 4 ...

.... ... .... 1 ... ...... ...... ........ ... ...... ... ... ... ... 1 1
.... .... .... 2... .... .... .... ... .... .... .... ... .. ... ... ... ...
... ....2 1 .... .... .... .... .... .... .... ... ... ... ... ... ... ... 5 ...
....1 2......... 1 .... .......... .... .... ..... ............ .... 14...
.. 1 ......... ....... ... ........ .. .... ... .. ... ... ... ... ... 1 ..


... ... .... .... ................ .... .... ....... ... ........ ....... .3...
; .. .... ---- --- 1 1 ............... .. ..... ..... .. ... ... ... ...


1 ..... .... ........................... 1

.... .... ..... ..1 ........ .... 1 ............ ... ............1 2 1
... ... 1 .. ... 1 .. ... .. .... .. ... ..... .. .... ... ... ... ... ... ... 1
..ii .... i. .... .... ........... 11.. .n.... 1
... ......... 1............... 1 ........................... 2

.... ............1.......... ........ .... ... ... ... ... ... ... ... 1
.... ............... 1.... ................ .... ... ... ......... ... .. 1 ...
...... .... ... ... ......... .... ..... ... ...... ... .. .. ... ... 33 ..
.... .... 4 ............... .. ... ... ... ... ... ... 24. 1.

.. .... .... .... ..... .... ............. ... .... ... ... ....... ..... ...
..1... 4... ..... ... ..... .. .... ... .............. ... 1
23 .... .... .... 2 1.... .... .... ..... ... ... ... .. ... .. .... ... ...I I..
S...... .... ................. ........ .......................
S1...l.................... .... .... ......... ... ... .......




... ................ 1 .... ... ....... 1.... ....... ...... ... ... ... 1 1
3 .... .... .... .... .... .... .... .... .... .... ... ... ... ... ... ... ... 9 ...






1.......... .... ........................... 1 1






49 9 620 29.... 1 7 6 8 1 ... ............... 17
1........1.... ....................1......... 6 .
2 .... .... .... ... ... .... ..... ..... ... ... ..
s:: "



,;. i ...... .. ...


















V lv-
WXI ggv 7 qv,



V






























CIA





WIRE








St








4w-%










W,








23

PANAMAA CANAL FOR NOVEMBER, 1916-Continued.


C Nonemployees.
fe:;; : '


Deaths.


Nonresidents.


Discharges. I Deaths.


hWhita White.
-". Black. Black. White. Black. White. Black.
Others. d Others.
'':*'" *'


F. I M. M.


M. I F. M.I F. I M.


I .II .I I .. I I III. I .
I.... l l ..............l......I.......I......III...


1::::I:::: .... I:::.:1: :.:::[::


f.':. i: :::I::::.I .::::::


2l212 2....2I 2...1


M. F.


----I... .... .... ....I .... ... .. -.. I'-I"


I... I..I..I.E


It-. 1.


I :..
2 1. I


~.I::::I::::


I ...




*o,,7w, 41. `,0 IV,

Ir








41
















F-

77
D*wek 0f Ow rev







tile ftmOV6 I-X

tb,6

cases '00 'au
gufftsv

D-
FOOwow t

W& (caite"Or cx6;iitea)
WS,




en





Ing'a ,m'v
thgr,


17

q', w-





4








25

PANAMA CANAL FOR NOVEMBER, 191-Continued.


':: Nonemployees.
'"..: "i


arges.


Deaths.


Nonresidents.


I- _


Discharges.


-- I I ______--


Black.


White.

Sol-thn
d'rs Othere.


'W I


1 ....::: ....
.... .... ....


1 1 ...
1.. .... ....
..1 .... 1












i i
.... 2 4....
2.. 4


.... 1.


Black. IWhite. IBlack.IWhite. Black.


III!l l


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


M. IF. M.i F F. M. F.


.10
. .;:.." : : .:.



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


Deaths.


--E-.I-'.--
--. ..


... ...I ... ...I...


:. .. ... q.S::.


-I


..


[:::I-:"




V4

TWO-* W'.
lJ:

/01;

OR
ph
ot
bW m
*Ae 7












i: 7 :.. : 27
. : ,.... ......





r Nonemployees. Nonresidents.



Discharges. Deaths. Discharges. Deaths.



White. White.


SBlack. Black. White. Black. White. Black.

d'r Others. d'r Others. 4







2 .....:.::.. 1 .... .... .... --- --. -- ---- -- - -- -

MM. F.... F.M. M..F F M. .... .... .... .... ... ... ... .. .. 2n
.... :... ....... .... .... .... .... .... .... .... .... .... ... ... ... ... ... ... ... 2

2 1 4 ....... ........ ............... ... ... ... ... .. 7






:.... .... .... 1 .... .... .... .... .... .... .... ... ... ... ... ... ... ... 3 ...
.... ... .... ... .... .... .. .. ... .... .... .... .. ... .. ... 2 ...
3 .... .... I ............ ...... .... .... ... ...... .. ... ... ...

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




S. ... ........................... ...... ...... ... ...... 6
............ .................... ................ ... ... ... ... ... .... .. ...

.. 1 ... .... .... ..... .. .. .... .. ... ... ... ... ... ...
... .... .... ... .. .... ... ... .... .... ... .. .. ... ... .. ... ...






2 ..... ........................ ... ... ... ... ... ... ...
S. .. .... .... .... ... .... ...... .... .... ... ... ... ... ... ... ... ...
.... 9 .... 1 .... .... .... .... .... .... ... ... ... .. .. ....... 19 ...


... .... 1 .... .... .... ... .... ........... .. ... .. ... ... ... ... 1 ...





.... .... .... .... .... .... .... ... ... ..... ... ... 9 ...
S2 .... ........................... ...... ...... .... ...
...- 1 --.... .... .. ... 1 .... .... .. .. ... 1





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



-:.... ..... ....... ............................ 1 ..
............ ............ ... ... ...







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

... ..1 .. .... 1 .... .... .... .... .... .. ... ... ... ... ... ... ... 1 ...
S..... ........... ......... ...
S.... 1 .... .... ...... .. ................ ... ... ... ... ... ...... ...


2 1 1 .... 1 .... .... .... .... .... .... ... ...... ... ... .. 8 ..-
'r ..'





"+. :






















......... .




Si



V




R,

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



61.
WS

.... ..






.... .... ...

'ILL

a,

.... .... .
.. ..... ...
07
. .
.. .. .. .......


igg
1 .4 ... .. .......
7i:!!:!:.,'.
j .K ..... .
......... ..
... .... .. ..... .


Ir. M, vV
.. ..... ... ...







R., x1n
N
M:., z
... .. ......
-4
'410



.. .. .... ..
I IF




R
4UR V.4 1
.xi .I::!: N
J.4

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

TM
'Vt'
5M.
Y3,

.... .... ...
....... ... .
-O 'N

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

i M 4,

,U



M .... ... .. .

VIE X 2'Aiko;.
Fi 4 :x


-x6 x

M U:, ilk:
I ...... .




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

.. ...... ..


W..


MAN:?!

.... .. ....
'k &.
Zd










29


?ANAMA CANAL FOR NOVEMBER, 1916-Continued.


I Nonemployees.
,;... ".. .


::.: .;.. ..



Black.




L.Y. .M. F.






14 ... ....



1 ... ....


Deaths.


White.

Black.
SOthers.


M. M. F. M. F.


Nonresidents.


Discharges. Deaths.


White.




M. F.


Black. White. Black.


M. F.

-


.... .... .... I .E.. .... ... L ..L ..


M F.


M. F.


e mew*,:; .' *
.:..... ..





tit':': .: t:itt:';:: t, .i: :' .
...... :....... .. .... ... ... .. .. .. *


10
10 1...


8 ..
1 ...


I ,


I 1....1.


.... .... .... .... .... 1 ... ... ... ..
.... .... .... 1 .... .... ... ... ... ...


::..:'.


....:::: ..::: ::::. .... : !:: ::: :




- t ,, '
mT

mmmwW,
ISO '
111 "l
iJ?



Affdin -pwmel
i!4
sp'3

10MIvooo.. ,3





iii ?'.. :
.r;:





"'i: i
i. ..;
1. ;,;
':'


31


P THE PANAMA CANAL FOR NOVEMBER, 1916-Continued.


..


Ii.f









IY',

C

11.1











'L~0~ i i




p:;~t.
*4*


o*l *




luwWa y
4151YOX:
4aoa"











... ......
won,
P:
W.M.


ly.. .. XM way.
ww" REEBOK_
,!N% it; WOW.
took sit
13 1 too Aj

... ... .....
&W 41 lowk

'IN


MIS w
;70 .. ...
U P ... ..
Wk, 4
am on 41?
PC yfmn -Ong
#27 F Y!,
... .... ......
..........
Wow _VA -
aL ;41-q
...... ... .

....... 5 4
9,;l f
41
R U
Fal, 1-ir

RP4 I "gum
.28;
7":
T:i. -Wopy g, in l k,
o:
m auv ... ... ......... 4 W ..
N

a .... ...... .
`wX ZU. i WN ly
Ti

q:: W wow lA...::.-..D= i
VA A W. Wnguyl. fgw .... .. ............ .
ANO A
MR.N. r

.11 .. ......... lw 4 _k
n.. i,_
vs, FV t W _':
_xx Y:
tt
U

-MST"
OR
A ... .........



va

W ..... ....


a.n. U.
Qqw,
-Not





y e%:.W ...., .. .....
.... ... ... .. ... ........ .
R

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







... '"





HOSPITAL REPORT.

I Whits foreign; B=Blacks.]


33


?'"'
;":5"

1...
"*;;;..

::~~"


'lumber of employees remaining in hospitals:
W hite.................................................................... O
Black.................................................................... 237

Total................................................................... 306

4! '*;*


I",-






9.I



K...
I-'a!

!r.


Discharged. Transferred. Average number constantly sick.


A. F. B. A. F. B. A. F. B. American. Foreign. Black. Total.




56 19 140 .... .... .... 25 10 113 24.33 13.13 112.87 150.23
.6 4 42 ........ 1 7 3 43 6.20 2.97 38.53 47.70
269 27 93 4 .... 1 84 23 65 103.80 23.17 58.03 185.00
13 3 28 .... 1 10 8 2 26 7.37 1.16 31.24 39.77

344 53 303 4 1 12 124 38 247 141.70 40.43 240.67 422.80.



.6 ........... ......... 6.00 6.00
..... ... 1 .... .... .... ........ 1 ........... ........ 1.17 1.17
... 1 4 ............ 2 34 188 2.00 33.53 188.10 223.63
4 ..... 1 .... .... .... 5 4 2 2.97 4.00 2.76 9.73
..... ..... ..... ............ 3 10 63 3.00 9.97 61.53 74.50

4 1 6 .... ........ 10 48 260 7.97 47.50 259.56 315.03

348 54 309 4 1 12 134 86 507 149.67 87.93 500.23 737. 8



..... ..... 3 ............ .... 10 55 ........... 10.00 52.87 62.87


.......... 1 .... .... 2 .... .... 24 .................... 21.77 21.77


11 2 24 2 1 8 3 2 7 2.36 2.73 9.21 14.30
8 4 24 ........ 9 6 3 12 4.03 1.36 8.71 14.10
1 2 .... .... 5 .... ......... .......... .60 .20 .80
15 15 4 2 1 2 7 6 .... 5.30 5.36 1.50 12.16
3 ..... 1 .... .... 2 2 -..- 1 ........... .80 .43 1.23

37 22 55 4 2 26 18 11 20 11.69 10.85 20.05 42.59


.... ..... ..... .... .... .... .... 2 38 ........... 2.00 40.56 42.56
.... ..... ..... .... .... .... .... 2 24 ........... 2.00 24.00 26.00

... ..... ..... ................ 4 62 ........... 4.00 64.56 68.56


67 21 167 2 1 8 28 22 181 26.69 25.86 180.95 233.50
14 8 67 ........ 10 13 6 56 10.23 4.33 48.41 62.97
... 2 6 ........ 5 2 36 226 2.00 36.13 228.86 266.99
288 42 98 6 1 3 96 33 67 112.07 32.53 62.29 206.89
16 3 30 .... 1 14 13 14 138 10.37 13.93 138.97 163.27

385 76 368 8 3 40 152 111668 161.36 112.78 659.48 933.62
u: __ __ __ ________________ 7





































































t4IM










35


IX.-CONSOLIDATED DISPENSARY REPORT-Continued.
: .CONSOLIDATED ADMISSION REPORT.


White. Black. TotaL


r admissions to hospitals, excluding Corozal
Sand chronic ward ............-............ 468 440 908
t madisions of employees to quarters......... 389 187 576
Total..................................... 857 627 1,484
ab ~ umber of patients transferred between hospi-
Itih and from quarters to hospitals, whose admis-
ons are duplicated in above figures............. 18 40 58

Net admissions to hospitals and quarters.... 839 587 1,426

EM PLOYEES.

I tto admitted to hospitals.................. 117 259 376
1~ptioyees admitted to quarters.................. 389 187 576
Totl--------------------------06 -4---952
total ...................................... 506 446 952
esm number transferred between hospitals and
Eoainquartersto hospitals, whose admissions are
iplicated in above figures...................... 10 20 30
-: Net admissions of employees to hospitals and
S quarters-.......... ....... .. ........... 496 426 922

lunual average per thousand of admissions of em-
:ityees to hospitals and quarters................ 1,265.79 168.55 315.83


ift exIOUS AND INFECTIOUS DISEASES REPORTED DURING THE MONTH OF
..:": NOVEMBER, 1916.


Disease. Panama. Colon. Canal Total.
Panma Col. Zone.


i... 3 ......... ...... 3
l syi o xlengi -----....................... 5 4 1 10
lida....................................... .......... ........ 2 2
a, c ................................... 4 2 4 10
..................................... 2 ........ ........ 2
.meningitia....................... ........ ........ 1
ver................................ 22 10 26 58



....tuberlar ................. .2........... 9 1 12 22
:....e.................................. 1 ........ ........ 1.
.................................. .......3 ... ........ I
.. ................................ 1 ........ ........ 1
I ........ ............................. 3 ........ ........ 3
...................................... 7 ........ ........ 7







Ca.
....e er................................ 2 ........ 1 3



H I :1aB >:;; titt h:.... 4A
H L ...H^ CO ff ..* *^ ** ** "uu *








Wn
i4


iJW
iAi
'T ,'k X




i-


i ~ (Hl ta
ioal



iaior
l~mmm7
iM

I -- -- ---












E'.LE XII.-FINANCIAL STATEMENT, DEPARTMENT OF HEALTH.


Oct., 1916. Sept., 1916. Oct., 1915.


' :: .Administration: Chief health office......... $407.18 5817.23 $959.22
Hospital division:
: Ancon Hospital....................... 27,815.06 26,129.16 24,427. 2
Board of health laboratory.......... 2,002.90 2,217.44 1,587.44
S.Corozal Hospital and farm........... 7,422.24 6,475.28 6,876. 07
SChronic ward..................... 209.80 215.26 215. 1E
Colon Hospital..................... 4,569.75 4,496.17 3,304. 1
S: Palo Seco Leper Asylum................. 1,482.59 1,979.55 1,828. 9
Santo Tomas Hospital................ 1,047.00 888.75 1,023. 7
Medical storehouse...................... 637.33 674.21 832. 7
Reserve for new tools.................... 2,159.04 2,095.77 ............

:: Total................................. 47,345.71 45,171.59 40,095.51


: District dentists............................
Dispensaries:
IB.::" boa ..................................
: : Corozal .................................
SPedro Miguel.........................
S Paraiso.................................
Gamboa................................
::: Gatun.................................
Total.................................

I : Sanitary division:
General inspector....................
Health office, Panama.................
Street cleaning, Panama..............
Health office, Colon.....................
Street cleaning, Colon.................

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

S' Zone sanitation:
Ancon .................................
Balboa.................................
SCorozal.............................
Pedro Miguel..........................
i":. Culebra...............................
S. Frijoles................................
Gatun .................................
Cristobal-Mount Hope................
Total ......... ..........................

E;, Quarantine division:
: Chief quarantine office................
S: Balboa-Panama....................
Colon-Cristobal....................
Inspection of cattle.............
Total.............................

-RECAPITULATION.

;.::i.E.hlef health office...........................
:'Hospital division...........................
*gDgpensaries................................
b'1WN Sanitary division..........................
quarantinee division........................

S Total................................


27.08 28.39 56.49

1,146.10 1,206.82 989.14
............ ............ 528.77
420.12 423.94 499.64
547.75 552.51 619.63
137.63 151.53 157.44
509.28 674.50 755.40

2,787.96 3,037.69 3,606.51

50.00 50.00 50.00
3,599.92 3,072.29 4,003.29
3,911.03 4,257.84 4.592.46
2,477.25 2,999.06 3,412.47
2,126.02 2,139.22 2,231.78

12,164.22 12,518.41 14,290.00

1,621.77 1,960.29 1,639.57
723.33 1,366.01 1,529.91
1.213.43 1,309.32 1,604.83
2,994.36 3,939.33 3,119.47
1.11
............ ............ 1.11
72.27 75.75 102.98
2,950.03 3,933.83 3,070.17
1,904.65 2.107.26 2,587.62

23,644.06 26,910.20 27,945.66

169.08 171.39 169.34
1,977.76 2,041.75 1,892.06
2,810.30 3,411.81 3,350.52
497.50 ............ ............

5,454.64 5,624.95 5,411.92


407.18 817.23 959.22
47,345.71 45,171.59 40,095.51
2,787.96 3,037.69 3,606.51
23,644.06 26,910.20 27,945.66
5,454.64 5,624.95 5,411.92


79,639.55


81,561.66


78,018.82


"I

r:;
r.

s.
I^

y


}
t

i
>
)

5


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I


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






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.. ... .... .


39

TABLE XIII.-ANCON HOSPITAL-Continued.
.:.i: ;:!; ....... ...
WAED LABORATORY REPORT.

ons (total number) ................ ...................... 54

un.........--.......................... .................... 26
: i In .................................................................. 14
])t: ent counts......-............................................... 1
m lobin estimations .. ................................................ 155
Asnl m counts .......................................................
R'o:' blood counts --....... -............ ............................... .. 8
xsfI nations (total number)a......................................... 508
-------------------------------------------------------------- I

i::' ac tests............................................................... 122
Asc'riB lumbricoides ................................................... 5
i: liatd nomads ............................. ........................... 6
S.Entamieba (hystolitica and tetragena) .............................. ...
;'::Tr a tests ............................................................ 92



itcinaria(ova)----------- ---------------------------- 30
Ur'j-Teinexaminuations (total number)......-.-....-....----................... 1,886
*N1u;::. s nil d blood............................ ............................ 427
S:o ?o B;it..o.;.es............................................................ 16
..*...: '' sfas nata disp.... r (ova) ............................................ T2

': iei a lus undspa -...--....--........................................-... 9
ha :::::: (ova) ........................................................ 949


S Gu tests (total number)......................................... 194
He.. crystals---------------------------------------------6



Bi ............................................... ..................... 681
S s and blood.................................................................. 42
.ga nomads......................................................... 11


p::: eai....nt......................... ............................... 34
SPitiv for tubrestse bacilli........................................................ 9433


S ea examination (total ..........number.............................................. 2
.......................... ..................................... 4it

: : t. ..........ite t .......................................................... 461
: t:, ai.r: oex sm.n neg. 35).................................................... 40

:iii. ;" :tF inal-Ui s........... ........................................... 346
i: sitieor tuberclebaci l ..... ........... ............................ 33






REPORT OF SURGICAL OPERATIONS.
,. ruminations (total mN.................. umber. Died.
ir;: be ral ................................................. 3i












9pera'xou on bones:
.Wrngof iractres, simple2- ................... ........----2..... .

S:;K: ii',: I~exiina ti................... .............................. .3 ........


~ Conical------------------------------------------S.......
'fluid' A ar -------------------------------------------------1-----
oatnnl singear-----------------------------------------------1
' 1.: tin smears~ne.... ............................................ .....
..,-... ea. s .............................................15. ..... ..



: t r: Number. Died.....2







i....gu ...le.................. ............................
^.i. oublei ................................................ .........
stifectom s ... ........................................ 2 ........
V.n g f d ue simple................................ 2 ........

eoal ................................................... 3 ........






urmary tract:
...pbrtomy-.............................................. 1 ........
.. .. ..t..tom I...... .'RaP ---- ------E- ---



.........otom external...................................... 4........
:::, radicalc. re.................................... 1 ........
a ::o'el natiadub e ......................................... 2 ........


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41

STABLE XHI.--ANCON HOSPITAL-Continued.
..MONTlym REPORT OF VAccmATIONS.
a a lts vaccinated ............................................... 522
takes ............................................................ 34
fhool children vaccinated...................................... 30
o takes....... .................. ................................... 6
S BOARD OF HEALTH LABORATORY.
Examinations of:
B ii ltutures (3 positive for B. typhosus) ............................. 20
c. t cultures (9 positive for B. diphtheriae; new 6, for release 3)..... 97
;kl"Y rm ................................................................. 155
Stiil;. : ............................... ........................... 142
pftuinm................................................................ 6
SFat oloical fluids, exudates, etc....................................... 8
S:,Smiars, goocoous...................................................... 2
iCi:lture of autopsies .............................................. .. 1
S: pe er susp ts .......................................................... 2
from Corozal................................................ 29
rinnetions ...................................................... 750
Its vaccineA prepared ............................................. 4
iftp'hod vaccinations ........... ....... .......... ...................... 1
.. vaccinations----------------------2
Vaccinations ..................................................... 26
iUillo allergin test (positive) ............................................
i l inoculations........................... ............................. 9
lwmination of blood preliminary to a transfusion; number of individuals.. 6
RBh field examinations .........................................----....... 13
ifogii points manufactured ...................... ...................... 2,355
Mitisj" l oe aminations of:
' i Jit ers' niilk .......................................................... 1
Wi' nC-.........---.........-.................................-........ 10
F;. at : determinations of milk from Corozal farm.......................... 4
i .PoiWer for poison ..................................................... 1
S' Sl~ tch contents....................................................... 4
SSto:: iaeh contents for opium...................................-........ 1
,:i onomy brand skim milk............................................ 1
I:'Spinal: fluids-
i::.- Butyric acid test ................................................... 10
:.-i'. :.Ammonium sulphate test........................................... 10
.O iW P. I oltest........... ............... .................................. 10
Colloidal gold test...................-................... .......... 3
l gfte l tissues prepared; paraffn 353; frozen 9......................... 362
tissues reported ................................................... 51
pathological examination....................................... 3
Smears ...........,............................................. 23
performed ...................... ................................. 2
atopsied (hogs 10; rats (complete) 10; calves 9; monkeys 1)........ 30
bodes examined.. .........-----.................................. 2
a mder observation ................................................ 1
mined (mus musculus, 535; mus norwegious, 757; mus alexandrinus,
ttas, 1)........................................................
rmunts at Corozal................................... .......... 10
to anma.......................... ........................... .. ...
to Gt unP .......................-........-...................... 1
en to Mount Hope.................................................. 1
tins.............................................................. 19



















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TABLE XIII.-ANCON HOSPITAL-Continued.
MOSQUITOES IDENTIFIED AT THE BOARD OF HEALTH LABORATORY-Continued.




Fe4
:.... n
o...'..:. :.' 3
: Stations. I. o

aS h- 0 0 .
as a 0 Z

P oc........ 1 1 1 .

r1e Ancon ................... ............ 2 .... 2....2 ..... .... .... .... 501
S Balboa .............. ................. .... .... 2 ..... ........... ..... 565
Corozal district..-....................... .... .... ....1 .... ........ ...... 75
SCorozal post........................... .... .... .... 3 .... .... .... .... 92
Pedro Miguel. 1 .. ................... .... .... ...... .... .... 280
Pedro Miguel railroad station............... .... .... ...... .... .... ...... 1,230
Paraiso ...... ........................ .... ... .. .... 1 1 1 ........ 237
Red Tank.......2.................-.... .... .... .... .... .... .... 25
Miraflores ............... ............. .... .... .... .... .... .... ..... 5
Rio Grande .......................... .... .... .... .... .... 536
Sr rLio & Cerro ........................... .... .... 1 ....I .... ... .... .... 666
i;Dredges, Culebra cut ................... ... 38 ... .... .... .... 1 .... 923
S Gamboa......... o ......................... .... .... 1 .... .... .... .... 2,654
oGatun.--..-a............................. 3.... .... 5 .... .... .... .... 554
New Gatunl............................ 1 .... ..... 1 .... .... ... .... 461
Frijoles................................ .... .... .... 6 .... .... .... 7,090
MonteLirio ........................... .... .... 1 .... .... .... .... 1,168
barracks, Cristobal..................... .... .... .... 2 .... .... .... .... 3,178
SSilver married quarters ................ .... .... .... 1. .... .... .... 1 1,232
Mount Hope village ................... ..... ..... .... .... .... .... 172
Panama Railroad cars, Cristobal ....... ............... ........ .... 123
S Colon Hospital............................. ............ ........ 1 1,026
Lincoln House, Colon ..................... .... ... .... .... .... .... 466
S: mp Gaillard-- ................ ......... .... .... 78 22 .... .... .... 2,673
Empire................................ ... .... 9 4 .... .... .... 627
Camp Otis .......... ...................... 1 ....... 1 ............ 1 4,328
..; : rt Randolph....................... .. ........................... 17
S b.. rt Sherman..................... .... .... .... ........ ........ 2 1,297
F rt Grant............................. .... 1 238 .... .... .... .... .... 697
Total............................. 10 41 240 116 -27 1 1 4 32,898









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45

TABLE XIV.-COLON HOSPITAL.
NATIONALITY.

White White tl
......... Black Total.
S : American. Foreign. B

ih tnlCa dl employees................. 16 5 39 60
iias.maB. R. employees ................ 14 7 46 67
-pagy.............................. ............ 2 8 10
si er ............................. 24 25 6 55
i~t y ............................ 5 .......... 4 9
:!; Ttal................. ......... 59 39 103 201


LABORATORY REPORT.
: mtiood examinations.................................................. 119
R:-. : Estivo-autumnal..................................................... 7
-:: Whits blood counts ............................................. 16
:. : Henglobin ........... ............. ............... .............. 4
t elentiacounts.............................. ........... ..............
i?;. iaria. ns....................................................... 5
Tricocephalus dispar................................................. 2
i:.ed.bood .... s ............................................. 1
r Pushalus..........pr............................................................... 1
: I idl exainations........... ......................................... 1
S bumen.................................................................. 109
a:Im, tats...I ns ......................................................... 167
S. Pu s.. .............................................................. 1
as Bood...-.........s.......ts.. ................................ 29
S."..................................................................... 4
l o' .................................................................. 29
c utum examinations..................................................... 61
S e' Psitive for tubercle bacilli........................................... 5
S*;miar exaninations................................................... 3
S:: ...ositive for gonorrhea................................................ 2

SURGICAL OPERATIONS.
: s iotomy:
n : L: guinal single........................................................ 2
I.. .t.l double.................... ............................... 1
-l-Tzturumary tract:
e.:: arizoeele, radical cure.; .......................................... 1
::...piddyJloto.my ..................................................... 1
ttage uteri.............................................................. 4
:M .aohelonhaphy ..................................................... 1
ow f6rceps ............................................................ I
.. lersionm................................................................ 1
S.Pr ineerrhaphy.................................................... 1
: Stab wound of chest, operation for............................... 1
2~~I.m: Hemorrhoids, radical cure......... .................... ...... 1
Tenorrhaphy................................. ...................... 3
tomy:
lGastroenterostomy (one for perforative duodenal ulcer, after closure of
loki and drainage).................................................. 2
S ndetomy .................................... ..................... 4
j m.' leutomy ...........................................................
': ari cspJeys tomy, bilateral ...................................... 1
i',...... l sio iteri................................................ 4
Imuior per nations, varous............. ..... ........ ......... 9
r oipeitions, various (disp sry)................................. 145

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47

TABLE XVI.--SANTO TOMAS HOSPITAL--Continued.
DISEASES TREATED.
M alari ..................................................................... 37
SSmalipox---------------------------3
: S. a lep ..................................................................... 1
S scarlet ever...................................................................
Diphtheria and croup ------------------------------------------------------
I, ,D ysuen ate ................................................................... 2
Lepy n ery .................................................................. 1
Dyrseney ----------------------------------------------------------i
Erysipelas.. ................................................................ 2
Other epidemic diseases................................................... 4
.;' Purulent infection and septicemia.......................................... 8
" ellagra.................................................................... 2
I ':- Tuberculosis of the lungs .............. i..................................... 12
K;.. Pott's disease---------------------------2
Pott's disease............................................................... 2
Syphilis .................................................................... 40
Soft chancre................................................................ 23
Gonococcus infection....................................................... 32
Cancer- and other malignant tumors of the breast.......................... 1
', Other tum ors............................................................... 4
Acute alcoholism ........................................................... 5
Other forms of mental alienations........................................... 4
S Epilepsy................................................................... 3
S H hysteria ................................................................... 2
S: Neuralgia and neuritis...................................................... 6
Other diseases of the eyes and their annexa................................. 8
i Organic diseases of the heart................................................ 9
-,, Diseases of the arteries...................................................... 4
Diseases of the veins........................................................ 3
Diseases of the lymphatic system........................................... 9
S Chronic bronchitis.......................................................... 21
Broncho-pneumonia....................................................... 2
I Pneum onia................................................................. 5
h: Pleurisy.................................................................... 4
Asthma-----------.................................................................... 2
Diseases of the pharynx.................................................... 19
I Other diseases of the stomach............................................... 4
Diarrhea and enteritis (under 2 years)...................................... 1
Diarrhea and enteritis (over 2 years)........................................ 6
Ankylostomiasis............................................................ 45
: Intestinal parasites......................................................... 9
Appendicitis and typhlitis.................................................. 11
Hernias, intestinal obstructions............................................. 12
SDiseases of the anus and fecal fistula-.....................-----------.....-......-----........-- 4
Other diseases of the intestines............................................. 10
S Biliary calculi .............................................................. 2
h), Other diseases of the liver.................................................. 2
Diseases of the spleen....................................................... 1
I ple peritonitis .......................................................... 2
.:'. Bright's disease (chronic nephritis)......................................... 34
SDiseases of the bladder..................................................... 2
:,Diseases of the urethra ..................................................... 3
Nonvenereal diseases of the female genital organs........................... 8
t rine hemorrhage........................................................ 2
SUterine tumor.............................................................. 1
ji4: ,:.. X tritis.................................................................... 14
*. Other diseases of the uterus................................................. 9
: Salpingitis and other diseases of the female genital organs................... 11
I" npuerperal diseases of the breast......................................... 1
M:.iI:m::,N labor............................................................... 100
:i:. dents of pregnancy..................................................... 18
Hi r accidents of labor.................................................... 2
: !;n;:: peral diseases of the breast............................................. 1
.&,. pte abscess.............................................................. 10
.rri 'C diseases of the skin and annexa...................................... 31
seases of the bones .......................................................
Dis1e7:6ases of the joints....................................................... 10

























































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49

EL". XVlH.-SUMMARY OF SANITARY WORK PERFORMED AND
MATERIAL EXPENDED DURING THE MONTH OF NOVEMBER IN
THE CA AL ZONE.
.Work requests on supply department:
Grass cutting......................................................... 40
r, eening.............................................................. 11
S,; ests on municipal engineering department...................... 13
S' orsereening........................................................ 1,622
:..: or mosquitoes........................................................ 5,237
For general sanitation................................................. 2,235
I Stores, inspections of ...................................................... 24
Restaurants, inspections of ................................................ 12
lShop, inspections of ..................................................... 76
: Notices served to abate nuisances.......................................... 2
Houses disinfected and fumigated.......................................... 4
:,. Pit closets inspected....................................................... 582
Closets disinfected......................................................... 665
Garbage cans emptied..................................................... 2,852
: at traps in use........................................................... 400
: ats d royed.................... ................... ..................... 489
; Number of mosquitoes destroyed in dwellings:
Anopheles............................................................. 919
Stegom yia............................................... .............. 40
S Cuex .................................................................. 1,696
I Masonia............... .............................................................. 12,498
Material expended:
Larvacide, gallons.................................................... 544
:rade oil, gallons...................................................... 12,872
Kerosene, gallons...................................................... 633
: Number of containers with stegomyla larva found ....................... 1
P:ly breeding places destroyed............................................. 5
REPORT OF ROUTINE WORK DONE BY HEALTH OFFICE, PANAMA.
I General sanitation:
Linear feet of ditches cleaned and maintained..-.......---.............----- ... ----74,400
: Linear feet of new ditches dug........................................ 115
Number of cubic yards of earth used in filling......................... 0
q;i (Gallons of larvacide used............................................. 935
l Gallons of crude oil used.............................................. 6,040
Gallons of kerosene used.............................................. 173
Square yards of pools oiled.......................................... 471,940
Water containers treated......................................... 10,685
i,:. Mosquito breeding places found (Stegomyia 128) .................... 329
S Fly breeding places found............................................ 54
Flies trapped (13,000 per quart)............................... .... 100
. :Number of rats killed............................................. 927
Number of room disinfections made................................... 25
Square feet of vegetation removed................................... 331,900
.arbage collection:
Number of loads of garbage removed to dump........................ 4,375
Number of cubic yards of garbage removed to dump...-............ 9,366
Total number of cans of garbage emptied............................. 42, 701
i, Sdings:
..Number of buildings inspected................................... 4,504
lu:tnber ol plans for new buildings approved........................ 13
Number of permits issued for repairs to old buildings................. 67
T;:otal building permits issued......................................... 80
'fi timber of buildings condemned..........-......................---. 10
3wamber of stables condemned...................................-------- 0
number of buildings demolished.......---.........................--.. 10
t meaning:
h've-age number of square yards of streets cleaned daily.............. 600,000
Average number of square yards of streets sprinkled daily ............ 0
iN:_aber of private properties cleaned during month.................. 7
WThnmber of nuisance notices served and nuisances abated............. 300
uiatluns:
.-itm ber of vaccinations performed during month ..................... 188
4i? o.falnu:nber of vaccinations since Apr. 1, 1914....................... 25,068














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t Hope-Continued.
b ..tf mosqqitps capght-Continued.
a .....-.................... ........................ 3,190
Bigver married quarters ................................. 1,572
Steam ship ........ ... ..... ... ........................... 1
9,y -m a sU1hip-------------------------------------------- 1I
ii,: Motnt Hope village... ............... 225
... ................................. 131
Total culex;::..U.......................-..... .- 5,119
"S6oE&f lirvabide used................... .............. 50
1 k i-~-lded oil used ......... .- ............... ............. 3,109.9
pe cemetery maintained.
jairs ditches constructed...c..........-................. 0
i .ib m a n ditaihes mnaintained............................... 9,650
s yards of vegetation removed.....--.....---....--.......... 125,200
Ei r of burials during the month ......-.....-.....-........ 40

_VIIL*--CONSOLIDATED REPORT OF QUARANTINE TRANS-
lfB AT THE PORTS OF BALBOA-PANAMA AND COLON
"i.FAL FOR THE MONTH OF NOVEMBER, 1916.
vessels inspected and passed .......................... .......203
Vessels h6ld in quarantine..................................... 16
il!n umber of vessels entered .................................... 219
. f special inspections made to enforce compliance with antiplague
f1i t.fl.to. breeding regulations...................................... 126
i.ivssels fldmigated on arrival .................................. 20
bid Ittessels ftmigated on departure................................ 1
:: ft vqssels detained but sailed in quarantine. .................... 8
eiofetaw examined.......-.. ..................................... 11,909
b.e:Ostowaways examined......... .................................. 5
itoIf passengers examined ........................... ............... 4,526
16,440
bit t supplementary examinations.;................................. 3,141
;'of. persons vaccinated at port of arrival because of compulsory-
i L law....................................... ............. 228
fpersonsvaccinated at port of departure........................ 1,283
S .. 1,511
ip persons held in quarantine at the detention houses to complete
O enbation of yellow (ever and.plague......................... 290
f persons held in quarantine on board vessels................... 1,613
1,903
Ibe.f persons landed from foreign ports:
.*-----. *'1,650
... ..... .. .............. 1650

3,620
o f trjmons embarked for foreign ports:
1,517
........ ...................................... 1,511
............ .............................................. 1 511-
3,028

ran sa arnivi from coast towns.................... 1,620
.ef persons sailingor coast towns......................... 1,413
nte.rease for month from coast towns..................... 207





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TABLE XX.-PERSONNEL REPORT.


bie health officer .........
edicest storehouse..........
r;ti~ tine division..........
"f ath office, Panama.......
S:talth office, Colon........
: Ancon Hosital............
hi|lon Hospital..............
Santo Tamas Hospital.......
"Pa': o Seco Leper Asylum.....
S.Zone sanitation ...........
; Hbspitiflarm...............
itfp ..es:
91bp4 ----bpf-a.........
S Coroa: ...............
Gamboa................
: Gatun.................
S Paraiso ..........
S Pedro Miguel..........
S Total.................






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LIj i 5.ll::.:.; ". ":


Nov., 1916.


Gold em-
ployees.


Silver em-
ployees.


I I i I


3
4
13
13
9
125
16
6
2
7
2

5
1
2
2
2


212 834 1,046


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Total em-
ployees.


Oct. 1916
(total em-
ployees).


4
8
46
152
160
367
41
6
35
124
51
8
.........
4
4
3

1,014


4
33
151
154
235
26
39
117
67

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

2
2
1


3
8
46
164
163
360
42
6
41
124
65
8
1
4
4
3


Nov.,1915
(total em-
ployees).


4
10
43
176
195
337
37
6
30
146
51

7
4
1
5
4
3
1,059






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PAGE 1

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REPORT OF THE DEPARTMENT OF HEALTH OF THE PANAMA CANAL FOR THE MONTH OF NOVEMBER, 1916 D. C. HOWARD Lieut. Colonel, Medical Corps, United States Army Chief Health Officer, Balboa Heights, Canal Zone WASHINGTON 1917

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VM C.s p ap

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CONTENTS. Page. Letter of transm ittal .5 General rem arks. 5 Vital statistics. 6 Health of employees. 6 Health of residents of the Canal Zone. 6 Health of residents of the city of Panama .6 Health of residents of the city of Colon. 8 Hospital division: Ancon H ospital. 8 Board of health laboratory. 8 Insane departm ent. 8 Chronic ward. 9 Colon H ospital ..9 Palo Seco Leper Asylum. 9 Santo Tomas Hospital. 9 District dispensaries. 9 Sanitary division: Canal Zone. 10 Panam a. 10 Colon. 11 Quarantine division: Balboa-Panama. 12 Colon-Cristobal. 12 Statistical tables: Table I. Admissions, deaths, and noneffective rates for employees; deaths of residents of Panama, Colon, and the Canal Zone. 13 II. 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. Discharges and deaths in the hospitals of the Panama Canal. 20 VIII. Consolidated hospital report. 32 IX. Consolidated dispensary and admission report. 34 X. Employees: Constantly sick and noneffective rates. 36 XI. Employees: Days' treatment per admission, hospital and quarters. 36 XII. Financial statement. 37 XIII. Ancon Hospital. 38 XIV. Colon Hospital. 45 XV. Palo Seco Leper Asylum. 46 XVI. Santo Tomas Hospital .46 XVII. Sanitary work done in the Canal Zone, Panama, and Colon. 49 XVIII. Quarantine transactions. 51 XIX. Issues of quinine. 52 XX. Personnel report. 53 (M

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#4*

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LETTER OF TRANSMITTAL. THE PANAMA CANAL, CANAL ZONE HEALTH DEPARTMENT, Balboa Heights, Canal Zone, December 9, 1916. Lieut. Col. CHESTER HARDING, Acting Governor, The Panama Canal, 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 November, 1916. Very respectfully, D. C. HOWARD. Chief Health Officer GENERAL REMARKS. The general health of employees and nonemployees in the Canal Zone and terminal cities has continued good. A case of smallpox was admitted to Ancon Hospital on November 2, 1916, from Panama City, in a West Indian sailor who was discharged from the British steamship Coya on October 18, 1916. The disease was contracted before his arrival on the Isthmus. This ship had called at Peruvian ports on her trip north, and took an original bill of health at Salaverry, Peru; she sailed from that port on October 11, 1916; called at Eten, Peru, and sailed on October 13, 1916. The patient was isolated in Ancon Hospital and is now convalescent. All known contacts were immediately vaccinated and isolated, and other usual precautions taken. The adult contacts had been protected by vaccination, but there were three young children contacts who had never been vaccinated. The first vaccinations were unsuccessful. On November 21 the second case appeared in a child "contact "-daughter of the first patient admitted. On November 23, a third case appeared in an infant "contact, living in an adjoining room of the same house. No further cases have developed. Of the three cases treated in Ancon Hospital, the first two are now convalescent, and the third (6 weeks old infant) died November 30. Previous to the above the last case of this disease brought to the Isthmus was in February, 1915; the last case originating on the Isthmus was in 1907. The annual physical examination of gold employees was commenced during the month. This year these examinations have been made by a permanent personnel of physicians, clerks, and attendants detailed for that purpose, and proceeding from one station to another as the work requires. Formerly the examinations were made by the district physicians in connection with their (5)

PAGE 8

6 regular duties. The present plan is resulting in more uniformity in the examination and is being accomplished more rapidly and with less inconvenience to the employees concerned. No diseases of a quarantinable nature, other than the smallpox cases mentioned above, originated on or were brought to the Isthmus during the month. VITAL STATISTICS. The following statistics are based upon the number of names appearing on the rolls for the preceding month, which was 35,031. The total number of admissions to hospitals and quarters ws 922, a rate of 315.83,1 as compared with 282.76 for the preceding month, and 311.01 for the corresponding month of last year. The total number of deaths from all causes was 13; of these, 9 were from disease, giving a death rate of 3.08, as compared with 5.77 for the preceding month and 5.96 for the corresponding month of last year. The constantly noneffective rate was 8, as compared with 8.16 for the preceding month and 9.79 for the corresponding period of last year. The total admission rate for malaria, hospitals and quarters, was 5.48, as compared with 13.71 for the preceding month, and 22.09 for the corresponding month of last year. The constantly noneffective rate for malaria was 0.24, as compared with 0.50 for last month and 0.70 for the month of November last year. The diseases causing the highest admission rates to hospital, in the order of their numerical importance, were: (1) Venereal digeases, (2) malaria, (3) tuberculosis, (4) bronchitis, and (5) pleurisy. These five diseases caused 22 per cent of all admissions to hospitals. Eight and one-half per cent of all admissions to hospital were caused by venereal diseases; malaria causing 4 per cent of all admissions. There were two admissions for typhoid fever during the month, giving an admission rate of 0.68, as compared with 0.72 for the preceding month. There were no admissions for typhoid durig November, 1915. EFFECTS OF RACE. The admission rate to hospital, and the death rate from disease, for black employees, were 65.68 and 3.56, respectively, gs compared with 66.82 and 5.84 for the preceding month and 133.23 and 6.88 for the corresponding month of last year. For white employees the admission rate to hospital and the death rate from disease were 250.05-and 0.00, respectively, as compared with 359.63 and 5.29 for the preceding month, and 365.77 and 0.00 for the corresponding month of last year. The constantly noneffective rates were 6.53 for blacks and 17.43 for whites. The admission rate to hospital and quarters for malaria was 5.14 for blacks and 7.65 for whites, as compared with a rate of 7.93 fr AUH morbidity and mortality rates are computed as equivalent annual-per 1,000.

PAGE 9

7 blacks and 47.40 for whites for last month, and 17.41 for blacks and 52.25 for whites for the corresponding month of last year. There was one death among American employees during the month, giving a rate of 2.84, as compared with 2.85 for last month, and 5.82 for the month of November of last year. DEPORTATIONS. There were seven deportations accomplished during the month, five employees (for injury 1, for disease 4) and two nonemployees. CANAL ZONE. EMPLOYEES AND NONEMPLOYEES. The population of the Canal Zone, according to the last police census taken in June, 1916, is 31,048. This includes employees, nonemployees, and military garrisons residing or stationed within the 'Canal Zone. Among this population there were 24 deaths during the month of November, 20 of which were from disease, giving a death rate of 7.73, as compared with 9.66 for the preceding month and 11.14 for the corresponding month of last year. Of the total deaths from disease the percentage under 5 years of age was 20, as compared with 32 for last month. There were 54 births reported, giving a rate of 20.87; of these 14 were white and 40 colored. There were three deaths of children under 1 year of age, all colored, giving an infant mortality rate, based upon the number of births reported for the month, of 0 for white and 75 for colored children, with a general average of 56. The percentage of stillbirths to total births was 7. PANAMA CITY. EMPLOYEES AND NONEMPLOYEES. The population of the city is 60,778, among whom there were 182 deaths during the month of November; of these 176 deaths were from disease, giving a rate of 34.75, as compared with 29.62 for the preceding month and 27.63 for the corresponding month of last year. Of the total deaths from disease the percentage under 5 years of age was 52, as against 47 for last month. The principal causes of death as compared with last month were as follows: Octoer.NovemOctober. ber. Tuberculosis (various organs). 31 28 Diarrhea and enteritis (under 2 years). 26 24 Broncho-pneum onia. 16 17

PAGE 10

8 There were 220 births reported, giving a rate of 43.44. There were 75 deaths under 1 year of age, giving an infant mortality rate based on the number of births reported for the month of 345. The percentage of stillbirths to total births was 8. COLON. EMPLOYEES AND NONEMPLOYEES. The population of the city is 24,693, among whom there were 53 deaths during the month of November; of these 52 deaths were from disease, giving a rate of 25.27, as compared with 30.13 for the preceding month and 20.87 for the corresponding month of last year. Of the total deaths from disease the percentage under 5 years of age was 43, as compared with 43 for the preceding month. The principal causes of death as compared with last month were as follows: October. November. Broncho-pneumonia. 12 7 Chronic nephritis. .--------------------------------7 7 Tuberculosis (various organs). .----------------------------10 5 There were 73 births reported, giving a rate of 35.48. There were 16 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 6. DIVISION OF HOSPITALS. ANCON HOSPITAL. The average number of patients constantly in the hospital proper during the month was 423, as compared with 416 for the precedig month, and 458 for the corresponding period of last year. The average number of days treatment per employee was 19.98. The daily per capita cost per patient for October was $1.64 gross. Thirty-six cases of malaria were admitted against 52 for October, 62 for September, 124 for August, and 143 for July. Seven deaths occurred from tuberculosis against 5 in October and 13 in September. Detailed statistics are shown in 'table XIII. Board of health laboratory.-The usual routine work has been continued during the month Two deaths in cattle from the Corozal farm were found to be due'to Texas cattle fe-v er, as a result of laboratory examinations. This is the first record of this disease on the Isthmus, so far as known. Corozal Hospital.-The average number of insane patients constantly cared for during November was 315, as compared with 310 for last month and 254 for the corresponding month of last year.

PAGE 11

9 During the month there were 21 admissions, 7 deaths, 11 discharges; and no transfers. The daily per capita cost for October was $0.49 gross. Detailed statistics are shown in Table XIII. Chronic ward.-During the month there were 10 admissions, no deaths, and 3 discharges. The average number of patients constantly cared for was 21.77. The daily per capita cost for October was $0.36. COLON HOSPITAL. The average number of patients constantly in hospital was 43, as compared with 38 for the preceding month and 23 for the corresponding* month of last year. The average number of days' treatment per employee was 9.25. The daily per capita cost per patient for October was $2.27 gross. Detailed statistics are shown in Table XIV. PALO SEcO LEPER ASYLUM. The average number of patients constantly cared for during the month was 68.56, as compared with 67.67 for the preceding month and 57.40 for the corresponding month of last year. During November there was one admission and no deaths or discharges. The daily per capita cost per patient for October was $0.75 gross. Detailed statistics are shown in Table XV. SANTO TOMAS HOSPITAL. One thousand three hundred and seventy-one patients were treated in the hospital during the month of November as compared with 1,414 for the preceding month and 1,388 for the corresponding month last year. The daily average number of patients treated was 450, as compared with 440 for last month and 453 for the month of November last year. The total number of days treatment was 13,340 as compared with 13,657 for last month. The number of deaths was 97, with tuberculosis of the lungs, diarrhea, and enteritis (under 2 years), and congenital debility the chief causes in the order named. Twelve cases of dysentery were treated during the month, with no deaths; 10 cases of pneumonia, with 1 death. There were no admissions for typhoid fever during the month. Detailed statistics are shown in Table XVI. DISTRICT DISPENSARIES. The dispensary having the highest admission rate for malaria was Gatun with an average weekly percentage of 0.11. There were no admissions for malaria among the employees of the Culebra-Empire district during the month. Detailed statistics are shown in Table IX. 74084-17-2

PAGE 12

10 ZONE SANITATION. CANAL. The energies of this division are directed chiefly toward the control of malarial fever, which has been responsible for the noneffective rate among employees to a greater extent than any other disease. The work has been so far successful that-as noted elsewhere in this report-there are now occasional months during which malaria takes second or third place in the list of causes for admissions to sick report. The extermination of malarial fever in a given district is best accomplished by the elimination of mosquitoes, and this is effected in a large measure by destruction of mosquito larvae. During November the residence districts have been almost free from mosquitoes, due to the fact that the usual measures employed by this division were supplemented by the very heavy rains, which flush out the streams, pools, and various other breeding places, destroying the larva. A few mosquitoes are present at all times in all districts and the search for their breeding places by the district inspectors is based on the reports from the board of health laboratory as to the kinds of mosquitoes present. These reports indicate that we have present certain kinds, the larvae of which are not destroyed by oiling the surface of the breeding places (thus preventing them from obtaining oxygen) and which are not vulnerable to any of our present modes of attack. A recent and very comprehensive publication on mosquitoes (The Mosquitoes of North and Central America and the West Indies, by Howard, Dyar & Knab), referring to the habits of the larvae, says, "Some, indeed, never rise to the surface and obtain the necessary oxygen from the water by osmosis, or in the case of Mansonia, from the vascular roots of aquatic plants." Fortunately, these species which are not reached by the usual methods directed toward the elimination of mosquitoes, have not been incriminated as carriers of disease, but they are annoying and, for this department, they complicate the problem of the absolute elimination of the mosquito. There have been no epidemics on the Zone during the month, but sporadic cases of communicable diseases have been reported as follows: Chickenpox. 5 Measles .--. 12 Diarrhea. 2 Tuberculosis (various organs). 7 Diphtheria. 4 Typhoid fever.1 Malarial fever. 26 PANAMA. For the month Santo Tomas Hospital reported 16 admissions for malaria and Ancon Hospital 6 admissions, making a total of 22 cases. Compared with the corresponding month of 1915 there were 20 cases chargeable to Panama and in November, 1914, 167 cases.

PAGE 13

11 There have been 4 cases of diphtheria reported during the month with 1 death. The same routine was employed as heretofore, including hospitalization of cases, the taking of throat cultures from all contacts, their restriction for 10 days following expo. sure, etc. Two cases of typhoid fever were reported during the month with no deaths. Both cases were in West Indians residing in the section of the city known as Guachapali, but no connection could be traced between them. In both cases the source of infection was undetermined. A bureau of child hygiene was inaugurated under the direction of this office during the month. One registered nurse was assigned to the work and Santo Tomas Hospital was made a central headquarters for the time being. The plan is to take a certain number of infants from birth and by instruction of the mothers as to proper feeding, bathing, clothing, and general care trace them for an indeterminate period. Visits are made to homes and one afternoon per week an opportunity for consulting a hospital physician is afforded. The goal sought is the lowering of the infant mortality rate in this city which has for years been excessive. The following is taken from the report of the registered nurse in charge: From the 11th, when the work commenced, to the end of the month 61 babies' histories were taken and appropriate instruction covering feeding, care of mouth, eyes, and general hygiene was given to the mothers who in the main evinced considerable interest. The first four days the attending nurse worked exclusively at the station (Santo Tomas Hospital) but beginning on November 15 she began visits in the city in the follow-up campaign and from then until November 30, 37 babies were visited in their homes. On the weekly day for physician's inspection, 17 babies were brought in; 2 it was deemed necessary to treat. Two infants who were being artificially milk fed were returned to the breast. Although in its beginning, the future outlook in this work is encouraging. The following communicable diseases were reported during the month: Beri-beri. 3 Sm allpox. 3 Chickenpox. 4 Syphilis. 7 Diphtheria. 4 Scarlet fever .1 Dysentery. 2 Typhoid. 2. Malaria. 22 Tuberculosis. 28 Measles. 9 Tetanus. 2 Meningitis. 3 W hooping cough. 3 Pellagra. 1 COLON. The activities of the health department have been along the usual lines during the month. Good progress has been made in the permanent antimosquito work that has been under way in the Cristobal and Mount Hope districts. Several large swamp areas have been filled and the drainage facilities improved by laying tile and cementing ditches.

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12 The following notifiable diseases were reported during the month: Chickenpox. 1 Measles.Malaria. 10 Pneumonia.1 Diphtheria. 2 Whooping cough.--. 3 Tuberculosis -5 Yaws. I QUARANTINE SERVICE. The quarantine transactions during the month on the Atlantic side were conducted without special incident, and no special changes have been noted in conditions on the Atlantic side in South America and West Indian Islands. No further reports of yellow fever at Barbados have been received since the report of six cases occurring in September. Quarantine conditions along the west coast of South America show little change except in Guayaquil, Ecuador, where the usual seasonal increase in both the yellow fever and plague is now manifesting itself. No cases of yellow fever have been reported at Buenaventura, Colombia, for some months, and the reports of the inspectors on the steamship Jamaica and the steamship Balboa would indicate that no cases actually exist at the present time in this port, although sanitary conditions are such that its reappearance at any time could not be considered as unlooked for. One case of bubonic plague was reported in a white sailor on the steamship Santa Rita, the infection in this case evidently having been received in the small port of Caldera, Chile. This man was removed. to the Lazareto, in Callao, Peru, where the case terminated fatally. Smallpox is reported as being more than usually prevalent along the coast of Peru and Ecuador. Supervision has been maintained over the inspection of animals at the abattoir at Cristobal during the month, and condemnations of meat made in accordance with the Federal Meat Inspection regulations. Quarantine inspection of 718 cattle was made, of which 156 were local inspections for shipments across the Panama Railroad. Quarantine inspections at the Cristobal abattoir were made on 1,023 cattle and 2 sheep; the routine procedure of inspection at the abattoir includes the microscopic examination of splenic smears. Anthrax occurred on pastures 59, 56, and 35 during the month of this report. The total number of deaths on these pastures was 13. One animal from pasture lower 59 died in the car at the abattoir. No deaths have occurred since the 22d of the month. The outbreak of anthrax referred to, occurring between November 11 and 22, was apparently caused by overcrowding of pastures 35, 56, and 59. This situation has been relieved.

PAGE 15

13 TABLE I.-ADMISSIONS, DEATHS, AND NONEFFECTIVE RATES FOR EMPLOYEES; DEATHS OF RESIDENTS OF PANAMA, COLON, AND THE ZONE. ABSOLUTE NUMBERS. Admissions to Deaths. tne fe sickness. Number of employ> 3 ees. -6 00 November, 1916. White. 4,703 117 98 19 1 0 1 2,459' 81.98 Colored. 30,328 259 166 93 12 9 3 5,945198.15 Total.35,031 376 264 112 13 9 4 8, 404 280.13 October, 1916. White. 4,538 151 136 15 41 21 2 2,125 68.55 Colored.28,734 245 160 85 15 14 1 6,292202.96 Total. 33, 272 396 296 100 19 16 3 8,417 271.51 November, 1915. White. 4,593 140 119 21 2 0 2 2,362 78.72 Colored.29,631 329 234 95 21 17 4 7,692256.39 Total.34,224 469 353 116 23 17 610,054335.11 PROPORTIONATE NUMBERS.1 November, 1916. White. 4,703298.53250.05 48.48 2.55 .2.55. 17.43 Colored. 30,328102.48 65.68 36.79 4.75 3.561.19 .6.53 Total. 35,031128.80 90.43 38.37 4.45 3.081.37 .8.00 October, 1916. White. 4, 538 399.29 359.63 39.66 10.58 5.29 5.29 .15.10 Colored.28,734102.32 66.82 35.50 6.265.84 .42. 7.06 Total. 33,272 142.82 106.76 36.06 6.85 5.77 1.08 .8.16 November, 1915. White. 4, 593 365.77 310.91 54.86 5.23 .5.23 .17.14 Colored .29, 631 133.23 94.76 38.47 8.506.88 1.62 .8.65 Total. 34,224 164.44 123.77 40.67 8.06 5.9612.10 .9.79 1 Annual average per 1,000.

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14 TABLE I.-DEATHS OF RESIDENTS OF THE CITIES OF PANAMA, COLON, AND THE CANAL ZONE-Continued. Deaths. Annual average per 1,000. Place. Population. Total. DisExternal Total. DisExternal ease. causes. ease. causes. November, 1916. Panama. 60,778. 182 176 6 35.93 34.75 1.18 Colon. 24, 693 53 52 1 25.76 25.27 .49 Canal Zone. 31,048 24 20 4 9.28 7.73 1.54 Total. 116, 519 259 248 11 26.67 25.54 1.13 October, 1916. Panama. 60,778 156 150 6 30.80 29.62 1.18 Colon. 24,693 64 62 2 31.10 30.13 .97 Canal Zone. 31,048 28 25 3 10.82 9.66 1.62 Total. 116,519 248 237 11 25.54 24.41 1.13 November, 1915. Panama. 60,373 146 139 7 29.02 27.63 1.39 Colon. 29,331 53 51 2 21.68 20.87 .81 CanalZone. 31,219 34 29 5 13.06 11.14 1.92 Total.120,923 233 219 14 23.12 21.73 1.39 TABLE IL.-DEATHS BY AGE, COLOR, AND SEX. White. Colored. Yellow. Total. 00 UnderIyear. 6 3 9 50 33 83 1 .1 57 36 93 1 to 4 years. 1 1 2 13 11 24 1 1 2 15 13 28 5 to 10 years. .1 1 3 2 5 ...3 3 6 10 to 20 years. .1 1 2 5 7 ...2 6 S 21 to 30 years. 5 3 8 17 13 30 1 .1 23 16 39 31 to 40 years. 3 .3 18 13 31 1 1 22 13 35 41to50years. 1 1 2 15 4 19 1 1 17 5 22 51 to 60 years. 3 1 4 4 6 10 1 .1 8 7 15 61to70years. 2 .2 1 4 5 .3 4 7 71 to 80 years ....2 2 1 1 3 .3 81 to 90 years. 1 1 .2 2 ..3 3 Total. 21 12 33 125 93 218 7 1 8 153 106 259

PAGE 17

15 TABLE III.-DEATHS BY NATIONALITY. Employees. Nonemployees. Totals. Grand total. Male. Female. Male. Female. Male. Female. Antilles. ....-.1 .1 Antigua ...2 2 2 2 4 Barbados. 6 .19 11 25 11 36 China. ..7 1 7 1 & Colombia. ..9 13 9 131 22 Costa Rica. ...1 1 Demarara. ...3 .3 3 Ecuador. .1.1 1 England. ..1 1 1 1 2 Greece.1 .1 1 Grenada. ...1 .1 1 Guadeloupe -..I .1.11 Hayti. ...1 Holland. ..1 .1 Italy ...3 3 1 4 Jamaica. 3 .38 28 41 28 69 Martinique. 1 .3 2 4 2 6 Montserrat. .1 .-. 1 Nicaragua. ....1 1 Portugal. .1. 1 .1 Panama. .-. .33 35 33 35 68 St. Kitts. ..1 .1 1 St. Lucia. ..2 1 2 1 3 Spain. ..6 2 6 2 8 Russia. ..1 .1 .1 Trinidad .1 .1 1 2 1 3 United States. 1 .4 .5 .5 West Indies. .1 .1 .1 Unknown. ...1 1 Peru. .3. 3 .3 Total. 13 .140 106 153 106 259 TABLE IV.-DEATH RATE AMONG AMERICANS ON THE ISTHMUS CONNECTED WITH THE PANAMA CANAL. Number Annual of average deaths. per 1,000. White employees from the United States (4,221): External causes.1 2.84 White women and children from the United States (3,918). White employees and their families from the United States (8,139): External causes .1 1. 47 Total number of Americans on the Canal Zone, including soldiers and their families (17,203): D isease. 1 .70 External causes. 2 1.39 Total. 3 2.09

PAGE 18

16 TABLE V.-CAUSES OF DEATHS OF EMPLOYEES OF THE PANAMA CANAL AND PANAMA RAILROAD CO. White. Colored. Total. Disease. Tuberculosis of the lungs. 2 2 Disseminated tuberculosis. .1 1 Lobar pneumonia. .1 1 Organic diseases of the heart. .2 2 Chronic nepbritis. .1 1 Pywmia, streptococcic. ..1 1 Rapture of aortic aneurysm into pericardium. .1 1 External causes. Drowning, accidental. .2 2 Accidental traumatism. .1 1 Suicide-hemorrhage from incised wound.I .I Total.1 12 13 TABLE VI.-CAUSES OF DEATHS OF CIVIL POPULATION (EMPLOYEES AND NONEMPLOYEES) AND MILITARY AND PLACES WHERE CHARGEABLE. PanaColon. Canal Totals. ma. Zone. 0 General diseases. Malarial fever, estivo-autumnal. ...1 .1 1 Smallpox. 1 .....1 1 Whooping cough.1. ....1 1 Diphtheria and croup. .1. ....1 1 Dysentery.1. 1 .1 Purulent infection and septicemia. ..I Pyemia. 1. ..1 .1 Septicemia. ..1 1 .1 Tetanuis. .1 .....1 Pellagra.2 .4 1 .1 6 7 Beriberi. 1 1 ....1 1 2 Tuberculosis of the lungs. .13 11 3 2 .1 16 14 30 Acute miliary tuberculosis. .1 ...I .2 .2 Tuberculosis meningitis. .....2 2 Disseminated tuberculosis. .1 .2 .2 1 3 Syphilis, tertiary. 1 .1 Syphilis, hereditary. 5 3 ....5 3 8 Cancer and other malignant tumors of stomach and liver.1. 1 Cancer and other malignant tumors of the peritoneum, intestines, rectum. ..I .... Cancer and other malignant tumors of the female genital organs. .3 ....3 3 Cancer and other malignant tumors of the breast.1 ....

PAGE 19

17 TABLE VI.-CAUSES OF DEATHS OF CIVIL POPULATION (EMPLOYEES AND NONEMPLOYEES) AND MILITARY AND PLACES WHERE CHARGEABLE-Continued. PanaColon. Canal Totals. ma. Zone. 0 General diseases-Continued. Cancer and other malignant tumors of other organs and of organs not specified.1. 1 1. ..2 .2 Diabetes. 1 .....1 1 Other general diseases.1. .1 .1 Diseases of the nervous system and of the organs of special sense. Encephalitis. ..1 .1 .1 Simple meningitis. 1. ....1 Locomotor ataxia. 1 ..1 Other diseases of the spinal cord. ....1 .1 .1 Cerebral hemorrhage, apoplexy. 1 1 ....1 1 2 Epilepsy. 1 1. ...1 1 2 Convulsions of infants (under 5 years). ..1 ..1 1 1 2 Diseases of the circulatory system. Pericarditis. 1 1. ...1 1 2 Acute endocarditis. .1 .....1 1 Organic diseases of the heart. 3 3 1 2 3 .7 5 12 Diseases of the arteries, atheroma, aneurism, etc. ....1 .1 Arteriosclerosis. 3 3 1 ...4 3 7 Diseases of the respiratory system. Acute bronchitis. 2 2 3 2 ..5 4 9 Chronic bronchitis. ..2 2 ..2 2 4 Broncho-pneumonia. 7 10 2 5 1 .10 15 25 Lobar pneumonia. 3 4 3 ...6 4 10 Other diseases of the respiratory system (tuberculosis excepted). ....1 .1 Diseases of the digestive system. Acute gastritis. 1 .....1 Diarrhea and enteritis (under 2 years). 16 8 2 2 ..18 10 28 Colitis. 2 .....2 .2 Appendicitis and typhlitis. .....1 1 Hernia, intestinal obstructions ..1 1 ...1 1 2 Intestinal obstruction. 1 .....1 1 Simple peritonitis (nonpuerperal). 1 ...... Nonvenereal diseases of the genito-urinary system and annexa. Acute nephritis. 5 1 .I. 5 2 7 Chronic nephritis (Bright's disease). 7 3 5 2 2 .14 5 19 Pyelo-nephrosis. .....1 74084-17--3

PAGE 20

18 TABLE VI.-CAUSES OF DEATHS OF CIVIL POPULATION (EMPLOYEES AND NONEMPLOYEES) AND MILITARY AND PLACES WHERE CHARGEABLE-Continued. PanaCanal Totals. ma. Zone. ma.a __ _ __ _ asC The puerperal state. Puerperal hemorrhage. 2 .....2 2 Other accidents of labor. 1 .....1 1 Puerperal septicemia. ..2 .2 2 Eclampsia. 1 .-2 2 Diseases of the skin and of the cellular tissue. Gangrene. .1. .I Malformations. Congenital malformations (stillbirth not included).1. 1 .1 Diseases of early infancy. Premature birth. 5 .5 Congenital debility.2. .2 .2 Malnutrition. 5 3 ..1 6 3 9 Other causes peculiar to early infancy 1 1 ..1 1 2 Lack of care.1. ..1. 1 Affections produced by external causes. Suicide by firearms. 1. .1 .1 Suicide by cutting or piercing instrixments. ..1. 1. 1 Conflagration.1.1 1 Accidental drowning. 2 ..3 .5 Traumatism by fall. .-. .-. 1 ...1 .,. Railroad traumatism.1. ....1 Homicide by firearms. .1 ....1 Ill-defined diseases. Infections of undetermined origin. 1 ...1. 1 Total.105 77 30 23 181 6 153 106 259 Stillbirths. 12 5 .4 1 4 13 13 26 Grand total.117 82 30 27 19 10 166 119 285

PAGE 21

19 DEATHS OF NONRESIDENTS. Residence. Nationality. Color. Sex. Age. Diagnosis. Interior of Panama. Martinique. Black. Male. 44 Pulmonary tuberculosis. Do. Panama.do. do. 22 Broncho-pneumonia. Do. Barbados .do. .do. 30 Accidental drowning. Bocas del Toro, Nicaragua. .do.do. 75 Chronic myocardiR. P. tis. Porto Bello, R. P., Panama. .do. .do. 44 Broncho -pneumonia. S. S. Quilque. Chile. White. .do. 20 Lobar pneumonia. Interior of Panama. Mexico. Black. .do. 40 Pulmonary tuberculosis. U. S. S. Charleston. U n I t e d White. .do. 45 Railroad traumaStates. tism. Interior of Panama. Jamaica. Black. .do .55 Arteriosclerosis. Bocas del Toro. Panama. .do. Female .29 Pulmonary tuberculosis. Interior of Panama ..do.do. Male .26 Chronic myocarditis. Mexico. China. Yellow. .do. 31 Estivoautumnal malaria. Interior of Panama. Panama. Black .do39 Pulmonary tuberculosis. Aguadulce R. P. Colombia. .do. .do. 28 Do. SantaMaria, R. P. Panama. .do. .Female. 29 Chronic nephritis.

PAGE 22

20 TABLE VIL-DISCHARGES AND DEATHS IN THE HOSPITALS Employees. Discharges. Deaths. Diseases. White. White. Black. Black. AmernEuroAmeriEurocans. peans. cans. pens. M. F. M. F. M. F. M. F. M. F. M. F. General disease. Typhoid fever. ...2 ....... Malarial fever, estivo-an.tumnal.4 110. .... Malarial fever, tertian. I .2 .4 ... Malarial cachexia. ..... Smallpox. ...... Measles.1. ........ Diphtheria and croqp. ........ Influenza. 2 1 1 .6 ... Dysentery, entamebic. ............ Dysentery, unclassified. ....3 ..... Dengue. ............ Chicken pox. ...6. ...... Purulent infection and septicemia. ....I ....... Pyemia ....1. ....1 Pellagra. ......... Tuberculosis of the lungs. 4 .....1 Acute military tuberculosis. ....1 ..... Pott's disease. ............ Tuberculosis of bones and joints. .1. ...... Disseminated tuberculosis. ....1 .....1 Rickets. ............ Syphilis, secondary. ....3 ....... Syphilis, tertiary. ....14 ..... Syphilis, hereditary. ......... Syphilis, period not stated. ......... Gonococcus infection. 2 .1 .5 ....... Gonorrheal orchitis and epididymitis. ...1. ..... Gonorrheal ophthalmia. ...... Soft chancre. 3 ...3 ....... Adenitis chancroidal. ........... Cancer and other malignant tumors of the stomach and liver. ......... Cancer and other malignant tumors of the female genital organs. ...... Cancer and other malignant tumors of other organs and of organs not specified ........ Other tumors (tumors of the female genital organs excepted)1. 1. Arthritis deformans. 14 1 5 68'.3 Other general diseases. 3 ......... Alcoholism acute1. 1 .....

PAGE 23

21 OF THE PANAMA CANAL FOR NOVEMBER, 1916. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. White. Black. White. Black. SolSolS'lOthers. S'rOthers. d'rs. d'rs M. M. IF. M. F. M. M. F. M. F. M. F. M. F. M. F. M. F. + 1. ..1 ......4 4 13 2 6 .....11 ...33 ...1 2 ....1 .....12 1 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ -..--...-.-. .....4 1.1 2 .1. .....1 1 1. ....1 2 .........9 21. .......... 1 2 .....14 1 1. .14. ..-.. 4 .............4 ...... 4. ..............4. 1 1. .....8 .. 1. .............2. .1 .....1 1 3 ...1 2 4 3 2 1 3 1 ..2 1 1 ....12 4 1. ...1 .........2 1 1 ........ ..........1 .. 1 ....1 .........2 2 1 ...........---......I .. 5. 1. .1 .......10 4 4 ...1. 1 ...24 1 ....1 ..-......1 1 1 ......1 3 .2 ............. ............2. 31 ............ 1 ....1. ......2 1 ........1. ............2 .. 3 ~~~~.1 .........1-------......1 1 ..1 .............6 49 9 1 6 20 29 ...7 8 1 .......210 17 1 ....................6 .. 2 2 o ....0. ............5

PAGE 24

22 TABLE VII.-DISCHARGES AND DEATHS IN HOSPITALS Employees. Discharges. Deaths. .Diseases. White. W te. Black. Black. AmeriEuroAmeriEurocans. peans. M. F. M. F. M. F. M. F. M. F. M. F. General diseaes--Contd. Alcoholism chronic. ......... Alcoholic psychosis. ...... Other chronic occupation poisonings. ....... Diseases of the nervous systew and of the organs of special sense. Encephalitis. ... Acute anterior poliomyelitis ..----. .... Other forms of mental alienation. ....-. .. Dementia precox. ....-. Epile s .y ........... N eurii -s .....1 .: .._. .1.1 Other diseases of the nervous system. I ... Neurasthenia. ....Diseases of the eyes and their annexa. 2 .3 1 Diseases of the ears. Diseases of the circulatory system. Organicdiseasesoftheheart. 1 4 -.2. Arterio-selerosis. Diseases of the veins (varices, hemorrhoids, phlebitis, etc.) ._ -_ -Hemorrhoid .~. 2 ------1 31 .-r-. Varicocele. 1 Diseases of the lymphatic system (lymphangitis, etc.). .1. Lymphadenitis (nonvenereal). .1 .9. Hemorrhage; other disease of the circulatory system. Diseases of the respiratory system. Diseases of the nasal fossa. 3. Adenoid vegetations. 1. Acute bronchitis .5. .. Chronic bronchitis. ....

PAGE 25

23 OF THE PANAMA CANAL FOR NOVEMBER, 1916-Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. White. Black. White. Black. SolSolrs. Others. d, Others. M. M. F. M. F. M. M. F. M. F. M. F.IM. F. M. F. M. F. 1E-4 2. ........2 .2 ....... ....1. ...... 1 ......... ........ 2. ..2 ...1. ........ -2 .........2. 1 .............3 4. 1 1. ..2. 43 .. ...... .2. 1. .1. ...8 3 .........11 S. ............... .T1 ..........8. ............-I. .1 3. .......... 3 .....13. 3 1. .............4. --. --.2 1 .-----. --.--. -10 2 2 1 ....6 2 2 6 2 .....17. S. ............3.

PAGE 26

24 TABLE VII.-DISCHARGES AND DEATHS IN HOSPITALS Employees. Discharges. Deaths. Diseases. White. White. Black. Black. AmeriEuroAmeriEurocans. peans. cans. peas. M. F. M. F. M. F. M. F. M. F. M. F. Diseases of the respiratory system-Continued. Broncho-pneumonia----------------1. ...... Lobar pneumonia. ....I .....1 Pleurisy .3 -. ......... Asthma. I .......... Diseases of the digestive system. Diseases of the mouth and annexa.------------------------1 ....... Diseases of the teeth and gums. ...3 ....... Stomatitis. ............ Diseases of the pharynx. ....2 .... Follicular tonsillitis-------5 ---1 .......-. Other diseases of the stomach (cancer excepted). 2 ...-.-. Acute gastritis1. .......... Acute indigestion. ........ Diarrhea and enteritis (under two years). ............ Colitis-. ....I ... Diarrhea and enteritis (two years and over).-------------------1. ...... Ankylostomiasis. ....4 .... Toniasis. ..........-------Acute appendicitis-------1 ---. 1 ...... Chronic appendicitis------2 1 1 .....---------Inguinal hernia------------.---.--2. 2 .6 .... Other diseases of the intestines .-----------------1 1 .1 ...... Constipation1. I ..I ...... Duodenal ulcer.-------------------1 .... Simple peritonitis (nonpuerperal).------------1 ....-.------------------Nonvenereal diseases of the genito-uwinary system and annexa. Acute nephritis. ....-. ....-----Bright's disease (chronic nephritis). ..4 -------------1 Other diseases of the kidney and annexa. 2 .-.-.-. Movable kidney. I .....------------..

PAGE 27

25 OF THE PANAMA CANAL FOR NOVEMBER, 1916-Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. White. Black. White.!Black. SolOthers. So Others. d'rs. drs Mf ~. F. M. F. M. M. F. M. F. M. F. M. F. MI. F. M. F. E0 --------.-.-.-.-----------------------2 1 1 3 1. ..1 1. ....6 2 1. ..........1 3 ..........4. .1K. 1. .. 1. .........2 ..1.8. .:. .....1. .... ............. 1 ..........2 .........3 ............. ......-.--. --. ....-. --2............4 .1. ....-........ 1 .......2. .-. 1 .....--S1 -. ............ 1 ---.1 .......1 ---. .....13 1. 2.1 -. ........ 2 1 4. .2. ....-. ...10 1 ...-. ...........11-.-.---. ............ 2 ...-. .......-.---.--.-.-3 ..........-...-..---. ..1 2 .........-.-...---...-. 1 .......1 .2. .........10 .4. .....-. ....2 ..--. --------1 ..........I --.......I. ..... 74084-17-4

PAGE 28

26 TABLE VII.--DISCHARGES AND DEATHS IN HOSPITALS Employees. Discharges. Deaths. Diseases. White. White. Black. Black. AmeriEuroAmeriEurocans. peans. cans. peans. M. IF. M. F. M. F. M. F. M. F. M. F. Nonveneral diseases of the genito-urinary system and annexa-Continued. Pyelo-nephrosis. .... Calculi of the urinary passages.2. ... Diseases of the bladder. ...2. Cystitis. .... Diseases of the urethra, urinary abscess, etc.2. .... Stricture of the urethra, nonvenereal. 1. .1. Nonvenereal diseases of the male genital organs. 1. Hydrocele. 1. Uterine tumor (noncancerous) .Other diseases of the uterus .1. Metritis. Cysts and other tumors of the ovary. Salpingitis and other diseases of the female genital organs. .. Nonpuerperal diseases of the breast (cancer excepted). The puerperal state. Normal labor. Accidents of pregnancy. Abortion. Other accidents of labor. Puerperal septicemia. Puerperal diseases of the breast. Diseases of the skin and of the cellular tissue. Furuncle.2. Acute abscess. ..... Phlegmon an'd cellulitis. I .-... Dhobie itch.1. ... Ulcer of skin. ...4. Ingrowing nail. .... Other diseases of the skin and annexa. .2 .1. ..

PAGE 29

27 OF THE PANAMA CANAL FOR NOVEMBER, 1916-Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. White. Black. White. Black.1 SolSol S'lOthers. d Others. d'rs. drs~___________ M. M.F. M. F. M.M. M. F M. F. M. F.M. F M. F 2 ..2 1 ------. .1. --------2. ............5 .................2 2 1 4 ...7 .2. 2 -4.-""I. ... 1. ........--. .-.-...--...2 .5.19. ....0.19 1. ...........12. ............. ............4 ..........-. ...1 ....-. -. .... 2 .2 ..... 1 .........1 ............... 1 .1 ......1 3 ..1 .....--.........9. 2 --5 .....................2 .. 2 ................-.-. .2 .. ...I ............' ... 6 ...i. ..............2 2 1 1 .1 .............7

PAGE 30

28 TABLE VL.-DISCHARGES AND DEATHS IN HOSPITALS Employees. Discharges. Deaths. Diseases.White. White. Black. AmeriEuroAmeriEurocans. peans. cans. peans. M. F. M. F. M. F. M. F. M. F. F Diseases of the bones and of the organs of locomotion. Diseases of the bones (tuberculosis excepted). 2 .1. Diseases of the joints (tuberculosis and rheumatism excepted). ....... Ankylosis ...... Arthritis. 5. 8ynovitis. .... Amputations. Other diseases of the organs of locomotion. 2 1 1 .1. Malformations. Congenital malformations (stillbirth not included). 1 .. Diseases of early infancy. Newborn child. .-. Including premature birth. ..----. Including malnutrition. .. Old age. Senility ... Affections produced by external causes. Poisoning by food. 5 .... Other acute poisonings. ..... Burns (conflagration excepted). .1. 1. ... Traumatism by firears. I ...... Traumatism by cutting or piercing instruments. 1 .12 .----------Traumatism by fall. ..1 .10 Traumatism in mines and quarries. ..1. .. T1rauinatism bymachines-. 1 ..6. .. Traumatismby other crushings (vehicles, railroads, landslides, etc.) .3 .I .5. Railroad traumatism.1. Injured by animals.

PAGE 31

29 OF THE. PANAMA CANAL FOR NOVEMBER, 1916-Continued. Nonemployees. Nonresidents. Discharges.Deaths. Discharges. Deaths. White. White. Black. Black. White. Black. White. Black. A SolOthers. Sol~ Others. d'rs. d'rs M. M. F. M. F. M. M. F. M. F. M. F. M. F. M. F. M. F. 4 1 2 .............10. .1 .-.-.-.-.-. --.----.-.-.----.--2 .1. ............2 2 1 --. ......---..---..5 .-.-. ...1 -. ...5 9 1 1 ... .7 ............. .5 2 5 5 ..1 .17.2 5 .-. 1 -..-..-. .-. 1. -..1. .....-...1 .......-.--.-. 1. .........-.. ..........8. ........----. .1 .....-. .....6K. 2 1 .1 ..-. .....6. ...18 1 ..1 ...-. .1 .........13 11 .....-..---1 ..-......., .-----------------------+ ----------1. .......1 .............2

PAGE 32

30 TABLE VIL-DISCHARGES AND DEATHS IN HOSPITALS Employees. Discharges. Deaths. Diseases. White. White. Black. Black. AmeriEuroAmeriEurocans. peans. cans. peans. M. F. M. F. M. F. M. F. M. F. M. F. Affectiow produced by external causes-Contd. Electricity (lightning excepted).1. .. Fractures (cause not specdfied). ..4. .. Dislocations.1. .... Sprains. ..3. .. Other external violence. 3 .4 .31. Ill-defined diieaei. Infections of undetermined origin. ..2. .. No disease. ..... Grand total. 78 3 29 .234 3 ..7

PAGE 33

31 OF THE PANAMA CANAL FOR NOVEMBER, 1916-Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. White. Black. White. Black. Sol Sold'rOthers. SorOthers d rs. d'rs 4 M. M. F. M. F. M. M. F. M. F. M.F. M.F. M.F. M.F. ..........1. S ..........4 21. ..........43. S .2 ......1 .......4 1 ~ ~ ............., 8 1 3 .....6 ..22 171 63 97 59 99 2 3 3 15 7 22 3 .1 1 ...862 38

PAGE 34

32 TABLE VIIL.-CONSOLIDATED [A=White Americans; FRemaining Admitted. Died. Nov. 1. A. F. B. A. F. B. A. F. B. ANCON HOSPITAL. Panama Canal employees. 22 11 105 59 18 151 ..3 Panama R. R. employees. 7 3 45 6 4 44 ------3 Other pay patients. 112 19 53 247 33 114 2 2 8 Charity patients. ..-------------------8 1 35 13 5 37 ------8 Total. .----------------------149 34 238 325 60 346 2 2 22 Corozal Hospital (insane). Panama Canal employees. ..----6 .-6-Panama R. R. employees --------------------2---------------------Panama pay patients. ..---------------2 32 188 -. 4 8 .1 4 Other pay patients. .-----------------5 4 3 4. Charity patients. 3 9 60 .1 4-------1 Total. 10 ,45 259 4 5 12 .-1 5 Grand Total. 159 79 497 329 65 358 2 3 27 Corozalfarm. Panama Canal employees. .10 52 ..6 Chronic ward. Charity patients. .--------------------------17 ------10---------COLON HOSPITAL. Panama Canal employees. 4 3 12 12 2 27---------Panama R. R. employees. .------------5 .9 9 7 37 ..-1 Panama pay patients. .1 ..1 8 .1 1 Other pay patients .7 4 1 17 21 5 .3 Charity patients. ...5.-4 Total. 16 8 22 43 31 81 .4 2 PALO SECO LEPER ASYLUM. Panama pay patients. .2 38-------1 ..1 Charity patients .----------------------2 24-------------------Total-.----------------. ---.-.--. .4 62 --1 --I GRAND TOTALS. Panama Canal employees. 26 24 175 71 20 184 ..3 Panama R. R. employees. 12 3 56 15 11 81 ..4 Panama pay patients.-----------------2 35 226 ..5 17 --. 2 6 Other pay patients------------------. 124 27 57 268 54 119 2 5 8 Charity patients. 11 12 136 18 6 55 ..9 Total. ...-----------------------175 101 650 372 96 456 2 7 30

PAGE 35

33 HOSPITAL REPORT. White foreign; B=Blacks.] Discharged. Transferred. Remaining Average number constantly sick. Nov. 30. Aergnubrcntnlsik A. F. B. A. F. B. A. F. B. American. Foreign. Black. Total. 56 19 140 ...25 10 113 24.33 13.13 112.87 150.23 6 4 42 ..1 7 3 43 6.20 2.97 38.53 47.70 269 27 93 4 .1 84 23 65 103.80 23.17 58.03 185.00 13 3 28 .1 10 8 2 26 7.37 1.16 31.24 39.77 344 53 303 4 1 12 124 38 247 141.70 40.43 240.67 422.80 .....6 ...6.00 6.00 1 ....1 .1.17 1.17 1 4 ...2 34 188 2.00 33.53 188.10 223.634 1 ..5 4 2 2.97 4.00 2.76 9.73 .!. 3 10 63 3.00 9.97 61.53 74.50 4 1 6. ..10 48 260 7.97 47.50 259.56 315.03 348 54 309 4 1 12 134 86 507 149.67 87.93 500.23 737.833 ..10 55 .10.00 52.87 62.87 .1 ...2 .24 ..21.77 21.77 11 2 24 2 1 8 3 2 7 2.36 2.73 9.21 14.30 8 4 24 ..9 6 3 12 4.03 1.36 8.71 14.10 1 2 ..5 .....60 .20 .80 15 15 4i 2 1 2 7 6 .5.30 5.36 1.50 12.16 3 ..2 2 .1 ..80 .43 1.23 37 22 55 4 2 26 18 11 20 11.69 10.85 20.05 42.59 2 38 .2.00 40.56 42.56 2 24 .2.00 24.00 26.00 4 62 .4.00 64.56 68.56 67 21 167 2 1 8 28 22 181 26.69 25.86 180.95 233.50 14 8 67 ..10 13 6 56 10.23 4.33 48.41 62.97 2 6 ..5 2 36 226 2.00 36.13 228.86 266.99 288 42 98 6 1 3 96 33 67 112.07 32.53 62.29 206.89 16 3 30 .1 14 13 14 138 10.37 13.93 138.97 163.27 385 76 368 8 3 40 152 111 668 161.36 112.78 659.48 933.62 Number of employees remaining in hospitals: W hite. 69 Black. 237 Total. 306

PAGE 36

34 TABLE IX.-CONSOLIDATED DISPENSARY REPORT. EMPLOYEES TREATED IN QUARTERS. ReRe mainAdDisTransmain ing mitted. charged. ferried. ing Station. Nov. 1. Nov. 30. W. B. W. B. W. B. W. B. W. B. W. B. W. B. Taal. Ancon. 5 .126 1 ..129 1 1 .1 .197 2 199 Balboa.-. 5 .136 8 ..133 6 4 1 4 1 286 25 311 Pedro Miguel.191. .17. I .1 1 24 3 27 Paraiso. ..15 3 ..1 6 1 ...30 4 34 Gamboa. ..-. ..2 ....2 7 9 Gatun-. 1 .11 3 .9 2 .1 3 .132 4 36 Colon. 6 15 82 169 ..84 164 ..4 20 175 605 780 Total. 17 15 389 187 ..386 178 7 2 1322746650 1, ALL CASES TREATED BUT NOT EXCUSED. Employees. Nonemployees. Totals. Station. W. B. Total. W. B. Total. W. B. Total. Ancon. 2,759 4,167 6,926 1,981 3,001 4,982 4,740 7168 11,909 Balboa. 3,173 3,721 6,894 2,092 572 2,664 o,265 4,293 9,558 Pedro Miguel. 978 1,331 2,309 781 430 1,211 1,759 1,761 3,520 Paraiso. 885 2,567 3,452 811 748 1,559 1,696 3,315 5, Oi Gamboa. 45 203 248 16 332 348 61 535 5% Gatun. 241 1,197 1,438 670 1,057 1,727 911 2,254 3,165 Colon. 1,357 3,444 4,801 1,037 1,.151 2,188 2,394 4,59 Total. 9,438 16,630 26,068 7,388 7,291 14,679 16,826 23,921 40,747

PAGE 37

35 ABLE IX.-CONSOLIDATED DISPENSARY REPORT-Continued. CONSOLIDATED ADMIsSION REPORT. White. Black. Total. Total admissions to hospitals, excluding Corozal farm and chronic ward. 468 440 908 Total admissions of employees to quarters. 389 187 576 Total. 857 627 1,484 Less number of patients transferred between hospitals and from quarters to hospitals, whose admissions are duplicated in above figures. 18 40 58 Net admissions to hospitals and quarters. 839 587 1,426 EMPLOYEES. Employees admitted to hospitals. 117 259 376 Employees admitted to quarters. 389 187 576 Total. 506 446 952 Less number transferred between hospitals and from quarters to hospitals, whose admissions are duplicated in above figures. 10 20 30 Net admissions of employees to hospitals and quartera. 496 426 922 Annual average per thousand of admissions of employees to hospitals and quarters. 1,265.79 168.55 315.83_ CONTAGIOUS AND INFECTIOUS DISEASES REPORTED DURING THE MONTH OF NOVEMBER, 1916. Disease. Panama. Colon. Canal Total. Zone. Beriberi .3 ..3 Chicken pox. 5 4 1 10 Diarrhea. ..2 2 Diphtheria. 4 2 4 10 Dysentery. 2 ..2 Cerebrospinal meningitis. 1 .1 Malarial fever. 22 10 26 58 Measles. 9 1.1 12 22 Pellagra. 1 ..1 Pneumonia. .1 ...1 Scarlet fever.1. .1 Smallpox ..3 ..3 Syphiis. 7 ..7 Teanus. 2. 2 Tuberculosis. .28 5 7 40 Meningitis, tubercular. 2 .2. 2 Typhoid fever. 2 ..3 Whooping cough. 3 6 Yaws. .1

PAGE 38

36 TABLE X.-NUMBER OF EMPLOYEES CONSTANTLY SICK IN HOSPITALS AND QUARTERS. White. Colored. Total. Hospitals: Ancon Hospital. 46.63 158.57 205.20 Colon Hospital. 10.48 17.92 28.40 Total. 57.11 176.49 233.60 Quarters: Ancon. 6.57 .07 6.64 Balboa. 9.53 .83 10.36 Pedro Miguel. .80 .10 .90 Paraiso. 1.00 .13 1.13 Gamboa. .07 .23 .3a Gatun. 1.07 .13 1.20 Colon. 5.83 20.17 26.00 Total. 24.87 21.66 46.53 Quarters. Total. ,tals. Average number of employees constantly sick: White. 57.11 24.87 81.98 Colored. 176.49 21.66 198.15 Total. 233.60 46.53 280.13 Average number of employees constantly sick per 1,000: White.,. 12.14 5.29 17.43 Colored. 5.82 .71 6.53 Total. 6.67 1.33 8.00 TABLE XI.-AVERAGE LENGTH OF STAY IN HOSPITALS OR QUARTERS FOR EACH ADMISSION OF SICK EMPLOYEE. White. Black. Total. Hospitals: Ancon Hospital. 10.53 24.21 19.98 Colon Hospital. 7.14 10.15 9.25 Quarters: Ancon. 2.07 2.00 2.06 Balboa. 2.00 3.28 2.05 Pedro Miguel. .1. .----1.33 Paraiso. 2.00 1.33 1.89 Gamboa. 3.50 3.50 Gatun. 3.67 1.33 3.08 Colon. .2.13 5.80 4.56

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3 7 TABLE XII.-FINANCIAL STATEMENT, DEPARTMENT OF HEALTH. Oct., 1916. Sept., 1916. Oct., 1915. Administration: Chief health office. $407.18 $817.23 8959. 22 Hospital division: Ancon Hospital. 27,815.06 26,129.16 24, 427.20 Board of health laboratory .2,002. 90 2,217.44 1,587. 44 Corozal Hospital and farm. 7,422. 24 6,475.28 6,876.07 Chronic ward. 209.80 215.26 215.18 Colon Hospital. 4,569.75 4,496.17 3,304.12 Palo Seco Leper Asylum. 1,482.59 1,979.55 1,828.96 Santo Tomas Hospital. 1,047.00 888.75 1,023.75 Medical storehouse. 637.33 674. 21 832. 79 Reserve for new tools. 2,159.04 2,095. 77 Total. 47,345.71 45,171.59 40,095.51 District dentists. 27.08 28.39 56.49 Dispensaries: Balboa. 1,146.10 1,206.82 989.14 Corozal. ..528.77 Pedro Miguel. 420.12 423.94 499.64 Paraiso. 547.75 552.51 619.63 Gamboa. 137.63 151.53 157.44 Gatun. 509.28 674.50 755.40 Total. 2,787.96 3,037.69 3,606.51 Sanitary division: General inspector. 50.00 50.00 50.00 Health office, Panama. 3,599.92 3,072.29 4,003.29 Street cleaning, Panama. 3,911. 03 4,257.84 4.592. 46 Health office, Colon. 2,477. 25 2,999. 06 3,412. 47 Street cleaning, Colon. 2,126.02 2.139. 22 2,231.78 Total. 12,164.22 12,518.41 14,290.00 Zone sanitation: Ancon. 1,621.77 1,960.29 1,639.57 Balboa. 723.33 1,366.01 1,529.91 Corozal. 1,213.43 1,309.32 1,604.83 Pedro Miguel. 2,994.36 3,939.33 3,119.47 Culebra. 1.11 Frijoles. 72.27 75. 75 102.98 Gatun. 2,950.03 3,933.83 3,070.17 Cristobal-Mount Hope. 1,904.65 2.107.26 2,587.62 Total. 23,644.06 26,910.20 27,945.66 Quarantine division: Chief quarantine office. 169.08 171.39 169.34 Balboa-Panama. 1,977.76 2,041.75 1,892.06 Colon-Cristobal. 2,810.30 3,411.81 3,350.52 Inspection of cattle. 497.50 .. Total. 5,454.64 5,624.95 5,411.92 RECAPITULATION. Chief health office. 407.18 817.23 959.22 Hospital division. 47,345.71 45,171.59 40,095.51 Dispensaries. 2,787.96 3,037.69 3,606.51 Sanitary division. 23,644.06 26,910.20 27,945.66 Quarantine division. 5,454.64 5,624. 95 5,411.92 Total. 79,639.55 81,561.66 78,018.82

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38 TABLE XIII.-ANCON HOSPITAL. REPORT OF NATIONALITY OF PATIENTS TREATED. Total American. Other nations. ber treatWhite. Black. White. Black. ed. Hospital: Pan a Canal employees. 366 81 1 29 255 Panama Railroad employees. 109 13 .7 89' Panama Government pay patients. .... Other pay cases. 578 359 .52 167 Charity patients. 99 21 .6 72 Total. 1,152 474 1 94 583. Asylum: Panama Canal employees.6. ..6 Panama Railroad employees 2. ... Panama Government pay patients -234 2 --. 36 196 Other pay patients. 16 9 .4 3. Charity patients. .77 3 .10 64 Total. .335 14 .50 271 Grand total. .1, 487 488 1 144 854 Soldiers. .242 242 .. Chronics. 27 ...27 Farm (cripples). 68 ..10 58 REPORT OF DAYS LOST 1N HOSPITAL. Hospital: Panama Canal employees. 4,510 730 19 394 3,367 Panama Railroad employees. 1,431 186 .89 1,156 Panama Government pay patients ..... Other pay patients. 5,550 3,114 .695 1,741 Charity patients. 1,193 221 .35 937 Total. 12,684 4,251 19 1,213 7,201 Asylum: Panama Canal employees .180 ...180 Panama Railroad employees. 35 ...35 Panama Government pay patients 6,709 60 ..1,006 5,643 Other pay patients. 292 89 .120 83 Charity patients. 2,235 90 .299 1,846 Total. 9,451 239 .1,425 7,787 Grand total. 22,135 4,490 19 2,638 14,988 Soldiers. 2,310 2,310 ... Chronics. 653 ...653 Farm (cripples). 1,886 ..300 1,586 Average cost per subsistence per day, $0.2709.

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39 TABLE XIII.-ANCON HOSPITAI-Continued. WARD LABORATORY REPORT. Blood examinations (total number). 546Estivo-autumnal. 26 Tertian. 14 Differential counts. 4 Hemoglobin estimations. 155 Leucocyte counts. 32 Red blood counts. 8 Stool examinations (total number). 508 Am eba. 1 Ascaris lumbricoides. 5 Ciliated nomads. 6 Entameba (hystolitica and tetragena). 1 Guaiac tests. 22 Pus and blood. 25 Strongloides. 16 Tenia saginata dispar (ova). 2 Tricocephalus dispar. 9 Uncinaria (ova). 30 Urine examinations (total number). 1,886 Album en. 427 Bile-. 12 Casts. .424 Ciliated nomads .11 Epithelia. 949 Guaiac tests. 94 Hem in crystals. 6 Indican. 111 Pus. 681 Pus and blood. 288 Sugar (pos. 5, neg. 35). 40 Sputum examinations. 346 Positive for tubercle bacilli. 33 Smear examinations (total number). 24 Urethral. 12 Vaginal. 21 final fluid. 4 Throat sm ears. 1 Urine sm ears. 6 REPORT OF SURGICAL OPERATIONS. Number. Died. Amputations: Leg. I Leg, double. 2 Operations on bones: Ostiectomy. 2 Wiring of fractures, simple. 2 Adenectomy: Cervical. 3 A xillary. 1 Inguinal, single. 15 Inguinal, double. 2 Femoral.1 Herniotomy: Inguinal, single. 7 Inguinal, double. 2 Genito-urinary tract: Nephrotomy.1 Nephrectomy.I Nephropoxy. Trethrotomy, internal. I Urethrotomy, external. 4 Varicocele, radical cure.2

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40 TABLE XIII.-ANCON HOSPITAL-Continued. REPoRT OF SuRGIcAL OPERATIONs-Continued. Number. Died. Genito-urinary tract-Continued. Hydrocele, single, radical cure. .2 Epididymotomy. 13. Curetage uteri. 7. Perineoplasty. 1 Tracholorrhaphy .1 Rectum: Hemorrhoids, radical cure.7. Fistula in ano, excision of.3. General: Excision of surface neoplasms. 2 Plastic operation for congenital defect.1. Plastic operation for effects of disease. 2 1 Laparaotomy: Exploratory.1. Gastrectomy, partial.1. Gastro-enterostomy .1. Enteroctomy.1. Appendectomy. 21 Appendectomy with local peritonitis. Splenectomy.1 Supravaginal hysterectomy.4. Hysteromyomectomy. 4 Salpingo-oophorectomy.4. Ovarian cystectomy.3. Oophorectomy.2. Suspensio-uteri. Mayo bilateral bunion.3. Minor operations, various other. 165 Total. 304 1 REPORT OF OPERATIONS, EYE AND EAR CLINIC. Tonsillectomy and adenoidectomy. 28 Tonsillectomy only. 7 Adenoidectomy only. 9 Submucous resections .9 Turbinectomy. 5 Mastoidectomy, simple. 1 Pterygium transplantations. 4 Evisceration. 1 Minor nose. 1 Minor eye. 1 Total. 66 Refractions. 111 REPORT OF OUT-PATIENT DEPARTMENT. Clinic. Total New Pay Prescripvisits. cases. cases. tions. Medical. 302 191 22 279 Surgical. .276 141 7 59 Eye and ear. 522 132 .26 Total. 1,100 464 29 364

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41 TABLE XIII.-ANCON HOSPITAL-Continued. MONTHLY REPORT OF VAcINATIONs. Number of adults vaccinated. 522 Number of takes. 34 Number of school children vaccinated. 30 Number of takes. 6 BOARD OF HEALTH LABORATORY. .Bacteriological examinations of: Blood cultures (3 positive for B. typhosus). 20 Throat cultures (9 positive for B. diphtheriae; new 6, for release 3). 97 Urines. 155 Stools. 142 Sputum .6 Pathological fluids, exudates, etc. 8 Smears, gonococcus. 2 Culture of autopsies. I Leper suspects. 2 Dairy milk from Corozal. 29 Wassermann reactions. 750 Autogenous vaccines prepared. 4 Antityphoid vaccinations. 1 Smallpox vaccinations. 26 Smallpox allergin test (positive). 1 Animal inoculations. 9 Examination of blood preliminary to a transfusion; number of individuals. 6 Dark field examinations. 13 Vaccine points manufactured. 2,355 Cheinical examinations of: Mothers' m ilk. 1 U rine. .10 Fat determinations of milk from Corozal farm. 4 Powder for poison. 1 Stomach contents. 4 Stomach contents for opium. 1 Economy brand skim milk. 1 Spinal fluidsButyric acid test. .10 Ammonium sulphate test. 10 Phenol test. 10 Colloidal gold test .3 Pathological tissues prepared; paraffin 353; frozen 9 .362 Surgical tissues reported. 51 Test meals, pathological examination. 3 Placental smears. 23 Autopsies performed. 26 Animals autopsied (hogs 10; rats (complete) 10; calves 9; monkeys 1). 30 Drowned bodies examined. 2 Sick calf under observation. 1 Rats examined (mus musculus, 535; mus norwegious, 757; mus alexandrinus, 5; mus rattus, 164). 1,461 Bodies embalmed. 3 Interments at Corozal. 10 Taken to Panama. 6 Taken to Gatun .1 Taken to Mount Hope. 1 Cremations. 19

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42 TABLE XIII.-ANCON HOSPITAL-Continued. MOSQUITOES IDENTIFIED AT THE BOARD OF HEALTH LABORATORY. 00 -d 5. .00 000 r r (I .'3 05s o 4 -.----) 0 0 0 0 Ancon .2 ....495 .. Balboa .2 -....554 7 Corozal district .33 .-.-. ..1 4 36 Corozal post .61 --. .1 1 15 11 Pedro Miguel .8 .2 ..4 265 Pedro Miguel railroad station .17 .1 .1 5 1,206 Paraiso. ..............8 ....33 193 Red T k. 3 ------. -. -. ..22 Miraflores ......1 4 Rio Grande .2 -.-. ....534 Lirio & Cerro .1 .-. ...664 Dredges, Culebra Cut .1 ....416 467 Gamboa .11 .....2,642 Gatun .63 ...1 10 458 14 New Gatun .87 ...2 19 340 11 Frijoles.* .--613 32 ....6,438 1 Monte Lio. 108 .....1,054 Barracks, Cristobal. .16 6 .1 .3,107 45 1 Silver married quarters.;. 1 ....4230 .. Mount Hope village. 18 7 ...134 9 2 Panama Railroad cars, Cristobal. ....123 .. Colon Hospital .statio. 1 ..2 834 185 Lincoln House, Colon. .....2 457 7 Camp Gaillard. 2 .22 Empire. ..4 6 Camp ran. ...2 42 .534 Fort Randolph.1.4. 4 1 Fort Sherman .23 ..4 .1 138 1,132 1 Fort Grant.1. 4 ..2,642 Total.1,095 49 3 3 12 8,14 23,091 31

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43 TABLE XIII.-ANCON HOSPITAL-Continued. MOSQUITOES IDENTIFIED AT THE BOARD OF HEALTH LABORATORY-Continued. cra Stations. > C3 to 0 ~ ca) Ancon. .2 2 ....501 Balboa. .2. ....565 Corozal district. ...1 ....75 Corozal post. ..3 ....92 Pedro Miguel. ...1 ....280 Pedro Miguel railroad station. ........1,230 Paraiso. .1 1 1 ..237 Red Tank. ........25 M iraflores. ........5 Rio Grande. ....536 Lirio & Cerro. ...1 ....666 Dredges, Culebra cut. .38 ....1 .923 Gamboa. ...1 ....2,654 Gatun. 3 ..5 ....554 New Gatun.1 ..1 ....461 Frijoles. 6 ....7,090 Monte Lirio. 5 .....1,168 Barracks, Cristobal. 2 ....3,178 Silver married quarters. ...1,232 Mount Hope village. ...2 ...172 Panama Railroad cars, Cristobal. ......123 Colon Hospital. ......1 1,026 Lincoln House, Colon. ........466 Camp Gaillard. ..78 22 ...2,673 Em pire. ...9 4 ...627 Camp Otis. 1 ..1 ...1 4,328 Fort Randolph. ........17 Fort Sherman. .......2 1,297 Fort Grant. .1 238 ..697 Total. 10 41 240 116 27 1 1 4 32,898

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44 TABLE XIII.-ANCON HOSPITAL-Continued. COROZAL HOSPITAL. STATEMENT OF COMMITMENTS, DISCHARGES, AND DEATHS, NOVEMBER, 1916. COMMITMENTS. Male. Female. From Canal Zone: First admission. 6 3 From Panama Government: First admission. 5 6 Third admission. 1 Total. 12 9 DISCHARGES. Well. Improved. Unimproved. Male. Female. Male. Female. Male. Female. Barbados. .1 .. Jamaica ... Panama. .1 2 .. United States. ..(D) 1 .(D) 3. Total.2 2 4 3 NOTE: (D) Four soldiers deported to United States. DEATHS. Medical diagnosis. Mental diagnosis. Male. Female. Broncho -pneumonia; sy p h i lis; Psychosis associated .1 chronic nephritis. with cerebral syphilis. Pellagra. Dementia precox. .1 Acute pyonephritis; arteriosclerosis .Epilepsy. 1 Tuberculosis of lungs; cistitis; unci.do. nariasis; epilepsy. Pellagra; broncho-pneumonia. Psychosis, associated 1. with cerebral arteriosclerosis. Syhilis, tertiary; stricture of urePsychosis, associated 1. t ra; gangrene of lungs. With cerebral syphilis. Abscess of brain. Dementia precox. 1. I Died at Ancon Hospital.

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45 TABLE XIV.-COLON HOSPITAL. NATIONALITY. White White White Wh~te Black. Total. American. Foreign. Panama Canal employees. 16 5 39 60 Panama R. R. employees. 14 7 46 67 Panama pay. 2 8 10 Other pay.24 25 6 55 Charity cases. 5 .4 9 Total. 59 39 103 201 LABORATORY REPORT. Blood examinations. 119 Estivo-autumnal. 7 Tertian. 1 White blood counts. 16 Hemoglobin. 4 Differential counts. 2 Stool examinations. 43 Uncinaria. 5 Tricocephalus dispar. 2 Red blood cells. 1 Pus. 1 Urine examinations. 157 Albumen. 109 Casts. 67 Pus. 4 Blood. 29 Sputum examinations. 61 Positive for tubercle bacilli. 5 Smear examinations. 3 Positive for gonorrhea. 2 SURGICAL OPERATIONS. Herniotomy: Inguinal, single. 2 Inguinal, double .1 Genito-urinary tract: Varicocele, radical cure. 1 Epididymotomy. 1 Curettage uteri. 4 Trachelorrhaphy. 1 Obstetrical: Low forceps. 1 Version. 1 Perineorrhaphy. 1 Thorax: Stab wound of chest, operation for. 1 Rectum: Hemorrhoids, radical cure. 1 General: Tenorrhaphy. 3 Laparotomy: Gastroenterostomy (one for perforative duodenal ulcer, after closure of ulcer and drainage). 2 Appendectomy. 4 Myomectomy. 1 Ovarian cystectomy, bilateral. 1 Suspensio uteri. 4 Minor operations, various. 9 Minor operations, various (dispensary). 145

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46 TABLE XV.-PALO SECO LEPER ASYLUM. NATIONALITY OF PATIENTS. Number treated. Americans. Others. Class. White. Black. White. Black. White. Black. Employees. .. Panama pay patients. 2 41 ..2 41 Charity patients. 2 26 --------------2 26 Total. 4 67 ..4 67 Cost of subsistence per patient per day, $0.28. TABLE XVI.-SANTO TOMAS HOSPITAL. RemainAdmitDisRemaining Nov. ted. charged. Died. Ng ov. 130 Pay cases. 18 80 67 3 28 Charity cases. 421 852 749 94 430 Total. 439 932 816 97 458 Average number of patients constantly sick. 450 Total number of days treatment. 13,340 Average number of days treatment for each patient. 9 Cost of subsistence per patient per day. $0.39 NATIONALITY OF PATIENTS. American. Other nations. Class Number treated. White. Black. White. Black. Pay cases. 98 1 36 61 Charity cases. 1,273 9 .114 1,150 Total .1,371 10 .150 1,211 DISPENSARY REPORT. Class. White. Black. Total. Natives. .20 615 635 Foreigners. 33 342 375 Total. .53 957 1,010

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47 TABLE XVI.-SANTO TOMAS HOSPITAL-Continued. DISEASES TREATED. M malaria .37 Sm allpox. 3 M easles. 1 Scarlet fever. 1 Diphtheria and croup. 4 Influenza. D ysentery. 12 Leprosy. 1 Erysipelas-. Other epidem ic diseases. 4 Purulent infection and septicemia. S P ellagra ...2 Tuberculosis of the lungs. 12 Pott's disease. 2 Syphilis. 40 Soft chancre. 23 Gonococcus infection. 32 Cancer and other malignant tumors of the breast .I Other tum ors. 4 Acute alcoholism Other forms of mental alienations. 4 E pilepsy. 3 H ysteria. 2 NeuralJa and neuritis. 6 Other diseases of the eyes and their annexa. 8 Organic diseases of the heart. 9 Diseases of the arteries. 4 Diseases of the veins .3 Diseases of the lymphatic system. 9 Chronic bronchitis. 21 Broncho-pneum onia. 2 Pneum onia. 5 Pleurisy. 4 A sthm a. 9 Diseases of the pharynx. 19 Other diseases of the stomach. 4 Diarrhea and enteritis (under 2 years). 1 Diarrhea and enteritis (over 2 years). 6 Ankylostom iasis. 45 Intestinal parasites. .9 Appendicitis and typhlitis.-. 11 Hernias, intestinal obstructions. 12 Diseases of the anus and fecal fistula. 4 Other diseases of the intestines. 10 Biliary calculi. 2 Other diseases of the liver. 2 Diseases of the spleen. 1 Sim ple peritonitis. 2 Bright's disease (chronic nephritis). 34 Diseases of the bladder. 2 Diseases of the urethra. 3 Nonvenereal diseases of the female genital organs. 8 Uterine hemorrhage. 2 Uterine tum or. I M etritis. 14 Other diseases of the uterus. 9 Salpingitis and other diseases of the female genital organs. 11 Nonpuerperal diseases of the breast. 1 Norm al labor. 100 Accidents of pregnancy. 18 Other accidents of labor. 2 Puerperal diseases of the breast. I Acute abscess. 10 Other diseases of the skin and annexa. 31 Diseases of the bones. 1 Diseases of the joints. 10

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TABLE XVI.-SANTO TOMAS HOSPITAL-Continued. DISEASES TREATED-Continued. Nurslings discharged from hospital without disease. 95 Venomous bites and stings. .,. ....-----------------------------------I Other acute poisonings. ......------------------------------------------Burns. .......--------------------------------------------------2 Traumatism by firearms. .........-----------------------------------------I Traumatism by cutting or piercing instruments. 7 Traumatism by other crushings. Sprains.3 Fractures. 12 Other external .1 No disease. 6 Total discharges.--------------------------------16 Deaths. .............----------------------------------------------------97Remaining. 4 Total number of patients treated during the month. 1,371 SURGICAL OPERATIONS. Number. Deaths. Digits, multiple----------------------------------------4. Adenectomy, cervical-----------------------------------2. Adenectomy, inguinal, single------------------------------2. Adenectomy, inguinal, double .1 Herniotomy, inguinal, single-. 5 Herniotomy, ventral .s. 2 Herniotomy, strangulated.1 Cystotomy .1. Uretlrotomy, external. .. Ulydrocele, single, radical cure. .. Hydrocele, double, radical cure.1--------Curetage uteri ... Thoracotomy. 1 1 Hemorrhoids, radical cure. 2 Fistula in anus, excision of. 5 Excision of surface neoplasm. 1 -. Plastic operation for effects of disease .10 Skin graft .ss. 11 Laparotomy for intestinal obstructions---. .1. Appendectomy .s.r.--. 10 Appendectomy.is. 1 Appendectomy with local peritonitis-------------. Pan-hysterectomy 2. Pa -h stret my ..2 Supravaginal hysterectomy. Salpingectomy, single. 1 Salpingectomy, double. 2 Salpingo-oophorectomy. 11. Oophorectomy. Suspensio-uteri.8. Major operations, various other. 1 Minor operations, various other. 22 Total .1

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49 TABLE XVII.-SUMMARY OF SANITARY WORK PERFORMED AND MATERIAL EXPENDED DURING THE MONTH OF NOVEMBER IN THE CANAL ZONE. Work requests on supply department: Grass cutting. 40 Screening. 11 M iscellaneous. 8 Work requests on municipal engineering department .13 Buildings inspected: For screen g. 1, 622 For mosquitoes. 5,237 For general sanitation. 2,235 Stores, inspections of. 24 Restaurants, inspections of .12 Shops, inspections of. 76 Notices served to abate nuisances. 2 Houses disinfected and fumigated. 4 Pit closets inspected. 582 Closets disinfected. 665 Garbage cans emptied. 2,852 Rat traps in use. 400 Rats destroyed. 489 Number of mosquitoes destroyed in dwellings: Anopheles. 919 Stegom yia. 40 Culex. 1,696 M ansonia. 12,498 Material expended: Larvacide, gallons. 544 Crude oil, gallons. 12,872 Kerosene, gallons. 633 Number of containers with stegomyla larvw found .1 Fly breeding places destroyed. 5 REPORT OF ROUTINE WORK DONE BY HEALTH OFFICE, PANAMA. General sanitation: Linear feet of ditches cleaned and maintained. 74, 400 Linear feet of new ditches dug. 115 Number of cubic yards of earth used in filling. 0 Gallons of larvacide used. 935 Gallons of crude oil used. 6,040 Gallons of kerosene used. 173 Square yards of pools oiled. 471, 940 Water containers treated. 10,685 Mosquito breeding places found (Stegomyia 128). 329 Fly breeding places found. 54 Flies trapped (13,000 per quart). 100 Number of rats killed. 927 Number of room disinfections made. 25 Square feet of vegetation removed. 331, 900 Garbage collection: Number of loads of garbage removed to dump. 4,375 Number of cubic yards of garbage removed to dump. 9,366 Total number of cans of garbage emptied. 42,701 Buildings: Number of buildings inspected. 4,504 Number of plans for new buildings approved. 13 Number of permits issued for repairs to old buildings. 67 Total building permits issued. 80 Number of buildings condemned. 10 Number of stables condemned. 0 Number of buildings demolished. 10 Street cleaning: Average number of square yards of streets cleaned daily. 600,000 Average number of square yards of streets sprinkled daily .0 Number of private properties cleaned during month. 7 Number of nuisance notices served and nuisances abated. 300 Vaccinations: Number of vaccinations performed during month. 188 Total nu;nber of vaccinations since Apr. 1, 1914. 25,068

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50 MONTHLY WORK REPORT FOR COLON-CRISTOBAL, AND MOUNT HowL Sanitation, Colon-Cristobal: Square yards street cleaned.-. 3,745,848 Square yards alleys maintained. .--.--. 624,000 Number of private properties cleaned. 7 '38 Cubic feet fumigated. 6272 Doses of quinine issued. .------. 6,435 Number of dogs caught. Number of dogs killed. 21 Number of rats caught. ..-----------. .6.36 Loads of yard garbage disposed of-. 576 Number of cans garbage (cubic yards, 2,505).-. 13,958 Colon dump maintained. Linear yards of ditches constructed. 0 Linear yards of ditches maintained--. 1,110 Acres of vegetation removedQuarantine station --.-. .8 Cristobal (Panama R. R. reservation). 4j Washington Hotel.--.--.----. 2 Colon Hospital. 2 Panama R. R. reservation, Colon (swamp). .40 Parkway and E Street maintained. Square yards oiled.---.-------. 45,325 Number of receptacles treated.-------. 46,960 Number of mosquitoes caught in Colon Hospital screensAnopheles.-------------------------------------------8 Culex.----.--------------------. 3,210 Number of mosquito breeding places destroyed. 2 Number of fly-breeding places destroyed. 6 Number of buildings inspected. 10,285 Number of gallons of larvacide used in Colon. 156.08 Number of gallons of crude oil used in Colon. 1,175 Number of nuisances abated. 347 Building-Colon: Number of building plans approved. 3 Number of permits to occupy issued. 12 Number of permits to repair issued. 52 Number of bills collected. 134 Sewers-Colon: Number of new connections made during the month. 3 Total number of connections made to date. 1,361 Number of houses on which connections were made .8 Outstanding permits.-. 32 Sanitation, Cristobal: Number of cans garbage-(cubic yards 705). 13,958 Loads of yard garbage handled. 194 Square yards oiled. 6,905 Number of receptacles treated. 5,700 Number of mosquito breeding places destroyed .0 Number of fly-breeding places destroyed. Gallons of larvacide used. 3 Gallons of crude oil used. 225 Number of buildings inspected. 1,330 Number of nuisances abated. 39 Sanitation, Mount Hope: Number of cans garbage (cubic yards 102). 780 Square yards oiled. 124,000 Number of doses of quinine issued. 074 Number of receptacles treated.-. 12,150 Number of mosquito places destroyed. 94 Number of mosquitoes caughtAnopholesBarracks-.20 Mount Hope village. 30 Total anopheles.50

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51 Sanitation, Mount Hope-Continued. Number of mosquitos caught-Continued. CulexBarracks .--------------------------------------3,190 Silver married quarters. 1, 572 Steam ship. 1 Mount Hope village. 225 Camp Beird cars. 131 Total culex. -. 5,119 Gallons of larvacide used. 50 Gallons of crude oil used. 3, 109.9 Mount Hope cemetery maintained. Linear yards ditches constructed. 0 Lineai yards ditches maintained. .-. 9,650 Square yards of vegetation removed.--. 125,200 Number of burials during the month. 40 TABLE XVIII.-CONSOLIDATED REPORT OF QUARANTINE TRANSACTIONS AT THE PORTS OF BALBOA-PANAMA AND COLON CRISTOBAL FOR THE MONTH OF NOVEMBER, 1916. Number of vessels inspected and passed .203 Number of vessels held in quarantine. 16 Total number of vessels entered. 219 Number of special inspections made to enforce compliance with antiplague and mosquito-breeding regulations. 126 Number of vessels fumigated on arrival .20 Number of vessels fumigated on departure. 1 Number of vessels detained but sailed in quarantine. 8 Number of crew examined. 11,909 Number of stowaways examined. 5 Number of passengers examined. 4,526 16,440 Number of supplementary examinations. ..3,141 Number of persons vaccinated at port of arrival because of compulsoryvaccination law. 228 Number of persons vaccinated at port of departure. 1,283 1,511 Number of persons held in quarantine at the detention houses to complete period of incubation of yellow fever and plague. 290 Number of persons held in quarantine on board vessels. 1,613 1,903 Total number of persons landed from foreign ports: Cabin. 1,970 Steerage. 1,650 3,620 Total number of persons embarked for foreign ports: Cabin. 1,517 Steerage. 1,511 3,028 Total number of persons arriving from coast towns. 1,620 Total number of persons sailing for coast towns. 1,413 Apparent increase for month from coast towns. 207

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52 Apparent increase for month from foreign ports: Cabin. 453 Steerage. 139 592 Number of clearances issued. 54 Number of bills of health issued or visded. 243 Number of inspections of docks. 10 Number of inspections of vessels at docks. 12 Number of immigrants rejected and deported. 43 Total number of persons landed. ..5,240 Less number for Pacific ports. 260 4,980 Total number of persons sailing. 4,441 Apparent increase for month. 539 IMMIGRATION REPORT FOR COLON AND CRISTOBAL. FromCabin. Steerage. Europe. 9 8 United States. 808 436 Jamaica and West Indies. 44 155 Venezuela. 6 0 Colombia. 82 129 Cuba .64 16 Costa Rica. .115 48 Bocas del Toro .39 148 Coast towns. .0 172 1,167 1,112 Grand total.2,279 M en. 883 Women. .556 Children. 256 United States troops. .....412 Unclassified. 172 Total. 2279 QUARANTINE TRANSACTIONS AT THE PORT OF BOCAS DEL TORO, PANAMA. Number of vessels inspected and passed. 16 Number of crew inspected and passed. 1, 367 Number of passengers inspected and passed. 258 Number of passengers, transit, inspected and passed. 110 An epidemic of mumps exists at Bocas del Toro at the present time. No quarantinable disease has appeared in tnis port, and the health conditions of the port andsurrounding territory continue good. TABLE XIX.-STATEMENT OF QUININE ISSUED. Quinine sulphate (kilos) .3.00 Pounds, avoirdupois ..6.61

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53 TABLE XX.-PERSONNEL REPORT. Nov., 1916. Oct. 1916 Nov.,1915 (total em(total emGold emSilver emTotal employees). ployees). ployees. ployees. ployees. Chief health officer. 3 .3 4 4 Medical storehouse. 4 4 8 8 10 Quarantine division. 13 33 46 46 43 Health office, Panama 13 151 164 152 176 Health office, Colon. 9 154 163 160 195 Ancon Hospital. 125 235 360 367 337 Colon Hospital. 16 26 42 41 37 Santo Tomas Hospital. 6 .6 6 6 Palo Seco Leper Asylum. 2 39 41 35 30 Zone sanitation. 7 117 124 124 146 Hospital farm. 2 67 65 51 51 Dispensaries: Balboa., .5 3 8 8 7 Corozal. ..4 Gamboa. 1 .1 1 1 Gatun. 2 2 4 4 5 Paraiso. 2 2 4 4 4 Pedro Miguel. 2 1 3 3 3 Total. 212 834 1,046 1,014 1,059

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