Citation
Report of the Department of Health of the Panama Canal

Material Information

Title:
Report of the Department of Health of the Panama Canal
Alternate Title:
Report of the Health Department of the Panama Canal
Creator:
Canal Zone -- Board of Health
Mason, Charles F
Place of Publication:
Washington, D.C.
Publisher:
U.S. G.P.O.
Creation Date:
August 1914
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_00017 ( 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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*S REPORT OF THE DEPARTMENT OF HEALTH OF THE PANAMA CANAL MONTH OF AUGUST, 1914 CHAS. F. MASON Lieut. Colonel, Medical Corps, United States Army Chief Health Officer, Ancon, Canal Zone 4S WASHINGTON 1914

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ii

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CONTENTS. Page. L e t t e r o f t r a n s m i t t a l ...........---..-..-. .-. ...-. .....-. .--. 5 General remarks. 5 Vital statistics: H ealth of em ployees..--..-.5 Health of residents of Canal Zone. .----. 6 Health of residents of the city of Panama. --. 6 Health of residents of the city of Colon. 7 Hospital division: Ancon Hospital. 7 Board of health laboratory. 7 Farm for disabled. 7 Insane department.---------.---.--------.---. 8 Colon Hospital.-.---. 8 Chrome department. 8 Palo Seco Leper Asylum.-.------.------------.--8 Santo Tomas Hospital. 8 District dispensaries. 9 Sanitary division: Canal Zone---. 9 Panama.-------.-.--.--.-----. 10 Colon. 11 Quarantine division: Panama. 12 Colon.-.---. Statistical tables: Table I. Admissions, deaths, and noneffective rates for employees; deaths of residents of Panama, Colon, and the Canal Zone.-. 12 II. Deaths by age, color, and sex--. 14 III. Deaths by nationality. 14 IV. Deaths of i white Americans. --. 15 V. Causes of deaths of employees.-. 15 VI. Causes of deaths of employees and civil population and places where chargeable. -. 16 VII. dmissions and deaths in the hospitals of the Panama.Canal32 VIII. Consolidated hospital report.-. 33 IX. Consolidated dispensary and admission report. --34 X. Employees: Constantly sick and noneffective rates per 1,000. 35 XI. Employees: Days' treatment per admission, hospitals, and quarters .36 XII. Financial statement .36 XIII. Ancon Hospital. 37 XIV. Colon Hospital.-.:. 43 XV. Palo Seco Leper Asylum.w.44 XVI.Santo Tomas Hospital. 44 XV II. Sanitary work done in Canal Zone, Panama, and Colon. 46 XVIII. Quarantine transactions. 47 XIX. Issues of quinine. 50 XX. Personnel report. 51 (3)

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LETTER OF TRANSMITTAL. ThE PANAMA CANAL, DEPARTMENT OF HEALTH, Ancom, Canal Zone, September 11, 1914. To the GOVERNOR OF THE PANAMA CANAL, Balboa Heights, Canal Zone. Sm: I have the honor to submit the following report of the operations of the department of health for the month of August, 1914. Very respectfully, CHAS. F. MASON, Chief Health Officer. GENERAL REMARKS. No cases of yellow fever, smallpox, or plague originated on or were brought to the Isthmus during the month. VITAL STATISTICS. EMPLOYEES. The health of the employees continues very good. The number of names on the rolls for the preceding month was 44,132. -The total number of admissions to hospitals and quarters was 1,352, a rate of 367.62 per thousand per annum, as compared with 366.57 for the preceding month, and 543.71 for the corresponding month of last year. The total number of deaths from all causes was 24. Of these, 12 died from disease, or 3.26 per thousand per annum, as compared with 4.12 for the preceding month and 4.31 for the corresponding month of last year. The diseases causing the largest number of ,deaths were as follows: .Nephritis, acute and chronic, 4; organic disease of heart, 2. No other disease caused more than one death. -The total annual admission rate for malaria, hospitals and quarters, was 89.73, and the total noneffective rate 1.95, each rate being lower than for the preceding month and lower than for the same month of last year. The diseases next to malaria causing the highest admission rates, in the order of their numerical importance, were diseases of the digestive system, venereal diseases, diseases of the respiratory -system and of the nervous system. These five classes of diseases caused 59 per cent of all admissions to hospitals. There was but 1 admission for typhoid fever, giing a rate of 0.27 per thousand per annum, as compared with 0.26 for the pre-ceding month, and 0.41 for the corresponding period of last year. (5)

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EFFECTS OF RACE. The admission rate to hospitals and death rate for disease for black employees were 128.06 and 2.90 per thousand per annum, as compared with 358 and 5.26 for white employees. The noneffective rate for disease and injuries for black employees per thousand was 10.05, as compared with 18.25 for white employees. The admission rate to hospitals and quarters for malaria was 70.47 per thousand per annum for blacks, as compared with 194.79 for whites. This month for the first time we have been able to separate the statistics for white Americans from those for white Europeans; the former had a strength of 5,178; the latter 1,660, mostly Spaniards. While the death rate for white Americans was 6.95 and there were no deaths among the white Europeans, the admission rate for disease for the latter was 404.82, as compared with 342.99 for Americans, and the noneffective rate 30.37, as compared with 10.56 for Americans. The admission rate for malaria was also much higher among the Europeans, being 231.33, as compared with 57.94 for Americans. DEPORTATIONS. There were 38 deportations accomplished during the month, divided as follows: Employees, 12; nonemployees, 26; for disease, 37; and for injury, 1. CANAL ZONE. The population of the Canal Zone according to a recent census is 37,702, among whom there was a total of 60 deaths; of these, 51. deaths were from disease, giving a rate of 16.23 per thousand per annum, as compared with 14.64 for the preceding month and 15.21 for the corresponding month of last year. Of the total deaths from disease, the percentage under 5 years of age was 45, compared with 35 last month. There were only 45 births reported, giving a rate of 14.32 per thousand per annum. Of these births, 11 were of white and 34 of colored children. There were no deaths of white and 21 deaths of colored children under 1 year of age, giving an infan;mortality of 618 for colored children. Either the registration of birtliis -very incomplete or the infantile mortality is enormous; in my opimon, the former is probably the case, but steps are being taken to check up the registration. I ,PANAMA CITY. The estimated population of the city is 62,172, among whom there was a. total of 133 deaths; of these, 122 deaths were from disease, giving a rate of 23.55 per thousand per annum, as compared with 33.20 for the preceding month, and 30.52 for the corresponding month of last year. Of the total deaths from disease, the percentage under 5 years of age was 49, compared with 47 last month. The principal causes of death showing an increase were acute bronchitis' and pneumonia. The infant mortality was 173 per thousand. A census of the city was taken during the month, but the result is not available in time-for this report.

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7 COLON. In Colon, with an estimated population of 20,232, there were 39 deaths; of these, 38 deaths wer_ from disease, giving a rate of 22.54 per thousand per annum, as compared with 39.14 for the preceding month, and 24.32 for the corresponding month of last year. Of the total deaths from disease the percentage under 5 years of age was 58, compared with 47 last month. The infant mortality was 173 per thousand. HOSPITAL DIVISION. ANCON HOSPITAL. The number of patients admitted has continued to decrease, ap has been the case for some months past. During the month the average number of patients constantly in hospital was 558, the lowest since May, 1908. The net per capita cost for hospital treatment went up from $0.396 in July to $0.593 in August. This was due largely to the auditor's decision that no credit should be taken for treatment of charity patients during the month. BOARD OF HEALTH LABORATORY. The following Work, in addition to the routine, was performed: Interesting and satisfactory experimental catches were obtained with a cockroach trap after the type devised by S. A. Graham, of the Minnesota Experiment Station. The trap catches and retains the roaches, and this would seem to be a more satisfactory method of treating these pests than by means of poison; particularly in households where there are young children. The trap is easily constructed, and banana skins are a satisfactory bait. For general use the double-cone device might be constructed of tin of such size and length that it could be adapted to an ordinary pickle, candy, or other wide-mouth bottle, thus completing the trap. Apparatus, material, photographs, etc., are being prepared and collected for the exhibits at Panama and at the San Francisco Exposition. -Observations are being continued on the bionomics of Stegomryia scutellaris, citrus tree moths, and. the relation of A-nopeles albimanus to A. tarsimaculata. A series of examinations of placental and peripheral blood smears are being made with relation to the diagnosis of malaria. The stools and urines -of all employees handling food and drink are being examined for the detection of disease carriers. Observations are being made on the initial bacterial count of milk from Panama daries and the rate of bacterial increase under leal -conditions -of handling. FARM FOR DISABLED. The per capita cost of the disabled was $0416, as compared with $0.246 m July. This was largely the result of a decreased yield of htrm products caused by the heavy rains. In addition to the usual farm work, .grading ftb te proposed dairy buildings was begun and about 90 per cent completed.

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8 INSANE DEPARTMENT. There were only 13 admissions to the asylum during the month, 1 of these being a patient who eloped during the month and was readmitted. Twenty-six of the 30 discharged were deported to Jamaica and Barbados. Several patients at the Corozal farm proved refractory, attempted to escape, or were not inclined to work, and were returned to the asylum. They were replaced by other inmates, thus keeping the total insane working force at that place up to 40. In other respects the conditions among the insane men assigned to the farm and the work performed by them were very satisfactory. Detailed statistics are shown in Table XIII. COLON HOSPITAL. On July 15 the Cristobal dispensary was moved to Colon Hospital and consolidated with that institution, of which it now forms the outpatient department. This move was in the direction of economy and efficiency. Congress having passed an act providing that the Colon Hospital site and buildings should be converted to the use of the Colon quarantine station, the buildings and grounds have been divided into two parts for that purpose, the southern end being assigned to the quarantine station and the northern to the hospital. The highest number of patients treate I on any one day during the month was 54; the lowest number, 40; the daily average being 44.41. Theaverage number of employees constantly sick was 34.28. The average number of days treatment per employee was 9.17. CHRONIC WARD. There were 30.22 chronic and incurable patients constantly cared for during the month. Detailed statistics are shown in table XIV. PALO SECO LEPER ASYLUm. The number of patients under treatment at the end of the month was 50, a decrease of 1 from the previous month. Detailed statistics are shown in Table XV. SANTO TOMAS HOsPITAL. During the month a total of 1,307 patients were treated in the wards, a decrease of 1 patient over the -previous month. The daily average of patients in hospital was 379, an increase of 17 over the month of July. The total number of hospital days was 11,686; the subsistence cost, $0.2435; and the per capita cost, $0.8159., The total deaths were 56, of which number 7 came from Colon. 'he number of deaths for August was 21 less than for the month of July. During the month 84 babies were born in the maternity home, as against 80 for the month preceding.

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9 During the last days of the month there was an increased admission for beriberi, the majority of cases coming from the Chiriqui prison. The hospital is being taxed almost to its capacity. This is due as -much to the greatly increased population as to the increased morbidity usually experienced at this season of the year. Detailed statistics are shown in Table XVI. DISTRICT DISPENSARIES. On August 8 the Naos Island dispensary was turned over to the Army, on August 15 Cristobal dispensary was consolidated with Colon Hospital, and on the 31st the dispensary at Empire was closed, thus leaving only the dispensaries at Gatun, Culebra, Paraiso, Pedro Miguel, Corozal, and Balboa in charge of physicians and subdispensaries at Margarita Point and Gamboa Penitentiary in charge of male nurses. The dispensary having the highest admission rate for malaria was Toro Point, with an average weekly percentage of 0.80, while Culebra had no admissions from this disease during the month. Detailed statistics are shown in Table IX. SANITATION. CANAL ZONE. The malaria rate remains low; the total number and percentage of employees sick with the disease were smaller than last year. Efforts have been made continuously to bring all malaria cases under treatment and to keep them under treatment for a sufficiently long time to free them from the disease, and a larger proportion of 'cases now receive thorough treatment than formerly did so. Nevertheless, many cases still take but a short course of treatment, and very much remains to be accomplished. The failure to get all cases to continue treatment is due partly to indifference on the part of patients, partly to ignorance. New hydraulic fills in the neighborhood of Ancon and Panama have required extensive antimosquito work, which has in general been very successful. The situation in regard to typhoid has been excellent, there being no case during the month. All employees in Panama Canal hotels and restaurants have been examined physically and had their stools and urine examined for the germs of typhoid, paratyphoid, and dysentery. One chronic typhoid carrier was detected-a waiter in the silver mess at Corozal-and was at once sent to hospital. A few men were also exc eluded from work for other reasons. As will be seen in Table XVII, the number of work requests on other departments shows a decrease, which is due to the fact that oilers are doing such work as they are able to do without neglecting necessary oiling. There has also been an increase in the number of rat traps used and in the notices served to abate nuisances. Detailed statistics are shown in Table XVII. 63902-14--2

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10 PANAMA. CONTAGIOUS DISEASES. No typhoid, diphtheria, or scarlet fever were found or reported in this district for the month. MALARIA. There has been an apparent increase in malaria during the month. This is probably due to the extensive building operations and excavation work which are being carried on in the outskirts of the city. BUILDING OPERATIONS. During the month 131 buildings were condemned. Activities on this phase of the work have ceased temporarily owing to the renumbering of the houses of the city, which is now in progress. Exactly 50 per cent of the work is completed on all permits issued since April 1. Property owners can now secure gravel for use in their cement work, and this arrangement has greatly facilitated the work now being carried on. The rat-proofing features of all new buildings and buildings undergoing repairs are given marked attention. MOSQUITO, RAT, AND FLY WORK. The number of mosquito breeding places found is again reduced for the month, and very few complaints have been made arising from the presence of mosquitoes. As to the fly-breeding situation. there does not seem to bdmuch improvement except in the reduction of the number of breeding places found, although apparently there has been marked increase during the latter part of the month in the number of flies. There was a catch of 683 rats for, the month, all of which were sent to the laboratory and were found negative for plague upon examination. SCORE CARDS. Hotel, restaurants, bottling works, ice-cream parlors, dairies, and bakeries were inspected at regular intervals, and score of the conditions existing in these establishments shows some improvement. STREET CLEANING. The street-cleaning service has moved along smoothly, and though the department has not been able to install the new street sweeper, it is expected to do so as soon as there are teams available. GARBAGE COLLECTION. The collection of garbage was satisfactorily maintained during the month and all garbage was satisfactorily cremated at the dump. The use of wagons for collection of garbage at night in certain dis tricts is meeting with success. Detailed statistics are shown in Table XVII.

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COLON. An arrangement has been made with the municipality for a monthly report of births to be submitted to this office. An inspection of all public schools in the district was made and they were found to be in very good condition. The new drainage system and mosquito work on Mindi Island has been, maintained and great progress has been made during the past month. Forty-three houses in the settlement of Guava Ridge and 23 houses of squatters in Florence Town settlement were condemned for sanitary reasons; also 20 cars of the Panama Railroad Co. camp at Cristobal. Some of the latter have already been removed. The arrangement with the Panama Railroad Co. for providing docking facilities for small coastwise craft has been made, and the work of remodeling pier No. 2 for this purpose is already in progress. The destruction of the old Pacific Mail Pier, which was condemned for sanitary reasons, is in progress. The progress of vaccination has been temporarily suspended until the arrival of additional vaccine. There were no cases of communicable diseases during the month. PROTECTION OF BREADSTUFFS. The efforts to secure adequate protection to breadstuffs were carried to the point where these products offered for sale at retail in the bakeries are now being wrapped in individual packages and kept in stock in this condition. All the breadstuffs are kept in fly and dust proof cases. Shopkeepers are being made to similarly protect these products. Street vendors keep their sweets and cookies in glass cases, as these prodilcts are too sticky to be wrapped, and these vendors also say very strongly that the public will not buy their wares unless they can see them. Posters in four languages are being placed over the city explaining the necessity of this action. It is intended as soon as these posters are out to enforce the regulations in every shop and stall in the city. Four prosecutions were made in this work and convictions secured in each case. RAT EXTERMINATION. The work against rat infestation has been continued by condemnation of some buildings and by vigorous efforts to enforce the proper disposal of garbage, by having food in stables protected, and by experiments with different types of traps. Five'different types are being used and one more is now under construction; two of these are much more efficient than the others. A number of rats have been caught alive and are used in these experiments. Two different species have been caught. An important observation was recorded in finding that certain small carnivorous ants get onjmeat or greasy food used for bait and greatly reduce the efficiency of trapping, as the rats will not enter traps infested by these ants. By using a strip of "Hoo-doo" ant paper around the outer base of the traps this has been overcome. Detailed statistics are shown in Table XVII.

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12 QUARANTINE SERVICE. The decrease in traffic-passenger boats-has been quite largely made up by an increase in freight boats passing through the-canal, the total number of vessels arriig for the past month being 124, as against 127 in the previous month. The plague situation in New Orleans is apparently as good as can be expected. The number of human cases appears to be decreasing, while a good many rodent cases are being discovered in various parts of the city. The plague situation in Habana has shown a decided improvement and no human cases have occurred for some time. The situation at Santiago seems to be worse than at Habana, and it is largely on account of the situation there that we are continuing our quarantine against passengers from Cuba. During the month certain cases of plague have occurred at Liverpool. No additional data regarding the situation there has been received. The plague situation in South America remains about the same, and yellow fever in Ecuadorean ports is still reported. No diseases of a quarantinable nature have arrived on the Isthmus during the month. Detailed statistics are shown in Table XVIII. STATISTICAL TABLES. TABLE I.-ADMISSIONS, DEATHS, AND NONEFFECTIVE RATES FOR EMPLOYEES: DEATHS OF RESIDENTS OF PANAMA, COLON, AND THE CANAL ZONE. ABSOLUTE NUMBERS. Admissions to hospitals. Died. foum sic1cne NumColor. ber Ttof em-ExterExterployees. To. Dis nal Total. Disnal Days stantly ease. causes. ease, treated nonefcauses. fective. August, 1914. White.6,838 238 204 34 3 3 .3,869 124.81 Colored. .37,294 550 398 152 21 9 i2 11,619 374.80 Total. 44,132 788 602 186 24 12 12 15,488 499.61 July, 1914. White. 7,113 267 229 38 5 1 4 3,916 126.33 Colored. 39,503 688 499 189 22 15 7 11,983 386.56 Total. 46,616 955 728 227 27 16 11 15,899 512.89 August, 1913. White.: 12,377 736 625 111 5 3 2 11 658 376.05 Colored. 46,088 1,037 706 331 34 18 16 16,420 529.68 Total. 58,465 1,773 1,331 442 39 21 18 28,078 905.73

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13 TABLE I.-ADMISSIONS, DEATHS, ETC.-Continued. --PROPORTIONATE NUMBERS.' Noneffective Admissions tohospitals. Died, from sickness. NumColor. ber Cn of emDisExterExterConployees. TotaL ease. nal Total. asnal Days stantly -cases.ease. causes. treated. nonefcause. cases.fective. August, 1914;White. 6,838 417.66 358.00 59.66 5.26 5.26 ..18.25 Colored. 37,294 176.97 128.06 48.91 6.76 2.90 3.86 .10.05 Total. 44,132 214.27 163.69 50.58 6.52 3.26 3.26 .11.32 July,1914. White. 7,113 450.44 386.33 64.11 8.44 1.69 6.75 .17.76 Colored. 39,503 208.99 151.58 57.41 6.68 4.56 2.12 .9.78 Total. 46,616 245.84 187.40 58.44 6.95 4.12 2.83 .11.00 August, 1913. White. 12,377 713.58 605.96 107.62 4.84 2.91 1.94 .30.38 Colored. 46,088 270.00183.82 86.18 8.85 4.69 4.16 .11.50 Total. 58,465 363.91 273.19 90.72 8.00 4.31 3.69 .15.49 Deaths. Annual average per 1,000. place. Population. DisExterDisExterTotal. se. nal. Total. ease. nal. e causes. causes. August, 1914. Panama. 62,172 133 122 11 25.67 23.55 2.12 Colon. 20,232 39 38 1 23.13. 22.54 .59 CanalZone. 37,702 60 51 9 19.10 16.23 2.86 Total. 120,106 232 211 21 23.18 21.08 2.10 July, 1914. Panama'. 62,172 176 1 4 33.97 33.20 .77 Colon. 20,232 68 6 2 40.33 39.14 1.19 CanalZone. 37,702 54 46 8 17.19 14.64 2.55 Total. 120,106 298 284 14 29.77 28.37 1.40 August, 1913. Panama .47172 124 120 4 31.54 30.52 1.02 Colon .232 42 41 1 24.91 24.32 .59 CanalZone. 62,342 96 79 17 18.48 15.21 3.27 Total. 129,746 262 240 22 24.23 22.20 2.03 'Annual average per 1,000.

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14 TABLE II.-DEATHS BY AGE, COLOR, AND SEX. White. Colored. Yellow. Totals. Age. 6 0DC 5~ 4 5 4Q4 0 .~.~ 0 Under 1year. 3 3 6 45 38 83. .48 41 89 1 to 4 years. .1 1 7 8 15 ...7 9 16 5 to 10 years. .-----------1 .1 3 1 4 ..4 1 5 11 to 20 years.-----------------3 4 7 ...3 4 7 21 to 30 years.---------3 1 4 27 9 36 1 .1 31 10 41 31 to 40 years.---------4 3 7 19 8 27 ..23 11 34 41 to 50 years.---------3 .3 7 6 13 ...10 6 16 51 to 60 years. ...4 3 7 .4 3 7 61 to 70 years.-----------------6 1 7 ---------6 1 7 71 to 80 years.---------1 .1 1 1 2 ...2 1 a 81 to 90 years1. ....1 1 .1 1 1 2 Not stated-. 1 1 2 3. 3 ----------.4 1 5 Total. 16 9 25 125 80205 2.2 143 89 232 TABLE 11.-DEATHS BY NATIONALITY. Nations. Employees. NonTotal. employees. Barbados. 9 15 24 Brazil.-.-. .1 1 Ch in a ..---.-------.-. .2 2 Colom bia ..--.-.-.-..-."4 4 Denmark. .1 1 Ecuador ..1 1 England. .1 1 France. .1 1 Grenada. 2 1 3 Guadeloupe. 1 .1 Italy. .2 2 Jamaica. .5 34 39 Martinique. 1 5 0 Mexico .1 Panama. 1 123 124 Santo Domingo. .1 1 Spain.1 1 St. Lucia.1 5 6 St. Thomas.1 1 St. Vincent.;. .2 2 Trinidad. ...1 1 United States. a 6 9 Total. 24 208 232

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15 TABLE IV.-DEATH RATE AMONG AMERICANS ON THE ISTHMUS CONNECTED WITH THE PANAMA CANAL. Number Annual Cas. Cause of -death. of average deaths. per 1,000. isease. 3 .9 White employees from the 5,178 violence. ses .3 60.12 White women and children 1 Tsas3 1.2 from the United States.3,557 'VOlenc;e------------------i AlIl causes 3--0.12 Disease. 6 8.24 White employees and their tam1 y 735 4ae 82 lies from the United States. 8,735 Violence. IAII causes 6 8.24 Total number of Americans on Ds 6 6.44 the Canal Zone 11,1.4 IV=n 1 1.07 Allcauses. 7 7.51 TABLE V.-CAUSES OF DEATHS OF EMPLOYEES OF THE PANAMA CANAL AND PANAMA RAILROAD. Causes of death. White. Colored. Total. Disease: Acute nephritis.t 1 1 2 Chronic nephritis.--.------------------------2 2 Cholecystitis. 1 General peritonitis--.----...1 Infection of undetermined origin.-1I1 Intestiin.L obstruction.1-1 Lobar pneumonia.----1 1 Pericarditis.-----------1 1 Organic disease of heart.1 .2 Accidental drowning.---4 4 Lightning ..1 1 Suicide by drowning.---1 1 Traumatism in quarry.--1 1 Traumatism by machines.--2 2 Railroad traumatism ------------------3 3 Total .3 21 24'

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16 TABLE VI.-CAUSES OF DEATHS OF EMPLOYEES AND CIVIL POPULATION AND PLACES WHERE CHARGEABLE. Disease. anaColon. Canal Total ma. Zone. General diseases. Malarial fever: Estivoautumnal. .------------------------1 2 .3 Tertian .----------------.----------------. 1 --------------1 Undetermined.---------------------------. .3 --------------3 Clinical----...-------------------------------1 1 2 Cachexia-.--------------1 Hemoglobinuric fever, malarial. -.1 1 Diphtheria and croup -----------------------1 ..1 Erysipelas. .--------------------------------1 --------------1 Pyemia. ....-.-------------------------1 1 Septicemia. ...-----------------------. 1--------.1 Pyemia and septicemia, pneumococcic -----------1 .1 2 Tetanus.---------------------------------2 --------------2 Pellagra. ....---------------------------------------1 1 2 Beriberi--.--------------------------------. 1 --------------1 Tuberculosis of the lungs----------------------21 5 4 30 Acute military tuberculosis .-------------------------------1 1 Tuberculous meningitis ..---------------------------1 1 Disseminated tuberculosis .-------------------------------1 1 Cancer and other malignant tumors of the buccal cavity---. --. .1 -.---------------1 Cancer and other malignant tumors of the stomach and liver.--------------------------------.1 1 Cancer and other malignant tumors of the female genital organs.------. .....------------1.1 Acute articular rbeumatis .-.-..1 ..-.-1 Anemia, secondary, cause not determined --------------------1 1 Alcoholism (chronic).------------------------. 1--------------1 Diseases of the nervous system and of the organs of special sense. Acute anterior poliomyelitis.----------------1--------------1 Cerebral hemorrhage, apoplexy----------------1 1 .2 Softening of the brain------.-----------------1 1 1 3 Diseases of the circulatory system. Pericarditis. ....------------------------------------1 .I Acute endocarditis. ...--------------------1 -------------1 Organic diseases of the heart.-----------------3 1 2 6 Diseases of the arteries, atheroma, aneurysm, etc. ---.-1 .1. I Arteriosclerosis. ..----------------------------1 --------------1 Diseases of the respiratory system. Acute bronchitis .-. -9 2 .11 Bronchopneumoiia-.,. 8 5 -4 17 Pneumonia (unqualified).--------------------2 --------------2 Lobar pneumonia.--------------------------1 4 3 ------7 Pleurisy. ..........------------1 ----.-. .-. .1 Diseases of the digestive system. Acute gastritis. ....-------------------------1 1 .2 Diarrhea and enteritis (under 2 years) .20 2 6 28 Colitis.------------------------------------. .1.-----------I Diarrhea and enteritis (2 years and over) .2 --------------2 Colitis. ......------------------------------1 --------------1 Acute appendicitis .------------------------------------1 1 Intestinal obstruction-------. ----------------1 .1 2 Cirrhosis of the liver-------------------------1.---------------1 Cholecystitis ............-.-.-1 1 Simple peritonitis (nonpuerperal) -------------------------1 1

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17 TABLE VL-CAUSES OF DEATHS OF EMPLOYEES AND CIVIL POPULATION AND PLACES WHERE CHARGEABLE-Continued. Disease. PanaColon. Canal Total. Nonvenereal diseases of the genito-urinary system and annexa. Acute nephritis .----------------------------1 .2 3 Bright's disease (chronic nephritis).------------7 1 3 11 Other diseases of the kidney and annexa. 1 ..1 Calculi of the urinary passages.-.-. 1 1 Diseases of the urethra, urinary abscess, etc. -1 --------------1 Hypertrophy of prostate.------------------------------------1 T*e puerperal state. Accidents of pregnancy.------------.-------1 ..1 Abortion .-------------------------------.1. .--------.-.1 Puerperal septicemia. --------------1 Malformations. Congenital malformations (stillbirth not included). .-------------------------------------------1 1 Diseases of early infancy. Congenital debility, icterus, and sclerema.-. 1 1 2 Prem ature birth .--.-. .-. ...1 ...1 Congenital deLiliti-y..---------------------2 2 2 6 Malnutrition. 3 3 6 12 Other causes peculiar to early infancy (including various consequences of labor)-----------3 1 1 5 Lack of care. ....----------------------------------------1 1 Old age. Senility. ..1 1 Affections produced by external causes. Suicide by hanging or strangulation.-. .1 1 Suicide by drowning ...-----------------------------------1 1 Suicide by cutting or piercing instruments. ..1 1 Other acute poisonings. 1 .--------1 Accidental drowning. 4 -. 2 6 Traumatism by firearms---------------------.2.----.2 Traumatism in mines and quarries .---------------------1 Traumatism by machines.--------------------1 1 .2 Traumatism by other crushings (vehicles, railroads, landslides, etc.)--------------------1 ..1 Railroad traumatism.-----------------------2 .2 4 Lightning. ...------------------------------------------1 1 Ill-defined diseases. Sudden death -----------------------------1 1 .2 Cause of death not specified or ill-defined .2 ..2 Infections of undetermined origin-. 1 ------1 2 Total.-------------.---------------133 39 60 232 8tillbirths -------------------------------18 6 4 28 Grand total.;--. -----. 151 45 64 260 63902-143

PAGE 20

18 TABLE VII.-TABLE SHOWING ADMISSIONS AND DEATHS IN THE Ancon Hospital. Employees. Nonemployees. Admissions. Deaths. Admissions. Deaths. Diseases. White. White. White. White. Tyhod acluscarir. .1 n u cd Ci3 PZ 0 e A ca 0 M 0 A General diseases. Typhoid fever------------1 ----------------Typhoid bacillus carrier -------1-1------I Malarial fever: Lstivoautumnal-----12 9 97 ---------9 12 6. Tertian------------3 5 16 ---------3 1 4---------Quartan.--------------1 2 ---------------------------Clinical------------7 9 34 ----------6 7---------Vaccima.--------------1.--. 1-------------------------Diphtheria and croup ..--------1 1 Influenza ---------------9----------------------------------Dysentery-----------------. .-----------------------------Entemebic----------1 .1--2 1. Bacillary. -. ----.2------------Unclassified .---------------1 -------------1. Erysirelas.-------1 ------------------------------------Dengue .-----------------1 --------------------------------Chicken pox. Mums---------------------6 -----------------------------Yaws -----------------------1--------------------------Filariasis .--------------------1. Acute infectious jaundice (Weil's disease). .1--.-.---------....1 Pymmia. .------------------.-------..--.---.---.1 Pyemnia and septichimnia, pneumococcic. -----------..----.------------.1 .1 Tuberculosis of the lungs. -1 ---3 ---------1 -.4 -----Acute miliary tuberculosis -----------------1 .4 Tuberculous meningitis -------------. -.I.-.-.-. .1 Tuberculosis of other organs -. .----.-------------.----1 Tuberculosis of the skin---------1 ---------------------------Dissem inated tuberculosis. ....--...--1 Syphilis: Secondary ------------.----1 ------------1 Tertiary.-----------------. 1 ---. .1 .. Period not stated. 1 15 ---------------------Gonorrhea. .t.s --------7 2 8. ----------11 .2. G onorrheal arthritis-------.8-6 .-. ....Gonorrheal orchitis and epididymitis.----------1 1 2 -----------------------Gonorrheal ophthalmia. ..----------. ..--. .. Soft chancre.--------------2 11 -------6 .1 Adenitis chancroidal ------------. ......Cancer and other malignant tumors of the stomach and liver -----------....-----.---.---------

PAGE 21

19 HOSPITALS OF THE PANAMA CANAL, MONTH OF AUGUST, 1914. Colon Hospital. Total. Employees. Nonemployees. Employees. Nonemployees. AdmisDths AdmisDths. AdmisDths. Admissions. Dths. sions8. siofls. SiofS. W. W. W. W. W. W. W. 0u; *A ri2 0 4 Ca Irn -1 -0 w -# W C2 0 0 n 4 .2.3 518. .3 14. --18.-----. .--1 2 4 7 1352. .7 9 8. ..-.-.---.-.3 5.----.1 4 4 ...1 3 1.7.1.11. .1.1.3 1. 2 ---.--.--.-..--.--.-.-.1. ..--...--1 --. ----. ---. ----. --. ---. ---..-----1.1. 1. 5. ..1. 8. .---5------.-.----.--.----.......1.--.-.-.-.1.--4-.-.-.-.--.-.-.-.--.-. --. ---. --. -.-. --. ----.---.1 ..1 ....--.---.-.---.-.-.--.---.---. 1. -. -.-. ---. I._.1-.-.-.--.--T. ....1--.-.-. ---. ..1 1. 15 .1. ..........1. ... ....72 111-2.-.-.1 .........1. .21.6.1. .1. I.I.1.1.

PAGE 22

20 TABiz VII.-TABLE SHOWING ADMISSIONS AND DEATHS IN THE Ancon Hospital. Employees. Nonemployees. Admissions. Deaths. Admissions. Deaths. Diseases. White. White. White. White. q 1 ,q (7 P General diseases-Contd. Cancer and other malignant tumors of the female genital organs.---------------------------Cancer and other malignant tumors of other organs and of organs not specified -------------------1. Other tumors (tumors of the female genital organs excepted).-------------2 1 ----------------1------. -Acute articular rheumatism .-. .-----------------------Chronic rheumatism and gout. .------------------------2 --------------Anemia secondary, cause ----------------------1 --------not determined. Other general diseases.----------------------------------------Alcoholism, acute --------2 ----------------------2------------Alcoholism, chronic-. 2 -------------------------------Alcoholic psychosis.-. 1----------------------------Diseases of the nervous system and of the organs of special sense. Simple meningitis ----------------------------------1---------Softening of the brain -----------------------------1 ------2 Paralysis without specified cause ----------------. .-----. -. Other forms of mental alienation---------. .-----------.-. ...6 Dementia precox ----------. .-----1 -----------------------Epilepsy.-. 1-------------------Convulsions of infants (under 5 years of age) -------------------------1 ----------Neuralgia.-------------------. .....5 2 Neuritis---------------2 -1---------------------Other diseases of the nervous system-----------1 ---3 ..--. .---Neurasthenia-----------1--------------4 2 ---------Diseases of the eyes and their annexa----------4 .15 ..2 4 5 .-----Follicular conjunctivitis. .......... Diseases of the ears. 3 .2 ...8 4 ----------

PAGE 23

21 HOSPITALS OF THE PANAMA CANAL, MONTH OF AUGUST, 1914-Coa. Colon Hospital. Total. Employees. Nonemployees. Employees. Nonemployees. AdmisDths. AdmisDths. AdmisDths. Admissions. Dths. sons. sions. sons. W. W. W. W. W. W. W. W. -P4 P4 14 1. ......1 .1 --.1 -----------------------------------.~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ..1. ......----1. ........1.-.-. 2 ..I 1 .1. ........ 2 ..1.1. .......2 ......... .............1 ..-. ........... ............... .3 ......-.-. -4 --------1. ---. ---.-. .-.-. .5 2. ..... ......4. .... ....... ........... ...4 2.5. 2.2. ........... .-. .........4---1 -..,-------5.......1. .4 ... 3. 2. ....

PAGE 24

22 TABLE VIL-TABLE SHOWING ADMISSIONS AND DEATHS IN THE Ancon Hospital. Employees. Nonemployees. Admissions. Deaths. Admissions. Deaths. Diseases. White. White. White. White. -f I r/) r --o $-4 0 C,4 r ~o O N wO Diseases of the circulatory system. Pericarditis. ..1 ...Organic diseases of the heart 2 .2 ..1 -.1 2. Arteriosclerosis1. 1 -. ....... Diseases of the veins (varices, hemorrhoids, phlebitis, etc.).2. ....-.-.---Hemorrhoids .1 .3 .1 1. Varicocele. ....2 Diseases of the lymphatic system (lymphangitis, etc.). ....1. .. Lymphadenitis (nonvenereal). 5 1 4 ...3 1 1. Diseases of the respiratory system. Diseases of the nasal fossm. 6 1 ....3 1 1. Adenoid vegetations. ....1 Diseases of the thyroid body. Acute bronchitis. 1 .3 ....-3 -Chronic bronchitis. 2 ...... Broncho-pneumonia. .....1 Pneumonia (unqualified). .1 ....-.-.-. Lobar pneumonia. ..13 ..2 .I ... Pleurisy. 2 .7 ....1 2 ... Empyema. ........1 .... Asthma. ..2 .....--.Abscess of lungs. 1 ....... Diseases of the digestive system. Diseases of the mouth and annexa. .....I ..... Diseases of the teeth and gums. ..4 .4 .... Diseases of the pharynx. 1 1 3. ...1 1.---Pharyngitis .2 ----------------------Follicular tonsillitis. 4 1 2 ...7 7 3 ... Other diseases of the stomach (cancer excepted). 1 ......3 ....

PAGE 25

HOSPITALS OF THE PANAMA CANAL, MONTH OF AUGUST, 1914-COD. Colon Hospital. Total. Employees. Nonemployees. Employees. Nonemployees. AdmisDths. AdmisDths. Admis Dths. Admissions. Dths. sions. sions. sions. W. W. W. W. W. W. W. W. 1. 10 2a ----------------------------1-.-.-.--.--.--------. ..2.-.2. .1 2 .....1. 2. .-.-. --. -.-.-. ...1. .... .1 .3. 1 1 ......2. .. ...............3.1 1 ... ..1 .4 --. 3 1 1. ........1. 1. 3 .3 1....2 V, ~2 .-.1. ....13 .2 .1. .1. .2 .8 ...1 2. .13. 1. 2. .4 ..1. 1 4 .. ..... .......4. 3 ..1 1 3 .. ......2 ...7. 7. .4 1 2 7 7 3 3

PAGE 26

OA TABLE VII.-TABLE SHOWING ADMISSIONS AND DEATHS IN THE Ancon Hospital. Employees. Nonemployees. Admissions. Deaths. Admissions. Deaths. Diseases. White. White. White. White. Diseases of the digestive sy~stern-Continued. Acute gastritis. 1 1 1. Acute indigestion.-.-.-. 2 Diarrhea and enteritis (under two years). ---.--.--.-2 3. Diarrhea and enteritis (two years and over)-1 1--------11. .1 1 Colitis.1 ..3--------------Ankylostomiasis.-.-.-.1 1. Acute appendicitis.--.2-.--.-.3 3-----1 --Chronic appendicitis. -3-.-.-.-.-. 1 5 Inguinalhernia.-.2 3 3 .-.-.2 2. Other hernias. 1.-. .-.-. .-. 2.-. .-. 1 Intestinal obstruction. ...1-.--. 1 .. Other diseases of the in-f testines---. j12 .-.-.-.-. 1 3 ... Constipation.-.-..-.1-..-.-. 2-.-.-.-. Duodenal ulcer.-.-.-. 1...-.-. 1. Other diseases of the liver. .. Cholecystitis--.-. ---.-1--.--.--.-. Simple peritonitis (nonpuerperal).---.----.--.---.-.Other diseases of the digestive system (cancer and tuberculosis excepted). -.-. -...-.-1. .. Kouveniereal diseases of the genito-uinary system and anneza. Acute nephritis. -1 .1 1 .1 .1. .. Bright's. disease (chronic nephritis.-. 3 .1-.-. 2 .3-.-. 1 Other diseases of the kidney and annexa. .-. .-.-.-.-. .-. 2 1.-. 1 Pyelo-nephrosis. 1-.-.-.-.-.-4-.-.-.-. Calculi of the uinary passDiseases of the bladder.-.-.-.-.-.-.-.-.I-.-.--.---. Cystitis. -. -...-. 4 1. Diseases of the urethra, urinary abscess, etc. 1-.-.-.-...-.--. Stricture of the urethra, nanvenereal. ......1 .-. .-. .-.-... Rypertrophy of prostate.--.-.-.-.-.-2 ...

PAGE 27

25 HOSPITALS OF THE PANAMA CANAL, MONTH OF AUGUST, 1914-Con. Colon Hospital. Total. Employees. Nonemployees. Employees. Nonemployees. AdmisDths. AmisDths. AdmisDths. Admissions. Dths. sions. sons. sions. W.w. W. W. W. W. W. W. 05~ 0500 Po 1pqM 0 MMM 0 cq -4 P 1 ...1 1 .....1 ------------------. -.-...-. 2 3 .2 ..------1 2 .4 ...-: .1 1 ----~~~~~~-------------------------1-----------23 -------------. 2 ...3 4 .2 1----------1-1----------------1 1 2 3 4 ...2 2 .----.--------. -1--2 -.-----3. 2 ------12 .....1 3 .------------1--.2 -..--. 3 ---2 3---. --------------------------1-------------------1 -------------1------------------------1-----1-----.-. ---. .---. -. .. ------1-------------------------1-...1. ........1 -----------------------------------1 -2------------4~ 3 2. 3--------1.I .~~~ ~ ~ ~ ....................1 ... ...24. -----------------------------4. .... ----1 .......... ....I .-. ... .......-. .....-. .. 63902-144

PAGE 28

26 TABLE VIL--TABLE SHOWING ADMISSIONS AND DEATHS IN THE Ancon Hospital. Employees. Nonemployees. Admissions. Deaths. Admissions. Deaths. Diseases. White. White. White. White. cao IK Nonvenereal diseases of the genito-urinary system and annexa-Continued. Nonvenereal diseases of the male genital organs. ..2 .--------1 1 -Hydrocele. 1 -1 -1. Uterine hemorrhage (nonpuerperal). -. ........2. U t e r i n e tumor (noncancerous) .......2 1. Other diseases of the uterus .--.------------------6 2. Cysts and other tumors of the ovary. .....6. 3 6 Salpingitis and other diseases of the female genital organs.o. ..1 ....2 9. The puerperal state. Norm al labor. .......14 1 Accidents of pregnancy. .......5 1 .1 Inc.extra-uterinepregnancy ...... Inc. abortion. .......1 1 Other accidents of labor. .......* 2 Puerperal septichemia. .-. ...:. ... Puerperal albuminuria and convulsions. .......1. Diseases of the skin and of the cellular tissue. Gangrene ........1 Furuncle .--------4 .3 ---------1 Acute abscess. ..-------1 .1. Inc. phlegmon and celluliits. 1 ----------------... Pemphigus contagious. 2. .-. ..-. -. Dhobie itch.2. ......2 Ulcer of the skin .1 .1 ....1 -------impetigo contagiosa. .....2 .. Ingrowingnail .-----------1 .....1 1. Other diseases of the skin and annexa .2. 2 ...4 2

PAGE 29

HOSPITALS OF THE PANAMA CANAL, MONTH OF AUGUST, 1914-Con. Colon Hospital. Total. Employees. Nonemployees. Employees. Nonemployees. 8A AdmisDths. AdmisDths. Dths. Admissions. Dths. sions. sions. sions. W. W. W. W. W. W. W. W. e~c -w -,o A +; n 0 1 0 -----------2----1 1 1. --------------------1 -.-------.~~~ ~ ~ .....-. .............2 ..... ............2------------------------------21 ------..-. .......--------3 .. 1 ......1 ......2 1. --------.--.---.-.--. --.-.--. --------. 1. S -4 ..... .1. ...2--.. .......... .............. .-----.-. .............. ............3 .... ....--. ........... ------------------1-------------. 1. .-.-.-.-.---.-.------.--.-.-.-.-.-.-.-.-2. ... 2-----------------------. .1. 3. 1. .............. .....2 2 ..4 2

PAGE 30

28 TABLE VII.-TABLE SHOWING ADMISSIONS AND DEATHS IN THE Ancon Hospital. Employees. Nonemployees Admissions. Deaths. Admissions. Deaths. Diseases. White. White. White. White. Diseases of the bones and of the organs of locomotion. Diseases of the bones (tu.berculosis excepted) .4 ....1. .. Diseases of the joints (tuberculosis and rheumatism excepted). ........... Arthritis-----. .......... Other diseasesof theorgans oflocomotion. 3 ....-1 ...-. Malformations. Congenital malformations (stillbirthnot included) .........1 ..-Diseases of early infancy. Newborn child. .......16 1 .. Old age. Senility1. ..1 .-. ...... Affections produced by external causes. Suicide by poisoning. ..1. .....--. .. Suicide by cutting or piercing instruments1. ..........1 Poisoning by food. ..-1 .....---. --. .-Other acute poisonings. .......1 .... Conflagration1. .1 .....--. ---..--Burns (conflagration excepted). .1 3 ....--.-. ..--Traumatism by cutting or piercing instruments. ..14 ..---------------------Traumatism by fall. ..12 ....1 ....-. Traumatismby machines. ..9 .-. ----.-. ---. ----.-------Traumatism by o t h e r crushings (vehicles, railroads, landslides,et.) .1 2 2 -------1 .1---.----Railroad traumatism. ..3 1 1--------1 Dynamite traumatism.-.-.1 .--.-.----------Traumatismbylandslides-.-.-.1..-.----------

PAGE 31

HOSPITALS OF THE PANAMA CANAL, MONTH OF AUGUST, 1914-Con. Colon Hospital. Total. Employees. Nonemployees. Employees. Nonemployees. AdmisDths AdmisDths. Dths. Admissions Dths. sions. sions. sions. W. W. W. W. W. W. W. 02 .o o ., o 00 00-o S. ....... S. --. .1. .1. ...4.1 21. ---1----------------------------------4 .2. ...1. ..... ........3. .1. .... ....-----. ..... ...... 21 ..3. .... .......1 2. .I ..-.-.1 ... .1. .13. ...1 5. .'. .-.19 .... ...3. ...1. ...... S 19. ..... 1 3 31 3 3 15 ....2 .5. ...15 ...1. 2 ..2 1 ..... .....1. 1. .1 ................... S .....

PAGE 32

30 TABLE VII.-TABLE SHOWING ADMISSIONS AND DEATHS IN THE Ancon Hospital. Employees Nonemployees. Admissions. Deaths. Admissions. Deaths. Diseases. White. White. White. White. rn n i r1 2 A ~ 0 4A affections produced by external causes-Continued. Starvation. .1. Electricity (lightning excepted) ----------------1. Homicide by cutting or piercing instruments. 1. Fractures (cause not specified). .1 .6 .2 3 1. Dislocations. .1. Sprains. 2 2 6 .. Otherexternalviolence. .10 2 64 .3 3 6 Ill-defined diseases. Ill-defined organic disease. ...... Infections of undetermined origin .2 2 ..1 No disease.-. 2 ... Feigned disease .1. Total. 155 53 447 2 0 10 112 188 117 0 6 17

PAGE 33

31 HOSPITALS OF THE PANAMA CANAL, MONTH OF AUGUST, 1914-Con. Colon Hospital. Total. Employees. Nonemployees. Employees. Nonemployees. AdmisDths. AdmisDths. AdmisDths. Admissions. Dths. sons. sions. sons. w. W. W. W. W. W. W. W. 1 A .4'm -..... ............................ 1 -. ....A1 .... .1. .....6 ...2 .. ...........1. ....I. ..7 ~~1. .23 7. .3 1. .......... .............2 2 .1. .. .2.2.12 7. ..........1. ..... 12 18 103 0 0 2 3 23 29 0 0 0 167 71 550 2 0 12 115 211 146 0 6 17 ........

PAGE 34

32 TABLE VIIL-CONSOLIDATED HOSPITAL REPORT. [A=American; F=foreign; B=black.] Remai Admitted. Died. Aug. 1. Hospitals. 'A. F. B. A. F. B. A. F. 13. Ancon Hospital. Panama Canal employees. 35 39 238 138 42 338 2 .7 Panama Railroad employees.7 9 69 17 11 106 .--. 3 Panama pay patients. .1 .1. Other pay patients. 76 44 45 208 68 83 4 2 10 Charity patients. .12 4 22 13 10 23 ..5 Total.130 96 375 376 131 551 6 2 25 INSANE DEPARTMENT. Panama Canal employees. 5 20 .1 Panama Railroad employees. .11 2. 2 Panama pay patients. 11 168 .1 9 ---. 2 Other pay patients. 4 .6. Charity patients. 5 4 72. 1. Total. 9 20 277. 1 13. 2 Grand total. .139 116 652 376 132 564 6 2 27: COROZAL FARM. Panama Canal employees. .7 42 .1 6. Colon Hospital. PAnama Canal employees. .1 7 21 9 17 68 ..1 Panama Railroad employees. 1 8 3 1 35 ..1 Panama pay patients. ..1 1 3 9 Other pay patients .1 3 10 9 11. Charity patients. 1. .3 9. Total. 4 10 33 23 33 132 .-.2 CHRONIC WARD. Charity patients. ..24. .--. Palo Seco Leper Asylum. Panama pay patients. .2 31 -.1 Charity patients.2 16. .. Total. 4 47 .1 Grand total. ---Panama Canal employees. 36 58 321 147 60 413 2 .8 Panama Railroad employees. 8 9 88 20 12 143 ..4 Panama pay patients. 13 201 1 4 19 ..3 Other pay patients. 81 47 54 218 77 94 4 2 10 Charity patients. 18 10 134 13 13 41 .5 Total .--.143 137 798 399 166 710 6 .2 30 1 White. Number of employees remaining in hospitals: White. .107 Colored. .388 Total. .495

PAGE 35

33' TABLE VIII.-CONSOLIDATED HOSPITAL REPORT. [A=American; F=foreign; B=black.] Average n-imber constantly sick. Discharged. Transferred. Remaining Au~g. 31. White. Black. Total. A. F. B. A. F. B. A. F. B. AmerForcan. eign. 123 55 344 .1 4 48 25 221 44.10 28.03 218.58 290.71 15 17 99 .1 9 3 72 7.39 5.42 67.80 80.61 1 ..I ......52 .52 205 79 81 ...75 31 37 74.97 40.38 39.42 154.77 20 13 14 ..4 5 1 22 9.23 4.47 17.71 31.41 363 164 539 .1 10 137 60 352 135.69 78.30 344.03 558.02 2. ..3 5 16 .5.00 18.87 23.87 4 ..9 ..9.81 9.81 8 12 167 .11.42 167.19 178.61 2 4 .-. 4 4.00 .4.84 8.84 1 .11 5 4 61 5.00 4.00 66.35 75.35 3 .28 9 21 257 9.00 20.42 267.06 296.48 363 164 542 1 38 146 81 609 144.69 98.72 611.09 854.50 1 ....8 47 .7.58 43.16 50.74 4 18 54 2 1 13 4 5 21 1.87 4.29 20.96 27.12 4 1 23 ..17 ..2 1.35 .09 5.70 7.14 2 6 ..2 ) 1 1 2 .61 .41 1.58 2.6 9 9 8 2 1 3 .2 3 1.83 2.61 2.19 6.63 1 5 .3 2 ..2 ..22 .64 .86 18 30 96 4 5 37 5 8 30 5.66 7.62 31.07 44.35 1. ....31 ..30.22 30.22 2 30 .2.00 31.45 33.45 2 16 .2.00 14.77 16.77 4 46 .4.00 46.22 50.22 127 73 401 2 2 20 52 43 305 45.97 44.90 301.57 392.44 19 18 122 .22 9 3 83 8.74 5.51 83.31 97.56 2 7 .11 1 15 199 .61 13.83 200.74 215.18 214 88 89 2 1 5 79 33 44 80.80 42.99 46. 45 170.24 21 13 21 3 17 10 7 132 14. 23 10.69 129.69 154.61 381 194 640 4 6 75151 101 763 150.35 117.92 761.76 1,030.03 i4

PAGE 36

TABLE IX.-CONSOLIDATED DISPENSARY REPORT. Employees treated in quarters, ReRemainAdDisTransMStations. ing mitted. Died. charged. ferred. ng Days lost. Aug.1. 31 W. C. W. C. W. C. W. C. W. C. W. C. W. C. Total. Ancon. 5 14 99 119 -----92 119 9 7 3 7 188 373 561 Naos Island ------2 1 15 .1 1 9 .7 -----6 28 34 Balboa. 2 1 61 24 -----45 11 17 12 1 2 99 47 146 Corozal------6 .88 1 ------84 1 5 .5 .127 4 131 Pedro Miguel. -------11 --------11 -----------12 .--.12 Paraiso-. 3 .17 1 ..16. 31 1 .-. 87 1 88 Culebra--------2 9 18 ..8, 20 1 -------13 47 60 Empire ---------1 19 12 -----19 13 ....38 *5 123 Gatun ---------1 .24 9 ..22 7 -. 1 3 1 64 41 105 C r i s t o b al Colon------9 21 85 60 -----90 72 ------4 9 212 398 610 Margarita Point ------------4 ----------------4 .---2 2 Total. 26 41 414 263 .1 388 252 35 32 17 19 846 1,026 1,872 All cases treated but, not excused. Stations. Employees. Nonemployees. Total. W. C. Total. W. C. Total. W. C. Total. Ancon------1,690 2,577 4,267 1,169 1,546 2,715 2,859 4,123 6,982 NansIsland.-. 89 1,004 1,093 ----------------9 1,004 1,093 Balboa -------3,724 3,960 7,684 134 169 303 3,858 4,129 7,987 Corozal -------2,304 1,487 3, 791 637 12 709 2, 941 1,559 4,500 Pedro Miguel 444 946 1,390 482 135 617 926 1,081 2,007 Paraiso ------626 1,151 1,777 295 303 598 921 1,454 2,375 Culebra. 302 553 855 197 301 498 499 854 1,353 Empire. 412 657 1,069 274 247 521 686 904 1,590 Gamboa. 59 150 209 25 318 343 84 468 552 Gatun------711 1,298 2,009 682 394 1,076 1,393 1,692 3,085 Cristobal Colon--. .691 1,800 2,491 384 326 710 1,075 2,126 3,201 Margarita Point-----104 375 479 ----------------104 375 479 Total. .11,156 15,958 27,114 4,279 3,811 8,090 15,435 19,769 35,204

PAGE 37

35 CONSAIDATED ADMISSION REPORT. White. Colored. Total. Total admissions to hospitals, excluding Corozal Farm and Colon chronic ward------------------564 696 1,260 Total admissions of employees to quarters--------414 263 677 Total-----------------------------------978 959 1,937 Less number of patients transferred between hospitals and from quarters to hospiLals whose admissions are duplicated in above figures .-. 45 107 152 Net admissions to hospitals and quarters -933 852 1,785 Net admissions of employees to hospitals and quarters.------------------------------------613 739 1,352 Annual average per thousand of admissions of employees to hospitals and quarters-------------1,075.75 237.79 367.62 TABLE X.-AVERAGE NUMBER OF EMPLOYEES CONSTANTLY SICK IN HOSPITALSAND QUARTERS. White. Colored. Total. Hospitals: Ancon Hospital---.---------------------89.94 315.06 405.00 Colon Hospital .----------------------------7.60 26.66 34.26 Total. ..----------------------------------97.54 341.72 439.26 Quarters: Ancon-----------------. .------------------6.06 12.03 18.09 Naos Island.--------------------------------.19 .90 1.09 Balboa. ....-----------------------------------3.19 1.51 4.70 Corozal. .-----------------------------------4.09 .13 4.22 Pedro Miquel.---------------------------.39 ---------.39 Paraiso------------.-----------------------2.81 .03 2.F4 Culebra. .-----------------------------------.42 1.52 1.94 Empire. ..----------------------------------1.22 2.74 3.96 Gatun. ..-----------------------------------2.06 1.32 3.3S Cristobal Colon.----------------------------6.84 12.84 19.6h Margarita Point .-------------------------------------.06 .06 Total.-. 27.27 33.08 60.35 Hospitals. Quarters. Total. Average number of employees constantly sick: White .-----------------------------97.54 27.27 124.81 Colored. 341.72 33.08 374.80 Total. ..439.26 60.35 499.61 Average number of employees constantly sick per 1,000: White. 14.26 3.99 18.25 Colored. 9.16 .C9 10.05 Total. 9.95 1.37 11.32

PAGE 38

36 TABLE XI.-AVERAGE NUMBER OF DAYS' TRtATMENT PER EMPLOYEE IN HOSPITALS AND QUARTERS. White. Colored. Total. Hospitals. Ancon Hospital. ...----------------------------11.87 19.03 16.79 Colon Hospital .------------------------------7.07 9.75 9.17 Quarters. Ancon. .....------------------------------------1.90 3.48 2.78 Naos Island. ...--------------------------------6.00 1.82 2.06 Balboa. ......-----------------------------------1.59 1.61 1.60 Corozal ......-----------------------------------1.49 4.00 1.52 Pedro Miguel.-------------------------------1.09 ----------1.09 Paraiso. ....-----------------------------------3.21 1.00 3.10 Culebra. .....-----------------------------------1.44 2.40 2.10 Empire. .....-----------------------------------2.00 7.23 4.12 Gatun. .....------------------------------------4.64 5.13 4.90 Cristobal-Colon. ....-----------------------------2.53 6.48 4.38 Margarita Point -.------------------------------------.50 .50 TABLE XII.-FINANCIAL STATEMENT, DEPARTMENT OF HEALTH-. June, 1914. May, 1914. Jine, 1913. Administration: Chief health office. $2,603.12 $1, 958.88 $6,176.62 Hospital division: Ancon Hospital. 72,217.52 41,894.99 44,095.92 Corozal farm. 1,410.66 1,391.77 1,035.67 Colon Hospital-. 5,988.15 2,404.81 14,235.11 Chronic ward. 249.54 248.80 Taboga Sanitarium-.----..2,396.98 Palo Seco Leper Asylum. 1,598.36 1,159.32 1,091.63 Santo Tomas Hospital. 930.00 925.00 772.50 Medical storehouse.----783.94 Construction and repairs to buildings 1,084.23 1,800.41 2,742.90 Total. 83,478.46 49,825.10 67,154.65 Dispensaries: Naos Island. 397.92 260.89 263.92 Balboa. 2,366.64 821.49 629.11 Tivoli.--------------------..655.35 Corozal.-. 1,983.53 535.40 696.89 Miraflores.--. ..422.18 Pedro Miguel. 927.44 417.69 509.78 Paraiso-. .1,365.08 612.28 476.68 Culebra. 1,988.46 660.83 890.80 Empire-.-. 2,127.71 703.75 939.68 Las Cascadas. ...460.44 Gamboa.-. 371.68 131.04 Bas Obispo.-------. ..853.47 Gorgona.---.--.-.-..699.58 Gatun. 1,447.93 664.43 1,360.71 Cristobal.-. .2,656.82 995.29 1,032.51 Margarita Point. 289.50 119.84 112.76 Toro Point --.--.--.--.---.-----.--. ..241.57 402.83 Porto Bello.-.-.-.---....-.--. 402.91 Total. .15,922.71 6,164.50 10,809.60

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37 TABLE XII.-FINANCIAL STATEMENT, DEPARTMENT OF HEALTHContinued. June, 1914. May, 1914. June, 1913. Sanitary Division: General inspector -----------------$ 225.00 $80.00 $825.00 Health office, Panama. 3,005.03 2,981.54 3,077.94 Street cleaning. 5,483.65 4,416,01 833.34 Health office, Colon. 2, 140.69 2,348.70 1,862.47 Street cleaning .1,820,53 1,758.32 1,602.88 Zone sanitationAncon. .-----------------------2,517.05 2,258.74 2,096.59 Balboa ------------------. 3,102.41 1,266.83 1,725.50 Corozal. ------------------------2,268.03 1,410.94 1,733.43 Miraflores. .-. .-------.---------------------3,680.53 Pedro Miguel. .------------------1,930'08 1,369.91 2,400.83 Paraiso.----------. ..------------1,324.31 1,342.42 1,918.51 Culebra.--. -1,677.49 .1,082.41 2,336.16 Empire. ....----------------------2,854.37 1,887.13 4,413.99 Las Cascadas. ..2,059.31 Bas Obispo. ..874.39 M atachin. 1,061.70 Gorgona. 1,645.88 Frijoles. 65.00 65.00 444.80 Gatun. 3,173.70 2,192.57 6,045.77 Cristobal and Mount Hope. 2,606.38 2,383.06 3,298.86 Porto Bello. ..315.77 Total. 34,202.72 26,843.58 44,253.65 Quarantine division. ....-------------------4,487.37 4,251.20 5,381.03 Recapitulation. Chief health office. ...---------------------2,603.12 1,958.88 6,176.62 Hospital division. ..---------------------83,478.46 49,825.10 67,154.65 Dispensaries. 15,922.71 6,164.50 10,809.60 Sanitary division. 34,202.72 26,843.58 44,253.65 Quarantine division. ...-------------------4, 487.37 4,251.20 -5,381.03 Grand total. 140,694.38 89,043.26 133,775.55 NOTE.-JUne, 1914, figures include payments for accumulated leave. TABLE XIII.-ANCON HOSPITAL. REPORT OF NATIONALITY OF PATIENTS TREATED. Total Americans. Other nations. Class. number treated. V. B. W. B Hospital: Panama Canal employees. 830 173 8. 1 576 Panama Railroad employees. 219 24 .20 175 Panama pay patients. 1 ...Other pay patients. 525 284 .1 129 Charity patients. 84 25 .14 45 Total. 1,659 506 .227 926

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38 REPORT OF NATIONALITY OF PATIENTS TREATED-Coatinued. Americans. Other nations. Total Class. number treated. W. B. W. B. Asylum: Panama Canal employees. 26 ..21 Panama Railroad employees. 13 .--. --------------13 Panama pay patients. 189 .12 177 Other pay patients. 10 4 .---. ..6 Charity patients. 82 5 .4 73 Total. 320 9 .21 290 Grand total. 1,979 515 .248 1,216' REPORT OF DAYS LOST IN HOSPITAL. Total. American. Foreign Black. white. Hospital: Panama Canal employees. 9,012 1, 367 869 6,776 Panama Railroad employees.2,4N9 229 168 2,102 Panama pay patients. 16 ..-16 Other pay patients. 4,798 2,324 1,252 1 222 Charity patients. 968 286 139 43 Total.17,293 4,206 2,428 10,669 Asylum: Panama Canal employees. 740 .155 585 Panama Railroad employees .304 ...304 Panama pay patients. 5,537 .34 5,183 Other pay patients. 274 124. ..150 Charity patients. 2,336 155 124 2,057 Total. 9,191 279 633 8,279 Grand total. 26,484 4,485 3,061 18 938 Cost of subsistence per patient per day, $0.27. WARD LABORATORY REPORT. Blood examinations. 732 Estivoautumnal. .142 Mixed.--. .2 Quartan. .5 T ertian. ......23 Differential counts. .84 Hemoglobin estimations. ..59 Leucocyte counts. .119 Red blood counts ..10 Stool examinations.-.-.-. .687 Ameba. .3 Ascaris lumbroicoides. 12 Balantidium coli. .1

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39 Smplexaminations-Continued. Ciliated monads. ..---------------------------------------& Entameba (hystolitica and tetragena) .-. Guaiac tetsts.-.--.-.* .-.--.-.-. 16 Pus and blood .-.---.-.-.--.-.----.--.----.--.-. -95 Strongloides -----. ....----------------------------------------17 Tricocephalus dispar -.-.-.-.-.-.-.--.--.-.-. 35 Uncinaria (ova) -. 49 Vrine examinations ------------------------------------------1,577 Albumen. 576 Bile ----------------------------------------------------------16 casts. .....--------------------------------------------------377 Ciliated monads.----------------------------1 Epithielia ------------------------------------------------------90 Guaiac tests---.-------------------------------------------& Indicon. 41 Pus and blood.-------------------------------------------379 ugar (Pos. 2; neg. 13). ....--------------------------------------is Sputum examinations. ...----------------------------------------178 Positive for tubercle bacilli -----------------------------------Bmear examinations.---------------------------.----------------21 Uretral. ------------------------------------------8 Vaginal ---------------------------------------------------4 Eye-. 4 REPORT OF SURGICAL OPERATIONS. Number. Died. Amputations: Th g ..1 Leg_-.------------------------------------------2 Operations on bones: Ostiectomy -------------------------------------. Fractures, simple. 1 Fractures, open reduction ----------------------------2. Adenectomy: Cervical------------------------------------------1. Ingulnal, single -----------------------------------16. Inguinal, double. 2 Femoral--------------------------------------------1I. Rerniotomy: Ing in lsin l .0. .6 Inguinal, double------------------------------------2 Ventral.2. 2 Strangulated--------------------------------------1. Genito-urmary tract: Nephrectomy---------------------------------. 1 Nepbropoxy---------------------------------------1. Urethrotomy, internal---------------------3. Urethrotomy, external. 5 1 Prostatectomy.----------------------. Hydrocele, single, radical e. 2 Hydrocele, double, radical cure-------------------------1. Epididymotomy.,.t -------------12. Curetage uteri------------------------------------5. V gn lpunctures. 3 Obteticl:pucus------------Cesarian section, abdominal1. I Low force .1 Perineorrliaphy------------------------------------.1 Thorax: T[horacotomy--------------------.I. Rectum: Hemorrhoids, radical cure7. 7 Prolapsus rectum, radical excision. 2

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40 REPORT OF SURGICAL OPERATIONS-Continued. Number. Died. General: Tenorrhaphy.---------------------------------------------Excision of surface neoplasms. .-.----------------------7 Plastic operation for severe injuries.-------------------1 Plastic operation for effects of disease. .--------------3 Skin graft ----------------------------------------. Mayo bunion, bilateral -------------------------------.1 .-. Laparotomy: Exploratory.-----------------------.---------1. Gastro-enterostomy----------------------------------1. Enterectomy. ....---------------------------------------------.1 Appendectomy.----------------9 Appendectomy with local peritonitis .3 -1 Cholocystostomy-----------------------------------2 Cholocystectomy. 31 Supravaginal hysterectomy..---------------------4 Hysteromyomectomy. ...---------------------------. -. 3Suspensio uteri. ...--------------------------------.1 Plastic operation for chronic pelvic peritonitis -----------5. For ectopic gestation.-------------------------------2 Various other major operations. Various minor operations.----------------------.-. 80 Total. ......-----------------------------------------223 6 REPORT OF OPERATIONS, EYE AND EAR DEPARTMENT. Number. Adenoidectomy. ---------------------12 Cataract extraction, senile .-------------------------------------6' Cataract extraction, traumatic. ....-------------.---------------------1 Capsulectomy. ..........----------------------------------------------3 Ptergyium transplantation.--------------------11 Ptergyium excision. .........------------------------------------------3 Submucous resection. ..........----------------------------------------9 Sublingual abscess, incised. -------------------------------------2 Plastic on eyelid.-----------1 Plastic on nose. 2 Mastoidectomy. 1 Polypi, nasal, snared. ........-----------------------------------------1 Resection of internal rectus. ........------------------------------------1 Iridectomy. ......------------------------------------------------1 Tonsillectomy. 18 -72 Various minor operations: Eye. 20 Ear. .........-------------------.-------------------------------12 Nose and throat. ..-----------------------------.-.----------10 -42 Total. ........-------------------------------------------------114 Total number of outside cases treated.,. 928 Refractions.--------------------------------143 OUT-PATIENT DEPARTMENT. Clinic. Total New cases. Pay Prescripvisits. cases. ions. Medical --------------------------267 234 64 278 Surgical--. -421 245 28 104 Eye and ear.---923 398 26 420 Total.1,611 877 118 800

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41 REPORT OF THE BOARD OF HEALTH LABORATORY. Bacteriological examinations ofChemical analysis of-Continued. Blood cultures. 13 Milk from private dairies supThroat cultures. 26 plying city of Panama. 10 Urine cultures. 319 Dairy feed. 9. Stool cultures. 347 Flour, for chief quarantine Pus. 4 officer. 2 Sputum. 1 Drugs and chemicals for Cultures from autopsies. 5 purity. 31 Knee fluid.I Rat poison, for police division I Fluid from gall bladder .1 Stomach contents. 3 Curettage. 2 Urine. 4 Placenta. 1 Urinary-calculus. 1 Eye cultures. 2 Mother's milk. 2 Milk, Ancon Hospital dairy. 1 Surgical tissues and neoplasms Autogenic vaccines prepared. 1 reported. 40 Wassermann reactions. 193 Autopsies performed. 31 Pathological tissues prepared, Bodies embalmed .& paraffin. 291 Animals examined or under obChemical analysis ofservation. 2 Hospital dairy milk. 1 Rats examined. 1,036 REPORT OF OPERATIONS OF HOSPITAL FARM, COROZAL. Expenditures: Supervision.-.$ 200.00 Labor. 533.40 Subsistence of labor.-. 362.83 Quartermaster, team service. 47.14 Electric lights.-----------. 3.90 Ice. .90 Material and supplies.-.---. 113.80 Total.-.-.$ 1,261.97 Receipts: Transfer and services rendered. 52.68 Products sold16,470 okras. 382.02 3,190 mangoes.-. 58.86 152 dozen eggs. 91.20 39 dozen roses. 19.50 18 dozen ears corn. 3.60 1741 pounds tomatoes. 9.85 89 pounds sweet peppers. 5.19 114 pounds papayas. 2.57 337 bunches radishes. 12.40 315 bunches spinach. 5.79 10 bunches bananas. 2.50 50 heads lettuce. 1.15 8 settings-eggs (112). 12.00 7hogs. .154.00 42 guinea pigs. 27.00 5 ferns. 1.75. 40 loads grass. 40.00 Pasturage. 20.90 Burial. ..3.20 Total. 553.48 606.16 Net running expenses. .655.81 Number of days' treatment. .1, 573 Not cost per patient per day. $0.4169

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42 STATEMENT OF COMMITMENTS, DEATHS, AND DISCHARGES, ANCON HOSPITAL INSANE ASYLUM. Commitments. Male. Female. From the Canal zone: Received on first commitment.-------------------------3 Received on second commitment-----------------------1 From the Panama Government: Received on first commitment. ..----------------15 4 Total. -9 I Returned from hospital. Discharges. Well. Improved. -Unimpromed. Nationality.---Male. FeMale. FeMale. Female. male. Male. amaica. .(110 110 Panama. ..1 Barbados--------. ----------------------------------1. Barbados ......16 --Montserrat1. .... Germany., .1. ... Guadeloupe ..... Total. 2 ...7.-19 10 I Deported. 2 Eloped. 'Transferred to hospital. Deaths. Mental diagnoses. Psychoses Physical diagnoses. accompanying other Dementia brain or praecox. nervous diseases. Tuberculosis of the lungs (female). .-.Softening of the brain (female).

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43 TABLE XIV.-COLON HOSPITAL. NATIONALITY OF PATIENTS. White, White, Amedi.ori'n Black. Total. can. foreign Panama Canal employees.-. 10 24 89 123 Panama Railroad employees-. 4 1 43 48 Panama (pay). 1 3 10 14 Pay (private). 11 -12 14 37 Charity cases.-----------------1 3 9 13 Total. 27 43 165 235 Cost of subsistence per patient per day, $0.35. LABORATORY REPORT. Blood examinations-. 103 Estivo autumnal. ..........------------------------------------------49 Tertian4. .4 White blood counts.:. 2 Differential counts1. 1 Stool examinations. ..........--------------------------------------------4 Negative. 4 Urine examinations. 123 Casts. ------------------------------------------------21 Album in. 32 Pus and blood. 31 SURGICAL OPERATIONS. I. Amputations: 1. Shoulder (died, 2). ........-------------------------------------2 3. Forearm1. 1 I. Operations on bones: 261. Bone plate (comp.). 2 IV. Herniotomy: 32. Inguinal, single.--------------------------1 37. Strangulated. 1 V. Genito-urinary tract: 45. Urethrotomy, external. ......---------------------------------1 48. Hydrocele, single, radical cure.-. 1 IX. General: 80. Thyroidectomy. 1 87. Gunshot wound of soft parts, operation for. ..------------------1 X. Laparotomy: 103. Appendectomy-. 5 117. Splenectomy. 1 119. Supravaginal hysterectomy .1 122. Salpingectomy, single.I. 1 123. Salpingectomy, double-. 1 124. Salpingo-oophorectomy. 1 127. Suspensio-uteri. 2 133. Rupture of spleen-. 1 137. Minor operations, various-. .13

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44 TABLE XV.-PALO SECO LEPER ASYLUM. REPORT OF NATIONALITY OF PATIENTS. Number Americans. Other treated. nations Class. W. C. W. C. W. C. Pay cases---------------------------2 31 ..2 31 Charity cases. ...------------------------2 16 ..2 16 -Total. 4 47 ..4 47 Cost of subsistence, per patient, per day, $0.23. TABLE XVI.-SANTO TOMAS HOSPITAL. RemainAdDisRemainClass. iug emitted. charged. Died. Mg Aug. 1. Aug. 31. Pay cases. 30 117 97 2 48 Charity cases. 330 829 753 54 352 Total. 360 946 850 56 400 Average number of patients constantly sick.-. 379 Total number of days' treatment. 11,686 Average number of days' treatment per patient. 9 Cost of subsistence, per patient, per day. .$0. 2435 NATIONALITY. Americans. Other nations. Number Class. treated. W. C. W. C. Pay cases. 147 ..63 84 Charity cases.1,159. .86 1,073 Total. 1,306 ..149 1,157 DISPENSARY REPORT. Class. White. Colored. Total. Natives. ..201 186 387 Foreigners. ..267 312 579 Total. .468 498 966

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4:5 DISEASES TREATED. Typhoid fever. .----------------3 Diarrhea and enteritis. 22 Malaria--. 98 Intestinal parasites. 6 Malarial fever, estivo-autum.n .57 Appendicitis and typhlitis. 6 Malarial fever, tertian.-----------2 Hernia, intestinal obstructions. 13 Malarial fever, clinical. 112 Cirrhosis of the liver. 6 Scarlet fever. ..------------------1 Simple peritonitis (nonpuerperal). 1 Diphtheria and croup .----3 Other diseases of the digestive sysInfluenza -------------------15 tem (cancer and tuberculosis exDysentery.------------------2 cepted).-. Erysipelas -------------------4 Acute nephritis. 17 Purulent infection and septicemia. 19 Diseases of the bladder.----------9 Tetanus. ...---------------------1 Other diseases of the uterus. 1 Pellagra. .---------------------3 Salpingitis, and other diseases of the Beriberi -------------.-.-. .3 female genital organs. 2 Tuberculosis of the lungs--------24 Normal labor. ..-----------------89 Syphilis.---. 41 Accidents of pregnancy---------15 Gonorrhea. .--------------36 Abortion. ..--------------------3 Cancer and other malignant tumors Other accidents of labor.---------.1 of the breast. .----------------10 Eclampsia1. Acute articular rheumatism. 20 Furuncle. ...--------------------3 Alcoholism (acute or chronic). 9 Acute abscess. ...----------------11 Other forms of mental alienation. .4 Other diseases of the skin and anOther diseases of the nervous sysnexa. ...---------------------27 tern .....-----------------------6 Diseases of the bones (tuberculosis Diseases of the eyes and their anekcepted). nexa. ....----------------------1 Newborn child. 84 Acute endocarditis. .-------------4 Burns (conflagration excepted)-. I Organic diseases of the heart. 9 Traumatism by other crushings (veArteriosclerosis. .----------------3 hicles, railroads, landslides, etc.). 25 Hemorrhoids.-. 1 Fractures (cause not specified). -8 Diseases of the larynx. 2 No disease. 20 Chronic bronchitis. .-------------24 Pneumonia (unqualified). 9 Total. 920 SURGICAL OPERATIONS. Number. Died. Ostiectomy. .......------------------------------------------1. Wiring of fractures, simple.-----------------------------------Adenectomy, inguinal, single----------------------------. Herniotomy, ingumnal, single-----------------------------3-------Herniotomy, inguinal, double.-----------------------------.2. Urethrotomy, internal---------------------------------. Urethrotomy, external. ..----------------------------------4 Varicocele, radical cure.:. 1. Amputation of penis. 1 Curetage uteri -----------------------------. 3 -------Hemorrhoids, radical cure1. -Fistula in anus, excision of.---------------------1. Laparotomy for tuberculosis peritonitis.-. 1 Laparotomy, exploratory. .3 -----Enterorrhaphy----------------. 1 -------A dectomy. .--------------------------ch eytotomy. .I. Abscess of liver, laparo-hepatotomy for. 1 -------Splenectomy.----------1 Panhysterectomy. 2 Supravaginal hysterectomy. Salpiugectomy, single. 2 Salpingectomy, double .3 ------Salpineo-oophorectomy. 8 Oophorectomy.-. .Suspensio uteri-------------------. 4 .Gunshot wound of abdomen. 2 2 Minor operations. 24 Total-----. 81 3

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46 TABLE XVIL-SANITARY WORK DONE IN CANAL 7ONE, PANAMA, AND COLON. The following is a summary of sanitary work performed and material expended during the month in the Canal Zone: Work requests onquartermaster's department: Grass cutting. ........--------------------------------------------16 Screening-----.........-------------------------------------------11 Miscellaneous. .......----------------------------------------------7 Work requests on engineering department .----------.----------------14 Notices served to abate nuisances. .....---------------------------------102 Arrests for violation of sanitary regulations--.------------------------3 Convictions. ...........-----------------------------------2 Inspections of closets ........-----------------------------------------2,753 Inspections of stores. ........-------------------------------------------113 Inspections of restaurants. .....--------------.-------------------------10 Inspections of shops.------------------------------------------. 174 Garbage cans emptied. .....---------------------------------------114; 712 Closets disinfected. .-----------------------------------------4,202 Houses disinfected -.--------------------------------------------18 Rat traps used daily..--------------------------------------1,838 Adult Anopheles destroyed in houses. ...-----------------------------2,478 Adult culices destroyed in houses. ...-------------------------------10,396 Containers found with Stegomyia larva. ---------------------------1 Larvacide used---------.-------------------.---------gallons. 3,055 Crude oil used. .....-----------------------------------------.do. -. 29,005 Rats destroyed. ...........----------------------------------------------949 SUMMARY OF ROUTINE WORK DONE BY THE HEALTH OFFICE, PANAMA, DURING AUGUST, 1914. Mosquito work: Linear feet of ditches cleaned and maintained. .------------------45,520 Gallons larvacide used. .......--------------------------------------641 Gallons crude oil used.-----------------------------155 Square yards pools oiled. ......----------------------------------63,005 M, ater containers treated. ........----------------------------------65,090 Mosquito-breeding places found-----------..-------------------573 Fly-breeding places found. ......-----------------------------------889 Garbage collections: Number loads garbage removed to dump. ..-----------------------4369 Total number of cans garbage emptied. ......------------------------1Ow 1 Buildings: Number of buildings inspected .-----------.------------. 582 Number of plans for new buildings approved.----------------------26 Number of permits granted for repairs to old buildings--------------2Total number of permits granted. .--------------------------08 Number of buildings condemned. ....------------------------------131 Number of buildings demolished. ..-------------------------------28 Street cleaning: Average number of square yards cleaned daily. -----------0,00 Average number of square yards streets sprinkled daily-----------1,8000 Number of private properties cleaned during month-----------------3 Number of notices served and nuisances abated.-------------------247 Vaccinations: Total number of vaccinations since Apr. 1, 1914. ..-------------------.56

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47 GENERAL WORK REPORT FOR COLON, CRISTOBAL, MOUNT HOPE, AND MINDI ISLAND. HEALTH OMCE sanitation, general Colon: Cietobal, August 31, 1914. Square yards street cleaned. 4,050,625 Number of doses q nine iss-ed --. 7,390 -Sq-.are yards alleys maintained. 701,870 Loads, garbage (cibic yards). 498 Private properties cleaned. 47 Number of rats killed. 59 Number of dogs killed. -. 85 Number of cans garbage (2,230 cibic yards). 67,200 Length, yards, ditches maintained. 3,055 Parkway and E Street maintained. Square yards oiled. 19,200 Number of receptacles treated. 28,300 Number of mosq -ito-breeding places destroyed .88 Number of fly-breeding places destroyed. 92 Number of b :ildings inspected .3, 189 Number of dogs ca ght. 91 Gallons larvicide :sed. 610 Number of nuisances abated. 149 Colon d -mp maintained. Buildings, Colon: Number of plans approved. 5 Number of permits to occ ipy issued. 4 Number of permits to repair iss ed. 6) Sewers, Colon, as reported by division of municipal engineer: Number of new connections made during month. Total number of connections made to date. 1,153 Number of houses in which extensions were made. 7 Number of outstanding permits. 3& Sanitation, Cristobal: Square yards oiled. 3,600 Number of receptacles treated. .-.-. 5,80() Number of mosquito-breeding places destroyed. 28 Number of fly-breeding places destroyed. 6 Number of buildings inspected. 550 Gallons larvicide used .59 Sanitation, Mount Hope: Square yards oiled. 90,000 Number of receptacles treated. 19,250 Number of mosquito-breeding places destroyed. 68 Number of mosquitoes killed in barracks (358 anopheles, 1,463 culices) 1,821 Number of mosquitoes killed in married silver quarters (571 anopheles, 314 culices) .885 Number of mosquitoes killed in cars (5,160 anopheles, 451 culices). 5,611 Linear feet ditches maintained. 19,693 Moilft Hope cemetery maintained. Gallons larvicide used .427 Gallons crude oil used. 1,750 Sanitation, Mindi Island: Square yards vegetation removed. 11,075 Linear yards ditches constructed (1,2751 cubic yards). 3,170 TTALE XVIII.-QUARANTINE TRANSACTIONS AT THE PORTS OF BALBOA AND PANAMA. Number of vessels inspected and passed.,. 20 Number of vessels inspected and held in quarantine. 11 Total number of vessels inspected. 31 Number of vessels fumigated on arrival .9 Number of crew examined .2,364 Number of passengers from foreign ports examined and landed: Cabin. 747 Stee ag ..170 -. --32 b#il number of persons examlne4i.'. ,8

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48 Number of persons vaccinated at ports of arrival because of compulsoryvaccination law -----------------------------------------36Number of persons vaccinated at ports of departure or en route because of compulsory-vaccination law.-. 514 Total number of persons vaccinated.--------------------------550 Number of persons held in quarantine at the detention house to complete period of incubation for fever or plague. 161.Number of persons held in quarantine on board vessels to complete period of incubation of yellow fever or plague.---------1,887 Total number of persons held under observation. ..----------------2,048 Number of persons embarked for foreign ports: Cabin. .332 Steerage. ..------------. .--.--------------------------113 445 Number of persons arriving from coast towns in small launches and sailing craft. ---------------------------------.1,094 Number of persons sailing for coast towns in small launches and sailing craft -1,611 Number of bills of health issued------------.-----------------------38 Total number of persons landed. ...----------------------------2,017 Total number of persons sailing-----------. .-----------------2,056 Apparent decrease for the month---. ...---------------------------39 QUARANTINE TRANSACTIONS AT THE PORTS OF COLON AND CRISTOBAL FOR. THE MONTH OF AUGUST, 1914. Number of vessels inspected and passed. ..---------------------87 Number of war vessels passed on certificate of medical officer. 3 Number of vessels held in quarantine. --------3 Total number of vessels inspected .93 Number of vessels fumigated on arrival. ..-----------------------1 Number of vessels fumigated on departure. .--------------------2 Numebr of crew inspected------.-----------------------7,109 Number of passengers inspected (including 55 United States troops) 4,336 Total number of persons inspected. ....-------------------------11, 445 Number of persons vaccinated in port of arrival. 852 Number of persons vaccinated in ports of departure or en route. -817 Total number of persons vaccinated ..1,669 Number of persons detained in quarantine to complete period of incubation for yellow fever and plague. 370 Number of persons detained on vessels.-. 533 Total number of-persons held under observation. 903 Total number of persons landed from foreign ports: Cabin. .-. ..----------------------------------------1,308 Steerage .------------------------------1,018 2,326 Total number of persons embarked for foreign ports: Cabin. 1,876 Steerage----------------------------------.1,629 3,505 Number of persons in transit. 1,270 Number of persons from coast towns (inspected). .--------------740 Number of persons from coast towns (not inspected). 261 Number of persons leaving Colon for coast towns .235 Number of persons landed during month: For immigration report. ..---------------.3,082 For Pacific ports.--------------------------245 3,327 *Nmber of bills of health issued. 12 "Number of bills of health visd.:. 53 Numberof bils ofhealt----e-----------------------------53 Number of persons recommended for deportation.-. 5 Total number of persons landed.---. 3,327 Less number for Pqcific ports.-------------245 3,082 Total number of persons sailing .....----------------------------3,740 Apparent decrease for month -.-------------------------658

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49 QUARANTINE TRANSACTIONS AT THE PORTS OF BALBOA AND PANAMA AND COLON AND CRISTOBAL FOR THE MONTH OF AUGUST, 1914. Number of vessels inspected and passed. .107 Number of war vessels passed on certificate of medical officer 3 Number of vessels held in quarantine. 14 Total number of vessels entered ..124 Number of vessels fumigated on arrival. 1 24 Number of vessels fumigated on departure. 2 Total number of vessels fumigated. 12 Number of crew examined.9,473 Number of passengers examined (including 55 United States troops). .5,259 Total number of persons examined. 14,732 Number of persons vaccinated at ports of arrival because of compulsory-vaccination law. ,888 Number of persons vaccinated at ports of departure or en route because of compulsory-vaccination law. 1,331 Total number of persons vaccinated. 2,219 Number of persons held in quarantine at the detention houses to complete period of incubation of yellow fever and plague. 531 Number of persons held in quarantine on board vessels to complete period of incubation of yellow fever and plague. 2,420 Total number of persons held under observation. 2,951 Total number of persons landed from foreign ports: Cabin. 2,055 Steerage. 1,194 3, 249 Total number of persons embVarked for foreign ports: Cabin. 2,208 Steerage. 1,742 3,950 Total number of persons arriving from coast towns on small launches and sailing craft. 2,095 Total number of persons sailing for coast towns on small launches and sailing craft. 1,846 Apparent increase for month from coast towns. 249 Apparent decrease for month from foreign ports: Cabin. 153 Steerage ..548 701 Number of immigrants recommended for deportation. 5 Number of bills of health issued or vised. 103 Total number of persons landed .5,344 Less number for Pacific ports. 245 5,099 Total number of persons sailing. 5,796 Total apparent decrease for month. 697

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50 IMMIGRATION REPORT FOR COLON. FromCabin. Steora. Europe. ...-----------------------------------------37 25 United States.---------------------------------. -697 39 Jamaica and West Indies-----.-----------------------183 634 Venezuela. ...--------------------------------.-----------9 7 Colombia. .....----------------------------------------. --51 131 Cuba. .......----------------------------------------------25 -31 Guatemala. ..------------------------------------------1 14 Costa Rica. .....------------------------------------------91 106 Bocas del Toro. ....--------------------------------------106 634 Coast towns. ...-----------------------------------------0 261 Total. ........---------------------------------------1,200 .1,882 M en .1,913 Women. .............----------------------------------------------------620 Children. ............---------------------------------------------------288 Unclassified. ...........-------------------------------------------------261 Total. .........-------------------------------------------------3 ,082 QUARANTINE-BOCAS DEL TORO. Number of vessels inspected and passed. ..-----------------------------28 Number of crew inspected and passed. ....----------------------------1,436 Number of passengers inspected and passed. ..-------------------------351 Number of passengers in transit inspected and passed. ..------------------229 Number of persons held to complete period of incubation of yellow fever-. 4 Number of persons held to complete period of incubation of plague---------3, No quarantinable disease has appeared in this port, and the health conditions of the port and surrounding country are good. TABLE XIX.-S 2ATEMENT OF QUININE ISSUED. q i Kilos. Quinine sulphate. -. .-.-. -. ..-. .-9 Quinine sulphate tablets-. ......-----------------------------------------2 Total.-------------------------------------------------11 Pounds avoirdupois, 24.25.

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51 TABLE XX.-PERSONNEL REPORT. August, 1914. July, August, 1914. 1913. officers Skilled and emaned Total. Total. Total. ployees. labor. Chief health office. 13 ---------13 16 32 Medical storehouse. 4 4 8 8 9 Quarantine division. 22 20 42 40 41 Health office: Panama.-26 124 150 174 48 Colon. 18 139 157 139 135 Ancon Hospital. 260 116 376 372 556 Colon Hospital.-. .26 ,11 37 33 184 Santo Tomas Hospital. 5. 5 6 5 Taboga Sanitarium. .-. ..20 Palo SecoLeper Asylum. .10 8 18 i8 15 Zone sanitation. 21 97 118 126 206 Hospital farm1. 1 50 51 49 Dispensaries: Ancon. .4 Balboa. 6 .6 5 5 Bas Obispo.--. ..5 Corozal. 4. .4 4 5 Cristobal.-. ...6 6 Culebra. 2 .2 4 6 Empire .5.5 4 7 Gaboa. 1 1 Gatun.4. 4 4 8 Las Cascada -.....4 Margarita Point. 1 .1 1 1 Miraflores. ....3 Naos Island. ..----------1 2 2 Paraiso. 4. .4 4 4 Pedro Miguel. 3 .3 3 4 Porto Bello---.-. ....4 Toro Point.-. ....3 Total-. 437 569 1,006 1,019 1,322 Included with Ancon Hospita'. ;0

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UNIVERSITY OF FLORIDA 3 1262 08520 1118


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