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:
May 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_00020 ( 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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TE
Page -
------------------ ------------- ------

- - 7 - - -
----------------------- --------------------
-------------- -------------------------- ----------
110 1 7
Aif Canal Zone ---------------- f ---------------
ts of the city of Panama --------- ------- 6
identsof the city of Colon- -------- 7

-------------------- ---------------------- 7
........ ---- --------- 7
---------- ------------
------------- -------------- --------------------

------------------------------ -------------
------------------ ----------- ---------------

------------- ------------------ 11
lfealfl Labora'tory- --------------------- 7 11
4"bled _7 ------------ ------------------ 7 ----------- '12
---------------------- ------------------------ 12
iep:jirtm ent ------------------ P7 -------- ----------------------- 12
------ ----------------------------
------------ ------------ ----------------- 13
1,3
-----------------
...... ----------- I -------------- 13

of emploYeag and (if the'roidents of Piahama, Colon,
Me canal zon6------, ------- 14
by a9p, cQlOr and isex- ----------------
bynational ty. -0- ----------------- --------------------- 15
of te Aju&lcaiis ---------- ...... ----------- m
df deathsof OMPIOYOO -------------- -- '16
6,aucf j3W" u deaths of wuployees i;b'p" 16
4de4tba in tbe ho'spitals ofh, "PanaoO Cabal'. O
a- ital report ------------------ 28
ata dispensaTy and admission rcport -, ---------- 29
C antly diek andnoneff o citive xat6a p or, 1,,OM- -30-,
Days, treatl4ont, ior, admimion, hosptak, and,
------------
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An
MIS;, fA'Y

N4
JA
40 V,
month, of T hA
dimtW
No4her 4mv
-iN

-0
,CTT4"6ndinglinoI y
The

for the -rry onl lig, wouthj4
giona W-I 4al0lltdjhiAlCAl-wO--
0 Aoa adifiAwm rat-0
e,*r "Pirm ry 0
numbef Of- c* and iohe n fk,-
Th 7pa-r-th
ciiiX; in fo PhoLW wer parth
0.5-5 compArod Rh, 2 26,Jor the
of JaSt yea
Corveoponlain, '0 r.

VFFECT 3 OF RACE. Q
djniSSion, an(I &ath TaW f ffi
The a t3pase or.,
were 1241,70,aud 5-95 pr'thouBapd`pelrajlTLWM
393.37 aiW,, 4.66 for wh4e employees The 11
e o e 4nd M'jlU1Lea fo r b &CC 106yoep P"Of
-d:w or
Aa ith 20.55 f
p Oye
-T.4e Admission mte f
annum.Jor'blaqks as.compared witA 87-07',fI
The' uluchMgher'admissian ind iapjief(,il
A *ith 66bi.q the,
COmparp- lar 24 days po e
Mcelve Tav ty6ar, whil ait,

PO

Tere wore, 16, deportations' av-CO4tp"hOd'%
diwaed*a foU6ws.,AinplOywi4 *Ua,
"d jury


'The number of pooong *Ie, and',010
o
Zone is estimated M,
P- Viitg''A iu- tio of 15,.,34 per
113.49 for ihe- th" :i$21
ppe C mon 6,
of lastVAr., V7a
p
Vx
In
-OP"A"
wpie f45 d 0416 UISO-IL
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eane o typhoid durin the mionh two of them
at dw, dishwashe in. two hotel: kiteens.
lJIted tfar as known,
Sh~ef t Pedro Miguel i ver, as ted in
vue during the month, though 14
4.tery expen ive by reason. o heavy,
odsdAdug the monih tdo clei uiht e
Ubrbs, such aeGoidn Green, Co
i.improvemen in i,
ihty condition, though neither is yet.
Mwor. here ht& treat ed4
k m:g. at e ndey fo. &lare pOsaW o t

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34d vauitd, the stables has
wbiiingvarii6d-onin all parts


imawtoy- conditions on their
g'
'*Ob& W asJound-1, The population of
:41[mm,'A floating on,6 And inmnitary'condi-
Uhgreaterfre cocy than 'Mij-he'M"Ore
"C' ty
,have, been placedin the public mArket, in
oo we mo)4
-Aumerou The bait used to
Jw )r, etc the ideabe' to give'the
to, khih they'Were Aceustomed.
U -,Vatvbi-ftg large numb ers of Ries,
S,;Wr'W pveed -throughout tho market. when

the,, cit a d except

y fiye beencleaned twice ay
ays, hen
the street men. worked only half
of woxk jor the-_street hien, have been increased
s where the traffic is heavy.
principall Arcot,
dale hem"Was'U'Period from 11 a, m. to 12-30
WW'pMg was Aone. it-nd it is during this time
Omest fteertiain 4reets. ITUdeT the present
AI m 12 noon to,12.30 p.-- m.j
- `,'mIf an"ho.ur, fro
are-notat-work- ,This -change has enabled u:s
jre Jk4m4 ebris thAn-forweily. A rotary
maphine has-. been i0quisitioned, and when
M-"t' tIou ti thatsomeof the _g a--Rgff now
",j Ikf gh
th and, fvihg i-nt cost of the

iakon at fairJy aci-ve pointR shows as

a. M. to 19.1
-tk3'0jeetWida,
tbW
'a. 11 WMO
Itaur lhere'4760,traffilo DIOVCMU
I[r
t,t]4 _twti6e that've,
ave, Ours'.
y-

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A f f'4" ",.l.,." .L.ADUA '. S :
Am. .-
I td6iiodovahumble work. Culturessaud .
frms 'plague suspect taken from a ilp
6j i; Woe99,Ak.l... ....9.. ..to..'
W0 -agativet zeslt,
iief;M Iborator, as seuo Colodbias
(.i.r n Uemment, to vestigate t:us-

4r. recoi'vedom .imth at th "e
Q nsmv neniazaftd not4 plae..
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FA4M
4-Ood work-6)h b; A A"
er6a
V
stea4y
on 6fgro,
't- [Mid
to org,4Rm- a
.`2 to yams and 131ajblesan&p
I "I Ye I -
'hun dted pJan- vei ,qhilpf' di- to ,M,. V i
archiltoct te
tivated and iended;'Isomc- repairs ljado, to It
ISOMe Other- miscellane,s done.
The number 6f'patients les) anJuno vv
were on, leave, ,a]_Ao 30'insalno -patients ln,-char -,e
an-d two at"dants.
I NS ANE 01P,RTMjNT AV FAAA_

'On NprA'24, an inigane colonyivaH estabhhed at,
At fixst 15 e' were selected f6r the urpoke a
proved so satisfaaory that the -number ha b
It is expected that this experiments *ill ro V6, veir,
thepatients themselves anA will also furi)U4,a
obtaining labor for the, fArm,
11)6ta' I Ta -6,
i ed hospital statistics will be foufd in Ta

COLON HOSPITAL.
it having been decided, to abandon, the, pxeHenV
ney hospital
:and, build a'peT-maneut emaTge In
Nras, appointed to select a s4itable site and1o
RpecifiCatioils for the' exection, of the 'same. The b 4
rep6rted.,
Puring, the month, an'anangement waomad
hich the citizens (1 Co
Government by w 4n
teitmeni., eitbe
ColoA Hospital fot t r 0 -PnV4_;,e pay,
Panama Government cases. Except for thjfpurjbq,
continue8 for emergeucy caBes, otdr


There. Were 27 chro andj
for during the month
Detailed hppptalstatifdfc I be fbund4nTibli,`.

PAW S E 0 0, LEWPE

Vonditions, contihud_$ us
patients'kt-!he"4m'.,_' A.'61111w_ A
JULAJJr_ 3 1 iiftA U.
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*r DETU INi;*: THE: .Oflfl -p' PAAM




OR .
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Aeri-sclernmdas ^.. .
C oanic.nephntis.f... -------*.,..
tClizal dysentery... 4.-
M ? phthe. a....;. .1.. ....
ned .. .~ ..,... ... .. ... .... ..



..ese.nal g olistr ngtin.;.g : ....;.:. .: .:.... ..... ....
S Lobar eta....uoma.. .. ..,.. .. .


Orgi t ldses...,.-......- ... .-:.,-..- ., --. .:
O Other diseases ofs _imach. .e.... ,';'..,..:............ ... ; ..
P tDatif ...ti a si icema ., ... ..... ... ... .

STubercnulae l' ; a ,temi" ary...... ".: ---'.....-- ..-- ...-.......:r- i
t. t.,bercuilosi di e ina d.;..;. : ...... ,...-..,; .... -. ;..;
.Tuberc losis ..of the lungs. -......... ,........... 1 't, '.',;
WA E .' t C'" A.,'E. AN L 'A' "C"ES E. '...;.'S .0',,DEATHS. O:;. .
VIOENC.
A c ide tal dron.. .'. ... .. ... ......... ..... ............: .... 3, ,, ,:,:i. r ..e'
.* .ect .ic:shoc. ... ................. ..... .. ..... .... ..
Homicide bOy other ieans-... ... ;.,..... ...
Railroad tra mnatism ........... ............... : '1.'

...Tot l..... ......... ... ......... .
__________,t______** __-_ .__________.: __.. ..... __ ..-:-: :4

BL V-,. A ND PLACE O. D.. ATH ::



-e, ;.. ..
Fleel c~s ock ''::-,... ... ,,., _,. ... -i


Ml itlf lever, estivo-atuial... .-
Diphtheria and croup....;. ..p... ;
ysantery... ... .,..,..--.,..
Dysentery, entamoeue;.. -. -
Dyysentety, unclasMs ied.,...,. ..-.: .
SPurulent infection alnd spticonia :
Septficentia. -......i...... ......
Tetpanr -..:.-...-.-..-..-- ... .....'.:- ....-:.;..- -
Pellagra...... ............ .....-


Pottd..isiy bi' er...u ls.. ....'
'.Iiberculosis.oTthe tRlin is..-...-
.ins; inated tube lis......- .
fnee~r and other naganat
of the6'eritoneu4inteta
r ct u m ...w ..:..:;.. .. .. ....
MCancer Mand .hV
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S. Disease es of aely fatcy. '

Praatar. rth.b ..r:.. .. ......4... .
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strum ts. .- ..-.. '... ------------ -
Burns (eonhgration excepted)..... .- .
Aidetae......... J .p
Tranatisai by other crashinge '
( iehis -trailr7oads, landsliu,

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Dyalmite uraliratiwnz ... ........ s.m.- .J.
Stairvationi ...... -. .......... .. ..
Electricity lightningg exceptedt).... 91 h.... p-
Somicide by cutting or piercing in-






v-d
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m.. B .mi .ide t. ot:, ,er m'. e. ... ... ,. .... .



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defined .... ..... r..- .-- .....
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: fever ..Z:. :'
fe" ; .: .t m nal; .... ... .
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Malaria qurtn- -- .............
Malarit fewer, cliniiu...
Mteesles ... .a..--.a..--..'---
* Scarlet fevers e ....... .... ..........
Diphth.r eand croup... : .......o....

: senta.; ia tm e.t ,....e...'..o ....-
r. r, ba ary .. ......... ........ .
l... ......ie d. ........ ......

Hemoglebfintric fevru quali...... -.
rieaiuthenction and sep-ticsnia..-
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S ept enia ~ -..... .......... .
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Pietagr.. .--.-....-----......---.
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tUAbseusi.. .bat belrmons. .....h..f....
eatiniiary titbereolosi
.4bdohtnui'al'ttnewuloas.--.i--s.-- ----
Tabe~iraosis of otle .rgans ......-.....
Taber e s Sof thee skin--..-.. ... *..

SDissninated ta losis............--

et oida-ry..... .......... ...,-.

Period .nrtstated-... ...........
Gonorrhea. ... .-.-..........
Gnrrheafl arthritis m ..-.......
Goxoirhest Ulb b. ........ ........ .
Gainwwbel o rtriti and epididmitis. --
G e al j .......i..o......:... ..




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Softnni en e t 032 .
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Constipatidn .... ................. ....
Diseases of the liver....s .....



A.bs.ess liver (nqt ;;,lified)..........:
Cholecystisis.' ......... ........-....
Anle peritnitis ,(nonerperal) ......

l9bnesenreel isdihea of the genito-


Brthts i (c i epbriti).
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s'.aes-f.the.blad..... .-..-.....

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otDiseases of. the retbitin.,ry ab cess,
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Sti eture of the ireth ven..........

oneneraldiseases ofthe al genital
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PAGE 3

REPORT W9 OF THE DEPARTMENT OF HEALTH S OF THE PANAMA CANAL FOR THE MONTH OF MAY, 1914 CHAS. F. MASON Lieut. Colonel, Medical Corps, United*States Army Chief Health Officer, Ancon, Canal Zone 4 WASH INGTON 1914 EE. ?L'

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..ffi44 44 ** s. -C

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CONTENTS. Page. Letter of transom ittal. .-.-. 5 General rem arks.e. .5 Hospital division, vital statistics .5 Health of employees. .....-------------------------------------------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 Sanitary division: Canal Zone .....-----------------------------.---------------------7 Panam a----. ........-. ...7 Colon .-10 Colon-----------------------------------------------------1 Quarantine division: Panama. .........----------------------------------------------------11 C olon ...-1 Hospitals: Ancon Hospital ...----------------------------------------------11 Board of Health Laboratory .---------------------------------11 Farm for disabled. .....-----------------------------------------12 Colon Hospital. ..--------------.-. .--------------------------------12 Chronic department. ...----------------------------------------12 Palo Seco Leper Asylum. ...---------------------------------------12 Santo Tomas Hospital. ......-----------------------------------------13 Sick camps. .......-------------------------------------------------13 District dispensaries. .......------------------------------------------13 Statistical tables: TABLEI. Deaths of employees and of the residents of Panama, Colon, and the Canal Zone------------------------. 14 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 and places of deaths of employees and civil population. 16 VII. Discharges and deaths in the hospitals of the Panama Canal. 20 VIII. Consolidated hospital report. ....----------------------------28 IX. Consolidated dispensary and admission report.-------------29 X. Employees: Constantly sick and noneffective rates per 1,000. 30 XI. Employees: Days' treatment per admission, hospitals, and quarters. ......---------------------------------------30 XII. Subsistence and operating expenses. ..----------------------31 XIII. Ancon Hospital. 31 XIV. Colon Hospital. ------------------------35 XIV.Coln Hopitl. .3. 3 XV. Palo Seco Leper Asylum. 37 XVI. Santo Tomas Hospital. ..---------------------------------37 XVII. Sanitary work done in Canal Zone, Panama, and Colon. 39 XVIII. Quarantine transactions.W. 41 XIX. Issues of quinine.-. 43 XX. Personnel report. .44 (3) .N I

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T A :: .: : --. .--.

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LETTER OF TRANSMITTAL. THE PANAMA CANAL, DEPARTMENT OF HEALTH, Ancon, Canal Zone, June 10, 1914. GOVERNOR OF THE PANAMA CANAL, Culebra, Canal Zone. SIR: I have the honor to submit the following report of the operations of the department of health for the month of May, 1914. Very respectfully, CHASE. F. MASON, Chief Health Officer. GENERAL REMARKS. On April 1 the department was reorganized on a permanent basis for the operation of the Panama Canal. The name of the department was changed from "sanitary department" to the "department of health," the "chief sanitary officer becoming the "chief healthofficer." The positions of assistant chief sanitary officer and chief sanitary inspector were abolished, the general inspector under the new organization performing all the duties heretofore belonging to the office of the chief sanitary inspector. The positions of chief quarantine officer and health officer of Panama, heretofore held by one official, were separated. The chief quarantine officer becomes also the quarantine officer of Panama. The accounting of the department of health and the cashier at Ancon Hospital were put under the jurisdiction of the auditor. During the month of May the districts of Porto Bello and Toro Point were closed and the forces of the department of health withdrawn. DIVISION OF HOSPITALS. EMPLOYEES. The health of the employees has continued good during the mouth. No cases of yellow fever, smallpox, or plague originated on or were brought to the Isthmus during the month. The number of names on the rolls for the preceding month was 48,039. The total number of admissions to hospitals and quarters was ~1,633, or a rate of 407.92 per thousand per annum, as compared with 350.59 for the preceding month, and 468.59 for the corresponding month of last year. The total number of deaths from all causes was 39. Of these 23 died from disease, or 5.74 per thousand per annum, as compared with 5.52 for the preceding month, and 5.42 for the corresponding (5)

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month of last year. The diseases causing the largest number of deaths were as follows: Lobar pneumonia, 7; and tuberculosis, 6. No other disease caused more than one death. The number of employees per thousand constantly sick was 11.65, compared with 12.07 for the preceding month, and 15.35 ior the corresponding month of last year. The admission rate to hospitals for malaria was 50 por thousand per annum, as compared with 36 for the preceding month, and 36 for the corresponding month of last year; 21 per cent of all admissions were due to this cause. The next highest admission rate was due to diseases of the digestive system and the respiratory system, each having the same number of admissions, and the next to venereal diseases. These four classes of diseases caused 47 per cent of all admissions. The discharge rate for typhoid fever per thousand per annum was 0.75, compared with 2.26 for the preceding month, and 1.20 for the corresponding period of last year. EFFECTS OF RACE. The admission and death rate for disease for black employees were 124.70 and 5.95 per thousand per annum, as compared with 393.37 and 4.66 for white employees. The noneffective rate for disease and injuries for black employees per thousand was 9.94, as compared with 20.55 for white employees. The admission rate for malaria was 42.56 per thousand per annum for blacks as compared with 87.07 for whites. The much higher admission and noneffective rates for whites as compared with blacks is no doubt due to the fact that the whites receive pay for 24 days per year while sick from disease, while the blacks do not. DEPORTATIONS. There were 16 deportations accomplished during the month, divided as follows: Employees, 15; nonemployees, 1; for disease, 8; and injury, 8. CANAL ZONE. The number of persons, white and colored, living in the Canal Zone is estimated at 54,755, among whom there were 70 deaths, giving a ratio of 15.34 per thousand per annum, as compared with 13.49 for the preceding month and 13.92 for the corresponding period of last year. PANAMA CrTY. In Panama City, with an estimated population of 47,172, there were 145 deaths, giving a ratio of 36.89 per thousand per annum, compared with 32.82 for last month and 26.46 for the corresponding period of last year. The higher death rate this year than last is largely due to the considerable emigration from the Canal Zone to Panama any increase in the official population figures. .46

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7 COLON. Ln Colon, with an estimated population of 20,232, there were 58 deaths, giving a ratio of 34.40 per thousand per annum, as compared with 21.95 for the last month and 21.95iforlthe corresponding month of last year. SANITATION. CANAL$ZONE. The malarial rate showed an increase overthat of JlastTmonth, though it has not been a great one. It is accounted for by four principal factors: First, the completion of contract work at Cano Saddle and the liberation of approximately 3,000 malaria-infected laborers in the zone during March, April, and May; second, the extensive breeding area for anopheles on a hydraulic fill lying between Ancon, Balboa, and Corozal, which area could not be treated; third, a markedly increased rainfall during April and May; fourth, the fact, that through resignations, leaves, and sickness, the number of sanitary inspectors in the zone was rapidly reduced so far that the ordinary close supervision of sanitary routine and special work was for a time impossible. The highest rate of malarial incidence was in the week ending May 16, since which time it is again declining. There were three cases of typhoid during the month, two of them in negro laborers (waiter and dishwasher) in two hotel kitchens. No secondary cases resulted so far as known. The cutting of the banks of the Pedro Miguel River, as noted in the last report, was continued during the month, though lately much delayed and made very expensive by reason of heavy rains. A special effort has been made during the month to clean up the very dirty negro towns and suburbs, such as Golden Green, Comacho Old Empire, New Gatun, etc., with resulting improvement in their appearance and their sanitary condition, though neither is yet satisfactory. The weakest point in the antimalarial work here is the treatment of the human carrier. The common tendency for a large part of the population, principally negro, is to take treatment for malaria only when in hospital, occasions that are as rare and brief as possible. The consequence is that there are many gamete carriers, probably several thousand, at all times ready to infect any malaria bearing mosquitoes that bite them. An effort is being made to have emoyees, at least, continue treatment for at least a month. Thus ,however, the result has not been very much of a success. Deatiled statistics are shown in Table XVII. PANAMA. DEATHS. One hundred and forty-five deaths from all causes are chargeable to the city of Panama. Of this number, 128 deaths were from disease and 17 deaths from violence. Fifty-two per cent of the total deaths from disease were among children under 5 years of age, ad.the cause of death in the vast majority of these cases was malnutrition. There were 18 stillbirths.

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GARBAGE 'COLLECTION. Night collection was started during the latter part of the month in the San Felipe district. This change from day to night service gave us the use of two extra teams during the day, which were needed for the satisfactory handling of the garbage in the more congested districts of the city. On account of the condition of the road leading to dump No. 1, we were compelled to abandon this dumlp, and dump No. 2 was started satisfactorily, but during the latter part of the month, we were gathering enough inflammable material in the city to cremate all garbage received at the dump before any fly breeding could take place. During the coming month, the work of installing automatic selfclosing covers on garbage cans will be started. The device adopted consists of a concrete base elevated about 3 inches above the surrounding surface and upon this base the can will be placed. The cover will be attached to the side of the building, the complete stand being located at aconvenient point of access to the tenants of the building as well as the garbage collectors. This device will afford at all times, perfectly fitting covers for the garbage cans, and one source of food supply for rodents will be cut off. RAT CATCHING. The trapping of rats from different parts of the city has been continued during the month, a total of 489 rats having been trapped, the vast majority of which were turned over to the board of health laboratory for examination for bubonic plague. All examinaiiw to date have been negative. The wire cage trap and the spring trap, baited with cheese and cooked meat, have been used exclusively in this work, no poison bait having been placed. In certain buildings with concrete floors where there were evidences that the rats had worked their way through breaks under the floors, formaldehyde and potassium permanganate was used to drive the rats out and our men killed them as they emerged from their harboring places. Each of the inspectors in the four districts in the city has one laborer who gives two hours of his time each day to placing and collecting traps. Enough rats are caught to determine if plague is present among them. These rats come f rom all parts of the city and when sent to the laboratory are tagged, showing the locality in which they were secured. FLY BREEDING. Fly breeding in the city of Panama is still extensive, especially in those localities where' stables are located. The majority of stables in the city are in a very bad state of repair and no permits for repairs will be given until the question of segregating the stables is settled. It has been the custom of the stable owners to give away all the manure from the stables to be used as fertilizer on the potereros and gardens near the city. Under section No. 66 of h sanitary rules and regulations, this office has directed that the manure from all stables be collected at least once in every 24 hour and taken to the dump to be cremated there. These orders H

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9 being complied with and fly breeding in and around the stables has been reduced. Fly eradication work is being carried on in all parts of the city. The congested tenement districts are receiving special attention and it has been necessary to cause the arrest of several property owners for maintaining insanitary conditions on their preiises, in which fly breeding was found. The population of these districts is more or less a floating one, and insanitary condiTions are to be expected with greater frequency than in the more settled sections of the city. Three Bath fly traps have been placed in the public market, in the fish section where flies are most numerous. The bait used to attract the flies was sirup, honey, etc., the idea being to give the flies a different bait from that to which they were accustomed. The traps have been successful in catching large numbers of flies, and additional traps will be placed throughout the market when they can be secured. STREET CLEANING. All the streets in the city have been cleaned twice a day except on Sundays and holidays, when the street men worked only half a day. The hours of work for the street men have been increased from 9 to 10 on the principal streets where the traffic is heavy. Under the old schedule there was a period from 11 a. m. to 12.30 p. m. when no street sweeping was done, and it is during this time that the traffic was heaviest on certain streets. Under the present schedule, there is only half an hour, from 12 noon to 12.30 p. m., when the street men are not at work. This change has enabled us to keep the streets freer from debris than formerly. A rotary brush street-cleaning machine has been requisitioned, and when it is placed in commission it is thought that some of the gangs now using brooms can be dispensed with and a saving in the cost of the work effected. An ,index of the traffic taken at fairly active points shows as follows: On the corner of Fifteenth Street and North Avenue, from 8.10 a. m. to 9.10 a. m there were 335 traffic movements of all kinds. This street is 30 feet wide. At Thirteenth Street and Central Avenue, from 10 a. m. to 11 a. m. there were 600 traffic movements. The street at this point is 26 feet wide. At Caledonia Bridge near M Street in one hour there were 700 traffic movements. The street at this point is 26 feet wide. The above figures show, in a measure, the difficulties that we experience in keeping the streets clean during the active hours. The general traffic conditions of the city could be greatly improved by an ordinance regulating the traffic. Under the present system all kinds of vehicles are allowed on all streets at all hours of the day, and as the traffic is far too great to be easily accommodated on the narrow streets, some arrangement should be made restricting the gn traffic to less-used streets. This could be easily accomplih d without causing inconvenience to the traffic. 'iThe regulation of this office, recently issued, requiring all occupants of buildings fronting on the sidewalks to keep the sidewalks a cleanly condition at all times, is being complied with by all persons concerned. 51656-14-2 i .10

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10 As shown in the report, 145 buildings were condemned during the month, of which number 39 were demolished as being a menace to public health and safety. One hundred and forty-eight permits were issued for repairs to buildings. All repairs to buildings as well as new buildings under construction are supervised by an inspector who gives special attention to the rat proofing of all buildings. VACCINATIONS. During the month there were 2,820 vaccinations performed. The total since April 1, when the work started, amounts to 3,065. The work so far has been confined to school children, but will be extended so as to include all unvaccinated persons in the city as well as those who have not been vaccinated within the past five years. A check of the vaccinations performed shows that about 85 per cent are successful. No infections have been found or reported among' those vaccinated. INFECTIOUS DISEASES. Four cases of typhoid fever were reported during the month. Two of these cases originated away from the Isthmus. In bothcases the patients were sailors, and were not reported sick till they reached the Isthmus. One other case was reported as clinical typhoid. This leaves only one positive typhoid case originating in Panama during the month. Detailed statistics are shown in Table XVII. COLON. The following new work has been inaugurated during the month: A systematic inspection and examination of milk offered for sale in the city of Colon, and of cattle and beef slaughtered. Out of 962 school children examined, 400 were vaccinated, the balance being found to be protected against smallpox. Arrangements were made to have examinations for diagnostic purposes made for the local physicians, by the board of health laboratory, free of charge. Steps were taken for the segregation of small craft and providing beach accommodations for same by an agreement between the Panama Government and the Panama Railroad Co. An arrangement was made between the alcalde and the health office whereby police patrolmen will aid in enforcement ofcertaiu important sections of the sanitary code. The department has been active in the enforcement of those sections of the sanitary code relating to rat-proof building and wharf construction and extermination of rats by trapping and poisoning. Installation of the new sewer system for use of the resideAtn of Colon Beach made upon the recommendation of this office to crrect insanitary conditions. Detailed statistics are shown in Table XVII. A

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I0 QUARANTINE SERVICE. No diseases of a quarantinable nature have been received at any of the stations during the month. The plague situation to the south remains about the same. Alleged cases of plague at Colombian ports on the Atlantic side' have proved to be negative. Theplague situation at Habana, Cuba, has shown no material change, and in all probability Habana will remain infected for a long time. Detailed statistics are shown in Table XVIII. ANCON HOSPITAL. A board has been appointed to prepare plans and specifications for the erection of a permanent hospital on the sites of the old frame buildings now in use for Ancon Hospital. It is proposed that the new buildings shall be constructed of concrete and tiles and gradually replace the present structures as they wear out in use. BOARD OF HEALTH LABORATORY. The laboratory has continued to do valuable work. Cultures and inoculations were made from a plague suspect taken from a ship at Balboa quarantine, with negative results. Dr. Samuel T. Darling, chief of laboratory, was sent to Colombia, at the request of the Colombian Government, to investigate a suspected outbreak of pneumonic plague at Cartagena and Barranquilla. Cable information has been received from him that the disease-referred to was lobar pneumonia and not plague. The study of the bionomics of local ticks has been continued. Further experimental work to determine the transmitting agent in the local type of piroplasmosis has been done. A study of the large joints in all cases coming to autopsy has been made with special reference to punched-out areas or erosions in the cartilaginous plates and their relation to venereal diseases, senility, and occupation. Routine observations have been made on placental smears with the idea of determining their value in diagnosing latent ma.laria. Observations have been made on the incidence and any interrelation of gall stones, gastro-duodenal ulcers, and pancreatitis in negroes coming to autopsy, with special reference to those cases without evidence of clinical manifestations. An investigation of .the irregularities in the electrolytic determination of copper in the presence of ethyl alcohol has been made. A new method for the determination of minute quantities of water in oils has been established., A study of the action of the different constituents of the atmosphere upon larvacide when it is allowed to stand exposed to their action has been commenced. An organism recovered from a caseous cervical gland of a Balboa rat has been worked out. It has been demonstrated that small mounts of carbolic acid in the amboceptor and alboline in the patient's serum do not influence the final results in the Wassermann reaction.

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12 FARM FOR THE DISABLED. Good work continues to be done at the farm. The yield has increased and the per capita cost of caring for the disabled shows a, steady decrease. About 10 acres of ground were plowed; 8 acres were planted out to corn, about 4 acres to sorghum and kafir corn, 2 acres.to yucca, 2 to yams, and 3 acres to vegetables and plants. One thousand five hundred plants were shipped to Mr. W. L. Phillips, landscapek architect, Balboa, for Balboa townsite. Banana plants were cultivated and tended; some repairs made to fences, and in addition some other miscellaneous work done. The number of patients (cripples) on June 1 was 51, two of whom were on leave; also, 30 insane patients, in charge of one nurse and and two attendants. INSANE DEPARTMENT AT FARM. On April 24 an insane colony was established at the Corozal farm. At first 15 men were selected for the purpose and the experiment proved so satisfactory that the number has been increased to 30. It is expected that this experiment will prove very beneficial to the patients themselves and will also furnish a valuable source of obtaining labor for the farm. Detailed hospital statistics will be found in Table XIII. COLON HOSPITAL. It having been decided to abandon the present Colon Hospital and build a permanent emergency hospital in Cristobal, a board was-appointed to select a suitable site and to make plans and specifications for the erection of the same. The board has not yet reported. During the month an arrangement was made with the Panama Government by which the citizens of Colon could be admitted to Colon Hospital for treatment, either as private pay patients or as Panama Government cases. Except for this purpose the hospital continues for emergency cases only CHRONIC DEPARTMENT. There were 27 chronic and incurable patients constantly ared for during the month. Detailed hospital statistics will be found in Table XIV.* PALO SECO LEPER ASYLUM. Conditions continued as usual at this asylum. The number of patients at the end of the month was 49, divided as follows: Adult males, 31; adult females, 11; male children, 4; female children, 3; whites, 5; and colored, 44. Detailed statistics are shown in Table XV.

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13 SANTO TOMAS HOSPITAL. During the month a total of 1,216 cases were treated, an increase over the previous month of 124, with a total of 11,223 hospital days, as compared with 9,989 days for the previous month. During the month of May an average of 360 patients per day were treated, and on May 28 the hospital census showed 393 patients in the wards. Our capacity has been taxed somewhat as we can care for about 400 patients per day. Our subsistence cost remains approximately the same, at 27 cents United States currency per day, while our per capita cost was 86 cents United States currency per day. The deaths during the month were 60, the same as the previous month, while the births numbered 90, as compared with 87 for the previous month. Malaria is the predominant disease treated, followed by syphilis, bronchitis, tuberculosis, and pneumonia in their order. Among the diseases causing death, pulmonary tuberculosis is predominant, followed by lobar pneumonia, traumatism, dysentery, and nephritis. During the month there has been one case of typhoid fever, a notable decrease over the previous month, one of leprosy, one of scarlet fever, and one of pellagra treated. The nurses' home has been completed and is now occupied and the quarters to be used by the pupil nurses are being put in condition. The general condition of the hospital buildings is good, and such repairs as are necessary-are being made. Detailed statistics are shown in Table XVI. SICK CAMPS. The only sick camp remaining in use at the end of the.month was a small one for prisoners at the Gamboa penitentiary, and this will be treated hereafter as a dispensary. DISTRICT DISPENSARIES. At the end of the month we had 11 still in operation. The district having the largest admission rate for malaria was Corozal with an average weekly percentage of 0.45; that having the lowest admission rate for malaria was Gatun, with a percentage of 0.04. Detailed statistics are shown in Table IX.

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14 VITAL STATISTICS. TABLE 1.-DEATHS OF EMPLOYEES OF THE PANAMA CANAL AND PANAMA RAILROAD. Deaths fromAnnual average for 1,000. Number Color. of employees. DisVioAll DisVioAll ease. lence. causes. ease. lence. causes. White.-------------7,718 3 7 10 4.66 10.88 15.54 Colored------------40,321 20 9 29 5.95 2.68 8.63 Total--------48,039 23 16 39 5.74 4.00 9.74 DEATHS IN THE CITIES OF PANAMA AND COLON, AND THE CANAL ZONE. Annual Place. Population. Deaths. average per 1,000. Panama-. 47,172 145 36.89 Colon. 20,232 58 34.40 Canal Zone. .54,755 -70 15.34 Total. .122,159 273 26.82 NOTE.-The figures relating to the number of employees are compiled from the pay rolls for the preceding month. The population and deaths as given for the cities of Panama and Colon, and the. Canal Zone, include employees and civil population. TABLE II.-DEATHS BY AGE, COLOR AND SEX. White. Colored. Yellow. Total. Age. Under 1 year.6 4 10 44 32 76 ...50 36 8 I to 4 years. 2 2 4 8 5 13 1 ---. 1 11 7 18 5 to 10 years. 1 .1 4 2 6 ...5 2 7 11 to 20 years. 2 1 3 3 4 7 ..-. 5 5 10 21 to 30 years. 7 1 8 32 16 48 1 .1 40 17 67 31 to 40 years. 5 1 6 24 5 29 1 .1 30 6 36 41 to 50 years. 3 .3 12 5 17 1 .1 16 5 21 51 to 60 years. 6 .6 6 4 10 ...12 4 16 61 to 70 years. .1 1 1 3 4 --. ---.--1 4 5 71 to 80 years. ..1 1 ....1 1 81 to 90 years. .1 1 1 -. 1 ....1 1 2 Not stated-. 1 .1 12 1 13 ..13 1 14 Total. .331144147 78 12251 4 4 184 89 273 To I I_ 1__47_____ 3 A

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15 TABLE III.-DEATHS BY NATIONALITY. Nations. Employees. Nonemployees. Toas Africa ..2 Antigua.---------------------------------2 1 3 Barbados. 9 22 31 China. .-------------4 4 Colombia-------------------------------1 7 8 Ecuador. 1 .1 England. ...-----------------------------------------1 1 France. ....------------------------------------------1 1 Greece. .-----------------------.-1. 1 Grenada. ..------------------------------------------1 1 Guadeloupe. .--------------------------------------3 3 India. ..-------------------------------------------1 1 Jamaica. ...------------------------. 14 41 55 Martinique. 1 11 12 Mexico.-----------------.--------------------------1 1 Montserrat. ......-------------------------------1 1 Panama -----------------------------------. 116 116 Santo Domingo.1 1 Salvador. .-------------------------1 1 2 pain-----------------------------------1 3 4 St. L ucia. ...5 5 Sweden. .----------------------.1. Trinidad.-----------------------------------------2 2 United States.,-----------. 5 4 Venezuela. .2 2 West Indies. ..---------------------------------------1 1 Unknown.--------------------------------2 2 4 Total .-. -.39 234 273 TABIE IV.-DEATH RATE AMONG AMERICANS ON THE ISTHMUS CONNECTED WITH THE PANAMA CANAL. -Annual Nationality. Cases. Cause of death. Aveal of deaths. average per 1,000. White employees from the 6,047 iee 1 1.98 United States. V 47.9 All causes 5 9.92 White women and children 5 Disease. from the United States. 4,503 Violence. 0All causes. White employees and their famDisease 1 1.14 Lies from the United States. 10, 550 Violence .4 4.55 RAll causes 5 5.69 Total number of Americans on I= iseas 1 12,352 Vioce 5 4.85 tAll causes .6 5.82 P.FS

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16 TABLE V.-CAUSES OF DEATHS OF EMPLOYEES OF THE PANAMA CANAL AND PANAMA RAILROAD. Causes of death. White. Colored. Total. DISEASE. Acute alcoholism. 1 -.-Arteriosclerosis ..--------------------------------------1 Chronic nephritis. ..-------------------------------------1 1 Clinical dysentery. ...-----------------------------------1 1 Diphtheria ------------------------------------------1 1 Il1-defined. ...-----------------------------------1 -.1 Intestinal obstruction ----------------------------------1 1 Lobar pneumonia. ..------------------------------------7 7 Organic disease of heart. .--------------------------------1 1 Other diseases of stomach .------------------------------1 1 Purulent infection and septicemia1. ..1 1 Tuberculosis, acute miliary. .-----------------------------1 1 Tuberculosis, disseminated. .2 2 Tuberculosis of the lungs.------------------------1 2 3 VIOLENCE. Accidental drowning.4. 3 6 9 Electric shock. 3 -.-.-.Homicide by other means.-------------------------------1 Railroad traumatism.---------------------------1 2 3 Total. 10 29 39 TABLE VI.-CAUSES AND PLACES OF DEATHS OF EMPLOYEES AND CIVIL POPULATION. Ancon Colon Disease. HospiHospiPanaColon. Canal Total. ma. Zone. General diseases. Malaria. ..2 2 1 5 Malarial fever, estivo-autumnal -----.------------1 1 2 4 Diphtheria and croup. 1 -----------------------1 Dysentery .----------------------------.----. 4 ------------4 Dysentery, entamoebic-----------1 -------------.-----1 Dysentery, unclassified -------------1 -----------------------1 Purulent infection and septicemia .1 -----------------------1 Septicemia ...-----------------------------------1 Tetanus -.------------------------1 1 ..-.-------2 Pellagra. ..---------------------------------2 .-----------2 Tuberculosis. 4 .18 3 2 27 Acute miliary tuberculosis. 1 -----------------------1 Pott's disease----. .----------------------.----1 ------------1 Tuberculosis of the larynx. ..------1 ------------Disseminated tuberculosis. 8 -----------------------8 Cancer and other malignant tumors of the peritoneum, intestines, and rectum ....1 ....-1 Cancer and other malignant tumors of the female genital organs. ..--. 2 Cancer and other malignant tumors of other organs and of organs not specified.----------------1. ..-------------1 Acute articular rheumatism. ...------------1 Scurvy. 1 ..-------.1 hlorosis----. .-------1 ------------1 Alcoholism (acute or chronic) --------1.-.-.-.-.-.-----Alcoholism, acute .------------1 .----------. Alcoholism, chronic ----------------------------1 Wq

PAGE 19

17 TABLE .VL-CAUSES AND PLACES OF DEATHS OF EMPLOYEES AND CIVIL POPULATION-Continued. Ancon Colon =a_ Disease. HospiHospim Colon. Zone. Total. tal. tal. Diseases of the nervous system and of the organs of special sense. Encephalitis .---------------------1 .1 ------------2 Simp e meningitis ..2 ..2 Cerebrospinal fever ...1 .1 Cerebral hemorrhage, apoplexy -----------------1 3 .4 Epilepsy.-.--.--.-.-.--Convulsions of infants (under 5 years of age)1. ....1 Other diseases of the nervous system. 1 ....1 Diseases of the circulatory system. Acute endocarditis. .---------------1--------------1 Organic diseases of the heart. 3 1 4 3 .11 Arterio-sclerosis-----2----------------1 2 ..3 Embolism and thrombosis.--------------------2 ..2 Hemorrhage; other diseases of the circulatory system1. ..------.1 Diseases of the respiratory system. Acute bronchitis. ...2 1 3 Chronic bronchitis.-------------. ..1 ..1 Broncho-pneumonia. ..4 1 3 8 Pneumonia (unqualified). ..6 -----------6 Lobar pneumonia. 7 2 3 1 2 15 Pleurisy. .---------------------. 1 ..-----.------------1 Pulmonary congestion, pulmonary apoplexy.----------------------1. ..... Diseases of the digestive system. Stomatitis.---------------------1. ....1 Other diseases of the stomach (cancer excepted).-. ....1 1 Acute gastritis. ...--------1 1 Chronic gastritis. ...2 .2 Diarrhea and enteritis (under two years)1. .28 2 6 37 Colitis. ....-----------------------------. .....3 ..3 Hernia, intestinal obstructions. 2 ..2 Intestinal obstruction.1. ...1 Other diseases of the intestines. I ....1 Other diseases of the liver1. ..-. .1 Abscess of liver (unqualified). ..1 .. Simple peritonitis (nonpuerperal). ..1 1 1 3 Nonvenereal diseases of the genitourinary system and annexa. Acute nephritis. I .4 1 .6 Bright's disease (chronic nephritis). 1 1 4 ..6 Pyelo-nephrosis.-. ....1 The puerperal state. Puerperal hemorrhage. .1 ...1 Eclampsia-------. ft ...2 ..2 51856-14----3

PAGE 20

18 TABLE VI.--CAUSES AND PLACES OF DEATH OF EMPLOYEES AND CIVIL POPULATION-Continued. Ancon ColonCo Disease. HospiHospiZo-Cne T tal. tal. Diseases of the skin and of the cellular tissue. Acute abscess.-----------------------. .-...1 ..1 Diseases of the bones and of the organs of locomotion. Osteomyelitis. ----------------------. .-. 1 ..1 Diseases of early infancy. Premature birth. .----------------------------4 .-. 1 5 Congenital debility.---------.-1 -----.4 1 6 Malnutrition -----. .---------. ..8 3 3 14 Other causes peculiar to early infancy (including various consequences of labor). .-------------------1---------.-. .1 Old age. Senility.----.------------------1 .-. -----------I Affections produced by external causes. Suicide by firearms .--------.-------2 ..2 Suicide by cutting or piercing instruments .---------------------------------------1 1 Burns (conflagration excepted) ------.------.1.-------------1 Accidental drowning. ....-. --10 Traumatism by other crushings (vehicles, railroads, landslides, etc.). ....------------------------------.------3 ---. ------3 Railroad traumatism. ---------2 ------------------1 3 Dynamite traumatis. ..--------------------. .------9 Starvation.---. ---------------1 ...-.1 Electricity (lightning excepted).:. 1 -------------.---. 2 3 Homicide by cutting or piercing instruments --------------------------------------.I Homicide by other means ----------.------...1 Ill-defined diseases. Ill-defined organic disease ..-------------------Sudden death. ....1 1 Cause of death not specified or illdefined-------.-----------------.------..1 Infections of undetermined origin. 1-----------------------1 Total---------------. 49 9 139 32 44 273 Stillbirths--------.---------------1 1 18 3 8 31 Grand total.----------------50 10 157 35 52 304

PAGE 21

"m~~. --~ -w -. x. .ON -N --.E N -.+. ., ..&.:-:.:.". ....:::: ::: :. -: :: -: : : ..: -: .:. : : : .: : : -N-:: .: : ---: -:: ..A .::: :--M -------: .---....--..-: ..-.-.: .-..: --:: -.....-.:: : : : : :. -: .-:: .: .-----.o ...: : -: : : ..4................

PAGE 22

20 TABLE VIH. -SHOWING DISCHARGES AND DEATHS IN THE UOS Ancon Hospital. Employees. Nonemployees. Diseases. Dis Dis charged. Died. chard. Died. W. B. W. B. W. B. W. B. General diseases. Typhoid fever. 2 ...1 1. Malaria fever, estivo-autumnal. 19 46 .26 7. Malaria fever, tertian -. 8 14 ..83 .. Malaria fever, quartan .1 ..1. Malaria fever, clinical .26 75 ..25 12 .. Measles. .I .. Scarlet fever.2 ..... Diphtheria and croup. ...1 .... Influenza.20. 6. .. Dysentery, entamoebic. .1 ..1 .1 Dysentery, bacillary ..1. Dysentery, unclassified. 2 .1 1 .. Mumps. ---. ... Hemoglobinuric fever, unqualified. 1 2 ..... Purulent infection and septicemia ...1. 1 ... Septicemia ....1 Tetanus. ....1 Pellagra. .1 .. Tuberculosis of thelungs. .3 2 2 2 .2 Acute millary tuberculosis. ..1. .. Abdominal tuberculosis. .1 ...1 .. Tuberculosis of other organs ..,. ... Tuberculosis of the skin. ...1 ... Tuberculosis of the lymph glands. ....1 Disseminated tuberculosis.2 2.6 Syphilis: Secondary. 2 3 .w. 7 1 Tertiary.4 3. Period not stated. .16 ..9 3 Gonorrhea. 9 15 .15 1. Gonorrheal arthritis.3 ...2 Gonorrheal bubo. 2. ... Gonorrheal orchitis and epididymitis. 1 1 .. Gonorrheal opthalmia. ...1 2 .. Soft chancre. 4 15 ..4. Adenitis, chancroidal.3 1. .. Cancer and other malignant tumors of the peritoneum, intestines, rectum. ......1 Other tumors (tumors of the female genital organs excepted). ........1. Acute articular rheumatism 2. Scurv y .-. -. ----. --.-.....-.....Anamia secondary, cause not determined .1 ...2 .--Purpura hemorrhagica. ....1. .. Alcoholism (acute or chronic).1 3. --. Alcoholism, acute ..2. 1

PAGE 23

91 PITALS OF THE PANAMA CANAL FOR THE MONTH OF MAY, 1914. Colon Hospital. Total. Employees. Nonemployees. Employees. Nonemployees. D's Di Di Dis charged. Died. Dhar Died. Died. Died. chre.charged. charged, charged. W. B. W. B. W. B. W. B. W. B. W. B. W. B. W. B. 1------------. ----.-. 2 1. 1 1. 3 4 .2 22 50 ---------28 7. ..8 15 --------8 3. ---------------; ....1-------------1 ---2.26 77 .25 12. 1 .2. .-. 2.....-----1. -2. ..0 ---------6. ...-1-1.1 2. .1 1. --. ...2. .....1.1........1. ..--1 1 ... ...... .....1 .2. .-.. ..........1. ----.....2 6 2 2. .7 1. 1. ....9 9 15 .15 1 ------w ...I ...3. .2 .. S. .2. .... .~~~~~ ~ ~ ~ 1. .......1. .4 15.4. .. 1 2. HUI. .......3 1. ..... ............1 S ..... ,. .......1 -......1. .2.-...-------1-.----.---.fi aw V ,-, --.---31 ... 2.

PAGE 24

TABLE VII.-SHOWING DISCHARGES AND DEATHS IN THE HO$PIT AL8$ Ancon Hospital. Employees. Nonemployees. Diseases. DisDid DisD charged. Died. charged. Died. W. B. W. B. W. B. W. B. Diseases of the nervous system and of the organs of special sense. Encephalitis.----------------------------------------1 Simple meningitis. .... Other forms of mental alienation-----------. ..4 13 Epilepsy .1 1. 1. Convulsions of infants (under 5 years of age) .------------------------------------1. Hysteria. ..... Neuralgia. ...------------------------1 1 ... Other diseases of the nervous system. ....-1 Neurasthenia ----------------------2 -----------2 ---------Diseases of the eyes and their annexa.-. 9 14 ..11 7 .. Diseases of the ears.-------4 2 -------8 1 Diseases of the circulatory system. Pericarditis. .-----------------------. ....1 ..... Organic diseases of the heart. 1 2 -------3 2 1 2 Aneurysm ..-. ....1 Arterio-sclerosis. ...1 .2 .. Hemorrhoids-------------------6 3 ..4 .. Varicocele.-----------------. 1 ..2 ----------Lymphadenitis (nonvenereal)---------4 3 ..8 ... Diseases of the respiratory system. Diseases of the nasal fosse-----------3 ...4 2. Diseases of the larynx.------------1 -------------------------Diseases of the thyreoid body----------1. ... Acute bronchitis. ..------------------11 23--------5 2 .. Chronic bronchitis1. .I .... Broncho-pneumonia---------------------------2 ... Pneumonia (unqualified). ..----------1 ... Lobar pneumonia. .----------------. .1 15-7 1 1 .. Pleurisy. 2 14--------2 ------1 Empyema.-------------------. .1 .--. ... Asthma. ..---------------------1 2-2 -----1. .. Abscess of lungs. 1 ... Diseases of the digestive system. Diseases of the teeth and gums--------1 2 .... Diseases of the pharynx-.-----------10 5 -. .27 3 .. Follicular tonsillitis. .-------------------1 ..1 1-. Foreign body in the esophagus. .1 ..1. Ulcer of the stomach --------4.-.-.-1----------. Other diseases of the stomach (cancer excepted). 1 3 ... Acute gastritis. 1 .... Chronic gastritis .1 .. Acute indigestion-------. 1 ...

PAGE 25

23 OF THlE PANAMA CANAL FOR THE MONTH OF MAY, 1914-Contd. Colon Hospital. Total. *Employees. Nonemployees. Employees. Nonemployees. DisDied. isied. DisD Dis. charged. charged. charged. Died. charge. Died. W. B. W. B. W. B. W. B. W. B. W. B. W. B. W. B. --.----------1 1 413 .1.1 1 ..4 1 ----. ----. ----.---.----.---.----.-.----.---.---.-1. .. 1 1 1 1. 1 1 ----------------2. ..-i2. .w--------2 .1. .1 1.-------2. ..... 2 .9 16 1.11 7. -------------5 2 ----8 1 ----------1 --1 ----1 2 .1 3 3 f 2 1 -----.---.----.----.-----.----1---1 ..2. -6 3 ----.4. 1 ...2 ...... -1. ... ..1. .........2. 1. i 1 15 7 1 1. 1 ..2 15 .1 .....1. .... 1 2 .2. ........ 1 2.f. 10 5.27 1 ....2. .1 2. 1 .1. 4 ...1. 1 3. .1 .1. ....-.-. ... ......1. .11. MA8

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24 TABLE VII.-SHOWING DISCHARGESAND DEATHSINTHE HOSPITALS Ancon Hospital. Employees. Nonemployee. Diseases, DisDisDied charged. charged. W. B. W. B. W. B. W. B. Diseases of the digestive syetem-Contd. Diarrhea and enteritis (under 2 years). ....6 5 .1 Diarrhea and enteritis (2 years and over) 5 2 ..3 2 .. Colitis. ..4 ----.... Ankylostomiasis .1 4 ...... Ascariasis. ..1 .---.1 ... Acute appendicitis. 4 2 ..8 Chronic appendicitis. .1. ..10. Inguinal hernia. 6 6 ..2 1-.-. Other hernias. ..1 Intestinal obstruction. .....1 Other diseases of the intestines. 9 2 ..16 1 .1 Constipation. 2 2. Diseases of the liver. .2. 1. Abscess of liver (unqualified)1. 1 .-. ..1 ... Cholecystitis. 1. .... Simple peritonitis (nonpuerperal). ...1 1. Nonvenereal diseases of the genitourinary system and annexa. Acute nephritis. 1 ...1 Bright's disease (chronic nephritis). 2 2 .1 5 3 .. Other diseases of the kidney and annexa. ..... Pyelonephrosis. ..1 ..2. Calculi of the urinary passages. 1. .... Diseases of the bladder1. 1 .... Cystitis. 1 1 ..... Diseases of the urethra, urinary abscess, etc.2.3. Stricture of the urethra, nonvenereal. 3 5 ...1 Chronic prostatitis. ....---. Nonvenereal diseases of the male genital orga. -.1 3.3 2. Hydrocele. 1 4 ... Uterine hemorrhage (nonpuerperal). ....2 Uterind tumor (noncancerous). ....1 2 .. Other diseases of the uterus. ...5 7 .. Salpingitis and other diseases of the female genital organs. 3 Nonpuerperal diseases of the breast (cancer excepted). ..1 ...2 .. The puerperal state. Normal labor. ..83. Accidents of pregnancy. ....4 Hyperemesis gravidarum. ....2 2 Other accidents of labor.3 ...

PAGE 27

25 OF THE PA NAMA CANAL FOR THE MONTH OF MAY, 1914-Contd, Colon Hospital. Total. Employees. Nonemployees. Employees. Nonemployees. xDiDDDisDisDied. Ds-. Did charged. carged. cha. charge d. charged. W. B. W. B. W. B. W. B. W. B. W. B. W. B. W. B. -..-. .-------------2-4 ----.--6 5 ----1 ..-. .-. --------3 ------.....4. ..... .~~~~~~~ 2. ..1 4. .1. ......w. .1 --....1 .2. .2 8 -----I.!. .-w. .----2. .1 1 ..2. -----------------------.-...-..1 .------w -1 -. .---.---------------2 -..1 1~~~~~ -----------------3 -----------.....w .---1 1 .-..--..-.1 ---------1--...... .......2. .. ......1. .... 1. .1. 1. 5. .~~~ ~~ 1. ...........--.-3..---------* -. ..------------------.~~~~ ~ ~ .5. ...1. -. ....1. ..3. ----1 23 ...1---* --*-* ---.--....3. B~qA. .1. 1. ---.2 ----.-1 ......9 ......4 ...:. .. .......2 ... -------_ --1 .....w.8-----...2. .....95----........................4 ..... W

PAGE 28

TABLE VII .-SHOWING DISCHARGES AND DEATHS IN THE HOSPITAL9Ancon Hospital. Employees. Nonemployees. Diseases. DisDischarged. charged. W. B. W. B. W. B. W B. Diseases of the skin and of the cellular tissue. Furunc1e. ...------------------------7 1 ..1-. .. Carbuncle--------------. ....1 .. Acute abscess. ..---------------------2 4 -------2 1 .. Phlegmon and ce11ulitis.-------------3 5 --------2 1 Scabies. .--------------------------------------1 Dhobie itch ----------------------2 --.---.----. 2 1 Ulcer of the skin----------------------8 -----------2 Impetigo contagiosa-. 1 --------.---1 .-. Ingrowing nail --------.1----------------.1. .. Other diseases of the skin and annexa. 3 3 -------5. Diseases of the bones and of the organs of locomotion. Diseases of the bones (tuberculosis excepted). .------------------------4 2---------.. Caries (nontuberculous) ---------------1. Periostitis. Ankylosis Arthritis-------------------------1 ------------2 Amputations.-----------------1 Other diseases of the organs of locomotion --------------------------.2 5 -------------------Diseases of early infancy. Newborn child.----------------------------------9 4--------Premature birth ----------------------------------------1 Malnutrition.--------------------------------2 1 1 Affections produced by external causes. I Poisoning by food.----------1 1-----------1 1 3-. 3---Other acut poisonings-----------------------------1 Burns (conflagration excepted)-------1 7------. ..2Traumatism: By firearms------------------------2. By cutting or piercing instruments -----17 ..1 1 By fall. ....-------------------------15 In mines and quarries .----------------2 By machines. ..------------------1 6 --------------------By other crushings (vehicles, rail.roads, landslides, etc.)-------. 2 Railroad--------------------------6 ----2. Electricity (lightning excepted) --------1 ----1------------------Fractures (cause not specified).-------4 14 -------10----------Dislocations.------------------------. ...2 ..-1 Sprains. ....-------------------------5 1 -------2 1--Other external violence.-----------45 126 ..10 6. Ill-defined diseases. Cause of death not specified or ill defined.-------------------------. ..-. .... Infections of undetermined origin. 2 2 ---------3 -----1 No disease. ....-----------------------1 2 -------13 3-. Total ...---------------------294 576 2 19 387 142 3 2 II 4 .N .A M <

PAGE 29

27 OF THE PANAMA CANAL FOR THE MONTH OF MAY, 1914-Contd. Colon Hospital. Total. Employees. Nonemployees. Employees. Nonemployees. DisDied DisDid DisDied Died charged. -charged. D charged. e charged. W. B. W. B. W. B. W. B. W. B. W. B. W. B. W. B. 2 ------------------------------9 1. 1. ..................1. .. 2 4 -----2---2 1. 3 5--------2 1. .............1.-....2.m.-----.1 8.---.-2 1.2 1. ..... -------------.----.---------1-. w ...1. 3 .3 .1. .. -~~~~~~ ~~ 3.-----------4. .5. .. 4 2.3. 1 ........ ...w-.-. ..w. .. ----------w.1. 1 ...2. .w 2 2 ..11.-. 2.3. 1.-. 2 2.1. ..-2 3 .... .~~~~ ~ ~ .5. .1 2. .6. .~ ~ ~ 2. .......1 ..---.......C ...........2. ..1 ..1 1.1.3. .................1. ... 2 ..1 9.--2 ...1. ...2. .1. .. 1 41.1 1. 21.2 2. 1 2 .1 ...1 17 --1. ... .~~~~~~~ ~~~ ...........e.e. .e ...... ...I ...2 1 1 ... ..2. 2 8 .1.11.1. 1 2 .1 .67.2. .Sur. ........w. ....... 2 8 .1. 2.1. ......4.2.1. .. ........1 .. ...5 14 ..10 ......2. .10. .........5 1 ..2 1 .. ...w .....45 126 ..10 6 .. .L ....1 S ...2 2 .3 .. 2. 4. ......1 2 ..133. 211431 0 3121 115 315 619 2 223i 5 430

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TABLE Vm.-CONSOLIDATED HOSPITAL REPORT. Re-RAdDd. c ransmanminTrnsm mg dit Did dag ferred. u Hospitals. May 1. -MaY 31. W. C. W. C. W. C. W. C. W. C. W. C. Ancon Hospital. Employees. 124 328 286 573 2 19 293 576 5 3 110 303 Nonemployees. 144 87 426 154 3 19 386 130 1 4 180 88 Insane (employees). 7 27 1 5 ..I. 7 32 Insane (nonemployees).:. 24 250 1 15 .6 1 12 1 4 29 243 Total. 299 692 714 747 5 44 1681 718 7 11 320 666 Colon Hospital. Employees. 4 26 28 54 3 21 43 3 8 8 26 Nonemployees. 7 2 20 20 1 5 11 10 4 1 11 6 Total. 11 28 48 74 1 8 3253 7 9 19 32 Palo Seco Leper Asylum. Nonemployees. 4 45 1 ----1 ..4 45 Grand total. Employees. 128 354 314 627 2 22 314 619 8 11 118 329 Nonemployees. 155 134 447 174 5 24 397 140 5 5 195 139 Insane (employees). 7 27 1 5 ...1 .7 32 Insane (nonemployees). 24 250 1 15 .6 1 12 1 4 23 243 Total. 314 765 763 821 7 52 713 771 14 20 343 743 Employees remainig .i hospitals: 'White.----------125 Colored. 361 Total. 486

PAGE 31

29 TABLE IX.-CONSOLIDATED REPORT OF CASES TREATED A DISPENSARIES. Employees. Nonemployees. Total. Stations. White. Col Total, White. ColTotal. White. Col Total. ored. ored. T ored. Ttl Naos Island. 121 1,294 1, 415 .-...121 1,294 1,415 Ancon. 576 1,874 2,450 187 217 404 763 2,091 2,854 Balboa. 3,178 3,467 6,645 91 118 209 3,269 3,585 6,854 Corozal. .1,766 1,565 3,331 528 56 584 2,294 1,621 3,915 Pedro Miguel. 478 1,053 1,531 317 73 390 795 1,126 1,921 Paraiso. 596 1,282 1,878 201 292 493 797 1,574 2,371 Culebra. 498 1,441 1,939 336 493 829 834 1,934 2,768 Empire. 1,047 1,213 2,260 472 374 846 1,519 1,587 3,106 Gamboa----w. 104 363 467 .....104 363 467 Gatun. 708 1,390 2,098 580 478 1,058 1,288 1,868 3,156 Cristobal. 818 2, 413 3,231 490 346 836 1,308 2,759 4, 067 Toro Point. .207 435 -642 22 48 70 229 483 712 Margarita Point. 50 422 472 ..50 422 472 Total. 10,147 18,212 28,359 3,224 2,495 5,719 13,371 20,707 34,078 CONSOLIDATED REPORT OF EMPLOYEES SICK iN QUARTERS, Days excused for quarters. New patients excused for quarters. Stations. White. Colored. Total. White. Colored. Total. Naos Island 3 48 51 1 37 38 Ancon. .99 111 210 56 29 85 Balboa. 142 29 171 66 9 75 Corozal. 199 1 200 98 1 99 Pedro Miguel. 34 .34 20 .20 Paraiso. 28 .28 15 .15 Culebra. 42 163 205 17 74 91 Empire. 131 38 169 41 14 55 Gatun. .70 63 133 37 23 60 Cristobal. 149 376 525 64 95 159 Toro Point. 2 3 5 2 2 4 Margarita Point. .7 7 .4 4 Total. 899 839 1,738 417 288 705 White. Colored. Total. Total admissions to hospitals. 765 763 1,528 Number of employees sick in quarters. 417 288 705 Total. 1,182 1,051 2,233 Less number of patients transferred from hospitals to hospitals, whose admissions are duplicated in above figures. .,. 14 20 34 Net admissions to hospitals, and those sick in quarters. 1,168 1,031 2,199 iet admissions of employees to hospitals, and those sick in quarters. 724 909 1,633 Annual average per thousand of admissions of employees to hospitals, and those sick in quarters. 1,125.68 270.53 407.92 r:J9

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30 TABLE X.-AVERAGE NUMBER OF EMPLOYEES CONSTANTLY '.K IN HOSPITALS AND QUARTERS. White. Colored. TotaL. Hospitals. Ancon Hospital.-----------------------------121.29 349.96 471. 25 Colon Hospital .--------------------------------8.32 24.00 32.32 Total ..---------------------------------129.61 373.96 Quarters. Naos Island.-----------------------------------.10 1.55 1.5 Ancon. ...--------------------------------------3.19 3.58 Balboa. ...--------------------------------------4.58 .94 5.52 Corozal. ..--------------------------------------6.42 .03 6.45 Pedro Miguel. 1.10 --------. Paraiso. .------------------------------------.90 .-.-.Culebra. ...-------------------------------------1.35 5.26 6.81 Empire. 4.23 1.22 .4 Gatun.--------------------------------------2.26 2.03 4.19 Cristobal. -------------------------------------4.81 12.13 16.94 Toro Point.------------------------------------.06 .10 .16 Margarita Point---------------------------------------.23 .29 Total.----------------------------------29.00 27.07 56.07 Average number of employees constantly sick: White. 129.61 29.00 158.61 Colored. ...---------------------------------373.96 27.07 401.03 Total. -----------503.57 56.07 559.64 Average number of employees constantly sick per 1.000: White.-----------------------------------16.79 3.76 20.55 Colored.-----------------------------------9.27 .67 9.94 Total. 10.48 1.17 11.65 TABLE XI.-AVERAGE NUMBER OF DAYS' TREATMENT PER EMPLOYEE IN HOSPITALS AND QUARTERS. White. Colored. TotL Hospitals. Ancon Hospital -.-. -.-. --. -. -12.69 14.58 13. F4 Colon Hospital. 10.00 12.81 11.94 Quarters. Naos Island.----------------------------------3.00 1.30 1.34 Ancon. ...--------------------------------------1.77 3.83 2.47 Balboa. .-------------------------------------2.15 3.22 Corozal. --------------------------------------2.03 1.00 2.2 Pedro Miguel-. 1.70 ----------1.70 Paraiso---------. .-----------------------------1.87 .1.87 Culebra. .-------------------------------------2.47 2.20 2.2 Empire------------------------------------3.20 2.71 3.07 Gatun.,.-. .1.89 2.73 2.22 Cristobal ------------------------------------2.33 3.96 3.30 Toro Point-----------------------------------1.00 1.50 1 Margarita Point -----------.1.75 1.7 A4

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31 TABLE XII.-SUBSISTENCE AND OPERATING EXPENSES. Hospitals. Sub8i8tence expenses. Number of days' rations issued patients. 34,563 Cost of rations issued to patients------------------------------------$8,288.21 Cost of subsistence per patient per day.-. $0.239 Operating expen8e8. Number of days' relief furnished patients ----------------------------34,563 Cost of operation ---------------------------------------------------$42, 189.70 Cost per capita per day. .......--------------------------------$1.22 Cost of operation with amount received from outside patieidts deducted $27,529.59 Cost per capita per day with above deduction---------------------$0.80 cost of dispensares -------------------------------------------$6164.50 TABLE XIIL-REPORT OF ANCON HOSPITAL. RemainAdDisTransRemaining Apr. mitted. Died. charged. ferried. ig May 30, 1914. 31, 1914. Class. W. B. W. B. W. B. W. B. W. B. W. B. Panama Canal employes. 117 277 243 465 2 13 264 493 5 2 89 234 Panama Railroad employees. 7 51 43 108 .6 29 83 .1 21 69 Pay patients. 129 77 398 134 2 12 363 109 .4 162 86 Charity patients. .15 10 28 20 1 7 23 21 1. 18 2 Insane employees. 7 27 1 5 ..1 ..7 32 Insane nonemployees 24 250 1 15 .6 1 12 1 4 23 243 Total. 299 692 714 747 5 44 681 718 7 11 320* 666 991 1,461 49 1,399 18 986 Transfers: 8 to Colon Hospital (4 white, Panama Canal; 2 black, Panama Canal; I black, Panama Railroad; 1 white, charity). 5 to asylum from hospital (1 white, Panama Canal; 4 black, pay). 6 to hospital from asylum (1 white, nonemployee; 4 black, nonemployees). White. Black. Total. Total number of employees died, discharged, and transferred. 301 598 899 Total number of days' treatment for same since adISio. 3,822 8,719 12,541 Average number of days'. treatment for each employee. 12.69 14.58 13.94 Average number of employees constantly sick. 121.29 349.96 471.25 Cost of subsistence, per patient, per day, $0.24311.

PAGE 34

32 NATIONALITY. Americans. Other naTotal tions. Class. number treated. W. B W. B. Panama Canal employees.-----------------1,102 208 3 12 739 Panama Railroad employees----------------209 22 .28 159 Pay patients. ..----------------------------738 414 -----113 211 Charity patients.-------------------73 38 .---. 5 30 Insane employees-------------------------40 4m--4 32 Insane nonemployees-.------------. 290 6 .19 20 I n a n n n m p o y e .....................2 06. ....1 9 2 6 I Total. 2,452 692 3 321 1,436 Ancon Hospital, June 5, 1914. WARD LABORATORY REPORT. Blood examinations. .....----------------.-------------------------1,144 E stivo-autum nal.--.-. --.-. .124 Quartan-------.-------------------. & Tertian. ......--------------------------------------------------25 Differential counts. ........------------------------------------------76 Hemoglobin estimations. ......--------------------------------------.148 Leucocyte counts. ........------------------------------------------200 Red blood counts.------------------------------------------4. 4 Stool examinations.-------------.-------------------------------. 979 Ameba. .........---------------------------------------------------.1 Ascaris lumbricoides ......----------------------------------------37 Balantidium coli ------.......-------------------------------------1 Cercomonas intestinalis.---------------------------------------1 Ciliated monads-------. .-------------------------------------29 Entameba (histolytica and tetragena).------------. .----------------7 Guaiac test. ..........------------------------------------------------6 Pus and blood--------. ..------------------------------------115 Strongyloides. .........-------------------------------------------53 Tricocephalus dispar ----. ....------------------------------------93 Uncinaria (ova) ....----------------------------------. ---------115 Urine examinations .........-----------------------------------------2,072 Albumen. ............------------------------------------------------641 Casts---............-----------------------------------------------522 Epithelia. ..........------------------------------------------------180 Guaiac tests-----------------------------. 12 Indican. .....--------------------------------------.------------2 Pus and blood. ...........--------------------------------------------495 Sugar (positive 6). ......------------------------------------------33 Trichomonas vaginalis. ..--------------------------.-------------1 Sputum examinations. .....-----------------------------------------193 Positive for tubercle bacilli. 26 Smear examinations---------------------------------------. .24 Urethral (1 positive for gonococci). ------.12 Vaginal (1 positive for gonococci) ----------.-. ---------------------3 Eye (positive for gonococci). ..-----------------------------Chancre (Treponema pallida) .-----------------------------------

PAGE 35

REPORT OF SURGICAL OPERATIONS. Number. Died. .Amputations: p? ..1. Digits, multiple -.3. Arm and leg. ..1.i Operations on bones: Uraniectomy, decompressive.1. Fractures, Simple .11 Fractures, compound. Ade.nectom Cervic ... I ,guinal, single. .2.----Inguinal, double. . lenotoMY: Wo ~~rd n .1 .. -ginail, single .1 tbIgurnal,, double. a. 4 V tral 1 1. (lenito-tirinarY tract: .K Ureterotomy. .1 Uretlirotomy, internal. .1. U-rethrotomy, external .4 X* Hydrocele, single,. radical cure ----------------------------Hydrocele, double, radical cure.1. Epididymotomy .xs. 7. Amputation of scrotum ..1 Curetageute. .7. -erineoplasty ..2. !&Tracelorrhaphy r.s. A. Obst~etrical: 3reaeorrhaphy ..2. Thorax: Thoracotomy .2. Hemorrhoids, radical cure. 12. stula in anus, excision of. 1. Gen eral: .Throidectomyy. I Varicose veins excision of. .1. Plastic operation for effects of disease .1. Skin graft .K Laparotomy: For general peritonitis (not traumatic or appendiial) .1 H F"A For intestinal obstruction.1.i Entero-enterostomy A appendectomy .19 ppedidectomy, with local peritonitis. 3 lostomy ... -Mjn cholecystostomy .w. .~. Oppravaginal hysterectomy. 2. Hysteromyomectomy. 3 Suspensio-uteri ..4. 'Plastic operation for chronic pelvic peritonitis.6.6. ,'Major operations, various other. 2 Minor operations, various .180. ~Total. .356 3 9 |||||||||N

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REPORT OF EYE AND EAR DEPARTMENT. Surgical operation. -Adenoidectomy ------------------------------------------.7 Capsulectomy. 1 Cataract extraction.-1 Enucleation-----------------. 1 G1.auonia trphn------------------------------------1 Glaucoma, trephine .w.w.w. .1 Iridectomy.-. 2 Iridectomy, optical. .------------1 Pterygium excision.1. f Removal of foreign body from esophagus. -------------------1 Rhino plastic.,. 1 Sequestrotomy---.-------------------------------------1. Sinusotomy, radical, frontal--.---------------------------------1 Sinusotomy, simple, frontal.-.----------------1 Submucous resection.-----------------------------------------. 5 Tonsillectomy--------------. 21 Trachoma, expression-. 1 Turbinectomy. .....----------------.----------------------------2 49 Various minor operations: E ar ...13 Eye--.-------------. .2 --------------.32 Nose.-. .I Throat. .-----------. .--. 15 61 Total. --------110 Total number of outside cases treated.-. 871 Refractions.--------------------------------. 112 OUT-PATIENT DEPARTMENT. Clinic. Total visits. New cases. Pay cases. Prescrip tions. Medical. 371 278 55 388Surgical.w. 412 234 19 102 Eye and ear. 871 344 31 391 Total. 1654 756 105 881 REPORT OF THE BOARD OF HEALTH LABORATORY. Bacteriological examinations ofPathological tissues prepared, parBlood cultures. .-------------21 affin. ...---------------------426 Throat cultures. 14 Chemical analysis ofUrine cultures. .-------------49 Hospital dairy milk .-.-.1 Stool cultures. 27 Milk from private dairies supPus.----------------------3 plying Panama and Colon.,. 20 Cultures from autopsies---t .7 Oil, transformer-room1. Spinal fluid. .----------------3 Monel metal, transmission line I Knee fluid. .-------------1 Pyrene (fire extinguisher). 1 Fluid from chest.------------1 Urine. 6 Smears from throat. 1 Surgical tissues and neoplasms reSmears from eyes. 1 ported.--------19 Cultures from eyes-----------1 Autopsies performed ----------37 Tap water-. .2 Bodies embalmed. 8 Autogenic vaccines prepared.5 Animals examined or under obserAntityphoid vaccinations.------6 vation.-------------------Wassermann reactions. .275 Leper suspects examined. 3 Agglutination reactions----------8 Rats examined. ..---------------. 953

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35 HOSPITAL FARM, COROZAL. Expenditures, May, 1914: Products sold, May, 1914: Supervision and ofice.$200.00 .3,347 heads lettuce. $74, 33 Labor .----------------489.08 261 pounds lettuce. 19.87 Subsistence of labor. 365.86 2,850 pounds yucca. 62.65 Quartermaster team serv 28 pounds tomatoes. 2.80 ice. .--------------120.42 2,392 pounds papayas. 50.95 Electric lights. 3.90 58 pounds sweet peppers. 5.16 Ice--------. 1.20 21 pounds egg plant. .1.02 Material and supplies 21.56 628 bunches radishes-----27.88 72 bunches parsley. 3.20 1,202.02 357 dozen eggs. 144.59 Transfer and services ren32J dozen-roses. 19.25 dered .-------59.25 10,003 mangoes---------176.64 9 pineapples. 1.01 1,142.77 35 guinea pigs-----------17.50 Products sold. 748.55 2 hogs .-.-. 75.00 51 loads gr ss.-----------51.00 Net expenditures. 394.22 Pasturage. -. .15.70 Net cost per patient per day.------------------.26 Total. 748.55 TABLE XIV.-REPORT OF COLON HOSPITAL. R eRemaining AdDd DisTransmaining first of emitted. i charged. ferred. end of month. month. W. B. W. B. W. B. W. B. W. B. W. B. Panama Canal employees. 4 14 21 27 .2 18 25 1 3 6 11 Panama Railroad employees .12 7 27 ---1 3 18 2 5 2 15 Pay (private). 5 .13 11 1 1 8 8 2 .7 2 Pay (municipal). .1 3 7 .2 .1 1 1 2 4 Zone charity. 2 1 4 2 .2 3 1 1 .2 11 28 48 74 1 8 32 53 7 9 19 32 Transferred to Ancon: One white, Panama Canal; 3 black, Panama Canal; 2 white, Panama Railroad; 5 black, Panama R ailroad; 2 white, pay; 1 white, Zone. Transferred to Santo Tomas: One white, pay (municipal); 1 black, pay (municipal); total, 16. White. Black. Total. Total number of employees died, discharged, or transferred. 24 54 78 M ITotal number of days' treatment for same since admission .240 692 932 Average number of days' treatment for each employee ....10.00 12.81 11.94 Average number of employees constantly sick. 8.32 24.00 32.32 Cost of subsistence per patient per day, 25 cents. mf 0

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36 NATIONALITY. White AmeriWhite Black. TotaL. Amer-, foreign. can. Panama Canal employees. 5 20 41 Panama Railroad employees ----------2 5 39 46 Pay (private)-------------------------4 14 11 29 Pay (municipal). ------------------------3 8 11 Zone charity. 3 3 3 9 14 45 102 161 LABORATORY REPORT. Blood examinations---....---------------------------------------72 Estivo-autumnal.w. .16 White blood counts.-------------------. 14 Hemoglobin estimations.-----------------. 23 Stool exam inations. .-. ..37 U ncinaria .-. .12 Strongyloides-------------------------------------------. -2 Ascaris.--------------------------------------------------.3 Tricocephalus dispar. .-----------------------------------------5 Ciliated monads. ----------------------3 Epithelia -------------------------------------------------1 Urine examinations. ....--------------------------------------------46 Albumen .14 Casts. ..----------------------------------------------------26 Pus. ...........-----------------------------------------------------8 Epithelia-.-------------. ...-----------------..7 Sputum examinations. .------------------------------------------Negative.-------------------------------------------------6 SURGICAL OPERATIONS. Amputations: Digits, multiple2. Herniotomy: Strangulated (died, 1).-------------. .------------------------. 2 Genito-urmary tract: Cystotomy.---------------. 1 Obstetrical: Casarian section, abdominal (died, 1). 1 Low forceps. --------------------1 Perineorrhaphy.w. 2 General: Plastic operation for severe injuries------------------------------1 Skin graft .1 Laparotomy: Minor operations, various. 12 OPERATIONS EYE, EAR, NOSE, AND THROAT. Tonsillectom y, double ...-.-........2 Minor operations. .---------------------2 Out-patients treated-------. ..----------------------------.-------. 1 Refractions. ..........--------------------------------------------------2 -A

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37 TABLE XV.--REPORT OF PALO SECO LEPER ASYLUM. ReRe...mainA-MaMin dAdDisTransS emitted .charged. ferred. ilend 7D.W B. O Class. month. month. W. B. W. B. W.l B. W. B. W. B. W. B. Panama Canal employees. Panama Railroad employees -. Pay cases.---------------2 31 "1 .1 ----------------2 31 Charity cases-------------2 14 --------------------2 14 Total. 4 45 1 .1 ...---.-.4 45 'From Santo Tomas Hospital. NATIONALITY. Number treated. Americans. Other nations. Class. White. Black. White. Black. White. Black. -Panama Canal employees. ....... Panama Railroad employees. ... Pay cases.-------------------2 31 .----.2 31 Charity cases. 2 14 .------------2 14 Total. 4 4 .-------4 45 Cost of subsistence per patient per day, 23 cents. TABLE XVI.-SANTO TOMAS HOSPITAL. Class. Remaining Adtted DisDied. Remaining May 1. charged. May 31. Pay cases. 36 140 118 6 52 Charity cases. 309 731 653 54 333 Total. 345 871 771 60 385 Average number of patients constantly sick. 360 Total number of days' treatment. 11,223 Average& number of days' treatment per patient. 9 Cost of subsistence per patient per day. $0.27 dAw

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38 NATIONALITY. Americans. Other nations. Number treated. White. Colored. White. Colored. Pay cases-------------------176 ------------------81 9 Charity cases----------------1,040 ------------------107 933 Total. 1,216 -------------------188 1,O28 DISPENSARY REPORT. Class. White. Colored. Total. Natives.--------------------------61 298 359 Foreigners.-------------------------------------53 229 282 Total. .-----------------------------------114 527 641 DISEASES TREATED. Typhoid fever. 1 Lobar pneumonia. ------------24 Malaria. ..-----------------------66 Asthma. .-----. .------------------1 Malarial fever, estivo-autunmnal. 27 Diarrhea and enteritis (two years Malarial fever, tertian ---------. 6 and over).--------------------14 Malarial fever, clinical .51 Intestinal parasites-------------16 Scarlet fever.--------------------1 Appendicitis and typhlitis-. 12 Influenza---------. --------------4 Other diseases of the intestines-. 14 Dysentery.-----------.---------10 Cirrhosis of the liver.-------------3 Leprosy-.-.-.-----------------1 Simple peritonitis (nonpuerperal). 1 Erysipelas----------. 1 Other diseases of the digestive sysPurulent infection and septicemia. 12 tem (cancer and tuberculosis exTetanus. ..-----------------------2 cepted)----f------------------3 Pellagra. ..-----------------------1 Acute nephritis. 12'Tuberculosis of the lungs.----. 30 Diseases of the bladder-----. 10 Syphilis. 42 Diseases of the prostate---.--. 4 Gonorrhea--------------------18 Other diseases of the uterus. 9 Cancer and other malignant tumors Salpingitis and other diseases of the of the breast--------------7 female genital organs ------------Anemia, chlorosis.--------------I Normal labor .-------------------76 Alcoholism (acute or chronic). 11 Accidents of pregnancy. .-.-.13 Simple meningitis. --------------1 Abortion.--------------. .-10 Other forms of mental alienation. -3 Extra-uterine pregnancy ----------1 Epilepsy---.------------------4 Furuncle. .----------------------1 Other diseases of the nervous sysAcute abscess. .--------------19 tern --. 2 Diseases of the skin and adnexa.19 Diseases of the eyes and their adOther diseases of the organs of loconexa. 3 motion. .----------------------4 Acute endocarditis.--------------9 Newborn child -------------------69 Arterio-sclerosis. .-----------------8 Congenital debility-.---------.Diseases of the veins (varices, hemBurns (conflagration excepted). 2 orrhoids, phlebitis, etc.). 2 Traumatism by other crushings (veHemorrhoids.-.----------------1 hicles, railroads, landslides, etc.). 36 Hemorrhage; other diseases of the Fractures (cause not specified).-. 10 circulatory system-------------3 No disease ---------------------82 Laryngitis ----------------------1 Chronic bronchitis--. 32 Total -----------------.830

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39 SURGICAL OPERATIONS. Number. Died. W iring of fractures, compound .-.-. 1 Adenectomy, axilary. -. ------.-.-. .2 0Adenectomy, inguinal, single .-. 1 Adeneetomy, inguinal, double.---------.-------------------3 Herniotomy, inguinal, single.----------8 Heruiotomy, strangulated...-----------------------1 Herniotomy, ventral. ..-----------------------------------1 Urethrotomy, internal -------------------------------3 Urethrotomy, external. .----------------------------1 1 Tydrocele, single, radical cure -------------------.-.1 Orchidectomy-------.----------------------------------1 Epididymotomy.--------------------------------------Vasectomy .-----------------------------------------1 Amputation of penis ----------------------------------1 Curetage uteri -------------------------------------2 Vaginal sections .----------------.-----------------------1 Vaginalpunctures ...------------------------------------1 Hemorrhoids, radical cure .-------------------------------2 Fistula in anus, excision of .----------------------1 Stab wound of soft parts, operation for.-------------. 1 Plastic operation for congenital defect--------.------9 Plastic operation for severe injuries.-1 Plastic operation for effects of disease -----------------------18 Laparotomy, exploratory. .-------------------------------1 1 Appendectomy .--------------------------------------2 Appendectomy with general peritonitis ---------------------1 1 Abscess of liver, laparo-hepatotomy for ----------------------.1. Pan-hysterectomy -.-------------. --------------------2 Salpiugectomy, single. -. -. -.-.-.1 Salpingectomy, double---------------------------------. Salpingo-oophorectomy.------------------------23 Oophorectomy.--------------------------------------2. Suspensio-uteri.----------------------------------------.-2 For ectopic gestation ...----------------------.------------1 1 Major operations, various other -------..-------------1. .Total. .....-------------------.----------------------81 4 TABLE XVII.-SANITARY WORK IN CANAL ZONE, PANAMA, AND COLON. The following is a summary of sanitary work performed and material expended during the month in the Canal Zone: Work requests on quartermaster's department: Grass cutting..------------------------------------. ----------10 Screening .-----------------------------------.------------15 Miscellaneous.------------------------------------.----------------13 Work requests on engineering department. ...--------------------------30 Work requests on other departments----------. 1---------------------Notices served to abate nuisances. ......--------------------------------137 Arrests for violation of sanitary regulations.---------------------6 <. Convictions .------------------------------------------------4 Building permits approved ....-------------------.-------------------5 Inspections of closets.-.----------------------------------------2,273 Inspections of stores. ....--------------------------------.----------298 Inspections of restaurants. 77 Inspections of shops. 199 Garbage cans emptied. 132,366 Olosets disinfected.-. -. .-..-. 5,344 Houses disinfected.-.2 Rat traps .1,298 Adult anopheles destroyed in houses.-5094 Adult culices destroyed in houses. 20,213 Lavacide used.-----------gallons. 4,197 Crude oil used----------..-24,888 Rats destroyed. -815

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40 Following is a summary of routine work done by the health office Panama, during May, 1914: Mosquito work: Linear feet of ditches cleaned and maintained .2-------------------24,50 Cubic yards earth used in filling.-Gallons larvacide used.-.--.... Square yards pools oiled.------.----------------------------58,845 Water containers treated.-------.--------------------------50,55l Mosquito breeding places found. .....-----------------------------1-400 Fly breeding places found -,------------------------------Garbage collections: Loads garbage from yards removed to dump.------------------4,921 Loads garbage from cans removed to dump----------------------4,346 Total cans garbage emptied. ..--------------------.------------99,541 Buildings: Buildings inspected.---------------------------------. 8,209 Plans for new buildings approved-.----------. .39 Permits granted for repairs to old buildings------------------.--148 Buildings condemned.---------------------145 Buildings demolished----------------------------------. 39 Street cleaning: Average number of square yards streets cleaned daily.------------600,00 Average number square yards streets sprinkled daily ----------100,000 Private properties cleaned during month.-------------------------10 Notices served and nuisances abated.----------------------------45 Vaccinations: 2 Vaccinations during month.---------------------.-------2,82 Vaccinations since Apr. 1, 1914. .-----------------. 3,065 COLON. [Including Cristobal, Mount Hope, and Toro Point.}COLON. General sanitation: Square yards streets cleaned. 4 073,226 Square yards alleys maintained.--------------------688,371 Loads garbage, cubic yards. ....----------------------------------449 Private properties cleaned. ..--------------------.---------------105 Rats killed. 6---------------------------------------Cans garbage. .........-------------------------------------------67,28 Cubic yards garbage------------.--. ..------------------------2,105 Linear feet ditches maintained. 1,564 Square yards vegetation removed. ....---------------------------72,900 Square yards oiled. .......---------------------------------------15,300 Receptacles treated.-------------.-------------------------24,90 Mosquito breeding places destroyed. ..----------------------------106 TFly breeding places destroyed. 142 Buildings inspected.---------------------------------------. .3,650 Notices served and nuisances abated. 2S9 (Colon and Cristobal garbage disposed at Ninth Street dump, Colon). Buildings: Plans approved. .....-----------------------------.---------------2 Permits to repair issued. 68 Permits to occupy issued. .-----------------------------------2 Sewers (reported by division of municipal engineering): T New connections made during month.----------------------------3 Total connections made to date. 1,145 Tota conectonsmadeto ate-----------------------------1,4 Houses in which extensions were made.-.Outstanding permits ..----------------------------------------61 CRISTOBAL. Sanitation: Square yards pools oiled -,------------------------------------3,00 Water containers treated -,-----------------------------------3,67 Mosquitoes killed in barracks (anopheles, 648; culices, 1,740). Mosquitoes killed in cars (anopheles, 1,689; culices, 496)-. Mosquito breeding places destroyed. Fly breeding places destroyed. Buildings inspected.-. 3 F0

PAGE 43

41 MOUNT HOPE. 8anitation: Square yards viled.11,600 Receptacles treated....-..-..29,150 Mosquito breeding places destroyed. 273 Cubic yards ditches constructed (open) -.-------------------------108 Linear yards ditches maintained, (open). ..----------------------17,986 TORO POINT. -0anitation: Square yards oiled. ......---------------------------------------6,150 Nmnber of mosquitoes killed (anopheles, 658; culices, 377). 1,035 Yards ditches maintained (open). 2,922 Doses quinine issued. ......-------------------------------------1, 170 TABLE XVIIL-QUARANTINE TRANSACTIONS AT THE PORTS OF BALBOA AND PANAMA FOR THE MONTH OF MAY, 1914. Vessels inspected and passed ---------------------------------14 Vessels inspected and held in quarantine.-------------------12 Total vessels inspected .------------------------------------26 Vessels fum igated on arrival .-.-....11 Crew examined ..........----------------------------------------1,820 Passengers from foreign ports examined and landed: Cabin. --.-. .------------------------------. 573 Steerage. ---------------------------------138 711 Total persons examined-----------. .....----------------------2,531 Persons vaccinated at ports of arrival because of compulsory vaccination law. ..........----------------------------------------------15 Persons vaccinated at ports of departure or en route because of compulsory vaccination law. .......---------------------------------737 Total persons vaccinated.-------------------------------752 Persons held in quarantine at the detention house to complete period of incubation for fever or plague. .....---------------------------169 Persons held in quarantine on board vessels to complete period of incubation of yellow fever or plague. .....-----------------------1,641 Total persons held under observation. ....----------------1,810 Persons embarked for foreign ports: Cabin. ..........---------------------------------------------340 Steerage. 149 489 Persons arriving from coast towns in small launches and sailing craft. 2, 233 Persons sailing for coast towns in small launches and sailing craft---2,077 Number of bills of health issued. .......----------------------------------29 Number of certificates issued to outgoing passengers. 21 Number of certificates refused on account of trachoma.------------------2 Total persons landed. .....----------------------------------2,944 Total persons sailing. ......------------------------------------2,566 Apparent increase for the month. 378 QUARANTINE TRANSACTIONS AT THE PORTS OF COLON AND CRISTOBAL FOR THE MONTH OF MAY, 1914. Vessels inspected and passed. ...------------------------------------106 Vessels fumigated on departure.-------------------------------5 Pieces of baggage handled and stored --------------------------. 102 Crew inspected. .......----------------------------------------9,558 Passengers inspected. ......---------------------------------5,575 Total persons inspected. ...----------------------------.------15,133 Persons vaccinated in port on arrival.-------------------------675 Persons vaccinated inports of departure or en route. 692 Total persons vaccinated. 1,367

PAGE 44

42 Persons detained in quarantine to complete period of incubation for yellow fever and plague. ..2 Persons detained on vessels. .0. 2 Total persons held under observation -------------------470 Total persons landed from foreign ports: Cabin---------------.--. .-------------------1,754 Steerage.-----------------------------------------1,802 Total persons embarked for foreign ports: Cabin. --------------------------------------------2 109 Steerage------------------------------------------2,305 4,414 Persons in transit.-----------------------------------1544 Persons from coast towns (inspected) --------------------------75 Persons from coast towns (not inspected) -----------------------294 Persons leaving Colon for coast towns2-------------------------71 Persons landed during month: For immigration report. ------------------------------4,019 For Pacific ports -------------------------------------306 4, 39S. Bills of health issued ..---------------------------------------9 Bills of health visled. ......--------------------------------------25 Persons recommended for deportation. ..---------------------------2 Certificates issued to outgoing passengers. .------------------------6 Persons refused certificates on account of trachoma------------------2 Total persons landed -------------------------------.4,325 Less number for Pacific ports ---------------------------3064 4, 019 Total persons sailing. .......--------------------------------4,685 Apparent decrease for month. .-------------.--------------666 CONSOLIDATED REPORT OF QUARANTINE TRANSACTIONS AT THE PORTS OF BALBOA AND PANAMA AND COLON AND CRISTOBAL FOR THE MONTH OF MAY, 1914. Vessels inspected and passed ......--------------------------------120 Vessels held in quarantine ..----------------------------------12 Total vessels entered. .------------------.-----------------.---. 132 Vessels fumigated on arrival.------------------------. .---------.11 Vessels fumigated on departure. ...-------------------------------5 Total vessels fumigated.-.-. 16 Pieces of baggage handled and stored-. ..--------------------------102 Crew examined -. -------------------------------------11,378 Passengers examined--------. .-----------------------------6,286 Total persons examined ----------------------------------17,664 Persons vaccinated at ports of arrival because of compulsory vaccination law. .........----------------------------------------------690 Persons vaccinated at ports of departure or en route because of compulsory vaccination law --------------------------------1429 Total persons vaccinated-------.....-------------------------2,119 Persons held in quarantine at the detention houses to complete period of incubation of yellow fever and plague.-.---.-.---.-.437 Persons held in quarantine on board vessels to complete period of incubation of yellow fever and plague. .---------------------1,843 Total persons held under observation -------------------------2,280 Total persons landed from foreign ports: Cabin. ---------------------------------2,327 Steerage.----------------------------------0. 1 4, 26T! Total persons embarked for foreign ports: Cabin. .-.------------------------2,449 Steerage -.------------------------------------2,454 4,903

PAGE 45

43 Total persons arriving from coast towns on small launches and sailing craft. ...------------------------------------------3,002 Total persons sailing for coast towns on small launches and sailing craft. .......------------------------------------2,348 Apparent increase for month from coast towns .------------------64 Apparent decrease for month from foreign ports: Cabin. ...........---------------------------------------------122 Steerage--------------------------------------------51 B teerage .................-. ..-. .514 636 Immigrants recommended for deportation -----------------------2 Certificates issued to outgoing passengers.-----------------------27 Persons refused certificates on account of trachoma.----------------4 Bills of health issued or visded. .....-------------------------------63 Total persons landed----......--------------------------7,269 Less number for Pacific ports. ....--------------------------306 6,963 Total persons sailing .-.--.-------------------------------7,251 Total apparent decrease for month. ...-----------------------288 IMMIGRATION REPORT FOR COLON. FromCabin. Steerage. Europe. .-. 53 21 United States----------. ....----------------------------960 69 Jamaica and West Indies. 225 1,307 Venezuela. 58 12 Colombia ------. 65 48 Cuba.--.----------------------------27 41 Guatemala. 22 121 Costa Rica. -------127 94 Bocas del Toro. 113 362 Coast towns. .294 1,650 2,369 M en. 2,666 W om en. 740 Children. .-.-. 319 Unclassified ..........------------------------------------------------294 Total. .4,019 QUARANTINE-BOCAS DEL TORO. Vessels inspected and passed--. 37 Crew inspected and passed.o. 1,818 Passengers inspected and passed. ..1,024 Passeners ininspeced-andpasse --------------------------30 Passenges n rni npeted and passed. 303 Persons held to complete period of incubation of yellow fever. 11 Persons held to complete period of incubation of bubonic plague.,. 11 No quarantinable disease has appeared in this port, and the health conditions of the port and surrounding territory are good. TABLE .XIX.-STATEMENT OF QUININE ISSUED. Kilos. Quinine sulphate. 4.00 Quinine sulphate tablets. 8.00 Total. .12.00 Punmds avoirdupois.-. .26.46

PAGE 46

TABLE XX.-PERSONNEL REPORT. Officers Skilled and emn d Total. unskilled ployees. labor: Chief health office -------------------------------13 3 16 Quarantine division ------------------------------8 30 38 Health office, Panama---------------------------12 149 161 Health office, Colon------------------------------8 102 110 Ancon Hospital .126 3$7 513 Colon Hospital. 10 22 32 Santo Tomas Hospital---------------------------6 .6 Palo Seco Leper Asylum .------------------2 16 18 Zone Sanitation--------.---------. 6 118 124 Hospital. Farm---------------------------------1 48 49 DISPENSARIES. Balboa. 4 2 6 Corozal ..--. 2 2 4 Cristobal.---------. 3 3 6 Culebra.----------------------------------------3 2 5 Empire-. -----------------3 5 Gatun .2 2 4 Margarita Point.-----------------1 .1 Naos Island.---------------------.1 1 2 Paraiso.----------------------------2 2 4 Pedro Miguel----------------------------------2 1 3 Toro Point .1 1 2 Total. 216 893 1,109 0:4

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