Citation
Report of the Health Department of the Panama Canal

Material Information

Title:
Report of the Health Department of the Panama Canal
Creator:
Canal Zone -- Health Dept
Isthmian Canal Commission (U.S.)
Place of Publication:
Washington, D.C.
Publisher:
U.S. G.P.O.
Creation Date:
October 1918
Publication Date:
Frequency:
quarterly[1918-Mar. 1919]
Monthly[ FORMER <Nov. 1904>-1917]
quarterly
regular
Language:
English
Physical Description:
v. : ; 20 cm.

Subjects

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

Notes

Issuing Body:
Reports for <Nov. 1904>-Mar. 1914 issued by the Isthmian Canal Commission.

Record Information

Source Institution:
University of Florida
Holding Location:
Centers of Excellence at UF
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:
29940569 ( OCLC )
ocm29940569
25402441 ( ALEPH )
Classification:
W 79. 12/5 ( sudocs )

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This item has the following downloads:


Full Text








































































































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*. '" VITAL STATISTICS.'
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Tim f wng statistics are based upon the average number of
o the pay rails of The Panama Canal and the
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n Railw Comapany far the three months ending Decembero


118, whiich was 25,122, as compared with 23,417 for the pre-
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So pital an quarters numbered 2,588, egii a
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Itreland five births were reported during the three months'

iug December 31, giving a rate of 39.44. One hundred and

A aths occurred aming children under I year of age, giv-

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Third quartta, 1918:
Faam.-. i.
Cdol.. ...... ....
Camc l Zone......


Fourth quertei 117t,
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Colon.. *.......
Canal Zoe...... .


.ot l. .....


51,309
23,078
*312,707

109,154


0 ,3869
26,078
124,038

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eau~ a children under I year of age......,.......... .......,.
nate atng Ameracsn children (number of deaths per 1,000 births).... 62.50


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Bronchitis, chrome. 3 1 *3*;,..1 ?.
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astritis. ........,a...,i........................ *...... ..,.
Acuteiondigestion. .*... ........... .......... 2 1 1 24 ..**.e*. -** -"i ..
Diarrhea and enteritis................... ......... a .a3 "1...
Nephrit2 .... i,


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Congenital malformations............. ............. .... ...... .. .. 1
Newborn child d................... ............ 2 2 a 4 .. .... I....,
Congenital debility, iaterus, andsaeerema..........., 2 1 .... 3 2 -.j.: i4
Prems 10 -h :3 8 5



Mnutriti.on..................................... 9 1 .....................
Other uses peculiar to early infant .......... .........:
Congeataon of debility.. .*. .. .a.. .a. .1.
1on 1 .* .** i:-
M a intrition.... a wns we we ew mm m ee Amm m e tgewp *. .E:***
Othmpasucspeaulatsady.in.fanay.. .. ..... .. .a. .... 3 1 .- .. .-.. H,,
I. H.:*.


External violence ........... ................ ... ...a ...,...
Cause not specified or ill-defined ............................4.......
C.Toal deil.................. ..... ..... ...... .... 4 .3 ..... ......

nM mor'i te, on *** um****.er o' bI fa. '7e7 8'1 5. i (et. ,
Ote ca se peula toea ina c .... .. f- 4 ., ~ .i4
nate mortalpeityd orae ilede one number. of. birth.... .4.. .rptefr th .izte ( 1ti s r

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Infant mortality rate, based on number of birth reported for the quarter (death :1.4'














DF RESIDENCE.


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1
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2
25
4
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General diseases.


Typhoid fever.... ... .............
Psratyphoid fever........ ..........
Relaps. ng fever....................
M alaria .. .. ., ..... .
Malarial fever:
Estivoautumal..............
Tertia .. ...... .. .. ......*
uarta... ...... .. .. .. .

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Clioral .......................
racbexia .. ... ......... .
Smallpozx:
Vaccinia ... ... .... ........ .
M easles.. ... -..... ........... .
scarlet fever.. .. ...... .. ..
Whooping cough ................. ...
Diphtheria and croup..'.............
Influenza....... ......... ..... ...
Dysentery:
Entamebie .... .. ..... ....
Unclassified ...................
Lepoy ........................
ysipela.......... ... ..

.ump .......... .. .......

Puruent infection and septicemia...
Pye ia. .. ... .... ....
Tetanus.... ... .. ..... .. ......
ella gra. ... .................


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PAGE 1

** te to,--.1 -A --A 1%~ -~~r -* --4 -t t-t 4i 7; A4 14 -It -* --------N *F *T*

PAGE 2

4>7 7 ~ 71~ ~ i. ~1747 N~7 ~ N7 7 7 v47 7 -7 *7 ~ 7 7 ~ ;;~ 7~J 47~ 7 7~ VV V 47 N* '4 N > V 7 7i N 4 > 47 ~~* N 4 4 7 444 A 77 7 %~* 4 7+777 -,47N *7 7 7*144 7 -4 V 3 -7 >~A 2 ~47!4 77 4+ 74 4~4 774 A *44 *N(4 4 474-;7 44 4 44 4<4 44 77 74 7 *7 *7447 4 V 7 *4 4 N 7 4 474 ~ ; *744 4 77 4 74 447474 1> 7; 47>7:, 7~ 7 ~ ~ 4 ~ 74 4 47 4 774 74> >4447747 7 4 47 4 44 7L 4447, *7! 7 4 4 7 4 *747777y 474; 7 7477 44~7~ A7.47 4 7 74444444 4 V 7 > 47 7 > 44*444 4447**77 4*74747> 44 7A447 777 77477 4 74 7/J 4 2 47<77/77>k4 b444 ~>>4~474 --7 74 4 44 7 4 74 4 7 4 47 4 > g~ 7J-k }~>4,<4~ >77 47 u4>4 44 Yr44

PAGE 3

REPORT OF THE HEALTH DEPARTMENT OF THE PANAMA CANAL FOR OCTOBER, NOVEMBER, DECEMBER 1918 ARTHUR T. McCORMACK Lieutenant-Colonel, Medical Res erve Corps, United States Army Chief Health Officer THE PANAMA CANAL PRESS MOUNT HOPE, C. 2 1919

PAGE 4

*4 OfP TJ

PAGE 5

CONTENTS. Page. Letter of transm ittal. ...5 Vital statistics: Em ployees. .5 Residents of the Canal Zone. .6 Residents of the city of Panama. .7 Residents of the city of Colon. 7 Statistical tables: I. Discharges, deaths, and noneffective rates for employees. ..9 II. Deaths of employees by cause, color, age, and length of residence on Isthmus 10 III. Deaths of iesidEnts of the cities of Panama. Colon, and the Canal Zone. .12 IV. Deaths of civil population (employees and nonemployees), by cause, sex, color, age, and place of residence. .14 IV.-A Deaths of nonresidents. .20 V. Deaths by nationality or nativity. ..22 VI. Statistics re American employees and their families. 23 VII. Births and birth rates in the Canal Zone and the cities of Panama and C olon .24 VIII. Infant mortality rates in the Canal Zone and the cities of Panama and Colon .25 IX. Deaths of infants by cause, sex, color, age, and place of residence. 26 X. Births classified by birthplace of parents. .28 XI. Discharges and deaths in the hospitals of The Panama Canal, by cause, color, etc. 30 XII. Consolidated hospital report. 46 XIII. Consolidated dispensary report.,. 48 XIV. Consolidated admission report, hospitals and quarters. 49 XV. Number of employees constantly sick in hospitals and quarters. 49 XVI. Average number of days in hospital or quarters for each admission of sick employee. ..50 XVII. Number of days hospital treatment furnished various classes of patients. 50 XVIII. Ward laboratory reports. .51 XIX. Surgical operations performed .53 XX. Report of operations-eye and ear departments. ...55 XXI. Report of X-ray department, Ancon Hospital. 56 XXII. Santo Tomas Hospital. 57 XXIII. Corozal Hospital.,. 59 XXIV. Contagious and infectious diseases reported ..60 XXV. Routine sanitary work performed in Panama, Colon, and the Canal Zone ..61 XXVI. Consolidated report of quarantine transactions. 62 XXVII. Immigration report. 63 XXVIII. Personnel report of Health Department. 63 (3)

PAGE 6

wS

PAGE 7

LETTER OF TRANSMITTAL THE PANAMA CANAL, HEALTH DEPARTMENT, Balboa Heights, C. Z., April 29, 1919 COL. CHESTER HARDING, Governor, The Panama Canal, Balboa Heights, C. Z. SIR: I have the honor to submit the following report of the operations of the health department for the quarter, October to December, 1918. An annual report for the calendar year is also being submitted, which will cover all items of special interest; no general remarks are submitted for this report. Respectfully, H. C. FISHER, Chief Health Officer. VITAL STATISTICS. EMPLOYEES. The following statistics are based upon the average number of names appearing on the pay rolls of The Panama Canal and the Panama Railroad Company for the three months ending December 31, 1918, which was 25,122, as compared with 23,417 for the preceding three ponths, and 29,440 for the corresponding three months of last year. Admissions to hospitals and quarters numbered 2,588, giving an admission rate of 412.08,1 as compared with 452.12 for the preceding three months, and 391.03 for the corresponding three months of last year. The constantly noneffective rate was 11.55, as compared with a rate of 11.53, for the preceding three months, and 10.32 for the corresponding three months of last year. All morbidity and mortality rates are computed as equivalent annual per 1,000. (5)

PAGE 8

6 Deaths from -all causes numbered 39; of these, 35 were from disease, giving a rate of 6.20 from disease alone, as compared with a rate of 7.32 for the preceding three months and 5.30 for the corresponding three months of last year. Diseases causing the highest admission rates to hospitals, in the order of their numerical importance, were (1) influenza, (2) malaria, (3) venereal diseases, (4) tonsilitis and (5) diseases of the eyes and their annexa. These five diseases caused 41 per cent of all admissions to hospitals, influenza alone causing 15 per cent and malaria 12 per cent of total admissions. The admission rate for malaria, hospitals and quarters, for the quarter year ending December 31, was 18.31, as compared with a rate of 15.36 for the preceding three months, and 20.52 for the corresponding three months of last year. The constantly noneffective rate from malaria for the quarter year ending December 31, was 1.08, as compared with a rate of 1.92 for the preceding three months and 0.70 for the corresponding three months of last year. By race.-For disease only, the admission rate to hospitals and the death rate for white employees were 226.20 and 1.80, respectively, as compared with 261.80 and zero for the preceding three months and 267.28 and 4.19 for the corresponding three months of last year. For black employees, for disease only, the admission rate to hospitalsand the death rate were 152.84 and 4.84, respectively, as compared with 107.04 and 8.96 for the preceding three months and 117.89 and 5.52 for the corresponding three months of last year. -For American employees the admission rate to hospitals from disease only was 202.96, as compared with 265.44 for the preceding chree months and 228.57 for the corresponding three months of last year. The constantly noneffective rates were 16.10 for white and 10.58 for blacks. The admission rate to hospitals and quarters for malaria was 9.92 for white and 20.08 for colored employees, as compared with 16.96 for white and 15.04 for colored employees for the preceding three months and 17.49 for white and 21.10 for colored employees for the corresponding three months of last year. CANAL ZONE. The civilian population of the Canal Zone, based on the police census, taken as of June 20-30, 1918, is 21,707. From thN population, 49 deaths occurred during the three months' period ending December 31, 44 of which were from disease, giving a rate of 8.12-from disease alone, as compared with a rate of 10.48 for the preceding three months and 9.32 for the corresponding three months of last year. Of the deaths from disease, 34 per cent occurred among children under 5 years of age, as compared with 39 per cent for the preceding three months. Two hundred and three births were reported for the three months' period ending December 31, 1918, giving a birth rate of 37.40. Of these births 77 were white and 126 colored.

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Ten deaths occurred among children under 1 year of age,, 2 white and 8 colored, giving an infant mortality rate, based on the number of births reported, of 26 for white and 64 for colored children, with a general average of 49.26 for 1,000 births. Of the total births reported, 8 per cent were stillbirths. PANAMA CITY. The population of the city, as shown by the health department census of June, 1917, is 61,369; in this population are included approximateiy 7,000 employees of The Panama Canal. From this population 336 deaths occurred during the three months' period ending December 31, 1918, 327 of which were from disease, giving a rate of 21.32 from disease alone, as compared with a rate of 23.12 for the preceding three months and 29.07 for the corresponding period of three months of last year. Of the total deaths from disease, 44 per cent occurred among children under 5 years of age, as compared with 39 per cent for the preceding three months. The principal causes of death, as compared with the preceding three months, were as follows: JulyOctoberSeptember, December, 1918. 1918. Tuberculosis (various organs). ...71 67 Pneumonia (broncho and lobar). 57 38 Diarrhea and enteritis. 31 35 Nephritis (acute and chronic). 17 23 Organic heart disease. 18 17 Six hundred and five births were reported during the three months' period ending December 31, giving a rate of 39.44. One hundred and twenty-one deaths occurred among children under 1 year of age, giving an infant mortality rate, based on the number of births reported, of 200. Of the total births reported, 7 per cent were stillbirths. COLON. The population of Colon, as shown by the health department census of June, 1917, is 26,076; in this population are included approximately 6,000 employees of The Panama Canal. From this population, 152 deaths occurred during the three months' period ending December 31, 1918, 146 of which were from disease, giving a rate of 22.40 from disease alone, as compared with a rate of 23.76 for the preceding three months, and 26.69 for the corresponding three months of last year.

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8 Of the total deaths from disease, 32 per cent occurred among children under 5 years of age, as compared with 42 per cent for the preceding three months. The principal causes of death as compared with the preceding three months were as follows: JulyI OctobierSeptember, December, 1918. 1918. Tuberculosis (various organs). ..28 29 Pneumonia (broncho and lobar). 30 18 Nephritis (acute and chronic). .10 12 Diarrhea and enteritis. 12 11 Bronchitis (acute and chronic). 15 11 Two hundred and sixteen births were reported during the three months' period endingDecember 31, giving a rate of 33.12. Thirtysix deaths occurred among children under 1 year of age, giving an infant mortality rate based on the number of births reported, of 166.66. Of the total births reported, 7 per cent were stillbirths. A

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9 TA= 1.-DISCHARGES, DEATHS, AND NONEFFECTIVE RATES FOR EMPLOYEES ABSOLuTE. NuWmBas. Discharges and deaths Deaths. Noneffective from hospitals. from sickness. a) Fourth quarter, 1918: White. 4,421 277 251 26 5 5 .6,407 71.19 Colored. 20,701 759 664 95 34 30 4 19,703 218.92 Total .25,122' 1,036 915 121 39 35 4 26,110 290.11 Third quarter,.1918: White. 4,247 298 278 20 ..6,718 74. Colored. 19,170 681 556 125 45 43 2 17,575 195.28 Total. 23,417 979 834 145 45 43 2 24,293 26992 Fourth quarter, 1917: White. 4,801 365 319 46 7 5 2 7,134 77.56 Colored. 25,018 962 727 235 44 34 10 20,805 226.21 Total. 29,819 1,327 1,046 281 51 39 12 27,939 303.77 PROPORTTONATE NUMBsERS.1 Fourth quarter, 1918: White. 4,421 250.60 227-08 2352 4.52 4.52 ..16.10 Colored. 20,701 146.64 128.48 15.56 6.56 5.80 .76 .10.58 Total. 25,122 164.96 145.68 19.28 6.20 5.56 .64 11.55 Third quarter, 1918: White. 4,247 280.67 261.83 19.84 .7 ....17.57 Colored. 19,170 142.10 116 .01 26.08 9.39 .97 .42 .10.19 Total. 23,417 167.23 142.46 24.77 7.69 7.34 .34 .7. 11.53 Fourth quarter, 1917: White. 4,801 304.08 256.76 38.32 5.84 4.16 1.68 .16.15 Colored. 25,018 153.80 116.24 37-.56 7.04 5 44 1.60 .9.04 Total. 29,819 178.00 140.44 37.68 6.84 5.24 1.60 .10.19 T Annual average per 1,000 employees MR 67633-2

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10 TAnT" I.-CAUSES OF DEATHS OF EMPLOYEES BY COLOR, AGE, AND LENGTH OF RESIDENCE ON ISTHMUS. Color. Age (in years). Cause of death. W. I B. 15-20 21-25 26-30 31-35 36-40 Apoplexy. .1. ....1 Aneurysm.2. .. Circulatory system, other diseases of. .2 .1. Cancer. .I. Heart, organic diseases of. 1 3 .. Liver, cirrhosis of. .1. .. Maria ..1 ..1. Meningitis, simple. .1 2 ..2. Meningitis, cerebrospinal. .1 ..1 Meningitis, pneumococcus. .1 1. Nephritis, acute ..1 .I -Nephritis, chronic. .2 ..I. .. -Peritonitis. ... (Paralysis, general.1 Pulmonary congestion. ... 7neumonia,lobar. 4 .2 1. Pneumonia, broneho. 1 .. omach, ulcer of ..I h ,ilis. ....1 .I .. Tuberculosis, pulmonary ..5 .1 4 External causes. 'Drowning, accidental. ..1 1 'Traumatism, by crushings. 3 ...1. Total. 5 34 2 5 9 3 6 Color. Age (in years). Cause of death. W. B. 41-45 46-50 51-55 56-65 66-75 Unknown. A poplexy. .I .. Aneurysm. 2 1. ..1 Circulatory system, other diseases of ..2 1. 'Cancer. I .1 .. 'Heart, organic diseases of ...1. .1 3 .. 'Liver, cirrhosis of. .I ..1. Malaria ..:. ... .Menineitis, simple. ...1 2 1 Meiiingitis, cerebrospinal ..1. Meningitis, pneumococcus. ..1. Nephritis, acute. ..1 Nephritis, chronic. ..2 .I. P ritontis. ..... Paralysis, general ....1 ... iWmonary congestion .1 1. 'Pneumonia, lobar. .4. .. Peumonia, broncho. Stomach, ulcer of .1. .. Byphilis.1. .. -Tuberculosis. 5. External causes. Drowning, accidental ..1. Traumatism, by crushing. .3 1. Total. 5 34 5 4 2 1 .2

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11 TaLE II.-CAUSES OF DEATHS OF EMPLOYEES BY COLOR, AGE, AND LENGTH OF RESIDENCE ON ISTHMUS-Continued. Color. Length of residence on Isthmus (in years). Cause of death. -W. B. Un1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-10 der 1. Apoplexy. .1 .... Aneurysm ..2. Circulatory system, other diseases of. .2. .. Cancer. .1. Heart, organic diseases of. 1 3 ... Liver, cirrhosis of. .I .1. Malaria ..1 Meningitis, simple. 1 2. Meningitis, cerebrospinal. .1. .. Meningitis, pneumococcus. ..1. ... Nephritis, acute. .1 ..1. Nephritis, chronic. .2 ..I. 1 Peritonitis. 1. ... Paralysis, general .1. Pulmonary congestion. 1. .. Pneumonia, lobar. .....4 ... Pneumonia, broncho .1 .1. Stomach, ulcer of,. .1. Syphilis.1. ... Tuberdulosis, pulmonary. .5 .1 1. .2 External causes. Drowning, accidental. .1. Traumatism by crushing ..3 ... Total. .5 34 1 1 2 2 3 5 Color. Length of residence on Isthmus (in years). Cause of death. W. B. 10-12 12-15 16-20 20 -30 30-40 Life UnToknown tal. Apoplexy. .1 ...1 Aneurysm. 2 1. ...2 Circulatory system, other diseases of. .2 ......2 2 Cancer. .1 ......1. ...1 Heart, organic diseases of. 1 3 I. ...2 4 Liver. cirrhosis of. .1 .......1 M alaria .....1 1 ....1 Meningitis, simple. 1 2 1 ....1 1 3 Meningilis, cerebrospinal. .1 1. ...1 Menin-itis-,-pneumococcus. ....1 I Nephritis, acute. .1 ....1 Nephritis, chronic. .2 ....2 Peritonitis. I. ....1 1 Paralysis, general. 1 ..1 ....1 Pulmonary congeotion. 1 .....1 1 Pneumonia,lobar. .4 1 ...4 Pneumonia, broncho. 1 ......1 Stomach,ulcer of. .I .1 .....1 Syphilis. .1 .....1 1 Tuberculosis, pulmonary. ..5 1 ...5 External causes. Drowning, accidental. .1 ......I I Traumatism by crushing .3 ......3 Total. 4.6.5. 1 1 2 9 3

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12 TABLE III.-DEATHS OF RESIDENTS OF THE CITIES OF PANAMA, COLON, AND THE CANAL ZONE. Deaths. Annual rate per 1,000 population. Plae Population. External Extdernal Total. Disease. Causes. Total. Disease. causes. Fourthuarter,1918: 61,369 336 327 9 21.88 21.36 0.60 Colon .26,078 152 146 6 23.32 22.36 .92 Canal Zone. .21,707 49 44 5 9.04 8.12 .92 Total. 109,154 537 517 20 19.68 18.96 .72 Third quarter, 1918: Panama. ..61,369 361 355 6 23.52 23.12 0.40 Colon. 26,078 160 155 5 24.52 23.76 .76 Canal Zone.'. 21,707 63 57 6 11.60 10.48 1.08 Total. 109,154 584 567 17 21.40 20.76 .8 Fourth quarter, 1917: Panama. 61,369 457 446 11 29.78 29.07 0.72 Colon. 26,078 ]so 174 6 27.61 26.69 .92 Canal Zone. 24,038 66 56 10 10.98 9.32 1.67 Total. 111,485 703 676 27 25.22 24.20 .96 'Exclusive of military population.

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14 Tirns IV.-DEATHS OF CIVIL POPULATION (EMPLOYEES PLACE OF Sex. Color. Age (in years). Cause of death. M. F. W. B. Y. der 1-4 5-10 11-20 1 yr. General diseawea. Relapsing fever.1 .1. ... M alaria. I ..1 ..1 Malarial fever: Estivoeutumnal.1. .I. Tertian. .2 .2 .2 .. Meas!es. 1. 1. .. Dysentery and croup.1 1 .2 .1 Influenza. 2 4 2 4 .3 Leprosy. 1 2 1 2 .. Purulent infection and septicemia. 2 ..2 .2 Septicemia.1. .... Tetanus. ...1 .1 ... Pellagra.2 .2 ... Beriberi. 1 ..1 .1 Tuberculosis of the lungs. 54 37 3 86 2 2 1 8 Tuberculous meningitis. 2 2 1 3 .2 2 Abdominal tuberculosis. 2 .1 1 .2. Tuberculosis of other organs. 1 ..1 ... Disseminated tuberculosis. 3 2 ...3 1 Rickets. .1 Syphilis: Tertiary. .3 1 1 3 lii .. Period not stated .I ..1 ...... Cancer and other malignant tumors of the stomach andliver. 1 I .2 Cancer and other malignant tumors of the female genital organs. .5. .. Cancer and other malignant tumors of other organs and of organs not specified 2 2 .4. Diabetes. .... Leukemia. 1 1 Alcoholism (acute or chronic). 1 ..1 Encephalitis. 1 ..... Simplemeningitis. 2 3 1 4. 1 1 1 Cerebrospinal fever.31.3 1 4 2 Pneumococcus meningitis. 1 ..1 1 Cerebral hemorrhage, apoplexy. 2 3 1 4. General paralysis of the insane ..1 ...... Epilepsy. .... Tumor of the brain.1. 1. .. Pericarditis. 2 ..2 Acute endocarditis.,. 1 3 .4 .2 Organic disease of the heart ..16 11 2 24 1 1 1 Angina Pectoris. .1. ... Diseases of the arteries, atheroma, aneurysm, etc. 3 .1 2. Aneurysm. 3 2 1 4. Arteriosclerosis. 2 5 1 6. Embolism and thrombosis. 2 ..2 Hemorrhage; other diseases of the circulatory system. 2 1 .3 .1. Acute bronchitis.9 18 .9 8 1 Chronic bronchitis .2 3 .5 .2 1 ... Broncho-pneumonia. 29 15 3 41 .25 8 .2 Pneumonia, unqualified. 4 7 4 6 1 4 21 Lobar pneumonia. 13 8 2 19 .2 .1 Pleurisy. 2 .:. .2 -Empyema.1 1

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15 AND NONEMPLOYEES), BY CAUSE, SEX, COLOR, AGE, AND RESIDENCE. Age (in yems)-Continued. Place of residence. 21-30 31-40 41-50 51-60 061-75 76-100 (?) PanColon. Canal Total ama. Zone. 1. ...1 .I ...I ... 1. ....1 .I 2 .2 1. .1 1. ..1 1 1. .1 1 ..4 1 1 .I ..3. 3 2 .2 ...I ...1 1 1 11 1 I I. ...1 1 ...1 ..1 234 2 .61 25 5 91 2 1 1 4 2 .2 ..1 .I 1.1. 2 21 1 2 2. .....1 1 2. *4. S. ..1 1 1. ...2 1 2 2 .1. 2 2 & 1 1 1 1 4 .4 1 .1 ..1 --1 1 ....2 1 ..1 I .1.1. 4 1 .I 2 ..3 1 .4 2. .. I1 ..1I. ....I 1 1 .I. ....I.:: 1 1. .....2. 1 ..2 1 1 2 ..17.4. 8 4 5 4 3 117 9 1 27 1 .....1.1. .I ..3 3. ....33 S. 1 1 4 5 1 1 3 2 4 3 7 1 1. ...2. 2 1 1. ..2 1 3 11 7 18 .2. .1 4 2 4 1 2. ..30 11 3 44 1 2 1. 7 2 2 11 7 6 1 31 8 7 6 21 ..1 2 1. ...t

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16 TABLK IV.-DEATHS OF CIVIL POPULATION (EMPLOYEES ANI RESIDENCESex. Color. Age (in years). Cause of death. --U--M. F. W. B. Y. der 1-4 5-10 11-20 I yr. General diteaaea .-Continued. Pulmonary congestion, pulmonary apoplexy. 2 2 1 3 .1 Gangrene of the lungs. 1 ...1. Ulcer of the stomach.t 1 1 .2 .. Other diseases of the stomach (cancer excepted). ..1 .1. Acute gastritis. Acute indigestion. 2 1 1 2 .3 Diarrhea and enteritis (under 2 years). 21 24 .45 .37 8. Diarrhea andenteritis (2 years and over) 1 3 .4 ..1 1 Ankylostoniasis. 1. 1 Hernia, intestinal obstructions. 1 2 .3 .. Intestinal obstructions. 1 ..1. Cirrhosis of the liver. 4 ..2 2. Other diseases of the liver.1 1 .2 .1. Abscess of liver (unqualified). ..1 .1 ...1 Cholecystitis. 1 ..1. Simple peritonitis (nonpuerperal). ..5 3 ... Other diseases of the digestive system (cancer and Iuberculosis excepted) ....1 .1. Acute nephritis. 5 6 1 10 .2 Bright's disease (chronic nephritis). .19 7 1 25 .1. Other diseases of the kidney and annexa. 1 1 1 1 .1. Bilharziasis of urinary tract .1 .1 Other diseases of the uterus. 1 .1. Hyperemesis gravidarum. .1 .1. Puerperal hemorrhage. .2 2 .1 Puerperal septicemia ..3 .3. Puerperal insanity. ..1 1. Gangrene. .1. Carbuncle. .1 .1 .1. Pemphiguts contagiosus. .1 1 .1. Mastoid abscess. ..1 .1 ..1 Congenital malformations (stillbirth not included). 1 1 2 2 .. Newborn child. 2 2 .4 .. Congenital debility, icterus, and seleroma 2 1 .3 .3 Prematurebirth.3 3 6 .6 .. Congenital debility. 5 3 1 7 .8 Malnutrition. 12 12 .24 .19 4 1 Other causes peculiar to early infancy (including various consequences of labor). .3 1 4 .4 .. Senility.2 .2 .. Suicide by poisoning. .1 .1 .. Suicide by hanging or strangulation. ..1 ... Suicide by cutting or piercing instruments.1.1. .. Conflagration. .1 ..1 .1 ... Accidental drowning. 3 .3 ..

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NFMPLOYEES), BY CAUSE. SE COLOR, AGEi, AND PLACE OF Continued. Age (in years)-Continued. Place of residence. 21-30 31-40 41-50 51-60 61-75 76-100 (1) PanColon. Canal Total ama. Zone. 1 2 ..3 1 .4 1. ....1 ..I .....2. 2 .1. ......L 1 ...1 .. ...2 1 3 ..34 9 2 45 .....1 3 ......1 ...... 4 ....2 ...4 1 ..I. ..2 ..2 1 ....1 1 2. .....2 8 2 5 1 .....5 2 81 .....1 .. 3 1 1 1 3 ..4 6 1 11 4 3 8 5 3 1 1 19 6 1 26 SI .....1 .1 2 ............1 ........1 -1 ..........I .......1 .1 1. ....2 2. .....2. ...1 .........I 1 1 1 1 11 *. .....1. ..I -~ ~~~ 1 .;. ........... 1 1 2 3 1 4 ...................1 1 1 3 2 3 1 6 ..8 8 15 7 2 24 22 22 ....2 .2. .. ......2. .1 1 ....I ... .........1 2. .... MR 676,13-3

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i8 TALr IV.-DEATHS OF CIVIL POPULATION (EMPLOYEES AND RESIDENCESex. Color. Age (in years). Cause of death. UnM. F. W. B. Y. der 1-4 5-10 11-20 1yr. General diaeases.-Continued. Traumatism byfall. 2 ..2 ..I. Traumatism by other crushings. 4 1 .5 ...1 Traumatism by landslides. 1 ..1 Lightning. 1 .1 ,Homicide by firearms.2 ..2 ... Fractures (cause not specified). ..1 1 ...1. Other external violence.1. 1 .1. Causeofdeathnotspecifiedorill-defired. 2 4 1 5 .3 2. Total. 302 23.5 38 492 7 167 49 6 25 Stillbirths. 41 34 10 65. Grand total. 343 269 48 557 7 167 49 6 25

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19 NONEMPLOYEES), BY CAUSE, SEX, COLOR, AGE, AND PLACE OF Continued. Age (in years)-Continued. Place of residence. Total. 21-30 31-40 41-50 51-60 61-75 76-100 (?) PanColon. Canal ama. Zone. 1 .....,. ...2 .2 2 ..I ..2 2 1 5 ........1 1. ..1. .I .............2 ......_ .....2 1. ...2 ..1 ... 1. 5 .1 6 92 78 62 30 16 9 3 336 152 49 537 43 15 17 75 92 78 62 30 16 9 3 379 167 66 612

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TAanz IV-A.-DEATHB Sex Color. Under Cause of death. 1 M. F. W. B. Cancer. 4 1 3 Pneumonia, unqualified. 2 1 1. Pneumonia, lobar .12 2 9 5 Pneumonia, broneho .5 1 2 4 Pyemia. Arteriosclerosis ...'1 Ttiberculosis, pulmonary. 6 2 Malaria. 1 1 Typhoidfever .1. .. Nephritis, chronic. 3 1 2 2. Influenza.4 4 Dysentery. 2 1 1 Erysipelas. ..I .1 1 Gangrene. 1 .. Peritonitis. ....1 Organic heart disease. 5 2 1 6 Epilepsy.1 .. Syphilis. .1. ... Cirrhosis of-the liver .1. Drowning, accidental. 2 .I Traumatism by firearms .1 .1 Total .54 11 27 38 1 i Includes deaths of all nonresidents, passengers off incoming ships, etc. Deaths of nonresidents are not taken up in the statistical charts relating to Panama, Colon.

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21 OF NONRESIDENTSA Age (in years). -Total. 1-4 5-10 11-20 21-30 31-40 41-50 51-60 61-75 +75 .1 1 2 .4 .1 .2 21 ..14 1 2. ... ....1 ....5 1 1 .. ....2 ...2 .. .2.2. 4 ...2 .2 ...4 ...7. .................. ....1. .....1 .......... ...........2. .....2 ................I 1 7 1 3 24 71 65 *nd the Canal Zone. ft

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22 TABLE V.-DEATHS BY NATIONALITY OR NATIVITY. Employees. Nonemployees. Totals. ____ ____Grand Nationality. total. Male. Female. Male. Female. Male. Female. Antigua. 2 .2 2 4 2 6 Barbados .6 .41 39 47 39 86 Bermuda. ..2 2 2 C hile. ..1 ..1 China. ..11 1 11 1 12 Colombia. 3 .15 8 18 8 26 Costa Rica. .1 2 1 2 3 Cuba.1. 1 .1 Demerara. 2 2 2 2 4 Dominica. .2 2 2 Ecuador ...1 1 1 1 2 Fortune Island. 1 .2 .3 .3 France. 3 3 3 6 Grenada. .6 5 7 5 12 Guadeloupe. 1. 1 1 1 2 Greece. .2 .2 2 Guiana, British. .1 1 1 1 2 Ireland. ...I ..I Italy .4 1 4 1 5 Jamaica .151 51 53 66 54 120 M artinique. .10 4 10 4 14 Mexico. ..4 4 4 Montserrat. 1 *. 1 Nicaragua. ...1 2 1 2 3 Panama. 3 .80 79 83 79 162 Peru. ....3 1 3 1 4 Scotland. .I 1 .1 Spain ..4 1 4 1 5 St. Vincent's. 2 .2 .4 .4 St. Lucia. I .4 6 5 6 11 St. Kitts .1 .1 1 St. Thomas ...I I Santo Domingo ..1 1 Trinidad. ...2 3 2 3 5 United Slates ...7 4 10 4 14 Venezuela. 1 3 1 3 4 Unknown. .3 1 3 1 4 Totals. 38 1 266 232 304 233 537

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23 TABLE VL-STATISTICS RE AMERICAN EMPLOYEES AND THEIR FAMILIES. Annual death rate per 1000 population. White employees from the United States: Disease. 3.24 External causes. Total. 3 .24 White women and children from the United States: D isease. 3.80 External causes. Total. 3.80 White employees from the United States and their families: D isease. 3.56 External causes. Total. 3.t6 Number of American children born on the Isthmus for three months ending December 31 64 Deaths among American children under 1 year of age. 4 Infant mortality rate among American children (number of deaths per 1,000 births). 62.50

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24 T"ai VIL-BIRTHS AND BIRTH RATES IN THE CANAL ZONE AND THE CITIES OF PANAMA AND COLON. Births. Rate per 1,00 population. Population. Total. Alive, born. Total. Alive. bo Fourth quarter, 1918: Panama. 61,369 648 605 43 42.24 39.44 2.80 Colon. 26,078 231 216 15 35.44 33.12 2.28 Canal Zone. 21,707 220 203 17 40.52 37.40 3.12 Total. 109,154 1,099 1,024 75 40.28 37.52 2.76 Third quarter, 1918: Panama. 61,369 567 517 50 36.96 33.68 3.24 Colon. 26,078 206 184 22 31.60 28.20 3.36 Canal Zone. 21,707 197 182 15 36.28 1 33.52 2.76 Total. 109,154 970 883 87 35.52 32.36 31.88 Fourth quarter, 1917: Panama. 61,369 825 770 55 53.77 50.19 3.58 Colon. 26,078 246 234 12 37.73 35.89 1.84 Canal Zone. 24,038 219 208 11 36.44 34.61 1.83 Total. 111,485 1,290 1,212 78 46.28 43.48 2.80 Exclusive of military population.

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25 TaE VIIL-INFAN' MORTALITY RATES IN THE CANAL ZONE AND THE CITIES OF PANAMA AND COLON. Births. Deaths among Death Popula__ ialdren rate per tion. under 1 1,000 me year of births. Wlemale. Total. age. Fourth quarter, 1918: Panama. 61,369 313 292 605 121 200.00 Colon. 26,078 126 P0 216 36 166.66 Canal Zone. 121,707 102 101 203 10 49 26 Total. 109,154 541 483 1,024 167 163 08 Third quarter, 1918: Panama. 61,369 282 235 517 99 191.49 Colon. 26,078 89 95 1S4 41 222.83 CanalZone. '21,707 89 93 182 14 76.92 Total. 109,154 460 423 883 154 174.41 Fourth quarter, 1917: Panama. 61,369 384 386 770 187 242.86 Colon. 26,078 107 127 234 62 264.95 Canal Zone. 124,038 105 103 208 16 76.92 Total .111,485 596 616 1,212 265 218.65 .Exclusive of military population. MR 67633-4

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26 TABnz IX.-DEATHS OF INFANTS BY CAUSE Sex. Color. -1 week, Cause of death. week. +1 M. F. W. B. month. Measles. 1 Diphtheria. .1 Influenza. .1 2 .3. Purulent infection and septicemia .2 ..2. Tetanus. .1 1 Beriberi ..1 Tuberculosis, pulmonary. 1 .2 Tuberculosis, memngitis. 1 1 .2. Tuberculosis, abdominal--.2. Rickets. .I .1. Syphilis. .1 1 Leuch mi a ...1 1. Meningitis, simple.1. .1. Epilepsy. .. Acute endocarditis. 1 i Organic heart disease. 1. Hemorrhage; other diseases of the circulatory system. 1 .1. Bronchitis, acute .5 4 .9 2. Bronchitis, chronic.1 I1 2 1 Pneumonia, broncho. 15 10 1 24 1 1 Pneumonia, unqualified. 2 2 .4 2. Pneumoma,lobar. .2 .2 1. Pulmonary congestion .1. 1. Intestinal obstruction, hernia. ....1 Gastritis .1 .1 1. Acute indigestion.2 1 1 2. Diarrhea and enteritis. 19 18 37 I Nephrits.2 1 .3. Diseases of the kidney and annexa. 1 .1. Congestion of the liver.1 .I Carbuncle.1 .1 Pemphigus, contagiosus. .1 Congenital malformations. 1 1 .2 1. Newborn child. .2 2 4 4 Congenital debility, icterus, and sclerema. 2 1 .3 2 Premature birth --. .3 3 .6 5 Congem tal debility. 5 3 1 7 6 1 M alnutrition. 9 10 .19 .1 Other causes peculiar to early infancy. 3 1 .4 419. Co fl gr .o ....... External violence ....1 1 ... Cause not specified or ill-deFned 4 Edternal voee. ...4 1f. Total. 77 A .6 Infant mortality rate, based on number of births reported for the quarter (deaths under 1 Percentage of deaths under 1 year of age to total deaths for 3 months ending Dceember 31,

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27 SEX, COLOR, AGE, AND PLACE OF RESIDENCE. Age (by months). Place of residence. 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10 10-11 11-12 Panama Colon. Canal Total. Zone. i. ..I 1 ..... 1 2 ...................3 ...3 S. ....2 ........... 2 ...2 S. .....I 2 1. 1 .2 ............ 1 ... S.1 ..1 ...... 1. ..1. 1 1 ...1 ...-I. ....1.4. S ..... 1. ..1. 6 3 9 12 .2 2 ..4. 1 2 1 22 3 ..25 .1 4 4. 1 1 1 2 11 1 ......1 1 1 1 3 1. ...2. 5 1 1 1.1 1 1 3 .....2 1 1. .. 1 1 1 1.1 1 2 3 1 4 1 1 1 3 1.2 3 1 6 1.8 8 1 1 5 .1 1 2 2 .4 1 14 4 1 19 .i. .2 24 1. 3 1 4 12 20 16 9 9 8 13 10 111 8 9 121 36 10 167 year of age per 1,000 births) ..200.00 166.66 49.26 163.09 1918. ...36 24 ; 20 31 i*

PAGE 30

28 TABnB X.-BIRTHS, CLASSIFIED Brth lace of mother. Birthplace of father. .IC -e 1 ~ C ci C -! Africa Antigua .9 1. Antilles. .. Barbados. .170 ....3 1. Canada. Chile ..1. 1. China. 2. Colombia. 1. 7 Costa Rica.1 Cuba Curacao D. W. I. ...._ I. Demarara.~. 2. Denmark ..1 Ecuador. England. 1 .. France. 2. Germany. ... Greece. .... Grenada. ...18. uiana Brts.2. ....... Guadeloupe. 1._. .2. Guiana, British ...2. Guatemala. .. Holland. Ireland. Italy. ......3 Jamaica .2 1 51. .. Japan. Martinique. Montserrat.,. ...... Nevis. ... Nicaragua. Nova Scotia. Pan ama. 2 2 .5 2 Peru ... Porto Rico ...1 Russia. St. Kitts._I. St. Lucia ..2. .. St. V incent. .......................-.I .. Scotland .. Spain,. 21. Trinidad. .. United States' 3.1 3. .. Venezuela Others. Total.12 3184 2 1202 3 3 2 2 24 3 1 1 3

PAGE 31

*J: .:: .amaica. .:Japan. .................IMartinique. Montserrat, Norway. .I. ...........N i c a r a g u a Panama. ..z ....Peru. Porto Rico. Russia. -----St. Lucia. .St. Kitts St. Vincent. Spain. ~~~~. .............. ...Sweden. Trindad. United Sta es. ----Venezuela. ......Others. ND t-IDTotal. -. 00.5.'

PAGE 32

30 TABLE XL.-DSCHARGES AND DEATHS IN THE HOSPITALS OF THE DECEMBER, Employees. Discharges. Deaths. White. White. Diseases. Black. 0 Black. M. F. M. F. M. F M F. M. F. M. F. General diseases. Typhoid fever ... rara.typhoid fever ....., ... R elapsing fever. ......... M alaria. ........ Malarial fever: Estivoautumal. 3 1 3. 49 ...1 Tertian ..1 13 Quartan .1 ..... Undetermined. 1 3 17. Clinical. 1. Cachexia. ..4 Smallpox: Vaccinia. .1. Measles. .1.-.-. .-. Scarlet fever. Whooping cough. ... Diphtheria and croup. Influenza. ..43 15 8 1 82 2 Dysentery: Entamebic. ....... Unclassified Leprosy. .1 Erysipelas. ...1 Chickenpox ..*-. 1. Mumps. .1. Filariasis. Purulent infection and septicemia 1 1. 2. Pyemia. Tetanus. Pellagra .1. Beriberi. .. Tuberculosis of the lungs ..1 1.7 .2. Tuberculous meningitis. Abdominal tuberculosis. ..... Pott's disease. ......'* *" -" 1 1 Tuberculosis of bones and joints. ....... Tuberculosis of the lymph glands 1 Disseminated tuberculosis. ... Syphilis: Prim ary. ..... Secondary. ...2

PAGE 33

31 PANAMA CANAL FOR THE MONTHS OF OCTOBER, NOVEMBER, AND 1918. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. White. Black. White. Black. 3 m mE-4 M.M.F. M. F. M. F. M. F. M. F. M. F. M F. M. F. 2 .........4 .2.1. ... 1 ......1. 1 ..........'.1 S. ........., ..I ..4 65 5 4 10 8 2 1. 2 .1 .....151 4 29 8 4 2 3 ..2 ......63 I .................2 6 1 .........31. 6 1 ..1 .............9 .. 2 1 30 34 .1 12 12 ....96. ........6 1 1 3 ........, .....6 .. 1 .......1 .....2 2 1 1 ..............4. 1.3 1 ......5. 201 35 43 12 13 6 1 1. 66. 9 1. 530 9 1 1. .....1 .....4 ..2 ...............2. 1 .2 ..............4 1 ................2 .3 3 ............8 1. ..2. 1 1. .......2 2 1 1 .......1 ........ ....I .......1 ................1 1. .I ........-..1 2 1 .I. ...........2 1 13 1 1 1 1 ..1 .6 7 2 ...I ...1 28 18 .I. .1 .....1 2 1 ..... 1 .....1 .~ ~ ............*. .-. ..-, 4 2 .......1 4 .....14 11. 3. ..17

PAGE 34

32 TALE XL-DISCHARGES AND DEATHS IN THE HOSPITALS OF I'HA DECEMBER Employees. Discharges. Deaths. White. White. Diseases. Black. Black. 0 M. F. M. F. M. F. M. F. M. F. M. F. General diseases-Continued. Syphilis: Tertiary. 2 46 Hereditary. Period not stated Gonococcus infection. Gonorrhea. ...14. Gonorrheal arthritis. ....1 Gonorrheal bubo. .I ... Gonorrheal orchitis and epididymitis .1. 6. Gonorrheal ophthalmia. ...1. Soft chancre. .....13. Adenitis chancroidal. .. Cancer and other malignant tumors of the baccal cavity. Cancer and other malignant tumors of the stomach and liver .1. ....1 Cancer and other malignant tumors of the female genital organs. Cancer and other malignant tumors of other organs and of organs not specified. ..1 .-. Other tumors (tumors of the female genital organs excepted) .1 .2 .-. Acute articular rheumatism. .-. Diabetes .....-. Exophthalmic goitre ....Anemia, secondary, cause not determined. .... Other general diseases. ...-. .. Alcoholism (acute or chronic .1 .. Alcoholism, acute. .-. Alcoholism, chronic. ... Alcoholic psychosis. Diseases of the nervous system and of the organs of special sense. Simple meningitis. ... Cerebrospinal fever. .1 Pneumococcus meningitis. ...2 Locomotor ataxia. ... Lateral sclerosis ...-Cerebral hemorrhage, apoplexy. 2 ....2 Softening of the brain. 4 A

PAGE 35

33 PANAMA CANAL FOR THE MONTHS OF OCTOBER, NOVEMBER, AND 19&--Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. White. Black. White. Black. I dld M.M.F. M. F. M. M. F. M. F. M. F. M. F. M. F. M. F. 4p32 ..1 8 131 .1 ...1 6 ..1 log, 2 -6 1 .F.M. ..M M. F. ..M. .. 3 2 1 8 1 3 ..1 ..... ..............1 ...........6. 2. ...........3 11.1. ...0. ......37. 1 ..9. 1. ...........2. 7 .2 .1 ..23 ............4. 7. .... ....2 .3 1 .2 .3 1 2. .3. 6 2. ..10 1 1 ... 6. ............1. I. ............ 1 21. .......1 1 2 1.4 2 1. .......1. I ~. .............4. 2 ..........2. 2 1 .1 .2 ...5 2 1.1. ....2. 2 1. 2 .~~~ 1 1. .....2. ..3 2 S. 1. 61

PAGE 36

34 TABLz XI.-DISCHARGES AND DEATHS IN THE HOSPITALS OF THE DECEMBER# Employees. Discharges. Deaths. White. White. Diseases. Black. Black. M F M F. M. F M FM F M. F. Diseases of the nervous system and of the organs of special sense.-Cont. General paralysis of the insane. 1 Other forms of mental alienation 2 Dementia prwcox Epilepsy. ..1 Convulsions (nonpuerperal) (5 years and over). Hysteria. Neuralgia. Neuritis. 2 2 .3 Other diseases of the nervous system. 1 1 ..2. Neurasthenia. ..3 .1. Diseases of the eyes and their annexa.3 ..20 1 --. Diseases of the ears. 4 2 6 Diseases of the circulatory system. Organic diseases of the heart. I .1 1 Angina pectoris.I. .. Diseases of the arteries, atheroma. aneurysm, etc. .. Aneurysm. ..-.l Embolism and thrombosis .Diseases of the veins (varices, hemorrhoids, phlebitis. etc.).1. I -. Hemorrhoids. 6 4 Varices. ..-. .. Varicocele. 3 .-. Phlebitis. .. Diseases of the lymphatic system (lymphangitis, etc.). I. ..1 Lymphadenitis (nonvenereal). ...1 8 Hemorrhage; other diseases of the circulatory system. .... Diseases of the respiratory system. Diseases of the nasal fossa .4 .2. Myiasis ofasal fosse and sinuses. .... Diseases of the larynx. ...... Laryngitis. .. Diseases of the thyroid body .1 .. Acute bronchitis.I. ...... Chronic bronchitis. .1 ..

PAGE 37

35 PANAMA CANAL FOR THE MONTHS OF OCTOBER, NOVEMBER, AND 1918.-Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black Black. White. Black. White. Black. w o -0 0 0 E-4 E-4 M. M. F. M. F. M. M. F. M.1F. M. F. M. F. M. F. M. F. 12 1 1 3. 2 .21 6 2 1 5. .14. 1 2. .4 S. ...1 ii. ..........1 4. ...2. 1. .17. 4 1 ..1 1 12 1 5 ...1 1. .24 1 28 3 1 10 6 ..2 ...76. 30 10 3 4 8 .4. .71. 4 1 1 1 3 3 ..I. 33 3 1. 1. 1.1 1 1 2 1 1. 2 2 1. 3 .10 10 1 3 .24. 1. ....3. ............Ii. 3 3 ....3 .......1. ... 3 2 1 2 ..1.18. 1 32 ..2 ..1. ..42 1 .1 .......2 1 ...............1. A. .........1. 2 .............4 18 4 3 2 5 ....1 2 .......36 1 8 ...1. ....1 ....12.

PAGE 38

36 TABLE XL-DISCHARGES AND DEATHS IN THE HOSPITALS OF THE DECEMBER Employees. Discharges. Deaths. White. White. Diseases. a Black. Blac M. F. M.PF M. F. M. F. M. F. M. F. Diseases of the respiratory system.Continued. Broncho-pneumonia. ......... Pneumonia (unqualified). Lobar pneumona. .3 -. ..5 Pleurisy .3 ..-. .--.1 Pulmonary congestion, pulmonary apoplexy. .. Asthma. .. Pulmonary emphysema. Abscess of lungs. ..-. Diseases of the digestive system. Diseases of the mouth and annexa Diseases of the teeth and gums ..1 1. Stomatitis .. Diseases of the pharynx ....1 Pharyngitis.2. Follicular tonsilitis. .11 2. 11. Ulcer of the stomach.1. 1 2. Other diseases of the stomach (cancer excepted). 3. Acute gastritis. ...... Chronic gastritis. ....2. Acute indigestion. .I. .. Diarrhea and enteritis (under 2 years). .. Colitis (under 2 years). ....1. Diarrhea and enteritis (2 years andover)2.3 2 .5. Colitis (2 years and over). .2. Ankylostomiasis. ..4 -. Intestinal parasites. Ascariasis. Teniasis. .... Appendicitis and typhilitis. Acute appendicitis. 7 1 .. Chronic appendicitis .2 2 Inguinalhernia. 3 3 .53. Other hernias. Intestinal obstruction. .......1 Other diseases of the intestines. .5 .2 ..2.

PAGE 39

37 PANAMA CANAL FOR THE MONTHS OF OCTOBER, NOVEMBER, AND 1918.-Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. White. Black. White. Black. -O Q 0 m1 EM. M. F. M. F M. M. F. M. F. M. F. M. F. M. F. M. F. 5 .1 2 3 1 .3 ......13 4 1 .2 1 1 ..2 ..1 .......6 3 10 1 .6 3 10 .1 .2 2 ...5 ...26 23 4 ..4 .1 2. ......19 1 1 ...........1 1 11. .........13 1 .1. 4 1 2 2. ...1 .14. 1 1 1 ..........7 2 .2 1. ..9 1 2 1 .........14 62 21 19 11 ....4 ....4 1 ...............4 1 1 .1. ......1. ....7 6 2 2. ----1 11 3................................1 4 .. 4 .... I ......I ...7. .... 2 2 ....2. .41 4 ....................................2 .. 6 2 2 1 .5 ........22 7 2. ..........2. 3 2 5 2. .........8. 1 3 ..5 .........68 1 ..1 ..... 91 .....2. .1 1 ....... 1. ....I. ........1I. 24 9 3 1 2. ...2. .... 12 2 3 .1. .....23.,. 24 .3 1 ....3 .1. .81. 1 ....2 4 ................2 6

PAGE 40

38 TABLE XI.-DISCHARGES AND DEATHS IN THE HOSPITALS OF THE DECEMBER, Employees. Discharges. Deaths. White. White. Diseases. SBlack. Black. M. F. M. F. M. F. M. F. M. F. M. F. Diseases of the digestive systemContinued. Constipation. 1 1 4 Duodenal ulcer. Duodenal.u. .....' Cirrhosis of the liver. 1. Biliary calculi. .... Other diseases of the liver. 1 1. 1 Cholecystitis. 1. ... Diseases of thespleen. Simple peritonitis (nonpuerperal) ...I1 Nonvenereal diseases of the genitourinary system and annexa. Acute nephritis. Bright's disease (chronic nephritis). 1. 7 .. Other diseases of the kidney and annexa. ........ Pyelo-nephrosis. Calculi of the urinary passages. 3.I. .. Diseases of the bladder. Cystitis. 1 1 2 Diseases of the urethra, urinary abscess, etc. ....28. Stricture of the urethra, nonvenereal .....13. Acute prostatitis. Chronic prostatitis. Rypettrophy of prostate. Nonvenereal diseases of the male genital organs .I .1 .... Hydrocele. .30. Uterine hemorrhage (nonpuerperal). Uterine tumor (noncancerous). Other diseases of the uterus. .1.1 Metritis. ..... Cysts and other tumors of the ovary. 2. Salnineitis and other diseases of the female genital organs. The puerperal state. Normal labor. Accidents of pregnancy. ..1.

PAGE 41

39 PANAMA CANAL FOR THE MONTHS OF OCTOBER, NOVEMBER, AND 1918.-Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. White. Black. White. Black. o o m 0 m( -E--4 M. M. F. M. F. M.M.F.M. F. M. F. M.F.M.F.M. F. 4 .2 .2 ..............14 .. 2 1 ...............3 1 .....1 ........I ...2 2 ..I .....I ..1 ......2 1 2 2 1 1 .1 ..I .......9 2 1 ..I. ...............3 S ...........1 ...1 1. ....1 ........3 2 1 1 1. .1 1 .........3 '2 1 .1 2 5 ...2 1 ....1 ...17 5 2 6 .2 .......12 1 .1 .1 .....1 ...1 ...4 1 I. ......4. 1 2 ....1 ........3 1 2 7 1 1 .....1 ...16 1 ..1 3 ..........33 3 ................16 I ....................1 .. 1 ..................1 .......1 ........1 28 5 2.1. 1. ....48 7 1 ..............38 2 .1 .............3 2 5 .............7 6 .22 .........30 2 .7 .............9. 6 .20 ................28 4. .12 ............16 62. 31 .....93 44. .1 ..........1 ..........5 ..

PAGE 42

40 TABLE XIL-DISCHARGES AND DEATHS IN THE HOSPITALS OF THE DECEMBER, Employees. Discharges. Deaths. White. White. Diseases. Black. 0 Back M. F. M. F. M. F. M. F. M. F. M. The puerperal state.-Continued. Extra-uterine pregnancy. Hyperemesis gravidarum. Abortion. .-. -.1 Other accidents of labor. Puerperal septicemia. ... Puerperal albuminaria and convulsions. Following childbirth (not otherwise defined). Puerperal insanity. Diseases of the skin and cellular tissue. Gangrene. Furuncle. Carbuncle. ....1. Acute abscess. ..1 .12. Phlegmon and cellulitis .2 1 .5 .1 1 1. Trichophycosis. Scabies. Elephantiasis. ....1. Myiasis of skin. ...1 .. Dhobie itch. .....2. Ulcer of the skin. ..7. Impetigo contagiosa. .. Urticaria.1. Ingrowing nail. .3 2 Other diseases of the skin and annexa. 1 .4 1. Diseases of the bones and of the organs of locomotion. Diseases of the bones (tuberculosis excepted). .2 .4. Caries (nontuberculous) Mastoid abscess. Oteomyelitis. Diseases of the joints (tuberculosis and rheumatism excepted). 1. Ankylosis. .. Arthritis. 3 .6. Synovitis. ..1. Other diseases of the organs of locomotion. .3 ...6

PAGE 43

41 ;ANAMA OANAL FOR THE MONTHS OF OCTOBER, NOVEMBER'AND #t&.-Ooatimued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. White. Black. White Black. --~ ----M. F.M. F. M. M. F. M. F. M. F. M. F. M. F. M. F. ....1 ..........1. S1 .2 ....1 .........3 1 14 .10 .............25 ..8 ..............16. ................ ............1 .........-.............1. 3 1 ...........1 4-1. .....1 .......5. 12 .3 8 ..3 ......44 8 4 1 1 ..-. ...2 .......24 3 2 .......2 .1 1. ......4 .......... 1. ........... .2 3 ....-.---.-.-.--.--... 2 ...........8 -r 2 ..3 ......8 S. ....3. .....2 .......-.-. 1. 2 1, 1. ....9. 2 1 2 1 3, ...6. ... 3. ....10. 71. .................1. 2 ........*. ........2 .........*. ............. 2. ............1. .......... .12 1. 1 1.6.30.

PAGE 44

42 TAm, XI.-DISCHARGES AND DEATHS IN THE HOSPITALS OF THE DECEMBR, Employees. Discharges. Deaths. White. White. Diseases. w Black. 0 Black. M. F. M. F. M. F. M. F. M. F. M. F. Malformations. Congenital malformations (stillbirth not included). 1 ..20. Diseases of early infancy. Newborn child. Premature birth. Malnutrition. Other diseases peculiar to early infancy (including various consequences of labor). Old age. Senility. .. Affections produced by external causes. Suicide by poisoning. .1. Suicide by cutting or piercing instruments. ... Poisoning by food. 4. -2 ..2 Other acute poisonings .1. Conflagration. ..1. .. Burns (conflagrations excepted).2. ..... Traumatism ,y firearms. ... Traumatism by cutting or piercing instruments. I .6 .28. Traumatism by fall. 8 .1. 5 .. Traumatism by machines. 1 .1 .6 ..1 Traumatism by other crushings. ....5 ....1 Railroad traumatism .....2 Traumatism by landslides .....1 Injuries by animals. Effects of heat. Lightning .... Electricity (lightning excepted). Fractures (cause not specified).I ... Dislocations. Sprains. .....2 Other external violence. 1. .39.

PAGE 45

43 PANAMA CANAL FOR THE MONTHS OF OCTOBER, NOVEMBER, AND 1918.--Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White Black. Black. White. Black. White Black. A ce CdE -~ ~0 0 C .M. M. F. .M. F. M. M. F. M. F. M. F. M.F.M.F.M. F. 14 4. 5 2 ..147. .35 30 15 14. 1 ....94 1 I.: 1. ..2. ........1 2 ..4. ...2 ....3 .........2 3 .............. .1. 17 .4 .............28 1. ..1. ............3. 1. 1 1. .3 1 1 1 .4 .............11 .7.1. ..81 2. 1 3 1 ..1. ..43. 3 5 4 2 4 1 1 1 9. ....41 3 ...2. .1. 1 2 ..1. .....2 ...2 1 ........U --.........10 ...........1 2-.............2 ....1. ............1. 2 ................. ..1.o.1. N, ...2 ......2. ......1. S. .... .1 1. .2 .2. .12 .....

PAGE 46

44 T~ara X.-DISCHARGES AND DEATHS IN THE HOSPITALSOF MM Employees. Discharges. Deaths. White. White. Diseases. Black. Black. S cc M. F. M. F. M. F. M.F. M. F. 'M. F Il-deflned disease. Cause of death not specified or illdefined. Infections of undetermined origin. 1 .1 2 No disease. .12 1. Feigned disease. Grandtotal. 175 38 54 2 716 12 3 1 2 2 28 t*

PAGE 47

45 PANAMA CANAL FOR THE MONTHS OF OCTOBER, NOVEMBER, AND 1918.-Continued. Nonemployees, Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. White. Black. White Black. 0 H~ E4 M. M. F. M. F. M. M. F. M. F. M. F. M. F.M. F. M. F. I ..1 .2 S ..I I ..I.14 1 18 3 23 6 11 .2 1 .77 1 .1 1. 1109 234 341 217 410 22 9 4 32 34 202 4 31 12 12 .1 3557 153 Em

PAGE 48

46 TABLs XII.-CONSOLIDATED HOSPITAL REPORT. [A.=White Americans; F.=White foreigners; B.=Black.] RemainIng Admitted. Died. Discharged. Oct. 1. A. F. B. A. F. B. A. F. B. A. F. B. Ancon Hospital: Employees. 24 10 129 172 45 804 2 23 171 46 674 Soldiers. 113 ..1,019 .10 .1 006 Panama pay cases. ..i ..1 Other pay patients. 27 24 75 357 226 375 5 10 35 33E 202 35 Charity patients. 3 6 39 65 12 160 .2 10 56 12 168 Total. .1671 40 244 1,613 283 1,340 17 12 68 1,571 260 11201 Corozal Hospital (insane): Employees. 2 2 13 ..2 11 Soldiers. 8. 15 1. Panamapaycases. 3 57213 .7 25 3 9 26 Other pay patients. .5 3 .2 3 .2 4 2 Charity patients. 10 67 .3 6 1 .2 Total. 13 74296 15 121 36 1 3 12 14 6 11 Grand total. 180 114-540 1,628295 13i6 18 15 80 1158 266 1,212 Corozal Farm (cripples): Employees. 9 48 1 11 .3 15 Chronic ward: Charity patients. .26. ..2 Nonresidents: Hospital. 16. .219. 7 ..88 Asylum. .2. 5.3. 3. Colon Hospital: Employees. 3 1 11 44 13 69 4 4 10 52 Soldiers. 16 2 .97 19 12 .7. 72 15 Panama pay cases. .2 7. 2 33 .5 2 25 Other pay patients. 11 5 18 97 89 96 3 5 3 83 60 90 Charity patients. 3 1 .16 3 17.1 1 .4 11 Total. .33 11 36 254 126 215 15 0 12 21 91 178 Palo Seco Leper Asylum: Panama pay cases. .2 42 .3 .2. 2. Charity patients. ...1 28 .3 .I. Total. .3 70 ..6 1 2. Grand total: Employees.*. 29 22 201 216 59 88C 3 27 21t 59 742 Soldiers ..137 2 ..11,131 19 .22 1,09 15 Panama pay cases. 3 61 263 9 62 C.-. .4 31 Other pay patients. .38 34 96 454 31i 474 8 15 4C 42 266 451 Charity patients. .6 18160 81 I2 189 12 7. 16 183 Nonresidents ..711 ..221 ..10 ..191 Total. 213 208 720 1,882 643 1,611 33 31 95 1,804 551 1,407

PAGE 49

47 TABLJ XII.-CONSOLIDATED HOSPITAL REPORT.-Continued. [A.=White Americans; F.=White foreigners; B.=Black.] RemainTransing Average number conferred. December stantly sick. 31. A. F. B A. F. B. A. F. B. Total. Ancon Hospital: Employees. ..11 23 9 225 224.33 105.66 141.85 174.84 Soldiers.13. 103 ..144.36 ..144.36 Panama pay cases. .2 ....75 .75 Other pay patients. 2 6 41 36 50 39.95 32.78 66.63 139.36 Charity patients. .2 7 12 21 14 10.37 2.22 32.82 45.41 Total. 13 4 26 179 47 2891217.11 45.56 242.05 504.72 Corozal Hospital (insane): Employees. ...1 2 14 1.03 2.00 12.60 15.63 S1oldiers. ..9 ...9.87 ..9.87 Panama pay cases. ..1 3 59 222 3.00 57.63 214.35 274.98 Other pay patients. ....3 2 .4.95 2.89 7.84 Charity patients. 13 70. 12.29 68.95 81.24 Total. 1 13 77308 13.90 76.87 298.79 389.56 Grand total. .13 4 27 192 124 597 231.01 122.43 540.84 894.28 Corozal Farm (cripples): Employees. ..7 44 9.35 44.97 54 32 Chronic ward: Charity patients. 1 26 .26.64 26.64 Nonresidents: Hospital.1. .39 ..36.38 36.8 Asylum. ..51 .52.61 .52.61 Cln Hospi tal: Eiiployees. 2; 1 14 1 3 10 3.16 1.15 8.79 13.10 Soldiers. .17 5 .7 1 .9.51 1.31 .10.82 Panama pay cases. .1 8 .1 2 ..37 3.10 3.47 Other pay patients. 13 21 7 9 8 14 8.83 8.66 15.22 32.71 Charity patients. .4 4 1 1.70 .37 .67 2.74 Total. 32 28 33 21 13 27 23.20 11.86 27.78 62.84 Palo Seco Leper Asylum: Panama pay cases. .2 43 .1.00 42.37 43.37 Charity patients. ..31 .80 29.27 30.07 Total. 2 74 .1.80 71.64 73.44 Grand total: Employees. 2 1 25 25 21 293 26.62 23.06 208.21 257.89 Soldiers. 30 5 .119 1 .163.74 1.31 165.05 Panama pay cases. ..1 11 3 62267 3.00 59.00 260.57 322.57 Other pay patients. 13 23 13 50 47 66 48.78 46.39 84.74 179.91 Charity patients. .2 12 16 15 142 12.07 15.68 158.35 186.10 Nonresidents.1. .90 ..88.99 .88.99 Total.45 2 254.21 28 0 61,119.5 1R A.:3 6 542 2.864.61195

PAGE 50

48 TAa XII.-CONSOLIDATED DIBPEN& RY EPORT. EMPLOYEES TiIrATED IN QUARTERS. ReRemainAd DisTransm!aing utted. Died. charged. ferret. Dg Oct. Dec. 1 31. W.! B. W. B W. B B. W. B. W. B. Tota Ancon.1. 261 .246. 8. 8 .561 .561 Balboa. 6 7 393 44 394 24 3 21 2 61,024 1741,198 Pedro Miguel. .51 .48 .3 ...15. 152 Gatun. 2 1 41 25. 24 9 19 17 ..72 122 194 Cristobal. 9 36 326 388 .328 378 .3 7 43 889, 3485,237 Totar. 18 44 1,072 457. 1,0401 411 33 41 17 492,698 4, ,342 Gamboa dispensary discontinued August 1, 1918. ALL CASES TREATED BUT NOT ExcusEw. Employees. Nonemployees. Total. W. B. Total. W. B. Total. W. B. Total. Ancon. 2,184 9,7371 11,921 3,025 4,687 7,712 5,209 14,424 1S,633 Balboa. 12,795 4,859' 17,654 9,871 3,015 12,886 22,666 7,874 30.540 Pedro Miguel. 4,812 6,403 11,215 4,203 4,301 8,504 9,015 10,704 19,719 Gatun. 1,110 1,572 2,682 1,339 1,248 2,587 2,449 2,820 5,269 Cristobal. 4,095 7,559 11,654 3,667 4,043 7,710 7,762 11,60f w,364 Total. .24,996 30,130 55,126, 22,105 17,294 39,399 47,101 47, 9t5B5

PAGE 51

49 TABrn XIV.-OONOLIDATED ADMISSION REPORT. White. Black. Total. Admission to hospitals excluding Corozal farm and chronic ward. 2,524 1,597 4,121 Admission of employees to quarters. 1,072 457 1,529 Total admissions to hospitals and quarters. .3,596 2,054 5,650 Less number of patients transferred between hospitals and f.m quarters to hospitals, whose admissions are duplitated in the above figures. 111 102 213 Net admissions to hospitals and quarters. 3,485 1,952 5,437 EMPLOYEES. Employees admitted to hospitals. 275 886 1,161 Employees admitted to quarters. .1,072 457 1,529 Total admissions of employees. 1,347 1,343 2,690 Less number transferred between hospitals and from quarters to hospitals, whose admissions are duplicated in the above figures.36 66 102 Net admissions of employees. 1,311 1,277 2,588 Annual admission rate per thousand employees to hospitals and quarters. .1,186.16 246.76 412.08 TABLE XV.-NUMBER OF EMPLOYEES CONSTANTLY SICK IN HOSPITALS AND QUARTERS. White. Black. Total. Hospitals: Ancon Hospital .36.02 154.45 190.47 -Colon Hospital. 4.31 8.79 13.10 Total. 40.33 163.24 203.57 Quarters: Ancon ..6.23 .6.23 Balboa. .11.38 1.93 13.31 Pedro M iguel. 1.69 .1.69 Gatun.80 1.36 2.16 Colon. 9.88 48.31 58.08 Total. 29.98 51.56 81.58 Hospitals. Quarters. Total. Average number of employees constantly sick: White. 40.33 29.98 70.31 Black .163.24 51.56 214.80 Total. .203.57 81.54 285.11 Average number of employees constantly sick, per 1,000: W hite. 9.12 6.78 15.90 Black. 7.89 2.50 10.39 Total. 8.10 3.25 11.35

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50 TAimz XVL-AVERAGE NUMBER OF DAYS IN HOSPITAL OR QUARTERS FOR EACH ADMISSION OF SICK EMPLOYEE. White. Black. Total. Hospital: AnconHospital. .12.37 15-79 14.99 Colon Hospital. 6.88 8.60 7.83 Total (average). 11.24 15.15 14.13 Quarters: -' Ancon. .2.30 .2.30 Balboa. 2.62 3.80 2.74 Pedro Miguel.2.92 2.92 Gatun. .1.67 5.88 3.26 Colon. 2.84 17.86 10.92 Total (average). 2.59 15.77 652 TABz XVIL-NUMBER OF DAYS HOSPITAL TREATMENT FURNISHED VARIOUS CLASSES OF PATIENTS. Class. American. Foreign. Black. Total. Ancon Hospital: Panama Canal employees. .2,061 973 13,088 16,122 Army and Navy patients. 13,267 .13,267 Panama government pay patients. 69 69F Other pay patients. 3,675 3,019 6,128 12,822 Charity patients. 952 205 3,023 4,180 Total. 19,955 4.197 22,30P 46,460 Corozal Hospital (insane): Panama Canal employees. 95 184 1,160 1 439 Army and Navy patients. 905 .905 Panama government pay patients. 276 5,302 19,721 25,299 Other pay patients. .424 266 690 Charity patients. .1,130 6,344 7,474 Total. .1,276 7,040 27,491 35,807 Corozal Farm (injured employees): Panama Canal employees. .859 4,137 4,996 Chronic ward: Charity patients. 2,451, Colon Hospital: Panama Canal employees. ....289 107 811 1 ,207 Army and Navy patients. ...875 121 .9.9 Panama government pay patients. .35 285 320 Other pay patients. 814 797 1,403 3,014 Charity patients. 157 35 62 254 # Total.,. .2,135 1;lf95 2,561 5,791 Palo Seco Leper Asylum (lepers): Panama government pay patients. .60 1,290 1,350 Charity patients. 930 930 Total. .60 2,220 2,280

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51 TABz XVIII.-WARD LABORATORY REPORTS. Ancon Colon Santo Hospital. Hospital. Tomas Hospital. Blood examinations (total number). .2,977 317 441 Crescents. 9 Estivoautumnal. 256 37 119 Quartan. 2 .. Tertian. 79 12 Filaria. .9 Differential counts. 61 27 8 Hemoglobin estimates. 919 5 Leucocyte counts. 255 56 20 Red blood counts.20 3 Spirocheta obermeyeri. .2. Stool examinations (total number). 3,077 31 2,151 Ameba. 38 Ascaris lumbricoides. 59 .331 Bilharzia.5. Entameba.2 Balantidiun coli. I .1 Ciliated monads.I. 27 .20 Gusiac tests.37 Pus and blood. 131 Strongyloides. 77 .51 Tinea saginata. .7. Tricocephalus dispar. 205 1 137 Uncinaria (ova). 405 .588 M ucus and pus. .11 Blood .8. 1 4 Urine examinations (total number) .6,798 705 1,725 Albumen. 1,495 115 318 Bile. .7. Gta s. 1,251 Ciliated monads. *.*. ...20 .. Epithelia. ... Guaiac tests.21. Hemin crystals.20. Indican. 301 .. Pus and blood. 1,905 Sugar. 1,340 7 11 Pus. .. Blood 4.4. Acetone. .7 .. Sediment.381. M ucus and pus. .137 Phosphates. .24 Urates. 5 Oxalates. ..2 Cylindroids ...7 Sputum examinations (total number). 2,141 39 234 Positive for tubercle bacilli. 141 1 68

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52 TAaLE XVIIL-WARD LABORATORY REPORTS.-Continued, Santo Ancon Colon Hospital. Hospital. Hospital Smear examinations (total). 350 2 1,014 Urethral.'. 147. Vaginal. 51 Eye. ....1 Spinal fluid. 149 .3 Nasal smears. 14. Smear from foot .. Positive for gonococci. .2 328 Positive for diplococci. Positive for influenza. .. Positive for diphtheria. 9 Positive for B. col. .1 Positive for leprosy. 1 Positive for streptococci. 3 Positive for typhosus. ..5 Positive for pneumococci. .I Surgical tissues. .18 Pathological tissues ...125 Chemical analysis. .5 Wassermann tests. 637 Positive .261 W idaltests. ..12 Blood cultures. .....8 Autogenous vaccines. .2 Throat cultures. -.....18 Positive for B. diphtheria ..10 Autopsies performed., .118 Total. 25,734 1,675 9,387

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53 TAE XIX.-SURGICAL OPERATIONS PERFORMED. Santo Ancon Colon Tomas Hospital. Hospital. Hospital. NumDied. NumDied. Number. ber. ber. Amputations: Leg. 4 .......2 Foot .... Digits, multiple. 2. .1 3 Amputations of thigh ....I Leg, double. .. Operations on bones: Craniectomy, decompressive. .1 .3 1 Laminectomy ....1 1 Ostiectom y. Wiring of fractures, simple. 4 .1. Wiring of fractures, compound ....1 Plating of fractures, compound .1. Anthrotomy of knee ..1. Bone transplantation. .1. Lane plate of femur. .1. Adenectomy: Cervical.3 .3 Axillary. Inguinal, single. 33 .. Inguinal, double.5 6 Fem oral. ...1 Herniotomy: Inguinal, single. 65 1 14 .22 Inguinal, double. 20 .6 .5 Ventral. .1 2 Strangulated. ..3 Gedito-urinary tract: Ureterotomy. .1 C ystotom y. ...1 Urethrotomy,internal.3 ....7 Urethrotomy, external. .9 Prostateomy .1. Varicocele, radical cure. 21 Hydrocele, single, radical cure. 39 7 6 Hydrocele, double. 4. Orchidectomy. .4. Epididymotomy. Amputation of scrotum. .14 Curettage uteri. 2 Perineoplasty. 2 .7 .1 Trachelorrhaphy. .5. Vaginal sections. ... Vaginal punctures .22 Obstetrical: Cesarian section, abdominal. 2 Accouchement, forceps.:. 4 .. Low forceps. 3 2. Version. ...2 Perineorrhaphy. 8 11reech extraction.

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54 TaX XIX.-SURGICAL OPERATIONS PERFORMED-Continued. Santo Ancon Colon Tomas Hospital. Hospital. Hospital. NumDied. NumDied. Number. ber. ber. Thorax: Thoracotomy. 2 .. Rectum: Hemorrhoids, radical cure. 24 .4 .30 Fistula in ano, excision of. 6 .1 General: Thyroidectomy. 5. Nerve stretching. .2. Varicose veins, excision of. 3 .3. Tenorrhaphy. 2. ..1 Excision of surface neoplasms. 9 ... Gunshot wounds of soft parts, operation for. ..2 Stab wounds of soft parts, operation for .1 1. Extensive injuries to soft parts, operation for. .2 Plastic operations for severe injuries. .2. Plastic operations for effects of disease ..8 1. Skin graft. 1 .1 10 For general peritonitis (traumatic or appendicial For tuberculous peritonitis. .I1 For intestinal obstruction. ..1 1 Excision of lower lip. .1. Laparotomy: Exploratory. 3 1 1 2 Gastro-enterostomy. 4 .. Appendectomy. .50 .27 Appendectomy with local peritonitis. 7 .2. Appendectomy with general peritonitis .1 .9 1. Cholecystotomy. I ...3 Abscess of liver, laparo-hepatotomy for 1 1 ..I.1 Splenectomy. ...1 Pan-hysterectom y. ..1 .23 Supravaginal hysterectomy. 13 1 21 .11 Hysteromyomectomy. .. Salpingectomy, single. .2. .9 Salpingectomy, double. ..10 7 Salpingo-oophorectomy. 24 .-21 Ovarian cystectomy. 1. 5. Oophorectomy. .5 13 Suspensio-uteri.9 20 15 For e-topic gestation. ..1. Gunshot wound of abdomen. .1 Stab wounds-of abdomen. .I. Major operations, various other.7. .. Minor operations, various other .364 .24. .120 Arsphenamine. intravenous .1,020 Reduction of humerus. ... Reduction of forearm. 3 Reduction of Pott's fracture .1 Dislocation, elbow .I Dislocati3n, shoulder. I Nailing of fractured femur .1 Open reduction of metacarpal .1 Circumcision. 81. ..43 Total. 1,927 5 269 6 476

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55 TABnz XX.-REPORT OF OPERATIONS, EYE AND EAR DEPARTMENTS. ANCoN HOSPITAL. Operations performed: Adenoidectom y. 51 Cataract extraction. 1 Chalazion excisions. .11 Evisceration. .2 Cautery of turbinates. 1 Ethm oid curettement. I Removal of foreign body, eye. 1 Removal of foreign body, nose. .2 Incision and drainage, peritonsillar abscess. .5 Incision and drainage, furnicle ear. 4 Lacrymal sac, rem oval of .I Lacrymal duct, Bowman's dilation of. 1 Mastoidectomy. .7 Myiasis of eyelid, removal 0. .1 Paracentesis .27 Maxillary sinus, perforation and drainage of ...1 Removal of nasal polyps. 5 Rem oval of nasal spur. 1 Pterygium transplantations. .18 Reduction of compound fracture, nose. 2 Submucous resection. 23 Turbinectomy. 1 Tonsillectomy. 132 U vilectom y ....1 T otal. ...312 R efractions. .414 SANTO TOMAS HOSPITAL. Ear: Furunculosis of canal. 11 Otitis media, acute. 42 Otitis m edia, chronic. 185 Foreign bodies. 7 M astoid operations. .2 Perforation of drum .6 Superative otitis. ..32 Eye: Gonorrheal opthalmia. 9 R enitis. 42 E nucleation ..-. 2 Foreign bodies. .6 C onjunctivitis. .177 Phlyctenular conjunctivitis. I1 Eye exam ination. .24 C orneal ulcer. .53 K eratitis. .62 I ti ...48 H ordeolum .3 C ataract. 260 C halazion .4 Blepharitis. 12 *Operations: Iridectom y. .5 Pterygium.59 D islocation of lens. .9 .K

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56 Nose an throat: : gitis ..,. .....ELI Tonsillitis .62 Tonsillectom y. 23 P laryngitis ..20 Adenoidectom y. 2 Submuous resection of septum .1 Turbinettom y. R hinitis. .28 Hypertrophy of turbinates. 46 Foreign bod ..4 Peritonsillar abscess ..9 Suturing of soft palates. ..1 TABLE XXL-REPORT OF X-RAY DEPARTMENT, ANCON HOSPITAL. Nature of examinations: Arm and forearm .54 C chest ...100 D ental. .67 Elbow ...15 Footanda le. 58 Foreign body. 7 G all bladder. ....12 H and. ..34 H eadi. .2 H ip ...16 Jaw ...12 Kidneys .32 K nee. 24 L egs. 27 L iver. .2 Ribs& ..4 Shoulder. ..19 Sinews. 33 Spine. I Spleen. 2 Stomach .067 Thigh. w. 1g Treatments.30 Wrist .24 Total ...674 CLASSIFICATION OF PLATES USED. 6by 8j. .290 8 by 10.;. 56& 10 by 12 .382 14 by 17. ..374 X-ray flms,8by10. .50 Dental films. .225 Total .1893

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57 TABLE XXI.-SANTO TOMAS HOSPITAL. PATIENTS TREATED. RemainAdmitDisRemainClass. ing ted. Died. charged. ing Oct. 1. Dec. 31. Pay cases. 22 236 6 223 29 Charity cases. .504 2,086 211 1,906 473 Total. 526 2,322 217 2,129 502 American. Other nations. Number Class. treated. White. Black. White. Black. Pay cases. 305 2 .94 209 Charity cases. 3,473 12 .258 3,203 Total. 3,778 14 .352 3,412 Number of days relief furnished patients. 43,479 Average number of patients constantly sick. 472 Average number of days treatment for each patient admitted. 11 Cost of subsistence per patient, per day. 0.42 DISPENSARY REPORT. Class. White. Black. Total Natives treated. 45 4,759 4,804 Foreigners treated. 88 1,362 1,450 Total. 133 6,121 6,254 DISEASES TREATED. General diseases: Malaria. .140 Smallpox. 5 M easles. 1 Diphtheria and croup. 11 Influenza. .62 Dysentery. 9 Leprosy. ..1 Erysipelas. ..4 Other epidemic diseases. 7 Purulent infection and septicemia. 20 Tuberculosis of the lungs. 25 P ott's disease. ...I Tuberculosis of other organs. 2 Syphilis. .88 Soft chancre. .7 Gonococcus infection .181 Cancer and other malignant tumors of the buccal cavity. I Cancer and other malignant tumors of the female genital organs. 3 Cancer and other malignant tumors of the skin. 1 Other tumors. ...5 Acute articular rheumatism .6 Scurvy ....I Anem ia, chlorosis. 8 Alcoholism-acute or chronic. .26

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5&A DmAsEs TRzmAN.-Continued. Nervous diseases: Locom otorataxia. I Other diseases of the spinal cord. ..2 Other forms of mental alienation. .13 Epilepsy ...6 Convulsions of infants .t Hysteria*. 3 Neuralgiaandneuritis. 8 Other diseases of the nervous system. 5 Other diseases of the eyes and their annexa. 40 Diseases of the ears. 4 CirculatoryOrgani diseases of the heart. 11 Diseases of the arteries. 8 Diseases of the veins. 29 Diseases of the lymphatic system. .23 Other diseases of the circulatory system. 3 Respiratory: Chronic bronchitis. 23 Broncho-pneumonia. J Pneum onia. ..40 Pleurisy. 9 A sthm a. ..3 Digestive: Diseases of the teeth and gums. 3 Diseases of the pharynx. 34 Ulcer of the stomach. 2 Other diseases of the stomach. 2 Diarrhea and enteritis. 3 Diarrhea and enteritis --2 years and over. .18 Ankylostomiasis. ...129 Intestinal parasites. .22 Appendicitis and typhlitis. 27 Hernias, intestinal obstructions. .37 Diseases of the anus and fecal fistula. 8 Other diseases of the intestines. .10 Cirrhosis of the liver. I Other diseases of the liver. 11 Nonvenereal: Acute nephritis. 5 Bright's disease .33 Other diseases of the kidneys and annexa. .1 Diseases of the bladder. 4 Diseases of the urethra. 14 Nonvenereal diseases of the male genital organs. .22 Uterine hemorrhage. 4 Uterine tumor. ..5 Metritis. 5 Other diseases of the uterus. 32 Cysts and tumors of the ovary. 3 Salpingitis and other diseases of the female genital organs. 33 Nonvenereal diseases of the breast. 4 Puerneral state: Normal labor. .260 Accidents of pregnancy. 45 Puerperal hemorrhage. 1 Skin etc: G angrene. 2 Furuncle. I Acute abscess. 26 Trichophytosis. .1 Scabies. 8 Other diseases of the skin and annexa. 104 Bones: Diseases of the bones. 4 Diseases of the joints. .16 Amputations. 3 Congenital malformation. 12

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59 DisEAsEs TREATED-Continued Early infancy: Nursli g discharge from hospital without disease. .250 Lack of care. I Affections, external causes: Sensibility. .5 Venomous bites and stings. 2 Other acute poisonings. 5 B urns. ..5 Traumatism by cutting or piercing instruments. 21 Excessive cold. ...2 Dislocations. 2 Fractures. 9 Other external violence. 21 Ill-defined: Diseases not specified or ill-defined. 8 N o disease. ..23 2,129 Deaths, patients ..217 Remaining. for next month. 1,432 T otal. ....3,778 TABLE XXIII.-COROZAL HOSPITAL-STATEMENT OF COMMITMENTS, DISCHARGES, AND DEATHS. COMMITMENTS. Male. Female. N From Canal Zone: First adm ission. 23 6 Second admission .2 Seventh admission From Panama Government: First adm ission. 17 10 Third admission.,. 1 1 T otals.44 17 DISCHARGES. Well. Improved. Unimproved. Male. Female. Male. Female. Male. Female. Antigua. ...1 Barbados. ... China. ..21. Colombia. .3 ..1. England. .1. Italy ... Jam aica ...1 2 Japan.1 .. Martinique. ..1 1. Panama. ... Peru. .1. Porto Rico. .2. United States. .2 .17 .2. Totals. 4 .18 5 4. .Deported to United States; 2 deported to China. A N

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60 DRA THS. Medical diagnosis. Mental diagnosis Male. Female. Pulmonary tuberculosis. Dementia precox. 4 1 Tuberculosis of the lungs. Imbecility General paresis. General paresis. Tuberculosis of the lungs .Cerebral syphilis .2 Broncho pneumonia. .Dementia precox .1. I Nephritis--Military tuberculosis. Imbecility. I Tuberculosis-peritonitis. .Psyshosis associated with epilepsyi a i e i. Syphilis-arteriosclerosis .Toxic psychosis-pellagra. ..I Pellagra ..Toxic psychosis-pellagra. ..1 Paresis. .Tertiary syphilis. .t Diffuse nephritis .Dementia precox.I Cerebral syphilis. Cerebral syphilis. Chronic interstitial nephritis. Psychosis associated with arteriosclerosis. .1. Epilepsy. Imbecility, with epilepsy. .1 Total. ..10 6 T&BLR XXIV.-CONTAGIOUS AND INFECTIOUS DISEASES REPORTED. PanaColon. Canal Nonma. Zone. -esident. Total. Beriberi. 2 ...2 Chickenpox. 15 4 8 .27 Diphtheria. .10 3 5 .18 Dysentery. 122 .14 Gonococcus infection. 68 1 126 3 198 Hookworm disease.1 ...I Influenza. 353 2 175 .530 Leprosy.3 1. 4 M alaria. 92 34 367 156 579 M easles. .1 3 3 .7 Meningitis. 4 2 4 .10 Mumps. 4 6 Pneumonia. .22 7 28 6 63 Relapsing fever. I ...I Sm allpox ....91 1 4 .96 Syphilis. .80 ..G7 .-. .147 Tuberculosis. 107 25 7 .139 Typkoid fever. 3 1 4 .8 Whooping cough. 7 7 9 .23

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61 TABt XXV.-REPORT OF ROUTINE SANITARY WORK PERFORMED IN THE CANAL ZONE AND THE CITIES OF PANAMA AND COLON. Canal Panama. Colon.t Zone. Linear yards of new ditches constructed.1,655 Linear yards of ditches maintained. .205,920 784,293 14,950 A-res of vegetation removed. 933 175 27 Number of garbage cans emptied ..14,045 .261,089 Cubic yards of garbage removed. ..28,688 Square yar ds of streets cleaned. .1,800,000 25,288,026 Square yards of alleys cleaned. ..1,963 170 Pit closets inspected during quarter. .721 Closets disinfected during quarter. 660 Number of water containers treated. 31 15,961 259,612 Number of mosquito breeding places destroyed. .80 886 359 Mosquitoes destroyed in dwellings: Anopheles. 8,591 .6,230 stegomyra.28. Culex. ..18,772 .4,772 Number of fly-breeding places destr oyed. .6 569 148 Number of rats destroyed. ..5,278 2,284 1,574 Private properties cleaned. .345 3,411 Number of notices served to abate nuisances. .84 1,198 2,662 Convictions for violation of sanitary code. .178 11ouscs disinfected or fumigated. 214 116 Square ya' ds of pools oiled. 1,310 37,655 511,653 Buildmgs inspected. .1,348 23,392 30,418 Buildings, construction and repair: Plans for new buildings approved. .1 6 Permits issued to repair old buildings. ..144 152 Buildings condemned. ..1 6 Food inspection: Dairies, milk venders, etc. ...238 21 Bakeries, ice cream parlors, etc. .149 306 Bottling woi ks, saloons, etc. 44 299 Hotels, clubs, restaurants. 39 451 713 Markets, fruit stands, miscellaneous .371 .2614 Material used during quarter: Crude oil .gallons. 10,765 5,186 257,080 Larvacide.gallons 578 60& 483 Kerosene.gallons. 767 463. Hide and skin disinfections and cattle and swine inspections: Number of hides disinfected. ,418. Number of skins disinfected. .6,300. Cattle and hogs inspected for Zone quarantine: Cattle (private owners .1,889. Hogs (private owners) .597 Includes Cristobal and Mount Hope, Canal Zone. Vk

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62 1 ABLE XXVI.-CONSOLIDATED REPORT OF QUARANTINE TRANSACTIONS AT THE PORTS OF BALBOA-PANAMA AND COLON-CRISTOBAL FOR THE THREE MONTHS' PERIOD ENDING DECEMBER 31, 1918. Vessels inspected and passed. 68D Vesselsheldinquarantine ..23 Vessels inspected and transition Canal in quarantine. .32 Vessels passed on medical officer's certificate. .12 Total vessels entered. 747 Supplemental inspections of detained vessels. 12 Supplemental inspections of vessels at docks. 275 Vessels fumigated on arrival. 47 Vessels fumigated prior to departure. 5 Bills of health issued. 374 Bills of health viseed. 487 Crew inspected on arrival. 33,788 Passengers inspected on arrival. 10,162 Total persons inspected on arrival. ..43,950 Crew passed on medical officer's certificate. 10,202 Supplemental inspection of passengers and crew. 3,444 Persons vaccinated in port on arrival. 620 Persons vaccinated in port of departure or en route. 1,874 Total persons vaccinated. 2,494 Persons detained at quarantine stations to complete period of incubation of yellow fever and bubonic plague. 568 Persons held in quarantine on board vessels. .3,784 Total persons detained in quarantine. .4,352 Passengers arriving: First class. 1,641 Other than first class. 1,302 Totalarriving. 2,943 Passengers arriving in small launches and sailing craft (from coast towns). 393 Passengers in transit passing through the Canal. ..6,962 Passengers in transit for Pacific ports not passing through Canal on arriving vessels. 454 Passengers in transit for Atlantic ports. 642 Number of immigrants rejected and deported. 182 BOCAs DEL ToRo. Vessels inspected and passed. 77 Crew inspected and passed. .1 407 Passengers inspected and passed. 605 Passengers, transit, inspected and passed. 439 Persons vaccinated on coastwise vessels.19

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