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:
January 1919
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 )

Downloads

This item has the following downloads:


Full Text
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Litle anal Zenes ........
t- ciity of Panama....
i:c eity of Colon......
0.ij" Canal Zone.. .


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'ha., deaths, and nonefFective rates for employees........ .....
it employees by eaune, color, age, and length of residence on Isthmus
"a of presidents of the. cities of Panama, Colon, and the Canal Zone...
tils.#of eivil population (employees and rnmemp!oyees), by cause, sex,


g.:Dige, and place of residence.......
cti,:- of nonresidents.. .......... ..
IWIut by nationality or, nativity........
Shcs re American employees and their
:il and. bfrth rates in the Canal Zone
n, ... ..
ft.northility rate.in the Canal Zone


fam ilies ......-..... ..
and the cities of Panama and
.and the ci*iesof Panama and*
and the cities of Panama and


rqU.J .. ,. ... ,'.. ,', ,. ,'., .'i .
h. of infants by cause, sex, color, ge, and place of residence........
i.lassified by birthplace Of .parents. ..-......, .-...........
ira .-s and deaths in the hospitals of The Panma Canal,, by. cause,


-.'a:' .. .t. .- ,. -. .
date d ho..p.. rep........ .. ... ... .. .......... ..... .,.
'iil*idated dispensary report .,. i ........ .....,....
ml tiat< a"dmi"sioi .report, hospitals and quiarters. .r ....
h.e.. of employees con~stanly sick in hospitals and qures....
ze: tllu i&oif daiy in hopital or quarters for each admission of
i" i ( "- i. ti. ia *_ U *i I
fIF .d.yu hospital treatment i.trnished varins clam eof. patie
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..** *'" : .* ** .- ** **
cin ear departments.; ..,. .:.


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THE


.PAAN AMA


CANAL.


.HEALuR DEPART NT,I ,
Balboa Heights, April 29, 1919


Panama Canal
Panama Canal)


Heights, C. Z.


:ihe.honor to submit the following report of the opera-
lealth Department for the quarter January, February.


McCormack, Chief Health Officer,


23, 1919, by War Department


tia,'; Superintende
Je Health Officer, pen
ippintedd Chief Healt
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SE-yr-'.'" : V <* % -


nt of AI
ding the
h Officer,


Respectfully,


orders, and


Maj.


ncon Hospital, was made
arrival of.the undersigned,
effective March 31, 1919.


SC. FISHR, i
Chief Helth Officer.


IONNELt.


a> s -4. ..


...p have occurred in the organization o the dleiart-


the quarter. When the Superifateddtent of Ancon
Sde Acting Chief Health Officer, Jantuary 24, 1919, the
medical Ctinic, IDr. IR... C. Contoar, was made Acting


iSMloairoe,
I S*'*. : .
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sha


and the


Assistant
. .-*


was. designated


Chi


ef of .th


Acting


Chie


Medical Climct
f 'of theMedic


ye.beena :Aftlaws
Y7 aw EiarClnic :Was: fijreliev


e. and Ear Clinic,,was relevi
s ritk lrf I oChief an itaity Insp
.E Q cer's &de$ :directi n a
to' uly with tl
.,iRC., C*iW f X.ir.-
.|r|.- .'.d;M. .; C p.. ,.W -


:. Ca"t G.G. M rshall,. M.i C.
1. .


Erit
~cto

f"Lj


y Lieut.A. F. Ryan,
ir was vaaited by tie
D. P. Cu.f ".
Eye and RaBChI;
nin4, was iet f ,by .
SMc- W.


a a
&:LYLY.


H-


was relieved


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rauwatuwP ien um'sa;, ptnese,., U were irom asease,
.**eae alone; .as -compared with a rate of
r. 4thze months and 5."4 far t-he corresponding
.... iH .
.. ':'.." : :
Shfitighest .admission rates to hospi tls, in the
i..... .mp tance, were (1) malaria, (2) .venereal
:, diseasess of tbeyyes and their annexa, and
.. o the, heart. These .five diseases. caused 28 per
... i... '.
to hospitals, malaria alone causing 12 p cent.
*xeae' S8per cent of total admissions. .
rate fr malari, hospitals and quarters., for the
a. .gMarch 31,--was 35,36., as compared with a rate
Si.receding three months, and 16.79 for the corre-
the of last year. The. constantly noaeffective
for the .quarter year ending- March 31, was 520,
.4 *. .. ." -," a a : l !
.. a rate of:.08 for the preceding three months and
...r' spending three.months of last year,1
.d dsease only, the. admission rate to hospitals and
*fr wite employees were 227.60 and ft88, respectively,
$h22.Os .and 4. 52 for the precedi.ng three .moatbe and
Srf- the-corresp.onding three months of'last year.. For
fordisease only, the admission rate. to hospital
iatbwere 185.92 and 7:20, respectively, as compared
'F y8O for- the preceding three months and 4
e orrebpoiding thrree monthsof last year..
'4itliyeaFective rates were 16 for whites and 16.90
i :.* .... ,p-*. *. .." ." .
: iii. .*" .. ..*.** .*
'''...:* ..__a l *a w a =? .7
H~6if nt0 eto hospitals and quarter f.o malariata 15?2
52 for colored employees, as compared with 9.92
.. t:O for colored. employees for -the preceding three.
49for white and 23.6.7 for colored emptirioye:sfor the
hc itintb di last year.
"... ..... ..' .. ..*y *.


CAi!iA


ZONE.
*4


'. based. ...
on f ;the Canal Zone,. based an thpcli
.. .. ...- L __. "
2030, 191is "70' .iFrmnt tThis.popiua-
btrig,..th .I wnnths' peiod ea ln
..g l : .. g .I .": .
rwer fom deas, g..z 7
.... .... Ir. .znn .di ii th h .. ..
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..and lobar).

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SOxtober-
December,
1918.


Janoarjy-
Math1.
1919.


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occurred


amar


-mor:ality rate,


rths reported,


DIVISION
# *


ZONE


Its


we


1919


re reported during the
, giving a rate of 28.68.


ng children under 1 year of age,.
based ,on the .num ner of births re-:


9 per cent were,stillbirths.


SANITATION.


SANITATION.


cItivities.in Zone sanitation, consisting largely of anti-
'k, have been vigorously pursued during the quarter.
tile and stone drains have been installed in-the Pedro


.district, on the east side of the Pedro M igyel rier
n. the hillsides east of the main line. of the Panama


ar iso. 'This work has been: almost entirely withinn
f the ..Cattle Industry, and has had.for its .object
of anopheles breeding areas which were being punched
tei:. The edges of the lakes about 'Pedro .Mijgaeland
re:: cle red: and cleaned .on. account of the anopheles


Sh. was found at these places; for some reason,; which was
yiderstood, these areas had not given mucK trouble until
Shad bieen.. found in a few isolated:areas, but n n so.
-a.'!.'& = "" ,, .. a" ", ..d;


4d as' during this quarter.. :At Areseit ths is
and grass hitting g .bot 'waterline.. .: -
-ozal district 'qnsiderable anamount of w work
sistinig 'of,:'straing tenie tihe stran- wch. ruis
,gadci:iits course bveen t new road. and.
i .. *r- :: i. : : "


I 1:cn~krt n~nivv.a uf~.~n. .


:and eighty-seven birtd
'ernod ending March 31,


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tena. ces.n.tu ..r., tc.-pt :fstraig
roek Led strea" ms in" "the old draf
-.. :* *-.. ...


a- -


type, for


-ectg gta


raner axtente-sy em rains nas- DC@e
ablyimprCved thfs Iarge switrp and wh. d
anopheles Hfight into Gatun.. .. .
'^L^. ** i .. i .


In ad&tion to the .above considerable tinke-hh
r


Division of Zone Sanitation in prophylactic .wo
The villages of Arraija, Escobal, Newrovidea
El Vigia (all points of ready access to the Qani
in spected :anid. about 1,000 p Icpee vaccinated..
S


smallpox
EscobaML


The


ft


quarter by locality and





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r


ees on


wuith e
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:' : t::
*r H..i


employ


Fronm-


Regularly eaitated.dis-
tiact m i onea..
lfte Aador, .,....
AI1con. ..... ..

Pedro .Migue.....
m; ** -:.*


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SGatn..
Viigwhm .


Tot...a ..


S* ..


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.From paatti* c
and$ianutabns:


*Carftao. ....
Cauidenase. ..


*aff


. ..


Miflores:... ..

' \Birn .-. i ., .1
Staiiiznit; a .....


, ,. ?


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nt!--i


lILA.


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-1tu


Tertian.


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At


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mimed.


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were found in any of- these places' i
where 14 cases of mild smalpox .weri
illowin .is a tabtlation of7 the malat


Number 'of employees admitted


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S,,ows',,,, thae pricpal source. of, infectia as
...itgil.r sanitated areas. The incidence within the
HSjwfas Ti8.-6 per cent -of the cases reported, with 8L4
:::.L-.: r s. "
Boetuesrfortedh corning from jungle camps or other points
i t g arly anitated areas.
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PAISAMA


HEALTH .OFFICE.


J" .
smallpox reported in the city was bn March 11
total of 37 cases during .this quarter, as compared
the two preceding quarters. All cases were sent


c .. .. ...:* % .
itq rt" 1,316 vaccinations have been made in the
ir house-to-house vaccination is being done; This
t*lble:in that it will, as time goes by,. result in complete
I..f b persons in the city, thereby preventing a recurrence
it'sbreak as that of last summer.
.i.ria rian attached to this office is in every way qualified
kidikk and dairy inspection work, but his time is very muchh
-lth.ineant and cattle inspection, and it will not be possible
S.rhemeat and cattle inspection work or the dairyr and food
H ork, to be done properly. The need of another veterina-


l.td inspection has been turned over temporarily to the dis-
i. inspectors ,I
f6 00 yards of ditches were cleaned in preparation for
lson. A large portion of this work was in the Savanas
mfrre much ditching has been done,. many water holes
*f :t. portion which we have sanitated can be easily con.
li it.-er.
:fioa with the question of sanitation of the Savanas- dis-.
Siehe survey of this .district is necessary in pir:a
b thoroughly sanitated; this should be done on acc ai t
h ber..of people who live there during aboat eei
1$ e '- 'This district is responsible for a large nuber
sieB caa -be easily eliminated in the future. ,
6t manyv ditches, and filled a large amber Wo
.e. that o water holes are left; this policy lis
iseale... tand although our reports show that aing
;L~ rlCmat mcL~frLll: 4-nrwnn




11111

















.. .. ..
i$et a'ndae.at;:fo products at Crjitobal has been
.. .. ...... .i .A. I H. 1H )." T ** *
fl.. usual manner. It was thought advisable to make
m..'"i"specti of aL vieta and.this has necessi-

|? the ,veterinary staff. The post-mortem minspec-
siaerg liaas not been done here according to the Bureau
Epdustry regulations, but with the. increase in the staff

oa' will 'be more thorough than that required by these


r I
prophylactic
enti ued on
t:Colon duri
mnins about


station .which was
January 1I5, 1919. -
ug the -campaign.
the same as it did


established in June,.
About 100 registered
With this exception,
before the campaign


health .nurse of this office made visits as follows:
to.S.: patients, 13; home service instruction, 783; hos-

.56. .business, 56.; She had a total.of 159 patients undir
i:tKheir homes.
itres were imposed as follows: Pertusis, 28; measles, 6;
.I.ckpo.px. diphtheria, 7 sniallpox, 1 -

ary. 18, 1I lectures have. been given by the .publie
S7tQ -the midwives of Colon and -Cristobal, the time of
veng two hours. .. .....
filmnes -were imposed daring this quarter for violation of
.'4ifr af id Regulations.
.-..,,, .. /


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1,365s



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121J


257 43
, 64 203

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PnOPDETOTMATS NUuMBERS.


Tfl u.rter. 1919:
ite., ......



lutai-..... .-, .

agrth qae 1918:

Colo red,..., .
.. .. ,


,tAI. ..


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- I ,JIB.. ..'


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1L~wtsI~


241L2S
2I5~S4
.


3l7..60
185.82


22 1-81s 13 .1


25~6

146.0

1*64.9


4,573
2.1,663:


26,2361
=41


20. 712

- .
2&.1A22


HJ '11


365.19
14053
m *


* rn II**a.


227.08
128.48


14,


11-es
29.88


28..52


23.52
18.5.

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8..32
8.82


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7.20


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23,82n


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'Iyphid fvpr.*.. ..,.-.,.,.... .*
M l'ia .ll: .'-.- .,---. .-.-.-.-., .-.
]Malriat vereo
S*r!Estivoautumnal ...........-........
~ Tertian.L. ..... 1

Whooping cough.....................,.
Diphtheria and eroup.-.....-..... o -


Purilent infection and septicemia......
apticenia.... .. .. '.. ... :
PeSara....,- :.-.;......-.......--
PTugrculos of the long. ...... ....... *
Aciu niliary tuhberiuois. ...,. ,.... -
Tulereuloius. men la ti. ............I
Abdominal tibercolosis.. :; ;..... ;.....
White sweling..... .. ..... ...... .
Diasseinated tuberculois..............
Syphilis:.'1 .
STertiaOIBy.............. ......
.. -*Period **ot sta 9- .., a
(onocoeou infection.......... ,...... ..
O saiesr-uld- othenialiguant -tumnors-otL j
the stomach and liver....... .....*.,,..
Cancer and other malignant tumors of
the female genital. organs...4. .......
SCancer and other malignant tumor of
the breast.... ,. ..-. .. .
Cancer another malignant tmnors. of
.other organ au4 oforgans not spe'cifed
Other tumors (tumors o the female gen-
ital organs excepted) .. ..., ..-.......
Diab!etes.. .. ............. ..
SLefemif.. '...... ..
Inedmie, lymphatic .:......,.. ...

Diseases of Me rm1ws aisles and of
.i ? -.
j jge o7ga of sieiial, ma


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Cerebro i fevr. .. -.....,.... 1 a- .
Suaiajde.mennga..... ... -. .. .... 2.j 2


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s ricoele. o.... r.....rator s .....

Diseases of tie respTiralry system.


Acute bronchities..... .
Chronic bronchitis .....
Bronach-pneumonia....
aeumania, unqualified.
Lobar pneumonia... ...


..


* .
* .. ... .


Gangrene of. the lungs....-. .....

Diseases of Lhe digesti qsteu.

Diarra and entetis (under 2 years)..
-( itis.,.;.....i .. .-. ..".. .....,.,
Diarrhea andentis (2 yiers and over)
i olitis.:...... ....,......... "......
.An lotomiasa -.. ...... ........;...

.Acute appendieitib.... .................
HerniaS;intatinat obstrucfao .. .......
Intetimal obstrubtions...............
'Eirrhoeis of the lver.. .*....... ....
. Biliary ealculi...... :.........-...../:...
Abcess of the :lier entamphie.....,,.
S. MAtJo.ecystitns. ...*.. ... ....-- *......
simplee .peritozitip (nonpuaerperal)......

N mnwnral diseap of the genito-urinary
1 system and una.e.


SAeaute ,.phritis.................,.....
S.Bright's disease (chronic iphritis)", ....
-OtheraSdeases of the kidneysandannea...


lo-. .... .,;,... ...,
'Salingiis and other dies.ses of the .e-
mal. 3e6ital oIi_~n .. a .. .. ... ..


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Diseases of early infecg.


. -.


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Congenil debility, icterus, and tleremal
Premature birth,. ................-
ongenital debilit. ..................
Malnutrition .. ....................
Other cause peedliar to early infancy
(inmludin various consequence of
labor);: :,...-..,.......* .. .......


Old'e.


*a* aI


Affections produced by external
': causes.


the adte poiouing.. ...


Burns (enflagration excepted).


Amiden tl, drowning........ .....
Trmat~ismuby cutting or piercing m-
i tmnent... .....................
Tramnatiamby fall:........ .........
Trtmauitism by macines.-.........: ...
Traumatainm by other crshings, (vehi-
- elm railroads, landslides, -etc.).......
tiarvation...... :.......,..... .,...


osmiidde by cutting or picngiinstra-


if mnta.. *. *. a.-


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a S a *


baqtureu (caune not specied)
Other external violence ......


IhdeleMd dinses.


Sase of death not speifed orill-defimed.
VJ eAlitiof indetermined ,ign... i..


- ......


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s t e Byier sp pp i I ..l 1 ..m 4 a mp 4 m. 1,
. .i a-*u -, a -
*. a ." a a a a .e
. aetr tio amidmtal ..............

Cirrhosis of the liver ....... .. .

Chronlil nepritts..;. ..am.- m
SBarnch -pneumonia ..,.. .......... S.., *


a aria.s... a ;. a... 4. .. m-. ..:.
Diarrhea and esteritis. e.....a...a ,...,
Pahnoiry tuberculosis. ..,.....,.....,


-. g"


w- a W p a-.


Other diseases of the kidney and numen......... a:
Congenital malformation. .. .. .. ............ .
Conge. ita debilitya. ... ......... .............


cute. appendiPitsC ... ... .... ... .......
Tij.ury aby anits.i. ...... .. .... ....... .......
Accidental drowni.. ... .. .... .........
BurnaB (onflagaton exceited)..... ....,.....
Oteri expterna iolenei... -........... ,... ..a.,
SInfetions, undetermined origin............. ....
ranat fall... .. ... a *.. .. .....

omancie by eans...... ............


ST tal....*.................. a.... ....
*


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Yellow fever.. ....,,...,..


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" I .)
". .. .. ". '

AISTICS BE- AMERICAN EMPLOYEES AND


rawF~


R FA2ULIUE;


"*..::i .:



Mr. "


Annual
death rate
per 1,000
< population.


lbfrm the United States:

I... a .: .. .. ..a .
. a *, *.., .a aa.., *......a*


* a *. ., p .- i a a.


* *H.. ** :* .
:E" Ei


. i i a aiel s i *. .. .a P 4 i .dl *ai


n childr~Men from the United States:
v i


B .. '* ; r -
uSe... a a .. .
- -I--!. --- *


Ple.ess from the United.Btstes and their famies:


pa *a**um ..dU.................... ... ...


* ~. **.4*& Ma. **aasa**
h:I


.a* ..s a a****-. .. aaa .-. ... ****


- -


.12,
-o


canochildren born on I.thmus for three months ending March 31. ..
l aA~ meria an children under 1 year of ae.... -......- ..... ..,

.:,* rate among. American children (number of death per 1,000 irths)....
.H*.. .: *1
: .. .":"::* : *
i .i H I iF .* *
::: ;.... ..:: p : : *, *
i ".... .. : *
..... *** : -
yix'." .. ." ..
;S "S^g : ,' .
**".. *. .
C .....a .* "
.: .*
j. i *. .. ..
. i. *:... .*:

'.|... .. .
:: .*.... ::: .

M :l !:.: ...
* .:* ::* *

* '. *
I .. .... -.
".. .
n.. .*.... ... .
n II *.. *. .
:L. ... .
....: :.".
:::-==.- :E .".
-- I *3-
*:l.: **" : ^

H *: i *** .
':H" i .. *
":E:=E .


bsi: S.I
iil*!HHE .. ..
I Hi: .

I .. .
-.'
.. t


it


.1
Iv.-:


. 0


-;
















* C


aW-airBs


Htl
Em %*:
d cC


- .. H Eli
.1i i


Sr hhqu.artr,, 1919:.
Panams.... ...s. -
"S I m .. i .. m..-..
SCanal Zoje.........


i IL .****-


. m 0


gftgifi inart 1018:
.alon.. ........-..

ianal Zon.-... -....


Total.,.......

tpqajjru tSI...
Panama E.. ..,
.*on .
f~aenrsswim....mqe


*aIs


Total.


P -
Po~pula-~
tion.


26,078

2a1,707

'109 I54
KS~. "

IW~lg


26,07&
*21,707

109,154


111,485


Births.~


Total


231


1,00ft


1.037


860
C


,1.,024


~~a.


U,
a~t


.* : ""

...-

'* :..."


". .*'. :
* .


. *... "'*.: *
E
I.rt


" pf


assifl.

"S~t.
,2'1*
-w9.1


nflbal

U a~


__ __ I_ __ _


Ius


27.-fl~
* -rat


37.21


- "
I H* 7


I ::.


I....


Ezluvve f military population.


.IH.J
t;:iE
H.Ht .Hn r
: HH


. *, "
: *** .:: s


-. .~i"
* *~E.H.... *,



E ..N ;fl


--


.1
4


S: r ,.


-I


i


i ~pO~i~~b7~


I;r


,~I~ILICI





u~l~~























::k..

rHe.



S.
*


t~ii ten



.3ai S *!L r
..I' .


b;. ..: .t .
. ,* ,


H.x
t w h a d L:
rr..- S r
..t .
at*S
Ai:ii~t

*4'.. :


pi ..ast Kf .4
AND ,OOZQI.


L ZONE ANDf TECITI.S


I A


i ..C,


- A


Sa .


m. a. p s e ,.
S .I a aI *I

l .. -
*i .e a sa


~Poptrd-


'61,369
'36,078
*21,707

109,154


61,3139
.2 ,0758
24,707

ionaMli


* 3614M
28,078
"MB,I38


111I1485S


Births


Mdal.


282
906
70


426-


II




3as s'


male.


S412


292

101

48S
* *

a aLS


Ml11
8G
86


~t~a


C
AOM-~


I'
025
184
157
%~


Deaths

dhltdren
under 1
year of


Tit~


33


fitz~
raperi
1110Wl
births.


rn-a;J~
'"Sid~


IlS


-tub~
INs E


' 16*3


- :s


Ins~


'RIP:


e of mUilitala pqpubatp.


ii ii :::- -:- : .


-EE:." :':'. .... : "
,: : ... ...
i...:* ..... ..:

... .
.::...:
S...::.. ..
.. ..*..*... .*X ... ....
I I....i. *.. *

.: .:.. ... i .
".. .: .. ,, *.
' *i'.... ih X i'. ": .
.H H.i" ... *..
. ..i* .H"
.* .::" :::*:" : ..
*:.::..:: .


*::. :.::. ..* *
H. :, .
:. *.. .. *.
S *V .. ..** .. ..
:...... ..* ".






I : :::".il E..'= :: .,_. : ,, "", ....;





I


















I


BLE
B ^!:


* .11


-DX2~T
:i j i


'. h


,
mm


.c.


: S.


I C..


m*


SCasuse of death.
Si l .* .


*s a


ag II: 1 IIas1 1 11;I I


Malaria fever, estivoautumnal
. Syphilis.........'. ... .. .-. .
Simple.meningitis. ... ... ...
SA.ute bronchitis..... ..........
Shrnfic bronc s...........
Broncho pnernmonia ......,


*ILobat r pneumonia ... .
Diarrhea and enteritis....
Colitis. '. .. .'... .
Biliary calculi..:.. .....


l .


. S *. *.* i S *


*I S *;


. b~ s S. *. S *'C *.. *
... ... .... .. .. .
S S C S S Sr. ***S***.


S i.. i S .


. i


S .. .. C. S *.. *.*.a


. a I *i s


Acute nephritiss ,.... ...... ..... ... ..
Other diseases of the kidney and annexa ...
Septicemiea. ....... ... -. .. .. .....
kCongenital malformations.............. ...
SNewborn child.,....:, ................. ...
Congenital debility, icterus, and sclerema.....
,- Irexatre ebirtl.. .................. ,. .
ongeniitsl debity,........; ......... .....
Malkutrition... ... ,.... .. .. ... .
lOther causes peculiar to early infancy. ..... .
Other acute poisonings ......... ...........
Burns (conflagration excepted). ...........
Cause of death biot specified .or ill-defined ...


JInfections:of undetermined origin

: T otal......... ........ ..


*4~55~l**


S. .*. .

*. S ..*-


S.....* .


S. bt... *


S... *...


S. **


* *~ ** *S** *** 5


-~~ IC *'* cr


.a:



-
'..
* **I.'
a.,. ~;~4w
.1'**.* :


-i

U..?.ii

ir

I' .14r
... i'
.1..




I

* t..dt''I
*.I .: rlM i
* .. ~:1:.
;hif




I''


.*H.



.I.

.....:':V ..
*iz


nfarit mortality'rate, based on the number of births reported for the,
Percentage of'deaths under 1 year of age to total deaths) for 3 mo


: ,C':
.11
.1 *)gr.


S* .. ...........
i I ....... .. .. ...:..'s:...: .:i
: '*i i .f:
-.. .:.
.*.. .."* V..

S. ** .
*. :. *. ** -* Wg *, '
., :-*...' :'s .:; .

.. ... ;II : ,
S : .*. 5 .
i : ." "* .* *.*

?~~a :. '.:! ::.ai.*. ..*::


. ,:: *,


".....: ..." ?
. .
' *, :


Mal~iyt


,' .* ." .


.a S S S S S S S <. S -. .


s. .S.. S ., S S ... A .
~ ~ ~ ~~~~~~' rr iii I


I


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Sjn"i..
I I .
.*i *I
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~*.**fl.
* i'i~':: ,b:. .....


. .r : .::: l .. o. -.... .., -..
. i ": : '* .* .
S...... ". ibgy (by nnte),
i : :* .. .
E. :. *. .* .. .. "' *


.i.:fl .,:.4$..





.:.
.,'







I..


*




1:1



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A, 4I *
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S4'4


10-1111142%


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* I* .ft


m ..* .


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a. **


- a. *


6


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i f *-. .: .*
S.... lbirh= .s).. .......... .
i> mild *: :: .*


*ir .. .U

d" I
H:;
.:H. .S.i i '.
? !!. : :*
**HI
H.' t


*gaapspag ** a


Place of residence.


Panama


9
1
14

.1.
'-3
1
1
1*
4
3
4
15

I
6
.3
2'
S1
21
I *
*~~ .a*. ai *-


122.18
23


Colon.


2.
2
1, *4
.. .


*1.


1

*. *a ** .8 *


lOILDS
**18`


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I
1
1

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1

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Andtigas.. -...
IBarbadice.. .. .,
Chinas..........
gIosta ica.:.. .
~ p-j
GColombia.......
Guracaei D. W. w.
Dominioa ......
Demara.......
Egypt-. c......
Icuador.... ....
Iance...+.......

Greece..,. ......
Grenadc.. .....
Guadeloupe......
hGermany.......
Ireland ........
Italy.-, 9*..a*
Japa........
Jamaica ......
~artininqe.....
Montetrat......

.DnWBLe ........


RPsi. ..... ..-.
PSaeden ....
St. Andres......
St. Lucia......
Sta Kits......
St. Vincents..'..
Spain. r..::n:.

SUnied Staie ..
Vyeneumela......
Othersm.........


..
*d
. "


* 1


a.. .c

* a 4

* *
* S *



S. *4 *
i.e...

*- a a


S. .a **. ..*
... .. ..


II


* I
13&ThPIS~
C H


. rI -.I ~


-...


I V


.4
F .5..


"" 1 : x ." f =
** ,*.I--. irl


tBrthphae of (sther.


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. .. :* '" ..:: :'... ": _* '...h 1 "

i nnhplaceonthker--Continited.

~--- V


a:v






Wi )



g:0.


V


I.... 1.
I....
*


m:rma
-
n wrewmm


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a;I.















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SS.~ ..*. *UA Jr.

1V.


* I) *4. i rC *jJ *d'*t


.. *i: a 'n .. .





..


I EU *,


iki CS


4.
....
*" S


- .


.* .


d,* .


.-Et.

4




* .. .


* S -

-. f


U .


a .* *


S. .


SI ____ __ I


S *


"'I


S *


* *


..I ...


SE. s- !..













' .. .


*.


gil


ji


* -


S



* U..


ii -


i *


I). d


nqU


.- .


I ".


I!.

I .


I UP,


e *


I.


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.'' :
"" "i .. .

. /, ill. ."
S:i.
4H


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. .' "It
4.*
3 m


r-.

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Ir--


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* a.*


I.

* S. *

* .


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.
;^


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- A


H *. .i.


S .. '
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X *i *F..... :
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..


4i


*.fiBe~a


General diaa ses.


Tpahoid fever............

ParatWphoid fe-er..,., ..

Malaria.. .* ... .*..

Malaria fever:

.athivoutumal......:.
*T rtiaa.....a...a


.. i ..I i.
* .- pI I


a **i *- p.*.


*a ..S*****


yu U a4.*d*4- ::::..: ...::.


.. Clinical. .. .. ........ ....

ehexi. .. a ............ :..
.. Hemoa lolnri fever, malarial.

ainallpor x........ ..... ...,.....
aVaa a*id.. ....... *..... ..

Vacciu .ia.... .... ..i*a....,.


A UM aJ.Sl ........a... .. ...

Diphtheria.and croup.......

Diphtler.,bacillus carrier...

I f u en.........- i... .i .


a *a a ..I


a *..


.. a *


. .. .1 a a a *s *aI !


* I .s.. a C.


. .. S *


4.*.' i .a ..-


* a*


* *.j *

*.. .. **...
S.r a *.


*.... *


' 4 *..


i -*. i **
-" *. .


W mp .... .. .. .. .. ... *
.


Pute..inftiand septiceia,...... ......


*11
V. *':::
':"'H..
- :
H-NI
ri;"


I C.'


i i !iI
H~ i'H-


H.::
' *





WIliaite<


I -







* *

* *b *

i


* *P. p....
. .;

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..t i.
30:

.6
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de.99
" a
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I'.
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. ... ......
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. .

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.. t .a :4


**


H : A **-


entry, enmebie.... : ii... a....


ow frtr.ei ..-.:. .. a..a.... .aa a
rosy *. .. a .... ..
** Y~ -. i


Ken pox33132 ......... a ....a ..u.


S -


titan


Imeasles.. .. a..,... -


* *


I:rlr

I .
:


i,


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r..rp. .*.x: M.. I t.


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ibi
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j r
n.j.
ilinni hi .~
i~fl.* H.
-I.
4%.

I

ri
niH. H ii -
..%iii. -
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...~.



H
~A

-- A
* H
HJ *.*.g

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'as"
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if..


: : '.i.
.: *.*: ..








., **. '. *I .






ri *


-- r *



: : : a *
.. .. ...
... .... i n.: .1


Black.


Nonrmeidents.


Discharges.
N.


White.


ItM.


Deaths,


Black. White.


* a

.. a *4 a


-ma .

.. ..h



* .
* a a

Ca s *



- .m


Black.


M. P.


* p .


* .


* S *
.*



*s a


* C
a a.
S.

. *"




C
C...
a .

.. h*
uS* *


*


221
81


1









..


* *


62 -

10 ...








2i....


6. *.





10 '"';


1: K.












-4--


'ea.


Deaths.


White.


[ ]


|



















*
.
I.
.
I.


I
... .
+ .1 4.1.


rR~*.**. .
..:.L ;A 1...: ,
i.wiuac


. 4.


,Thsean.


Gemera .didseases.-Continued.


GonotheaI artlritis..... ......*...
Gonorthea orbditis andiepididynitis.
Soft .dancre...... f... ,.... .....
Adenil9fichanczoidal...... .'...
C(ncde and other aidlignai-t timora


S i.. ..


i'i"i"


cit ii; mw~i


Sgenital organs... .,, ... ........ ... .
Canedr and other malignant tumors of ti4e beast .-.
mC a~hrnd .~thuer mtigant tuntior of other organs
snd~ of organu niot sqt cified.. .....*..:..,..-.....
Other tumorsa (tumwr of: the female: genital drgans


S. .. .


. *". a .I U. *


. .. .*. .... a


a *4 *.


- .


i.d a i i '. *.i i .i .


. a. *.. S


. ..4..


, *i a *


. ,'..


,-. ,*


.r. .** .*
ia, secondaryy, canoe ot ditemined:i...
eenera l disease es, ........ *............


a **.~ .


. .i.


*
~Y'Vk Phs .


Dihsm ea of Ae ntelasa austem: and% of ihe orgaaa
1. -.1 'f peeialezse.. .


... *
' ..V.


C..~ .' .
.;.t: ,


-White.


' *i

2
. 4
e


P.


j r*.

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*. ..


* *."'j j it



II


"I.i


I..



* ..
i-.' *]


M.
SI.


*...n




I..

*1


es cepted): ...........
Aucte artizculr rheinnatism.


Chrod ia rheui.atin uanda got.,

,: ....


Leukharia ypai
HIodg'i^ desae. .
At. e .nima.ltia .
'r~iil vrftcna


." I


:


' ;' ;:.;.:


Irztr~g


;


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I.


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ii'C

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I.,


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WI


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Neurasthenia :......................
Diseases of the eyes and their annex.
Follicular conjunctivitis...............


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Aneurysm..... .... .. .
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TasL XI.-DISCHARGES AND -D.ATHS IN 'TH
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Disease.


Affeions produced by eztmerna caues.-
Continued.


Burns (conflagration excepted)......... ..........
Traumatism by firearms. .. ...... .........
Traumatism by cutting or piercing instruments...
Traumatism by falJ..............................
Traumatism by machines..........................
Traumatism by other crushing vehicles, landslides,
etc.) .* .. ....* *. .
Railroad traumatism........................ .....
Dynamite traumatism............................
Injuries by animals..............................
Starvation ... ... ... .... ...................


Homicide by cutting or piercing instruments.
Fractures (cause not specified) .............
Dilocations .................... ......... .
Sprains...... ... .......... .......
Other external violence...................


. ... .


Ill-defined diseases.


Ill-defined organic disease...........
Idections of undetermined origin...
No diseasee................. .....


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a .Ii -


i .


i :h


. *


..
l


~lA


I &:f


S .


.*. ..* .. U
. .- .. 5


S 8 34


V_277 j s4
====1-


S. .. .


*- -. *.


I.


I
A. 'F.
1"
,Ic 2
- -
S

a
I
t



*1~ :1
Its
2i
1.
~y4I

L
I.
C
F' j~.* -.
I.
* -
1~
*
1. .
:1K.
*
J
4


It 6


..flHr
FUJimnrrBu -~-~---~
v11145rIAII.IJJEE4rtnrt. ~j~j Ii!
.H.A.f
*in -
EUZ~-UYZfltDhIJZCj5EiDIPJ.
..
I hr
hr


* K:.H.
H IH"'

1 ii


-; I




H i.


..Pr

341





'ink


2


-- -




* i


" "\^: !
S.


..

I
- $i*..^: s"
.ne


AeCOn


SaTtaL.....


Grand total.


* OroEFarm (cripple)::
,.E, oy eeM:.,... ..


Chroui wa d:
OCharity patients...


Colon Uosplital
....


.. **
- .. pay prntitndnts...
Otherjiy patIentst...
tehaji P iiin js. .. .


;. """ 5 .
*
_. .', -: ^ ;^ '


.. "'



29 6 '.. ,' i"
H .; :,.:
f lf 11 a 4.. "i:.
W 1 'i' k
.. f 51. 1......i
*... *. .. .
ISA.. .


.. ...408 .




9*. H..


:at


-


_ ..


Hl~i


i


-1


i
]


L


|


|















*.. b.


NC::.


.,,,


C~anS *.,*- *


\
I I
* *:I
* L .. .
mume f -
*. ..


Te s..


lung


.4..::
~ji~A.


432
*3A~


* i 1 .... i
- .~ ~1ir -- -


ww: .. ..-rs :...s
1I


1<


260
451
39
, 35
197

982S


V
* -.
a-







..',


A I
WF -WA,


-fl


Tr

I...

I~eii j~p* ....... '
i::

~~c..



I


'ar

'1-b.. *W Hr


'ait


- *


A noo.


*4!~~ *~P


Stun:. .- -. -.. -
Prdk^mk


TeLB~


'itW.


'iZEJim


Zi~PS~
C.-.. ,.
49407
*lol


aeonE*V~eeL.


* .m


4,763

4,100
4., 6
% s0.


T~o~ti~.


7,813

8.,150
2,41I
MS5t


.I:
'i,


:. ::


. ..--
charge..


. .


..


i


I'~jiij~B


Dj~e~Fi~;


;~Rl~O$i~Ct~















-N.
r..


- .,
- ..-.

M. "H"* ..... C
.. ...


-n ...I~DCQY~I~Y


nu : *r


* *..:


a-c hmnia


a..... *.* I


to iqpartjrir. ...... -


| napi-nl land quarters
1 ^hut trassfeied between hb yi
#iftsi~iaens wNse aaMdmiisions ar
II. ** *e npz..u......... ..........
*ii" .. ".


edal and
e dupli-


,nut0 hspitalsand quarters..........


gi


to hospitals...
to quarkters...


* a. s. .. .. a.. i


hniiou of employees........... .......
i alrdo Be tween hesmpitals and from
HlfstalB, whose admisioas are diuplicaled


...a.a* U a


Sof emplyemsy...................
rate per thousand employees to hospitals


th,&. b


White.



1,683
9g2

2,665


70

2,595


1,273


1.251


1,094.24


Black.


1,897
S9S

2,786


S128

2.68


889


2,151


I 2.079


383.88


Total.






5,451





Kmmm.



! 1,553
1,871

3.426


94

3.33,


5O7.55


rii[i"I
'tV.


'] OF EMPLOYEES CONSTANTLY SICK W HOSPITAl AND
SQUAIEIR& .


.. :" .. *. .

|j J:3. -, .:' *. .
.i.Hi. *
"..::,'.F .,
p. -.. .." "


*. *a a *sa


*;:3wWin rF wi n .. *'* -
jA*. r --. .. .. *
S" : i .. .
S 3 *.u i*::* *a** a
S-S....- .--- .
.&.. g .. -

H~Yfci-F.^11^1'*** L * *w : /*...:." ** :
Ilin~ff* *. ** ** .i
{ iidi**., SS **.. J. **.


...


.*


I

. .. .... ..


S. SWUM


*... *


,s..t. d. E.* e. e o*:. So,
r;.r HP
,t gue asgymer:+I~'nl .ae. es~,*e


'H 7
:.H .. ... :
..., .. .
!**! IH *3|"^*I H
r: E.* ..**:: **
li !*:* ::** :. 1, .r .. .
!Xzy ::v: *:> .X "** *"a
S....:.. ... ....... .
= .. ." .*:
::":!K.:E; :. *4*:. ," qL
. .: i:*! 9.* ***::::.* I V V
HEi" ..i ":""i :.': "" .:


S. .-pa* **


a *.. :..


*a..... ..i ..* .


. H.ii


H ....


White.


I

33.61
6.33

39.4


Rink~E


221.08
37.9.-


25. 501


"Ti~t~lal


%98.g5


Ir I-- _


'6.29
b-H" i

.92
S6.0799
6.07


'~Si;


p.67.

.19
4.98
.. .5

't.1?


12.87
1.11
5.97
67*.S


'us.5


sn


e igure ........................


1111


~?IT


~u


.- .


. ".


I irlr r. I


:: ;


I


I


I


,r


n~i~~CnklFn af~i~

















TaBaU XVI.


TVBR A ..UM
. .M ." "A


*

-a *.s*.


*r~l a b r *


. i


Total (average)...... .., .

A.cn. -
Bsalboa. .... b....p...
Pedro Miuel .............
atim.-..2. ...
Colo 1a*n...*p.S*
O~agem i a gis .i $i2 p i


. d


n N n i


* *s *~i~* Wa .. .a *


S* .,


HI!


g :. A *.. :*
.* *. ..: *
4. E


*
White~.i~
.*
.4. .1'
H
c:~,
*7.44~
*

It .72


BA?4


: : ": : ::i .. ".:
*.*


- i




' I..

.-ts~.

A..:


Tar XVIL--NUMBER OF DAYS HOSPITAL TREATMENT FumnIS
CLASSES OF PATIENTS. .."
....... ** i... .


Clams.


Ateon Hospital:
Panama Canal employee.
Army and Navy patients.
Panama Governmentp py
Other pay patients..... ..
Charity patients.........


patients........


a a.* p -


*. us


Total....... .. a .... .. ...


Corosal Hopital (insane):
Panama Canal employees........ .. ..
SArnmy and ,ay patients.... .......
Panam~ir Governmeit pay patienta. .
... Other pay patients.... ... ... ..
Ch. charity patents........ .....a...a


a i.


T. .t........


oral Farm (injured employees): Paaman
. .J M.aId employ eeN .... *............. i., .,
Chromnie ward: Chaity patient. ..............
*. .


Ainerican.


2,)21
7,398


3,595
9560


13,970


. s.d


. ..a.--.*


Foreign


812


2,564
203


3,579


1033

S5.,20
27'0
. ,07


66.i55i


.54
S '
- a 5 a. .


-. i ii. 4t I


S, 1* ...J..

.
-- ".
........ ....


.'.. : .. "
* *,* '* lu ;
,.-f'"


.7i


*: :.' .:i.: Hi:
.............................................................. .*:..... S..hl '


] ONr FiK.
Im, .w D A @., mi1I. ..


Anon Hospitl....
Colon Hospital...


* a .
* aa aa -a e


Total (average).......... .........


I


n


1 I


I


















'Ti






tin.~: i t:'


K...
r!r.ia I.f


I
I


I~s..'.

IAs*bi *
hakea


3I--WAI


(total number)..f...


a *I a 5 a p a a
. a* *af a. *

* .S ,







... .. .. .











a and temara


; .


41i*iiou3 (totl number)



.. -... .. ... ... .
*i.. a:: *.
S *jgj "'J i a .a1*





':..:..:.i "d-. '
S. .....*. 'p a... a ....

3a a a' m a .* .


** *. a
*. *. a ***.:- -


Sa


***y :* ..* : .* *
S. I
*.. a a a a a


i. .A *. -


~. .. ..... ...
.ir^ *s .*
wk.any *... p *a. .a.*
m ma- S a a a *
S. a" ...
irtfal counts.
idm nludate

a o .( total

La .I a S *

hm ihricnes.


)RATlORl~


Ancon
. Hospital.


1,861


.. ..p
a......



* au a *s a a









a..a*..
a.......












amm mlg # l


W, mM~Wla
*. ~














- .---.-,.
a a a .

a a a



........
a.......










g-gammeal
*gei ).
. a..



*.*aa
* a *a a


* a a *a a 1

a

a~. a..





*. a.


'a...,...
S .


57
26
40
59
91
4
171
350
2



*a *


5.073.
1,366

S854

S17
1,072
24
8
68
1,831
854
.. *..






I I a


K -1,455
117


Colon
Hospital .


213'
12 .

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


b** *6-* *, **


99
1Z




mmanr-mag-
aapaa* *.aa*a
*







a .. ......


a w. *

.a ..*...J....




115
*. a


81







59
lS
a a .. 7 .




a *. t i .. *




* a S .* s a
-j
*. **a .
**

36
t*23.
8
4


santen


Haspital.


Sa a aai
S


527
,12T


68

US



. 12
1.963
15


113
6

a a a *. N
S.
*.-








14
17
14
1,384
318
. .....* j ....
281





I6,
* *t ega S*g*-a *a
...i....... a
* aa**a-aa


129
",
18




* 1" s"a....**a


102


S


. 4 u


*. a- a S




tesi
.
.Wa@B
Ia a
teeth


istoalytii


H


I



















. A:


*1
*j'. *~:. .. *tw*~
.4
%hSRfl~g
.4
~' .1-


" "..
' -" '


~t~'~ -.


-'": : -


:. :"". -" n ..:* : ...; -, ., ..n: .: ^ : :' EE:
S. *: .. .. .....* ...: ..: : .. (
.., '. .... .':. F:' .":.: .:i:*. i-
."". "^ ^.. ..a.
.. .. ~ 1......


:"* *: ...:* .*. .: ." "
'. r fip if illin:^"**." ':'* 'w. Igilk* "f d


A


.H.
C :


Y.12


* ..


:. ...
- I..


Sieat ahminatiusm (ttotal nmater)....

I i htEral a p *.. a *.. ..*:b.a. .* .


.. *...a


q .


Spinal fl c. ..............................
.- -



SEye ... .. ...-. .. ...... ..... ,

Functional kidniey ~taeat ...--..

' Pcsitivefar gonococdi. -...,.....-..... ....

Pouitivefor B. .Koh-W :........*. ..


Positive for Ipieumo.o.........

S fo-etive forleitasye ..,.. ...

Positive ofor diphtheria. ... .. ......

UeFas'ernnn reactions (totha hzmber).....

Positive....... ......... .*,.**


.-.* **g a


* a. .. .


. "a* '.


1. ee USVS UuWIrs&..*.. ..laa *sc.


Wida s .reimtion .a.. a.......'.. .**a*. a
______________________________________


3 i::'.1 .


piita::


2 1~





103.


i I i m m mllij



........ ... i


*SbS SW


aS....


a*


1:i .: i:::i: i

A. ri .


*i -
Cl94 : : .
gA. Zr
I..-.r: 4.:....h S
K-t -

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I... Af..
i. .~'"S.
H .***"*&i~


S.... ..
| h *
'*^ :",,


*' ..* *1
~ :.


..


. .. '* /..:.. .g
. .* ...,. ;.. *q;;' F'L *!!


i::" lhlC ...
.. :"***xMJ *
.,.."; : '.::"::::".
-i
.. .: .....



.: .. ,


: .* **I .i
..... .... :..... .::.... .
*. : .::.










*m: 5*


"* ':: :.... :1

_. y ... "
S. i".. .


S. .. -. ..... .. is
* **: H.* **
IH*.I : .. : I


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" ) H ii "H I11


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..' '.:.E .
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:- "...:i ."3 :" "." *t


.. : l.. .i. ... *

H.* .
e':. ......




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K X : *'
l ii ::xi' .." : *
H" .. :. .









.EBpg. 6. -
M:. ............ *.
.. .,, E I
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Slp. *. ... ....



.. S:".; a* .. .* .
. ......... .........
.... .. .....*......









.:a. "a *S a. *. .
* *m *


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m p*z* .... ... 1I

S I l 1 *
i i ** ~* .ti* ....... a .. ..... ,


S. *






S .
*.--













.* ..a. *
,p ..... .............









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... ........... ...
.*. .



......a
I. ....S...A........













..*.. *. .
.t *






.*" ."i
:. *.. .. .


-A-fl-- -


.. Anon.

Hospital.


Num- Died.

her. Died


* .

a...


* a i

2



27

.3




"* *

al
*r. .
I.
i ~"



.* tj ..*s' .. 2
I .: RE: "


I












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Colonpitl.

HoEpital.l


Num-

her.


. S *



....



.. .. .
.* ... .* *. 4








I


'. *^ .;-*


Did .


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r. L


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H:,
IA

V
:.::::ili C'


I
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I:


ama...


*






.* ..

A










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5
I
n











: *

*




S.' "


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sr


19








a
25
. .










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r


























B :i";: ^^ -:- .'.:. **." .;"= f *-. .* \ /i : ** *
)'.' "**. "'::. *" "
r1:- f. .. :.,. I 1 -
::.. .. .** .

ri: ;:. : *"
: *.: ...*.. L. .. .. .*
.i:* T a.w:.H:... '4..I: GON





,, o.. .
~. Li


*i.i aB *, .0. *.. of *...a.....a..


*::~ ~ .. ..
C S:C .



smuq, p...e foratio and drainage....



Anti ftudnf eaanance n amr
.* I .:.* I e", *
.I. 1t I


I. .
a
.C
*
i.
S..*
ge a eae'g a a e g a e *e g


*mpa m p a

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* *..* **. *


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I


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S..
* ..... p


.. .' ... .. ... .. .. ..... .......
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S........ .................. .



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**



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*1 *a *i o f-4........ .. ... .. .. ...*.. .. .. .. .. ..... .... ...
S.. .

..fSZaJ A WAlSfl a. *a S* *. a a s* a a. .* a* ** S .. ... : .
:2'drum.
^ ^^. ,... s .. ,-..J .. .
^f|| (B ia g~ a *.. i.a.a.a. .. .......aa. *S. e. ...pp....*.... ..









L a S < S a p* a *< p g a. a* p .* h a ** p a.. *
............. -----.---..-.---.----.<-.---.,.----

*i ...*. :.. *.a* S *


i*** **S C p 4 P 5 S S S S S S P S a S P i S Pd 'i t
...* ...: :, -. _
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:Hp. ~. .:.
H i
."...*..." .. .
i. r: *.. ~
"*. i.:.... .. "..**

a:**.p ::4. .,.. .
*.. .. .*.**

,.............i.*.4.: *. ": *a l o T He ,"
..' .=!i : I ": i .1= _.(

.. .. ....W TMBBBRL
::. ***.:. ...*.... .a*
*p;:.. ......:...- -
*i'cm ,,EcEcc" ,::: :"i : *


..

a -
'*

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I
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74
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p.... Al
A
A
i 2

2



I '.. ... 4''




.1
....
9r~


,12


* 13

.1

- 3
* S
. 2


- 10

*. 124-
inr


* 5 5 P P
. ...


yI I r 051 2 .*.. Sb- .... a...** S.**.** S*- *is. -.;......a
i .e.,iPS., ..- ... ... ......... .....: ... ...


.. .it. ftP S3 *f S N U P. C P 5
...' ": .". ... ." S* .S .* S S *
.,!t,,... ...- .-..-.... --.-..-...
* EE*l ., ,. .... .. ..



a ..1
A
C P *..s :p a & i n s
:^?' :;3a..' ': *:ll. I i. "*I: ,I I i I III I I 1"I I i I


1 -'i li: -sr'a*"* se as i,, ,...... .n m ...,i aa p.w e.. ;.me. --..M


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a p..-,; .S C C *
* ..a..e*P p. Aam


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P.. 5-s.



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a *, r



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....*.*.f.


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.. n u ns n n, l m .w ., .. .,. .. ..**:





*ot.b F reigt b dies.e .. [.... ,..,.i... l ,,, ., ** .. n i .ii, ,rI
*e **ecSM .t. C ..C*..C. .. -: ; *.. ). ...*. : AL
m ,,-: ,, 1i
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4 *.ew"- ....... ... .. ..
.i. ti. .. : ...,. -. ..... .. *r.i. ... *i:*
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tw : .j .- i H:
. ....' ":,, .' -. :"" r* ". ": : :1'*, *



ar..gitia .. ... .:. .:! ,

ei'o "l .e *. ., .. ..* '


Adenoidetomy ...........
1To''isilltemy.. ........

Opris *ons:


-Iriet-my................
J 4111


'S


. a .* *.*- a a- s. .a .b.


--. ." ." "
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a. *a ..***....*u*pa .e..* *a** aaga


.ameS~Sum*a ..m*..m.m..m.. -m. ..m... a


t. ** a
"iigiE. :. : *.. **. .
i ^i h-f! jiL', <-, -


*:cgafs treated ..........................
*ii'* .


-. w-....:- "
$[*_i.il*.2
M.:*."ii:II


AxesL

Honpitalt.


60
101
89
18
a83a
4.


38
14
12
10
31
29







1.
4I













S26
' 21


Santo
Tompiaa.
Hospital.


Hi.
.


S.P** 15


a *





2.
7
6
21
7



i -3

15
B
28

*... ..-....





I

34
5
9

10
H :. a
teegg main


tig--' S C:S:.... ..S
*1 : :: .. ** ** l
-. .. .. .
!=ii : h" :!.": .
S* ix :.:*:.:.. a
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: *.. *.. ..

.. ...
H Ii... I... .... *
.:.. .* a *: .".
|:l.; .:........ ...... *
^ I*: .<:*: : .......*...




* i ....:.:.. *.:i.. *. .* *
i l.:.r: ~".
.a.n.".4 ..* .. a.. .

. : 1:: :. ... .*.
.. .. ,


PICATION OF PLATES USED.


Ancon Hospild.


A 'i *.- -


I* ,-,i t bp a i


ma m I em bw. i ,m ,
* a a a ** .* .
**


.. *
__.- J ^,, f.. '. .,,. ".


H
'H
~
~ I~
He. S


*, 140


L


.


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.
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t. J**J*?~'
~~t"A~rtgWtu&uD I
I~~.*A ..


, .; ,


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. .
4


a* T. y c ^. *


P Charity I ........
S, I -: ,


" t i .
I.. ** "*


i S i *I i *


*.*... .:
m m m m m
*., m i


a at..


. I

Remaining
. *Ja..* : "
i ,


29

473-
a m



"*


** "*" '"" *" "*, :.
* : "**

**** : *.. .- ** '
:Adi iff-
tdd;,'


2,178i


2,4T


.Hi



IA:'


.I..


.CIaa


--* .'
PFy wcases ./. ...*

Chainty c ases........


TotalO......


. a* .*


. a. *


*. a. aii ai a


N teabe.

treated.


364
3,564


3.928


A~mec.~


White.


I.%

III..


.
*: :

*i


.. .

S- --1- *- -
- ..

' :.1


Number, of days relief furnished patients.-............. ..* ....

4Average number of patients constantly sick..........,.......

Average number of daya treatment for each patient admitted.
t of ubistence per.patient, per day........, .........,


DISPENSARY PR


. .." l..^y
... :

E* v C,,rg
,.,


.* .* s..:.f i :X "
'~~ ~ ~ *** *" ***i^:


: .. J&IJ
.* ... .1,f


Clap.


Natives treated.

PNtdigueus treated.


Tota .....


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pr p r -* *. pa


- Ul -. p ***


* C* j* *


.S** *


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., pI
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*... .. .. a .*.. ..* .. :-*.
V ** ~, x.I

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S:e .: ..... .. ..
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~ ta ,........ ,. .. .. ..... '
,,, ,, ,, ., ,, ,
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.. .... ., ... .. ... .. :. ,.r. .. ...


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SmnaIzinurwunor, me pernoeeum ec....;.................. i

-.-

.tualganmtaior, ,of the organs not epecfied. ..........., ...... 2
i iniof lthe fem.aleogenital organsexcped).......... ....... i 2

: .:"too: t h,..: a .'. .

S .... .. a.... ...... ...... a.. .........,.

g*m'u : *.'- ,. .".. :" -
g. *a* ** 16
-,,,-,,' -
| aiMlr.c^rorb.......-. ... ...-- ... ...--... 23



,,e a, al cs,,t ,on.......... ............................. ......... I
:* *.. .,.. a.se ...... ... . a a a m a.

n tiia .... ... ............................... .. ... 3



f~i^'& eyes and their a.ne.xa.............................'/..., r 13
.. .a .m a r a i
ct*. ..: .. .. ,*- .... .



... ;..i -.. .... ., ., .. ................... ........ .. ... ... ^ ..... -3. -
i tis lhe.nert.,... ,.- ... .............-.. .... ... ., .. .. .. 2
a e e es e a ro.. a ............ ... .. .. ... ... -, ... 8

.a C a Cr .. i *a a a ** .. m .aa. a... 1a

nhErhvao s s y.s '..... ."....... .......... "............ C


esa d,..t h ae .. ... ... a., ... ..... .. 18

gase. o.f.... .e .i.....,.r........................ ..... .......
E i .. .te. .. .. .. .... .. .. ... ., :'. .': 1
II il.l:toi". .* .. .a. .. .. .. .... .. ..a:a. i .

*.r.w :r o-. 2 -.... r .
' ,.. .E ** m .. a .. .. w. .
.."::e*::. ,l .
!a 3i.. ia. .* jS .f* .a. *a* : a*** C a. 4 h 2








iv:e e, atherina_ ..: : .* : : : : a..... ... ..........a:. as,,
.. a C. .. : .
.,a" :f .o.. : : .. .... .. ...
*.. ;. '. 2 *
.ssUem.. .e iraor Ca.tem. *....*.......*.. .a.. .. .... :..: t
et nd g.. ....... .. ...... .. .. ...... ...... .

ugw* ." : .(*,.h d ..nd oe r... .-.-..... ..a*.. .. ** i .. *1
.. .. ... ,



i.- (2..- 7 s o .i. ) .j *. .a ..a m -. m I
l.aFa.*.*a.* *: **. ..**... ** :***...t -
n*g .*.* *. ** p a **a **p.m. *p**.. .4. & .
.....h u e 2 *a .nd .S *s**aam* .. *a. a ...a .... .
a ..* i
a.. -





Ca. (. .. y. ..*) ... .... ** .. *
: ** ,** .. I *. : *
t?"2***. ... an *d**e *).-*k ** a P* *
11..| i** C** S*C .* a .** a a ..S' .a a.. 'a . *.
I .2 :. : .. a..* 5. A*. iA W .*S .a. y*C:C 14.




S. : .. ..... ..***. : .. .. *....
I.- :


C:Ii
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* Nj,

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l's

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U ner macasea uor uor.t ... -. ,..........-., .. ,,..
a .. Pp l. -. i: ii :.i :i..il
..... 4. ..
...
C*. i .I .. r. i .* .. .i : i:. .iaI
h. D i f. 0 .-hejia ** ,-: .. .
-.Dise-a-o l the, |to .. ..... ........... -...... ... -




."Am p a"ti s m a ham" ." .".*ee Jiumi i, ii i,,
Othirpdiseases of the organs of locomotion... A..
Conge~ital malformation....
Nu n discharged from hospital. .,........ '.
-Ben ii "..... ... .... ...... ....." ":, "," E
SuDicidei. -. -. .. -. *. + +.. ..n
. Acutie.pomU...i....... .....-...... ...
Poiqnieng byfood..... ........... ........-q-....... ..i

Trauiatism. by cutting or-piercing instruments. =.... ......^;..-.:
r'aumatism C iarparnas... .....-.................* .. -...i.. .^:3|^
Tr at at iasm byorrnhig. .... ..*..... ... .. .,.......... E
islocatioa. .. .. .o u.. .. .. .
S. .. .. *. .1




Spraing....... ........ ......... ................ .
Other external violence..... .... ....................... ..,.'.... .


Disseae nptapecifed 0o iWl-de4ied. -. d ...... .-.. ...... .. ..
NDisease ..............
b .: ,+


Deaths anoug patients.. .......................
Remaining in hoeapitalMdC*o 31, 1919.........a

cttl tested..,....-......................


. .


i ym


. 4..


. .
* 41


a. q S *
...: .. :. 4:.


S.. C a.. ... -


-.


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. Ii.a


a *i .iii .l


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."

a.. .*.. ..
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fjlirt"'
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M4N. 5TATEME
iND DEATHS.


Kam


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- ~rlI:(
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; ,
. i
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* .


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-Improve &


Male.


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**. *.** ..



1*i ft 4
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.R. I.Pd 4. wrte to-NIudaRU

*.:* :, .. .
...:: .. :.. .. ..- WC


uo1Et ;.iru us


.DISHARGS,

S.COMMITMENTI


-e I'U ei -~


:.1
k !:.::; -.


H(..."i.



H.

anlli









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. .* a *




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+l



._ l **** H
.. .. .. .. n *. .. m* -. :' .. .. .i : ....
..n ".. An ..4 h w e.ars .4 : pe .. *. O .. .. '.. ...... .
.: *" . ... .. .... .. ..*,* ".

.. e s .. .... ;... ; ... .. ... .. .. ...
,*AT *# .i' ,i^ i .pire. C ..- i d-.. -. ...-.. ... ... .
Bl1d ..mears examined for E (.ahe..i..p...... I.....t hc .


B* 'd amunrid.frninMqor a.3ial.taoS^
*tvef....r r r f itive or .... .. ..
.. Sae f i ..... .... ... .. .*. 4....


.t...t.elne I.saear.(..a po s iie.far rt .. *e!i. Ila
*. l ture irom lred. :.... .... .. ..|... .. ......... .. .... .
Da rk id:exain a on for" piroee ts paida..-....... .'n.
:Smeats cemined lr oriier( .pooti or Bleprae) ,. ; .:.- .,' '^S

S net x amined or Rig diseae....... ..... .
.S. m ....mined f:smiat.ed od .2. .a.tPl..... ..S..:.....-...... *, ....
." .m Si. .*.. .. .. .* :. .... ... ..'.'. .-,, '', .*.? *..* :,"
..J. .. *$*r* a *.. a..... .*..... ... .... .a. .. ... -*... i.,, i:.'. .


.... ".... ... .: ... .. ..- ...... ... ... .. .... ..... ...., ,,
S. .tueait~Tr (frxie inmeilear F.i-ent. l).. .. .... .I .,:.. ..
P-. .iined o rl u oredc,-e..." -..:br. .'* : ': """...* *. *i
... olulture polite por -Bs...iivaertyehesuht n........ .....




Skinolesions for.instiea(l p'Mte (Po.. : f rl
*.ii.r. : .. t u d. .* .* i
',ri r,: :: ; j. N






S .. j. o. ei... ). .....fm.. ,.o.e. a.. .... ..... U.. ....
c.u. l .. md ..- .. ..- =, .,. -. ........ .. .*1 ".*
pouitv .oho. -e...r B. diptheriane ...................



SoC. ,troat eangms, efmoiatnod f(r pitnt's.ana (1p o. p ive) ., a .- ..4r.
o o. h o examine o. f oriu p t... *1





jto. freeimesa psitive for .. .t rongloid, 8 postiv for .
Dl o *:e a *. .. *. C *f r A ... .* ..* .:
.. ... ..... .. ,,.


l"I A.i p 3. ..: !. .I ..."':
*- 'l auos lpIest mfre..i.an.... .. ... ......... .... ... ,. .. ,. ....




Th* ot ne fB. dp t.:hrae 1?"3).... *a.
Sthront lsenas euma iined (fo pVoinent' ang a (1.. p...j : ..








.. a l ao
.. l re s t d... ,........... ...








S.* .. .A : ".

.. .. r, ,.. .... .
d a n or : am ed. for lu a ...,f l.l p,. .. .. ., .. ; .. l .,.
IC o] ~ulsrting( eitig.a d Ci ilre..p


:.ua. arI ".. ...". .. *..: .. ... a ... .. .. I.
t. n f .. _. ...


.fl .. .,. .5 2 .*.*jI* .....

13g4L 15 i.3d .- ... "". ** ".: *:.;*'*




-T- 4 '..r ::..


h .iU. .... .. "* s*: .". !..






:::: ::: *.i. *** :.* .. *
S. **... ..: .
:. :1 :E .: : .' : .3 .. ..*: .
II b.i ........." :. .:....." ...
.:n *.....- .. .




... ... '..-. t
...K. .:: ..: i .:. *


gi F: ...." a ** **
Ai ii 'H M" ...t ac.. .
H **:..* .. *. H.*

.. : a.*

s3" r h kate.. i alt-rct...... ..




lEI^Ian hOildren-:-(under-5yer)


.. .- *..: M .




tbey falIL .. ...- .. ... .

. h. ..a.. i i b ... .

Stl brain. a a .

| r. ofu ascedin.g orta.... .......


i.....-. -..-..


*. a


i and enteritis (Imder 2 years)...........
j ... ._.. I. .
. ... .

a pig from Corosal farm, 1 alligatr)....
S~(HMua-muasulus,. 3,223; Mus-Nor egioun,

..... 375)... ...... .... .... *... ..* .*-
is. : ": .. *...


a ......a 5


* a a a a -

rr


'a.... ...a


*
* S -.-

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Si


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ha.
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1 4

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.. :


22; Mus-Alexandrix, 399;
aaa..... a...aa- ..*... .. 4.020


nations. ......... -.-... ... ...........a.U
Amined for anthrax (4 positive)..................... .. ........
Ir blood of native cattle for trypanosomee... ...... .............
tflinjected with blood of native annials for "tick fever"Immunization


io ettle blood or piroplasnata after immuniation (32 positive) ....
i.E"om Army mules.........-..-'........ .-..... ....... .. .. ..:;.
~i(eattle spleen for anthrax (5 poaitive)................... ......
OexamIi ed for anthrax.. .. .......... ....... ..... ....... .....
t iore. and 1 ule)-.... ... .. .... ..
i -oe .


3,078
4
.3


43

L. 43
a" 2


lf'or igar, N.I. 4 Nitrogen.. .aa.............. ..... .,


t 24 liours... ... ............... ... .*................ .e......a. 1


. ia s.......... *..... -. .................. .-a.. ...,... *.....,.. 19
peteanalysi (condensed, 2)..... ....-....
: cojIkpete analyir).... ...... ;..... .... .... 2
.f ~Wa*co.nt ...., + ,, .
..... ia ...... i. ................... .. ... ,..... ... 10



:.,: :i.,:*s....,, ** S a....s.. .., ... d.*a..* ..e.... .
i ~ --- ---is a..... .. ... .....- .. ....a. a.. -.... ..... ....... .. ........ 2

.. l. o.. l -..... ..- -....,- 9

r a .r .** *.a .. s a. a1
H .* .
.iIiC*..*.,,*.. *.: *::*" **. ," .'. ...**, :. .. .
-.. .*.: s. sa a. a. A *** .* *

.. .B. ... *'.t. .-.. a.*t. s.. .. .. : ... i .. 7' .a ...i"
o-. --l t.. mo f ..e A,... ....... ... ..,...,.-...... ..,,. ............... .

S | <: ... *"i : .. *.. .. 2
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S" C oU .. .'. ..-. .J..... ..' "pi1 ...... i "
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t m I f L *
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a n. m,/f im ,m i m O m m m^m~i t m ( i N l i t ( d' m ^ii~iui. "iii *i*i I +


n n n i . a* i
t..a..I Anep at s:s il.u .. : .. *. ..i


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A ophels alia.ua.....,....... .. ..8..

c. .rA R. i f i r, .-* *q f !... ... ..$ 4. I.*? :-




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1 o. ..u.. ... ....; ..-- -,._.,,. "


fes~el~itiinalp. -::;:
AedP~iefipraied .




Wre~islwga erneop~ifir...


Total .,g.tae. ..,
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Linear yad of new ditches constucted.....-..........
Acres of vegetation temoved.-.... .. ....
Nuiiber of garbage .anw emptied.... .. .. ........
Cubic yard of garbage remo ed ...................
Square yas de of sti eets kept clean...................
Square yards of alleys cleaned daily..........-:......
Pit'closets.inspected during month...................
Closets disinfected during month. ..................
Number of water containers treated..... ...... J .... -
Number of mosquit6-breeding places destroyed........
Mosquitoes destroyed in dwellings:
SAnopeles. ......... ... .........,
a Stegomyia.................. ........ ..-.... ...
Clex.,..... ....i. m i .
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Private properties cleaned... -... ............,. ...
Number of notices served to abate nuisances..... ,......
Convictions for violation of sanitary code............'
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Buildings inhjected.,....... ; ...... .... .:......:
Buildings, construction and repairs:
Plans for new buildings approved................
Permits issued to reair old buildings,...........
Building condemned. .......... .. .......
Building demolished. ..... ..................
Food inspWeftion:. .
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INGEST IEID E3QBW91Y6_61S24A INGEST_TIME 2012-01-17T18:15:34Z PACKAGE AA00006091_00002
AGREEMENT_INFO ACCOUNT UF PROJECT UFDC
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PAGE 1

REPORT OFTHE HEALTH DEPARTMEr.NT, OF THE PtANAMA CANAL FORI JANUARY,, FEBRUA RY, -MARCH 1919 Gitof he panama CanadMuseux H. C.0 FISHER colon *I Medical Corps,United States, Armn -Chief Health Officer, -* THE PANAMA CANAL MES MOUNT HOP3, C. Z. -1920

PAGE 2

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THE PANAMA CANAL HEAL, DEPARMENT 'ffective with this number, the quarterly report of the flth Department of The Panama' Canal'will be disconAhed, You will be continued on our list for annual cendar year reports. CHIEF HEALTH OFFICER. 5;a 4

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REPORT OF THE HEALTH DEPARTMENT OF T HE PANAMACANAL FOR JANUARY, FEBRUARY, MARCH 1919 H. C. FISHER Colonel, Medical Corps, United States Army Chief Health Officer THE PANAMA CANAL PRESS MOUNT HOPE, C. Z. 1920

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For additional copies of this publication address The Panama Canal, Washington, D. C., or Balboa Heights, Canal Zone.

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CONTENTS. Page. Letter of transmittal. .5 General remarks. 5 Vital statistics: E m ployees. .6 Residents of the Canal Zone. .7 Residents of the city of Panama. .8 Residents of the city of Colon. 8 Division of Sanitation: Canal Zone. .9 Statistical tables: 1. Discharges, deaths, and noneffective rates for employees .14 II. Deaths of employees by cause, color, age, and length of residence on Isthmus 15 III. Deaths of residents of the cities of Panama, Colon, and the Canal Zone. 17 IV. Deaths of civil population (employees and nonemployees), by cause, sex, color, age, and place of residence. .18 IV.-A Deaths of nonresidents .24 V. Deaths by nationality or. nativity. 26 VI. Statistics re American employees and their families. 27 VII. Births and birth rates in the Canal Zone and the cities of Panama and -C olon ..28 VIII. Infant mortaility rates in the Canal Zone and the cities of Panama and C olon .29 IX. Deaths of infants by cause, sex, color, age, and place of residence. .30 X. Births, classified by birthplace of parents. 32 XI. Discharges and deaths in the hospitals of The Panama Canal, by cause, color, etc. 34 XII. Consolidated hospital report. .43 XIII. Consolidated dispensary report. 50 XIV. Consolidated admission report, hospitals and quarters ..51 XV. Number of employees constantly sick in hospitals and quarters .51 XVI. Average number of days in hospital or quarters for each admission of sick em ployee. 52 XVII. Number of days hospital treatment furnished various classes of patients. .52 XVIII. W ard laboratory reports. 53 XIX. Surgical operations performed. 55 XX. Report of operations-eye and ear departments. 57 XXI. Report of X-ray department, Ancon Hospital. 59 XXII. Santo Tomas Hospital. .60 XXIII. Corozal Hospital. 63 XXIV. Board of health laboratory, report of operations. 64 XXV. Contagious and infectious diseases. 67 XXVI. Routine sanitary work performed in Panama, Colon, and the Canal Zone. .68 XXVII. Consolidated report of quarantine transactions. 69 XXVIII. Immigrattidh report. .70 XXIX. Personnel report. .70

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LETTER OF TRANSMITTAL. THE PANAMA CANAL. HEALTH DEPARTMENT, Balboa Heights, 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 operadons of the Health Department for the quarter January, February, and March, 1919. Lieut. Col. A. T. McCormack, Chief Health Officer, was relieved from duty January 23, 1919, by War Department orders, and Maj. R. L. Loughran, Superintendent of Ancon Hospital, was made Acting Chief Health Officer, pending the arrival ofthe undersigned, who was appointed Chief Health Officer, effective March 31, 1919. Respectfully, H. C. FISHER, Chief Health Officer. PERSONNEL. Many changes have occurred in the organization of the department during the quarter. When the Superintendent of Ancon Hospital was made Acting Chief Health Officer, January 24, 1919, the Chief of the Medical Clinic, Dr. R. C. Connor, was made Acting Superintendent; and the Assistant Chief of the Medical Clinic, Dr. F. F. IMonroe, was designated Acting Chief of the Medical Clinic. Other changes have been as follows: Capt. G. G. Marshall, M. C., Chief of the Eye and Ear Clinic, was relieved by Lieut. A. F. Ryan, M. C.; the position of Chief Sanitary Inspector was vacated by the Chief Health Officer's orders directing Capt. D. P. Curry, M. C., Chief Sanitary Inspector, to duty with the Eye and Ear Clinic; Lieut. C. M. Ming, M. C., Chief of X-ray Clinic, was relieved, by Capt. L. S. Townsend, M. C.; Capt. W. L. McFarland, M. C., Chief of Board of Health Laboratory, was relieved by Capt. L. B. 3ates, M. C., who was returned from the service of the Medical Department of the Army in the United States. In addition to this, many other changes have taken place among doctors, nurses, and sanitary inspectors. GENERAL REMARKS. The health in the Canal Zone and terminal cities has continued good, except for the usual increase in malaria, which occurs at this (5)

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6 time of the year, among the jungle-clearing gangs of the Cattle Industry. The communicable diseases have been, in general, as follows: Typhoid fever.-Three cases were admitted to hospital in January; 1 from Colon, traced to a carrier; 1 from the interior; and 1 from a ship passing through the Canal; no cases in February, and 2 in March. Diphtheria.-Eight cases occurred in January, 7 of which were in Panama and 1 at Coco Solo; in February there were 5 cases in Panama, 3 in Cristobal, and 5 in Colon; in March, 1 case in Panama, 2 in Cristobal, and 2 in Colon. Influenza.-A total of 188 cases for the quarter. Pneumonia.-Twenty-eight cases were reported, of which 7 were from passing ships. Meningitis.-Three cases reported, 1 from France Field, 1 from Las Cascadas; the third, a suspect, was not proven. Mumps.-Twenty-three cases reported during the quarter. Measles.-Twenty-one cases were reported. Chickenpox.-Thirty-five cases reported. Dysentery.-Thirty-two cases reported. Leprosy.-Two cases were picked up and sent to the leper asylum. Smallpox.-Forty-six cases admitted to hospital from Panama, Colon, and the interior. All but 10 cases have been discharged well, and those remaining in hospital are in good condition; no deaths. Tetanus.-One case, which recovered, occurred in a boy living in Balboa. There have been no cases reported of the following diseases: scarlet fever, German measles, pellagra, and beriberi. Yellow fever.-One case was brought to the Isthmus from Guayaquil, Ecuador, January 30, 1919. The last case previously brought to the Isthmus was on December 10, 1915. The last case originating on the Isthmus occurred in November, 1905. 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 March 31, 1919, which was 26,236, as compared with 25,122 Tor the preceding three months, and 28,349 for the corresponding three months of last year. Admissions to hospitals and quarters numbered 3,330, giving an admission rate of 507.68,1 as compared with 412.08 for the preceding three months, and 328.90 for the corresponding three months of last year. The constantly noneffective rate was 16.74 as comparedwith a rate of 11.55 for the preceding three months, and 9.93 for the!cerresponding three months of last year. 'All morbidity and mortality rates are computed as equivalent annual per thousand.

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7 Deaths from all causes numbered 46; of these, 40 were from disease, giving a rate of 6.08 from disease alone, as compared with a rate of 6.20 for the preceding three months and 5.64 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) malaria, (2) venereal diseases, (3) influenza, (4) diseases of the eyes and their annexa, and (5) organic diseases of the heart. These five diseases caused 28 per cent of all admissions to hospitals, malaria alone causing 12 per cent and venereal diseases 8 per cent of total admissions. The admission rate for malaria, hospitals and quarters, for the quarter year ending March 31, was 35.36, as compared with a rate of 18.31 for the preceding three months, and 16.79 for the corresponding three months of last year. The constantly noneffective rate from malaria for the quarter year ending March 31, was 5.20, as compared with a rate of 1.08 for the preceding three months and 0.85 for the corresponding thee months of last year. By race-For disease only, the admission rate to hospitals and the death rate for white employees were 227.60 and 0.88, respectively, as compared with 227.03 and 4.52 for the preceding three months and 227.18 and 5.30 for the corresponding three months of last year. For black employees, for dise-se only, the admission rate to hospitals and the death rate were 185.92 and 7.20, respectively, as compared with 128.48 and 5.80 for the preceding three months and 106.45 and 5.71 for the corresponding three months of last year. The constantly noneffective rates were 16 for whites and 16.90 for blacks. The admission rate to hospitals and quarters for malaria was 15.72 for white and 39.52 for colored employees, as compared with 9.92 for white and 20.08 for colored employees for the preceding three months and 16.79 for white and 23.67 for colored employees for the corresponding thrqe 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 this population, 41 deaths occurred during the three months' period ending March 31, 1919, 38 of which were from disease, giving a rate of 7 from disease alone, as compared with a rate of 8.12 for the preceding three months and 10.98 for the corresponding three months of last year. Of the deaths from disease, 45 per cent occurred among children -under 5 years of age, as compared with 34 per cent for the preceding three months. One hundred and forty-one births were reported for the three months' period ending March 31, 1919, giving a birth rate of 26. Of these births 53 were white and 88 colored. Eleven deaths occurred among children under 1 year of age, all colored, giving an infant mortality rate, based on the number of births reported, of 125 for colored children, with a general average of 78.02 for 1,000 births. Of the total births reported, 7 per cent were stillbirths.

PAGE 12

PANAMA CITY. The population of-the city, as shown by the health department census of June, 1917, is 61,369; in this population is included approximately 8,000 employees of The Panama Canal. From this population 278 deaths occurred during the three months' period ending March 31, 1919, 266 of which from disease, giving a rate of 17.32 from'disease alone, as compared with a rate of 21.36 for the preceding three months and 18.51 for the corresponding period of three months of last year. Of the total deaths from disease, 38 per cent occurred among children under 5 years of age, as compared with 44 per cent for the preceding three months. The principal causes of death, as compared with the preceding three months, were7as follows: OctoberJanuaryDecember, March, 1918. 1919. Tuberculosis (various organs). ..67 63 Pneumonia (broncho and lobar). 38 35 Nephritis (acute and chronic). 23 25 Diarrhea and enteritis. 35 21 Organic heart diseae. 17 11 Five hundred and thirty-two births were reported during the three months' period ending March 31, giving a rate of 34.68. Sixty-five deaths occurred among -children under 1 year of age, giving an infant mortality rate, based on the number of births reported, of 122.18. Of the total births reported, 5 per cent were stillbirths. COLON. The population of Colon, as shown by the health department census of June, 1917, is 26,078; in this population is included approximately 7,000 employees of The Panama Canal. From this population, 127 deaths occurred during the three months' period ending March 31, 1919, 117 of which were from disease, giving a rate of 17.96 from disease alone, as compared with a rate of 22.36 for the preceding three months, and 18.71 for the corresponding three months of last year. Of the total deaths from disease, 32 per cent occurred among children under 5 years of age, the same percentage as for the preceding three months. The principal causes of death as compared with the preceding three months, were as follows:

PAGE 13

9 OctoberJanuaryDecember, March, 1918. 1919. Tuberculosis (various organs). 29 28 Pneumonia (broncho and lobar). 18 20 Diarrhea and enteritis. 11 12 Nephritis (acute and chronic). ....12 11 Organic heart disease.9 10 One hundred and eighty-seven births were reported during the tree months' period ending March 31, 1919, giving a rate of 28.68. Twenty deaths occurred among children under 1 year of age, giving an infant mor. ality rate, based on the number of births reported, of 106.95. Of the total births reported, 9 per cent were stillbirths. DIVISION OF SANITATION. ZONE SANITATION. The usual activities in Zone sanitation, consisting large ly of antimosquito work, have been vigorously pursued during the quarter. A number of tile and stone drains have been installed in the Pedro Miguel sanitary district, on the east side of the Pedro Miguel river .and lake, also on the hillsides east of the main line of the Panama Railroad'near Paraiso. This work has been almost entirely within the pastures of the Cattle Industry, and has had for its object the elimination of anopheles breeding areas which were being punched up by the cattle. The edges cf the lakes about Pedro Miguel and 'Red Tank were cleared and cleaned on account of the anopheles breeding which was found at these places; for some reason, which was not entirely understood, these areas had not given much trouble until this year; larvae had been found in a few isolated areas, but not so generally distributed as during this quarter. At present this is controlled by oiling and grass cutting about water line. In the Ancon-Corozal district, considerable amount of new work has been done, consisting of straightening the stream which runs through the Corozal garden in its course between the new road and the Panama Railroad embankment. On the flat just north of this stream, new tile drains were laid and several hundred feet of old 10-inch tile were taken out and replaced by 6-inch concrete tile. The stream which runs down in the section of this district between the upper and lower Corozal pastures, was straightened, graded, and lined with concrete. In Espinosa's pasture. (Corundu River section), the drainage is being taken care of by subsurface tiling. Balboa district.-Very little permanent work has been done within the district proper. Considerable drainage work has been done at _Erfan, in order to protect the men in the Cattle Industry jungleclearing camp, also to eliminate the possible menace of mosquito flights from this area into Balboa.

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10 In the' Gatun district the work has been principally of a maintenance nature, except for straightening a great many of the old rock bed streams, in the old drainage systems. At Mindi swamp a rather extensive system of drains has been put in which has considerably improved this large swamp and which should help decrease the anopheles flight into Gatun. In addition to the above, considerable time has been put in by the Division of Zone Sanitation in prophylactic work against smallpox. The villages of Arraijan, Escobal, New Providence, New Limon, and El Vigia (all points of ready access to the Canal Zone), have been inspected and about 1,000 people vaccinated. No active cases of smallpox were found in any of these places with the exception of Escobal, where 14 cases of mild smallpox were discovered. The following is a tabulation of the malaria incidence for the: quarter by locality and type, for employees only: Number of employees admitted with each type. FromE. A. Tertian. Quartan. UndeterClinical. Total. Regularly sanitated districts in Zone: Fort Am ador. .1 ...I Balboa. 3 2 ....5 Ancon. *2 ...2 Pedro Miguel. ..I 1 Paraiso. 2 ..I .3 Culebra. 1 .....1 Gamboa. ...1 Gatun.1 1 1 3 .6 Cristobal. 2.2. 4 Total. 9 6 2 7 .24 From pastures camps and nlantations: Farfan. 51 11 ..14 .76 Cardenas. I ..1 Miraflores. ...I Barunc:a. 6 3 .13 .22 Summit. 1 .4 Lim on. I ...1 Darien. .1 4 .5 Darien No.2. 9 5 .8 .22 Frijoles. 3 1 .I .5. 5 Bohio. 28 8 .10 .46 Mount Hope. ..1 ....1 Total. 102 33 .,. 49 184 Other miscellaneous cases from Zone: Corozal-P. Miguel road. .1 1 ..... Colon. 5 1 ...6 Panama. 10 t3 ..13 Las Savanas. 1. Interior, Republic of Panama. 1 1. 2 Grand total. 129 45 2 56 23 Two recurrent. t One recurrent.

PAGE 15

The tabulation shows that the principal source of infection was without the regular sanitated areas. The incidence within the sanitated area was 18.6 per cent of the cases reported, with 81.4 per cent of cases reported coming from jungle camps or other points outside of the regularly sanitated areas. PANAMA HEALTH OFFICE. The last case of smallpox reported in the city was on March 11, 1919. There was a total of 37 cases during this quarter, as compared with 46 and 58 in the two preceding quarters. All cases were sent to Ancon Hospital. During the quarter, 1,316 vaccinations have been made in the city. A general house-to-house vaccination is being done. This work is valuable in that it will, as time goes by, result in complete vaccination of all persons in the city, thereby preventing a recurrence of such an outbreak as that of last summer. The veterinarian attached to this office is in every way qualified to do the milk and dairy inspection work, but his time is very much occupied with meat and cattle inspection, and it will not be possible for either the meat and cattle inspection work or the dairy and food inspection work, to be done properly. The need of another veterinarian is urgent. The food inspection has been turned over temporarily to the district sanitary inspectors. Abaut 64,000 yards of ditches were cleaned in preparation for the rainy season. A large portion of this work was in the Savanas district where much ditching has been done, many water holes filled, and the portion which we have sanitated can be easily controlled hereafter. In connection with the question of sanitation of the Savanas district, a comprehensive survey of this district is necessary in order that it may be thoroughly sanitated; this should be done on account of the great number of people who live there during about six months of the year. This district is responsible for a large number of malaria cases which can be easily eliminated in the future. We have shortened many ditches, and filled a large number to a proper grade so that no water holes are left; this policy is being continuously pursued, and although our reports show that cleaning and oiling of the remaining ditches is done several times oftener than previously, a reduction in oil used has been made as follows: Number of gallons of oil used during the first quarter of 1916, 6,530; 1917, 6,168; 1918, 2,400; 1919, 1,762. Two hundred and forty fines were imposed during the quarter for violation of sanitary regulations. The imposition of these fines has a very marked effect upon maintaining sanitary conditions in the city, as threats do not avail. and the ordinary small fine imposed seems to be the best method of controlling the bulk of the population. In the matter of building inspection, especial attention is being. paid to overcrowding and its necessary sequence, ventilation. We have had little, if any, trouble in having the ordes of our building

PAGE 16

12 inspector carried out. Three buildings were condemned as unsafe and unfit for occupation, tWo of which were demolished. Plans for five new buildings were approved, and 141 permits were issued for repairs. The building inspector is now about completing a survey of all schools in the city. The survey to date shows much overcrowding and lack of proper ventilation. When this survey is completed, a personal inspection will be made and the number of pupils per school will be reduced so as.to conform to the regulation of 300 cubic feet of space for each person therein. The streets have been kept in uniformly good condition. A few hours overtime each day during the carnival were found necessary in ox der to take care of the unusually large amount of debris. The hours of garbage collection have been changed a number of times at the request of the Municipal Engineering Division. who now have charge of the operation of the incinerator. At present the garbage collection begins at 8 p. m. This is too early to get the best results for the labor expended but we are endeavoring to comply with all requests made from the Municipal Eigineering Division regard'ny the collection of garbage. One additional street sweeper is needed within each district in the city; although the streets are now kept reasonably clean, the addition of one man per district would add much to the efficiency of the work. COLON HEALTH OFFICE. Antimalarial work has been extended in the Mount Hope district so as to include several large anopheles breeding areas, notably in pasture No. 12, which is located about three-fourths of a mile from Mount Hope railroad station, and the swamps in the vicinity of the hog farm. These swamps were drained during this quarter and good results are expected from this work. The large swamp located between G Street and New Cristobal is being filled and when completed mosquito breeding in Colon will be practically eliminated. A permanent concrete drain, approximately 2,000 feet in length, is being installed across fill No. 2-A and 2-B, Mount Hope. We are using coarse coral rock and sand for this drain, instead of Gamboa gravel and sand. Several depressions in the Mount Hope scrap yard were filled during this quarter, and several remain to be filled. These depressions which were caused by the heavy scrap iron, etc., have been a constant source of mosquito breeding during the past, but with the removal of this scrap which is going on rapidly at present, these mosquito-breeding areas will soon be under control. The malarial rate in this distract continues to remain low; only 10 cases among employees were reported during the quarter as compared with 8 cases for the corresponding period in 1918. The large swamp south of the coaling station was filled during the quarter by the Dredging Division, thereby eliminating a large mosquito-breeding area. There were 25 cases of tuberculosis reported during the quarter, as compared with 16 cases for the same period a year ago. Ten cases of smallpox were reported from this district from September, 1918, to February 3, 1919. No cases -have occurred since

PAGE 17

13 the latter date. The entire population was vaccinated against smallpox during this quarter. Inspection of meat and meat-food products at Cristobal has been carried on in the usual manner. It was thought advisable to make a careful post-mortem inspection of all viscera aInd this has necessitated an increase in the veterinary staff. The post-mortem inspection of the viscera has not been done here according to the Bureau of Animal Industry regulations, but with the increase in the staff our inspection will be more thorough than that required by these regulations. The Colon prophylactic station which was established in June, 1918, was discontinued on January 15, 1919. About 100 registered prostitutes left Colon during the campaign. With this exception, prostitution remains about the same as it did before the campaign was started. The public health nurse of this office made visits as follows: To tuberculosis patients, 13; home service instruction, 783; hospital clinic, 256; business, 56; She had a total of 159 patients under her care, in their homes. Quarantines were imposed as follows: Pertusis, 28; measles, 6; mumps, 2; chickenpox, 7; diphtheria, 7; smallpox, 1. Since February 18, 11 lectures have been given by the public health nurse to the midwives of Colon and Cristobal, the time of each lecture covering two hours. Forty-five fines were imposed during this quarter for violation of Sanitary Rules and Regulations.

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14 TABLE I-DISCHARGES, DEATHS, AND NONEFFECTIVE RATES FOR EMPLOYEE& ABSOLDr NUMBERS. Discharges and deaths Death Noneffective from hospitals. from sickness. First carter, 1919: White .4,573 285 260 25 1 16, 587 73.18 Colored ...21,663 1,169 1,007 162 45 39 6 2,9591366.21 Total ....26,236 1,454 1,261 187 46 40 6 3q.546 439.39 fourth quarter, 1918: White .4,421 277 251 261 5 5 .6,407 71.19 Colored .20,701 759 664 95 34 30 4 19,703 21s.92 Total ...2.5,122 1,036 915 121 39 35 41 26,110 290.11 First quarter, 19 18: White .4,525 300 257 43 G 6 6,521 72.46 Colored .....23,824 837 6341 2031 45 34 111 18,825 209.16 Total .28,34 1,137 8_1 2461 51 40 11 25,346 1 281.62 PROPORTTONATE NuiBRs.' First quarter, 1919: White .4,573 249.28 227.60 21.88 0.8i 0 88 .16.00 Colored. 21,663 215.84 185092 29.88 8.32 7.20 2 16.90 Total. 26,236 221.681193.16 28.52 7-09 6.08 .92 .16.74 Fourth quarter, 1918: White. 4,421 2 27.08 2352 4.52 4.52 .1610 Colored. 20,701 146.641128.48 18.56 6 56 5.80 .76 .10.58 Total. 25,122 16496 145.68 19.28 630 5-56 .64 .11.55 First quarter, 1918: White. 4,525 265.19 227.18 3 ..2 2.4. Colored. 23,8241 34.53 106.454 34.08 7.56 5.71 1.85 8.78 Total. 28,349160.43125.72 34.71 '.19 5.64 1.55. 9.93 Annual average per 1,000 employees.

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15 I' Eu II.-CAUSES OF DEATHS OF EMPLOYEES, BY COLOR, AGE, AND LENGTH -OF RESIDENCE ON ISTHMUS. Color. Age (in years.) Causes of death. W. B. 15-20 21-25 26-30 31-35 36-40 Apoplexy. .4. ....1 1 Abscess of the liver. .1 .1 Cerebrospinal fever ..1 ..1 Cirrhosis of the liver.1. .. Embolism and thrombosis. .1. Gonococcus infection. I. Meningitis, simple.1 ..1. Nephritis, acute. .4. ....3 Nephritis, chronic. .3 ...1. Organic disease of the heart.2. .....2 Peritonitis ..2 ...I Pneumonia, broncho. .I .... Pneumonia,lobar. ...i 1 1 Syphilis.1. ..1. Softening of the brain. .1 Septicemia. ..1 Tuberculosis, pulmonary. .8 .1 1 5 External causes. Drowning, accidental. .1. Traumatism by machine. ...1 Homicide by cutting or piercing instruments ..2 .1 1. Starvation.1 .I Otherexternalviolence. Total. 1 45 .5 o 10 1a Color. Age (in years). Cause of death.I W. B. 41-45 46-50 51-55 56-65 Apoplexy ..4 1 Abscess of the liver. .1. Cerebrospinal fever. I. Ci hoism of the liver. 1. Embolism and thrombosis. ... Gonococcus infection. .... Meningitis, simple. .. Nephritis, acute. .4. Nephritis, chronic. ...3 1 .I Organic disease of the heart. .6 1 2 i Peritonitis ....2 1. Pneumonia, broncho. ..I. Pneumonia, lobar. .L. 3 Syphilis. ..I ..... Softening of the brain. 1 1. .. Septicemia. .I .. Tuberculosis, pulmonary.8. External causes. Drowning, accidental ... Traumatism, by machine ..... Homicide by cutting or piercing instruments. .2. Starvation ....I ............ Other external violence. Total. 1 45 4 6 3

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16 T&sz.3 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 8-16 der 1. Apoplexy. ... Abscess of the liver. .1 .... Cerebrospinal fever .... Cirrhosis of the liver. .1 ... Embolism and thrombodi3. ....1 .. Gonococcus infection.I. ...... Meningitis, simple .I. .... Nephritis, acute. ..4 ... Nephritis, chronic.3. ..1 .. Organic disease of the heart 6 .....1. Peritonitis. .2 .......1 Pneumonia, broncho. .1. ... Pneumonia, lobar. .3 Syphilis.1. ......1 Softening of the brain. -1 ...1. Septicemia. .j ... Tuberculosis, pulmonary,. .8 .1. .1 External causes. Drowning, accidental. .I. Traumatism by machine. .1. Homicide by cutting or piercing instruments ..2 ... Starvation.1. Other external violence. .... Total. 1 45 1. 1 2 3 4 Color. Length of residence on Isthmus (in years). Cause of death. W. B. 10-15 15 Life. UnToknown tal. Apoplexy. ..4 2 2 ...4 Abscess of the liver. .1 ....I Cerebrospinal fever ...1 ....Cirrhosis of the liver. .1 ...1 Embolism and thrombosis. I .....1 Gonococcus infection ..1 1 ...I M eningitis, sim ple. 1 ..1 .1 Nephritis,acute. 4 2 1 1 .4 Nephritis, chronic. .3 1 1 ..8 Organic disease of the heart. .6 2 2 1 .6 Peritonitis ....2 1 ..., 2 Pneumonia, broncho. .1. .I Pneumonia, lobar. .3 3 ...3 Syphilis. 1 .....1 Softening of the brain .1 ...I Septicemia. I ...1 Tuberculosis, pulmonary. .8 4 1 *. .8 External causes. Drowning, accidental. I .1 I Traumatism by machine ...1 Homicide by cutting or piercing instruments. 2 ..1 2 Starvation n. ...... Other external violence. 1 1. Total. 1 45 19 7 3 5 46

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17 TAD 11.-DEATHS OF RESIDENTS OF THE CITIES OF PANAMA, COLON, AND THE CANAL ZONE. Deaths. Annual rate per 1,000 population. Population. External Externil Total. Disease. causes. Total. Disease. caa First quarter. 1919: Panama. 61,369 278 266 12 18.12 17.32 0.80 Colon. 26,078 127 117 10 19.48 17.96 1.52 CanalZone. *21,707 41 38 3 7.56 7.00 0.56 Total. 109,154 446 421 25~ 16.36 15.44 0.92 Fourth quarter, 1918: Panama. 61,369 336 327 9 21.88 21.36 0.60 Colon. 26,078 152 146 6 23.32 22.36 0.92 Canal Zone. *21,707 49 44 5 9.04 8.12 0.92 Total. 109,154 537 517 20 19.68 18.96 0.72 First quarter, 1918: Panama.61,369 291 284 7 18.97 18.51 0.46 Colon. 26 078 133 122 11 20.40 18.71 1.69 Canal Zone. *24,038 71 66 5 11.81 10.98 .83 Total. 111,485 495 472 23 17.76 16.94 .82 *Exelusive of military population. MR 68566-2

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18 TABnz IV.-DEATHS OF CIVIL POPULATION (EMPLOYEE$ 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 diseases. Typhoid fever.1.I .. Malaria ..1 1 .2 1 1. Malarial fever: 2 Estivoautumnal. 2 1 .3 1 4 Tertian. 1 ...1. Whooping cough. Diphtheria and croup. 3 .1 1 I. Leprosy. 21 1. Purulent infection and septicemia. 2 ..2. Septicemia. 1 2 .3 Pellagra .2 .2 Tuberculosis of the lungs. 48 39 6 81 3 1 Acute mifiary tuberculosis. 8 ..1 Tuberculous meningitis. .3 3 ... Abdominal tuberculosis. 3 1 4 ..I W hite swellings. ..1 ..... Disseminated tuberculosis. .1 Syphilis:7 Tertiary ..... Period not stated. 2 1 3. 1 1 Gonococcus infection .1 Cancerand othermalignant tumors of the stomach and liver. .1 1. 2 .. Cancer and other malignant tumors of the female genital organs. .3 ...3 Cancer and other malignant tumors of I the breast. .I Cancer and other malignant tumors of other organs and of organs not specified 2 1 3 .. Other tumors (tumors ot the female genital organs excepted) ...I. Diabetes ...1I .. Leukemia ..I. Leukemia, lymphatic ..1 ... Diseases of the nervous system and of the organs of special sense. Simple meningitis. .2 2 2 1 .1. Cerebro-spinal fever. 1 ..1. Other diseases of the spinal cor4. ... Cerebral hemorrhage, apoplexy. 5 7 1 11. Softening of the briiE .1 .1. Paralysis without specified cause. 3 ...3. Other forms of mental alienation. .I .1 .. Convulsions of infants (under 5 years of age). I ... Diseases of the circulatory system. Acute endocarditis. 2 2 1 3 j. 1 Organic disease of the heart. .16 7 2 20 Diseases of the arteries, atheroma, aneurysm, etc. .. Arteriosclerosis ..5 2

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19 AN) NONEMPLOYEES) BY CAUSE, SEX, COLOR, AGE AND RESIDENCE. Age (in years)-Qontinued. Place of residence. Age 21-30 314o 41-50 51-60 61-75 76-100 UnPanColon. Canal Total. known. ama. Zone. ......1 ..1 .....3 11 ......1 .....3 .3 ......2 1 1. .2 2 S. ....o. 3 .. 1 1 ......3. ..3 1 1 2 2 38 21 13 3 1 2 1 56 26 5 87 38 21. ..2. .6. I 26.8I7 1. ...1. I 1 ....2 2 3 1 .4 .....1. I. I 1. .1 ....2 I 3. 1. .f. .1 1 S1 .1.2 1 1. .3. 3 I. ....I 1 1 .2 1 1 4 ...I. ........I1 .... .......1. I 1 .1 1 1 1 1. ....4. .4 1. ...I 1 ...1 I .1 3 .7 4 f 12 1. ...1 I 2 ..2. .....1 1 ':. 3 1. 2. .I. 1 .....1 1 1 1 4 3 4 10 2 2. .11 10 2 23 1. ..1 1 1 1 1 .-2.2.4 1.2

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20 TABLE 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 l yr. Diseases of the circulatory system.Continued. Embolism and thrombosis. 2 .2. Varicocele. 1 .1 .... Diseases of the respiratory system. Acute bronchitis. 6 5 .11 .7 4. Chronic bronchitis ..2 .2 Broncho-pneumonia. .26 16 2 40 .13 17 3 4 Pneumonia, unqualified .1 2 .3 .1. Lobar pneumonia. 9 4 .13 1 Gangrene of the lungs.1. .... Diseases of the digestive 8ystelM. Diarrhea and enteritis (under 2 years). 23 12 1 33 1 2510 Colitis. 1 ..1 Diarrhea and enteritis (2 years and over) 3 1 .4 .3. Colitis. .1 .... Ankylostomiasis. .1 .I .. Ascariasis. ..... Acute appendicitis. 2 1 1 ..1 Hernia, intestinal obstructions.1 1 .2 Intestinal obstructions.,. 1 .1 Cirrhosis of the liver. 1 1 .2 Biliary calculi. .1 .1. Abscess of the liver entamebic. .1 Cholecystitis.1 .1. .. Simple peritonitis (nonpuerperal). 8 4 1 11 ...1 Nonwenereal diseases of the genito-urinary system, and annexa Acute nephritis. 7 8 2 13 .3 2 1 Bright's disease (chronic nephritis). 18 6 2 21 1 2 .. Otherdiseasesofthekidneyandannexa. 2 .2 .1 ..1 Pyelo-nephrosis. 1 1. 2 Salpingitis and other diseases of the female genital organs.1. 1 .1 ..1 The puerperal state. Puerperal hemorrhage ..1 .1. Puerperal septicemia. .1 .1. Eclampsia. 1 .1 ... Malformations..Congenital malformations (stillbirth not included). .1 2 1 2 .2 1.

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21 NONEMPLOYEES) BY CAUSE, SEX, COLOR, AGE, AND PLACE OF irntinued. Age (in years)-Continued. Place of residence. Age :21-30 31-40 41-50 51-60 61-75 76-100 unPanColon. Canal Total kow ama. Zone. ....1 1 .2 .2 2 1 1 .2 4. 13 3.42 1 1 .2 1. ....1. ..7. 2. .1. 3 4 2 1 1 1 .7 6 .I 18 11 8 35 1 1 I. .1 4 ...1 .. 1. ...I. ..1 6 3 S. ...4 .I. ...... ...2 I. .....1. ..1 .1 2. 1 .. 1. ....I:. 2 1 1 .7 1 1. ...7. 4 3 2 .9 3 3 1 6 8 ...2 .24 '' *" ** --"*'* '**2.I ...2 1. ....2. ..2 1 1 2.1 4 --......933i 1. ....1. ......1. ..I 1. ...... ..... ................

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22 TABLE IV.-DEATHS OF CIVIL POPULATION (EMPLOYEES AND RESIDENCESex. Color. Age (in years). Cause of death. Un M. F. W. B. Y. der 14 50 11-20: 1 yr. Diseases of early infancy. Newbornchild. 3 1 .4 .4 Congenital debility, icterus, and sclerema 1 2 .2 1 3 Premature birth. 1 6 .7 7 .. Congenital debility. 1 .1 1 Malnutrition.:. 6 5 .11. .9. Other causes peculiar to early infancy (including various consequences of labor). 1 2 1 2 .3. Old age. Senility.1 .1 ... Affections produced by external causes. Other acute poisonings.2. 2 ... Burns (conflagration excepted). 1 1 .2 2 Accidental drowning. .3 ..3. Traumatism by cutting or piercing instruments.1 .1. .. Traumatism by fall. 2 .2. .2 Traumatism by machines. 1 ..1 Traumatism by other crushings, (vehi* les, railroads, landslides, etc.). 3 ..3 .. Starvation. I .1. Homicide by firearms .1 .1 ... Homicide by cutting or piercing instra.ments. 3 ..3 Fractures (cause not specified). .4 1 1 4. 2 Other external violence .1 ..1. Ill-defined diseases. Cause of death not specified or ill-defined. 2 3 .5 2 1 1 Infections of undetermined origin. 1 ..1 ... Total. 263 183 32 410 4 96 60 14 14 Stillbirths. 25 31 4 52. Grand total .2S8 214 361 462 4 96 60 14 14

PAGE 27

23 XONEMPLOYEES), BY CAUSE, SEX, COLOR, AGE, AND PLACE OF -Continued. Age (in years)-Continued. Place of residence. Age 21-30 31-40 41-50 51-60 61-75 76-100 ananColon. Canal Total. known ama. Zone. 4. .4 .....4 3.7 4 4 3 7 .............I. ...... 8 1 2 11 1 1 1. ..................3 ....................3 ........... .............2 ....................1 2 .~i<:. .......2 1 3 2. .~~. .......I 1. .1 2 ...... 3 1. .....4. I 2 .1. .....I 3. .....I .43 1 5 .......1 81 75 53 26 16 9 2 278 127 41 440 I. ........29 17 l(0 56 8137 26 16 9 2 307 14; 51 502

PAGE 28

24 Sex. Color. Cause of death. M. F. W. .-Organic disease of the heart. 1 ..I Anemia, chlorosis ..1 1 ... Abscess of the liver. 2 ..2 Dysentery. 2 .2 Eclampsia.1 .1 .. Electrocation, accidental. 1. 1 .. Cirrhosis of the liver. .1 .1 Chronic nephritis. 3 1 1 3 Broncho-pneumonia.2 .2 1 Lobar pneumonia, .7 .1 6 Malaria. 1. 1 .1 ... Diarrhea and enteritis. 1 2 ..3 Pulmonary tuberculosis. 9 .2 3 8 Empyema. .I .. Typhoid fever. 1 ..1 Yellow fever. 1 .... Other diseases of the kidney and annexa ....I ....,. 1 .. Congenital malformation. I .1. I' Congenital debility. ...1 1 Leukemia lymphatic. 1 .1. .. Acute appendicitis. 1 .1 Injury by animals. 1 .1 Accidental drowning. 1 ..I Burns (conflagration excepted). .1 .1 ... Other external violence. I ..1. Infections, undetermined origin. I ..1. Traumatism by fall. .1 .1 ... Homicide by firearms. .1. Total. 43 10 16 37 2 Includes deaths of all nonresidents, off incoming ships, etc. Deaths of nonresidents are not taken up in the statistical charts relating to Panama, Colon,

PAGE 29

a 25 0F NONRESIDENTS.9 Age (in years). -Total 1-4 5-10 11-20 21-30 31-40 41-50 51-60 61-75 Over 75 years. -.-.-. -. ..................... 1 .....1 1. .... 1. 1. ... S. .... .1. .. .......3 5 2 .......I ...1. ....1 1 .~~ ......... ..2. ....3 .1. .... 1 1I 3 .. ..1. .I .1. .I ....I ...... .1. .. ........1 1 0 3 13 11 16 3 3 53. wd the Conal Zone. xA I --1:.-.x. 1.-.-.

PAGE 30

26 TABLt V.-DEATHS BY NATIONALITY -OR NATIVITY. Nationality. Employees. Nonemployees. Total. Grand total. Male. Female. Male. Female. Male. Female. Antigua. 3 .2 .5 .6 Barbados ..17 .37 27 54 27 81 BritishGuiana. ..1 1 1 1 2 Chile. ..11 .1 China. ..5 1 5 1 8 Colombia. I .16 11 17 11 28 Costa Rica. 1 .1 1 2 1 3 Quba. ..1 .. Dem erara. ....1 .1 Dominica. ....i 1 2 Ecuador ...1 1 1 2 England. .1 1 1 1 2 France .....I .1 I Grenada. ..2 3 2 3 6 Ouadeloupe. 1 .5 2 6 2 8 Greece. ...1 ..1 Guatemala. ....1 Haiti:. 1 .1 Ireland. .1I I Jamaica. 11 .45 47 56 47 103 Martinique. 2 .?. 8 3 10' 3 13 Alexico. ..1 .1 ..1 M ontserrat. ..1 1 1 1 Nicaragua. 1 ..1 1 1 2 Panama. .71 60 72 0 132 Peru. ..3 1 3 1 4 Porto Rico. ..1 .I Spain ..4 2 5 2 7 St. Andrews. 1 1 1 t. Kitts. 1 .. St.Lucia. 2 .2.4 4. 8 St. Thomas .1 .1. St. Vincent's. I .2 1 3 Trinidad. .5 3 5 3 8 United States. .2 2. 2 Venezuela. ..1 3 1 3 Virgin Islands. ...1 .I Total. 46 .217 183 263 183 448

PAGE 31

27 T"mI VL-STATISTICS RE AMERICAN EMPLOYEES AND THEIR FAMILIES. Annual death rate per 1,000 population. White employees from the United States: Disease. o External causes. 0 Total .:. .0 White women and children from the United States: Disease. 1.92 External causes. 0 Total. 1.92 White employees from the United States and their families: Disease. .1.12 External causes. .0 Total. .1.12 Number of American children born on Isthmus for three months ending March 31. 38 Deaths among American children under 1 year of age. 0 Infant mortality rate among American children (number of deaths per 1,000 births). 0

PAGE 32

28 TnmaV.-BIRTHS AND BIRTH RATES IN THE CANAL ZONE AND THB CMTS OF PANAMA AND COLON. Births. Rate per 1,000 population. Popula-___-___ tion. stillstill Total. Alive, born. Total. Alive. born. First quarter, 1919: Panama. 61,369 561 532 29 36.56 34.68 1.88 Colon. 26,078 204 187 17 31.2S 28.68 2.00 Canal Zone. *21,707 151 141 10 27.84 26.00 1.84 Total. 109,154 916 860 56 33.56 31.48 2.04 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 2.78 First quarter, 1918: Panama .61,369 662 626 36 43.15 40.80 2.34 Colon. .26,078 212 194 18 32.52 29.76 2.76 Canal Zone.*24,038 163 157 6 27.12 26.12 1.00 Total. 111,485 1,037 977 60 37.21 35.051 2.18 Exclusive of military population.

PAGE 33

29 T&ALB VI.-INFANT MORTALITY RATES IN THE CANAL ZONE AND THE CITIES OF PANAMA AND COLON. Births. Deaths among Death children rate per Populaunder 1 1,000 tion. Feyear of births. Malemale. Total age. First quarter, 1919; Panama. 61,369 282 250 532 65 122.18 Colon. 26,078 96 91 187 20 106.95 Canal Zone. *21,707 70 71 141 11 78.02 Total. 109,154 448 412 860 96 111.63 Fourth quarter, 1918; Panama. 61,369 313 292 605 121 200.00 Colon. 26,078 126 90 216 36 166.64 Canal Zone. 21,707 102 101 203 10 49.26 Total. 109,154 541 483 1,024 167 163.08 First quarter, 1918; Panama. .61,369 325 301 626 102 162.94 Colon. .26,078 114 80 194 33 170.10 CanalZone. *24,038 71 86 157 20 127,39 Total. 111,485 510 467 977 155 158.65 *Exclusive of military population.

PAGE 34

30 TABLE IX.-DEATHS OF INFANTS BY CAUSE, SEX, Sex. Color. + i -1 .week Cause of death. week. -I M. F. W. B. month. M alaria. ... Malaria fever, estivoautumnal. 1 ..I. Syphilis.1 .1 .. Simple meningitis. ... Acute bronchitis. 4 3 .7 1. Chronic bronchitis.2. Broncho pneumonia. 7 6 1 12 .2 Lobar pneumonia. .1 ..1. Diarrhea and enteritis. 15 11 1 25 2 1 Colitis.I. 1 .1. Biliary calculi. .. Acute nephritis ..1 2 1 2. Other diseases of the kidney and annexa .1 ...1. Septicemia .11. Congenital malformations. 1 1 1 1 Newbornchild. 3 1 .4 21 Congenital debility, icterus, and sclerema. 1 2 .3 2 1 Premature birth. 1 6 .7 7. Congenital debility. .1 M alnutrition. 6 3 .91 Other causes peculiar to early infancy. 1 2 1 2 3. Other acute poisonings. Burns (conflagration excepted). 1 1 .2. Cause of death not specified or ill-defined ...2 ..2. Infections of undetermined origin. 1. .I. Total. 51 45 6 90 19 8 Infant mortality rate, based on the number of births reported for the quarter (deaths under I Percentage of deaths under 1 year of age to total deaths) for 3 months ending March 31,

PAGE 35

31 OLOR, AGE, AND PLACE OF RESIDENCE. Age (by months). Place of residence. --2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-1010-1111-12 Panama Colon. Canal Total. Zone. ..1 .... 1 ...1 ....1 ..... 1. ........1 ... 2 ..1 1. 2 4 2 1 7 .....1 ...2 .2 I 1 .1 2 1 1 2 1 9 4 .13 3 ....1 ..I 3 3 4 4 1 3 ..2 1 1 1 14 7 5 26 ....1 ....1 ........3 ..3 13 ..........3 ..3: I. .....1. ...I .....1 2 .1 ..4 ....2 1 4 ..4 3 ..3 ...............4 3 .7 ...I 1 2 1 1 ......w 1 1 ..6 1 2 9 .I.1.3 ..3 1 ..1. .......2 ..21 ..1 1 .1 2 1 ......1 2 .2 1. .....I 14 8 6 8 1 7 4 6 1 41 5 6 65 20 11 96 year of age per.1,030 births). .122.18 106.95 78.02 111.63 1919) ....23 16 27 22

PAGE 36

32 TABLEi X.-BIRTRS, CLASSIFIE Birthplace of mother. Birthplace of father. Birh0ic of 0ather. J5 C) -00 Antigua. 4 Barbados.129.1 4., I.1. China. .3.1. Costa Rica. .. Colombia. .9 I. Curacao, D. W. I. Domunca. Demarara. .1. Egypt. .1. .... Ecuador. France. .12. ...3 1 .. Finland. ......1 Greece. ..... Grenada. 2. ....... Guadeloupe. .......2 Germany. Ireland ...1. tapt. Jcaarn. ......... Jamaica .2. ...1 Martinique.*. Montserrat.1 Panama. .23 1 .. Pueru. ...........2 Porto Rico. Russia. Sweden. St. Andrews. .: St. Lucia. .1. St Kint. St. incents. ........ Panama ..16. 3 1. .. Tr -id. .... ..s i .............:. -:.-. S. -.ed.-::.1 :1. 1 -. St n r w .......-. -. .* Seneuela ....I. ........ St i ce t .........8 -.--:. :. ........ Trsx. 2 : Totates ..--3:8:1 -:3 :.-. T otal~~~~~~~~ ~ ~ ~ ~ ~ ~ ..........1 7 3 1 1 3 8 8 t 3 1 F 2

PAGE 37

33 BY BIRTHPLACE OF PARENTS. Birthplace of mother-Continued. --2 ....1. ....8 ...16 .2 1 11 165 48 1 ..7. 2 ..15 ......................1 28 ......1 4 ............1 -.6 -2 2 2 22 S2 2 ...... --~ -o W 2 ............5 ......................... ....14 .....1 .....2 1 .......15 S. ..........7 ...1 ...........1 4 1' 4 ....2 ...I ....6 2 .........2 2. ............-T S. 2. ........2 1 ...........U .2 ........... 1 1 ..1. ....14 24. 1 ....2. ....1 2 ......, .........2 2 1 ..192 ........1 .1. .1 1 ...1 .....2 .2 1 10 ...... .........3 1 7. 1. .3I. ...1 1. 25 2 .I.2. ......1 I~~ ~ .0. ....1. ......12 .-. ...2. ...i .........2. ........1 4 2 .I .....*,*1 2. 1 2I. .........7. .2 2. 1. ... 2. .27 41. .. .....1. .4. ..I I I : I : : I I : ....8 1 4236 115I3302 1 2 22 1 16441 9281 5 860. MR 68566-3 A-

PAGE 38

34 TABLE XI.-DSCHARGES AND DEATHS IN THE HOSPITALS OF AND MARCH Employees. Discharges. Deaths. Disase. White. Black. White. Black. M. F. M. F. M. F. M. F. General diaease8. Typhoid fever. Paratyphoid fever. .. Malaria. 1. Malarial fever: Estivoautumal. 13 2 92 4. Tertian. 11 1 17 9 Quartan. ..... Undetermined. 3 .29 14. Clinical .I. Cachexia. .... Hemoglobinurie fever, malarial. .. Smallpox .1 .3. ... Varioloid. 1 .. Vaccinia. Measles.1. Diphtheria and croup .. Diphtheria bacillus carrier .. Influenza. .30 2 32. ... Dysentery, entamebic .1 ... Yellow fever. .... Leprosy. Chicken pox. 9 .. German measles .... Mumps ... Filariasis. ... Purulent infection and septicemia ..2. .. Septicemia. .... Pellagra. Beriberi. .... Tuberculosis of the lungs ..3 .14 1 7. Tuberculous meningitis. .. Abdominal tuberculosis. Pott's disease. ....... R ickets. ........ Syphilis: Prim ary. ..1 2 .... Secondary.1 1 1 ... Tertiary. 6 .50 4 ..,. H ereditary. ......,. Period not stated. Gonococcus infection. ...1. Gonorrhea. 2.

PAGE 39

35 THE PANAMA CANAL FOR THE MONTHS OF JANUARY, FEBRUARY, 1919. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. White. Black. White. Black. *o o o M. M. F. M. F. M. M. F. M. F. M. F. M. F. M. F. M. F. 2. .2. .2 ....4 ........ 2 ................3 69 10 9 7 13 ....2 .......221 24 5 2 3 7 ...I .2 .......81 1 3 ........... 10 2 ...........62 6 ..1 .1 .............1 ......... 1 ............... 1 16 22 ..............44 1 3 1 ..... 1 I 1 .....1. ......... 21 .1 .......4 28 5 8 2 1 ..47 .......155 6 .1 1. ..........10 ...1 .... ...I ....1. 2. 1 2 3. ......17. .I. ..1. ..........1. 6. 1 .1. ..... ................1 1. 1 .............4 1 S. ......2 1 ..............2 S. .1 13.1.6.1 .3 ..432 .......2. ........2 1. ...6 .2. ...... 4 1 .2 .6. 16 1 5.11. ......18. 4 ............7. 1. .1 .2 .1 12 1 1 1. 9 .48.

PAGE 40

36 TABLE XI.-DISCHARGES AND DEATHS IN THE HOSPITALS OF THE AND MARCH, Employees. Discharges. Deaths. Diseases. White. Black. White. Black. M. F. M. F. M. F. M. F. General diseases.-Conti nued. Gonorrheal arthritis. .3. Gonorrheal orchitis and epididymitis. 1 17 5 Soft chancre. 2 19 12 Adenitis chancroidal. 3. Cancer and other malignant tumors of the female genital organs. Cancer and other malignant tumors of the breast Cancer and other malignant tumors of other organs and of organs not specified. Other tumors (tumors of the female genital organs excepted) .1 .4. Acute articular rheumatism. ...1 Chronic rheumatism and gout. Sc-irvy. Leukemia. Leukemia lymphatic. Hodgkin's disease. Anemia, chlorosis Chlorosis. Anemia, secondary, cause not determined. 1. Other general diseases.2. Alcoholism, acute.4. Alcoholic psychosis. Diseases of the nervous system and of the organs of special sense. Cerebrospinal fever. .... Locomotor ataxia .1. 1 .. Cerebral hemorrhage, apoplexy. 1 ..3 86ftening of the brain. ...1 Paralys's without specified cause ..2. General paralysis of the insane. Other forms of mental alienation .1. Dementia precox .1. Epilepsy .2. Convulsions (under five years). Chorea Neuralgia. .1. Neuritis. 3. Other diseases of the nervous system. 2 2.

PAGE 41

37 PANAMA CANAL FOR THE MONTHS OF JANUARY, FEBRUARY, 19.-Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. White. Black. Wlite. Black. S 0EEM. M. F.M. F. M. M. F. M. F. M. F. M. F. M. F. 1 ..2. .4 2 ......26. 4 .....3 3 .3 .. 2. 2 .2. .1.3 2 1 1. 2 1. 1 .1.2 3 .2. 1 ..10 1 1. ...........4. .....I ....1.I ......1I .............. .1. .....I ......I. ..2 I. ......I. 1. ........2. ........I. ...... .2 2. ............. 1 .4. I1. ..i. .I. ......6. ...1. ........ .I. 2 2. ..I. .....1 : ............ 1 ..........3 1 ............-.3 1 .i 1 .~~~. ...I. .......I. ..1 7. 11 5 1 ...I. ..I. ..... .2 ..........4. ....1. ....... .............I. 16 12 1.

PAGE 42

38 TAULz XI.-DISCHARGES AND DEATHS IN THE HOSPITALS OF AND MARCH, Employees. Discharges. Deaths. Diseases. White. Black. White. Black. M. F. M. F. M. F. M. F. Diseases of the nervous system and of the organs of special 8ense.-Continued. Tumor of the brain. Neurasthenia .1 2. Diseases of the eyes and their annexa. 3 .47 Follicular conjunctivitis. 2 1 2 Diseases of the ears. 2 1 Diseases of the circulatory system. Pericarditis. Organic diseases of the heart. I. 1 28 ...6 Angina pectoris. .. Aneurysm. .3. .. Embolism and thrombosis. ...1 Diseases of the veins variese, hemorrhoids, phlebitis, etc.).5. .. Hemorrhoids. 6 .7. Varices. 1. Varicocele. 1 .6 ... Phlebitis. ... Diseases of the lymphatic system (lymphangitis, etc.). ..4. .. Lymphadenitis (nonvenereal). 2 .15 .. Hemorrhage; other diseases of the circulatory system. 1. .... Diseases of the respiratory system. Diseases of the nasal fossae. .9 .3 ... Myasis of nasal fossm and sinuses ... Diseases of the thyroid body. Acute bronchitis. 10 2 5 Chronic bronchitis. .1. Broncho-pneumonia.1. Pneumonia (unqualified). ..I. Lobar pneumonia. .4 .3 Pleurisy. ..3. Empyema. .. Asthma. Other diseases of the respiratory system (tuberculosis excepted) ...... Abscess of lungs. ......

PAGE 43

39 THE PANAMA CANAL FOR THE MONTHS OF JANUARY, FEBRUARY. 1919.-Coutinued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. White, Black. White. Black. -M. M. F. M. F. M. M. F. M. F. M. F. M. F. M. F. M. F. .1 .........1 2243 4 .9 -j 3. .....37. 10 1 1 10 14. ..2 .....88. 2. ...7 14 1 3 1 1. ....2. ....25 .....1 ...............7 14 1 3 1 4 .....1 .......45 ..........1 ..1 ...........4 6 1 ..............1 ....I. .......4. 17 .1 .3 .....2 2 ..1 ......4 18 1. .........26. 2 ...............2 4 1 1 .2 .....1 .......12. 10 .I -1 1 .....3 .......33. I. ..............2 25 3 5 3 2 ..........51. ...... S. .... 13 3 4 -......3 ........45 1 .........2 .......4 1 S. .....3 .1 1 ..1. ..1 5 0 1 .I ......1 .......1 2 ..1 1 2 .......1 .....11 1 6 1 ..I .....2 .......13. .................2 S. ............. 1 ..1 .............2 1 ......................

PAGE 44

40 TAsRn XL-DSCHARGES AND DEATHS IN THE HOSPITALS OF AND MARCH, Employees. Discharges. Deaths. Diseases. White. Black. White. Black. M. F. M. F. M. F. M.jF. Diseases of the digestie system. Diseases of the mouth and annexa ...1. Diseases of the teeth and gums .2 2 Stomatitis. .. Diseases of the pharynx Pharyngitis. 1 7 Follicular tonsillitis. 13 3 11 Foreign body in the esophagus. .. Ulcer of the stomach. 2 Other diseases of the stomach (cancer excepted). ..4 2 1 Acute gastritis. Chronic gastritis. Acute indigestion. .. Diarrhea and enteritis (under 2 years). ..... Colitis. .. Diarrhea and enteritis (2 years and over). 4 1 2 .. Colitis. ... Ankylostomiasis. 2 .1. Intestinal parasites. .. Ascariasis. Teniasis. Acute appendicitis. .2. Chronic appendicitis. .. Hernia, intestinal obstructions. Inguinal hernia. 13 .203 .1 Other hernias. .. Intestinal obstruction. Other diseases of the intestines. 1 .2. Constipation. .2 Duodenal ulcer. 2 .. Cirrhosis of the liver. Biliary calculi. .2 Other diseases of the liver. 1. Abscess of liver (unqualified). Abscess of the liver, entamebie.I Cholecystitis. 2. Diseases of the spleen. Simple peritonitis (nonpuerperal). I .. Other diseases of the digestive system (cancer and tuberculosis excepted). ...

PAGE 45

41 THE PANAMA CANAL FOR THE MONTHS OF JANUARY, FEBRUARY, 1919.-Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. White. Black. White. Black. M. M. F. M. F. M.M.F.M.F. M. F. M, F. M. F.M. F. 6 2 1 2 ............17 1 4I. .. 38 22 32 14 28 .2 16 ...:L. ...::: .j :> v 21. .-. 3 ...I. ..:. .I. .......: 6 I1*.I* --'**I* I.IY ......2. 3 1 2 .u 2 ....1 1 ......i6 ...1. ..I. ... 2. ....I. 51 1 42. 1 .21 3.>I .2. ...2 ..4. 1 1.:: ... 1 41. ....1 .I. ......., fl) .... 16 .1'* 9 1. ...I. .....2 2.I. ..........I. 4 6 1 4S .2 ....298 1 .I 1 1 1 ....8 2 ....2 101 1 2 ..6 .-...II ..-* 25 5 2 ...2 ...12 1 2 ....-. .......I I ...--.... 2 .... 1 2 1 ....4. ......

PAGE 46

42 TABLz XL-DISCHARGES AND DEATHS IN THE HOSPITALS OF AND MARCH, Employees. Discharges. Deaths. Diseases. White. Black. White. Black. M. F. M. F. M. F. M. F. Nonvenereal diseases of the genito-urinary I system and annexa. Acute nephritis ........31. Bright's disease (chronic nephritis) ...9 ...1 Other diseases of the kidney and annexa 2 Pyelo-nephrosis. Calculi of the urinary passages ..2. Diseases of the bladder. Cystitis.I. Diseases of the urethra, urinary abscess, etc.2 ..8 Stricture of the urethra, nonvenereal .7 Acute prostatitis. ..I. Abscess of the prostate. Nonvenereal diseases of the male genital organs. 4 .10. Hydrocele. ..71. Uterine hemorrhage (nonpuerperal). Uterine tumor (noncancerous). .1. Other diseases of the uterus. .. Metritis. Cysts and other tumors of the ovary. Salpingitis and other diseases of the female genital organs ..... Nonpuerperal diseases of the breast (cancer excepted) Benign tumor of breasts. The puerperal state. Normal labor. .. Accidents of pregnancy. .. Extra-uterine pregnancy. .. Hyperemesis gravidarum. Abortion. Puerperal hemorrhage. Other accidents of labor. .. Puerperal albuminuria and convulsions. Eclampsia. Puerperal diseases of the breast. Diseases of the skin and cellular tissue. Gangrene. ....... Furuncle. 3. Carbuncle. .2.

PAGE 47

43 THE PANAMA CANAL FOR THE MONTHS OF JANUARY, FEBRUARY, 1919.-Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. *White. Black. White. Black. w E-4 M. M. F. M. F. M. M. F.M. F. M. F. M. F. M. F. M. F. ....1 2 ........2 6 3 1 1. 1. 1. 1. .....15 3 .3 .-.1 .....--. .....6 1. .......1 .------.----..........2 .......6 ............ 2 ..1 .1 ..:-. .----.-..-----.-----. 3 ...........14 -.................8 ............2 .......I. 1. .......1 7 2 .2 ...........26 5~~ ....1 .......-----..-2 ............2 ..2 .9 ............2 .10 .11 ...1 .....21 ..4 .9 .......u --..---.-. -----.J. -13 ............----.13 .........17 ..4 .....-.2. ..2 ......2. ..56 ..15 ---........-. .......71 S. 3 ......6 ..2 -. ........-..2 .3 ........5. 22 .4 .......26 S. ..........2 1 1. ..1 .... 1 ..i. ... .....-.*.*. ..'. .. 1 ..........I S. ......... .....4 -1 I. .4 ....* ..* * 1 .........

PAGE 48

44 TALBLB XI.-DISCHARGES AND DEATHS IN THE HOSPITALS OF TRE MARCH, Employees. Discharges. Deaths. Diseases. White. Black. White. Black. M. F. M. F. M. F. M F. Diseases of the skin and cellular tissue.Continued. Acute abscess. .14. Phlegmon and cellulitis .8 1 4. Trichophytosis ... Scabies. 1 2. Ground itch. Dhobie itch. .... Ulcer of the skin. ..25 1. Impetigo contagiosa. Urticaria. .1. Ingrowing nail.I. Other diseases of the skin and annexa. .3 2 3. Diseases of the bones and of the organs of locomotion. Diseases of the bones (tuberculosis excepted). ..1. Mastoid abscess. .. Msteomyelitis. ... Periestitis. Diseases of the joints (tuberculosis and rheumatism excepted). ..... Arthritis. ...8 .... Synovitis ....... Amputations. ..6 ..... Other diseases of the organs of locomotion. 7 2 2 Malformations. Congenital malformations (stillbirth not included). 1 13. Diseases of early infancy. Newborn child .. Congenital debility, icterus, and sclerema Premature birth .. Malnutrition. .. Affections produced by external causes. Suicide by firearms. Poisoning by food. .1 Other acute poisonings.-. Conflagration. ....1.

PAGE 49

45 PANAMA CANAL FOR THE MONTHS OF JANUARY, FEBRUARY, AND 1919.-Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Blawk Black. White. Black. White Black. MM.F. M. F. M. M F. M. F. M. F. M. F. M. IF. M. F. 6 1 2 6 4 .4 37 4 ..1 4 ......1 .........23 2 -02 2 -I3 2 ..............................2 M .M ..2 ..F ...M .F .M ......4 ..1 2 4 ......33 1 ...............2 1 2 ..........3 4 .2 .......7 21 4 .3 4 ...28 ....i ...33 I. ............1. 8 1 ......28. 3. .........3. 1 .2 ....4 1 .....2 T I 1. 1. ..-. ...5. 1 2. .2 4. 2 1. 20 1 1 2. ...21 57 6. 1 1. 2 .34 2 29 28 4 4 1 .65 1 2. ......1. ....... ......I. ........3 ...1. .......... .1. .......... .I1.

PAGE 50

46 T&sx. XI.-DISCHARGES AND DEATHS IN THE HOSPITAL$ OF THE MARCH, Employees. Discharges. Deaths. Diseases. White. Black. White. Black. M. F. M. F. M. F. M. F. Affectiona produced by external causes.Continued. Burns (conflagration excepted). .4. Traumatism by firearms. .3. Traumatism by cutting or piercing instruments. 1 .37. Traumatism by fall. 4 .16. Traumatism by machines.3 4. .1 Traumatism by other crushings kVehicles, landslides, etc.).2. 11 .. Railroad traumatism. 1 .5. Dynamite traumatism. I ... Injuries by animals. 1. Starvation. ...1 Homicide by cutting or piercing instruments. ....2. Fractures (cause not specified). 1 .7. Dislocations.2 .2 .. Sprains .2 .4. Other external violence. 6 1 67 Ill-defined diseases. Ill-defined organic disease. 1 ....I. ...I. ... Infections of undetermined origm ....1 ..2 Nodisease. .. Total.253 32 1062 70. 37 __ __ _ __ _ __ _ __ __ _ _ __ _-__ 37

PAGE 51

47 PANAMA CANAL FOR THE MONTHS OF JANUARY, FEBRUARY, AND 1919.-Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White Black. Black. White. Black. White Black. o ..A) T EEM. M. F. M. F. M. M. F. M. F. M. F. M. F. M. F. M. F. 2 ..1 3 ...I ..2 ...1. 12 2 8 ..2 .1 ....3 .......16 1 7 3 .3 1 .1 ..2 ......54 1 4 4 2 3 1 .....5 ...1 ...39 1 1 ...3 .......11 1 5 1 .1 1 ...1 .........21 1 1 ...............7 2. ............ 2 .....1 21. ........... .........2 10 1 ......-1 .I .......21 1 ...1 1 .............6 3 .........1 .......10 12 2 1 4 1 ..........94 1 1 ......2. ..81 6 1 2 2 1 .I ..........1 13 6 Q7 8 24 .....2 1 ......91 681 189 343 171 334 4 9 3 27 31 190 6 7 2 8 1 1 .3340 121

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48 TABLm XJI.-CONSOLIDATED HOSPITAL REPORT. [A.=White Americans; F.=White foreigners; B.=Black.] Remainiing. I Admitted. Died. Discharged. January I. A. F. B. A. F. B. A. F. B. A. r. B. Ancon Hospital: Employees .23 9225 160 55 964 1 31 164 53 931 Soldiers. 103 ..550 ..3 ..589 Panama pay patients. ....2. Other pay patients. 41 36 50 323 196 374 3 1131 327 198 320 Charity patients. 12 2 14 40 18 111 .2: 4! 45 17 83 Total. .179 47 289 1,073 269 1,451 6 14 66 1,125 268 1;334 Corozal Hospital (insane)# Employees. 1 2 14 ..1 Soldiers. .9 .7 ...12 Panama pay patients .3 59 222 8 17 3 8 11 Other pay patients. .3 2. 9 ...2 .1 Charity patients. .13 70 1 5 .2 3 2 Total. 13 77308 8 8 34 .3 12 12 10 15 Grand total. 192 124 597 1,081 277 1,485 6 17 78 1,137 278 1,34 Corozal Farm (cripples): Employees. .7 44 4 4 ..2 4 Chronic ward: Charity patients. ..26 ..1. Colon Hospital: Employees. .1 3 10 60 16 296 .5 52 16 221 Soldiers. 7 1 -. 80 19 1 ..68 15 Panama pay patients ..1 2 612 5 .2 .2. .2 Other pay patients. 9 8 14 71 63 92 .12 71 471 68 Charity patients. 4 1 12 2 15 ..j. 16 11 11 Total. 21 13 27 2231 102 408 1 2 17 207 791 302 Palo Seco Leper Asylum: Panama pay cases. .2 43 ..3 ...4 Charity patients .........31 ...1 ........I Total. 2 74. -...t Grand total: Employees .251 21 293 220 75 1,267 .1 36 2161 7211,157 Soldiers. 119 1 .637 19 .4 ..669 15 Panama pay patients. 3 62267 .10 27 .5 .6 17 Other pay patients. 50 47 66 394 259 475 3 11 45 398 245 389 Charity patients. 16 15 142 53 20 133 .2 6 61 21 97 Total .213 146 768 1,3V4 383 1,902 7 19 96 1,3441 359 1,660

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49 TABz XII.-CONSOLIDATED HOSPITAL REPORT.-Continued. [A.=White Americans; F.=White foreigners; B.=Black.I RemainTransing Average number conferred. March ;1. stantly sick. A F. B A. F. B. A. F. *B. Total. Ancon Honital: Employees .-. 11 19 10 216 22.46 9.01 205.82 237.29 Wodier; ....8 ...53 ...81.81 ....-. 81.81 Panaa pay pati. ....2 ......10 .10 OtE pay patients. ..12 34 23 61 39.98 2817 57.08 125.43 Charity patients.1 .15 6 1 23 10.78 2.25 19.05 32.08 Total ...9 40 112 34 300 155.03 39.63 282.05 476.71 Corozal Hospital (insane): Employees. .1 1 16 1.00 1.14 15.78 17.92 8ldiers. 4 ..5.32 ..5.32 Panama pay patients. .1 3 58 219 3.00 57.55 219.10 279.65 Other pay patients:. ..3 8 .3.00 6.82 9.82 Charity patients. .1 10 71 .11! 11.21 70.81 82.13 Total. ...1 9 72314 9.43 72.90 312.51 394.84 Grand total. .9 41 121 106 614 164.46 112.53 594.56 871.55 Coronal arm rippleses: Enigoyees ..9 44 .9.03 45.57 54.60 Chronic vrard: Chaity patients. ..1 26 ..25.73 25.73 Colon Huspital: Employees. .2 2 29 1 51 4.04 2.29 37.93 44.26 8oldier. .7 3 ..11 2 8 .96 2.11 .11.07 Pdnaay patients. .1.03 .17 1.20 Othr pay patients. .2 21 14 7 3 12 6.98 5.60 11.24 23.82 Charity patients. .1 5 1.66 .12 .67 2.45 Total. 11 27 53 25 7 63 21.64 11.15 50.01 82.80 Palo Seo Leper Asylum: Pana pay cases. ..2 41 ..2.00 42.09 44.09 Charity patients. .31 ..31.21 31.21 Total. .2 72 .2.00 73.30 75.30 Grand total: Employees. 2 2 40 27 21327 27.50 21.47 305.10 354.07 soldiers. 15 3 .G8 2 .96.09 2.11 .98.20 Panama pay patients. 4 8 3 61260 3.00 60.58 261.46 325.04 Other pay patients. 2 21 26 41 29 81 46.96 36.97 75.14 159.07 Charity patients .21 21 7 11 151 12.55 13.58 147.47 173.60 Total. 25 27 95 146 124 819 186.101134.71789.17 1,109.98 MR 68566-4

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50 TU E XIII.-CONSOLIDATEDDISPENSARY REPORT. E~moyEs TEm nx QUARTERS. ReRemainAdD. DisTransmainD ing emitted. Diedcharged. ferred. ing Days lout. Jan. 1. Mar.31. W. B. W. B. W. B. W. B. W. B. W. B. W. B. Total Ancon. .8 .260 203 ..245 169 8, 12 15 22 56 872 1,438 Balboa. 2 6 451 15. .439 9 3 6 11 61,084 751,159 Pedro Miguel. ..39 21 ..39 18 ...3 83 17 100 Gatun. .35 50. .28 41 7 6 .3 89 448 537 Cristobal. 7 43 197 600 ..194 569 .9 9 65 546 5,356.081 -7 .9 ---. I94 Total.17 49 982 889 .946 806 18 33 35 99 2,38 ,d?7 316 AL CAsES TREATED BUT Nor ExCUSED. Employees. Nonemployees. Total W. B. Total. W. B. Total. W. B. Total. Ancon. 1,943 12,873 14,816 3,049 4,763 7,812 4,992 17,636 22,21 Balboa. 12,558 4,500 17,058 10,232 2,966 13,198 22,790 7,466 30,256 Pedro Miguel. 4,702 6,214 10,916 4,050 4,100 8,150 8,752 10,314 19.066 Gatun. 873 2,571 3,444 1,074 1,337 2,411 1,947 3, 90S ,85 Cristobal .2,612 11,1161 13,673 3,109 3,476 6,585 5,721 14,537 20,258 Total.2. 2,688 37,219 &9,907 21,514 16,642 38,156 44,202 53,881 99,063

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51 TArnz XIV.-CONSOLIDATED ADMISSION REPORT. White. Black. Total. Admissionsto hospitalsexcluding Corozal farm and chronic ward. ..1,683 1,897 31580 Admissions of employees to quart ers .982 889 1,871 Total admissions to hospitals and quarters. 2,665 2,786 5,451 Less number of patients transferred between hospitals and from quarters to hospitals, whose admissions are duplieated in the above figures. 70 128 198 Net admissions to hospitals and quarters. 2,595 2.658 5,253 EMPLOYEES. Employees admitted to hospitals. .291 1,262 1,55S Employees admitted to quarters. 982 889 1,871 Total admissions of employees. .1,273 2,151 3,424 Less number transferred between hospitals and from quarters to hospitals, whose admissions are duplicated in the above figures. 22 72 94 Net admisions of employees .1.251 2.079 3,330' Annual admission rate per thousand employees to hospitals and quarters. 1,094.24 383.88 507.68 TABrn XV.-NUMBER OF EMPLOYEES CONSTANTLY SICK IN HOSPITALS AND QUARTERS. White. Black. Total. Rbspitals: Ancon Hospital. 33.61 221.08 254.69 Colon Hospital. 6.33 37.93 44.26 Total. 39.94 25 .(1 298.95 Quarters: Ancon.;. .6.29 9.67 15.96 Balboa. .12.04 .83 12.87 Pedro M iguel. .92 .19 1.11 Gatun. ..99 4.98 5.97 Colon.V. 6.07 61.50 67.57 Totat. 26.31 77.17 103.48 Hospitals. Quarters. TotaL Avenge number of employees constantly sick: White. 39.94 26.31 66.25 Black. .259%01 77-17 336.18 Total .299 95 103 4Q 402.43 Average number of employees constantly sick per 1,000: W hite. 8.73 5.75 14.48 Black. .11.95 3.56 15.51 TaL. .11.40 3.94 15.34

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52 TABLz XVI.-AVERAGE NUMBER OF DAYS IN HOSPITAL OR QUARTERS FOR EACH ADMISSION OF SICK EMPLOYEE. White. Black. TotaL Hospitals: Ancon Hospital. 13.13 18.20 17.26 Colon Hospital. 7.44 12.36 11.28 Total (average). 11.72 16.98 15.97 Quarters: Ancon. 2.32 5.13 3.48 Balboa. 2.41 5.35 2.50 Pedro Miguel. 2.27 3.66 2.71 Gatun. 2.60 9.58 6.64 Colon. .2.83 11.82 952 Total (average). 2.47 10.01 5.97 TABLE XVII.-NUMBER OF DAYS HOSPITAL TREATMENT FURNISHED VARIOUS CLASSES OF PATIENTS. Class. American. Foreign. Black. Total. Aneon Hospital: Panama Canal employees. 2,021 812 18,514 21,347 Army and Navy patients. 7,398 .7,398 Panama Government pay patients. ..2 2 Other pay patients. 3,595 2,564 5,148 11,307 Charity patients. 956 203 1,727 2,886 Total. 13,970 3,579 25,391 42,940 Corozal Hospital (insane): Panama Canal employees. 90 103 1,374 1,567 Army and Navy patients. 498 .f. 498 Panama Government pay patients .270 5,209 19,709 25,188 Other pay patients. 270 531 801 Charity patients. ..5 1,073 6,386 7,464 Total. 863 6,655 28,000 35,518 Corozal Farm (injured employees): Panama Canal employees. .814 4,105 4,919 Chronic ward: Charity patients. ..2,315 2,315 Colon Hospital: Panama Canal employees. 365 207 3,393 3,965 Army and Navy patients .811 190 .1,001. Panama Government pay patients. .93 16 109 Other pay patients. 627 507 1,013 2,147 Charity patients. 150 11 59 220 Total. 1,953 1,008 4,481 7,44a Palo Seco Leper Asylum (lepers): Panama Government pay patients. 90 3,878 3,968 Charity patients. 2,809 2,809 Total. .90 6,687 6,777

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53 TABLX XVIII.-WARD LABORATORY REPORTS. Ancon Colon Santo Hospital. Hospital. Tonw. Hospital. Blood examinations (total number). 1,861 213 527 Estivoautumnal. 203 12 127 Quartan. 9 Tertian. ..75 .7 68 Filaria. .I Differential counts. 146 8 2 Hemoglobin estimates.947. .-Red blood counts. 47 5 White blood counts. 262 99 12 Stool examinations (total number). 1.936 12 1,963 Ameba.34 15 Asearis lumbricoides.57 113 Ciliated monads.26:::. 5 Guaiac tests.401. Pus and blood.59. Strongyloides. 91 .82 Tenia saginata. Tricocephalus dispar. 171 .62 Uncinaria (ova). 350 .485 Cercomonas, intestinalis.2. Entameba (histolytica and tetragena). 6 .18 Mucus and blood.26. Blood. .17 M ucus and pus. .14 Urine examinations (total number) ..5,073 795 1,384 Albumen. 1,366 115 348 C s. 54 Casts. 854 81 8 Ciliated monads. 17 Epithelia. 1,072 .: .::6 Guaiac tests. 24. Hemin crystals. 8. Indican. ..68. Pus and blood. 1,831 59. Sugar. 854 5 10 M ucus and pus. ..129 Phosphates. .18 Urates ba. .8 M otile bacteria. ..I Acetone. .36. PUS ....,. ..36 ...... Sediment. .* 23 Sputum examinations (total number) .1,455 8 351 Positive for tubercle bacilli. 117 5 102

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54 TAJrL XVIIJ.-WARD LABORATORY REPORTS.-Continued Santo Ancon Colon Tomas Hospital. Hospital. Hospital Smear examinations (total number). 251 1. Urethral. Vaginal. Spinal fluid:. 103. Eye .. Functional kidney test.1. Positive for gonococci. 1 1,075 Positive for B. Koch-Weeks. .g Positive for pneumococci. ..S Positive for leprosy.I Positive for diphtheria.s Wassermann reactions (total number). 625 Positive. .246 Throat cultures. .75 Blood cultures. .4 Widals reactions.

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55 'TAiL XIX.-SURGICAL OPERATIONS PERFORMED. Santo Ancon Colon Tomas Hospital. Hospital. Hospital. NumDied. NumDied. Nuiber. ber. ber. Amputations: Thigh .I .1 1I Digits, single. .. Digits, multiple. ...2 .. Leg. ..1 Foot ...I Resection of ankle. .....t Operations on bones: Laminectomy ....1 Craniectomy, decompressive. 1 1. Ostiectomy. ..3. 3 .j Excision of maxilla. .1. Resection of elbow. 2 Wiring of fractures, simple. 2. Wiring of fractures, compound .... Nailing of fractures, simple. 2 .. Lane plate of humerus. .1. Adenectoiy: Inguinal, single .37 Inguinal double. 8 .7 Femoral. 4. .. Cervical. ....3 Rerniotomy: Inguinal, single. 74 1 103 .25 Inguinal, double. 6 .34 .6 Ventral,.3 4 2 Strangulated. 2 1 2 .2 Femoral. 1.2. Genito-urinary tract: Urethrotomy, internal. 19 Urethrotomy, external. ..8 Varicocele, radical cure. 13 .1 Hydrocele, single, radical cure. 27 .-49 .5 Hydrocele, double, radical cure. 3 .I .. Amputation of scrotum. .5. ..2 Curettage uteri. 41 .3 .25 Orchidectomy. 4 .4 Cystotomy, suprapubic. .a Trachelorrhaphy. ...2 Epididymotomy. 4. Perineoplasty. 2. .. Nephrotomy. 2. Nephrectomy. 1. Vaginal sections. ...i Obstetrical: Lowforceps. ..2 Perneorrhap .4 Caesarian section, abdominal. 2 Version. ... Circumcision. ....63 'Tborax: .. Excision of breast. 1 2. Thoracotomy. 2 ...1

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56 TABnz XIX.-SURGICAL OPERATIONS PERFORMED-Contnued. Santo Ancon Colon Toma Hospital. Hospital. pital. NumDied. NumDied. Nbiber. ber. ber. Rectum: Hemorrhoids, radical cure. 40 .6 .24 Fistula in ano, excision of. I .4 ..to Prolipsus rectum, radical cure. 1 .2 General: Thyroidectomy. 2. Varicose veins, excision of. 8 .4. Excision of surface neoplasms. 6 .3 .. Gunshot wounds of soft parts, operation for. 1 .3 ..1 Plastic operations for severe injuries. .1. .I Skingraft. ...3 Plastic operations for effects of disease. 1 .9 Stab wounds of soft parts, operations for. ..5 3 Extensive injuries to soft parts, operation for. 1 .1 Laparotdiny: .. Entero-enterostomy. 1 Appendectomy.35 33 1 37 Appendectomy with local peritonitis. 4 .4 .1 Appendectomy with general peritonitis 14 1 4 1 2 Colostomy. ..1 1. Cholecystotomy. .3 ..Hysteromyomtectomy. ..12 Salpingo-oophorectomy. 3 .12 .45 Suspensio-uteri. 12 .12 19 For general peritonitis.I 1 .. Exploratory:.3 1 6 Splenectomy. 2 2 ..I Pan-hysterostomy. 1 ...30 For ectopic gestation. .1 Abscess of liver, thoraco-hepatotomy. I 1 Supravaginal hysterectomy. 10 .14 .10 For intestinal obstruction. ..1 1 2 Salpingectomy, single. ...8 Salpingectomy, double. .7 .18 Oophorectomy .....13 Ovarian cystectomy.4. .. Gast-o-enterostomy. .-2 Enteiectomy. .1. Minor operations, various. 480 .30 .124 Major operations, various.4. Total. 1,096 7 397 10 803 7-

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57 TAILx XX.-REPORT OF OPERATIONS, EYE AND EAR DEPARTMENTS. ANcON HosPITAL. Operations performed: Adenoidectomy. .74 Cataract extraction ..7 Cauterization of cornea. 1 Cauterization turbinates. 6 Chalazion, removal of. 8 Foreign body from ear, removal of. 1 Ethmoid sinus, curettement of. 2 Frontal sinus, drainage of. Maxillary sinus, perforation and drainage .2 In vision and drainage of abscess of ear. 3 Iridectom y. 1 M astoidectom y. 6 Nasal polyp, removal of.7 Enucleation of eye. .1 Needling of eye. 9 Evisceration of eye. 1 Peritonsillar abscess, incision of. 12 Paracentesis ear drum .2 Pterygium transplantations. 13 Plastic eyelid (skin graft). .....1 Rhinoplasty .3 Submucous resection. 28 Turbinectomy. 10 Tonsillectomy. 124 Total ..324 Refractions. 486 SANTO TomAS HOSPITAL. Ear: Furunculosis of canal. 18 Otitis media, chronic. 123 Otitis m edia, acute. 32 Foreign bodies. 11 Polyps of canal. 10 Cerum of canal. .3 Perforation of drum .41 M astoiditis. 8 Celositis. 13 Eye: Gonorrheal opthalmia. 17 Enucleation. I Foreign bodies.10 Conjunctifitis. .....182 Folicular conjunctivitis. ..9 Phlyctenular conjunctivitis .5 Tracom.27 Eye examinations. 25 Corneal ulcer. 114 Keratitis. 130 Iritis. .297 -Blepharitis. 6 Hordeolum .10 Dacralitis. .10 Chalazion. 13 Pterygium ..13 Cataract. .148 Chosoiditis. 14 Refractions. 7 Optic nerve atrophy. 8

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58 Nose and throat: Tonx 18 Tons tis. 187 Sinusitis. .129 8i~usiis. ................2 Hypertrophy of n ..(I Rhinitis ..47 Foreign bodies. 12 Deflected septum.33 Screw-worm infection. 3 Abscess Of septum .2 Hypertrophied tonsils. .16 Pharyngitis ..24 Atrophic catarrh. 15 Laryngitis ..29 Peritonsillar abscess. .7 Adenoidectom y. 18 Tonsillectom y. 21 Operations: Cataract.17 Iridectomy. 14 Pterygium ..20 Ectropion. 1

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59 TABrB XXI.-REPORT OF THE X-RAY DEPARTMENTS. Santo Hospital. Tomas Hospital. Nature of examinations: Arm and forearm. 60 15 Chest. .101 Dental. 09 33 Elbow. ..18 6 Foot and ankle. 83 14 Foreign bodies.4. Gall-bladder ..9 2 and.38 7 Head ....14 6 Hip .12 22 Jaw ...10 7 Kidney.31. K nee. .29 Leg ...19 3 Liver.2 15 Pelvis. .4 8 Ribs.8. Shoulder. 26 Sinus. 25. 8pine. 8 5 Spleen. .2 Stom ach. 85 34 Thigh .13 5 Thorax. .9 Treatment .44i 10 Wrist .21. Total ninber of cases treated. 733 217 CLASSIFICATION OF PLATES USED. Ancon Hospital. 61 by 81. 326 8 by 10. 767 10 by 12. 427 14 by 17. 253 by 10X-ray films. .116 Dental films .251 Total. 2,140 U

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60 TABLE XXII.-SANTO TOMAS HOSPITAL. PATIEwTs TREATED. Remaining AdmitDisRemaining Class. Jan. 1. ted. Died. charged. March 31. Pay eses. 29 271 9 252 39 Charity cases. 473 2,176 190 1,986 -473 Total. 502 2,447 199 2,238 512 American. Other nations Class.Number treated. -_White. Black. White. Black. Pay cases. 364 3 .108 253 CharityCases. 3,564 8 .262 3,294 Total. 3,928 11 .370 3,547 Number of days relief furnished patients. .43,706 Average number of patients constantly sick. .486 Average number of days treatment for each patient admitted. 11 Cost of subsistence per patient, per day. 40.21 DIBPENSARY REPORT. Class. White. Black. Total. Natives treated. 67 4,187 4,254 Foreigners treated. 98 1,350 1,448 Total. 165 5,537 5,702 DisEASES TREATED. i3eneral diseases: Typhoid fever. 2 M alaria. .230 Smallpox .3 M easles. 2 W hooping cough. 1 Diphtheria and croup. .13 1fluenza.,. 33 Dysentery. 22 Leprosy. .2 Erysipelas. .I Other epidemic diseases. 13 Purulent infection and septicemia. 36 Beriberi .., .I Tuberculosis ofthe lungs ..21 Acute miliary tuberculosis. I Tuberculous meningitis. I W hite swelling .I Tuberculosis of other organs. 4 Syphilis. 71 Soft chancre. .20 Gonococcus infection. .203 Cancer and other malignant tumors of the buccal cavity. I Cancer and other malignant tumors of thetomach and liver. 3

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61 DSZAms TIIEAT.-Continued. Cancer and other malignant tumors of the peritoneum etc. 1 Cancer and other malignant tumors oi the female genital organs. 4 Cancer and other malignant tumors of the breast .1 Cancer and other malignant tumors of the skin. .3 Cancer and other malignant tumors of the organs not specified. 2 Other tumors (tumors of the female genital organs excepted). 2 Acute articular rheumatism. 4 Diabetes. 2 Anemia, chlorosis. 5 Other general diseases. 16 Alcoholism (acute or chronic). 23 Simple meningitis. ..2 Other diseases of the spinal cord. 2 Paralysis without specified cause. 3 Other forms of mental alienation. 18 Epilepsy. .5 H ysteria. .3 Neuralgia and neuritis. 23 Other diseases of the nervous system. 4 Other diseases of the eyes and their annexa. 13 Follicular conjunctivitis. 13 Diseases of the ear. 1 Organe diseases of the heart. .23 Diseases of the arteries, atheroma. 8 Diseases of the veins. 21 Diseases of the lymphatic system. 40 Hemorrhage, diseases of the circulatory system. .2 Diseases of the nasal foss. .2 Diseases of the larynx.z. 1 Diseases of the thyroid body. .2 Chronic bronchitis. 15 Broncho-pneumonia. 3 Pneum onia. .6 Pleurisy. 8 Asthm a. .4 Other diseases of the respiratory system. 1 Diseases of the teeth and gains. 3 Other diseases of'the mouth and annexa. 1 Diseases of the pharynx. 51 Ulcer of the stom ach. 1 Other diseases of the stomach. 0 Diarrhea and enteritis (under 2 years). 4 Diarrhea and enteritis (2 years and over). 16 Ankylostomiasis. 110 Intestinal parasites. 14 Appendicitis and typhlitis. 27 Hernias, intestinal obstructions. 34 Diseases of the anus and fecal fistula. 12 Other diseases of the intestines. 10 Cirrhosis of the liver. 4 Biliary calculi. I Other diseases of the liver. 7 Diseases of spleen. 6 N ephritis, acute. .6 Bright's disease .35 Diseases of the bladder. .10 Diseases of the urethra. 28 Diseases of the prostate. I Nonvenereal diseases of the male genital organs. 20 Uterine tumor. 6 M etritis. .8 Other diseases of theuterus. 33 Cysts and other tumors of the ovary. 5 Salpintitis and other diseases of the female genital organs. 35 Nonpuerperal diseases of the breast. 3 Normallabor. 218 Accidents of pregnancy. 49

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62 Dxuwaa Twaw-Continued. Other diseases of labor. 1 Puerperal septicemia. I Furuncle. 3 Acute abscess. 33 Scabies. 12 Other diseases of the skin and annexa. 99 Diseases of the joints. 4 Diseases of the bones. 8 Am putations. I Other diseases of the organs of locomotion. 2 Congenital malformations. .13 Nursling discharged from hospital .212 Senility .2 Suicides. n. ..1 Acute poisonmes ..I Poisoning by food. I B u rns. .6 Traumatism by cutting or piercing instruments. 12 Traumatism by firearms. 3 Traumatism by crushing. 3 Dislocations. 4 Fractures. 19 Sprains. .3 Other external violence.t. .21 Diseases not specified or ill-defined. .3 No disease. 4 Total. ,207 Deaths among patients. 199 Remaining in hospital March 31, 1919. 512 Total treated. .2,918

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63 TAznz XXIIL-CORQZAL HOSPITAL FOR THE INSANE IN STATEMENT OF COMMITMENTS, DISCHARGES, AND DEATHS. COMMITMENTS. Male. Female. From Canal Zone: First admission. 17 8 Ftom Panama Government: First admission. 16 6 Second admission.2. Totals.:. 35 14 DISCHARGES. Well. Improved. Unimproved. Male. Female. Male. Female. Male. Female. Barbados .1 1. China. .. Colombia. .. Grenadao. ... India. .1 Jamaica. ..1 Mexico.1. Martinique. ..5 zI. Nicaragua. .1. Porto Rico. ..1. Panama. .. Spain. ... T1urk's Island. United States. .19 1 '1 # Venezuela ..... Totals. 5 1 18 7 4 2 aSoldiers transferred to U. S. A. 2 Deported to U. S. A. 3 Deported to Martinique. 4,DepQrted to Jamaica. s Eloped. kDeported to Nicaragua. Patient not insane. DEATHS. Medical diagnosis. Mental diagnosis. Male. Female. Pulnonary tuberculosis. Imbecility. 1 Pulmonary tu'berculosis. Dementia precox. 2 Ascariasis. Toxic psychosis.I Tuberculosis of the lungs. Dementis precox paranoid. 1. Pulmonary tuberculosis .General paresis. .* Pulmonary tuberculosis. Alcoholic psychosis. .1 Infection psychosis, exhaustive. Infection exhaustive psychosis with pellagra,. Tuberculosis meningitis. Dementia precox .1 P-yelo nephrosis .Psychosis with epilepsy. Broneho-pneumonia. ..General paralysis of insane Psychosis with organic brain diseases. Psychosis with organie brain 1. disease. Chronic interstitial nophritis, organic Senile dementia. I. brain disease. Syphilis nephritis. Dementia precox. .I. 1 Pulmonary tubernlosA. Infection exhaustive psychosa. .1 Total ...a 7

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64 TABLE XXIV-REPORT OF BOARD OF HEALTH LABORATORY. Bacteriological examinations: Autogenous vaccines prepared. 2 Blood agglutinations. 8 Blood cultures. 24 Blood smears examined for malarial parasites (25 positive for E. A. malaria, 27 positive for Tertian malaria, 2 positive for Quarten malaria). 152Blood smears for differential count. 5 Blood smears examined for anemia (1 positive) .I Conjunctival smears (4 positive for Garm-negative intracellular diplococci, 1 positive for gonnococci). 40 Cultures from tonsils. 13 Dark field examination for spiroecheta pallida. 9 Smears examined for leprosy (? positive for B. leprae). .4 Smears examined for leprosy at Palo Seco asylum. 44 Smear examined for Rigg's disease. 1 Miscellaneoussmears. 8 Nasopharyngeal smears. ..3 Pleural fluid, cultured. ...I Skin lesions examined (1 positive for trychophyton). ..2 Spinal fluids, cultured. .21 Sputum cultures (from influenza patients, 16). ....22 Sputum, examined for tuberculosis (1 positive) .34 Stools, cultures (3 positive for B. Paratyphesus). ...33 Stools, examined for ameba (5 positive) ..10 Stools, examined for intestinal parasites (Positive for tricocephalus dispar, 5; positive for uucimaria, 11; positive for strongyloides, 8; positive for ascaris, 4; positive for ciliated monads, 2). 5W Synnovial fluid. 7 Plural efftisions 2. ..2 Throat cultures positivee for B. diphtheria 13). .241 Throat smrars, examined for Vincent's angina (II positive). ..19 Urines cultured. .25 Urethral smsars. ..4 Autopsy specimens. 8 Blood smears examined, for filaria. 1 Smears examined for Gonnococci. 4 Milk examination: Corozal hospital farm. ..38 ~Mindi farm dairy. .46 Panama dairies, bacteriological count .12 Vincent's angina examinations (2 positive). .5 Pathological examinations: Tissues prepared, autopsy. 139 Tissues prepared, surgical. 105 Tissues prepared, animai. .3 Autopsies performed, human: as follows:. ..71 DiseasesStarvation; contributory, paralysis of muscles of deglutition. .1 Perinephritic abscess. Organic heart disease. 5 Yellow Iever. .1 M alnutrition _. .......-4 Bright's disease. 1Tuberculosis of the lungs. 12 Acute nephritis. ..3 Pulmonary carcinomatosis ...I Acute lymphatic leukemia. ....1 Cerebro-spinal fever. ...I Concussion of the brain. ..I Acute general peritonitis. .2 Ruptured aneurysm of the ascending aorta. ...1. Sarcomatosis. ...3 Exhaustive psychosis. 1 Tuberculons meningitis. .3 -. ydr.ocephalus. .-; .:; ::. -.

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65 Autopsies performed, human-Continued: Diseases-Contnued: S Malformation of intestinal tract. .1 Broncho pneumo a. .5 Phlegmanous cellulitis. .1 Convul-ions, ot children (under -5 years). Abscess of liver. .. Lobar pneumoxia. 4 Pyelo-nephrosis. 1 Septicemia. .1 Paralysis without specified cause. 1 Traumatism by fall. 1 D iphtheria. 1 Cerebro syphilis. .1 Apoplexy. 2 Softening of the brain. I Rupture of ascending aorta. 1 Ascariasis. 1 Diarrhea and enteritis (under 2 years). .I. 2 A nimal autopsies: (1 pig from Corozal farm, 1 alligator). 2 Rats examined: (Mus-musculus, 3,223; Mus-Norm egious, 22; Mus-Alexandrix, 399; M us-Ratus, 376). 4,020 General: W asserman reactions. 3,078 Cattle ears examined for anthrax (4 positive). 4 Examination of blood of native cattle for trypanosomes. 3 Imported cattle injected with blood of native animals for "tick fever" immunization (3 deaths). ..43 4 examinations of cattle blood for piroplasmata after immunization (32 positive). .43 i Blood.smears from Army mules.-. 2 Examination of cattle spleen for anthrax (5 positive)i. 9 Ear of horse examined for anthrax. .1 For murrina (2 horses and 1 mule). 3 Chemical exa minat ions: Blood analysis for sugar, N. P. Nitrogen. 1 U rine. 27 Urine complete, 24 hours. 1 Stomach contents. 4 M ilk, Sheffield. 19 Milk (complete analysis) (condensed, 2). 13 Mother's milk (complete analysis). 2 Potatoes for water content. 2 Aspirin tablets for glass. .10 Powder for cocaine. 2 Feces. .1 Medicinal preparation for alcohol. 1 Soft drinks for alcohol. 9 Bleaching powder. 1 Bay ruf ..1 Examination of canned salmon for the Army. 48 Molasses for sucrose. .2 Cherries for coloring. 2 Substance for narcotics (police department). 2 Coffee for adulteration. .1 Stomach contents of dog for poison. I Ensilage, M indi farm .I Cocoa butter (as to purity). I Cotton seed oil (as to purity). 1 Rum (as to purity). 1 Dairy feed, Corozal farm. 3 M iscellaneous. 4 Spinal fluids, for January, not reported Colloidal gold test. 40 Butyric acid test. .42 Ammonium sulphate test. 42 Phenol test. 42 MR 68566-5

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Spinal fluids, for February: Colloidal aold .57 Butyric acid. ...55 Ammnium sulphate .,. 55 Phenoi ..52 Gum test. .29 Entomalogical examinations: Identification of mosquitoes, adults: CuliiniAnopheles albimanuR. .2,961 Anopheles tarimaculata. .61 Anopheles pseudopunctipenni. .142 Anpoheles malefactor. ..22 Total Anopheles. 3,278 Culex swpp. .,. 358 M ansonia titillans. 652 M ansonia nigricans. 25 Aedes calopus. 52 Aedes specified. .9 Aediomyia squanipennis. Total Culicini non-anopheles. .1.099 SabeithiniW yeomia specified. .5 Total masquitoes. .4,382 Undertaking Department: Bodies cremitei. 50 Bzdies embalmed. ...14 Bodies shipped to United States. 10

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TABLE XXV.-CONTAGIOtS AND INfECTIOUS DSVASAS. (Reported during the three-month period ending March 31, 1919.) PanaColon. Canal Nonma. Zone. :esident. Total. Chickenpox .21 12 .35 Qhancroids ..3 *phtheria. 13 7 6 .2 Dysentery. 17 2 10 3 5 Gonococcus infeetion. 32 197 85 18 332 Influenza. .43 3 60 47 188 Leprosy ....I .2 Malarialiever. 44 21 428 163 56 Measles. 2 17 2 21 M eningitis. .2 Mumps. .10 13 .23 Ophthalmia neonatorun. .1 Pneumonia. 9 6 1 12 28 Syphilis. 9 19 16 .44 Smallpox. 37 4 T etanus. ...I .I Tuberculosis. 79 25 5 .109 Typhoid fever. 1 3 1. Whooping cough. 1 49 15 5 Yellow feve. 1

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TABLE XXVL-REPORT OF ROUTINE SANITARY WORK PERFORMED IN THE CANAL ZONE AND THE CITIES OF PANAMA AND COLON. Canal Panama. Colon., Zone. Linear yards of new ditches constructed. 7,085 3,520 45,07a Acres of vegetation removed. 189 86 172 Number of garbage cans emptied. 10,080 .66,922 Cubic yards of garbage removed. .11,520 11,030 Square yai ds of sti eets kept clean ..600,000 281,718 Square yards of alleys cleaned daily ..21,811 Pit closets inspected during month. 761 Closets disinfected during month. 1,001 .3,923 Number of water containers treated. 600 17,519 222,814 Number of mosquito-breeding places destroyed. 86 655 117 Mosquitoes destroyed in dwellings: Anopheles. 12,783 .183 Stegomyia. 1,267. ... Culex. 9,288 .4,898 Number of fly-breeding places destr oyed. 20 521 495 Number of rats destroyed. 3,879 3,036 2,008 Private properties cleaned. .103 11,345. Number of notices served to abate nuisances. 31 1,083 1,075 Convictions for violation of sanitary code. .240 51 Houses disinfected or fumigated. 71 15 Square yar ds of pools oiled. 187,864 27,895 232,901 Buildings inspected. 6,787 19,570 42,219 Buildings, construction and repairs: Plans for new buildings approved ..5 7 Permits issued to repair old buildings. .141 185 Buildings condemned. .4 2 Buildings demolished. Food inspection: Dairies, milk vendors, etc. .246 26 Bakeries, ice cream parlors, etc. 243 336 Bottling works, saloons, etc. .60 402 Hotels, clubs, restaurants, etc. 39 517 723 Markets, fruit stands, miscellaneous. 190 145 3,249 Material used during month: *Crude oil .gallons. 6,083 1,762 2,593 Larvacide.gallons. 10,049 726 908 Kerosene.gallons. 442 117. Number of hides disinfected. .8,405 4,050 Number of skins disinfected. .11,166. Number of cattle inspected. .2,050 9,848 Number of swine inspected. .1,033 4,238 Number of goats inspected. .3 287 z Includes Cristobal and Mount Hope, Canal Zone.

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TAkr1 XXVI.-CONSOLIDATED REPORT OF QUARANTINE TRANSACTIONS AT THE PORTS OF BALBOA4PANAMA AND CRISTOBAL-COLON. "(For the thr m nths jeriod ending March 1919.) Vessels inspected and passed. .642 Vessels held in quarantine ....22 Veszels inspected and transiting the Canal in quarantine .28 Total vesselsextered. 692 Supplemental inspections of detained vessels. 22 Supplemental inspections of vessels at docks. 303 Vessels fumigated on arrival. ...42 Vessels fumigated prior to departure. 11 Bills of health issued. 625 Bills of health vis6ed. .477 Crew inspected on arrival. 32,541 Passengers inspected on arrival. 7,850 Total persons inspected on arrival. 40,391 Crew passed on medical officer's certificate. ..22,191 Supplementary inspections of passengers and crew. 4,203 Persons vaccinated at port of arrival. 577 Persons vaccinated at port of departure or en route. 807 Total persons vaccinated. 1.,384 Persons detained at quarantine stations to complete the period of incubation of yellow fever and bubonic plague. .861 Persons held in.quarantine aboard vessels. 5,220 Total persons detained in quarantine .6.081 Persons in transit passing through the Canal .12,702 Persons in transit from Patific ports and passing through the Canal on arriving vessels. 900 Pasengers in transit for Atlantic ports. 1,252 Imrhigrants rejected and demrted ..147

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70 TASLE XXVIII.-IMMIGRATION REPORT FOR TE PORTS OF BALBOA-PATAMA, AND CRISTOBAL-COLON FOR THREE MONTHS ENDING MARCH 31,1919. Cabin. Steerage. United States. .1,345 314 Europe. .15 i Porto Rico. .10. West Indies .51 191 Venezuela ..11 4 Colombia. 32 145 Cuba.2 129 Costa Rica ..53 14 Bocas del Toro. 3 384 Total.I. 1,t22 1,181 Grand total. ..2,703 TABLE XXIX.-PERSONNEL REPORT OF HEALTH DEPARTMENT. EMPLOYEES. March 31, 1919. I ', Dec. 31, Match 31, Gold. Silver. Total. 1918. 1918. Chief health office. 4 .4 5 .3 Medical storekeepd. 6 11 9 8 Quarantine service. ..9 37 46 47 44 Health office, Panama. 13 140 153 159 157 Health office, Colon. 17 141 158 156 153 Ancon Hospital. .143 243 386 342 333 Colon Hospital. 21 34 55 49 49 Santo Tomas Hospital.7 7 6 6 Palo Seco Leper Asyum .2 39 41 34 .32 Zone sanitation. 4 213 217 168 150 Corozal Hospital and farm. 16 110 126 120 113 Balboa dispensary. 4 4 8 9 8 Gatun dispensary. 2 2 4 4 4 Pedro Miguel dispensary. 3 2 5 5 4 Total. 250 971 1,221 1,113 1,064

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