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:
August 1917
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:


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cal Corps. .United States Army
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Admissions, deaths, and noneffective rates for e
of residents of Panama, Colon, and the Canal
Causes of deaths of infants by sex, color, age,
dence ..... ... .-.-.---.. ----. -.. -......-..a. -
Deaths by nationality. .-...----.....---........ .......
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Iloyees; deaths
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-place of resi-


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and the cities


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Causes of deaths of employees, arranged with reference to age
and length of residence on Isthmus-... ------.. --.-.---... .-
Causes of deaths of civil population (employees and nonem-
Sployees) and military, by sex, color, age and residence........
Discharges and deaths in the hospitals of the Panama Canal.....
Consolidated hospital report -- .. ------------.---.....-..---.-
Consolidated dispensary report; report of contagious diseases.....- -
Employees: Constantly sick and noneffective rates per 1,000;
number of days' treatment per admission, hospitals and quar-
tes--,....---memmsm---mm.-.----...----em..e...--------.-.em-------.
:Deaths of white Americans connected with the Panama Canal ..
Finaial statement.................. -.-.... -.- ... ....... ---- ........--

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~.THE PANAx
.. ..E'... .: :. ..RA L

... ...R Balboa Heights, Canal Zone, 8
ii. HETE HTARDING,
...oii.i....... "of The Panama Canal
......." H. isr
.. ...... Balboa Heights, Canal Zone.
...i.i.. ." ... i .
...... have the honor to submit the following
3SMe health department for the month o
'A' H Hl, H- key *:'repectftil1y,
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*.:. 1" GENERAL IE E ARuS.. ,.


.. .. ..
C.H ojeath of employees and nonemployees of
S.* .....* ..* ** .. .. .ities has continued good.



.t ctoe of infantile paralysis reported last
*. ** .. S.



a d making good recovery. The con



tlii in quarantine. Nonwcases have
...:*: ...... *. .. : and measles have c ntin
........ .. .Ancon districts. While all report .

.......... ...w d there has been a failure on the



!lr.II;K: ansoible heads of households in report
:.. ... .. .in violation of existing regular
px:,::y.. ::. "j .ma Efq .." i '\ "* < _
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liS^IB^W^^31:. *A eo dit.cs "hl al "ep::
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k. CANAL,
DEPARTMENT,
eptember 10, 1917.


report of
f August,


the opera-
1917.


C. HOWARD,
chief Health Oficer.


the Canal Zone and


month


is in Ancon


itacts remain under
Appeared.
d prevalent in the
ed cases have been
part of parents and
ng these diseases in
Lions. This lack of


H H in.has made it necessary to take more rigid measures than
cding house-to-house inspections, closing of moving-
hus.es,.. Sunday schools, swimming pools, etc., to children,
t control these diseases before the opening of the public
u* = cases are how appearing, and it is believed the
.St ubsiding. .,
.. smallpox appeared at Balboa Quarantine on August 22


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The following statistics are based upon the total numbn6r iii

. appearing on the pay rolls of The Panama Canal and I.i .

Railroad Co. for the preceding month, which was 33,294'1,H:11

Admissions to hospitals ad-qumrters numbered 1,179

424.94,1 as compared with 334.37 for the preceding month, j.

for the corresponding month of last year. H I.

Deaths from all causes numbered 23; of these, 21werefromt

giving a rate of 7.57, as compared with 8.84 forthe precede nK1

and 2.86 for the corresponding month of last year. .*-

The constantly noneffective rate was 10.35, as compat:tt
8.98 for the preceding month, and 8.06 for the corresponding
1 ._ ..'. .*.: .E Shi

of last year. .;Iti
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Diseases causing the highest admission rates to hospitO H

order of their numerical importance, were: (1) Venereasr diii|

(2) malaria, (3) organic diseases of the heart, (4) influeiza.. id
chronic nephritis. These five diseases caused 30 per cenf.j.
el *' .l : .. ..'" "-.:

admissions to hospitals, venereal diseases alone causing 12 jer

and malaria 10 per cent of all admissions. .
A r* .. 4 r**::
The admission rate for malaria, hospitals and quarters, 's I

as compared with 19.52 for the preceding month, and 29.90iSaiv
corresponding month of last year. The constantly noneffecl n

for malaria was 0.58, as compared with 0.83 for the precedJ

and 1.13 for the corresponding period of last year. "S
By race.-For'disease only, the admission rate to hospitaksi"II

death rate for white employees, were 273.85 and 2.47, re..

as compared with 279.01 and 7.47 for the preceding In .-E

228..79 and 0.00 for the corresponding month of last year. Vd

employees, for disease only, the admission rate to hospital i

death rate, were 132.96 and 8.44, respectively, as conitC

96.79 and 9.07 for the preceding month, and 99.98 and 3

corresponding month of last year. 't*
The constantly noneffective rates were 16.88 for whiwt

for black employees. H '"

The admission rate to hospitals and quarters for ma'iat" .*
for white and 19.84 for colored employees, as compared .... S

for white and 14.69 for colored employees for the precei .

and 55.23 for white and 26.03 for colored employees forl ..


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......n ""occurred during the month, 31 of which were from
a rate d6f 15.47 from disease alone, as compared with
fithw preceding month, and 8.12for the corresponding month


mammmmmm mlmm mm'ci eR '
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eths from disease, 39 per cent
i.o years 61 age, as compared with 4
4ieven births were reported during
si; of these births, 18 were white and
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tie total births reported, 11 per cent'


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occurred among children
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the month, giving a rate
29 colored.
under 1 year of age, all
based on the number of
vhite and 276 for colored


were stillbirths.


PANAMA,


. tiuulation of the city, as shown by the health department
II. fjune, 1917 is 61,369; in this population is included approx-

'n...'...' _, ., .
S'18-,000 employees of The Pa~na~ma. anaj. From this popli-
r.140 deaths occurred during the month; 135 of which were
.. e, giving a rate of 26.40 from disease alone, as compared

,,,.3,9 for the preceding month, and 28.43 for the corresponding
a a.t t las.t year.
,#lii.i* he. total deaths from disease, 52 per cent occurred among
flJlye under 5 years of age, as compared with 60 per cent for last
iiHiii RIL, *" *


Principal causes of deaths as compared with last month,


were


I.I
........... ...........
f... -. :..... .-- .
il t j :II,.i ... .-" =t- ? .. *
... ... *,
." ... ..
K W : "" s--" : 'uily i^-
::"..''y. ... August.
" .:.; ; .-...i r- -
. r.. a? .*
. .(.)..g. .v ..: .- -. .
es various:organs* 30 23
.*. i =aum ii mi maNm memw e m weim m 4 e i ma i im me m imem mm. '
( u and broncho) ---------------------- --- 25 15
. =i. H I
..*HI .. .. *
A .....m* ........


'4
!iJ u'
* .ifi,


* I

" Iadred and twenty-five (225)
l, giving a rate of 44.00. Fif
children under 1 year of age,
S d on the number of births
S.: *-


births were reported during
ty-four (54) deaths occurred
, giving an infant mortality
reported for the month, of


Ii

Ii
i,


..X












WI ...." .*" .** .'.' "
precedig monttht, ad' au hi
tesponding month of latl: ar ..
Of thd deaths front direae, 56
under 5 years of age, as compared
m o frth '' : .. .
The prinefal daiises of death
as follower .


I.fl.* :'!'^ f
t : .." ...
^S .. .i .* .
fIS ;:=?. -*** .
.,
*.L *kr.aI ..
: .. 7,:" *
.*'7 H*
' ** *" *

'" -A "'-' ',- & = .
pwrth ecr cet (f
with 53 per cent for the


s ecdtompared wit


.Tuberculosis (u.various organs).. -...---........-- -.. --.-*-*.-.-.
Pneumonia (including lobar and broncho)" 3.---..::......mn...
Diarrhea and enteritis ...-.......-.- .-..-.---. ----.-.-.-..---
mmmm mmam eme amme mem meme eme mmem mm*


1 .* -. I



1 *: 5 .:
,..*. ":. ., :
S- .. '.-. :.* *.. *"
. *. i* _j 41" .** .. h Ji
*: ,*= *7 == == :==
*." = =="* I .*. .



** =,I ,=


.
*. -**
~~ ~~.*,...-H:.....+


< "- 'J ^ ~ "
'y :" :"
S:: .. ,


Seventy-seven (77) births were reported during th mtS1
a rate of 35.43. Twenty-fie (25) deaths occurred amd %.
under 1 year of age, giving an infant mortality r
the number of births reported for the month, of 32'1 'r
Of the total births reported, 12 per cent were stillbirths. i
-y* 4* .:
"" ".i ... :
DIVISION OF HOSPITALS. .
S 4 :. i ... :

ANCON HOSPITAL. 4
=== === : .: = =i!
: .. :.

The average number of patients constantly in the hopit
during the month was 528, as compared with 489 for the.peq
month, and 453 for the corresponding month of last :ye*
average length of stay in hospital for each employee admItii
18.50 days. .
Statistical charts are shown under Tables VII, VII,I j4 "
Corozal Hospital.-The average number of insane pata i
for during the month was 361, as compared with M33R fi
ceding month, and 290 for the corresponding month of .,g
During August 13 patients were admitted, 13 dischatg i4j
transferred to Ancon Hospital for surgical treatment...
Statistical charts are shown under Tables VIII and.-
t i -- -^ =* ^Ji"*' < *J'ic ^rx^ ^S'i'k~
Boarno health laboratory .--The investigation of the
occurring in .Panamanian cattle has ,been continued *


.4 k
k
H
.
gait
':1.
1~~~~~~~
..
-








osemes seven 4ye after th.lat inoculation. The calf,
gained well 'aIihough trypanosomes were readily found
-$a blood for a number of 4ays.. This calf furnished
_riad for the .gtuy of the morphology of the try-
.e have decided th,...we havq..hre trypanosoma thei-
ppz specimehs agrpe with tha. descriptions of this organ-
dze, (2) in morphology, E(.3).in. .ing .readily cultivated
ad. C(4) in being. unable to develop in other species of
an cattle. Trypanosoma. theiled is considered by most
t nonpathogemc. .
nation of three sick hogs sent in by the bureau of supply
........ ill of them were affected with hog cholera. These hogs
m.olbmb... TThey suffered also from a verminous. pen-
ut hog cholera was considered the prininary cause of their
i the first time that the laboratory has encountered
~ in animals other than American hogs.
M well-nourished pigs died at .Corozal farm and autopsy
Abcause of death ,to be a gas-bacillus infection following
of antihog-cholera serum.
df horse were reported to* have, died recently in the
between. Panama_ City and Chepo. The enjrnnation of
imck.horses.at Buena Vista, beyond Pacora, and at Tapia
piroplasmata in the blood of three of the horses; trypano-
ere found in no instance and two guinea pigs inoculated with
Hbir of two of the sick horses have failed to develop trypano-
".The evidence obtained indicated that the horses were
"japlasmosis and .not of murrna. Since.that time, how-
hbree was brought to the laboratory .from another villagee
~Md~aand its blood contained numerous small trypno-
S~Therefore both equine piroplasmonis .and murins are
St on the Sabanas at the present time and it is recommended
e A y veterinarians be informed of this fact, as Army horses
are very susceptible to both diseases.
E *e. of canine .piroplasmosis was diagnosed microcop-


.oif routine
'a ---The
i onth wa:
J ged fro
.- ':. .... ..
.. ; i : .
*.:: *.... .:.
"" '.h


operations is shown under Table XIII.
average number of chronic patients cared
s 29.87. Fourteen patients were admitted
this ward during August.


COLON


HOSPITwL.


ft a C --C* ..- -


r .i r.


.












PALo SECO


L MEPEi' A SYtmuM


. i.


7'
[4


. "". i


.1~ V

~


* V.'


~HL


1.
H~* i*.*..*
~%4.
* ,.. .-
1 4:
a.

'n.j


:" .. l .l '"i~
of persons cnsetantly cared fb9
)mpared wit' 65.70 for the jreeI
ponding Month-of last year..' ..
iatienits were admitted,'wit rio


1~


the. inmates.


SANTo


TOMAS


HOSPrTAL.


One thousand three hundred and twenty-fix


rep


during August, as compared wft]
and 1,439 for the corresponding


The average daily number of patients under
-- -a a c


for the


.prec


trf


.'..
-II
I
-1~~
~**i
air.
4 .
it 4
I 1.1-H
t .....
:ii~ynr~.


atients.Tzi
. ... :

S1,3024a6
m o t' :. *f.
'moatien 6
iatineit:-H


ceding month, and 440


responding month of last year. The total number (
was 14,173 as compared with 13,450 for last month.


n *


occurredd
(2) diarr]


f da


at the institution during
hea and enteritis, aid'.


the chief causes in the order named


Statistical charts are shown under Table XV.


DIVISION


shows


employees


SANITATION


average


both


monthly


hospitals


C


he percentages being based o0


from


each


District.


Balboa .-.-.----
Ancon-Corozal. -


Pedro Miguel....
Paraiso..........
Wpgt. af tPln .a.1


am l e m lmm m m m m ie m m m i n i m lm m pm m mmiml im


district


.?* r.::, jj*' "'


:-*irr ,SAt
r. ~
*
chtsrsan~


.4 be4N~Az
I.
i..:. %..p~ihJI
.4
H
adiiiesNt~

rnd 411jj~ja H'
nth~3ip
~ ~


tcta1';i


Number
of em-
Sployees.


2, 68
2088
I,
1,151
1,352
995


, as co
corres


-~-
* .
t
- 1, -
hr


. V-V i - i S S S -


The


month was


average number


65.61


and 67.58 for the


During August two
deaths occurrig am'o


E"" ITM


the hospital


ceding month,


1


compared


with


with


Seventy-six deaths c


tuberculosis,


diseases of the heart,


The


from


following


table


malaria among


the month of August, t
number of admissions


employees residing therein


fir.: ~
~ ~H .~
lit-
s"f t'-..
'4-i...
~iJ.~'


4
it'...
v.....
lb ~

H
.L ~ 5
1 .IIj~ U
A
Av:s.
'=I*
4iv*.iii~*
.., Li.~.. *
V
.1*

A...
A..
1~


H.
,.I.
,.-. .
*4A.y~ 1
9:?:
.1.
F,
7.
.4
.ii&H....H
*1E~ *
iii,.

.1
tAr
\ p..i.
I~
A"
hL~


'" ""


m


in';u


I'I


I'.


'


* *





iii.
flH.~ I .
fl..i~.
*-~ hEr :~ .1'
~iI. iI~*.
~.
p.
~ ~. H
I, .
~
;j ~A
H..


I:


CANAL ZONE.


ItSief of many medical officers ot the Army from duty
ai and their replacement by officers of the reserve corps,
necessary on account of the war, makes it difficult
Si ntay work in the Zone and terminal cities at the
dard of efficiency. The assistant chief health officer,
tary inspector, and the health officers of Panama and
e thus been relieved during the past few weeks. The
Wltt aent to replace them are wel qualified physicians
A:..... zealous, but necessarily lack experience in administra-
tpical sanitation which is essential to secure best results.
daiathis respect, however, should improve as these officials
.peience and familiarity in their special field.
Sbeenan increase in the number of cases of mdIlaria
both in Panama and Colon, among the civil population
4ti onth. The record, so far as concerns employees, com-
brabiy with that of the previous month and the correspond-
.ii of last year. A high percentage of admissions among
eres .continues to come from outlying camps of the supply
ttint beyond the limits of sanitated districts.

1.. r PANAMA.

Salary, have been more numerous than recorded for the
monthss of the current year. Several adverse conditions
a:e ponsible thereforer among which may be mentioned
,up of. the Corundu River during the construction of the
ume i=n the river bed, thus inundating a large area in close
Sto city districts and making antimosquito measures
I Further, cases of malaria coming from the Savannas
tere not chargeable to Panama City until recently. Natu-
nauburban districts are less favorable at to mosquitocontrol
terity.proper, and it is noted that a large percentage of the
.;ases .come from these districts. :
= is continues to show a highs mortality rate, and little
tit can be expected until we have better facilities for
endhospitalization of' open cases of this disease.=. An
ep... been taken in the. establishment of a free tuber-
....under .:.the auspices of the Panama Red Cross and in full
.with:tbheiih department, The positive cases, re-
.. .- I"""m -- -- nib.MM s












the Panama Red Crou
done. .
.Ordershave been .pla
collection, rep .ing...
that ,these tru will
garbage ininerac its.


* ,RijI
* V....-
H
SI',:.
a HTM
..:. .4.

Si .HrLH..


where
/ .


- a ., : .- ..: .
completed and ready


7- : r-o .,y .* ; *y ** *^ i .; ** ..^, ^v i'
." T I x* .i ... *.
\* .ON .i. :

Considerable drainage work has been completed in.
pasture nm the Mount Hope district during the mnub:
There were 15 cases of malaria: reported among ene
the month as compared with 8 cases during the precat.
.,. __ .? P. .., ., ., __ ..SI' '"*P w^,
The diphtheria incidence decreased during the I.
month, only one case being reported the last.two.weekd
An effort is being made to enforce existing regui4
installation of running water with sewer connectio.nt iA V
ide-cream parlors, soft-drink stands, etc. This work
rapidly. .:.
TT&"l T lrlTl" .-"T T .' '
nTADA-NTrINE~l TDTIVIflTSION*:~


' U I'-lJ'lI JL. .1.12J


I.JI. V/ JJ.U 1'.


r!tiOqNI
~~'~1
'2


No important changes with reference to plague and
conditions on the west coast of South America have pccurrm
conditions in Buenaventura, Colombia, are generally; r.
improving, nevertheless mosquitoes are still very ]p
rainy season in Guayaquil, Ecuador,. is about comm
marked increase in the number of plague and yelowr
particularly the latter disease, may be expected in the*"
The following inspections of food animals were mad
month: **
.. L .. ..:
.For supply department: ..::.

Cattle, ante and post mortem inspections. -..:-
Hogs, ante and post mortem inspections.- --:.-.,..
Cattle, quarantine inspections.. -...---------. -..'. ..- .
Hogse, quarantine inspections. ... -- --.- -- -
For outside-interests:
Quarantine iinsntinections tOrtaba docate


Ixn


r..---


is sections by.veterinarian under the healahrod
Panama, quarantine (Zone), (cattle) -.. :- -.--.-t -
.a--- "l. .- .' l -" "-.. "':


'C::::.
...


--


I:...













L-Rn


pfltations were accomplished by the hospital authorities
s 6 employee an d 6 nonemployees, all suffering
SIn addition to theabove, 32 deportations were effected

aitine authorities during the matnt.


.SS : .. .
. |:|::: *:...:" :.** *
A. J


DEATHS, AND
EMPLOYEE


NONEFFECTIVE


RATES


FOR


ABSOLUTE NUMBERS.


H LIII
lb.
it.
Mdi.:i... *
*1
h
K Y
9pLTr H

1.~II I

l1~
HI.
~Ifr. I
HI ~ I...


S r


*1i.4 w


- a-I. -
b~ t9~
-
'II


hiS:::i. -?".** :*i*:*]"* --*
gII.==q,,.::*:.-*:**.-

-! -


U .. -
9BE1S ^ .f .:*--
lh2rs ti. '.:


:.!I: l- -


HII'"


U,
C
C
fri
I 0
-
Pd
2
C,
a-I
0
C
'.0


4,864
28,430

33.294


Admhospitals to
hospit als.


1
1



I
03 C
0
o


128
400

528


4,817
27,770

32,587


4,563

29,046

33.609


11l
315


22
75

97


Deaths.


i


-I


J.
20

21


25~


' 10


8


a -


- i


Nonefiec-
tive from
sickness.


2,544
8, 135

10,679


2,298
6,778

9,076


2,135

6,266

8.401


C
S




a.
O.
0


82.08
262.41

344.49


74.12
218.65

292.77


68.88
202.13

271.01


H
S
.
*!~ ~ I


PROPORTIONATE NUMBERS.1


4,864
28 430

33.294


315.70
168.84

19.30


273.85
132.96


153. 54


41.94
35.88


1364 6


. ......


2.47
8.44

7.57


0.84

.72


-. -----I


16. 88
9.23


10.85


: 1 ".


1111!~r .;


un' *r, e -_ h. ..


'I


i ----r


.


I .


I


i


1


1


|










143A


TABLE I-A.-DEATHS OF ]
COLON,


IEENTS OF THE CITIES
THE' CANAL 1ONE.


.. 11EV
-. ~1-a


'H,
* .4.,
H':,...
- *~1m.
ii
4


August, 1917:
Panama... -
Colon. ..


- .-


Canal Zone.


Total.


July, 1917:
Panama.-... --
Colon.......------
Canal Zone..


Total.


August, 1916:
Panama-.....---
Colon .......-----
Canal Zone..


Total. ........ .


Popula-
tion.


61,369
26,078

.24,038


111,485


61,369
26,078
1 24,038


111.485


60,778
24,693
31.048


116, 519


Deaths.


Total.


ease.


External


causes.


..- -


- 7


II


Total
4


-27. 38
29.45
15.97


25..40


35.78
27.61
17.47


29.92


29.22
27.21
9.66


23.59


1. ;~


*'4. ..


.1
..






2S.4


2 4#*!?':
rr-i.:.*


.. :
35 39


14.98.:


29.17


U


,::!::.
~

nfl
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*. H~1!E~1
i. ~
.1~ lit.

-4."
Hi.. *
Al.
~!-.-j!- ~


1":***
k*
* H...
*
Hai.&
LEE
h.. :5: P



K:.7.. p


jIjrL:~r-

1H*1.~.

1sr-...
*I.
.h~. -
..., .4.S.: .J

~ *.
11* *.. *
-.
.
s'H:
,H..i.IH:.
.
A .
~er.:q~"1 *3
t
S
~
!&-4 IF*
"H.-..
~.. -.

*~H**
A.:
..-... A
~' ~H 1~ .~
H~
,...~..,,. A
* *
*1.4..
~"
w...
'hr.
I.. *
.1.


_________ .~*i...* -S
.. .. .. q. S
h
hr.,:!.
.'1.1.!
1** .* ii ..
28. rn~; -. .. I"
Liii
.i..
______ I.
________ H
hr. H
22.. 66H
C H :...
V..
.. F!. iiiI~rl5irJE ~ 1.:i. V
H.
I~H. iN'*
H'*H ~ H. .:**j
.
~.~fiLa~bHAH;IH~
~
ia~ v-A
1 L.LHH H1~..ii1* .~ -
*.. hj
...A.H~ r H HiHili 91.
'J~~ELEj H ~..H H.!l~H. .11...
s.*-~ i,1H.
~ .
nj.' :1.*. .
SIP.
.11 ... 1~V
.14.**
I. ~i ~
'h limE. H
.111..
.1. Al
.~ .Hii* '. ~. .1: tH .. H
~** H* *~j~H
I .r~ l!d!a.M..IEH..J.
It---...
*~~*H** ..
2--. HrH ~
*.flqU 3
HH H ii.1H
~ *'H.~H ~~.:::iN* %a.
*.*H. *~~HT H4
ill's
--
I~ *Ij~ -s.-
ii 1k1~H
.11k.: I:
,& ~n~
;H h
.'Ei-. 11H1 11 .H*
H HH H
H~


1 4,:


1 Civilian population only.


i













H. "
,,:::. ,,,* .*. .

)3G:..:::*h *"
,N.

::: *. ..* ..
i"'" ::*."i .
H.


...~iB" ;* :.:" ":








H. :: '"" H : .



:4 ,!n":... Hill.
::*. ...A*:. .*
*..: ... .. .
....ll.a.


S ..iiH .
BE i= ::;*:: i'x : ,. ::*- -
r.. -*



S.. ... .









*"IJ.. ( ** *
: :: .. ** *' .
:: h. *:. ;*.:. : *"*. : *.





k j *.,!, 'S
.5.1lim:= .
..j.t.-:- ...H --








.hshjll,: j : H .

:: ': ..::" :
I::H **H *4*""



H:* H *. :"iSH. "


*!!h'q. '2 .r :.*
K"' S. *~ lj~lH.H*..~t~

ii. *~ K.
H .H!~',.A.:Ei** -
~ 'K
-. .11w
H H
Hit
H
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:41. ~Hl~ -
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Pm H* H5j'
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illk.* I H.E -
H HV ~lA~
HI'
H~ 1. ~j*

II1~~
H.. .. K.: A
I.... All
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Wi.:! tv
I. a:
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HH..lll.H.lP


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II HI*


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I.., ? .


.: .. ..i :'*..::.:. *.'.. : *
iH ::i "S :* ** '
H.... .." **, x :* ..* ( "A **...
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|... i...1 .. *
*....x .. ... ... psf --: l* *
H H.. H I..




H.... .* n.


iHi l. *4 "*

KA. : .A.

1: .: ::jji "::i ::: .
t .. ME.... :* "
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":i : .::: :" .i:: ": "::


. .H...
: :: ..x **

M XX! !!'!:!* : ::** *" .
X X ..: *
: "":'::.:: :" : "x-": "
iE:E :x ::::EEE E : l" .*::" '
::: :... ... I :
l:::.. .::. ..^ ;::!::: .
:.. .. ..


"g........* .:. .




i::' :.::r : x. -
3: x.E : : ". .... .** .














*C pc *3CPCpl &* *** ---
H .. -
li .K:*H!.*. "'
H... H.....



.. -- .:. .: .. .
.n T "i .... .




9*:. ...* : :: *
.. .. ... : :.. M *
.. .... .*...."
.. .... ::.:..*
~~* ~~ ~ x ...
.::.*.:...::*.. .
!!::.. ...:. 1 :. *
H *. :::







.E .E. *
: .:...... v ...
...:::::*: .
.... H






:" ." .:" "

H.;: ; : .
.S : = .. .
H. : EEE ,::. :" "* i







= *HII.


I H" I. I
"" "


, J


!i:3:





















TAn.E IL-CAUSES OF DEATHS OF


Cause of death.


Whooping cough..................... -------

Miliary tuberculosis- -------..................---

Abdominal tuberculosis...... ------........--

Acute meningitis .---..-.-.-.---------

Convulsions of infants. -..--.-- .- -....- ..-. ---:.--.-

Acute bronchitis- .-------------------
Chro0 brochit.t.s: ----------------.-


Broncho-pneumonia.................. --

Lobar pneumonia.- -..-................--------

Diarrhea and enteritis.... ---........

Colitis............ ....................--- -- -

Intestinal hemorrhage................

Acute nephritis- .-..--..--.---....-

Pyelo-nephrosis ---..............-.---...--.. -

Diseases of skin and annex --- -. --

Premature birth -.-.-.-.-.---- -------

Congenital debility..---- ----- --- -- -- -

Malnutrition --------------.

Other causes peculiar to early infancy

Traumatism by fall ..................

Undetermined. .---..-.-.- ..--- ..--.--....-.- ..--.. .- ..--


Total.... -

Stillbirths......


- S --


-----------------t


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


-SOxa


Color.


.5
A
*i *.%H..i
~ M

-~-~.1=~


111W


.". :....i ,cwl;r:
..........:.:


." Iwe.fe,
S .. v ..l i

H. El 'ill.


. .
1lwet s..


**l~ ..lll~,*.


-

I


L" *;!;
:rblVfl'4

it-: Sr
l.l.~.

* .. ~ ~ ..*H. II

.ilr.. *l!IH!!H.
- a -. jik.. ~tr






.

.1
I l.~C~i


9.
. .- ...'

-




--*I


n.


n .*n a

-.-. -


Grand total ....... .... ............... 71 1 53 1 l I 15
Infant mortality rate, based on number of births reported for month (

Percentage of deaths under 1 year of age to total deaths for month......


..,. .
*.. $1.

.~7t
* .1~
N:. .


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h.


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4
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an:


sir~


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HV .
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...... ..

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P"..:.... h. l:.L f II ..


h' ....H:* .






H **,-H:j : 11.1 *H -
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... ..

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S i iii:: -:.... :: .
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'***: '"::*:* **:.**:::1
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................................................................................................................................................

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...m.... ..


....


1




rlm-*ll...-.
it...
:qi;fli-..


j! I 1 S*~ :* .
Hid- .r -.

*:l~. 1~

~
411.
Hwrk~n
114...,
V
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I.
I 4...~. :a.~. -
A.
A
iHHl~

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1 41.
H 4.~ ~t
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.1
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hqiiI1hii. ..~ -4 ...
.1~~


k...1. lv
ilH~lfi1111l~l. 1
IIHII..41
..*y.~4Lq,, in--.
rIeII~ **~ H.... ....
Hill: H!
's,~.A 1
:.Is~;Kli II' .... d. -
It C~ ~
H..
2'~~.~~~
~.
......... 1, 1
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4s ~t.. ~ -
jIHaL .~*J*=~ P 4,3
H.
H~. ..
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C
P1.. "1'~~
-
................
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InTl. -. -
I
.1
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H. ....it .
--
..a ** ~ a ---
.- I--.-
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IHI..'%* L .~ ..

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WI.: J.: ~*H*H* I .~ ~r. 1

.4'
*H. *... ..<*I* C-I
iN;..






--
.. Ps WlS**S we.. -- -


B, AGE, AND PLACE OF RESIDENCE.


Age by months.


5-816-7


51 5 I 8


--- .


10-11


11-12


I.. i.


6 6 6 6




6 6 6 6


Place of residence.


Pana-
ma.


emii
* -i


74


39


Colon.


.i.ii
g-.mm-


naimo
- -


modm--
-m.. .


f
-n. --


36
324.68
39


Zone.


14

170.21
25


Total.


124

20.28
37


i!is" ,;*.!B!j.: ;:. ^..**I a# --17---0
i:3e::::aiL'""^~~ *::*. "'f-
..:
P:'?^. "2.9

.:.| .. .



^ ~ ~ ~ ~ **" ** v
*E :i ,, ,, .: ,
,:: ,,, ,, .: *,



"i:*"::*: ly:.ieBx "
H::" "..: ..... ..


i||:::" |:= :E i..E "' "


: I'IH"-- .*-
H ...*



I..*.......
.. M H. H...
... ... .HH.I



-* --



H r I
*1 ... "
..! M .
L %. i


H
















TaBLE


".:i u *:*:. ilir
:H .



III.-DJ ATUS,.Y yNATiONALITY. .
^. i *S ^ 3!H "


Nationality.


Antigua- -
Barbados .
China..- ..-
Colombia....
Costa Rica..
Cuba ..-...-.


France ------
Greece..-....-
Grenada....-


Guadaloupe.. -


Holland...


. .....- .-


Italy -.-.------
India.---. ----
Jamnica -...-.
Martinique....
Montserrat ....
Panama-. -
Perun--.. ....
St. Lucia.... .
St. Thomas -.
St. Vincent .
Spai ...m------.
Trinidad .....
United States -


Tetal...


*. -. -.-.-




* -..- S -


- S


.TABLE IV,--BIRTHS


August, 1917:
Panama..-.
Colon--- .......--
Canal Zone..


Total...


TIli 1017-


Male.


3


2


- ..--
1
1


' i. -


AND


Female.


Nonemployees.


Male.


-N--i-.--


-m-m -ma-m- -
-.---..-.-.- -
-.-..-.a-.- -


Smmm-n-* -


BIRTH


24
2


-m-- m- a -
42



3
1
4
6


RATES


Female.


1











.........
-. --- -.




25
7
I.





1


. a-. .. -
1


THE


Total


* ifl~iiflH.5
I:.
*..:.,
H
- :. 5?. ,~j:Hk
I


~ .I~
-'.ME

ale. Feuu.gs
*
_________ a .L"


1.
1
1-.

3
3
.1
4 2


35
2


41
1
5


THE CITIES OF PANAMA AND COI


Popula-
tion.


61,369
26,078
1 24,038


111,485


Births.


Total.


Alive.


Still-
born.


*


4


^'
.. *











..
..




.. ..5
.. ... *I


.
*::
-M






- ---.

.A *...
- .^. H- ?T -S








. .5
. *,:"^


- .2

4 .;




.. ... .n
*f "
'"""""1
~ ** .
** ---- 'll : *


nn.rn.inonnn
liii
..
j.. :,.. .
Iii. H
V
* S
H I.
H...~
.4...
H'.
H
H.
* IE H
On:.,
in.'.. A::.
a..N~
* .H

hn.
..H. *~i~H*. N
* Hi*
H .~
.
~
..nr. ~~.nnq*
a sin
i..**i. ni*US
* ~
-a
*4iH~
* .. .. *
I
*

*J jJ~Hj1
...1h4
A:., Harj1

-.jm
.An C ii~AA~
H*iii
.4
nn.nt .j: *
Ii
I...,.
* e.,c1jjn
*H.


CANAL dxl


. E ......': :...:. i 3~
.A '


atBate


Total.


47.91
40.49
2.646


MWi


r.r "..
I


.An. It
SHHAH..~ji*Fj


* .
IliuM.


. :. ....
. i ..r
..


i


23~-6
aimi

T : "
.. ..
, ; h


Employees.


* k -


m


. .
.


~1*~~H~.


I.
S.
.4.





..
H.
App
l.A.
!~r t:.* ~
"4. .tI..
=4
-U

en.
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HJ~
H
I..
H ~
Pr..,-.
~ nIH
- C
HH~. *

.10...
a
Ph.
niH inn. W
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~
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ii.fln.!h:!.
9k'~~ ~- *
H H
-
iHH *
*

H
*1
i*.
.H
Li:. .ini.
H~ii''~'V
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H. *n..

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:11

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jrH.~.dC4.
A..
H .A..nn.
M
%t.. ii>
41 t.*L* I
H 7H** -r
t
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it.
H H
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hi ~
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nnHnA=*~~'
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l.a..
ii,-.I;
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I. H


~ON;


alI


ill















iL--TFAMNT WORT&AIsTY BATES IN THE CANAL ZONE AND
.AIl::. r u'rE CITIEa OP PANAMA AND COLON.


H
~ '; Nb H kH *
HI: ..i.*
Ht.~ .
H
.jNH.HP.
;NIhirIhITut: t C.
.>j1::~r :2


A~.I
C
~ ~.. 1 -
V
p,11 .1.
NH

- ... .- 1 -J -


H::.:. .. =...:a r I"r1 s.



..............
.. fir... .atrar ..
S* .*** H -


UMM P,..':J'"'..-",,. **' **" BB^ **~ ~ ^f, ,n m

t .:,. !.: :,i.* .r*. g..
H :** ** ** ** --- *1*





::':: ::j :::.. : .. [a 'i
i 'H
.3H .1 1 .. -

-
aAa





.. ...- .. ....


.... m. m,...
.::.... ... .....
H ..g.. ..H H


. ...i 1 ...,.. s n. m-
".: "i:" : ;: : .. ..


il ., .... :i! ." ..
H.. --
*. ....... 1 o




.. .: .
.:: .*":"." *:* [
::: .. -
::..::: **::" : $ 1Jf~~t H T

H: ... ... .





i !:::: ..:: ^^ "T n o
.* .. :. :x. .
^S^S&txguat, 1916:








... .:. ...... ... .. *. .: *
....P.....nam a
B *.. (j. .. : : .

I" : ...:1 : : :: .
1k: .: *:. .. ".
S.:::. .. :: .. .
..:::::::::.. ..




HH* ~ 1 .: I*
... ... .*. .: .- *
.:: ::" : .* F !!. *
i ... *
******* -- 1* *



i... .... .. .. ... .. :
. ..... : :
H N.*......
N .....


.. .. : .1.:"
....k... *



KJ:::'i :::... ."*' .y ,
fx:r:jL.': 'v ":
.....


. *i I .. ..
.*
N.H H .. .
I .:EL. ... ::E
I.... '

.......

:' {i; :::i:::,..::..
... ,! "':: ...... .
m.
H m
': ; :.: ;i : "


1e


-.-. -


.- .. ....*.
* -- 0 -m-- m* m S *S S


S i i i i i i i i i i


Popula-
tion.


61,369
26,078
1 24,038


111.485


61,369
26,078
t 24,038


111,485



60,778
24,693
31,048


116,519


Male.


a.i,


Deaths


wmong
children
upder 1
year of


240.00
324.68
170.21


87 240.28


399. 01
324.68

150.00


338, 24


280.00
218.75
66.66


232.09


1 Exclusive of military forces.


"B .i : .."i. "' '
I Hi.i"" "
. H. i .i. i.. r#
" i ::; :'::. :" I

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

.P.. :: .. *"


Births.


mile.


Total.


Death
rates per
1,000
births.


.
.:




















I-tn


Cause of death.


Abscess of brain.............

Aneurysan-- ....-- ..-- .-. .....

Endocarditis, malignant. -.. -.

Epithelioma of esophagus...- -

Heart, organic diseases of....-

Nephritis, chronie..........

Pneumonia, lobar. --........ -

Tuberculosis of the lungs-- -

Tuberculosis, disseminated..

Tuberculosis, acute military. -


railroads.....


......-..


Suicide by firearms........


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


Color.


Ri JILLL


*. H
,, /* u'"^ "B ^ 3

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

Agi* ....
ig

21-25'


26-30


-C---

6



I


36-40


-

* .

..-.

~
---S.


a.-.. I


1 15 years old.


iris. ~
Ii. r a
* IbJir
*
w
-.
~1*
I.
:~'.'. >



1..
**1i I.E.
-
.1k1*:..~.

4r.:~









II:. ht


~


1.

C.
4......

gd:

C'.'

~1'~

J~JWW~
q
I. H.


.. A A .~.~jIti-diSrE
4~ 'I.E RI:. --
J~
~ :.%t..$i4
.-- ...;
yr
*
* ~ 9 Ti
..J-t- a,
rK~.
* V

5''!:
L~IHH

t
:H~W:fl~
4 .... ..-. 1~H**j~!j* H 1~v !'~:H~ ~


A: *l-:*-H
.A".' ...
WI. ..a~ A
'a ..1si
V..
.
*
~~'~-'
*~HIr .~
.4 .1 ~Ij. *
*~H -.1H1-. .
I....-
.4.:..
~ H
'p1:4 .
*.s~:
.S.L. .....
I:...
.pHH *
...IH..
.-
LeE.. A
.
H hfl V..
.. r
a.
.....-.:
* ..... H.H;
.,
r
H.~..'~H*4 fl-A
...rY. fri. .:...j...~.

.r~ ..,&.
*'~Ir, e. H
4~..II.H. I
:1......~jiL27..~~'~
~4 :.:..:M;Hsr -;
Isu~..
KTM 1" H~~<*
: *1 *. H*** H..,1#*. ....
~! '**~~'*~~kJ..H
.1!
~q
I..H..:A~ H tHAK~~~
I,..
V -
N *

IHAILEHU*U.
HE, J*~Hj.K


U


TABLE


Traumatism


I


t'








xxG":|y: .~U~ i :. ^^ *
"ic "|




: : ::: :" : :.: .



S .. .* .
:iP! i^iHi: -^



.*** ** u s s***** .- *::: ** *

j.H ,r ,, : ..
S. ...: : :: .. :* *
"i :: ...%,,: %.:.
.l ,, ,,,,,,h,
ss .s, ss s ss s


.... O AGE AND LENGTH OF RESIDENCE ON ISTHMUS.


Hi.~
.41 *11
Hill
H H~ *iiH.4
H!.... S
H ~.VH *
I
H
i~ ~.~1


*..ii.
*1
r l*~ji4I*
1HHIJ; I
:.q4.9q
H.
**4~4. .*ii *
sEll::.-..
5.
*.q~i:*jH4
.
H I....
ill..'. .~1
V.-
i.i~I~H!H~ii***..4 .4' *
41%~. ~
iI3LjEl&E~~**I ... -
i~ L:lJI,
4:.
.ill
~r -. :.r;-

-.
;*f* ~E:*
~ F
H- -'
-I. *
i~H ~. ...
H r
-r
PH t
H
WI"...:.
.~ I:.: -
H
..4 -.4.
5.*
9 .iHilj
it
H
~
ii ..-
p.11. .~
.. .
M -
H. .11111
- :1
V -.
H
Vii.... .~ A
Hii~~~t**.
-- -
.. *
Hill:. .
1.11**i *


:1Cm':
--- -


p4. .~. :." 4.~.! .1"
..... ..... ..... .
.i.. .. **" .- *. ,


^* ^..- Length of residence on Isthmus (in years).
.- .: ,,:

4:1 :..~- ...- --


. 2*aA *,


.. ii "'
\ik$^*" i


3


.. ...




-.S..



-.....







-.....
i.t. -

ii t
.....t


8-10


-. ...

5*S*S

- S. -


4


10-12


"1'




1
. 1







..4..








4


12-15


U


+15


Life.


Un-

known.


Total.


1

2

1

1

5

3

4

1

2

1

1

1



23


H~ii!i. s.

; >_ m
:' .. ".
,, ; ,,,,, ,, ,
:.. .. .. '*




I s '* m a
iH ii*.-

:*. .H .* ..
*:: ":* :j ".


i"i! ;; ":. .."'* i .
t.... : ..




s ,
***- -* *
i? i .;T I it




*** ** ** *
*i .* .. -
,~..




Si : S .: "
!*.: : B : "
,:I f ,, .. :i 1 *
f.:h x *










H ,, i ,,,
w ~~*x ^^^ *
"-** :* **R -
S *
H...4 r.: :. A -









,, :* ... : .. :







: : *
iH:: *..









iE ':. ": E::: ::: !.: .

i' "' ".: ". ":

: .



,,,,,. ,,*
H ii*H H ..
.1; :1. j

........i.

.........
i ..H-.i* A!isi .

















VI.-CAUSES


Cause of death.


General diseases.


Malarial 'fever, estivo-autuInnal -........
Whooping cough. ...... --....----- ............---
Purulent infection and septicemia..- -
Septicemia-l --------- .- .-.------ -- ---

Pyemia and septicemia, pneumococcic.
Tetanus -----------.................. --...S-S.-..-.... --
Pellagra..- .. -.-- ------ -.-- -.- ---..---

Tuberculosis of the lungs. ...- .....
Acute military tuberculosis.............
Abdominal tuberculosis ..---............
Pott's disease.. .....-. .. .----------.-
Disseminatedtuberculosis..............
Syphilis, hereditary. ..... .....
Cancer and other malignant tumors of
the stomach and liver... ...........
Cancer and other malignant tumors of
the peritoneum etc ...... of
Cancer and other malignant tumors of
the female gemnital organs.--....-.....
Cancer and other mahgnant tumors of
the breast.-. ..- .........
Cancer and other malignant tumors of
other Org as.... .--.-. .-. .- .- .-. .. .- --------
Anemla, chlorosiS........ -.........-..--------------
Alcohohlism, chronic -.-.-.-...---...--


Diseases of the nervous system and of the
organs of special sense.


Encephalitis ... -. .- ... --. .--
Simple meningitis... -...---........
Cerebrospinal fever.. -----.---. -
Cerebral hemorrhage, apoplexy..
Convulsions of infants (under 5
of age)..........---- ..-..-..---........--


- .



- ... -

years


Diseases of the circulatory system.


Acute endocarditis. ..,.---
Malignaut endoearditis- ...... ....... .
Organic diseases of the heart-.-.....
Aneurism...--. ----............. ... ...


OF DEATHS


Sex.


. SEX,


Color,


"" "1-


*fl..H... .
H
D.C.
I
rffj CrC k.Cf

OWfl~~
~
.h~;:i~.t

'"'H
K *..

-


*- "

-lyear)

-
*
3




!




S.
I
1 -



f
-""" 1*
-a- *S


-.S.- 5-s


S
~




~:' N'.
I--?
Arc

.r *t~H
-
*
he H .~ t.
* -s.-~
A

1:

.m

-.
'I'.

-
I



.i. *

- -~ r-*
.1
I.. -
- w.


~~~l'
- ..-

- ..
* .. ~:

A ..;~ ii'
A
----'U.


.hil
1 .* .



1 .. ... *. .I
.. .
*--- -.--S. ---; --


-- 1 -. ...S..-*.:..--
-= ~ z .' ^




i:-i ".



"'
,, J


IL;.




4r .IJj,~~
:1 :r.
r. rq


H

I..





23

~t'~ Lcd'.


.!~ H.:
C. H:.Ek~I



*

i~*
...

H
H


H
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I.
I:...
.. C~.
H
I... ..
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.11
:...... M~U
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I::.,,
:r..

A

I~. C.~t


I r ~'-I.;
~
II:
-~
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a.
*.. 'V.
I~.HL.
H.
Al HtIIJIH ~:!
~sbr
H H
H"
H H
H
*


S


~


.. .f.i. .:i ... C.* ..

IC-..
.. ... .




If ** *~imiW Xi!! *:
-ihE~x: -liai**l *~:x'"*""t
.F:








u l r~ Iu~w~f Ejll .* *
3.'*
... !.t. : .





*.*.* *:, F,, :'
= ... ...


* ilh .i


H H
l~h^::l"- ':" *""



i ,,,,,,,,, :B >:, BE ,,,, .:x:
. .... ..x' i...x: : .*. ."
,,:j lj.,, ,, V,, ,
i-S tt" : "'



,,!X ,,KJ: :AX" ,,, .:
:*:: K .: "::: I IE:::: :'II I.e'
:: *"::::"7". ie:":.'... E ::":^:
in niiiii mm. iE H.. .:.!* i "fE: EE;! 'c ... ...
air -afi"r!^ '%

i x:a ,: S,:,: ,, :, ,
;E" :!EEE:" S^'iE"'E... ..:n' :, *.:
"*Vj :" I'.t." .:
*- 1* jAHB ***
i-^sSBU : .::,":." ..J!.. :
ilLaHP4 Vjmrru fs

,E::" ":. : ",E" "xI.. '.
H J::'!.::H.i : : ::.i.. ... .....

H:3::" HA5E""~: .: 4


TABLE


*


* i


I






















)INONEMIPLOYEES) AND MILITARY, fY

INCoE.


4..
H***IH.

N

,; H.
.12"


I.:


.Jn.
*k k.
H
H K.
tHEEd H:*

S

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*.qfl*. isA
I
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it.
A
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.4
IS~--
-'wIn. .4

* .


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a.
EqS *.7i
H




r.
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Age (in years).


IUAO-4


-- m i--

- -- --


...mm.
ma-m- -

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* S l-


41-50


.2.


*iN a.

N...- O

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51-60


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m S m m S m S

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- S *-


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61-75


S -

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- -m-- -

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76-100


maimmiim

* W N BN I
imi-m-m l
-- I -


emmemmm



ammimme

mimimml


ammimimm


1
m" "'iS


wommamv


Place of residence.


Panama.


imeemem
i- NS SN


2



7

- mim-i. -


Colon.


m m
* -5 7 j


1

- -

---S-s-I


*" "5"
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S


Canal

Zone.


w:mme


mm-m-


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mammW
Mlimm
- .m


n iQ
--m---

... ..


S.-.-.-

a.
6

* 1


ITotal.


1111


1

















V I.--CA U.ES


Cause of death.


Diseases of the digestive system--Contd.


Intestinal obstruction.- -......

Other diseases of the intestines. -

Duodenal ulcer--- ....-.....----......-..

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

Abscess of the liver, entamebic.


- ...-. -



*. --. *.. -

-.. *---


Non venereal diseases of the genito-

urinary system and annexa. ,


Acute nephritis .. .. .- .-.-.-.-.-.-.-.- .- .--. .-.--.-.-.-.--

Bright's disease (chronic nephritis).. -

Other diseases of the kidney and, an-

nexa ..... .. .. .... ......... .. ..
Pyelo-nephrosis ........................----------------------

Stricture of the urethra, non venereal...


The puerperal state.


Puerperal albuminuria and convulsions.


Diseases of the skin and of the cellular

tissue.

Gangrene .- -.-- ....-- ...- .---...- .-- ..- ........ .... .

Other diseases of the skin and annexa. -


Diseases of early infancy.


- -
* a .. --- .

*.-..-. .- .-..-.-


...I...
-. ... S


Other causes peculiar to early infancy


..


Old age.


Senility.. .-


Affections produced by external causes.


Other acute poisonmings.
Traumatism by fall....

*Railroad traumatism.. -

Injuries by animals -

Suicide by firearms -...


-m .t -m i -
i- *i.-- -
- -..- --.- .-.--.- .- -


- -S --.a *


fWra niina nia olon nrn4- ?orfflEAl


DEATHS


*Sex*
Bex:.


3

3
















2

1

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Age


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Premature birth..i

Congenital debility. -..

Malnutrition .........


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<,'iQi BSWDENCE--ContIued.

i:..: llii* *. *__ _____


MILITARY, BY


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Zone.


* i --IIII


-.. .


a -


-5555.5
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Total.


Age (in years).


Place of residence.


---


--I- ---I- --


I -



















Residence.


Escoval
Tonmosi.


A.*
iv:.
V ihhi~ Hid!..
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Tkrnz tA..~..I9UATM8 ON NQNR$8~v
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w... C--n...


Darien --
Juan P1st.


8. S. cspa--- -.


Paeonj.~


Interior of Panama.


Juan Diaz.
Do....


Chepo. -


Interior of Panama.


Nziti~iialty.


oomr


...-do --..
Spain -. -.

Jamaica.....

Pama......
Spain--o-.-.


Parnamas..


Colombia- -


Panama..-
Colombia -


Panama..
Colombia.


- -


Martinique... -


Granada- .....


Color.


Black...
Blc.-.-
*- .win. -
-..do.-..-
White...

Black....
W'hite...

Black...


am@ a i d~
. .do.


...do.



. .do..
. do.
.'..do.

.. -do.


...do.


HaLtix


a
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alemle
...do...


Male..
... L t ...




...do.-.


Female
Male- .. .


...do.
...do.


...do.

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Age.
.4*2
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I
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25
I 47


20


3
36


-3D


1 Deaths of nonreuidents are not included in the statistical chart!
Canal Zonem or the cities of Panama and Colon.


.:. ::*:::m
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TABnLE


Diseases.


General diseases.


Typhoid fever- .- -- *.-..

Typhus fever .., --..-- ------- --

Malarial fever:
Estivo-autumnal.......


Qurlterini .. .. ..


Undetermined ....

Measles ---.....--...........

Whooping cough......

Diphtheria and croup..

Influenza... ....... --------
Dysentery, entamebic.
Leprosy--...............-

Dengue...............
Chicken pox..........

German measles.. .....


- i- i -
* .

.. ..... .*. -







- -. S -

* .... .
*.-. ** -

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


M um ps -. .-. .-... .- .-- .--. .-.-........ ......

Acute infectious jaundice (Well's
PdZ t e) ---. -.-- .- .- ..- ... -.-.

Pr lent infection and septicemia..
Pellagra -.. ........ .. -...-.... .. -

Tuberculosis of the lungs...........

Acute military tuberculosis........
Pott's disease......................

Tuberculosis of the lymph glands. -

Tuberculosis of the genito-urinary

organs -..-.---..-.-. -... ..- ---
Tuberculous abscess.........-......

Disseminated tuberculosis..........-
RvrnhiliQa


m 28 .I...
*. *. V*.1.
.
28. ; A NDD Ri




V.1.-DISCHARGES AND..DEAa?|T

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Discharges.


White.


Black.


1


M.


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Nonemployees.


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White.


Discharges.


White.


Black.


White.


Black.


M. F.


S I I I I I


Nonresidents.


Deaths.


Black.


I


i














TABLE VW-DTSCHARGEW Al AWT.
a k,


Diseases.


General diseases-Con tinued.


Cancer and other malignant tumors
of the female genital organs.....
Cancer and other malignant tumors
of the breast.......... ---..... --
Other-tumors (tumors of the female
genital organs excepted)....... .
Chroic rheumatism and gout... ...- .
Diabetes.. -.---- -.----.. -..- ..--
Amenia secondary, cause not deter-
*iiiiaed__ .-------.-.---- ..--..---
Othe general diseases. _. ...........
Alcoholism (acute or chronic) ......
.AOIDohoism acute. -.-:-::-:::::
AlcoholMsm chronic............

Diseees of the nervous sysem awd of
the orgasm of special sense.

E.ncephalitis- --- .. -----. -.---
Cerebro-spipal fever. --.-..- ----..-
Cerebral hemorrhage, apoplexy- ....
Paralysis without speified cause ..
General paralysis of the insanie. ....
Other forms of mental alienation...
E oepsy-........................ ------------..-----------
-ytei- -- -- -- -- .-- S- -- -.
N ris-. -.-- -. -- -- -
Other diseases of the nervous system
Netrasthenia- -... --.. --- .--. .
Diseases of the eves and their annexa


E u~a~r


uairs~es.


I -


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I. H LjIh
I:
iIi~. *
rr:.
.1.... "HL~
-I
H *~~*

9:;.
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H
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r-j-I
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'II.


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~: ~

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.411 .1.



.. '4


Netpsu~i~pe


F.

.Black.




I .

L


F .~ r~ ---. I


NOD re sid exts.


Disdhargesi.


White. IBlack.


yr I rL


-- ---
m


Ilrl''"l~













TaBLE V;iI. DISGHABJROES, AND 9flfl
ak .". E,, ,, :
I : -.* *'" "" 'K *

S* ... ......
.. : :.,
S *.. !!!
.. :-. .e .. !
.S. -0 .... .. .....


-,,,, : i ,s ,,
9..

..A
*.... ......rq -'
~.**

Whit.
-- i '. j it ER^ IEi


Diseases.


Diseases of the circulatory system-
Continued.

Diseases of the lymphatic system
(lymphangitis, etc.)........o.....n
Lymphadenitis (nonvenereal).
Hemorrhage; other diseases of the
circulatory system -- ........ ---.....

Diseases of the respiratory system.


Diseases of the nasal fosse.


Adenoid vegetations.- -
Acute bronchitis ..........
Chronic bronchitis -. ..- --- ....
Broncho-pneumonia ---......---
Lobar pneumonia.......
Pleurisy ----------------.........-
Asthma- -.-----.-


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


. ..- -
-.- .-.- .-


Other diseases of the respiratory sys-
: tern (tuberculosis excepted) ...... ..

Diseases of the digestive system.

Diseases of the mouth and annexa.. -..
Diseases of the teeth and gums. ---
Stomatitis. ...... --.- .-. .- .-...... --- -
Diseases of the pharynx.....--..... --
Follicular tonsillitis. ....--- .....---
Ulcer of thestomach...... .
Other diseases of the stomach (can-
cer excepted)..------- -...- --
A Ail+n eno+..4-wS.n I


Discharges.


White.


Black.


14


*I It I r I


I


.~ 4- r,1
W i~ :'*k:.
H..
A~".
**1..
i~/;

1*~

K.
' iii..-
C.....


I



















mH. I H. I

SB.W..h. it. ...B

II.41.. !
*. .:**. ..:.*. ... .. .

.4... .*ii + "" m ..++Ililt .


i; ." p '-.* : + "I I "I I I I I
**9.. .p +. **, .,

:I :.* : I l l .. -.*. .I I -
: ;::. :. : :J.:I I:*I I/.I* i.I
.- -.-.- -
..- -*-!.-.-.::*-a.- ab













I. 2! -l Iai I..
":"i""."i.~~l. 1k. ---.. B" a-. W hi=e Back.a





.,,,. .. ....- .a .-- .=--=. ---=. .= -.-
I* a ... a a **














I.-,.,- ,. .I.-.. I.. I. ,I .+ ....aI. .... .I.
,, .. ... .. .-. .... .. .
--i.:a -.."- ..-a a -.


::I. ...
a..* *.- *, -.-- ** *- *
k ~ .*. :..r *. Ix b2a a a a.

en. ..!!- !. .': j! a S** ue
.. .. W:. J. F. .A --- '.----.- --- -F.-M -. -


Deaths.


IrlThie.


Black.


. c -. -


IImII


pemts.
















































Othe dieae ofii. th.iny nd;\.*.
44-












M o. *bl ..

.----- 1 ; ., H s

.. ...r:.JHi .s!-















.seas: .. .e a:
*. -* ..:: :..:.* **.........

Diseases of te. d*iiv str.e .m-








j ^& -h U^ XM^S&HH* "". ... .: :* *S CX --u 3uB Boli~F3p M
Continue. .F.. .


















ixiguixial hernia - 6 -** *^ ^** -.8 *- -... m .





Duadeni~ *leer ..... -i *iibt
Other. dise:ses fHi .
a t e iv r -* b- -- -- .5- a.- *- -- *: ..n :1..........*jl4
..-) -.- .. .-*.--*a i im1.. ...
Abscess of:..l:er*(:*q**l.*le
Abscss f te lier ntaebic- .- -*- -*:: -::-:.:*. .:*a. *..:

Sipe etniionpepra). .----* ---. .- .i Hi


s~iiaary sBltm.and anus. A

o a .. .:..trw

H ~ .." I .i..."................... f



h~o v lue Iid~ii~r.. S 5 -- -- -S -5- i -.- .. *- *--. -.- .-. :--- -- *
1~eIo.~riiuiis S *- -. -- -- S -I *- 5:. i. =-u, 1.
Diseasesof the.ladder:.. .:*j ... *

s(3es ,ete ... .. inn --- ...-.. -=. 3 .* .. H.
Strctreofth uetra. *:.:* ih",

proat-atitis .1 -. .1.
-*5-**s*- ** **
~Tnnw:nnenol = *

























. : iFi. I *.: i .. .. .ii 1. *
MS eme..neum..eemedommusememm ...... ...... mmes eqm eqImm ease ***- we q,9
Wawarsaweenemanni Ass..innames saf She wwanlea =:. -- .= -- .










.HH............
1 H "*H :
H .. ..
** : .* *-
*: :mn****r t.. .*tl....a .*a..n.

.- *
H...

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H H= ::H ==


.. ***.| h2.ta.uil

.1... .
:i.I*. .~. .mz ..na **. D .B
.: pm: :: ,, "F*i:F ,,,,,

H. ..... .. .... :"
.,,,.. ... ,,t,,.,Dshres.Dt,,



Hg ii" .H: e
.-"" ... } o i


...W........


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



S... Black. """Black White. Black. White Blak.
.. ..... ... *.. *.. .
.' .*: *: H










W*. F. .M.-F. A. M.I F.M. P.--M. F. M. F.M. P.M. F.
Mn.n. .. .. :* ..





5S
.: .. *: "...:. ..










---- ,--- ----

. H. H c... L .





H .j..--

.r .. ..H
.1:.. .- *- .. ...*. *-


*5*



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*At -*a. 1 -.--a---*-a-.aaaaa*a
1*

..... 1: -Ed-


.. 1 P.Ia&;:*e.ia s ... ***.. ab a .... a ad ... .. t. 1 --1

b.1t c 1 1 .. i: :........ .. a.. a* ..-- a-- b a--... 10


H H U.. .4*.



Si. *-:-- -- I -- -- -- -- --- ---- ---- -- --a- --- -- -- -



>; -.. ...2 .. .. a a a a 1 .* .- --. --a- .... .. S 2.






H H .**4**

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*.-.. -
.fl -t h ...* he i--s. & -- *aa **.* at .. c.. 1 .I .. -
,,p ,r










* La.
.-'r --. -
A *r.*.: >1
* I. -


TA~B~ VII.


: .


Diseases.
I -


The puerperal state.


Normal labor..................
Accidents of pregnancy.............
Extra-uterine pregnanScy...-...
Hyperemesis gravidarum....... -
Abortion..-............
Other accidents of labor.- --.--...


Diseases of the skin. and of the cellular
tissue. ,
S- -
Furuncle..........................
Carbuncle........ --."..... ..
Acute abscess- ,--...--.--......-...-
Phlegmon and cellitlitis -.......---
Ulcer of the skin .-.- ------..--
Impetigo contagious. ..............
Ingrowing nail......... .........
Other diseases of the skin and an-
Snexa. ......... --- -- ---


Diseases of the bones and of the
organs of lpcomo on.


Diseases of the bones


excepted) ..- -
Periostitis.. .
Ankylosis. -
Arthritis&...
Synovitis... -
Other diseases of
motion. .- ---... -


(tuberculosis



- -- .- *--


the organs of ioco-
a -a a a .


Discharges.


White.


a
C)
-
14
C
*0


02
C
M
p ..







M. F





-


* .
.a.. *...


Bin


;... ,... ... e1
i .. ... .. 2
IIII(I T!II: 1


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*:. .*'. L f .;< i"^e. >..::*;y* ..
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a-- i ..... -

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,r














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..=-. ..=. ,. .Bm
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l I I .,' A.-
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I


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.un::ha. ... "" .l -


I. OP.THE PANAMA CANAL---Continuefi.

'.IL:m g .. *


i.. .=r .. : 4 ..."..
-S
i~K~~y '^^ -S-"^ ,
. ** ^^^" Hil ^"l:I '* '* "'

~ Nonemployees.

""RB.' -- .n : .*I'* -

Deaths. Di .






*t' "White.
. A r ** *.






Bla .flnnir Wb
*.
^|Mi : ,":i![j~'i.. .ri',' : .. :*. .,A. f






.. ..


W...... h
( m A. F ::. : i s* : ___________






: I -. .
S .AM .. :. ..


F. M F. M.F. M. F .
.*s.:. ..*... .. .. .. ** .- ---*
^'i^ :'";;?!'- *. *^ Ttf"lz R nrl









ip=;: ..-*--*: 4q --
I "f > *" *. -. S .*
*K^ : .. .' :









*.: .. .
;:";:^ ^^ *":!












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1* --.. .










t:~~~~~ -n-f-u I- a -fl -1 -a -- -_ a. -._-_ a _- _









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



* .*:** ---* .- -
* ... : .. i
"....: K .. : *"
"*. f *' ** .






.i, .. .-/ -,, 16 -.1.. ... ........... ....


:-- -.:" : *: -* -



t .[
"* : .
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l a i. qu. ,a iga w me ie m ew i i i m em, m ami
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. ..-
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*: I *
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1^ l..- -** ^ ** .:.. 1 ... .. .. .. ..
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*,y Q ....1





. *r i S .* '* : .*
. .^ *. .
'I ".i 1. ': :. .
S* .. *': ': :. .!
" *:, ^ . .* *. .. .. -
*. -



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-It y sa'" *,
"1^ d. ii hi." .

:i i *= : .. ." .
:^ T "" fr. *


Nodnrosidnts.


iscdeare.


ite.


Deaths.


Black. White.











M. .AM. F.


i-l-



... a --

-.. ...


SI I


Black.


M. F.


I I










.H 1
~1S
.iL H
NJ
.1'. 1.1.1


TABLE


Diseases.


Old age.


Senility ---.-. ----... -*... -.......



Affections produced by external

causes.


Suicide by poisoning ...--... ....

Suicide by firearms. .-. .--. .-. .-.

Poisoning by food..............

Other acute poisonings. .--.--

Venomous bits and stings ..

Burns (conflagrations excepted)

Traumatism by firearms ---.....--..


yII.-DISCHAFRGES AND


-..- -


- -- -

- .-


- -..


Traumatism by cutting or piercing
instruments- -..----...-.-------


Traumatism by fall -


Traumatism by machines...-.....

Traumatism by other crushing

(vehicles, railroads, landslides,

etc.)- .--..- ....-.. ............ ... -

Railroad traumatism.. .-. -. .-.- .-. --

Traumatism by landslides.. -

Injuries by animals.. -.-.. -- ....- .. .-..

Fractures (cause not specified) ...-

Dislocations.-.-. -. .. --.--. --

Sprains- .-..-* --**-..-..-

Other external violence... ........


S


I


Ill-defined diseases.


-' : .. 4* .


Employees.


Discharges.


White.


i ~
2
I I
I
1
C
*
I
I
I




F.





-I


.....

i .

*...



- S .


"- --


- .I
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Black.


_." .... '. ""hi~dim..
7- ;*-.... *9
. ...: .. .. .

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


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Hl*..~..l. l* H I
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a

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lIHIN
H. '~. H
I.


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If,
flkl.~j- -
H ~
4.
Hl~ .1g.
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H~**~l~ H


~WHp.

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-
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uk H
aHH..
t II Hl.~
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1.'
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-


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I...
It1X!l1~i'
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*

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rl. HH.I
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ll.%l*.. I
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k.Hl *.
H


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p1'. HIll HllLI~
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lll.Hll~ lfl
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Hl*.
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S.
.1 A
H .*Jil
i H
NiH
NH. H.l.H ..*
1~tl
S.-.-
HI.l..
~ll.t.I~HH
H tfl.
K
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14
~
II I
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rw


T.. Ca 4 S aS 1 ... .!....II .. ..


I I I I .


I














g. -'THE PANAMA CANAle-Continued.
illW "iiiii .: < *. : *


w. *' -
4. IH.H..H..ihi.H**d**r ..-,.-.--.-
aUJJUEIAjJJ.U3cflfl.
.4

"r
H
-- I


.Rc .
A
fr' 1* 4
V
N...,,; .1
...t
I
NH...
"rn
tHE
k K'.
HA~

- 4' A


'F- ~. -Il ~jr
-, V
Hj4j


it H ~ ii:. qEH...





EE~*H.. ~S #H b

k!" ~..












~ -r

Iad[t*~I

Jj*- ~ *a.. ... -.


I..'.:






H **n*~**~1 *~v.
~' h


Ii: ..n
r
*
A.
I


34.44* a~ I I


*a-


Black.


I
I



I
- !F
*

-




---i


F.1 "M.


:::5:::


Nonresidents.


Discharges.


Deaths.


White.


Black.


Wrnte.


Black.


F. IM


IN:
d..ii I
HHL
.1,.
q. *~...


I'i


,*


r I


I *


I *


I














ttLBLE


White Amerians; F= White foreign,


ANCON HOSPITAL.


Panama Canal employees.. -.... -
Panama Railroad employees...
Soldiers.-- ....-. ........--
Panama pay patients..........
Other pay patients............
Charity patients...............


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


coRozAL HOSPITrrAL (NSANE).


Panama Canal employees.. .-....
Panama Railroad employees....
Soldiers- -................- ..-.....
Panama pay patients............
Other pay patients.............
Charity patients-................--


Total.-....


Grand total.


coRozAL FARM (CRIPPLES).

Panama Canal employees.......---


CHRONIC WARD.


Charity patients...........


COLON HOSPITAL.


Panama Canal employees.....
Panama Railroad employees...
Soldiers.----.......---............ -.
Panama pay patients..... ....
Other pay patients............
Charity patients--.... .... .


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


PALO SECO LEPER ASYLUM.


Vanon amar no ~n na~aa


Remaining
Aug. 1.


I


7
1
....



21
3
75


AdiUJ


15
11
5


. .. -
.h *^ ^
*.:"I^


hir. q11we'*:.


-*A a *r **A


... "i "':;. L "


itte.d. ..
-.
*A *X ..
,. '."^'.i E|'


41

38

. 7

10
1


I~Ji


VIII.-CONSOLIDATED. HOSPITAL: ; P


* .4
t '
*4.. .
iiN. *.r
,~j..
It. ~rL. .
I
*1'*
* .
-

I.
V
:;jYJ a:.
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-
-

.1
~ h~ *~i
ii..
I..
~
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4
a.-.
in,. ~: p.
a,....,
"F;.
I'ka .
.. -


14 ii.!'.
%s.:H$t *~H~

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H:. 's'.


**... ~
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i3 T..,~ -

i.h.

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It::
H
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Nh: ?
A
'hi.. ..
I......

i~.
I
H~.
.i -
:'
iii' ... .
:1. ~ .1.
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H i*i*
..ii..
.
ii.i.. H.
*
i.
4.
N
I H I

.~.
.4.5
.?i.I.
~ h1 ~ '.
~

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I


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I I II 'I Y .:1


I


T I


I c Wh







**. .j .h *
..* ...*. ..-. *
::..k .* ..
Siir llC .
* '.:* i*": :
5^ : ii=b \. **..
,.i ""il** ""* E..
X:::::::: :::: **:r *:V :*
il!<::* =.2i=::::*".
' ;;. 1M...
...lH ..
H.. H.. .
...:.. fl ..


-.
..fl* L.
.s..
.:.iHk. hi.


i-ONSOLIDATE D


HOSPITAL REPORT--Continued


i
White Americans; F= White foreign; B=


Blacks.


~~11=i~i.
r
r
EHIPH H. H
etn.. N... '.j
'~
N 4? ~
:7.


-x"* ":: I : :: .
KBi'*h?" *i.-"i ** .*.
p ..B..** r* :..H i
W* '" H "
Hk*JMi HosPITAL.

.. e erpoloyees.....
.read :employees..
*mus ..t -
......................... .. iv ti nt --...--
........ ..a .ts. ..


-zxL .,


. i. *.: *
..........' -'.1'


**.... ":.. > .. M
2108?ITAL (INebm E).

.... employees. .-.
...tbtd employees....
- .- *a *

t.. aients. ...........

ts..............


tI~~.;HHr .4~ Sr
.. .. H.
IC a........
~ HEN!
*,.... 1~:b
H H
Hill...
illH. I .4~ b4
'I
I.
-
I4HHHH A .1
I.
jr' H
fle4WA iaiwqtrnarna
15 .1
SH H.
::j~j Y' u .n


ttal...........-- -----

P A (CRIPPLE

al emnlovees....


:4 tM'S h... ~*. .
.u1.
K~~.SflTflWr flflCflTn~AW
H qi. 4. r.a.as~r~
r A.** .1
H I
tH ...i~kiLHI:1....,. ~:IIIk~F. -


pal'employees........
Kiro.a employees. -. .


P : -. -


Patients.
ytients..
asntk


^:::-\H^i.^fgiP -- **-*" *
:. ,' ..........
*::.: ,, -:, fS H-S***K *A -- K l
*q:: .::":, : .:E:E:. ;": "L ,':" -'" .. t: : :;' *if-ii ^ .a *
.:".:|.E:": "fE:^'" ::: =; :EffEg'JW l1 **:" "" :
iss.A....A *o oi 4 'tU

|||S3aO LUPER ASYLUM


Patients.


i. :. *... :


........:...............-.......

::si.L .g i r *-*- -- -
:.'l *!".. ,. "**h :'L '. r .


Trans-
ferred.


- -
-i


- -I


Remain-
ing
Aug. 31.
i


17!1651


55'312


Average number con-
stantly sick.


15.55
7.16
100.74

34.48
21.19

179. 12


31.52
5. 8 4


55. 97


I


- -----I


1.941
4.00:


48.00o


9.58 61. 68

188.70117.65


8.221 6.80
1.28 .90

20.63 10.75
I ^ J --. ^ *


nf a


2.00
1.00


104.90
81.97


78 58
26.94

292.94



7.55
1.0o

202.52
3.00
75. 97

290.04

582.98


48.13


29.87


8.26
11.29


25.65



36.03
26.58


62. 61


r m fl ll *n Il


Total.


528. 03



8.55
1.00
1.94
254. 52
9.58
85.71

361.30


889.33


57. 71


29.87


57.03


38.03
27.58

65. 61


.1i .rnt~n~ flr-fl rs lit fn*n* ***~h S ** ~ U t* -l


rw:;sra~a;l


rl





I









































A.leon.......
Balboa ......----
Pedro Miguel.
PLso-----.......

Ga-mba.-----
Gatun........ -
Colan........-- -.--


Total


TABE IX.-OPSO^IPIDATED


man-
ing
Aug.1.


Ancon.----. -..
Balboa-....--....-. --
Pedro MigueL -... -
Paraiso.-....-.....-

Gamnboa--.........-
Gatun--...........
Colon.. -....-- .....--


Total......


- -


27


I 9


Ad-

mitted.


ris-
Died. charged.

-


Trans-
ferred.


S i- .


3,771
1,323


10,878


Re-. -!

mau.1

ing .
Aug.31.


HH*~

..-.iii..
Hill.:



L
* .
Ci.,..,
I -
.
-'p

I-


L4


:fl1.1i1
t.
1Ik~


I ,-* **^ r1= gn:*g *" "
if_ 1 1 1- I I I I I ^fgg
I
*"..- *i.... :. ...
,' *' h.. ". "* ": "e: :.
i i* H***-k

A E ED ,N ,E, ,:'..: ,: ,,.9
ALL CASES TREATED BUT NOT EXCUSEP,.. *'=...:!^
.............. .. .
.. .. .. :...3E:........
. . .5 ...... .
I |... 1. .


Employees.


1,324

3,724
1,533
712
100
232
2,346


9,971


3,987
3,809

2,032

2,110
326

1,108
8,727


22,099


Total.


32,070|


I
1,531
4,120

1,333
901


1,932


10,421


Total.


21,299


I *. ..
.: .:: *:* J....


rw.1


an
ILL...


EMPLOYEES TBlATED IN A-QuBR sR .


.Ai. m;..




H ~*iS *11:.:*
-. N.H
H ..i.i.*H N. H
:7' _
.~iuiiiILu
** As-i
T
U.
-
1%~~~.i~..........
.I:~i.I


"... .. ..:
* i "* i::::
* I I
: ." r ^ B i ^
:.: .". "W..
.** ,,,


. .. H....
** ~ l i
* : :, ,,
-. .
v ,,'-I: : it .
=' ==' jig


~~~pgWsr~t5~Fi;~l~::


Nonemployees.


i,


1..;,. -
.7:4 ..~**
*l ~ .
* .. A..
* ..
* I.?
-
I..
,. *l~ *
1, ..
54'.:...
!'; ~ .'
Hi.
..iiit. -
*i. -
-. ......
iii..ir ..
-.
.12.



I



* ..~,Hc:
..
i~rrHH.. ..
-.
rP.
.1
V *.~. .4
it!.: jlqi. *ijif
,w *:*,*.
Etc.'

'ii. C .~tI -
*r.j. .1
..LN .
i...
V
~ H.~
-- ~*i
.....,
ijilen.. .~
**HHH. .
ii.
*i~*i..i.
H
*iifl 4d
HI
Hi.
A
ii*..i I .
.ir*[l
,WH 4
I.
N.
iii. -
H
4!
K '~
*~;: H
*H~j* iii
i~iis
% :i .. 1
*HL 4..
---a..
,...
H**
MI ~ V
~j!rji
Hii.Hi .1..
N..
.jjjJpir....
H
"A.
a
H
*H
H H
.Kq
H
.r1.NP *H*
H
"NA::, a
.1i~
r I. ..H..
Hii.* h
II~















l-A.- -CiNSOLIATBED. AD BS ON REP ORT.
m 4


...-r-; -
"I:.::
*ii*i.
IHI


:: ""

hospitals, excluding Corozal farm and
*: r*.: -- ^-* -- -- -- -- -

; ----.ploy.s to quarters--... .............. .
I! Epoyees to q.-u
th osil::. .be. n o *
* ~m .. ::.* *f
11 admiaons to hospitals and quarters ....

JB, .patients transferred between hos-
i.. fromquarters to hopitals, whose ad-,
aa rt duplicated in above figures.. .........


:.i~ias..:


to hospitals and quarters-....


EMPLOYEES.


emitted. ..to hospitals... .... .... .-. ..
ea^Lmitted to quarters------...................---
* *


.....iionon mnoees.q............
...ransferred between hospitals, and from
'ii!i:ash:. 'aospitals, whose admissions are dupli-
... .*...... ...a o e g res..o..........................-.ao~
*:..i.,.ii i ::, *:: .. *, : .: :. _.a...
.* *** *:: i*"4 i ii. *.
..... .. .
ii..;i; ,... niso of employees.-........... --......-
Igail:.s.ra per thousand of admission of em-

:. .os as and. quarters.-...--------.
. ,,,:,,, ... .- !.: ....... q-. ...
i ""i: BBE"i """'^ ";. -,S-: ; *- -: : -- w


White.


634
353

987



21


Black.


297. 57


Total.


692


1,952


1,879


1,220


1,179

424.94


RI., i :.',: ; "***.:"
* : : **'**"* ...." *..

B'SE-B.-2CONTAGIOUS AND INFECTIOUS DISEASES REPORTED
.... ., DURING THE MONTH.
.. "..E": "'... .. .
......... ..:: *:" "". .
". vil'".i 2 / issl.^ i k3 '5" ...**.uu^.. .:s ...* ..


,:""u i < :i: *,:i',., .. .. ;! *..
:: : ::.. .. .... .
* .
. .. ...
i ::: :. *: : *.

.1 ** ... *yw... ilh**l" ... :*.*
q'A: h f .t *
i.gS F: ,,,^
."iV..:;,.: xlG~ '.'
***nn* -*DI V JL*:rn *


-. .-


g:..:::.i"...:* ** -
::* .:.::** :: ..* **-*: **

4,*,,,, ***- ..*-*- -
*: : .










*.j. ^,k sles .
. *'^ 'S~ i "'J .ra.? '* W'



S n...


epidp.-emic
Je*J f~lci^^. ^ ".s ~*'J *


. .


* S C S -
- -
-- -e ...m

* -
-mC- *
---C---m
m---m---


cerebr
* --
* --- -
- ..m

... --


S i


- -- .- S*~- C*


-w --- -. -
- S -
- a
- ... S *
- -- -m


- -m me
mm flflmm

- -eC .
- -m *


Panama.


1
3
a
1



41
2






- -.



1O


Colon.


9
27
- .





19
-V.
-m*- in
.. ...




- .. *6"-

a


Canal
Zone.


* -
mmmmmi


Total.


I-


I


.. .. ., .a


I


1,169. 4~*













.
:, :: ..


TABLE X.-NUMBER OF' EMPLOYEES OONSTANTLYk
HOSPITALS AND QUARTERS. :
.f .* .*.. ".i. ..
*.' :" : iii ':
*. .. : *. .. a .


Hospitals:


Colon Hospital.......-.


Totals ---. ----- -. ---------.-------
l~t


Quarters:
Ancon. -. --. -
Balboa .-.. .-
Pedro Miguel -


Paraiso-..---. .. .......................---
Gamboa. -- -. .- ---- .-. -
Gat -n........--........ ...........
Colon .-.-.--.-. ..--- -------.-- ...-


Totals.- .. ...... .-..... ...... ....... ........


Average number of employees constantly sick:
W hite... -..--.. --...- --...a .... ....- ...
Black.......--- .. ....- .. ........- ...-.........


Total..


Average number of employees constantly sick, per

1,000:
W white .......................... .. ......----- .....
Black........... .......... ...-...- ....... .. ...--- ..


Total -.--- --- ------- --.-.-.- -


White.


.

42.32

9.47


51.79'
i*" l


30.29


Hospi-
tals.


51. 79
214.97


266.76


10.65
7.56



8.01.
0


..:.. rr
-. .i :
/^l~~ "*'t"^tL
Colet&
:, .:/ :iS
-- H*' *

* ......I..
.:
* ::
IQS 4-(.i
.:. :h. ,SA


....... ....
- .-. ..

*.- .!
i..


. *
: .' .


4v~ 4~H
,


-
H
.4
Qu~rtn
*
1 .1


1.*r,".

4<



H


77~.7$


4



.....
*.
. S.I: ."
* 'i .:


. ... ,. .'


'A



-"A'.:..
II.; I
L~iItbj~
Er
II":
-~
I..~H
10
I. It


"U- rr -,

H
H
4W.
AN$ ...'J.
~
,~4I7.E~4.
-.r.
- *: ..,. V. II
A~j*~J
..*..~ .H*~




j
.I..A
7-

H*III..~~.H
:1.~.
.~ lr!.Jj
I.;, H Hr.,. rrs.
HI**Ij**d
4
C.
flu


* ..~. .

4q~I. -
*
*:... V.':
.
-
F:.....
I..
'.*
S.
V..
..fl .:~
.fl:fl~;. I
It.;:..
4*.* *** -
~ H
*III..
I *I*. .j ji
I -, -.
-- I
p.

.fl--. -'
~H1. ...
fl
* II.
r
*



A..
in..
H-...



....
...

I.
Mr...
.

3~ c~:
A .**~ .4 I'
~iH-
..*I%!y..~ III. hi
~ H
1%.
.4.
.LI~t.

*H'.:HIflI
~ *JYI*
-
-H I!~~I Hj~.**.
- A
m.!j...r, I.
I.
* H..
'
I, ..I~ ~
* .. .
~
S *
I..*...I I
%jI
-
~ .. p.4.. H
IPH. H.:
h. .
rn~v.I.
A -
~, !~
~h
ML :*[jh'P.. .**I
.. .1 9
9..:: ::
.4
H ~ ***fl:
*
a ,
I. I~ H.
~ 14
.1.


TABLE X-A.-AVERAGE NUMBER OF DAYS IN fHOBPP :-
QUARTERS FOR EACH ADMISSION OF SICK EMPTY,
," SHH* H: ,
*~~~ *: .^ "* .i
... .. .&f."a^ X' X'M:.@ "i "i


Hospitals:
Ancon Hospital.
Colon Hospital -..
Quarters:


- I-


White.


12. .76-
6.96


I I A H 4x


Blookry.f
BJak. .
: ::", *.
V ,


..2

7.^


I e


1111:1.1111


IllllllLIIll1111161










I :* *i ; : .' *'
: j ** fv* C :: .. ,..
BATiH RTES .LON'AMERICANSB ON THE
....QNN.GTED WITRU .TE PANAMA OANAL.

'vS'ssi'W :":" "
IgAi *HH .*E ** 4 i. .
::;** *LI
...Hi" ..
H .
1 .t
a r .. .

...
'HI .:1;. 7 --


-ISTHMUS


Annual
death rate
per 1,000.


1m loro the United States....------.--------.
d children from the United States. ... ...
Sand their families from the United States.
J *i:L A. A


* -.......- ..


'^ fK' ",j S **c .: -- c *
*IA *STTE
iSF.NCIAL STATEMENT, DEPARTMENT OF HEALTH.
1 H11: A*
m .:..*. .


^s:' ..:." :'
-:" *HH". .
..:. .. =****.*.,
.-. ***:' G :* :*
. *-'-V.
.:-.: -.?*
X!!! ......!3 ".


r- General expenses:
. .i office.. -------. ...
wion alnotments........
. ^'.: U -" -.-
HflB^Afmaj'.aTi ** > m" i -m- u


I1r.. ew tools -


and farm..


* a a a -I


s~?'r -


*;='-^XWi' M. W'A

5.. ryinspe
. :; fce, Piina

cleaning,
~.. ee, Colon
cleaning,


I tM .ion. -
n:: : .** :" .
I..


ctor..a. ---
la --.-. --.
Panama. -
* .. .
Colon.... --


^imiion.= ..-.
Yt- a ..:a


U.:..';
a4 ~ ,I~ *
a'
.
!H. s.,.,~.
.r *.: ...


.. &?i T .O
,if, ', A ox.


tj general exp.enses...


i


July, 1917.


S$700.92
216.70
124.58
212.36


1,105.40


54,164.17


50.
3,788.
4,390,
3,214.
1,994.
8,472.


21,910.44
4,201.56
5,356.63


* 1,105.40


June, 1917.


$982. 37


12.76
1.819. 10


1823.97


34,293.06
7,936.99
4,925.22
2,310.93
1,025.00
.966.39

51.457.59


3'
4.
2,

42,


5a 56. 38
4,086.24
, 7325 44


823. 97
if. ArPM .ra


July, 1916.


.$792.97


.835. 80

1,628.77


27, 385.
6,-143.
'3,803.
1,691.
866.
930.


40,820.72


. 50.00
.3,338.25
,4 254.49
2,680.64
S2,101.29
16,242.80

28,667.47
-2,989.99
S5,265.44


Sn


628. 77
a-ned WaM


~iip~:


*gl I'S .


* 0


I


W















. 'TABLE XII.--ANOQN ROBFPIT


* REPORT OF DAYS'LOST TN Rbwl?1


Hospital:
, Panama Canal employees..... -

Panama Railroad employees.
Army and Navy... .-.-...-..
Panama Government pay .... --
Other pay patients... .
Charity- ---..... .. .... -


.a i i ..i i
..- -. .-.i
* S .- *
-.- .- ..- -


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


Asylum:
Panama Canal employees -
Panama Railroad employees..
Army and Navy- "............
Panama Government pay cases

Other pay cases. ............---------
Char ity.. ..........- -. ... .--.......---


- ai-- -


3--


-..


T otal.. .....................------------ --........-----


Chronics-- --. --.- .-.------.. -.-

Cripples (Corozal farm .- -- -- -- .-. -


Grand total.. -. .-----------.. .-.-


Ameri-
camn.


3,
.. ..
1,1


5,553




-- -. -. -



124
28
85


297


Si i i .
- --BG- .. a*


5,850


V .t.. *

-, 4 r L .***
'~~~ ~ ~ .. t .EAn.S?^
. .. .. i.. S
S .. -


Foreign.


*299'
278




.977.
181


1,735


- ...

1,


1,912


* v.~II,


A...
11.1* ....
.
.1 :r~7.r
4*L.L4~
H
N.

j
4.
- ~ -


2,.
*
s
*.* ~
t I
42
~~
A H
K
.3
Ct 4



- at
ejggt
I.


- -
297
_____________ As.i.TK:e


3, 944


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

patient per day, $0.4285.

LABORATORY REPORT.


Blood examinations (total number)..- .........
Estuvoautumnal. -..-..-..-...-..--..----.....


Qaan--...- ..- --

.ian-...... .. ...... .....
DTfferentia l cou-ts. --. ..-.-


Hemoglobein estimations......
SLeucocyte counts.-......-...
Red blood cou s. .... -....
Stool examination total number)
Ameba -..............---..--........--
Ascaris lumbroicoides... .......


-a--
iand
- -


.i..
-tat-

i-el-I


- a- *



- a S



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




agena)
- -...


-ia i- -


i -d


". .. "Iy
---
! .* *:.: F *i *<.: .i
* *: "r i..L 4 ilu!


i" .'":" ".x :.:.i ...':


.* a -. *.
: .. 1.. ..
........J

V..
- --- -***5* i H4.L.
*,* "!-S -


- S *




* -
a-.-.

---.

--a-
-.a-
---a

.. .

---a


....4
s p. A r *: IL*
,-~~.-.IUtU



'he a L ''
#**' "9,'" ****A"^
...... .." .

* *... : K.:" l




*: :,S iS%
.... .... ."l
.' ~ ..
_.. .:. .






.....:: .
4... .W..-


* *-D a.'a ',*
.-. ~*.4.




S* I *

-- -- A **
-..
... .
.| ..-.


-. *
I
~ 'I.. *
~ -I~'
I ~
i*.i
nV. C
... '
V

K~t / :~
V....
I .1**
S
...* :4
*
1~ :.S: ,:
.S...

*.**

*4j

it' *..;..rV~
-.
-Jr
:1
t I..
F.
I. *..I*%.:.

N .~*H~*i~
:4.. *!..


*::,
H
.;


S **
-I
.1:1*
~.r..=. .1
H

V.
7,
W IHH*
*.II S.*.
*1.
~.j* lit
I~. H;
~I.
I, '~Ifl. .. Ii

H
i
'~
hiS,. H .. S.
i*'~ H.
I*I**I
% .
H ~ *
r
.J..A:..
r '. H~ *
I.
.J
-! I~:>w* .1
-
n.j.. Za......
9~.r
'A j.'*H k
1..,.
*.H***.
MH.PEIAq.. .. I
.
I.
H ~
H.V

hSIHAN IONS
HAt

NH


Nonresidents, hospital --.....-.-. -
Nonresidents, asylum...... ......

Average cost of subsistence per

WARD


Balantidium coli.....
Ciliated monads......
Entameba (hystolitie
Guaiac tests ..... ..













** -:il. --ll*..T~g,-III-W-OQN- ~HQBfI'TAL---Continued.
...... ...... .*
.. ..::* . .

.. : **: n.* .
:* pme... .sh....... me......g.m....... ... ..... ..... .....
.-* m a. -**t. ot.ba n illi..3..... .. ..


.'6 -1 .- -a -. m .--- -a
*.:..*....-.... -. --.--.----. -.-....
.. :
W h"* ".: 10* *

as .**S... ,
....
.... .. ... ... ... .. .. .

4n4IXAL OPERATIONS PERFORMED DfRlNrG THE MONTH.[1

._ ... *. *-** **.
j .4..lw-umaber. DiedA
IIHN..*I
"ih*:*::*. .* .:. .. .,
...... ..H. .L.

.......... ... ......S .. .., .* I:.** .
~~~~~~~~~~~~~~~~~... i.... ... ... ... ..... . w m m w m n i e s a m = = w e -= = = =
.... ~a
:" :: ::- -. "

::* S.m .* Sa a ..
.-. -- -.-,'.

.:".: s" ": .:"." 1 *
*Hn **olie **: *" -
i".i. .. Iid am mm mm mmm mm mmple....'mm ulng em l "p~p
....... ...... co m po-nd .. ....m.-....-... -.- -..- 1 .....



... 1 iE W m m i ia h mam me m ia misgu m ma smaiam ime lm gi mmi di m aW n L am igm p iaa
.. .... .e..... .. -- --. .-. .-. ... .. .


** .iiF ...*. .*..
HiIH

':. :-6 ... ""'-*

11 rea -:l.-r- .. .
do be.. 3 ~ -- .5I -.-m.m* -.**-
Hi Hi -:- -): pi-= .i.il p-* -,. p-.




......gi..r .....l.. .......... ..... .. .....--.-*..
.".J :- -,id ,.=s, -. .. **----- -.---.-----.--------...--.--- -mm1
*X 31ofc*t*:. -- -- .- **- --. ----- ... -. -*

.i i*** i -i a
ti..n..a.domi....l......- -i-- .- .- "'"' "'"a"

*:_ i: 9 ii *. "a:. -*-*. .
s r:* ..1r --:--:--'""-=" "*---a-;"*
". : M .... .i I I. I i. m I I m m as m m a m m a m m m m I a I m Is l I e a l s e e I m Is II I i I

::am ),:H .: :eno.-.*-..***:*---- ---.*-1-
:**oa ---" "- .5 ::...*a-*-l1
*p**y. ,.. a ain a...... i........ ..




**::*:c..u:o...:pe:cso ,r.tonfo :j
**fl*-***.. ..... .. .. ....-




..-. i" **ill. "
: m : n. .. .
.d. ".". ...' "... 4 ... .' "

....... ..:.
... d. ." .gk .. ...m eum memmmmiomm om m" "m"' "






ii.''**for effe .ts of- :- -e .... .* *. ..
... 1
.Hli. i.". tA M e a m a a m Mglm m # WID1 W g M HI M di m i W M iB 11 51B 4B I 1lg $1 a
@:":5.*, .. .:. e .
8".. .... .. ....
.i ." : .
.. .. .. ."*. "-
























Stibmucous resections.......
flerygium transplantation.
Turbinetomy. -... ----..-

Chalazion...- -.....-.. ..
Adenoideetomy.....-.....

Toiisillectom-y.......... .....-----
Mastoideotomy...-...,....
Scbleral trepine.......------

Evisceration... ..... .. ....

.Irle0tomy.. 0., ..... .-.......
Uvlectomy..................
Cataract extraction........
Minor nose operations.......

Minor eye.operations... -.--


Clinic.


Medical.-.-.........---...-..*-*.......--.-.

Surgye al e-- -.--.---.-.-....------ ---
Eye and ear---e ..m..---..-- -... ... ......


i .... i

ilimimi


.....
- -~~ S


i*I-
*-. -.-


- --i-
ii- BB-D-- G-


Total

visits.






339
32ft

501


1,166


- Tp 4
i: i ft ,
.W ":X
.I ..
..
i- 1-
-i


,1


-e- -
-i-i-i-


- S -
i i S i


...l. ...
e-e. -


- i- S -


Total* .- --.-- .-. ..- -
Refractions...-- .- .... .... ... .---.-. -..-.-.-


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


* i l i.i-i i
-.-.S -S -


-S *- -


New
cases


- .- -:
I.
---,.-
&g1 ..IIJ.i4.
K
~.q
.I~rL
-
A F
I.-~...
- -. a. ..4~L
..~.II.
.
-- .4k1
s. rr 9 .% S
V
.H
- -. -. S.,
I.
- -
---a1.--
nsa-c
w
SdbmII~
-a
*
-... Irn.fl
*
.* .II.'..r lIE S.se...1I


I.:
*1. 444j
*1A
.. *~
* .*
* --S


Err:
...> ...tt


S. :k
j r I
.. .A K
* '


I.


260
157

166-


VACCINATIONS DURING MONTH.


Number of adults vaccinated...-......

NumIber of" takes"-..---................

Number olschoolchildren vaccinated

Number of"takes"'............... .


*- .


*. S.-.....S. S --..-..
i ...i.....i ..i ...... i


-S..-
a..a..


-- ...


'~ 2tj~* $44











*Ac
*1 ..
*1 JIrnrsin..
Ida".


~.*.

- ...:i.riPNIPI
.t. .
-- ai.A
r
*4. *
A~1fl.aJ


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*** .. ** .
T noxr,, ,,,,o xt'wit:
*: :'.E : ;!::si;::
: :::..::::*, .:::





-** **. *. **
REPORT or OPER A ONS^, "E E< '$*'S ..S
f ." : ,,] *. *"


HI


MONTHLY REPORT OF BOARD OF HEALTH LABVU'ATOS Y*


1 lexaminatinno nf .'";


Blood cultures (1 B. coli, 1

5 B. typkosus; 1 strepococr
Throat cultures (34 positive

Stools.....................

Urine (9 B. coli; r1 staphyloco

Sputum (7 positive for B. iu


staphylococcus al
us).. ... ... ... ... .
z^) --- .
for B. diphtheria;

G.C.... i..--. .-. .
ceus albs) ....
berculoiua)........


mus; 2' aksphvloWW

.. .. .. .. ....*-.* -...
14 positive repeats

-- ...-...- ..-. -'

./ .. iE a Elm
*****-* ***** **! ft


rwh


REPORT OF OUT-PATIENT DEPARTMENT.


tarinindw


'I




'S


,: :*, : ,, **
:. *".." .
.. ~ .- ..

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Bi^'fc "A" ir
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f lx .: ,::


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... :..... .. ..
ii ":i .*'.':X












lf.
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:" .. ." .::..


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,s!3"..'... :'!:: ::" x^...?

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J ." .:. .

L It.- : .!.,K'.:>
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.. ... ...
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..: ly ..:4,,,,,M,,
E~l:: "~::E.:^.' "^,^






: -.:: ........H
? -f:l.::...HV ::4 : :h
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.. ..W
...... .... fl ..
P. E.xi:^:..EE "E.
-*-I. ,--*. **-- j












..I..


r~C~ow


HOSPJTTA~r-.Cantjnued.


:-BIpJza n oV: .

oiBr 0 Corozal far,....
l^^l..from p anaina.-.......,

l^^l~ialt(If temintio-. -- a


Ht*tibol i. ... ....-.....-
: if m m a e. m i
deterlminBa R...


..Btivolng.....


,lm.i* um* sulphate test-....
IS.1IltiflO=t. -.-
da.srgu1tion test... ------ -
~^^n f ^igld.test.........__..
l".i! t.issuqs prepared, paraffin
.. .. .. .........
***: fAL r v m e e e m


B, animal, performed (h(


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


Iod films.----- -------..............-

h-4$e- od. film s..- .----...-. -. -.
.gfi'HIxs -i .. i -l


ogi
es


* S


-..a.-..-.-.*..... ....... --..... *-.- .-.... -
-* .a-.. -11



*.....- S ...--.-...... S... *....--....... S
s, 13; oposmums, 4; dogs, 3; calves,
, 1; mules, 1; monkey, marmoset,




- - .. a- .. .S S a .. a
-m--mm- a- -m -m-a -- 5--mm S -.- -m- ..m-
S S--* ..S--- ----.
* -- m *5-C-m m- m.. -S Sm-e. e. -


-, -


med (Mus muscuius, 1,268; AMus nrvegicas, 510; Muas
" .E &yjgtjts 316) --..-- ---- -. ...-- ...-.- .. -.-- ....


ar:.
. .otmbanmea.....*.-.---
frnts at Jorozal........
ito the U..nited States.
^(36.ranajina.. .---.- --
to Colon....-- ....---...-- -
|t6 IParaiso...........
I~p ns...-- -- ^- *-S-*S*.. *- ----
- 1 a* ... a *
AK


alex.


aSS
37
. 37

. 30
m42


an



wd
a-


-S
.5-


SI-


2,142


lamion
l.ii..
..l.i.
.l.l..
- -i-


naii retionstoi. -- .------*---
ation reactions (2 positive with B.


oeo vaccines prepared-. --. .- ..

|o10ia examinations.........
ii ":""" i.in."e points manufactured
eters calibrated ...........
o a eTnamtions.rtd...... ........


MI toS PA -STAZMN OP CO
.... .h .


..l..


tgplaoau4.


*5-- a S


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


1,162
5
5
7
11050

22
1


IMETMNTS, DImSHARGES, AMD DEATHS.


conuTMaP~fls~.


-. 41 1 1


EE'".. ':.. .. .. ..
.i : m : "
S ii :"" : i : '. ", : .


Mate.


*


Ihrmaprh


, n:. j


*
I


"' "
















.1

TABLE XIII.-ANCON HOSPITAL-Conti


DISCHARGES.
~ ^


Barbados. ----m.-..........*....
Jamaca..........-...-..........-

Trinidad S..........tm........ -

United States of America.......


Total.....


Male.


2

*.--. -


*...

*-..


Male.


-.-. ..
* -


Female.


*..... -


1 Transferred to Ancon Hospital for surgical treatment.
2 Three cases deported to United States of America and


No deaths during month.


TABLE XIV.-COLON HOSPITAL


REPORT OF DAYS LOST IN HosPrIT


Class.


Panama Canal employees- ..........

Panama Railroad employees......

Panama Government pay patients
Soldiers........-----..............

Other pay patients...-.. ----......-.....

Charity patients. ----------...............---


- --..-...-.-.. -
- -- -. -.- -- -- -


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


ii. .i.
*i.l-- -i

-i- -. -i

*i. -.i.i


A. mer-


*146

54

-.... .. iii-

255

43


640


I


...


LABORATORY REPORT.


Blood examinations -. .1.:
Estivoautumual.....
Tertian. -----..... -.--

Red blood counts...
White blood counts..
Differential counts...

Hemoglobin.........
Stool examinations ......
Ameba* ............. .--


-a mi i S -


- .
- -


-i -i *i .i-l.

* S i- .i-i a a

-.- -- -- -i*


.. .
-*-.


Well.


Dye


Im~c


*. :** *








-* .. *;: *j .Ay- ** *
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: ...: "E' ..: ."


















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.. .+ "| "i ,




















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I












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,,*. s .... .... : .
i.. ..


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.* *. .: .
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: *... : .. .














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.e 4... ..*. ...
: .... *&..:. ..... .$: ...." '.:. .. A..
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S... *
r !* / ** *uC u "* n l "tt ." ; "* ** 4
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.. s, ,:t' + .. .
























*
28 a. ... .. .:'*. *. I.










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.*.. -:.f
3 : .* .. *: "'..i .:. ..... .*










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*e0 I .. ..A.. .:: .. .. .

.... ..... -












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

















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.. !: s,, ,

4 .
50 +. '





































.-. i -
28 I.... .. .
,, -, ,, ..u-e, .. *. : ..




























.. .:. ,* WTA ~ *

*- -. *" .H... b ....... .:... : :.r
::. ..A...*:. .. *. H
r j j -- :: 4 w J* :.* :.. *. ...
.. E .., +:. < ':. e y:" :." 5 :*.:.. .:



























.b .I. .. .. r ::. :,
.. 4* .. r .I
S .
*s A H. :.. ss... .t
=r = = -:- s rE ...n :n*s:- :.::: *. *:* ~*

... T i : *" .. :.. H:: ::" p -: e .






a A *. r..h.' :I* ". :.:.q : *
1 ....... .. *,r ..... ..


























/g *. .. ...'**
: :.* i .. :.. i :. .



H...... .......
.. ....
.. .. ..... .. .... .
: ."**. .. "" ... .
......... .P
::.1 .: :-. *
,. .. + ..+ .. .. ..,.
.. ,,. .. .. .
... .... ..
.* ..... .. .. ... .I
,, ,, ,. ,mr: .:. 1, -, .... --i4 : ..
.. ... +, ...:. .. q.*.Mil < li :*.*.. :






























..:..X ..... .. .. .
4.
.......
... q :..'.X'..:. .. ... ... .. ...
...... "' ,,... t
............. X
...... ....,_
i I 1 .IIIIII. II I" II .I
1 I ... .X ""
...... n.. :X
.." .. .'.. '. .... ......." m":. :::."..:...:
J
.., .. .










*t.^ a ,
*:::: ".. : ** J*
*i'*I.. *" ". 5

*,,,, ,,, ,5
ABLE XIV".-COLON HOSPITAL-Continued.
* .. : *: *
9"...* :, *, "

B" """~h'1 T'~ XIV
i.... .. -. Su cAL.. O AINS.
:. :. .. "
.. .:
"ii:.. : f* ": i "


H. ta ...:-----------.----U-GIC---- OPE.ATION-.-.
.. .
aa .... .-a.-.. ....
,,- *, ,

i i i. i*im


Ie---- ..... -
sfioible.------..
S.Mact;
e:,.radical cure..
0e single, radical

itey. -- -..- -
TIIhpby...---a ---


- a a -a a ... .. a a a .
i. a a a a. a iai -ai a ia a a a a -


* -. i a i i i a a a i i o a
i n -- a i a i i a i a i .. i- -


i.. -.
cure
i* ii -


. -


:1. .- di radial cure




...
** -.
li ^ ;i,,t :nvarions.






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


i ...,~;O~.. .. .
::::iw .: ;* ..:.; .



M...i'. x:. "0,1:8,'.r arl'.:'J*:.,: oW
.::. .. :....:. ..
^::r^tions various <




-i .*.. *
".. ^l- :.:. ^. ..:.. ......:* : : *:' : i *
E^ .~.. .^ J' -~ Si' :S< TF 3-S-t -l a
!:::;-'s""^"J^--s. A K D
'^Sx'I'y~~~~~~~~~~ -i ^'^^EKS^^t131" x^ 7


tI-s-
a .
... .
"i *"" ... *
'St^ ^i ..i-^ .*... .. '..


.a a a a .a.
*


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


(dispensary).....


.-SANTO TOMAS HOSPITAL.


Remain-
ing
Aug. 1.


a '. .* ..-- .'"


Ad-
mitted.


a881


Died.


5'
71


Dis-
charged.


1;x:.^":,:";;; q ,
:' E-K." ::,:::E::E'. :BJ ::h /X .'.. X" K A'R

' ::r .. : *. .*


NJ."f H .* .las




-. .H 1 .

"|.i:":.": "^'",w,. ..* *.
|Sys.. :, ,, ..... ,,,.... ,.:. ,, ... .. .





. .. .
=..,=,.,...4. m. .
.;" ': r
% ... 4*.. ...
S.......




2 I:.* :.-.'. ..-.: ...,
.. .. .i

I,,: ,w .. .. .
S q : ,.. -'.-- --. .- --"


Number
treated.


123
1,202


1, 325


White.


S.. *
9.


Black.


--* U -C
i WWWW i i i W i
.p.l......i


Si m I -I -


Other nations.


White.


Black.


S75 .
1,049

1,124


,,,, ,. "
X.. *:..;;."" ". --" .V
%tt n.. : .ieLf furnished patients....-..-.....-

-. tia of patients constantly sick........
einia=- Adtrln tr+a+TltflTt few anai natwent


. *I...


a. S m i-a- ..


... 14,173
I ... 457
In


Remain-
Aug
Aug. 31.


Americans.


.


.













rfl i'


TphIoid fever -- --- r ---
Ma-arial ------------ a------- --
Searlet fever -----------*----------
...... .......e
Diphtheria and croup- -.---.-.-..-
Influenza--..-....------ .. ----------.. -.....-
Dysentery- -...-- .....- .---- ....-.- ..... ...-
Erysipelas---. ..-. -- .--.-. -- ----
tLeprosy. -. .- .----.--- .-.-- .,-
Other epidemic diseses -.,.
Purulent infection and septicemia..
Beriberi .....---....---..--.... --... --.....-...
Tuberealosis of the lungs.... .
Abdominal tuberculosis. ----------
Syphiris. .... ......,--.-.... .....
Soft chance -- -' ..- : .
Gonococcus infetion -..........
Cancer and other malignant tumors
Cancer and orher-mahgnant tumors
Other tumors--. --. ---------.--
Acute articular rheumatism .-.---.....-
Anemia, chl or osis -------. -- I
Other general diseases.............--- ---
Alcoholism, acute or chronic.....- ----..
Other forms of mental alienation. .
Epilepsy..-.. .. ....- ..
Neuralgia and neuritis .....
Other diseases of the nervous system
Other diseases of the eyes and anne
Diseases of the ears ---------- ... .
Organic diseases of the heart- .----.
Diseases of the arteries... ----.--..
Diseases of the veins ......-.--
Diseases of the lymphatice system..
Hemorrhage, other diseases of the ci
isaeaco nf the nnsal fnaurs


MA sm TAH A api i m I m i mm:l

.". ." ".., '. :" .. ": .' .". ." '2 : ", "
~- --.r-iu
m .m e m m e w m m e A m "m n~e .. p.... wiH..ii
k" *U'l

i. .2 'a,."--.; .: ". .- *. :i.
-.. o..rg... .......- ..o..gaT. .
*!!-- -". : *.


i....... .... .
'.:
--. -....-..-. ....a..----. ---a.- -
-- *- -- ~---- .-- *-*
.t

::::::: : :.-.... ..



of other organs and.of organs n--.,, 4'-:


* S i -

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


- -- -



.a...-
ca -l-




I i -I
Tmu]Sa


- --


rIy i


S


r.oneho- One .o a ....s .......... .. .... .....a
Cbrutile 1brocxehiti s.- *- -- ---- *-- ---I
Broncho-pneumonia ---------------- ------
Pneum onxa ...... ..... ... ... .. .......:....
Pleurisy ........-.... .-- --- ......-.---- ..... .... -- -.. --....---
A stlx a -.----- --------m ---- -------m----m m-m
Diseases of the teeth and gums.. ..........
Other diseases of the mouth and annexa. ......
Diseases of the pharynx.. --.------.-- -.- -
.I) iSiBSi xS tdI eji etiis -- -. -.. -. -
Diarhea and en.teritis....... -....'.'.....
Diarrhea and enteritis (2 years and over) .- .--....
A kyostois ........... ------....---........-------.
Ine-ia pasts---- --S- *- -- .-.- -- .- --
A ppendiettis sad typhlitis.-- -.-.--------------
Ha, intestinal obstructions- --.-..-.-------
Diseases of the anus and fecal fistula. -...... -
Other diseases of. the intestines ...
Cirrhosis of the liver-.--.---. -.-----.. ----- ---
Other diseases of the liverm... .. -,....'...,-.,
Bright's disease (ehrontio nephritis)..........


.- ...**::-. -aS -
... .........A....... ...
.. .....




.. ...: .
ii--^------!.-'----- -,.^^^:i^^


.... .............. -., -:.. .-.
*-. H.J .


.. .M .
S..-n- -
---- -1 -*- -.-- ----

,::: :::,w::::



IYi eI i .I ,II .I i i ii W .. .,i .. ..
i.. Si".
. -. -.....--,.a.. -.- ..


.. i- :






......... .... .. ......
- -m ll -- -- -- r _..

.ii" .:::f':ilij.il!



"i
-- S* -- -S --*



..a... -.--- .- -:' .

.. *::*...::m
:, J'H r
* .. S -.. -.. -- .. -



,:-, ,"i,*:::."* *
*- -:-****...*-..i- ::* -.



-.- -.--..--......--- ., l-





.. .. ..,_ .,,,
..* a H" E .

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










H
A
H*,.
r ~-' H
'.
Al1

II.


F
1~.
Ba


te"
ien a -- it--- wi---. n- d--a-
ad from the hospital without disease


Itpufengs--
:- ... -......-
aby firearms..
fly cutting or
a by or cru
A. --,--
*h.


s1 violence. -..
eama disease.


V : :i ?:* X E.:: *: f:, .
*. ttSpeaiiod. will


!*i... ". "" .:. ".. .i i .?
. is harge dur
among
H.. -.


EH :iH H': .:"'H.:. ....: \.... .
:Ba::HH .. ::":: .,




~.
.. :". 3, :. ...:. :. .
-; "' H




H **
E:E jE::E :EEE "* ..: *A|K t :
H*.. :.
.rv ~ H H
H:,'.............
..:....


t::E.1 II.




::..:..l..... l.
:1..


Hliii


SI S ii- i *5 i- i -

.. ....... --.....-.....-






defied ...........----..


ng month. .....,......
itients during month...
'ital at end of month....


22

806
76
. 443

1,325


: .dl number of patients treated during the month......


C


tty, ingiinal, single...
t, inginal, single....
.., ntral...........
y, strangulated.l. ... -


aiuiuiis, -inte-rnal... -......
hi d ble, radical cure.. -


e.es..i.o.. ......... -

s, rial cure......
inans, excision of.....
t::. vtmr


'- .S SSm-- -mmmem-mm- U



: ^^~ il~f^^hysterectomiyU -- *
| ... .. t s m*. .. ..*


. l^ dongle. -m.m-


. ..j:H Fjj
!....... .. .
":.tr l* ::i :; .

:il:a' a hysteecoteom
-illi .


.. *"...~~gH ..riit gfaf jS .--- -_




I II


-flcf fl-tODB .- --,-----
...r li
,*: A: .... :: 4h'. *.* .- / *
:&3- :":::XK"-- ::::" ^" f t r C O ~ .



."
.: "::::: .. : .. :. .. ,
**.: *:HHI : ." .* : "
I.I"i. -.' ..ii.-i o ris o h e .


. u. *:. *ns S
5 ,::,: ":*"* -** *e _&mm m e
....; *. ." ..*
: !::::: .iM .* .*: *: *
* :r... ... ..... *
*. ,,,' ~:i g pime ommimimmem '
l5;!^::-*:' **j ^ i r ^ ** ~ ~w .. a .. ..-


--illl-i
i--a----
- -am.m-mm*


6
2
-1
3
2
10
.S
. 10
7

a1
aS
aI
2
11
10
1
1
2
2
2
1
6
8
43

146


,670

36


SURGICAL OPERATIONS.


LABORATORY REPORT.


- -------


.. -


w











54


*.. "Sl....": *ii .
s- -1"=-Kii.!! :4E 1 !j, .I~t!!!*S~^~~
H ..*..1 **
*k H. 111!: *h ***
*~~~~ ~ t.*. i: :: *S ... yf" jS..aeB 'n
41111:=-..i.d -H-..H
: ll -. ..---:. = ,
.-:... ]=--I:..: r' ..
..........................-.- .g-:;.fl...
.A. *:*: t ..

- -- ., :p .: :...IlB G*


1~



.~rHH
.1 A. -
.4:.

I...


Sputum examinations...........


-B l-oo < e. ..-_.o.s ----,. .""-- -*- ; .. -1 4,, ..
Poi'etiae ." ... ..."... .* ., .. ..-.' --A"-- -" .' .,.--- "*..-"..h". "tj
1r a --- --- m t- cu- s---lturesr-- 9 ". -. -i s:.., :
m~~ .:* *:.v *::. *.. .... :::^B 'A ^B f .*. *-
--.. mm m...n :..*: : .n*'
Estiveo-autuio Ip. -. -. -...-.... ...- .... -----.. -"..-.--.--...."
ohitie blood counts.c *-.. -.-.... -......... ..." I... .
iii ifierenitial count s-. n .i i - i i i ... -
WTasserma reac a tiors -* **-*- -* *.-gi- ..":*?
Posiitive.....b..........................-- .--... ...... ...- -. .. ..
T h r O t^ *l *r e s m m m e m e seJm_ 'm m e m*'sn e s e m e m e m m e*e' m mm .' .. B: i~i ..** *


Positive for leprosy -,.
Throat cult imres -- ... -m- .. *... ...*. ...
'osit iTeW fia ---. Tib .Ikj^G^'rWd!.-;1- :
S-- - -- --- --*.- H *-. .. g ; ".... ,,-
I'OS IVy for gonOCOCCI -I- -*-*- .1 -*-****-***- ** *- *- *-** *
Boodi e fores"os -.. .""..............*....................................*..... .1. ." "
B loodt es -- -** -*-- ***. *:: ;: *:--* :-i!** *!' -i,* j ,
O O iS ... .i i.. .i .i.ii.i..i ... .. i.n .... i......I.. .. ... I

Pe r pO sy- -- --.--- -- --- .--.. S -* ,- : -.4ill -t... .
W idals react ions *" "'*^^W^J<,l~Sil:~**:::*' "

Surgical tissuess, o -.- -..,..-....-t.. ......... ....
Surgical tissues, post-rmoedem -...- ....- ... -. ... .. .-.*a. .. -.. .. --.. ... ... .. ...:. '..-
.-* -. =* : -1
po.'m om : ........ii"i..



TlABLE XVI.-SANITATION. -. -' '*'.1 ^S' .;
.Hh I.r' c* **.. :: : *. s **. "
i- -.- --.-- -.--i-- -i- .-." .. I..
Work. i.r.iqi.eisti .on. siu.ipi.y d.epartmien. i: i i =
T LVAe g ..........................................................




rsc reling...................................................... .... ,,.,.. .&: ,. *
^^ ^^ jE4 f jt'* 'vi *. '* *~i



Work requests on mupy cipal engdeerg dpaartmentrtme..nt: ..----<4.. .*- :1: *
NIl a eu* .' -- *- -- -L At.r 4-!H, .~. .....: "**

Work requests on other departments .... ............................-. -. :". .i- :.;
1t0 c osin spected". .. .... ... .'. *. .....:..
W ota r k reqes o h de,* p tes" .... ... .. ......
"" "C :." .i.::.:. .:. -
E~itclos ts iisib c~ea- .- -- -- .. -- -*-. -. .*-. .:.- .* .:.* -: ..;#*M*.1* I ***

B n op s S nse c tl ...ed ........q ........... ..H.....................".,... ..." .. ..-
or s reen iii~ -- -. -- .- -. -. -. .: ..--.- -.--.- -..!M*
F or si .- ---. -.-- --- -... -.- --- .-.... .. H.... :,.
Garbag cans empted" "" "*, C* !""
or general san. ita ion -- ..- -- --- -. ..-. -- iI- H I ......
.ose s..e.ted"L.......... .... .... ... ...-............................................. ..il


i i i i ".. .. t g..=N i" = "
ofe ta ....-.- -* i... .i "



nm~ i'io ~ / I d P i I n I I I m i i i d "' *r "*....r? ^ ^" *" y ""n.' ^
N u m b e r o r ato s I 8 ee. .r .- ..---.........U..-.....-.-. A .
J" i *** 5 |.=.5* q = ..** *, *******
RShops inspect o: mo.qmto.. de oye mdw..-...g:.".-".!-....-1-.1 I;. *"
--be-ep e .. .--- -..--.-.-.- .. -**.-. S .4 *.' ..


U ............ ..1.
A nope l c ...io.ser t p t ie -a M :-:- :.. : .......
.S..... ...... ............ ........ .............................................-.... .... ......... .. *":: p..:. .
Ce-...---,* *. -.. ... H ... ,.. ... ,

t .... ............................................................... .. .....
n_ J
Itt-aJ ~ 1 0 -d c -^Ll -i- -LC ***** -*-**-*-***-*** *** *-* -w .fa af'lg B ==" ."


I ub.U ..........-...-..... .... .-.... *H. ............
Nbusbes diofemoquteed d-- st.- ro.ye. d in -dwe-llings: -- .-- -.. .'-i. ***** I
A i .i. .i i. i i..1.... i a : i..*^l ... ... *l l ... .

.......l.....................................'............................................,.-.4......
Number of rats destroyed.. .. ............. -....-..-.:: .. H.. .
Number of mosquitoes destroyed in dwellings: 1 .,v.. iicnly
tego mheyis -- - - -- -. -. -^iS. fi

--d .. -- -- a .. .!r .-:- .:. .. .. -
m -a lf \T m O'.< : : *'.'* *-:* S fJ .iSi.ii :***" li "i "*ai, i..
.................................................................. ............, ....... i i .gi.... ..r ..*...

C*ex and manso:aH i H..... .....i .H

erosene 3 -- --- --- ---* -- ---- --** *. J.. ... -- .... ..-
Crude oil, gallons...-..-...... ...-........-.....-.-................,-..,,^... .. .. :=i.
4 .*. .H i.H i L :.
}}4.1. jH i". : :**.11
-* **** .. ..x. .. : *. ..*F H-K'"- *" *a *;
*w J c* HII*I "H : h. ^. r;. F ::l.::I **
^k *rujswiit.. _~iji s -- *** w* *** r** -- ** -*** ***w** *k....."I' .* -^ <"Ei~ii" iif ii i*:: .".Ed!iii:i':;.ir .:*^





ii:: i i.l pt.
Hr.. ""H
: : n .





I.-.;3is^rsa rn sec---.-- ---
., I. :*: H".a*".* I
.,. *:: : *
*.*. .. *
.-- ... *.. *.
I. i.. t:s"'r"" "
*r : ::j I. ..*.... ..*. H ..... ...
S;........... .. ... ..... ..
ii "' "..:. *:
.:: .* h ...:' "* K "

H : .
.-TABLE X VL-S ANIMATION






*~_^::- i] : ""iwl*]U UpE .UT l .it I *L.I.
i ::.d .: .* :**.'af :. i ^u m iT ri : .
.i .' ** *. **
p ...- g th
iilk vendors, etce. a.. --.-.--- .-.--
WOI'. k8nd r, etc. .......... ... .... ....... .
+-Ni~"+:++++:"" $,11 .s, TOr staurants,'" ... .. ....e c "....."......"'"
.:....I ps et... c....... ........ .. .... -.... ....-
". buildings:

i e of- buildings inspected. .......
... tir:new buildings approved....... .....
(" *';: rr sssu ed to repair od buildings..........
H .. .I ..
"me'--'ed Mt- gabageedu ads,2883)


:te o f na.. .H .. ..;. ."*.. ..
"ts"ped during the month:








Iiitt5,rzbi"e ga.c s4 -'* -!^ "'^ ^^^ ^'a*- .f -a j -L -a- ---------
... .. .......................... ....
-..........a .. -a-nai. a. -. -..--.
-::, -:1o ..l th" eemovem Paomnth -s

(:* :'::" of. Vgcinations made during the month..
r. .. :.*... i
+L WORK REPORT FOR COLON-C


.Gol~on- Criatobal:





"E... ... .. ." "
:tare .ars redetrcleeteaed..... ......
r........qdsalleysintaine.
.. ..*n mniber-of private properties cleaned .......-..
S..H. ; X: rnher of rats c aught..flt....de ...ed ..n ..olo ..
1; .... laas of yard garbage disposed of. Col-...




inziber of cans garbage (cubic yards, 2,883)...
*I~.AtI~JI.. t falds ditches constructed (cubic yards,



I ... *
*.... H* ...i Oof -ld i ge plain ap -i-e*.--*.....

cso tVegetLi removed, PssedR.R.res
ii~HS "flb r ofreseptreetclesned







I:" of builldings inspcteed. ----- --.

of nveg ogalons eoiov mcde ued Rin. C ..e
*.t h '. W be r of graion reotioe ousad tin Catn ---

p-" :enof builtes plan atdiproedl. cmnne
......... I ,. St o c tp ........-
ilc.'l c- --....- ,.-.-.....- ..- ..-
.'. 'Nmer of yew, gaconeionspmade duringtne.
.'.jl numboe oallons madrede (cubic to datl.....-3
-~ ....-.. O B"CS' a
.... "...." .. + ,mm )mmofmtchesmamtmne









.. .., bar
H "V" at-hof ueowtcdiin leio roama cnec
- OLi'l- rl!l~ is of Veermatio tomocendsud.--..... .. Panama-R -R-. re-
"-:" 4", ..-.g*O I1 S O O RT su d
, :, -:. .. .. ,,g







." ". b~er of galloneios oslmaade usdurn Colon
)iF .. ..... number oerf nofegalons mfcd d ued o dolon """
Ni' """...,b.er. of hoases anbateh ddiolcm t


"...- utstanding npermnitsq
... .. S1 erof cans garba
as :.:. ,... ja of yard garbage
l : :..=. :.....
I'. ......
r:' 1ol......"
N fflaer of receptale+
E u ..h.. ** .... u _L


-Continued.


5, 495
525
300
369


RISTOBAL--MOUNT HOPE.


4, 200,
702,
5,


*.-.-
-..-
710)


ervation, Colon-swamp.
servation, Cristobal ....
n ..- ...- -


a
*.-


-m m i m m m m m m m m i m-m- m m- a am
a m i i *. m m m m m m m m m m
*.- a..a -. -a .a -
-m- -m -am-ama- a mb- -m


- -- -- -- -- -- -- --a- -- -
* -a -- a- --mm- m-mm- -a -m -m-


aonth..


i'no were made.


-: .. --


cubic yards, 745).


Treated.


- a a 4 -l m m m m m a m... m i a a -.. .

- .. -... ..-.. .. a-a---a--- -**- ... P -


3
140,350
97, 500
10,801
184.6
750
462

4
7
49
156

5
1,437
1
50

14,445
229


6. 100
















TntBL -KVI.-ANITATION-Coluti~3I


S. M. Q....


.1:-S
r r..
*
-.5
.4
*~ ~
*
4 A
S
I.. ...~
.4.


:1.74: 4.
.~
-----
.~


~W Sq1.


~ *4*

:VT~.:i... lIly


....:
I.'
-. .11 ... -


.~EE. Si
.'


" .*
S. ***.
:~b .

:1


2
*.. a
A.
* ..:ipIj::...
h....
......,.4-*~. ,.%
.4 .i:
U.. *
aug. *
S
..4. ibj .. ~.. .4.
-. .~:* S.:.
-~ ,~..)

I;
K.~: *~
I*t***i. ~ I.
.*= %ii...
-."9..'i* r%
-Ed
..... *
.1~;fl..........q~*
.A...IC ~.r, HI
~1'j~
~E.p
WE.qSi~ ~.AEE h'
Eft
A...
Li .~r.:
* a..... .. *~ *4~4
.qI:~.. ~.


Gallons of crude oil used....
Gallons of laryacide oil used.
Linear yards ditches mainta
Linear yards ditches constru
Square yards of vegetation r
Number of burials during th


TABLE XVII.-CONSOLID


TIONS AT
TOBAL.


THE


POR


Number of vessels inspected
Number of vessels inspected
Number of vessels inspected


Total number of vessel


Number of supplementary ii


Total number of inspew


Number of vessels fumigated
Number ol vessels fumigatedc


Number of bills of health issi
Number of bills of health vis


.* 2 *': ,, ,. ,
..*

... .,, ............... ........ -.
*. *
..
cted (cubic yards, 804) -..... .. ...... ---... ''"
."
emov "7 E
B m o u t -- -- -- -- --. -- ..- .- i-,-. i.:1 ..i ^:14o~dE* :.E***..:.E*
.. 4 m ..... ................. ..E. ...
E* rr.,* .. ": 4 :. .
_* : .r K 1. :.h: *A.: X:.S .. :
I*":'I **.S*AEI :. .. *".. ".
....:, *f ,,| :::..-* ....** .:
.t~i.
'ATED REPORT OF QUARANTINE -..-"
T8 OF BALBOA-PANAMA AND CoQ ii. : '
.:k :.. .:* 4: A :": *"' ", ** .
S-.* ..A*. ": :: ... .* *I 4 .*
J H..: A .

an d assed ,.. ... ..- ... ,,. .. '..... ................ : .

and detained in quarantine..- ----. --- -- ,.. s..
and transiting canal in quarantiunea -. -...r \ .

ls en ered uri..................... ........ ........
anJz,,,*1 1 ::
,: ~ ,, a^ ,*l*:":H '"^ ,, 3 :h s, ,,^








onaria..................................
prio to eparure.................. *.
Is entered during the mouth ----.-..... ......, .'-4;. AAS..LS. I
SE ;, ,, ,,,E,,, ..S.*! r* : : S:



tfions of vessels d during month. -,-- .-.:' ^il

-: : S

:EE ,, ,,,:,,,,, :, ,
P..orae-aj to, dep rt re -- 5- .- -:* , nr -^ -ly -. -j -c;- *:;; -yg-! .a .-~.
,,,IE ,,,h s,,
a1 o D e .. .... "":: il : '4. '' "aB 'e a









.B_^** .*1 a i w *** u S iT ** E.* K A
.... .. ..
and" detine m^ o*rnm -" -^I" "" "'K """ "J|












" -- -"-- "-'- -- -".'-, 2 -- ".. *"

6 e d~3 .* -** -* -* --* *v **f -s -t -HB il a -
an d nsltm..............'e.. ... ......- ,,: :s....-w~~ "jW.......,,..:."












*.: ..s. ****. ** *! .*
S.*. : *...... .- : sl .f.S.. E A *


Number of crew inspected and passed.....................
Number of passengers inspected and passed. ... ...--.......----


*b:,..S


Number of mosquitoes caught, 10,005--


Barracks..... --------
Cars.-- ......---...-......
Mount Hope village.
Sub. shed... ....---- ....-


P. R.


I. B..


.4
*1
.1




I'
.5
itl
1:1

I

A
II


~LLII'~I~











,.. .
t II ,



i .::THE .PORTS OF

rtintinued.
.ihB~ i p'f* a' *'
*** :: "

aons detained on board
er and bubonimc plague.
HN
E::.:.i ":
* i. .


REPIBPT .OF. QUARANTINE TRANSAC-
BALBOA-PANAMA AND COLON-CRIB-


vessels to complete period of incubation
a.a..a.S.-.S.-.S...*.*.-.*.*.a.a.a.*.*.-.. a


iber of persons detained in quarantine..................... 1, 965

..".. .' : 713







.*-.---- .-----aa. .-. .. -- 1-2

,.*iMPersons OU departing for coast towns in small launches and sailing
1
*f ersonsin transit for Pacific ports, not passing .through Canal.... S
..g personss in transit passing through Canal. ............ ..... ......--- 624
e ns transit for Atlantic ports -- ---------- 372
tinnimg:ants rejected and deported- ...f. 32



alSTION REPORT FOR THE PORTS OF COLON-CRISTOBAL AND
a, :: .... BALBOA-PANAMA.'
: ':: '.:. .:: :.i .: :.:.* '*". H
*:.. .." l ,F
S.": From- Cabin. Steerage.
.. "*:*. ...:.:.. 4
*!!-ui" : *** .


..l.... ." .. .-"'''" 468

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


49 202
a d West Indies (not shown above)................... 4 2
..,.. -'.,'j _m mmm mm-m mJL I ^ nmcl


k
1r4E'.
..
H ATflmrl0
Iv~4~ H
"H
.AV ra..ainaa.S.
4...~t. .

.P~.
--
A
~ ~- W.* S
I'
., .... ,,
H..*E ~M~i .* *
sI!!~.
H I.-..
...........................
12'*IL.~I H..~ .ru.. .
- I .. ..: I
i,:rjr~,qHJ %..
~
.11


-
H. A
irs.
ii
jH iEs~~ui5*U45j,.... UI*M -.
LV


lim'""-" l, ,,
.i... ..*
., h :, l..
di* *


I-aii..

iI i IIIgu el


.... ... .
* .. i
* -i. -I
iia ai -I-
iI..iI.I


-eai a mI--
ImememII
* i I II
-ii iliI


E~no


102 138

4
8 4
12 4
7 4
6 4


765 637
1,402


-m- mS aa a.m-- -- m- ma -- a- m*- ma- ma a S m -a --mU*m-* S a am-- -- a
* *U --m- -a am -at -- C a -- a -m -a aa -a *- -a -mm-a a


768
426
208


1,402


1, 635


, S
..i!"....!.i=:=












TABLE XVI.-PERPES ONNEL REPORT.
-~~ H.'* I I


Chief health office.......
Medical storehouse.......
Quarantine division......
Health office, Panama....
Health office, Colon......
Ancon Hospital..........
Colon Hospital...........
Santo Tomas Hospital...
Palo Seco Leper Asylum.
Zone sanitation......... .


Se--.
----S


Corozal Hospital and farm..


Dispensaries:


Balboa.. .-. .
Pedro Miguel...
Paraiso......


Gamboa. ....
Gatiun


-I


.......


. C .


-..- -.. .....




*... S -- -- -
- s ... S...*


* ... .
* a -


5SS*S**S


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

Totals.............................

1
I
1 Includes Corozal Hospital.


August, 1917.


Gold
em-
ployees.


I
Silver
em-
ployes.


Total
em-.
ployees.


1.080


S Corozal farm only


It


.







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hi H
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PAGE 1

Ar 44 REPOR T :* OF THE LTH DEPARTMENT OF .'E PANAMA CANAL FOR THE ONTH OF AUGUST, 1917 eI A D. C. HOWARD Co$enq), Med1ca1 Corps, Unite4 States Army hI lth Officqr, Palboa Heights, Cana Zone AA K AC, -A **I 4 TA

PAGE 2

s e 4 4 e e 4 e e e & * e 9 e e e e e e a 4 e e o e + 4 e 8 * s -+ e 3 4 * 4 9 e e 4 + x 8 -4 e one 4 8 8 8 8 e 3 & 8 8 ++ + -e a 9 6 p a e e e e b e es 4 e e e e 4 e e 8 8 48 e % e e e 8 4 s e e e o 8 + 8 e e e o b e e 3 ----x -------------------------+ -------------.--. ---.--.--. -.----.--..-x-.----------x -x ------------------------x ------x -. -----------7 ------------------------------------x ---x -----------x -. -----.--------T ------------------. --. ----------: + :.-::. --. --d: -. -: ---: .-.---: ---: -: -:----: -.-: : .-..: -x .------:: -.: .--.:: ---: : ---------x --. ::----. -: --:-: ---: ---:::-:: +:-:--.-. -::. : .+ ------:---. -:.--:-: --: ::: .--:: -: -: ------: --: ---:--. --------------------.-------x -------.----------x T -.---x ---------------------------x ------------. C --------------. -------------x -.--....x: ..--..-.-.--...-. ---.-:.--....---.x -. -----. .-----------x ---------------------.----------

PAGE 3

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

PAGE 4

FI*

PAGE 5

CONTENTS. Page. Letter of transmittal. 5 General remarks. 5 Vital statistics: Health of employees. 6 Health of residents of the Canal Zone. 6 Health of residents of the city of Panama. 7 Health of residents of the city of Colon. 7 Hospital division: Ancon Hospital. 8 Corozal Hospital. 8 Board of health laboratory. 8 Chronic ward. 9 Colon Hospital. 9 Palo Seco Leper Asylum. 10 Santo Tomas Hospital-. 10 Division of sanitation: Canal Zone. 11 Panam a. 11 Colon. .12 Quarantine division. 12 Statistical tables: Table I. Admissions, deaths, an'd noneffective rates for employees; deaths of residents of Panama, Colon, and the Canal Zone. 13 II. Causes of deaths of infants by sex, color, age, and place of residence. .16 III. Deaths by nationality. 18 IV. Birth and infant mortaility rates in the Canal Zone and the cities of Panama and Colon. 18 V. Causes of deaths of employees, arranged with reference to age and length of residence on Isthmus. 20 VI. Causes of deaths of civil population (employees and nonemployees) and military, by sex, color, age and residence. 22 VII. Discharges and deaths in the hospitals of the Panama Canal. 28 VIII. Consolidated hospital report .40 IX. Consolidated dispensary report; report of contagious diseases. 42 X. Employees: Constantly sick and noneffective rates per 1,000; number of days' treatment per admission, hospitals and quarters. ..44 XI. Deaths of white Americans connected with the Panama Canal .45 XII. Financial statement. 45 XIII. Ancon Hospital. 46 XIV. Colon Hospital. 50 XV. Santo Tomas Hospital. 51 XVI. Sanitary work done in the Canal Zone, Panama, and Colon. 54 XVII. Quarantine transactions. 56 XVIII. Personnel report. 58 (3)

PAGE 6

.-

PAGE 7

LETTER OF TRANSMITTAL. THE PANAMA CANAL, HEALTH DEPARTMENT, Balboa Heights, Canal Zone, September 10, 1917. Col. CHESTER HARDING, Governor of The Panama Canal, Balboa Heights, Canal Zone. SIR: I have the honor to submit the following report of the operations of the health department for the month of August, 1917. Very respectfully, D. C. HoWARD, Chief Health Officer. GENERAL REMARKS. The health of employees and nonemployees of the Canal Zone and terminal cities has continued good. The case of infantile paralysis reported last month is in Ancon Hospital and making good recovery. The contacts remain under observation in quarantine. No new cases have appeared. Whooping cough and measles have continued prevalent in the Balboa and Ancon districts. While all reported cases have been quarantined, there has been a failure on the part of parents and other responsible heads of households in reporting these diseases in some instances, in violation of existing regulations. This lack of cooperation has made it necessary to take more rigid measures than usual, including house-to-house inspections, closing of movingpicture houses, Sunday schools, swimming pools, etc., to children, in the effort to control these diseases before the opening of the public schools. Fewer cases are now appearing, and it is believed the epidemic is subsiding. A case of smallpox appeared at Balboa Quarantine on August 22 in the person of a passenger from Bolivia via Peru arriving on the steamship Aysen. All passengers and members of the crew were vaccinated, fumigation carried out, and the bedding used by the patient destroyed. The patient had been isolated aboard the steamship immediately on the appearance of the eruption. It is probable that the disease was contracted in the interior of Bolivia, where smallpox is known to be more or less prevalent. The patient has been held in isolation at the Quarantine Station, and is now convalescent. With this exception no cases of quarantinable disease originated on or arrival at the Isthmus during the month. (5)

PAGE 8

6 VITAL STATISTICS. EMPLOYEES. The following statistics are based upon the total number of names appearing on the pay rolls of The Panama Canal and the Panama Railroad Co. for the preceding month, which was 33,294. Admissions to hospitals and quarters numbered 1,179, a :rate of 424.94,1 as compared with 334.37 for the preceding month, and 282.06 for the corresponding month of last year. Deaths from all causes numbered 23; of these, 21 were from disease, giving a rate of 7.57, as compared with 8.84 for the preceding month, and 2.86 for the corresponding month of last year. The constantly noneffective rate was 10.35, as compared with 8.98 for the preceding month, and 8.06 for the corresponding month of last year. Diseases causing the highest admission rates to hospitals, in the order of their numerical importance, were: (1) Venereal diseases, (2) malaria, (3) organic diseases of the heart, (4) influenza, and (5) chronic nephritis. These five diseases caused 30 per cent of all admissions to hospitals, venereal diseases alone causing 12 per cent, and malaria 10 per cent of all admissions. The admission rate for malaria, hospitals and quarters, was 19.46, as compared with 19.52 for the preceding month, and 29.99 for the corresponding month of last year. The constantly noneffective rate for malaria was 0.58, as compared with 0.83 for the preceding month, and 1.13 for the corresponding period of last year. By race.-For disease only, the admission rate to hospitals and the death rate for white employees, were 273.85 and 2.47, respectively, as compared with 279.01 and 7.47 for the preceding month, and 228.79 and 0.00 for the corresponding month of last year. For black employees, for disease only, the admission rate to hospital and the death rate, were 132.96 and 8.44, respectively, as compared with 96.79 and 9.07 for the preceding month, and 99.98 and 3.31 for the corresponding month of last year. The constantly noneffective rates were 16.88 for white and 9.23 for black employees. The admission rate to hospitals and quarters for malaria was 17.27 for white and 19.84 for colored employees, as compared with 47.33 for white and 14.69 for colored employees for the preceding month, and 55.23 for white and 26.03 for colored employees for the corresponding month of last year. For American employees, the admission rate to hospitals, from disease only, was 248.91, as compared with 248.72 for the preceding month, and 177.16 for the corresponding period of last year. CANAL ZONE. The civilian population of the Canal Zone, based on the police census taken as of June 10-30, 1917, is 24,038. From this popula1 All morbidity and mortality rates are computed as equivalent annual per M.

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7 tion 32 deaths occurred during the month, 31 of which were from disease, giving a rate of 15.47 from disease alone, as compared with 14.98 for the preceding month, and 8.12 for the corresponding month of last year. Of the deaths from disease, 39 per cent occurred among children under five years of age, as compared with 47 per cent for last month. Forty-seven births were reported during the month, giving a rate of 23.46; of these births, 18 were white and 29 colored. Eight deaths occurred among children under 1 year of age, all colored, giving an infant mortality rate, based on the number of births reported for the month of 0.00 for white and 276 for colored children, with a general average of 170. Of the total births reported, 11 per cent were stillbirths. PANAMA. 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, 140 deaths occurred during the month; 135 of which were from disease, giving a rate of 26.40 from disease alone, as compared with 35.39 for the preceding month, and 28.43 for the corresponding month of last year. Of the total deaths from disease, 52 per cent occurred among children under 5 years of age, as compared with 60 per cent for last month. The principal causes of deaths as compared with last month, were as follows: July. August. Diarrhea and enteritis. 43 28 Tuberculosis (various organs). .30 23 Pneumomia (acute and broncho). 25 15 Two hundred and twenty-five (225) births were reported during 'the month, giving a rate of 44.00. Fifty-four (54) deaths occurred among children under 1 year of age, giving an infant mortality rate, based on the number of births reported for the montn, of 240. Of the total births reported, 8 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 64 deaths occurred during the month, 62 of which were from disease, giving a rate of 27.61 from disease alone, the same as for the

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preceding month, and as compared with a rate of 26.75 for the corresponding month of last year. Of the deaths from disease, 52 per cent occurred among children under 5 years of age, as compared with 53 per cent for the preceding month. The principal causes of death as compared with last month were as follows: July. August. Tuberculosis (various organs).------------------------------7 12 Pneumonia (including lobar and broncho). 9 9 Diarrhea and enteritis. 7 6 Seventy-seven (77) births were reported during the month, giving a rate of 35.43. Twenty-five (25) deaths occurred among children under 1 year of age, giving an infant mortality rate, based on the number of births reported for the month, of 324.68. Of the total births reported, 12 per cent were stillbirths. DIVISION OF HOSPITALS. ANcON HOSPITAL. The average number of patients constantly in the hospital proper during the month was 528, as compared with 489 for the preceding month, and 453 for the corresponding month of last year. The average length of stay in hospital for each employee admitted was 18.50 days. Statistical charts are shown under Tables VII, VIII, and XIII. Corozal Hospital.-The average number of insane patients cared for during the month was 361, as compared with 353 for the preceding month, and 290 for the corresponding month of last year. During August 13 patients were admitted, 13 discharged, and 1 transferred to Ancon Hospital for surgical treatment. Statistical charts are shown under Tables VIII and XIII. Board of health laborator.-The investigation of the trypanosome occurring in Panamanian cattle has been continued with the following results: After taking the defibrinated blood with distilled water and centrifugating, smears were prepared from the sediment, which showed trypanosomes of uniform morphology, instead of the varying types observed in our cultures. Inoculation of the blood of cattle, known to carry the trypanosome, into guinea pigs, dogs, opossums, chickens, a goat and a mule yielded entirely negative results; the animals showed no signs of illness and we were unable to demonstrate trypanosomes in their blood. A discarded vaccine-calf, previously shown to be negative by the culture method, was inoculated twice with the mixed blood of several steers and its blood contained num-

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9 erous trypanosomes seven days after the last inoculation. The calf, however, remained well although trypanosomes were readily found in smears from its blood for a number of days. This calf furnished us abundant material for the study of the morphology of the trypanosome. We have decided that we have here trypanosoma theileri because our specimens agree with the descriptions of this organism; (1) in size, (2) in morphology, (3) in being readily cultivated in broth, and (4) in being unable to develop in other species of animals than cattle. Trypanosoma theileri is considered by most writers to be nonpathogenic. An examination of three sick hogs sent in by the bureau of supply showed that all of them were affected with hog cholera. These hogs were from Colombia. They suffered also from a verminous pneumonia, but hog cholera was considered the primary cause of their illness. This is the first time that the laboratory has encountered hog cholera in animals other than American hogs. Several well-nourished pigs died at Corozal farm and autopsy showed the cause of death to be a gas-bacillus infection following the injection of antihog-cholera serum. Numbers of horses were reported to have died recently in the Sabanas between Panama City and Chepo. The examination of several sick horses at Buena Vista, beyond Pacora, and at Tapia revealed piroplasmata in the blood of three of the horses; trypanosomes were found in no instance and two guinea pigs inoculated with the blood of two of the sick horses have failed to develop trypanosomiasis. The evidence obtained indicated that the horses were dying of piroplasmosis and not of murrina. Since that time, however, a sick horse was brought to the laboratory from another village in the Sabanas and its blood contained numerous small trypanosomes. Therefore both equine piroplasmosis and murrina are prevalent on the Sabanas at the present time and it is recommended that the Army veterinarians be informed of this fact, as Army horses and mules are very susceptible to both diseases. A third case of canine piroplasmosis was diagnosed microscopically. A report of routine operations is shown under Table XIII. Chronic ward.-The average number of chronic patients cared for during the month was 29.87. Fourteen patients were admitted to and 6 discharged from this ward during August. COLON HOSPITAL. Fifty-seven patients were constantly cared for in the hospital during the month as compared with 52 for *the preceding month, and 34 for the corresponding month of last year. The average length of stay in hospital of each employee admitted -was 7.24 days. Statistical charts are shown under Tables VII, VIII, and XIV. 1M28-17---2

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PALO SEcO LEPER ASYLUM, ihe average number of persons constantly cared for during the month was 65.61, as compared with 65.70 for the preceding month, and 67.58 for the corresponding Month of last year. During August two patients were admitted, with no discharges or deaths occurring among the inmates. SANTO TOMAS HosprA.i One thousand three hundred and twenty-five patients were treated in the hospital during August, as compared with 1,302 for the preceding month, and 1,439 for the corresponding month of last year. The average daily number of patients under treatment was 457, as compared with 433 for the preceding month, and 440 for the corresponding month of last year. The total number of days treatment was 14,173 as compared with 13,450 for last month. Seventy-six deaths occurred at the institution during the month with (1) tuberculosis, (2) diarrhea and enteritis, and (3) organic diseases of the heart, the chief causes in the order named. Statistical charts are shown under Table XV. DIVISION OF SANITATION. The following table shows the average monthly admission rate from malaria among employees to both hospitals and quarters for the month of August, the percentages being based on the ratio of the number of admissions from each district to the total number of employees residing therein: Number Number of admisAverage District. of emsions from monthly p e malaria admission ployees. during rate. month. Balboa. ....---------------------------------------2,668 1 0.037 Ancon-Corozal. ...---------------------------------1,151 Pedro Miguel. ...----------------------------------1,352 1 .074 Paraiso -----------------. ..-----------------------995 W est of Canal...----------------------. 367 Gatun. .....---------------------------------------16 2 .176 Cristobal -------------------. 3414 9 .264 Colon. ....----------------------------------------7,115 15 .211 Panama. ....--------------------------------------8,383 5 .060 Miscellaneous 1 .-----.--.--. ...--------------------------5,796 21 .362 Total. ....-----------------------------------33,294 54 .162 1 Employees engaged in pasture and jungle clearing, etc., outside of above sanitated districts.

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ti CANAL ZONE. The recent relief of many medical officers of the Army from duty with the Canal and their replacement by officers of the reserve corps, which has been necessary on account of the war, makes it difficult to carry on sanitary work in the Zone and terminal cities at the highest standard of efficiency. The assistant chief health officer, chief, sanitary inspector, and the health officers of Panama and Colon have thus been relieved during the past few weeks. The reserve officers sent to replace them are well qualified physicians, active and zealous, but necessarily lack experience in administra.tion and tropical sanitation, which is essential to secure best results. Conditions in this respect, however, should improve as these officials acquire experience and familiarity in their special field. There has been an increase in the number of cases of malaria reported, both in Panama and Colon, among the civil population during the month. The record, so far as concerns employees, compares favorably with that of the previous month and the corresponding month of last year. A high percentage of admissions among employees continues to come from outlying camps of the supply department beyond the limits of sanitated districts. PANAMA. Cases of malaria have been more numerous than recorded for the preceding months of the current year. Several adverse conditions may be responsible therefor, among which may be mentioned damming up of the Corundu River during the construction of the concrete flume in the river bed, thus inundating a large area in close proximity to city districts and making antimosquito measures difficult. Further, cases of malaria coming from the Savannas district were not chargeable to Panama City until recently. Naturally, the suburban districts are less favorable as to mosquito control than in the city proper, and it is noted that a large percentage of the reported cases come from these districts. Tuberculosis continues to show a high mortality rate, and little improvement can be expected until we have better facilities for segregation and hospitalization of open cases of this disease. An important step has been taken in the establishment of a free tubercular clinic under the auspices of the Panama Red Cross and in full cooperation with the health department. The positive cases reported from this clinic are followed up by the health officer and necessary precautionary measures taken so far as the limited facilities permit. Investigations are now being made with a view to improving so far as possible certain insanitary conditions existing in some of the tenement houses in the districts showing high rates of this disease. The infant mortality rate for the month was 240.00. Continued good work has been carried on by the district nurse in charge of the infant-welfare department. In conjunction with the health department activities in this direction, a separate station is maintained by

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12 the Panama Red Cross, where equally satisfactory work is being done. Orders have been placed for two motor trucks to be used for garbage collection, replacing horse-drawn transportation. It is intended that these trucks will be available for use by the time the new garbage incinerator is completed and ready for operation. COLON. Considerable drainage work has been completed in the Emiliana pasture in the Mount Hope district during the month. There were 15 cases of malaria reported among employees during. the month as compared with 8 cases during the preceding month. The diphtheria incidence decreased during the latter part of the month, only one case being reported the last two weeks of the month. An effort is being made to enforce existing regulations as to the installation of running water with sewer connections in all saloons, ice-cream parlors, soft-drink stands, etc. This work is progressing rapidly. QUARANTINE DIVISION. No important changes with reference to plague and yellow fever conditions on the west coast of South America have occurred. While conditions in Buenaventura, Colombia, are generally reported as improving, nevertheless mosquitoes are still very prevalent. The rainy season in Guayaquil, Ecuador, is about commencing, and a marked increase in the number of plague and yellow fever cases, particularly the latter disease, may be expected in the near future. The following inspections of food animals were made during the month: For supply department: Cattle, ante and post mortem inspections. 1, 757 Hogs, ante and post mortem inspections-. 140 Cattle, quarantine inspections. ..--------------------3,894 Hogs, quarantine inspections-----------------------146 For outside interests: Quarantine inspections at Cristobal docks (cattle)------2 Inspections by -veterinarian under the health officer, Panama, quarantine (Zone), (cattle) -----------------829 Number of hides disinfected at Cristobal slaughterhouse.---------------------------------1,759 Number of hides disinfected by veterinarian, under health officer, Panama .-----------------------3,168 Total number of hides disinfected-. 4v 927 No cases of anthrax were reported during the month.

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13 DEPORTATIONS. Twelve deportations were accomplished by the hospital authorities during the month, 6 employees and 6 nonemployees, all suffering from disease. In addition to the above, 32 deportations were effected by the quarantine authorities during the month. TABLE I.-ADMISSIONS, DEATHS, AND NONEFFECTIVE RATES FOR EMPLOYEES. ABSOLUTE NUMBERS. NoneffeeAdmissions Nteoec Aospias. to Deaths. tive from hospitals. sickness. Ce4 -3 + 3-D Ce 62 3 -CdO+ 0 ca August, 1917: White. .------------4,8641 128 111 17 1 1 .2,544 82.08 Colored.---.28,430 400 315 85i 22 20 2 8,135262.41 Total ----------33,294 528 426 102 23 21 210,679 344.49 July, 1917: White.--------------,817 124 112 12 3 3 .2,298 74.12 Colored .-. 27,770 299' 224 751 22 21 1 6,778 218.65 Total----------32,587 4231 336 87 251 24 1 9,076292.77 August, 1916: White.24,563 109 87 22 1 ..1 2,135 68.88 Colored .29,046 317 242 75 9 8 1 6,266202.13 Total----------133,609 426 329 97 10 8 2 8,401271.01 PROPORTIONATE NUMBERS. August, 1917: White .4,864315.79273.85 41.94 2. 2.47.---. 16.88 Colored.28,430168.84132.96 35.88 9.28 8.44 0.84. 9.23 Total----------33,294 190.301153.54 36. 76 8.29 7.57 .72 ------10.35 July, 1917. White. 4,817308.91!279.01 29:90 7.47 7.47 ..15.39 Colored. 27, 770 129.20 96.79 32.41 9.50 9.07 .43-----7.97 Total. 32, 587155.77123.73 32.04 9.21 8.84 .37 .8.98 August, 1916: White. 4563286.651228.79 57.86 2.63 -----2.63 .15.10 Colored .046130.96 99.98 30.98 3.72 3.31 .41. 6.96 .33,609152.10117.47 34.63 3.57 2.86 .71.8.06 I Annual average per 1,000 employees.

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14 TABLE I-A.-DEATHS OF RESIDENTS OF THE CITIES OF PANAMA, COLON, AND THE CANAL ZONE. Deaths. Annual average per Population. Total. DisExternal Total. DisExternal ease. causes. ease. causes. August, 1917: Panama. 61,369 140 135 5 27.38 26.40 0.98 Colon------------26,078 64 62 2 29.45 28.53 .92 CanalZone --------'24,038 32 31 1 15.97 15.47 .50 Total----------111,485 236 228 8 25.40 24.54 .86 July, 1917: Panama. 61,369 183 181 2 35.78 35.39 .39 Colon------------26,078 60 60 --------27.61 27.61. CanalZone. 24,038 35 30 5 17.47 14.98 2.49 Total---------. 111,485 278 271 7 29.92 29.17 .75 August, 1916: Panama----------60,778 148 144 429.22 28.43 .79 Colon ------------24,693 56 55 1 27.21 26.73 .48 Canal Zone. 31,048 25 21 4 9.66 8.12 1.54 Total----------116,519 229 220 9 23.59 122.66 .93 I Civilian population only.

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44 xa -sI

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16 TABLE II.-CAUSES OF DEATHS OF INFANTS BY, Sex. Color. I weekCause of death. 1 we) 1 Month. M. F. W. B. Whooping cough.-------------------------.---1. iMiliary tuberculosis. Abdominal tuberculosis .---------------------1 .1. Acute meningitis. .-----------------------1 .1--------------------Convulsions of infants.1 1 .2 1 1. Acute bronchitis.-.2 2 1 3 1. Chronic bronchitis.-.2 1 .3. Broncho-pneumonia.-. 6 4 1 9. Lobar pneumonia--------------------------1 .2. Diarrhea and enteritis ---------------------18 14 5 27 1. Colitis----------.------------------------. 3 ------3. Intestinal hemorrhage.-. .1 1 .1. A cute nephritis. 1 -. -. 1 Pyelo-nephrosis. ..-.1 Diseases of skin and annexa-----------. -1 .-. 1 Premature birth-. 6 3 .9 9. Congenital debility .-----------------------3 .--. 3 1 -------M alnutrition ..------------..4 3 1 6 Other causes peculiar to early infancy.1. 1 1 Traumatism by fall -.-------------------. 1 -.1. Undtemied.2 .2. Undetermined -------------------------2 --2----------Total------------.---. .----. 48 39 10 77 --------Stillbirths ..23 14 4 33 ---. .. Grand total-. 71 53 14 110 15. Infant mortality rate, based on number of births reported for month (death rate Percentage of deaths under 1 year of age to total deaths for month.

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17 SEX, COLOR, AGE, AND PLACE OF RESIDENCE. Age by months. Place of residence. 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-9 9-10110-11 11-12 PanaColon. Zone. Total. ma. .....1 1 ...1. ...1 ..1 .... ....2. 1 ...2 ..2 .....2 2 .4 2 .-...-.-.-.--. ....-. .3 .3 -1 1 1 2 ..4 6 .10 ..1 ..1 ...2 ..2 4 4 3 1* 2 -5 1 21 2 1 25 5 2 32 ~~~~2. ....-I--1 3 ..3 ...~~~~~~. ....................-----------1. ......1. .----1 ..1 1. ....----1 7. ...6. ..5. ..... per 1,00 ..3 ..3 ...1 1 1 1 1 .3 1 3 7 .1 .1 1 4 -7 -I--.....-. 1 .2 6 11 7 6 5 5 18 16 6 6 6 54 25 8 17? ..20 116 37 61-1 7 6 5 5 8 6 6 6 6 74 36 14 124 per 1,000 births) .240.00 324.68 J70.21 249.28 ...39 39 25 37 14428-17---3

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18 TABLE III.-DEATHS, BY NATIONALITY. Employees. Nonemployees. Total. Nationality. Grand total Male. Female. Male. Female. Male. Female. Antigua. ..3 3 3 3 6 Barbados. -2--------17 11 19 1130 China.-----------------------------4 -------4 -. 4 Colombia. .3 .-. 6 5 9 6 14 Costa Rica. -.-. .1 1 1 Cuba .-. .1 ....F ran ce ..-. .-. ..-1 .-. 1 1 Greece -.-.--.-.-.--.--.1 1 1 1 2 G renada ....3 1 3 1 4 Guadaloupe---------2 .1 3 .-.-.-. 3 H ollan d .--.----.---.--.-..--.-.1 .--.....1 Italy.----------------.----. ---------2 ---------2 --------2 In d ia ........-------.--. -.-.--. .--1 ...' Jamaica.--11 .24 25 35 25 60 Martinique. ..-27 1 Montserrat.1 1 Panama.-.-1 -.-. 42 30 43 30 73 P eru ...-.-.---.-. 1 .--. 1 St. Lucia -----------1 .4 2 5 2 7 St. Thomas ...1 1 1 Vicn------------------St.Vincent--------------. -. 3 .-.-. 3 --------3 SpainT-----------23. ...---------1 1 1 1 2 T rinidad .--. .-.-.-. .4 .4 ---. -. 4 United States.-1 .-. 6 -7 1 8 Total. 23 .126 90 149 90 239 TABLE IV.-BIRTHS AND BIRTH RATES IN THE CANAL ZONE AND THE CITIES OF PANAMA AND COLON. Births. Rate per 1,000 popuPopula-lation. in.rTotal. Alive. Total. Alive. August, 1917: Panama---------------61,369 245 225 20 47.91 44.00 3.91 Colon.-----------------26,078 88 77 11 40.49 35.43 5.06 CanalZone.-----------124,038 53 47 6 26.46 23.46 3.00 Total.---------------111,485 386 349 37 4i.55 37.57 3.98 July, 1917: Panama.--------------61,369 224 203 21 43.80 39.69 4.11 Colon.-----------------26,078 87 77 10 40.03 35.43 4.60 CanalZone------------' 124,038 62 60 2 30.95 29.95 1.00 Total.---------------111,485 373 340 33 40.15 36.60 3.55 August, 1916: Panama---------------60,778 249 225 24 49.16 44.42 4.74 Colon.-----------------24,693 70 64 6 34.02 31.10 2.92 Canal Zone------------31,048 65 60 5 25.12 23.19 1.93 Total---------------116,519 384 349 35 39.55 35.94 3.61 IExclusive of military forces.

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19 TABLE IV-A.-INFANT MORTALITY RATES IN THE CANAL ZONE AND THE CITIES OF PANAMA AND COLON. Births. Deaths among Death Populachildren rates per tion. F under 1 1,000 Male. FeTotal. year of births. male. age. August, 1917: Panama. 61,369 120 105 225 54 240.00 Colon. .------------------26,078 36 41 77 25 324.68 CanalZone --.---. 24,038 24 23 47 8 170.21 Total.----------------111,485 180 169 349 87 249.28 July, 1917: Panama--------:--------61,369 101 102 203 81 399.01 Colon. .-------------------26,078 40 37 77 25 324.68 CanalZone .124,038 32 28 60 9 150.00 Total.----------------111,485 173 167 340 115 338.24 August, 1916: Panama.----------------60,778 118 107 225 63 280.00 Colon. .------------------24,693 36 28 64 14 218.75 CanalZone-------------31,048 27 33 60 4 66.66 1-Total. .-----------------116,519 181 168 349 81 232.09 1 Exclusive of military forces.

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20 TABLE V.-CAUSES OF DEATHS OF EMPLOYEES ARRANGED WITH Color. Age (in years). Cause of death. W. B. 121-25 26-30 31-35 36-40 41-45 51-5556-65 Abscess of brain..-. 1 .1 ... Aneurysm ..2 2 Endocarditis, malignant. w. .I ..1 ... Epithelioma of esophagus. ...1 Heart, organic diseases of. .5 .1 2. 1 1 Nephritis, chronic. 1 2 .. Pneumonia, lobar. .4 2 .. Tuberculosis of the lungs. 1. ..... Tuberculosis, disseminated. 2 .2 Tuberculosis, acute miliary. .1 .1. Traumatism, railroads. .1. Suicide by firearms. ... Total. 1 22 4 6 4 1 3 4 1 15 years old.

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21 REFERENCE TO AGE AND LENGTH OF RESIDENCE ON ISTHMUS. Length of residence on Isthmus (in years). Life. kon1Total, -1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-10 10-12 12-15 +15 1 ..1 ...1 ....2 -1 ........2 ..........I ...-.........1 5 1 .......------.3 1 1---1 4. ....... ........I .4 .1 .....1 ......... .I -. -. ...-----I -. ............ 1231 21 3. .4 4 1 -2 123

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22 TABLE VI.-CAUSES OF DEATHS OF CIVIL POPULATION SEX, COLOR, AGE, AND Sex. Color. Age (in years). Cause of death. M. F. W. B. Y. -I year. 1-4 5-10 General diseases. Malarial fever, estivo-autumnal -------1. 1 ...-Whooping cough. .--------------------.1 .1 .1 Purulent infection and septicemia. 2 2 ...1 Sop'i m a.--.-. 1 ..1 ---------Pyemia and septicemia, pneumococcic. 1 ..-.. Tetanus.-------------------------. 1 1 -----Pellagra------------.---. .----------------. .1 1. 1Tuberculosis of the lungs-----------22 6 1 25 2 1 Acute miliary tuberculosis. 2 2 .4 .Abdominal tuberculosis. 2 1 .3 .1 Pott's disease. ...----------------------1 .1 Disseminated tuberculosis. 2 1 .3 Syphilis, hereditary. .---------------1 ..1 --------1 Cancer and other malignant tumors of the stomach and liver. 1 1 .2Cancer and other malignant tumors of the peritoneum, etc. .1 .1-------------------Cancer and other malignant tumors of the female genital organs. .1 1 Cancer and other mahgnant tumors of the breast .t. 2 ..2Cancer and other malignant tumors of other organs. ...--------------------1 ..1 Anemia, chlorosis-----------------1 ..1 Alcoholism, chronic. 1 .1. Diseases of the nervous system and of the organs of special sense. Encephalitis. 1 ----1-------------------Simple meningitis. 1 .1---------1. Cerebrospinal fever.1 --------------------1 .1 Cerebral hemorrhage, apoplexy. 4 3 2 4 1. Convulsions of infants (under 5 years of age). 1 1 .2. 2--------Diseases of the circulatory system. Acute endocarditis----------------2 ..2 Malignant endocarditis.-. 1 1 .2. Organic diseases of the heart. 14 4 4 14------------------Aneurism. 2 ..2 Diseases of the respiratory system. Acute bronchitis. .----------------3 4 1 6 .4 3 Chronic bronchitis. 2 2 .4 .3 Broncho-pneumonia .8 8 2 14 .10 5 Pneumonia unqualifiedd) ---------------1 2 .3 .1 Asthma. 1 ...1. Pneumonia, lobar. 6 2 1 7 .2 1. Diseases of the digestive system. Diarrhea and enteritis (under 2 years). 22 14 5 31 .-. 32 4----Colitis-. 3 ..3 .3. Diarrhea and enteritis (2 years and over) 1 ..1 ------------1.

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23 (EMPLOYEES AND NONEMPLOYEES) AND MILITARY, JY PLACE OF RESIDENCE. Age (in years). Place of residence. n Total. 11-20 21-30 31-40 41-50 51-60 61-75 76-1001 Panama. Colon. Zone. ..111:::1i1. .... ----........-----.........2 ...---2 ...2. ..1 ..:. .1.1 1 ...........1. ...1 1 13 8 4 .1 19 7 2 28 3 -.........3 1 .4 1 1 .....1 2 .3 --.....1 1 3 ......1 ...--1 .1 .1 3 --~~ ~ ~ ----------. ...... ----. .........................1 2 ..1 ...1 1 .-. ....1 1 .1. .. .... 2 2 2 .4 2 1 7 1 ...1 ....2 ..2 K>;l.1 .:. .2. 4 7 .3 3 1 11 18 ....12 ......1 .. ..... S. ...1 ..............4 .4 -........9 7. .1 6 ---2 3 ----:-------:----3

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24 TABLE VI.-CAUSES OF DEATHS OF -CIVIL POPULATION SEX, COLOR, AGE, AND Sex. Color. Age (in years). Cause of death. M. F. W. B. Y. -1 year. 1-4 5-10 Diseases of the digestive system-Contd. Intestinal obstruction. 2 .2 Other diseases of the intestines-----------1 1 Duodenal ulcer. 1 ....1 Cirrhosis of the liver. 3 .. Abscess of the liver, entamebic. .1 .1 Nonvenereal diseases of the genitourinary system and annexa. Acute nephritis. 3 3 1 5 ---1 2 Bright's disease (chronic nephritis). 4 5 1 8 Other diseases of the kidney and annexa.1 ..1 ----1. Pyelo-nephrosis .2 Structure of the urethra, nonvenereal. 1 ..1 The puerperal state. Puerperal albuminuria and convulsions.1 .1 Diseases of the skin and of the cellular tissue. Gangrene.1 .1 -Other diseases of the skin and annexa. 1 ..1 ..1 -. Diseases of early infancy. Premature birth. 6 3 9 .9. Congenital debility. .3 .3 .3. Malnutrition .6 3 1 8 .7 2 Other causes peculiar to early infancy. I ..1 .1 Old age. Senility. .1. 1 Affections produced by external causes. Other acute poisonings. 1 2 .3 Traumatism by fall.1 1 2 .1. Railroad traurmatism.1. 1 ... Injuries by animals.1 .1. Suicide by firearms .1 ..1 Fractures (cause not specified)1. 1 -. .1. Ill-defined diseases. Cause of deathnotspecified or ill-defined. 1 4 1 4 .2 2. Total ---. 149 90 37 198 4 87 27 2 Stillbirths-.--. 23 14 4 33 Grand total. 172 104 41 231 4 87 27 2

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25 EMPLOYEES AND NONEMPLOYEES) AND MILITARY, BY NLACE OF RESIDENCE-Continued. Age (in years). Place of residence. -_ Total. Canal 11-20 21-30 31-40 41-50 51-60 61-75 76-100 Panama. Colon. Zone. 1 ..1 2 ..2 ....1.1. .1 1 1 .1 .-. 1. ...-. .-. .1 -....2 ------2 2 3 .1 1 4 3 2 9 .1. ...1. 1. .1 1 1 2 ..1. .1 1 ......1 .1 ....-.--1 ------1 .1 ......1. 1. .1 .4 4 1 9 3 3 4 1 4 9 ....1. .1 1 1. .1 2 1 3. -. ...3 ii 1 2 1. .....1 I 1 1 1. ..-----.--..--. ....2 3 ------5 7 39 31 17 13 12 4 140 64 35 239 .20 11 6 37 7 39, 31 17 13 12 4 160 75 41 276 14428-17-4

PAGE 28

26 TABLE VI-A.-DEATHS OF NONRESIDENTS' Residence. Nationality. Color. Sex. Age. Cause of death. Escoval. Colombia. Black. Male. 5 Ankylostomiasis. Tonosi. Panama. .do. .-.-do._. 45 Pulmonary tubrculosis. Darien. do.do. Female. 7 Malaria. Juan Diaz. Spain. White..do. .7 Gastro-entero colMOS. tis. S. S. Zacapa. Jamaica. Black. Male. 26 Lobar pneumonia. Interior-of Panama. Spain-------White.do. 47 H pertrophy 'of Do. Panama-----Black. .do. 20 Pulmonary tuberculosis. Pacora. Colombia.do.do. 49 Acute general peritonitis. pen Interior of Panama. Panama. .do. Female. 3 Gastro-enteritis. Do. .Colombia. .do. .Male. 36 Acute general perljtonitis. Juan Diaz. Panama. .do .do. 31 Hemoplegia, left. Do. Colombia. .do. .do. 30 Myocardiacins ficiency. Chepo. Martinique. .do. .do. .30 Traumatism by I firearms. Interior of Panama. Grenada. .do. .do. 60 Pellagra. 1 Deaths of nonresidents are not included in the statistical charts relating to the Canal Zone or the cities of Panama and Colon.

PAGE 29

4 4 9 s s 4 x -u --e : a --* ------------g -a .--. ---------.-.----...-. ..--. : : :n: ..: -5:::: 8 8

PAGE 30

28 TABLE VI.-DISCHARGES AND DEATHS IN THE Employees. Discharges. Deaths. White. White. Diseases. S I BlackBlack. C)C C) 0 Tp sF. eFve F.IM. F.M. F.M. F. General diseases. Typhoid fever. Typhus fever .I. .....---... Malarial fever: Estivo-autumnal. 2 4 .29 Tertian. 2 1 .7 Quartan.1 ---.. Undetermined. ... M easles ..! 1 ..................... Whooping cough. Diphtheria and croup. 1 ....1 Influenza. 6 ... Dysentery, entamebic. ... Leprosy ...... Dengue. Chicken pox. ..1K German measles. 2 -... M um ps. I ... Acute infectious jaundice (Weil's disease). ... Purulent infection and septicemia.". ... Pellagra ........ Tuberculosis of the lungs. ...... Acute miliary tuberculosis. .........1 Pott's disease. .. Tuberculosis of the lymph glands. .. Tuberculosis of the genito-urinary organs. 1 Tuberculous abscess. .1-. Disseminated tuberculosis. .2 Syphilis: Secondary. Tertiary. 2 .1 .22 Period not stated. 1 ... Gonorrhea. .... Gonorrheal arthritis. ....1. Gonorrheal bubo.1.--.-. ....... Gonorrheal orchitis andepididymitis I ...3 ...... Gonorrheal ophthalmia. .. Ao nt ih ancro .al. .....2 Adenitis chancroidal. ... Cancer and other malignant tumors of the buccal cavity. 1 .. Cancer and other malignant tumors of the stomach and liver. L. .......1 1 A=American.

PAGE 31

29 HOSPITALS OF. THE PANAMA CANAL. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. 3 Black. White. Black. White. Black. M. ..I. M.F. M. F.M F. M F IM. F. M. F. 1--------2--7-----2 1 --. 1 13 11 .1 .30 2 11 2 1. 2 7 1 2 ..12 1 3 1 ............3 111 2 .............2 .--S 1 3 1 2 .. 2 ............. 28 1 .....1. ..1 _1.: .10.--........1. 4 2. 1 1 1 1. ....5 3 1 ......1 ........3 2-1. ----.----.---.---.5. 7. .g.40--1------------2. ..1. 1 -. -1 17 1 -1 ............43 2 ..............1 ............3 ..........5. ...... 2 ....6. 1. ........... 2 .......* ...-. ..--..--. ..I-. ..5 17 1 ..z. 1 ....o. ...3 .......35 ...1 .............. ............2 ......1 42 P.R.mPorto Rican.

PAGE 32

30 TABLE VII.-DISCHARGES AND DEATHS IN THE Employees. Discharges. Deaths. White. White. Diseases. Black. Black 2 0 0 M. F. M. F. M. F.M. F.M. F.M. F General diseases-Continued. Cancer and other malignant tumors of the female genital organs. Cancer and other malignant tumors of the breast. .. Other tumors (tumors of the female genital organs excepted). Chronic rheumatism and gout. 1. Diabetes. Amenia secondary, cause not determined. Other general diseases. 2. Alcoholism (acute or chronic). Alcoholism acute. 1. Alcoholism chronic. .1. Diseases of the nervous system and of the organs of special sense. Encephalitis. 1 Cerebro-spinal fever. .:Cerebral hemorrhage, apoplexy. Paralysis without specified cause. 1. General paralysis of the insane -----.1. 1. Other forms of mental alienation .1 Ep lepsy .-. .2. Neuritis. Other diseases of the nervous sytem 1. Neurasthenia. 3 2 --1. Diseases of the eyes and their annexa 1. 4. Diseases of the ears. Diseases of the circulatory system. Malignant endocarditis. -------. Organic diseases of the heart ..1 ---6 --4 Diseases of the arteries, atheroma, aneurysm, etc.: Aneurysm ..-.-. .2 Arterio-sclerosis. ...3. Diseases of the veins (varices, hemorrhoids, phlebitis, etc.): Hemorrhoids .4. ... Varicocele.-. 4 ..-.

PAGE 33

31 HOSPITALS OF THE PANAMA CANAL-Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. g Black. White. Black. White. Black. 4-1-i -M--.----A. M F. M. F. A. .F. M. F. M. F. M. F. M. F. M. F. EE-& ....-..---I ------.----------.---------------------------------1 -...----------'-------------------......----..-------------------.....---. f -t -..--. .-.---.---. ----. .....6 -....-----------------------------------A ,------------... 1-------------------------------------------------~ ~ ..1 .......1-......-.----.-. .......--. .1 .1 .7 ...-............-. ..1-....-......--.4 .---. ......-. ........... 7 ........--. ....--.----14 -...............3 ..............1. 2 2 .............. 1. ....2 ...------.-.----------8 ----1 .2. ..........1 3. 1 4 2 2 ....1 ......17 3 ..---. 1 .1 ...----------------------. 1. ......... 1. ......1. .......2. .-. .-. ...-----........ -. ...........1 2 .1 .-6. ....---------.....10 1.2.

PAGE 34

32 TABLE VII.-DISCHARGES AND DEATHS IN THE Employees. Discharges. Deaths. White. White. Diseases. I Cl Black. Blac M. F. M. F. M. F. M. F. M. F.M. F. Diseases of the circulatory systemContinued. Diseases of the lymphatic system (lymphangitis, etc.)----------------Lymphadenitis (nonvenereal). 1 .. Hemorrhage; other diseases of the circulatory system -----------------Diseases of the respiratory system. Diseases of the nasal foss --------4 ----------Adenoid vegetations .....1 Acute bronchitis-------------.---.1 1 .3 Chronic bronchitis--------------. .----. ... Broncho-pneumonia --------------.-.------------------Lobar pneumonia. -----------------..----6 -4 Pleurisy ----------------------------------------5-------P le ris ............--Asthma.---------------------1 --------2 Other diseases of the respiratory system (tuberculosis excepted) -----------1. Diseases of the digestive system. I Diseases of the mouth and annexa. Diseases of the teeth and gums. Stomatitis. .. Diseases of the pharynx -----------------------1. Follicular tonsillitis----------2 1 -------4 1----------------Ulcer of the stomach. Other diseases of the stomach (cancer excepted). .1. Acute gastritis. Acute indigestion.1. Diarrhea and enteritis (under 2 years). Colitis. Diarrhea and enteritis (2 years and over).-.-.----6 Colitis. .1 Ankylostomiasis .....i .1.1--a--Appendicitis and typhlitis. .. Acute appendicitis. 1 .1 ... Chronic appendicitis. .1 ..

PAGE 35

33 HOSPITALS OF THE PANAMA CANAL-Continued. Nonemployees. Nonresidents. Diseharjes. Deaths. Discharges. Deaths. WbIte. White. Black. Black. White. Black. White. Black. 0d CS A. M F. M. F. A M. F. M. F. M. .M. F.M.F. M. F., P0 ; 191 1 1----------------------------------3.23 .......-...--.--1 .. 9 1 1 2 ...3 ......23. 1 1 *. ..16. 3 4 .1 .......I. ........ .T 1 .....................3 .. --------------1------------11.---------I---------------------.1 .K -. ..............7 .~ ~ 11. ...------.........4 .8 --.---.---.-1~. ...... 72 2 41i .............4. 12 1 ---------------------------------------1236--------------1-------------11--1-1------------------------------------2 7 113 f ............I. ..41 .. 1. ............. ----------------......1. ............. *. 1. .8. 1.1----------------------2. ..........., 3 .2 ................2. 1 ...1. ..... 4 -,2 2 .1~i .j----------1 32 1~ 1

PAGE 36

34 TA3LE VII.-DISCHARGES AND DEATHS IN THE Employees. Discharges. Deaths. White. White. Diseases. cBlack. Black. M. F. M. F. M. F. M. F.M. F. M. F. Diseases of the digestive systemContinued. Hernia, intestinal obstructions: Ingoralhernia. ..... Other diseases of the intestines. 3 1 .4. 4 Constipation. .1 Duodenal ulcer. 1 Cirrhosis of the liver. Other dishes of the liver ..1. .Abscess of liver (unqualified).1 Abscess of the liver entamebic .. Cholecystis--. Simple peritonitis (nonpuerperal). Nonvenereal diseases of the genitourinary system and annexa. Acute nephritis. Bright's disease (chronic nephritis). ...6 1. 2 Other diseases of the kidneys and annexa. 1. Movable kidney. Pyelo-nephrosis. 1. ... Diseases of the bladder: Cystitis.1. Diseases of the urethra, urinary abscess,etc. .3 Stricture of the urethra, nonvenereal. .1. Diseases of the prostate: Chronic prostatitis. .. Nonvenereal diseases of the male genital organs. .2. HIydrocele. .2. Uterine tumor (noncancerous). Other diseases of the uterus. .1. Metritis .... Nonpuerperal diseases of the breast (cancer excepted).

PAGE 37

35 HOSPITALS OF THE PANAMA CANAL-Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black White. Black. White Black. A. M. F. M. F. A. M. F. M. F. M. F. M. F. M. F. M. F. 1 1 4 2 ....e. e. ..1 ..e. ......... 20 .1. ......--. ............1 -x 5 .3.1. ..26. ....1. ..1.4 ....1. .. 1. ....31 -. ...........1 ....1 2 .11 .......4 -x .1. ....8. 1. ...---.---.-.I. ...1 .1.1. 1. .....11 3 f. .........8.4 1. ..1 1. ..2. ........4. .1 1. ...5.1 ......1 4. ...1. .:. ....1 3. 2 ........... 1. ...41 1 ..31

PAGE 38

36 TABLE VII.-DISCHARGES AND DEATHS IN THE Employees. Discharges. D6aths, White. White. Diseases. Black. Bladk* r -o F. M. F. M. F. M. F.M. F. M. The puerperal state. Normal labor. Accidents of pregnancy. .. Extra-uterine pregnancy. ..I I Hyperemesis gravidarum. Abortion .................. Other accidents of labor. Diseases of the skin and of the cellular tissue. Furuncle. ... Carbuncle. 1 Acute abscess. 2 ...1 Phlegmon and cellulitis ...5 .8. Ulcer of the skin. ....2. Impetigo contagiosa. Ingrowing nail. Other diseases of the skin and annexa. .2 ...8. Diseases of the bones and'of the organs of locomotion. Diseases of the bones (tuberculosis excepted).21. Periostitis. Ankylosis. 1. Arthritis .. Synovitis. ..... Other diseases of the organs of loco-T-. motion. 2 ...2 Malformations. Congenital malformations (stillbirth not included) ..2 Diseases of early infancy. Congenital debility, icterus, and sclerema. Malnutrition. .... Other causes peculiar to early infancy (including various consequences of labor). ..

PAGE 39

37 4 OSPITALS OF THE PANAMA CANAL-Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. White. Black. White. Black. 0 4Q 0 C A. M. F. iM. F. A. M. .M. F. M. F. .F. M. F. M. F. I Io ..16 .10 .....26. 3 ......3 ......1 ........ 311. ..5. ..2. .........3 1 ......2. 2 6. 2T.-.---.-.-.-.-.-.-. ........ 4 ..1.2. ..20 ........... 1 1. 3 1---------1 ----16 2 3. 11 7 7 4 --2-9------3 1 .1 4 .----1.1

PAGE 40

38 TABLE VII.-DISCHARGES AND DEATHS IN THE Employees. Discharges. Deaths. White. White. Diseases. Black. 3 Black. P4) 0 M. F. M. F. M. F. M. F. M. F.M. F. Old age. Senility. Affections produced by external causes. Suicide by poisoning---------Suicide by firearms Poisoning by food ----------------1 ----------1. Other acute poisonings. Venomous bits and stings -----Burns (conflagrations excepted). 1 ..3---------------Traumatism by firearms. ..... Traumatism by cutting or piercing instruments. .8 Traumatism by fall. 1 ..7 Traumatism by machines --------1 ...3-Traumatism by other crushings (vehicles, railroads, landslides, etc.). ...3 Railroad traumatism. ...3 Traumatism by landslides. .-------Injuries by animals. .--Fractures (cause not specified). 1 .. Dislocations.---. .. Sprains. ....5 Other external violence----------2 .1 .34.-Ill-defined diseases. Infections of undetermined origin. ....4 No disease. Grand total. 83 4 24 .308 1 1 ...20

PAGE 41

39 HOSPITALS OF THE PANAMA CANAL-Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. White. White. Black. Black. White. Black. White. Black. C) CS A. M F.M F. A. .F. F. M. F. M. F. M. F. M. F. '0 o 0 --. -.... 1 ~ ~ ~ ~ ~ l ..... 2 -..---. .----. --------------------4--------------------------------------------1 ...2--. -......-----.---12 1 ---~--------------------------------------------5------......-2------------------------------------------------4 21--------------------------2 1 ..-----. ---. .... ..... 3. ...-1-. 22....-. 9 9 ...2 ......4 7 6. ....... 6 .2 1 ....-...--...-.-. ..-. 3 3 10 .5 ..............2 25 22 82 143 58 118 1 6 .7 9 29 .2 ...1 .1099 45

PAGE 42

40 TABLE VIII.-CONSOLIDATED HOSPITAL REPORT. A=White Americans; F=White foreign; B=Blacks. Remaining Admitted. Died. Aug. 1. charged. A. F. B. A. F. B. A. F. B. A. ANCON HOSPITAL. Panama Canal employees. 16 7 91 58 12 175 1 .5 57 11!147 Panama Railroad employees. 81 6 78 11 14 145 ..9 11 81109 Soldiers. 117 ....2 .236.1 Panama pay patients. .... Other pay patients. 28 29 64 122 38 159 .1 2 15117 371124 Charity patients. 19 3 30 57 9 37 1. 1 50 4 41 Total. 188 45 263 455 73 517 5 2 $0471 66421 COROZAL HOSPITAL (INSANE). Panama Canal employees. .1 7 .1 ...2 Panama Railroad employees. ..1. .. Soldiers. 2 ..21 ...2 Panama pay patients. 4 48 201 .5.1 Other pay patients. .5 3 1 1. Charity patients. 3 7 75 .3.3 ..1 7 Total. 9 61 287 3 1 9 .3 .10 Grand total. 197 106 550 4581 74 526 5 2 30 474 60 431 COROZAL FARM (CRIPPLES). Panama Canal employees. .10 49 .2 8 ....3 7 CHRONIC WARD. Charity patients ...24 .14 .2 COLON HOSPITAL. Panama Canal employees.31 1 10 15; 2 41.-. 1 14 2 28 Panama Railroad employees. 1 2 11 11 5 38 ..5 5 3 25 Soldiers. 9 ..5. ..12. Panama pay patients. .1 ..1 7 ..1 3 Other pay patients .5 6 5 37 21 10 1 1 1 24 14 7 Charity patients. 1 1 1 5 .1 ...5 1 1 Total. 19 11 27 73 29 97 1 1 7 60 21 64 PALO SECO LEPER ASYLUM. Panama pay patients. .2.2 Charity patients. 1 27 .1. Total.3 62.3. GRAND TOTAL. Panama Canal employees. 19 19 157 73 16 225 1 .6 71 16 184 Panama Railroad employees .9 8 90 22 19 183 .14 16 11134 Soldiers. 128 ..2141 ..2 .250. Panama pay patients. 4 51 236 .1 15 14 Other pay patients. 33 40 72 160 60 169 2 3 16141 51131 Charity patients. 23 12 157 62 9 56 1. 1 56 5 51 Total. 216 130 712 531. 105 648 6 31 37534 84504

PAGE 43

41 TABLE VIII.-CONSOLIDATED HOSPITAL REPORT-Continued A=Wliite Americans; F=White foreign; B=Blacks. RemainTransinAverage number conferred. Aug. 31. stantly sick. A. F. B. A. F. B. A. F. B. Total. ANCON HOSPITAL. Panama Canal employees. .11 16 8 103 15. 55 9.64 104.90 130.09 Panama Railroad employees. ..1 8 12104 7. 16 8.97 81.97 98.10 Soldiers. I. 85.100.74. 100.74 Panama pay patients .-. .---..1 ...55 .55 Other pay patients. 1 1| 1 31 27 83 34.48 31.52 78.58 144.58 Charity patients. 4 25 8 21 21.19 5.84 26.94 53.97 Total. 2 1 17165 55312179.12 55.97 292.94 528.03 COROZAL HOSPITAL (INSANE). Panama Canal employees. ..1 6. 1.00 7 55 8. 55 Panama Railroad employees. ..1 ..1.00 1.00 Soldiers. .....2 ..1. 94 ..1. 94 Panama pay patients. .1 4 48204 4.00 48.00 202. 52 254. 52 Other pay patients. .1 6 3 .90 5.68 3.00 9.58 Charity patients. .2 7 71 2.74 7.00 75.97 85.71 Total. 1 9 62285 9.58 61.68290.04 361.30 Grand total. 2 1 18174117597188.70117.65582.98 889.33 COROZAL FARM (CRIPPLES). Panama Canal employees. ..9 50 .9. 58 48.13 57. 71 CHRONIC WARD.Charity patients. ..32 ..29.87 29.87 COLON HOSPITAL. Panama Canal employees. .10 4 1 12 4.71 1.41 8.26 14.38 PanamaRailroad.employees. 3. 7 4 4 12 1.74 1.61 11.29 14.64 ,Soldiers. 4.58 ..4.58 Panama pay patients. .2 ..03 1.61 1.64 Other pay patients.7 2 4 10 10 3 8.22 6.80 4. 29f 19.31 Charity patients. .1 1 ..1.38 .90 .20 2.48 Total.12 2 24 19 16 29 20.63 10.75 25.65 57.03 PALO SECO LEPER ASYLUM. Panama pay patients. ...2 371 .2.00 36.03 38.03 Charity patients. ..1 .1 27 .1. 00 26. 58 27.58 Total. ..1. 3 64 .3.00 62.61 65.61 GRAND TOTAL. Panama Canal employees. ..21 201 19 171 20.26 21.63 168.84 210.73 Panama Railroad employees. 3 .8 12 16 117 8. 90 10.58 94.26 113. 74 Soldiers. 87. 87. 107.26 ..107.26 Panama pay patients. ..3 4 51 2441 4.00 50.03 240. 71 294.74 Other pay patients. 8 3 5 42 43 89 43.60 44.00 85.87 173.47 Charity patients. 10 28 16 151 25.31 14.74 159. 56 199.61 Total. 14 3 47 193 145 772 209.33 140.98 749. 24 1, 099.55 Number of employees remaining in hospitals: White. .67 Black. ...288 Total. 355

PAGE 44

42 TABLE IX.-CONSOLIDATED DISPENSARY REPORT. EMPLOYEES TREATED IN QUARTERS. ReRemainAd1 PisTransM Pays lost. ing emitted ied charged. ferred. ing Aug.1. Aug. 31. W. B .W. W. B. W. B. W. B. W. B. W. B. Total. Aicon. 3 .i 73 ......76 .....121 .121 Balboa. 6 .154 2 ..152 2 3 .5 .375 10 385 Pedro Miguel ..12 ..-. 11 ---------1 .37. 37 Paraiso-. .4 8 ..4 5 .3 ..17 20 37 Gamboa. ..1 2 -. .1 1 .1 -------2 4 6 Gatun. 1 1 17 5 ..15 5 1 1 2 .39 24 63 Colon. 8 27i 92 322. .93 312. .7 37 3481,413 1,761 Total 18 28 353 339. 352 325 4 5 15 37 9391,471 2,410 ALL CASES TREATED BUT NOT EXCUSED. Employees. Nonemployees. Total. W. B. Total. W. B. Total. W. B. Total. Ancon. 1,324 3,987 5, 311i 1 5311 3,771 5;302 2,855 7,758 10,613 Balboa. 3,724 3,809 7,533 4,120 1,323 5,443 7,844 5,132 12,976 Pedro Miguel. 1,533 2,032 3,565 1,333 722 2,055 2,866 2,754 5,620 Paraiso. 712 2,110 2, 822, 901 8181 1, 719 1,613 2,928 4, 541 Gamboa. 100 326 426 45 231' 276 145 557 702 Gatun. 232 1, 108 1, 340 559 9281 1,487 791 2,0362,827 Colon. 2,346 8,727 11,073 1,932 3,085! 5,017 4,278 11,812 16,090 Total. 9,971 22,099 32,070 10, 4211 10,8781 21,299 20, 392 32,977 53,369

PAGE 45

43 TABLE IX-A.-CONSOLIDATED ADMISSION REPORT. White. Black. Total. Admissions to hospitals, excluding Corozal farm and chronic ward. 634 626 1,260 Admissions of employees to quarters. 353 339 692 Total admissions to hospitals and quarters 987 965 1,952 Less number of patients transferred between hospitals, and from quarters to hospitals, whose admissions are duplicated in above figures. 21 52 73 Net admissions to hospitals and quarters. 966 913 1,879 EMPLOYEES. Employees admitted to hospitals---------. .128 400 528 Employees admitted to quarters. 353 339 692 Total admissions of employees. 481 739 1,220 Less number transferred between hospitals, and from quarters to hospitals, whose admissions are duplicated in above figtres. 7 34 41 Net admissions of employees. 474 705 1,179 Annual average per thousand of admission of employees to hospitals and quarters. 1,169. 41 297. 57 424.94 TABLE IX-B.-CONTAGIOUS AND INFECTIOUS DISEASES REPORTED DURING THE MONTH. Panama. Colon. Canal Total. Zone. Beriberi. 1 1 Cancer. 3 ..3 Chicken pox--------------------------------3 3 7 13 Diphtheria. 1 9 7 17 Gonococcus infection. .27 52 79 Leprosy.-------------------------------------1 .1 2 Malarial fever. 41 19 62 122 Measles.2 2 33 37 German measles ...1 1 Meningitis, epidemic, cerebrospinal ...1 1 Mumps. ..1 3 4 Pellagra. 2 .2 Pneumonia, acute.14 2 16 Scarlet fever.2 1 3 Syphilis. 5 10 15 Tuberculosis .36 8 4 48 Typhoid fever.1 .2 3 Whooping cough. 10 1 27 38

PAGE 46

44 TABLE X.-NUMBER OF EMPLOYEES CONSTANTLY SICK IN HOSPITALS AND QUARTERS. White. Colored. Total; Hospitals: Ancon Hospital.-. 42.32 195. 42 237 74 Colon Hospital. .9. 47 19.55 29.02 Totals. 51.79 214.97 266.76 Quarters: Ancon. 3.90 .---. 3.90 Balboa. ...------------------------------------12.10 .32 12.42 Pedro Miguel. 1.19 ..1.19 Paraiso. .55 .64 1.19 Gamboa. .06 .13 .19 Gatun. .1.26 .77 2.03 Colon. ...-------------------------------------11.23 45.58 56.81 Totals-. 30.29 47.44 77.73 ospi'Quarters. Totals. Average number of employees constantly sick: White. 51.79 30.29 82.08 Black. 214.97 47. 44 262.41 Total. 266.76 77.73 344.49 Average number of employees constantly sick, per 1,000: White. 10.65 6.23 16.88. Black. 7.56 1.67 9.23 Total. 8.01 2.34 10.35 TABLE X-A.-AVERAGE NUMBER OF DAYS IN HOSPITALS OR QUARTERS FOR EACH ADMISSION OF SICK EMPLOYEE. White. Black. Total Hospitals: Ancon Hospital. 12.76 20.28 18.50 Colon Hospital. 6.96 7.34 7.24 Quarters: Ancon.1. .1.71 Balboa. 2.44 5.00 2.48 Pedro Miguel. 3.36 .3.36 Paraiso. 4.25 2.50 3.08 Gamboa. 2.00 2.00 2.00 Gatun. 2.50 4.16 2.95 Colon. 3.96 5.76 5.35

PAGE 47

45 TABLE XI.-DEATH RATES AMONG AMERICANS ON THE ISTHMUS CONNECTED WITH THE PANAMA CANAL. Annual death rate per 1,000. White employees from the United States. 2.89 White Women and children from the United States. .7.45 hite employees and their families from the United States -----------5.35 TABLE XII.--FINANCIAL STATEMENT, DEPARTMENT OF HEALTH. July, 1917. June, 1917. July, 1916. Administration-General expenses: Chief health office. $700.92 $982.37 $792.97 Construction allotments ------------------216. 70. Stock-. 124.58 12.76. Suspense. ...------------------------------212.36 11,819.10. Reserve for new tools .-.-.-.835.80 Total.--------------------------. .1,105.40 1823.97 1,628.77 Hospital division: Ancon Hospital. ...----------------------35,818.18 34,293.06 27,385.51 Corozal Hospital and farm ---------------9, 054. 65 7,936. 99 6,143. 71 Colon Hospital. ..------------------------5,078.66 4,925.22 3,803.60 Palo Seco T eper Asylum. 1, 915.83 2,310.93 1,691.10 Santo Tomas Hospital .------------------1, 129.67 1,025.00 866.63 Medical storehouse ----------------------1167.18 966.39 930.17 Total. ....-----------------------------54,164.17 51,457.59 40,820.72 Sanitary division: Chief sanitary inspector -------------------50.00 50.00 50.00 Health office, Panama -----------------. ..3,788.34 3,703.19 3,338.25 Street cleaning, Panama-------------4390.73 4,388.16 4 254.49 Health office, Colon. .------------------3,214.41 2,873.60 2,680.64 Street cleaning, Colon-------------. .1,994.62 2,257.45 2,101.29 Zone sanitation ...---------------------8, 472. 34 42,883.98 16,242.80 Total .....-----------------------------21,910. 44 54156.38 28,667.47 Dispensaries .-------------------------. 4,201.56 4,086.24 2,989.99 Quarantine division. .-----------------------5,356.63 7,325.44 5,265.44 RECAPITULATION. Administration, general expenses. .1,105.40 1 823.97 1,628. 77 Hospital division. 54,164.17 51,457.59 40,820.72 Sanitary division-. 21,910.44 56,156.38 28,667.47 Dispensaries. 4,201. 56 4,086.24 2,989.99 Quarantine division. 5,356. 63 7,326.44 5,265.44 Total.--.-------. 86,738.20 118,201.68 79,372.39 1 Credit.

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46 TABLE XIII.-ANCON HOSPITAL. REPORT OF DAYS LOST IN HOsPITAL. AmeriForeign. Black. Total. can. Hospital: Panama Canal employees ------------482 299 3, 252 4,033 Panama Railroad employees. .222 278 2,541 3,041 Army and Navy .------------------3,123 .------------3,123 Panama Government pay .--. -.-.17 17 Other pay patients. -.----------1,069 977 2,436 4,482 Charity. ..--------------------------657 181 835 1,673 Total. ...-------------------------5,553 1,735 9,081 16,369 Asylum: Panama Canal employees.---------------------31 234 25 Panama Railroad employees ----------------------------31 31 Army and Navy ---------------------60 -.-.-. -.-.60 Panama Government pay cases.----124 1,488 6,278 7,890 Other pay cases ---------------------28 176 93 297 Charity.-----------------------------85 217 2,355 2,657 Total.-----------------------------297 1,912 8,991 11,200 Chronics ----------------------------------------------926 926 Cripples (Corozal farm)---------------------------297 1, 492 1,789 Grand total. ..--------------------5,850 3,944 20,490 30,284 Nouresidents, hospital--. 268 Nonresidents, asylum-. 936 Average cost of subsistence per patient per day, $0.4285. WARD LABORATORY REPORT. Blood examinations (total number). 721 Estuvoautumnal. 15 Quartan. I Tertian..10 Differential counts-. 25 Hemoglobein estimations.200 Leucocyte counts. 70 Red blood counts.w. 1 Stool examinations'(total number). 585 Am eba. .7 Asearis lumbroicoides. 11 Balantidium oli. 3 Ciliated monads. 4 Entameba (hystolitica and tetragena). 2 Guaiac tests. 17 Pus and blood. 8 Strongyloides .-20 Tenia saginata. I Tricocephalus dispar.,. 25 Uncinaria (ova). 42 Urine examinations (total number). 2,596 Albumen. 616 Bile. 20 Casts. .,. 388 Epithelia. 1,128 Guaiac tests. 190 }emin crystals. 13 Indican. 296 Pus and blood-. 1,22 Sugar, pos. 1, nog. 870 .-. 871

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47 TABLE XIII.-ANCON HOSPITAL-Continued. Sputum examinations (total number). 350 Positive for tubercle bacilli. 31 Smear examinations (total number). 70 Urethral. 59 Vaginal. 3 Eye. 1 Spinal fluid. 19 SURGICAL OPERATIONS PERFORMED DURING THE MONTH. Number.1 Died. Am nations: Forearm. .......--------------------------------------------1 1. Thigh. 1 Operations on bones: W iring of fractures, simple .-. 1 Wiring of fractures, compound. 1 Adenentomy: Inguinal, single. .24 Inguinal, double. 6 Femoral. 3 -Herniotomy: Inguinal, single.-. 11 Inguinal, double ............-. .5 Ventral.-. 1 Genito-urinary tract: Nephropexy.1. Urethrotomy, external. 1 Hydrocele, single, radical cure.6. Epididymotomy. 14 Amputation of scrotum. 7 Curettage uteri ---. 12 Perineoplasty. Trachelorrhaphy. -1 Obsterical: Coesarian section, abdominal .1. Low forceps. Rectum: Hemorrhoids, radical cure. 13 Fistula in ano, excision of. General: Varicose veins, excision of. 1 Tenorrbaphy. 1 Gunshot wound of soft parts, o ration for. Plastic operation for effects of disease. .2 Laparotomy: For intestinal obstruction. 1 Exploratory .2 1 Gastro-enterostomy. Enterostomy. Appendetomy. 11 Appendectomy with local peritonitis. 4 Supravagmal hysterectomy. .7 HRyteromyomectomy. 2 Salpingectomy, double. Salpmgo-cophorectomy. 4 Suspensio uteri. 14 Various other major operations. 3 Various minor operations. 185 2 354 3

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TABLE XII.-ANCON HOSPITAL-Continued. REPORT OF OPERATIONS, EYE AND.EAR CLINIC. Submucous resections-----------------------------------------------.16 Pterygium transplantation-----------------------------------. .3 Turbinectomy --------------------------------------------------------2 Chalazion. ...----------------------------------------------------1 Adenoidectomy-----------------------------------------------------. 22 Tonsillectomy.-----------------------------------------------------31 Mastoide::tomy -----------------------------------------------------3 Schleral trepine. .-------------------------------------------------1 Evisceration ...I Eiscetony-----------------------------------------------------------12 Iridectomy. 2-----------------------------------------------------2 Uavlectomy. .----------------------------------------------------1 Cataract extraction ..3 Minor nose operations.-----------------------------------------2 Minor eye operations ----------------------------------------------2 Total ------------------------------------------------------89 Refractions .---------------------------------------------------96 REPORT OF OUT-PATIENT DEPARTMENT. Clinic. Total New Pay srivisits. cases. cases. Medical. 339 260 49 255 Surgical. 326 157 8 42 Eye and ear. 501 166 1 24 1,166 583 58 321 VACCINATIONS DURING MONTH. Number of adults vaccinated. 157 Number of."takes". 53 Number of schoolchildren vaccinated. 15 Number of"takes". 8 MONTHLY REPORT OF BOARD OF HEALTH LABORATORY. BaAteriological examinations of: Blood cultures (1 B. coli; 1 staphylococcus albus; 2 staphylococcus aureus; 5 B. typhosus; 1 streptococcus). 33 Throat cultures (34 positive for B. diphtheria; 14 positive repeaters),. 213 Stools .2. .29 Urine (9 B. coli; 1 staphylococcus albus). 37 Sputum (7 positive for B. tuberculosis). 32 Fluid from gall-bladder. Mouth smears.1 Smears, gonococcus (eye, 2; vagina, 2). 4 Cultures from glands. 3 Eye cultures .----------------1 Cultures from autopsies. -1 Spinal fluids. .2 Kneefluid:.----1 Milk from Corozal Hospital farm dairy -----------------------------31 Dairy milk from health office, Panama. 5 Leprosy, suspects for (positive 1).-. 2

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49 TABLE XIII.-ANCON HOSPITAL-Continued. Chemical examination of: Mothers' milk.,. .2 Dairy milk from Corozal farm. .2 Dairy milk from Panama. 4 Urine.--------. 35 Water for salt determination. 1 Crab killer. 1 Beverage (for street vending). 1 Disinfe.tant, carbolic. 1 Crushed strawberries. 1 Butterine. 1 Spinal fluidsAmmonium sulphate test. -. 35 Phenfl solution test-.:. 37 Colloidal gold test .37 Pathological tissues prepared, paraffin.-415 Autopsies performed. .30 Tissues reported, surgical. 42 Autopsies, animal, performed (hogs, 13; opossums, 4; dogs, 3; calves, 3; pigeons, 2; guinea pigs, 2; horses, 1; mules, 1; monkey, marmoset, 1; chicken, 1). .31 Plaental films. ...22 Cattle-blood films. 20 Dog-blood films. 10 Horse-blood films. 7 Goat-blood films. 1 Guinea-pig films. ..4 Monkey-blood films. 1 Rats examined (Mus musculus, 1,268; Mus norvegicus, 510; Mus alexandrinus, 48; Nfus rattus, 316). 2,142 Undertaker: Bodies embalmed. 5 Interments at Corozal.-.-. 10 Shipped to the United States. 5 Takento Panama. .7 Shipped to Colon. ..3 Shipped to Paraiso. 1 Cremations. .26 General: 04 Wassermann reactions. 1,162 Agglutination reactions (2 positive with B. typhosus). 5 Autogenous vaccines prepared. 5 Antityphoid vaccine administered. 7 Smallpox vaccine points manufactured. 1,050 Toxicological examinations. 1 Thermometers calibrated. .22 Dark-field examinations. .1 COROZAL HOSPITAL.-STATEMENT OF COMMITMENTS, DIsCHARGES, AND DEATHS. COMMITMENTS. Male. Female. From Canal Zone, first admission. 5 3 From Panama Government, first admission. 3 1 From Panama Government, third admission. 1 Total. 9 4

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50 TABLE XIII.-ANCON HOSPITAL-Continued. DISCHARGES. Well. Improved. Unimproved. Male. Female. Male. Female. Male. Female. Barbados. .1 Jamaica. .26 22 1 Trinidad. .1. ... United States of America. ..22.2-------2. Total. 1 .8 2 2 1 I Transferred to Ancon Hospital for surgical treatment. 2 Three cases deported to United States of America and 8 to Jamaica. No deaths during month. TABLE XIV.--COLON HOSPITAL. REPORT OF DAYS LOST IN HOSPITAL. AmerForClass. ler ForBlack. Total. ican. eign. Panama Canal employees. 146 44 256 446 Panama railroad employees. 54 50 350 454 Panama Government pay patients. .1 50 51 Soldiers. 142 ..i. 142 Other pay patients. 255 211 133 599 Charity patients. 43 28 6 77 640 334 795 1,769 LABORATORY REPORT. Blood examinations. 248 Estivoautumnal. 34 Tertian. 8 Red blood counts. 3 White blood counts. 25 Differential counts. 6 Hem oglobin. 8 Stool examinations. 145 Ameba. 1 Uncinaria (ova). 5 Cilated monads. 10 Strongyloides. 8 Blood. 4 Pus. 16 Urine examinations. 335 Albumen. 47 Casts. 21 Red blood cells. 8 Pus cells. 88 Sputum examinations. .45 Positive for tubercle bacilli. 6 Smear examinations. -16 Positive for gonococci. 5 Autopsies. 8

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51 TABLE XIV.-COLON HOSPITAL-Continued. SURGICAL OPERATIONS. Amputations: Digits, multiple.-. 2 Adenectomy: Inguinal, single. .1 Herniotomy: Inguinal, single. 8 Inguinal, double. 1 Genito-urinary tract: Varicocele, radical cure. 1 Hydrocele, single, radical cure. I Curettage uteri. .4 Perineoplasty. 1 Trachelorrhaphy. 1 Rectum: Hemorrhoids, radical cure. 4 Laparotom : Appen ectomy. 3 Salpingo-oophorectomy. 1 Minor operations, various-. 8 Minor operations, various (dispensary). 176 Normal deliveries. 3 TABLE XV.-SANTO TOMAS HOSPITAL. RemainAdDisRemainAsg~ 1 mitted. charged. mg Aug. 1. Aug. 31. Pay patients. 34 89 5 91 27 Charity patients. 410 792 71 715 416 Total. 444 881 76 806 443 Americans. Other nations. Number Class. treated. White. Black. White. Black. Pay patients. 123 ..48 75 Charity patients. 1,202 9 .144 1,049 Total. 1,325 9 .192 1,124 Number of days relief furnished patients. 14,173 Average number of patients constantly sick. .....457 Average number of days treatment for each patient admitted. 10 Cost of subsistence per patient per day. $0.56 DISPENSARY REPORT. Class. White. Black. Total. Natives treated. 35 742 777 Foreigners treated. 42 314 356 Total. 77 1,056 1,133

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52 DISEASES TREATED. Typhoid fever. ......----------------------------------------------I Malarial.-----------------------------------------------------43 Scarlet fever..-----------------------------------------------2 Diphtheria and croup .........--------------------------------------------4 Influenza----. .----------------.-------------------.--------------15 Dysentery.-.-------------------.-----.-----------.------------------6 Erysipelas. ............-----------------------------------------------------1 Leprosy. .........------------------------------------------------------Other epidemic diseases-. --------------------------------------2 Purulent infection and septicemia ------------------------------. 6 Beriberi-.---------------------------------------. 2 Tuberculosis of the lungs ----------------------------------------------10 Abdominal tuberculosis. .......-------------------------------------------I Syphilis.-.-.----------------.-----------------------------------45 Soft chancre. ...........---------------------------------------------------15 Gonococcus infection. ......------------------------------------------.-44 Cancer and other malignant tumors of the female genital organs -----------3 Cancer and other malignant tumors of other organs and.of organs not specified. 1 Other tumors. ...........--------------------------------------------------2 Acute articular rheumatism----.--------------------------------. .7 Anemia, chlorosis --------.--. ..--------.----------------.-------5 Other general diseases. .......--------------------------------------------1 Alcoholism, acute or chronic. ......---------------------------------------10 Other forms of mental alienation ------------------------------------.5 Epilepsy. ...........------------------------------------------------------I Neuralgia and neuritis. .........--------------------------------------------3 Other diseases of the nervous system. ....---------------------------------4 Other diseases of the eyes and annexa ......--------------------------------12 Diseases of the ears.--------------------.-----------.--------------. .-.2 Organic diseases of the heart. ....---------------------------------------15 Diseases of the arteries. ..-------------------------------------------10 D iseases of the veins..4 Diseases of the lymphatic system. .......-----------------------------------15 Hemorrhage, other diseases of the circulatory system ..---------------------2 Diseases of the nasal fosse. .......-----------------------------------------2 Chronic bronchitis. ...........----------------------------------------------10 Broncho-pneumonia. ........------------.----------------------------------1 Pneumonia. ............----------------------------------------------------4 Pleurisy. .........----------------------------------------------------------4 Asthma. ............-------------------------------------------------------1 Diseases of the teeth and gums ----------------------------------. 1 Other diseases of the mouth and annexa. ....-------------------------------1 Diseases of the pharvnx. 17 Diarrhea and enteritis. .........-------------------------------------------12 Diarrhea and enteritis (2 years and over). ....------------------------------14 Ankylostomiasis.-------------------------------------------. .67 Intestinal parasites-------........--------------------------------------8 Appendicitis and typhlitis. ........-----------------------------------------5 Hernias, intestinal obstructions. ...------------------------.-------------9 Diseases of the anus and fecal fistula. .....---------------------------------3 Other diseases of the intestines. ..--------------------------------------5 Cirrhosis of the liver----------------------. 2 Other diseases of the liver. ........-----------------------------------------4 Bright's disease (chronic nephritis)----------. 11 Diseases of he bladder. ........-------------------------------------------2 Diseases of Ihe urethra-----.......--------------------------------------7 Nonvenereal diseases of the male genital organs. 4 Uterine tum or. ...........--------------------------------------------------2 Metritis-----------------. 10 Salpingitis and other diseases of the female genital organs .----------6 Nonpuerperal diseases of the breast-------. 2 Norm al labor. 76 Accidents of pregnancy.w. 19 Puerperal septicemia.a.1 Furuncle .1 Acute abscess. ..........--------------------------------------------------5 Other diseases of the skin and annexa. ---------------------------------34 Diseases of the bones. 5

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53 Diseases of the joints. 1 Congenital malformation. .5 Nurslings discharged from the hospital without disease. 71 Other acute poisonings. 2 Burns. 3 Tratmatism by firearms .2 Traumatism by cutting or piercing instruments. 8 Traumatism by other crushing. 2 Excessive cold. 2 Dislocations. 2 Fractures. 9 Other external violence. 19 Ill-defined organic disease. 1 Disease not specified or ill defined. 2 No disease. .22 Total discharges during month. 806 Deaths occurring among patients during month. 76 Patients remaining in hospital at end of month. 443 Total number of patients treated during the month. 1,325 SURGICAL OPERATIONS. Adenectomy, inguinal, single. 6 Herniatomy, inguinal, single. 6 Herniotomy, ventral. 2 Herniotomy, strangulated. 1 Urethrotomy, internal. 3 Hydrocele, double, radical cure. 2 Curettage uteri. 10 Vaginal section. 3 Circumcisions. 10 Hemorrhoids, radical cure. 7 Fistula in anus, excision of. 1 Tonsillectomy. .6 Adenoidectomy. 2 Skin graft. 11 Appendectomy. 10 Colostom y. 1 Splenectomy. 1 Supravaginal hysterectomy. 2 Salpingectomy, single. 2 Salpingectomy, double. 2 Salpingo-oophorectomy. 1 Suspensio-uteri. 6 Major operations, various other. 8 Minor operations. .43 Total. 146 LABORATORY REPORT. Urine examinations. 670 Albumen. 182 Hyaline casts. .36 Granular casts. 30 Mucus and pus. 75 Blood. 13 Egithelium cells. 22 osphate .5 Sugar. 9 Stool examinations. 1,018 Uncinaria. 142 Strongyloides. 14 T.dispar .17 Ascarides --.--. 40 Ciliated monads. 4 Mucus and pus. 5 Blood. .5

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54 Sputum examinations. 102 Positive for tubercle bacilla. 35 Blood examinations. .215 Malaria. -1 Tertian. 9 Estivo-autumnal. 21 White blood counts. 13 Differential counts. 1 Wassermann reactions. 212 Positive. .72 Throat cultures. 21 Positive for diphtheria. 3 Smears examined. 8 Positive for gonococci.#. 1 Positive for leprosy. 1 Blood cultures. 2 W idals reactions. 4 Surgical tissues. 8 Surgical tissues, post-mortem. 80 Autopsies performed. 73 TABLE XVI.-SANITATION. Work requests on supply department: Grass cutting. 18 Screening. 8 Miscellaneous. 4 Work requests on municipal engineering department .1 Work requests on other departments. 4 Pit closets inspected. 531 Buildings inspected: For screening .1. 4039 For m osquitoes. 3,046 For general sanitation. 1,410 For safety. 1 Stores inspected. 24 Restaurants inspected. 14 Shops inspected. 60 Garbage cans emptied. 3,324 Closets disinfected. 544 Houses disinfected. 16 Rat traps in use. 419 Number of rats destroyed. 694 Number of mosquitoes destroyed in dwellings: Anopheles.2, 285 Stegomyia. 75 Culex. 5,140 Culex and mansonia. 833 Number of containers with stegomyia larve found. 3 Material expended: Larvacide, gallons. 215 Crude oil, gallons. ;. 8,504 Kerosene, gallons. 618 REPORT OF ROUTINE WORK DONE BY HEALTH OFFICE, PANAMA. Linear yards of ditches maintained during the month. 134,'601 Acres of vegetation removed. 103.88 Number of cubic yards of garbage removed during the month. 10,528 Square yards of streets cleaned. 600,000 Square yards of pools oiled. 333,880 Number of rats destroyed during the month. 1, 086 Number of wat er containers treated. .7,575 Number of mosquito breeding places destroyed during month. 276 Number of fly-breeding places destroyed during month. 58 Number of notices served to abate nuisances. 300 Number of private properties cleaned during month.-. 17 Number of convictions or fines imposed for violations of the sanitary regulations. 16

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55 TABLE XVI.-SANITATION-Continued. Food inspection: Dairies, milk vendors, etc. 22 Bottling works, etc.-. 1 Hotels, clubs, restaurants, etc. 23 Miscellaneous .235 Inspection of buildings: Number of buildings inspected. 3,783 Plans f or new buildings approved. 3 Permits issued to repair old buildings. ..------------------------------99 Buildings condemned. 6 Buildings demolished. 2 Houses disinfected or fumigated. .23 Materials used during the month: Crude oil, gallons. 5,495 Larvacide, gallons. .......---------------------------------------------525 Kerosene.-.----------------------. 300 Number of vaccinations made during the month.-.-. 369 MONTHLY WORK REPORT FOR COLON-CRISTOBAL-MOUNT HOPE. SanitationColonCristobal: Square yards street cleaned. 4,200,552 Square yards alleys maintained.-. 702,000 Number of private properties cleaned. .----------------------------5,239 Number of rats caught. 688 Loads of yard garbage disposed of. 582 Number of cans garbage (cubic yards, 2,883). 69,458 Linear yards ditches constructed (cubic yards, 710)------------------476 Line yards of ditches maintained. 1, 687 Acres of vegetation removed Panama R. R. reservation, Colon-swamp. 30 Acres of vegetation removed, Panama R. R. reservation, Cristobal. .10 Acres of vegetation removed, quarantine station .3 Square yards oiled .-. 140,350 Number of receptacles treated.-. 97,500 Number of buildings inspected. 10,801 Number of gallons of larvacide used in Colon. 184.6 Number of gallons of crude oil used in Colon. 750 Number of nuisances abated-. 462 BuildingColon: Number of building plans approved. 4 Number of permits to occupy issued. 7 Number of permits to repair issued. 49 Number of bills collected. 156 SewersColon: Number of new connections made during the month. 5 Total number of connections made to date. 1,437 Number of houses on which additional connections were made.-. 1 Outstanding permits.-. 50 SanitationCristobal: Nuniber of cans garbage (cubic yards, 745). 14,445 Loads of yard garbage handled. 229 Square yards oiled.-. 5, 300 Number of receptacles treated. 6,100 Number of buildings inspected. 1,250 Number of nuisances abated. 58 Number of gallons larvacide used .-. .19 Number of gallons crude oil used. 250 Number of private properties cleaned. 10 SanitationMount Hope: Number of cans garbage (cubic yards, 180). 1,040 Square yards oiled. 152,000 Number of receptacles treated. 14, 900 Number of mosquito places destroyed. 60

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56 TABLE XVI.-SANITATION-Continued. Number of mosquitoes caught, 10,005AnopheCulex. les. Barracks. 1,265 380 Cars. 1,087 165 Mount Hope village. 1,187 98 Sub. shed. 196 34 P. R. I. B .3,072 99 S. M .Q .280 83 M .I. 1,790 269 8,877 1,128 Gallons of crude oil used. 1,763 Gallons of larvacide oil used. 70 Linear yards ditches maintained. 6, 490 Lineal yards ditches constructed (cubic yards, 804). 2 511 Square yards of vegetation removed. 137950 Number of burials during the month. 51 TABLE XVII.-CONSOLIDATED REPORT OF QUARANTINE TRANSACTIONS AT THE PORTS OF BALBOA-PANAMA AND COLON-CRISTOBAL. Number of vessels inspected and passed. 237 Number of vessels inspected and detained in quarantine. 11 Number of vessels inspected and transiting canal in quarantine. 8 Total number of vessels entered during the month. 256 Number of supplementary inspections of detained vessels. 100 Total number of inspections of vessels during month. 356 Number of vessels fumigated on arrival. 17 Number of vessels fumigated prior to departure. 2 19 Number of bills of health issued. 101 Number of bills of health viseed. 120 221 Number of crew inspected and passed. .13,013 Number of passengers inspected and passed. 11,561 Number of stowaways found on board incoming vessels. 2 Total number of persons inspected and passed on arrival. 24,576 Number of supplementary inspections of persons on detained vessels .1,131 Total number of persons inspected during the month. 25,707 Number of persons vaccinated at port on arrival. 425 Number of persons vaccinated at port of departure or en route. 518 Total number of persons vaccinated. 943 Number of persons detained at quarantine stations to complete period of incubation of yellow fever and bubonic plague. 330

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57 TABLE XVII.-CONSOLIDATED REPORT OF QUARANTINE TRANSACTIONS AT THE PORTS OF BALBOA-PANAMA AND COLON-CRISTOBAL-Continued. Number of persons detained on board vessels to complete period of incubation of yellow fever and bubonic plague. 1,635 Total number of persons detained in quarantine-.---. 1,965 Number of persons arriving from foreign ports: Cabin. ...........---------------------------------------------------713 Steerage. ........-------------------.------------------------------409 Number of persons arriving from coast towns in small launches and sailing 1122 craft. 1,539 Number of persons departing for coast towns in small launches and sailing craft---------------------------. 1,289 Number of persons in transit for Pacific ports, not passing through Canal .223 Number of persons in transit passing through Canal. 624 Number of persons in transit for Atlantic ports. 372 Number of immigrants rejected and deported. ..--------------------------32 IMMIGRATION REPORT FOR THE PORTS OF COLON-CRISTOBAL AND BALBOA-PANAMA. FromCabin. Steerage. United States. 468 8 Europe. 4 2 Cuba .14 20 Porto Rico. 10 4 Jamaica and West Indies (not shown above). 49 202 Costa Rica. 26 19 Bocas del Toro. 52 228 Central America----------------------------------------3. Colombia. 102 138 Venezuela---------------------------------------------4. Ecuador. 8 4 Peru. 12 4 Chile. 7 4 Asia. 6 4 765 637 1,402 M en. .768 Women .426 Children. 208 1,402 QUARANTINE TRANSACTIONS AT THE PORT OF BOCAS DEL TORO, PANAMA. Number of vessels inspected and passed. 21 Number of crew inspected and passed. 906 Number of passengers inspected and passed. 229 Number of passengers, transit, inspected and passed. 247 No quarantinable disease has appeared in this port, and the health conditions of port and surrounding territory continue good.

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58 TABLE XVII.-PERSONNEL REPORT. August, 1917. July, August, 1917. 1916'. Gold Silver Total Total Total emememememployees. ployees. ployees. ployees. ployees. Chief health office.4 4 3 5 Medical storehouse. 4 4 8 8 8 Quarantine division. 13 35 48 48 49 Health office, Panama. 14 140 154 149 163 Health office, Colon. 9 144 153 183184 Ancon Hospital. 121 222 343 333 1375 Colon Hospital. 21 27 48 46 40 Santo Tomas Hospital. 5 6 .6 Palo Seco Leper Asylum. 2 25 27 23 40 Zone sanitation. 6 136 142 133 139 Corozal Hospital and farm. 15 111 126 118 265 Dispensaries: Balboa. 6 3 9 10 8 Pedro Miguel. 2 2 4 4 4 Paraiso. 2 2 4 4 4 Gamboa.1 1 1 2 Gatun. 2 4 4 4 Totals. 227 853 1,080 1,073 1,096 'Includes Corozal Hospital. 2 Corozal farm only.

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