Citation
Report of the Health Department of the Panama Canal

Material Information

Title:
Report of the Health Department of the Panama Canal
Creator:
Canal Zone -- Health Dept
Isthmian Canal Commission (U.S.)
Place of Publication:
Washington, D.C.
Publisher:
U.S. G.P.O.
Creation Date:
October 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 )

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This item has the following downloads:


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INGEST IEID EPY2O0WUD_268BQ5 INGEST_TIME 2012-01-17T19:18:31Z PACKAGE AA00006091_00008
AGREEMENT_INFO ACCOUNT UF PROJECT UFDC
FILES



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A REPORT xa x OF THE ALTH DEPARTMENT OF' THE PANAMA CANAL FOR THE MONTH OF OCTOBER, 1917 II ALBERT E. TRUBY, Medical Corps, United States Army HJth Officer,. Balboa H*fht., Canal Zone + W-2 wA 4 P N4, WA ww -3m."!

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0nox x C ; ?A ; Ae 4++ Uu pt

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CONTENTS. Page. of triansmittaa. ...'. 5 Genea~reark.1. 5 ltlof employees. 5 ba of residents of the Canal Zone. 6 btof residentsof the city of Panama. 7 .,-of residents of the city of Colon. 7 dvIsion: Shospita. 8 Orozal ospitaL. 8 SBard of HatLa rary. .8 Cr7inic ward. 8 Hospital. ..8 SecoLeper Asylum. 9 o Tomas Hospital. ..9 ofSAnitation: Zone .10 5==. .11: ..12 tables: Table I. Admissions, deaths, and noneffective rates for employees; deaths of residents of Panama, Colon, and the Canal Zone. 14 IL Causes of deaths of infants by sex, color, age, and place of residence. 16 III. Deaths by nationality.,. 18 IV. Birth and infant mortality rates in the Canal Zone and the cities of Painama and Colon. 18 V. Causes of deaths of employees, arranged with reference to age and length of residence on Isthmus.:. 20 VL Causes of deaths of civil population (employees and nonemployees) and military, b sex color age, and residence. 24 VII. Discharges and deaths in the spitals of The Panama Canal 30 VIII. Consolidated hospital report. .42 IX. Consolidated dispensary report. Report of contagious diseases. 44 X. Employees constantly sick and noneffective rates per 1,000. 46 Number of days' treatment per admission, hospitals and quarters. 46 XL Deaths of white Americans connected with The Panama Canal. 47 XII. Financial statement.47 XII Ancon Hsital. 48 XIV. Colon Hospital .52 XV. Sauto Tomas Hospital. 53 XVL Sanitary work done in the Canal Zone, Panama, and Colon 57 gXI. qua'tn transactions. 57 II I Personnel report. .59 V, .I W.,'

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4:4 9; 4* Y* 4W4 44 7i 5 9

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LETTER OF TRANSMITTAL. THE PANAMA CANAL, CANAL ZONE, HEALTH DEPARTMENT, Balboa Heights, Canal Zone, November 10, 1917. .TER HARDING, governor of the Panama Canal, Balboa Heights, Canal-Zone. .have the honor to submit the following report of the operatio f the Health. Department for the month of October, 1917. Respectfully, ALB.ERT E. TRUBY, Chief Health Officer. GENERAL REMARKS. Th Lth of employees and nonemployees in the Canal Zone e terminal cities has continued good. cases of typhoid fever were admitted to hospitals, which do have had their origin on the S. S. Advance during the rNew York, Se'ptember 22 to October 2, 1917. These rsick when they arrived, or took sick within a few days 7. The ship was carefully inspected and all members of ward's department were examined to determine whether or o.hy were typhoid carriers; no carriers were found, but the dishfacilities of the ship are totally inadequate, and recomons have been made to correct this condition. ase of a quarantinable nature originated on or was brought mus during the month. VITAL STATISTICS. EMPLOYEES. Owing statistics are based upon the total number of names the pay rolls of The Pana.& Canal and the Panama Railroad Co. for the preceding month, which was 29,926. on. to hospitals and quarters numbered 1,098, a rate of .as compared with 382.15 for the preceding month, and 282.76 or orreaponding iionth of last year. aTntly noneffective 'Ate was 10.78, as compared with a .7. for e preceding month, and 8.16 for the corresponding lat year. -talty and mortaty rates are computed as equivalent annual per 1,0W. (5) 4 IWO 0 4.H' a;P -kv

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64 *V Deaths from all causes numberedi'6, of these14 w ease, giving a rate of 5.62 from disease alone, as comt-h rate of 7.28, for the preceding month, and 5.77 for theg month of last year. Diseases causing the highest admission rates to hospi order of their numerical importance, were; -(1) Veners (2) malaria, (3) diseases of4the nasal fossae, (4) influent ( bronchitis. These five diseases caused 31 per cent -of all to hospitals, venereal diseases alone causing i21 pe malaria 11 per cent of all admissions. The admission rate for malaria, hospitals and quarter as compared with 28.36 for the preceding month, and 1 1t corresponding month of last year. The constantly nn ei rate for malaria was 0.81, as compared with 0.74 for the d month, and 0.50 for the corresponding month of last year. By race: For disease only, the admission rate to hospitaad death rate for white employees were 318.45 and 7.77, re t as compared with 294.81 and 7.50 for the preceding m 359.63 and 5.29 for the corresponding month of last year. employees, for disease only, the admission rate to hopi death rate were 137.13 and 5.22, respectively, as cor d 127.68 and 7.25 for the preceding month, and 66.82 and corresponding month of last year. The constantly noneffective rates were 16.71 for white d for blacks. The admission rate to hospitals and quarters for malaria for white and 25.14 for colored employees, as compared for white and 25.81 for colored employees for the pre and 47.40 for white and 7.93 for colored employees for the corr ing month of last year. For American employees the admission rate to hospi disease only was 287.16, as compared with 255.38 for the month, and 319.32 for the corresponding month of last year. CANAL ZONE. The civilian population of the Canal Zone, based on census, taken as.of June 10-30, 1917, is 24,038. From tion 25 deaths occurred during the month, 23 of which disease, giving a rate of 11.48 from disease alone, as co 12.48 for the preceding month, and 9.66 for the correspon of last year. Of the deaths from disease, 61 per cent occurred amngh under 5 years of age as compared with 52 per cent for last Seventy-nine birihs were reported during the month rate of 39.44; of these births, 28 were white and 51 co Ten deaths-occurred among children under 1 year ofg w and 9 colored, giving an infant mortality rate, based onu of births reported for the month,. of 36 for white and 17r children, with a general average of 127 per 1,000 birth. Of the total births reported, 7 per cent were stillbirth.

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The op~uatimn of the city, as shown by the health department censusof Jue, 1917, is 61,369; in this population is included appimriatel8,00O employees of the Panama Canal. From this popilltin;17 deaths oqpurred during the month, 166 of which were from dieaegiving a rate of 32.46 from disease alone, as compared with 22.8 orthe preceding month, and 29.62 for the corresponding month ar .O te' total deaths from disease, 53 per cent occurred among chilrenunder 5 years of age, as compared with 50 per-cent for the Tepunicipal causes of death, as compared with last month, were SeptemOctober. ber. T oerulosis (various organs). 31 26 Dirreaand enteritis. 17 24 Pne 0inia (including bronclio and lobar). 7. 18 Tw hjundred aund fifty-five births were reported during the month, givinga rate of 49.86. Seventy-one deaths occurred among children under1 year of age, giving an infant mortality rate, based on the utharof births reported' for the month, of 278. he totg births reported, 7 per cent were stillbirths. COLON. Population of Colon, as shown by the Health Department eenuspf iune, 1917, is 26,078; in this population is included approxJnaey 7,000 employees of the Panama CanaL From this populatn,61 deaths occurred during the month, 58 of which were from disase gving a rate of 26.69 from disease alone, as compared with 31.9 fr te preceding month and 30.13 for the corresponding month oflat ear. Ofte 4otai deaths from disease, 53 per cent occurred among 'enunder 5 years of age, as compared with 37 per cent for the preedngmouth. Teprincipal causes of death, as compared with the preceding monthwere as follows: Se temOctobers (kemai bar andl bronAcha) .5 1i5 INA rgaiedieaesof hehert.IN ro~nchtis (cute N dhoi)*.

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-8 Fifty-three births were reported during the, rate of 24.39. Twenty-six deaths occurred among 1 year of age, giving an infant mortality rate, based ohb births reported for the month, of 491. Of theltotal births reported, 12 per cent were still DIVISION OF HOSPITALS. ANcON 'HOSPITAL. The average number of patients constantly in the 1p pp during the month was 508, as compared with 534 fo th month and 416 for the corresponding month of last year. length of stay in hospital for each employee admitted was.2 y Total admissions to hospital numbered 1,040, as against 1, r preceding month. Detailed statistics are shown under Tables VII, Viii,dX COROZAL HOSPITAL. The average number of insane patients cared for during the was 344, as compared with 356 for the preceding month for the corresponding month of last year. During October 12 patients were admitted, 3 died, discharged. Among the discharges are included 13 patient to the British West Indies and 3 to the United States. Detailed statistics are shown in Table XIII. BOARD OF HEALTH LABORATORY. A report of routine operations is shown under Table XIII CHRONIC WARD. The average number of chronic patients cared for d month was 31.84. Two patients were admitted to and charged from this ward during the month. COLON HOSPITAL. Fifty-five patients were constantly cared for in the los ing the month, as compared with the same number or thep e month and 38 for the corresponding month of last ye. admissions to the hospital during the month numbered against 192 for the preceding month and 146 for the month of last year. The average length of stay iii hospital for each employee was 8.51 days. Detailed statistics are shown under Tables V eta-i~~~ +Hson

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9 PALO SEcO LEPER ASYLUM. Th Yaerage number of patients constantly cared for during the was 67.67, as compared with 66.56 for the preceding month 677 for the corresponding month of last year. death occurred among the inmates during the month. SANTO TOMAS HOSPITAL. Oe thousand three hundred and eighty patients were treated SOctober, as compared with 1,256 for the preceding month 1,414 for the corresponding month of last year. The average y number of patients under treatment was 449, as compared 440 for the preceding month and 440 for the corresponding last year. four deaths occurred at the institution during the month, tuberculosis, (2) diarrhea and enteritis, and (3) organic d of the heart the chief causes in the order named. Dtiled statistics are shown under Table XV. DIVISION OF SANITATION. The following table shows the average monthly admission rate Mro alasa among employees to both hospitals and quarters for month of October, the percentages being based on the ratio of thnmber of adiissions from each district to the total number of ployees residing therein: Number of admissions Average Disti. Number of from monthly employees. malaria admission during rate. month. .--------------2,668 1 0.037 0-Oa.-------------------------1,151 1 .087 Miguel.---------------------------1,352 4 .296 ------.-. .-.-. -. .-. .995 4 .402 ofCaal. ..---------------------------367 1 .272 G ..-------1,136. -------------. .3,414 16 .469 ......----------7,115 9 .127 ..8,383 3 .036 .2, 427 21 .865 Jor month------------.2 .201 Toalfo m nt. .2 W92 60 .0 Employees engaged in pasture and jungle clearing, etc., outside of above saml2779-17--2. E.

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10 CANAL ZONE. Gatun district.-The inspections at Gatun have found tbis to be in excellent condition. The work of the district sani spectors at this place has always been satisfactory and has manif itself by a continual drop in the malarial rate in this district, Only two cases of malaria have been charged against this for the month of October. Pedro Miquel-Paraiso district.-In addition to sanitation in n about the cities of Pedro Miguel and Paraiso, this distri' incde sanitation at Gamboa; which covers cattle camps and supply -1. at various points, e. g. Juan Mina and Limon plantation, "J Chagres River, Caimito on. the Canal, and relocations of camps due to land clearing for the Supply Department; also, Cerro and LVrj on the west side of the canal, and the relocationof the West I cattle camp, which is to be moved to Coca Lea, and which will increase the distance which the sanitary inspector must travel to inspect these places. The chicken farm at Summit (New Culebra) has opened up an ,extensive sanitary problem at that point. Extensive anophele& breeding was found in all ditches and pools and in the swamp -n the east side of the Panama Railroad tracks, within 200 yards of the station, during the first week of the month. Since that time t district sanitary inspector hs done considerable work heip, clean ditches, establishing new ditches, etc. The amount of work required of the Health Department at Sumit can not be determined until the work now in progress is more advanced. A system of concrete drains about the chicken houes is being installed, which will have to be connected with a sanit drain ditch at a later date. Ancon-Corozal district.-This district covers sanitation at Mirafiores and a portion of Corozal, extending south aslfar as the Ourundu River along the old Corozal Road and along the new CorozaJ R from the Curundu to and including Ancon. The -portion of district between Corozal and Miraflores which is to be sanitated the Army is not definitely established. The Army mules horses increase the difficulty of mosquito control on account of th hoof prints which they leave in low and seepage areas. ThQ inn sive military training in progress at the present times makes it cult for the commanders to observe all the desired precautionsab the boundaries of these reservations. The hydraulic fills on the east and west side of the new r Road are nearly complete, but can not be completed at the p time on account of lack of funds and also on account of lack ai factory available material. Most of the material available present time consists of silt. Balboa district.-The Balboa district at present has no camps or distant points which require active sanitation. An tion was made at the site of an abandoned town at the mouth Matutela River. Anopheles albimanus were found, tw

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point. The ditches were cleaned out and thoroughly larvaThe distance from Balboa or other habitation is such thatSikely that malaria will be contracted from this point. 'Ins were also made at Farfan, where numerous Mansonia were found in the bushes. Nei work.-Seepage areas have been mapped out in various disr r interception ditches and the histallation of tile drains. T enforcement of instructions in regard to follow-up treatment rmalarial cases has been difficult on account of shifting gangs and ion of camps. A large proportion of the silver employees rk interlnittently, sometimes being idle for several days, which es the effect of the five-day suspension clause for failure to ply with instructions. PANAMA. A close investigation of all cases of malaria reported to the Panama ealth Office showed that most of these cases had been contracted de, our census limits. If the history given by the patient showed that such patient had, within two weeks, been living or ting in a section where little or no antimosquito work was being a such case was not charged to Panama. PITAL CASESS OF MALARIA FROM CIVILIAN POPULATION AND EMPLOYEES LIVING IN PANAMA DISTRICT. 1914 1915 1916 1917 y ..-.-. -. .-. -. 319 127 30 17 .e r A maninanary. .o.n.t.o-67 16 12 -c ..-123 68 19. 24 Api. .107 57 15 11 % y ..2. 194 50 9 14 un ..-. 137 50 11 22 I .179 71 30 10 A. .274 36 16 41 0. 168 21 27 21 S 0. 254 19 14 5 eprto Of cases of tuberculosis with subsequent investigations Of these eval many''insanitary conditions in tenement houses, which ae slowly but 'gradually being remedied. The death rate AUtis disease remains about the same. e increased infant mortality rate is due to the increased number ahs from gastro enteritis, the number of deaths from this cause neaxry double the number for the preceding month. The high of 'milk and its substitution by coarser foods is doubtless at the .*of these gastro intestinal diseases which cause so many deaths 1mhe poor people of the city. :. .Nm aNF

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12E COLON. Several cases of typhoid fever were reported during none, however, originating in this district. All of the passengers on the steamship Advance, which arrived October with the exception of one case which arrived here on the Advance August 5, 1917. All of the cases were sick when y or took sick within a few days after arrival.' Specimensw from every person connected with the steward's departmen steamship Advance. No carriers were found. A fill is being made at the quarantine and radio stati will greatly improve the sanitary conditions in this area. Several salt-water drains were installed in the swamp b Cristobal and G Street, Colon, during the month. Antimalarial work in the Mount Hope district is progress idly, and it is expected to eliminate every source of mosqd ing in this district shortly. During the first part of the month several inspections w in Colon and the swampy areas at Coco Sola and along Road. This was done in an effort to locate the source of anop breeding which is responsible for the high malarial rate at Colon d Cristobal. As a result it was found that extensive anopheles ing occurs in the swampy area which extends from Ameliana along Marguerita Road to within a few hundred yards f FortR dolph. This area has been divided up into what is known aa age areas, No. 1'and No. 2, and No. 3. Area No. 3 is oppositcluded in the area which is being filled for the naval aviationvation; No. 2 is a part of what it is expected that the Armys for aviation purposes; and No. 1, which begins at Amelana, which concerns Colon and Zone sanitation primarily And sb responsible for flights of anopheles into Mount Hope andAdc territory. It is proposed to flood this area with salt water bye of deep ditches connecting with the bay to eliminate breeding at this place. The swampy areas between Colon and 9ew Cristobal wern tigated on several occasions without demonstrating the pr anopheles or breeding of any mosquitoes with the exception culex. QUARANTINE DIVISION. The plague and yellow-fever situation along the wst t South America has remained about as usual. Condition'T ventura, Colombia, remain as previously reported. The work of the quarantine division as a whole for the this report has been slightly below the average. On the Atlantic side the repairs to cabin buildings and portion of the reservation to the rear of the present f dressing satisfactorily. No cases of anthrax were reported during the month.

PAGE 14

13 inspections at the slaughterhouse, Cristobal, for the as follows: department, ante and post mortem inspections: S.-.-.-.-.-.---.---.-.-.-.-.-.-. 1,586 ..------------. ..--------------------1,628 y department, quarantine inspections: ---. ............1,819 ------------. .----------------------1,164 tide interests, quarantine inspections: local. .------------. -.------159 goreign.------------------------------6 tine inspections by.the veterinarian under the health at Panaiha: Cattle, local ----------------------1, 253 of hides disinfected in 1:1,000 bichloride solution for -. .......----------------------------------4,386 supervising veterinarian and meat inspector reported for hy ber 13, relieving Veterinarian Casserly, who was transdt the supply department. veterinary inspection work at the slaughterhouse was conin the usual careful manner and included microscopic examif smears from the spleen of each animal slaughtered. DEPORTATIONS. en deportations were accomplished by the hospital authorid the month, of whom 8 were employees and 11 nonem,. all suffering from mental or other diseases excepting one .m'edeported because of injuries., I addition to the above, 24 deportations were effected by the tine authorities during the month. AA 7' m:

PAGE 15

14 TABLEI.-ADMISSIONS, DEATHS, AND NONEFFECTIVE RTE EMPLOYEES. Admitted to hosDeaths' pitals. f s. 04 October, 1917: .White. 4,635 136 123 13 4 3 1 2,40 74 Colored.25,290 379 289 90 12 11 1 7,63f52 .Total. 29,925 515 412 103 16 14 2 10,0 2.7 September, 1917: White.-.-.4,803 133 118 15 7 '4~ 2,501 38 -Colored.-.-.26,504 353 282 71 17 16 1 7,942p1 Total. -.31,307 486 400 86 24 19 5 10,9 .360 October, 1916: White.---. 4,538 151 136 15 4 2 2 2,126 8.3 Colored. 28,734 245 160 85 15 14 1 6,292 2Q2. Total. 33,272 .396 296 100 19 16 3 8,47 2 PROPORTIONATE NUMBERS .3 October, 1917: White. 4,635352.10318.45 33.65 10.36 7.77 2.59 Colored.25,290179.83137.13 42.70 5.69 5.22 .47. Total---------29,925206.52165.22 41.30 6. 42 5.62 80 September, 1917: White.--. 4,80332.29294.81 37.48 17.49 7.50 9.99 Colored.26,504159.82127.68 32.14 7.70 7.25 .45 Total----------31,307186.28153.32 32.96 9.20 7.28 1.92October, 1916: White. 4.4538399.29359.63 39.66 10.58 5.29 5.29 Colored.28,734 102.32 66.82 35.50 6.26 5.84 .42. Total .33,272142.82 106.76 36.06 6.85 5.77 1.081. 'Annual average per 1,000 employees. A -r

PAGE 16

15 S -.-DEATHS OF RESIDENTS OF THE CITIES OF PANAMA, COLON, AND THE CANAL ZONE. Deaths. Annual average per 1,000 population. Population. Total. Disease. External Total. Disease. External causes. causes. 13tobr, 1917: Panaia.-61, 369 167 166 1 32.65 32.46 .19 Co.on. 26,078 61 58 3 28.07 26.69 1.38 Uanal Zone .24,038 25 23 2 12.48 11.48 1.00 Total. 111,485 253 247 6 27.23 26.59 .64 epmbpr, 1917: 19: 61,369 123 117 624.05 22.88 1.17 Colon. 26,078 69 68 1 21.75 31.29 .46 CanalZone1 24,038 28 25 3 13.98 '12.48 1.50 otal. 111, 485 220 210 10 23.68 22.60 1.08 ber, 1916: .60,778 156 150 6 30.80 29.62 1.18 n.24,693 64 62 2 31.10 30.13 .97 Zone. 31,048 28 25 3 10.82 9.66 1.62 Total. .-116,519 248 237 11 95.54 24.41 1.13 J Excluding military forces. .j~iA

PAGE 17

16 TABLE II.-CAUSES OF DEAT HS 0F Sex. Coor. ________-1 Cause of death. e M. F. W. B. Malarial fever .2 .2 Tuberculosis of the lungs. 1 .1 Acute military tuberculosis.1 .1 Epilepsy. .1 .1 Convulsions of infants. 2 .1 1 2 Organic heart disease.1 I. I Acute bronchitis.-. 2 5 7 Chronic bronchitis.--------.-------------2 3 1 4. Broncho-pneumonia .-. 8 5 1 12 Pneumonia (unqualified) ------------------1 .1 Pneumonia, lobar--------..-------------3 1 .4 Empyema.-.-. Acute gastritis. ..--------------------------1 ..1-----Acute indigestion -.-. ..2 .2 Gastro enteritis. 14 13 4 23. Colitis. 4 4 .8 Hepatic congestion. .... A cute nephritis. .....-. .--. I Acute pyonephritis. .1 ..1 .Acute cystitis. .----------------------------1 .. Congenital malformations. 3 .1 2 .1 C Congenital debility, icterus, sclerema. 1 -.1. Premature birth .2 2 .4 a Congenital debility. 2 .2 1 Atrophy of infants .1 .. Malnutrition. 6 3 .9 Other causes peculiar to early infancy. 3 2 1 4 5 Undetermined. .1 .1 Total.56 51 11 96 16 Infant mortality rate, based on number of births reported for the month ( Percentage of deaths under 1 year of age to total deaths for month. 444

PAGE 18

404 17 P. if-COLOR, AGE, AND PLACE OF RESIDENCE. xU Age by months. Place of residence. 3-4 6-7 7-8 10-1111-12 Panama. Colon. Zone. Total. 1, .......2 ...1. ...1 ...:. ......................... -.1 ..1 .1 .......2 .2 ...1. ...1. .1 1 1. 1 1. 2 7 I .......5 4 3'. 2 ..1 2 .6 6 1 13 S. .......1. ..1 S1 ..-1.1. 1 1 3 .4 ...........1 ...1 ..23 4 .27 1 2 ........7 .8 ......1. .......1 ...1 ..1 ..1 ............... ......1 .......I. ..... ...3. .....1 ..4 1:. .........2 ..2 .............. 1 ..7 .2. ...3 2 1. ..........I 1 1 11 4 6 5 4 4 7 7 4 71 26 10 107 r year of age per 1,000 births). .278.43 490.57 126.58 276.49 .42 43 40 42 26779-17---3 A MA .A A MUM

PAGE 19

A:. Vft8 9t LIS Tt9 9( TU~ 19 9 Z W 1 TI I ____:9161 'aqfoo ALI p Top % "8III 9*9-2 19 99 sm z UOZ IMMC3) F ol88T 6 0 TOT 8LO9Z 11.100Mlc 9VWol 9z 9ZL 69C'119:u qtda J ~ ~ ~ ~ ~ ~ ~ 16 T*tC 8 8"t--------~Jq0I LL~ & 9C'19. ....WJ~ o *** 1 CC~***S ..a. A o~ul Wm9 1.9 1.C----------9 umvs pu qv *.etc. .. UNWF S7. j .--------MOI 1 **61T 911 9K 44 N. c. ..doIpn~ 6NL IKC.CC.t .* .w. ... "N 9J to~iuxuo so .1 -uli 00L1.60.1 Y :: .-J I ...1 ....Y Lo .......8. .. ..............

PAGE 20

19 A FANT MORTALITY RATES IN TIRE CANAL ZONE AND THE CITIES OF PANAMA AND COLON. Births. deaths among Death roynilachildren rates per Lions Feunder 1 1,00D M3le. Total. year of births. age. 61,369 125 130 255 71 278.43 .26,078 27 26 53 26 490.57 nZne. 24,033 so 29 79 10 126.58 TotaL. 111,485 202 185 387 107 276.49 17:I .61,3"9 -137 114 251 44 175.30 Coo. 26, 078 44 45 89% 18 202.25 Zone. 24,038 37 24 61 11 180.33 ..111,485 218 183 401 -3 .182.01 16; .6,778 103 108 211 54 2&5.92 QA 24-,693 19 35 54 20 3W0.37 One31,048 22 24 46 6 130.43 ...116,519 144 167 311 80 257.23 A INFANT WELFARE WORK-PANAMA CITY. T ntnber of babies seen. 348 lmu ts given to mothers, total cases ..175 Treames given to babies. 60 los taken. ..3 Exaintions made*. 348 Outside ork: Tia uber of visits made. ..1,556 of cares not located ..35 Uberocasesmoved to Colon or elsewhere. 58 o breast-fed babies. .219 of bottle-fed babies. ...27 1ube.r of breast and bottle fed babies. ..82 of babies fed on soft food. 0 .*. 0 5 of babies seen, total. .1,g04 of cases admitted to hospital. .11 berof cases treated at Santo Tomas rispensary. 40 reof cases treated by physician at station. 37 e nditions found: Skin -,. ..; .....15 .....3 Ndni elbbIes dMed .b.c.p. 9 Mo*o o00**** S.S AI 0A EphA.

PAGE 21

20 TABLE V.-CAUSES OF DEATHS OF EMPLOYEES, A A Color. Age (in years). Cause of dea. W. B. 21-25263 31-35 36-40 4"-5665Brain, softening ef. 1 ...... Heart, organic diseases of. .4 2 .... Liver, amebie abs,.ess of. ...1-. .1 .. Liver, cirrhosis of. .... Nephritis, aeute. I ...... Nephritis, chrome.1 1 ... Prostate gland, hypertrophy of. 1 ... Pneumonia, lobar. .1. ...1 Septicemia .1 1 .... Tuberculosis, disseminated1. .I 1 Traumatism by machines. 1 ..... Other external violence. .1 1 .. Total. H AS AMC CE 44 r

PAGE 22

21 A NCE TO AGE AND LENGTH OF RESIDENCE ON ISTHMUS. length of residence on Isthmus (in years). A Tctal. -1 1-2 2-3 3-4 4-5 5-6 6-7 7-8 8-10 10-1212-15 +15 S. .......... ..1.11 4 ......... a ......... m 1 .....2.2 ... S ....1 ,. ...........1 1 .... ..1. 1 1 11 .1 21 .1 1 .3 3 3 16 4 ffm

PAGE 23

22 TABLE V-A.-DEATHS O NONRESIDENTS.' Residence. ait Color. Sex. Ag. Ca y. Bayano, Republic of Colombia. Black. Male. 40 Acute Panama. .uJois. Interior of Panama. Panama. .do. .do. 4 Esti larna. Cameron, Republic of Martinique .do.do. 26 Traun iny Panama. arms. Cartagena, Colombia. France. White. Female. 56 Atrophy J n" U.S.S.Gen. Hodges. Spain. .do. Male. 21 Pulm Paja, Republic of Colombia .Black. .do. 44 De. Panama. Interior of Panama. Panama. .do. .do. 40 Chronip Bocas del Toro, ReColombia ..do. .do. 47 Pul public of Panama. losAs Interior of Panama. Spain. White. .do. 19 Aeuty David, Republic of. Panama. .do. .do. -21 Pulmonary be Panama. Pala, Republi -of Jamaica. Black. .do. 62 Organic anama. the heart. I Deaths of nonresidents are not included in the statistical charts relag h Canal Zone or the cities of Panama and Colon. 4; M U

PAGE 24

44 *4 44 *a 4* * J4 1 ** A V** &i s;4++ + + .:, q x + + + ++ * * ;o

PAGE 25

24 TABLE VI.-CAUSES OF DEATHS OF CIVIL POPULATION L Sex. Color. Aga(n Cause of death. M. F.W. B. Y. 1 yer. 1 General diseases. Malaria. 1 1 Malarialfeverestivo-autumnal. 2 1 2 1 .1 Pyenia.1 .M.1. Septice a. 1 ..I .. Tetanus.1 .1 .1 .-. Pellagra.1. 1. .. Beriberi. .1 .1. Tuberculosis of the lungs. 16 10 2 23 1 1 Acute miliary tuberculosis. 3 .3 .1 2 Tuberculous meningitis. 2 4. 3-.-. 3 Pott's disease.1. .1-.-. ]Disseminated tuberculosis. .1 1 .2 .f. Syphilis, hereditary. .1 .1 .. Cancer and other malignant tumors of the stomach and liver. 1. Cancer and other malignant tumors of the female genital organs. .4 1 3 Other general diseases. .1 .1 Alcoholism (acute or chronic). 1 .1 Diseases of the nervous system and of the organs of special sense. Encephalitis. .. Simple meningitis.1 1. Locomotor ataxia. .1 1 Other diseases of the spinal cord. .1 1 Cerebral hemorrhage, apoplexy. 1 2 .3 Softening of the brai.1 1 Paralysis without specified cause. 1 2. General paralysis of the insane. ..1. Other forms of mental alienation. 1 ..1 Epilepsy.1 1 .. Convulsions of infants (udder 5 years of age). 2 .1 1. Chorea. 1 .1 .. Diseases of the circulatory system. Pericarditis.2. .2. Organic diseases of the heart. 11 7 1 17 Aneurysmn .1.1. Diseases of the respiratory system. Acute bronchitis. 4 6 .10 7 Chronic bronchitis .3 3 1 5 Broncho-pneumonia. 11 1 21. 13 Pneumonia (unqualified). 2.1 i 1 Lobar pneumonia. 6 6 2 10 .-4 Empyema. .1 1 .1 Pulmonary emphysema. 1. .1 1

PAGE 26

4V 0 0E8) A MILITARYr BY REX, COLOR, AGE, AND Ago (In years)-ContInued. Place of residence. Total. 21-G 31-40 41-50 51-60 61-75 76-100 Panama. Colon. ...1 1 .1 2 3 1 ..1 .1 S ......1 1 .....1 asC-.1 1.1 7 12 .1. ..20 4 2 26 ......2. 1 3 .,. 3 .3 1 .....1 1.1 1 2 ......1. .1 S .4 ..4 S. ...1 .1 .. ec, e. 1. .1 .c. .1 .e e. .e. ...1 ..I .....1 .I ....1 .-1 ..1 w ..... 1 .P. 1 1 ..-..-. .... .....* .. ~e, ca. 1 ..C. ..........1 .-. .e. .e. 1 .. -----. ..-.....o v wo .....3 .......1 w. ..w. *, e e~c. e .c. ...1 e .1 I e ........... o e ....-7 1 I c. a. .......e. ...6 e. 6 ,, .,eee o ., ..e. 12 .2 23 ..ow w p ...1 --e 1 2 1 41 .,. 1 5 > 7 .12 * ~e ,.e S.e .e. .e.e. I .e. ..1 .e.e I ....e. I p. .1 --AAXA w T *.**wo

PAGE 27

AA TABLK MVL-CAiJ8E8 OF DEATHSS O0IVIL PGPULATI Cause of death. M. .r .B. Y. 1 yowV -i Diseases of the digestive system. Acute gastritis. ... Acute indigestion. 2 Tiarrhea and enteritis (under 2 years). 13 15 4 23 1 27 Colitis. 4 7 .11 Colitis (2 yearsand over).-. 1 Cirrhosis of the liver.-2 1 .3 .. Other diseases of the liver. 1 ..I Abscess of the liver entamebic. 1 ... Simple peritonitis (nonpuerperal). 2 ... Nonvenereal diseases of the genito-urinary system and annexa. Acute nephritis. .2 4 1 4 1 1 Chronic nephritis (Bright's disease). 6 4 3 7 ..2 Pyelo-nephrosis. 2 ..2 .a. Cystitis.1 1 .2 .1 Hypertrophy of prostate .1 ..I ... The puer peral state. Puerperal albuminaria and convulsions. .I .I ...,. Diseases of the skin and of the cellular tissue. Phlegmon and cellulitis. .....0 Malformations. ,Congenital malformations (stillbirth not included). 3 .1 23 Diseases of early infancy. Congenitaldebility,icterusandselerema. I .1 ..1 Premature birth. .2 2 4 .-4 Congenital debility. .2 .2 Atrophy of infants .1.1 Malnutrition. 9 Other causes peculiar to early infancy. 3 -2 1 4 Old age. Senility .2. Affections produced by external causes. Traumatisth by fall. 1 2 Traumatism by inachines. ..... Homicide by cutting or piercing instrunzats. ..1 ---1. ., :.-*Otherexternal violence. ...ANN

PAGE 28

27 Y AND MILITARY, BY SRX, COLOR, AGE, AND .A) Place ao residence. Total. -1-0 41-0 6-es 81-75 76-100 Panama. Colon. Canal Zone. ............. 1 .1 2 -24 4 .28 .....-9 2 2. ............... ..1 .......2 ..2 3 1 1. 3 3 -.1 2 2 1 1 3 3 4 10 ...2. 1 .2 2. .......1 1. .1. .2 ..1 1 3 ..1. .2 ----. -.-.-------. .-. ....1 ........ .---------.---.-.-. ... .-....1 1 3 ........... ...... -........2 .... "J .............. k> N IMF. I

PAGE 29

TVAWX Vl-CAUSES OF DEAT H8. 0701VIL 2P1OPULA 8ex. Color. Ag(nyar Cause of deal. f. F. W. B;Y.9 y Ckmuesof deatd not specified or iM-definea. 'Causeof doat'h not specified "rII-dened. .2. .1. -0 V Total. ..134 119 33 215 St~bith. 15 18I 5 2$ .. Grand total. 149 137 40 24.3 5 OT iTwo age unknown. .; 4 AF** ,~ *L %AK

PAGE 30

DP E AND ILITARY,-BY SEX, COLOR, AGE, AND A (n years)-Continud. Place of residence, Total. canal 31-40 41,) 51-0 61-75 78-D00 PanaM. Co Can I ...1 .1 2 35 '25 15 10 '8 167 81 25 253 "'o' *.e.-j .*wo. .s2D 7, 6 33 mh25 35 25 15 10 8 187 68 31 286 44 4 4 44 44 I A A4* X 4 x 4 4A 4 .4444.4 ..w. ;p 4> 4 4 4 mm 4444 44 44 44 ?W 4 4o .4. 'A m 2 7 44 m .4 4 44444 4444444 44 4 m mu 44 .4 mm 44444 #4~ mp4. x4

PAGE 31

TAUXa VXI---D1SCIU ARGE N3D AA White. Diseases, "M. Fe IO I.M. F. V. General diseawe. T~hl fever.'. ... typhoid bacillus carrier (suspected) .a. Relapsing fever, *. ....e .a.a.aa Malalia:A Malarfalfever, Estivoautumnal. 7 .2 .47 .4. .... Malarial fever, ertan ..2 .8 .... Malarial fever, Quartan ...1 ..... Ifaarll fe, undetermined. i.ta.2. .a Malathrial afdvcru.~ ... Measles ..a. ....a. Dephtheria .r.p. .... Chicken ...3 Dysentery, Entamebi. ...A Detnu. ... Chicken ox. ..a. 3 ..: Mumps. .....2 ... Septicemia. .....A Tetan. .a. a. .eat Beriber s. ....a Tuberculosis of the lungs. .... Acute military tuberculosis .... Tuberculosis of bones and Joints. .... Tuberculosis of the s ain. ...a a Tuberculosis of the lymph glands. ..... Tuberculous Abscess ...a. ..2 ... Disseminated tuberculosis. ..2 ..... Syphilis, primary'. ....... Syhlis, secondary .....2. teriar ...1 .2 .27 Syphilis, hereditary ...... Syphilis, period not stated ......woo. a a .rte,. .3 et.a~ aa18 .a. Gonorrheal arthritis. ....1 Gonorrheal bubo ...1 .I Gonirrheal orchitis and epididynritis. .a. .t f chacre. ..10 Adeniltis charicoidala. ..tea 1 ., Cancer and other malignant tumors I of the stomach and liver. ..a lA .-American. IA Ino 7m r

PAGE 32

31 10T. TE PANIAMA CANAL. Nori ents. Deaths. Discharges. Deaths. WZ .-White. Blak. Black. White. Black. White. Black :944 00 .&TJOF A F. It. F., M. F. M. F. M. F. M. F. -.2 -.-. ....1 .........-7 IN. ..N ....2. .....a. .N, ON ...O*.2 1 ., 2 2 .............. '42. I ...........1 S .......----. -..1 *F at, ......ON., ON. 4 1 ...... 11 .9 2 3 ... ..........1 N *.2. ......N. 1 S.N ....-.. -1 ................1 1 ~~.1. ...w .-..., ...-. ..*. .. ... .............2 S. ..---2 ......m ..2 ....N.O. .-. ..1 2 .*. ..........-% .....O ..........-,. .............4 3 .1 .........., .......2 ..........2 3. 1 ..............2 S. I 5as *. .........4 .. >< ;N* *5 ....s0 ............ P. ., *rt Rica. h4 i4 IF ~ ~ ~ + i. NN N, ON. .w .-. A* .b

PAGE 33

Discharges. Dab Bl. # K Genier4 diseaaesCoOtInued. Aetnte artleular huatsi.a.atta.asa.aa Other general dse. a. .2 ....a. *. .a .e~ Parpura hemorrhaglca. ...........00 0 -CO Alcohollssm (acute or chronic). .......*. Disease, of the izenozD chstem gne of the orgawas of special sease. Bofteinig of th0,bralI,,. .aae. at. .....a.a 1 PSIaIysis WIthoUt Spcfed Cause., ........5 er ofrs mentall Wbito t 0 8y ..ea. .S ....... ye. .t. .1 .a a. .4 Other diseases of the nervous sysA .te .r.t.a .....a. Oa ... Diseases of the eyes and their anetxas. .f.a.e. ..*a .4 s. ..a. D)iseasea of the oars. .1 ...5. .a. .* Ot t Diseases oftlae circugat.ry apstem. Organte diseases f the heart. ....4 sass ... DIseases of the veins, (varices, hemorrhoids, phlebitis, tc.).e. mo. .0 .a. 1 .... a a.r ..............a a a .2 ..e sa ..........o t m Diseases of the lymphatic system. (Iyipagts etc.).s. ...2 .a. tat. 'ts(nonvenereal).1 .1 .4 ..a.~, ; other dise"#4 tiw circulatory system,. .e. a e. ....ew t. .. Disease, of p lye respirator system. Otderoid v fegetation alienatio. ma~a sass 00 .* 1 O a m a a m# Chorda~.e.e~e ...a ae e. .0mo eo .00 e. .m" Nerts.e.e. .a.' .'. Diseases of the thyesoid todir an'AM,.mAmr ioau. A* 7 m

PAGE 34

0A O TH "A AMA AN AL--Continued. SNnresdents &A ge Deatbs Discharges. Deaths. White. Black, Black. White. Black. White. Black. A I.0 o .. -.-. F M F M. P. M. F. M. F. M. P. a E-4 777 .. 7e a. ...........1: S .a. .....e. .ma .........12 *. SIM J .i. ................... .f. il .................... ..............., ... NO: 7 16 ..................a &m~akt io1 a .ts. ....................7 4S1 to~ m4.4.m ...4. ............. .3. 1 ............. ..i ...4 ...a. .....m ......2 .m 13 ...i ..om .....m. ...4 .a. ....4.1 1A kw. I -1 ................2 ."I .oa -............2 I .r .2 ...4. ..............18 .. 1 'A. L. ........a. ..U! a. o. s am a .m, t a w. .6

PAGE 35

Employes AA Discharges. Da White. ht Diseases. Su SBlack. B Dieeasea of the respiratoryj syat emContinued. .Acute bron chit.i. 3 .2 *. 3 .,.r. Chronic bronchitis.-I. ...** Bro nho--pneni.i.i ....* Pneumonia (unqualified). ..... Lobar pn eu m onia. ..3 .... Pleurisy. ...-1 ....* Asth.a. ..1 .. Other diseases of the respiratory system (tuberculosis excepted). ..1. Abscess of lungs. ..* Diseaew of the digestive aytem. Diseases of the mouth and anunexa. .... Diseases of the teeth and gwns. ...2 ..,a*,, Diseases of the pharynx. 1 ...1 ...., Foficaular tousiditis. 2 1 ..6 ...,, Foreign body in tihe esophagus. ..A. Ulcer of the stomnach.-. .1. .1. ... Other diseases of the stomach (cancer ex.pt.). .... Acute gastritis. -. ... Chronic stritis. .,. ... Acute indigestion. 1. ... (i0o1its.1. Diarrhea and enteritis (two years and over). 1. .2. .~ Colitis. ..1 .2 Ankylostomiasis. ..3 ... intestinal parasites. .. T.s .s. ....... TAnitais.i. ....1. cuten append1icitis. 1. ....0.1. ., IIngUikal Jiernia. 3f. ..8 .~. Other diseases of the iutestines. 2 ..7 .~. Constipation.'. ...1 1 ... Duodenal ulcer. ..1 ~. .. Cirrhosis of the liver. ...... Biliary calculi. .... Other diseases of the liver. ...... Clholecystitis. .1 .1 *. ... Simple peritonitis (nonpuerperal). ...-. ....44A44,

PAGE 36

A. Nonerploees.Nonresidents. Whl -White. Blak. ~ Black. White. Black. White. Black.t 'i .0 4o V.,, 1sm. m~s. F ..-..F .F K F I .. a~~m. .4=. ammm~~~~m. -.me-. .--~~-----------ma ----.--.-.-----. -.~---------.------"""E4--E .-4 *p ....' .. *eC ...e.a. ........... .......1 3 .....4 e,
PAGE 37

46 TABLE VL.-DISOHR&REK AND ) N White.Wit Diseases. 4 UBlacL %F. M. F. M. F. .ML )Thiweuereal diaeasea of the genito?rBUGTy Syltem and antnezg. Acute nepbritis. ..1 Brgtsdsae(hrncnpiii) 1 ..2 .1 Other diseases of the kidney and Movable kidniey.'. .......a .S 5 Pyeloneprs l. ..1 .... Calculi of the urinary' passages. Diseases of the bade. ..... Stricture of the urethra, nonvenere l. ....1 .2 .a. .. ~Abscess of the prostate. ....., ..., Hypertrophy of prstte. ........... Nonvenereal diseases of the male genital organs .2 ...... Hematocele .......e .a ...a Hydrocele.aa. .6 Uterine tumor (noneaneerous). .a. ...1 Other diseases of the Uterys. ..... amexai. ..... Cysts and other t.ors of the ovary. ..... yelephgeisa .g. .....4 W w* Nonpuerporal diseases of the breast (cancer excepted).a .... The puetpera tate. Nri.l ....I .a Extra-uterie pregnancy ....aa t. d or a b r ...0a. w a0a ". einatea ........ .Diueuaes of the iun aut? of the Cd.zaar tin7ue. F'rneile.a. .aa. a 2 ...2 ,.* ...*. Acute abscess.an. as. .4 ass. ..3 ... Phergion and cUIt aters. ......... 'MDeOD ith. ...... Uleer of the skin. ...... Hyermet4.

PAGE 38

TAS OF THE PANAMA CANAL-Continued. Nonemployees. Nonresidents. Discharges. Deaths. Discharges. Deaths. W~toWhite. Black. Black. White. Black. White. Black. S i.F. X. F. .M. F. M. F. M. F. M. F. X. F. M. F. 0 0 ............................... ...................23 ,.:woo W V .i. .2 ..............2 ........................7 2 ...2 .2 ..........7 2. ........w. .... 1 ........................ ...........8. .... K.F. ..'M .... ........... 1 ........................0. ..........7 2i. ............. ..... ...............4 .,. 1 a4 2 .6 ..............97 -a. ...1 L4 .1. 4 ..............20 2 2 .2. .....6 1 .............. 00W 4 ...0 ..............14 2.1. .... a~S,*. ......1 .* 9. w~ .2w. 4. 37 .......... A 5C3 .0 a. 0. ...6. 44w6 0.A4 1 -.1. ......7 a 1 ~ *s .a a. ........at ....*. ...., 1, 1 .*0 1 w wvs 2V 14,1 ** 1 Pm .-Pato Rican. S0 J-

PAGE 39

38 TABLE VIL-DISCUARGE8 AN ) DEAT Employee. Discharges. White.shie Diseases. Black. 040 M. F. M. F. M. F. M. F.M. F Diseases of the skin and of the cellular tissue-Continued. Impetigo contagiosa. .. Ingrowing nail. ... Other diseases of the skin and annexa .3 .... Diseases ofthe bones and ofthe organs of locomotion. Diseases of the bones (tubereulosis excepted). 3 ...3. Osteomyelitis. Periostitis .1. .. Diseases of the joints (tuberculosis and rhenmatism excepted) .1. Arthritis -. 2. A mputations.*. W Other diseases of the organs of locomotion. 3 .I .2.Malformations. Congenital malformations( stillbirth not included). ..... Diseases of early infancy. Newborn child. ....... Premature birth. ..... Malnutrition. .... A fections produced by external causes. Acute poisonings. .... Burns (conflagration excepted). ..... Traumatism by firearms. ...1 Traumatism by cutting or piercing instruments. ..1 6 .a Traumatism by fall. .12 Traumatism by machines. 2. 1 L-Amertan.

PAGE 40

Fa 39 OFTHE PANAMA CANAL-Contued. Nonmployces Nonresidents. Deaths. Discharges. Deaths. White. Black. Black. White. Black. White. Black. l. a F. Me X. F.M. F. M. F. M, F.X. F. M. F. A a 0-1* ...2 ......... O ..4 : .6. .........13 1q ..e. S ...........12 2j.& *,ua ..1. *. ..3* 55** 1 .M. ...............4 *. .......-.........2 .................1 .a. ..mK .................4 2 .a s 4 .......... .1-.10 3. ...0. .2. ...0. ...., .4 .0 M 1! .* .O. ...* .........w. .... 1 ...1 .............1. .. ..v ......e .0w. ...0 .a e. .wo.I .* *w .0. ...........M. o.w 4 P. .-Porte R2au. ..oo ** .* 00 .0 *& ..+

PAGE 41

4%f 402 TABLE VI.-DISCHARGES AND PEAT Employees. Discharges. .Deat.s White.Wht Diseases. Black CS A) M. F. M. F. M. F. If. F. F Affections produced by eternal cause-Continued. Traumatism by other crushings (vehicles, railroads, landslides, etc.) ...1 ..1 .... Railroad traumatism. ...1 .OR. Traumatism by landslides. ....1. Fractures (cause not specified). 1.6. Dislocations. ...2 Sprains. ..1 Other external violence. 2 .5 50 lI-dtfsid diseases. Infections of undetermined origin. 3 ...2 No disease. 2 .6 .. Grand total. 91 6 30 .352 3 1 1 A.= American. |s4 MI

PAGE 42

41 ALS OF THE PANAMA CANAL-Continued. Nonemployees. Nonresidents. DISx charges. Deaths. Discharges. Deaths. White. Black. g .Black. White. Black. White. Black. g K.' m a 5 0 0 agow 0 1d g M. F. X. F. M. F. M. F. M. F. M. F. .............................E. 2 ......................................4 .. 7,' '. 2 ..2 ...............................7 -2 .................................13 .. .....8 .4 ................................4 7F0 0 .7 85 167 92 14 10 27 2 2. .119345 2 P. R.=Poito Rican. */ SA +3

PAGE 43

42 7 TABLE ViII.---,CO1SOLIDATED HOSPITAL RE.ORT [Ak=White Americans; Fx=W1ite foreign; B=Blacks Remaining Admitted. Dd. Oct. 1. A. F. B. A. F. B. A. *4 ANCON HOSPITAL. Panama Canal employees .16 12 97 79 13 138 1 Panama R. R.employees. 6 10 96 8 13 161 1 Soldiers. 75 .201 .... Panama pay patients. ..--. Other pay patients. 34 31 96 11314 184 1 Charity patients. 6 9 50 3 z! I .E Total. 150 53 308 451 6 520 6 2 31 COROZAL HOSPITAL. Panama Canal employees. .1 6. 1 .... Panama R. R. employees. ..1. Soldiers. 3 ..2 .... Panama pay patients. 4 49 202 ..3. Other pay patients. .4 1. 3 Charity patients. .8 72 .. Total.,. 1.021S Toal. 76 8 2 .I0.3321 Grand total. 157 121 530 456J 530 62 3445: 7 COROZAL FARM (CRIPPLtS). Panama Canal employees. .9 52 ..2 CHRONIC WARD. Charity patients. .32. ..2 COLON HOSPITAL. Panama Canal employees. 3 2 6 S 4 31 .. Panama R. R. employees. 4 2 14 5 5 47. .4. Soldiers. .7 .. Panama pay patients. .1 2 1 4 6i. 1 Other pay patients. 10 9 5 40 15 24. Charity patients. 2 ..11 1 4I. Total. 19 14 27 73 23 113. 2 PALO SECO LEPER ASYLUM. Panama pay patients. .1 38. .1 Charity patients. .1 28 ... Total. .66 .. GRAND TOTAL* Panama Canal employees. 19 24 161 88 17,172 1. 71 Panama R. R. employees. 10 12 111 13 18 20 2 14 Soldiers .78 2j0 ..1 Panama pay patients. 4 51 242 1 4 9 .. Other pay patients. 44 44 102 153 55 211 1 IS Chary patients. 21 16 151 61 4 4 1. Total. 176 146 767 526 98 647 64 7

PAGE 44

43* VI.-CONBOLIDATED HOSPITAL UEPORT-Continued. Trans Remain-Average number constantly [erred. ng Octsk A F. B. A. F. B. A. F. B. Total. A HOSPITAL. Uanalemployees. ..1 21 14 88 15.42 10.87 93.67 119A.6 A .R.employees. ..3 6 12100 6.77 10.48 91.17 108.42 ...2 ..84.---87.19 ..87.19 n patients. ..-. .I. .. patients. .4 16 25 94 25. CO28.94 -97.29 152.13 ts. ..2 18 5 18 20.55 3.64 16.16 40.35 .2 10 f45 56300 155.831 53.93'238.2508.05 ~COOZAL HOSPITAL.I Canalemployees. ....1 4 .1.00 5.13 6.13 nm .R. employees. .....2 ..1.52 1.52 ....2 .1.55. 1.55 pay patients. .4 48168 4.00 48.26 199.35 251.61 pay patients. ..31 4 .3.0 3.20 7.10 C patirnts. ...8 63 .8.00 67.64 75.64 T ..6 60'2711 5.55 61.16 276.84' 343.55 .2 .10 151116 5711161.38 115.091575.13 851.60 FARM (CRIPPLES). I I r] al employees ....9 45. 9.00 49.26 58.26 CHRONIC WARD. patients. .2 ..32 ..31.84 31.84 COLON HOSPITAL. Canilemployees.1. 4 1 1 7 1.17 .88 6.62 8.67 R.R. employees. ..13 1 3 10 2.22 1.83 11.75 15.80 N. ...2. .2.57 ..2.57 pay patients. 1 1 4 .2 2 .06 .45 1.29 1.80 tients. 11 3 7 16 5 9 9.71 6.O6 5.74 22.41 ients. .2 1 3 2. 1 2.77 .45 .97 4.19 .lo 5 31 22 11 22 18.50 10.57 26.37 55. 44 SECO LEPER ASYLUM. patients. .1 37 .1.00 37.67 38.67 C. 1 28 .1.00' 28.00 23.00 S. 2 65 .2.00 65.67 67.67 NN, -IN NN: lf4 RK i N

PAGE 45

44 TABLE VIII.-CONSOLIDATED HOSPITAL REPORT TransRem Averagenumb: feared. g n w sit A. F. B. A. F. B. A. F. B. GRAND TOTAL. Panama Canal employees. 1 -5 22 25144 16.53 21.75 Panama R. R. employees. .16 7 15112 8.99 12.31 .44 12. Soldiers. 2. 88 91.31 ...-. Panama pay patients. 1 1 4 4 51237 4.06 49. 71;23$.41 2 Other pay patients. 11 3 11 32 33107 35.61 39.80 16.2 JAW. Charity patients. 2 1 7 20 14142 23.32 13.03 144.61 181. Total. 171 5 431731381742179.8813.6748.271,04. 1 Number of employees remaining in hospitals: White. Black.2. Total. .7* TABLE IX.--CONSOLIDATED DISPENSARY REPORT, EMPLOfEEs TREATED IN QUARTERS. ReAdmitDisTransRemaining ted Die. maining Dayslost. Oct. 1. chre.ire.Oct. 31. W. B. W. B. W. B. W. B. W. B. W. B. W. B. ToaI. Ancon. 81 2 .79 2 ..2. 179 2 :X Balboa. 8 .140 11 ..141 5 3 5 4 1 374 23 397 Pedro Miguel ..21 3 ..15 2 3 1 3 .31 9 4 Paraiso. .1 9 14 ..8 13 1 2 ..3 Gamboa. ....1 ..3 Gatun ...12 3 ..10 3 1 .437 Colon. 3 27 64 258 ..63 247 .4 38 159 1023 ,1 Total. 11 28 328 291 ..317 272 81 8 14 39 831 1097 1, ALL CASES TREATED BUT NOT EXCUSED. Employees. Nonemployees. TotalL. W. B. Total. W. B. Total. W. Ancon. 1,780 4,993 6,773 1,208 3,685 4,893 2,988 8,78 11, Balboa. 4,079 3,868 7,947 4,813 1, 456 6,269 8,892 5,34. Pedro Miguel. 1,370 1,933 3,303 1,345 682 2,027 2,715 2,f45 Paraiso. 752 2,701 3,453 699 1,032 1,731 1,451 3,733 ,1 Gamboa. 81 353 434 32 285 317 113 -638 Gatun. 163 1,122 1,285 383 821 1,204 546 1,94 Colon. 2,549 6,879 9,428 1,764 1,910 3,674 4,313 879 Total. 10, 10,244 -9,871 20,115 21, 18 31,720

PAGE 46

45A IX-A.-CONSGLIDATED ADMISSION REPORT. White. Black. Total. to hospitals, excluding Corozal farm and ----------.-.-. ..-. ..-.624 643 1,267 An employees to quarters.---.-. -328 291 619 oal admissions to hospitals and quarters. 952 934 1,886 Patients transferred between hosihospitals to quarters, whose admisduplicted in above fbgures. 30 49 79 issionstohospitals and quarters .922 885 1,807 EMPLOYEES. admitted to hospitals. 136 379 515 admitted to quarters. .-------------328 291 619 Total admissions of employees. .464 670 1,134 smnbedrtransferred between hospitals and from "'to quarters, whose admissions are dupliat injabovefigures.,-------------------------9 27 36 Net admissions of employees. .-455 643 1,098 average per thousand of admissions of emto hospitals and quarters. 1,177.99 305.10 440.30 IX-B--CONTAGIOUS AND INFECTIOUS DISEASES REPORTED -DURING THE MONTH. Panama. Colon. Canal NonTotal. Zone. resident. .4 ..2 6 D-------. .10 5 13 --------28 C OX. 2 1 -3 ..6 try ..1 2 --------3 infection. 22 59 1 82 ha ia-. ..-1. .1 ...1 1 .I., .5 15 65 4 89 .5 2 10 .17 tuberculous .-. 4 ..4 ..-2-1 8 ..11. Opfa~inneonatorin. ...1 Pel ....2 1 ....3 .16 11 5 1 33 r. 2.....-2 .1 10 16 1 28 .. Tis. 14 7 2 3 26 .1 1 1 2 5 ng ough.12 2 5 .19

PAGE 47

46A TABLE X.--NUMBER OF EMPLOYEES CONSTANTLY SICK H S PITALS AND QUARTERS. White. [Co re Hospitals: Ancon Hospital. -.-. 44.54 191.4 360 Colon Hospital. 6.10 18.37 4 Total--.-. -. -. 50.Oi 209.86 205 Quarters: A ncon ..-.5.77 .06 5 8 Balboa--. ..12.06 7. 40 .8 Paraiso....'. .1.00 .91 2 Pedro Miguel.-.-. -. 1.35 1.06 2.41 Gamboa-. .10...--(latun.--.------.---.6 Colon. ....................5.13 33.00 .1 T otal. ..26.7 .83 .1 Hospitals. Quarters Total. Average number of employees constantly sick: W hite-. ..-. 50.64 26.79 77.43 Black ...209.86 35.38 245.2 Total--.-. ..260.50 62.17 3 2 6 Average number of employees constantly sick per 1,000: W hite. ...................1 ..7 .7 Black. 14 97 Total.87 .007 TABLE X-A.-AVERAGE NUMBER OF DAYS IN HOSPITAL O QU TERS FOR EACH ADMISSION OF SICK EMPLOYEE. White. Black. Hospitals: Ancon Hospital. .----------------------------11.37 21.25 1. Coloni Hospital. -----------------------8.64 8.46 Quarters: Ancon.-------------------------------------2.18 1.00 Balboa-----------. .------------------------2.77 2.1%. Paraiso. ..-. .1.00 4.019 Paraso---------------------------------17 .0 Pedro Miguel. .-----------------------------4.66 2.33. Gamboa .------------------------------------. .0 Gatun. .-----------------------3.91 23 Colon -.--------------------------------------2.64 .9 M M

PAGE 48

47 -DEAVIH RATES AMONG AMERICANS ON THE ISTHMUS CONNECTED WITH THE PANAMA CANAL. Annual death rate per 1,000 population. loyees from the United States: -----------------------. .-----.------------------.6 .1 1 causes .-. ...--. ...3.05 -----. .-.-. .-. ..-. -. -. --. .-. 9 .16 and children from the United States: --------. .-. ...4.84 loyees and their families from the United States: sease--.-. -. .5.40 .x e n causes .--.otal----------------------------------------------------6.75 XII.-FINANCIAL STATEMENT, DEPARTMENT OF HEALTH, SEPTEMBER, 1917. September, August, September, 1917. 1917. 1916. Ad rtion, general expenses: hIe health office. $643.89 $507.71 $817.23 rtion allotments. 1,447.32 661.20 k.-. 3,854.94 11,962.45 -------. .....1138.30 f175.24 e for new tools. .I.--------2,095.77 Total:. 5,807.85 1968.78 2,913.00 Hosptaldivision: eon Hospital. 36,507.93 37,963.87 28,561.86 ozadHospital and farm. .7, 494.33 7,435.05 6,475.28 jHospi al. 5, 893.34 5,015.95 4, 496.17 Seco Leper Asylum. 2,228.27 2, 395.83 1,979.55 oTomas Hospital. 901.76 900.56 888.75 dicalstorehouse. .932.69 1,070.40 674.21 TotaL. .53, 958.32 54,781.66 43,075.8? Saniatydivision: sanitary inspector. .50.00 50.00 50.0&) atholice, Panama. 3,222.18 5,296.59 -3,072.29 eloaing Panama. .4,359.46 4, 307.45 4,257.84 bhfce,drtstobal-Colon. 3,241.01 a,185.06 2,999.06 cleaning, Uristobal-Colon. .2,412.13 2,380.07 2,139.22 Z .itation. .8,788.48 .11,909.65 14,391.79 .22,073.26 27,128.82 26910.20 ..4 162.68 3,774.13 3,037.69 .5,346.95 5,137.53 5,624.9t 'Credit. A., 4.d

PAGE 49

48 TABLE XI.-DEATH RATES AMONG AMERICANS ON'T CONNECTED WIT 1 THE PANAMA CANAL-Cou September, August, 1917. 1917. 11 RECAPITULATION. Administration, general expenses. 5,807.85 j 968. 78, Hospital division.-------53,-958.32 54,781.60 4a Sanitary division.----------------------22,073.26 27,128.82 Dispensaries --------------------------4,162.68 3,774.13Quarantine division .-------. 5,346.95 5,137.53 Total .-------------91,349.06 89,853.-3&. 1 Credit. TABLE XIII.-ANCON HOSPITAL. REPORT OF DAYs LOST IN HOSPITAL American. Foreign. Black Tt Hospital: Panama Canal employees-. -------478 337 2,904 Panama Railroad employees .210 325 2,826 Army and Navy -------------------2,703 .. Panama Government pay cases ---------------.--------.-. Other pay cases.------------803 897 3,0164 Charity cases.-. ---------------637 113 501 Total-----.-----------------4,831 1,672 9,247 ,7 Asylum: Panama Canal employees.--------------31 159 Panama Railroad employees ----------------.-474 Army and Navy .---------48 .-.---4-8Panama Government pay cases. 124 1,496 6,180 Other pay cases ------------------------------121 99 Charity cases -------------------------------248 2,97, Total--------------.--------------172 1,896 8,582 Chronics. ....................2. ..8 4jroic---------------------------------Cripples--------------------------------------279 1,27 Grand total.--------------------5,003 3,847 20;3432 Nonresidents, hospital. ..-----------------. Nonresidents, asylum------------.-.--.-, Cost of subsistence per patient per day, 10.3366. WARD LABORATORY REPORT. Blood examinations, total number. .-.----Estivoautumnal.------------------. ..--------Quartan. ............---------------------.I.-. Tertian. .....-------------Differential counts. .------------------------------Hemoglobin estimations--. .-. --------.. Leucocyte counts.-.-.---.-.-----.---------. -. Red blood counts----------.---.----

PAGE 50

49 a ations, total Irmber. .693 a. ...---------------------------1. 4 s-bricides. --------------------1 a. -------------------------------------------aa s. -. -----------a (lustolytica and tetragena) ------------------------------------1 Gui-a.--------------------------------------------8 P sa dblood.'. ......w. 327 oids. ---------------------------. 25 Teia a. ..------------------------------------------------. eep al s isp r. ........w. 8 Un a (ova .---------------------------------------------3 Urinp examinations, total number. 2165 A-----e. .--. .------------------------------------1 -s.n.n.t.:.--------------------------------426 Urethral---------------------------------------------------24 E--------. .., ......---7,52 If m n crystals. ........................-------------I------. ...225P sa d blood .................------------------95a, Sugaf ( ositive 1, negative 643). ................----44----iitn 'Aminatiois total nm nber. .-. .-----------t-226 .0itv for tubercle bacilli. ....---.--. 18 im a xa iatibns, total num ber. .U U-------. .-. ..24 V agin --. -. -.:. -. ..4 S ...9 SURGICAL OPERATIONS PERFORMED DURING THE MONTH. Number. Died. Apntations: DigIts, multiple -----------------------------------1 Operations on bones: Cra WAectomy, decompressive .--------------------------1 Lamnnectomy.I.-----.---------1 etomy. .-----------------------------. .1 Wiring of fractures, simple. 4. Wiring of fractures, compound.-.-.1 1p~inl, sigle------------------------------22. sB n pi ting ..3. 'wob .----9--------. Adeecony: Cerv cal. .....;. al,single----------------------------------1--------. 1, douible----------------------------7--------I.9. IZg'n l single. .-. ....17 .... Sadonble ..7 ... G 'iourinary tract: p roto y. .2 Neph e to y. 1 phropexy.-.1 otomy, internal .3 U t otomy, external.,:.---.---. P ros ate to m ....... iocele,ricalcure-------.2. ocelesingle, radical cure-. 3 oeele, doul, radical cure.-.-. 3uteri.9. on play. T ...3. Acco che entfarce. ;w lA 2 ..

PAGE 51

500 50K SURGICAL OPERATIONS PERFORMED D RING THEA ONTH-COntiT1Wd Thorax: Thoracotom y ...-Pneumothoracotomy. -----------------1 Rectum: Hemorrhoids, radical cure.----------------------16 Fistula in ano, excision of. .-------------------------General: Thyroidectomy. -----------E Excision of varicose veins. .2 Excision of surface neoplasms. Plastic operation for effects of disease. Skin graft .-------------------------------1 Laparotomy: Exploratory. .-----------------------------------1 Gastro-enterostomy.---------------------------------1 Appendectomy. .------------------------11 Appendectomy with local peritonitis ----------------------.Cholecystotomy.:. d Cholecystectomy.--------------------1 Choleystetomy-------------------------------Supravaginal hysterectomy.-. 10Hysteromyomectomy. 7 Myomectomy.-1 Salpingectomy, single .Salpingectomy, double. .Salpingo-oophorectomy------------------.6 Ovarian cystectomy.'. 2 Suspensio-uteri.:.------------------------------------. .8Plastic operation for chronic pelvic peritonitis. .T1 For ectopic gestation--------.-1 Major operations, various other.Minor operations, various. 195Excision of semilunar cartilage knee joint ----------------3 Totals.410 REPORT OF OPERATIONS, EYE AND EAR CLINIC. Adenoidectomy-----------.-.-. Catrac etratio---------------------------------------------S Cataract extraction.-----------------------------------------------. Iridectomy .;. ........ Minor operations. .-----------------------------------.4 Pterygium transplantation.-.-. Submucous resection ....----------------.---------------------------Tonsillectomy. Turbinectomy. .........--------------------------------------.--------Removal nasal polypus .END Total asal.-----------------------------. Refractions. REPORT OF OUT-PATIENT DEPARTMENT. Clinic. Total New Pay P visits. cases. cases. Medical. 278 202 .45.'.2 Surgical---------.--------------------334 143 15 Eye and ear-. ---. 383 195 144 Total .995 540

PAGE 52

51 VACCINATION REPORT. b f adults vaccinated .123 ..--.8---------------------. xMONTHT4Y REPORT OF BOARD OF HEALTH LABORATORY. cal examination of: ~ Throat cultures .312 Ns ctures (24 positive first time and 59 repeated). 20 cultures (3 positive B. typhosus and 2 positive Staphypococcus au e s) ...24 8tools (2 positive B. typhosus). -----------------------77 Urines (1 positive B. typhosus, 8 positive B. coli and I positive B. pyocyeou).-. .----------------------. 56 Bacterial counts of milk (30 from Corozal farm and 20 from health office, fluids (1 positive B. tuberculosis). .4 id from knee .1 .lidfrom chest. .3 US'(+d pomhstive-------)--------------------------------------38 Egesmears (4 positive Gonococcus).-. 8 I smears (2 positive Gonococcus). ------------------------------4 Bood smears (1 positive for malaria-tertian forms). -------2 1Pu from liver abscess. .......----------------------------------------1 Wassermaun tests.------------------------------------. 1,176 h iaa examinations of: Iairy milk from Corozal farm .....-----------------------------------2 Dairy milk from Panama. 18 Mother's milk.----------------------------------------------2 r e. 35 hide disinfectant (Panama health office) .---------------------------4 C al (Halter & Co., Panam a).-.-. 1 bstnce for identification (Dr. Prosser, Gatun). .1 II, petroleum. 1 Cattle dip" (Corozal farm). 1 rn (ron claros). ..--------------------------------------------1 "'Sni-Flush" (district quartermaster, Balboa Heights). 1 h lorinated lime (drug store, Ancon Hospital). 1 Aological tissues prepared ........-------------------------------------271 Autopsies performed ------------------------. ----------------22 Tissues reported, surgical.,. 49 Autopsies, animal, performed (dogs, 4; chickens, 6; rabbits, 4; pig, 1). 15 Ra1s examined (mus musculus, 1,,448: mus norvegicus, 322; mus alexandrinus, 2; uaratts, 265). .2. ,055 Unetaker: emations---.---. 20 torments at Corozal. .19 embalmed. -. .----.-. 5 Dipped to United States-.--.---.---. 3 Slipped to Panama .5 pped to Colon .1 l ped to Colombia. .---------------.--------------------.---------1 Wasse mann reactions-. ..1,176 liituiation, recin---------------------------------4 a ionreactions. 4 ypod vaccinations. -------------------------------------------4 Smallpo's v cn to s. l. ..2. togeuous vaccine prepared .-. 2 C L HOSPftA~-STATEMENT OF COMMITMENTS, DISCHARGES, AND DEATHS. COMMITMENTS. Male. Female. '-Zone, first admission.-..5 4 Government, first-amnission. -1 a. ..6 1-r

PAGE 53

52DIsCHARGE$. Well. Improved. U Male. Female. Male. Female. MaW Antigua--------------...-1 12 1 Barbados. .11 1 12 Dominica. -----------------.-.-------1 ------Grenada.-----------------------------------------11 Montserrat ---------------1 1 2.-. Panama------------------1 1 3 .. St. ]Kitts. .-----. -. .---------United States. ..12 Total. 2 2 10 3 1 Eleven males and two females deported to West Indies; three soldiers to the United States. DEATHs. Medical diagnosis. Mental diagnosis. Maie. Acute miliary tuberculosis. Manic depressive------. .1 General paralysis of insane. General paralysis of insane. 1 Disseminated tuberculosis. Psychosis associated with cerebro--.spinal syphilis. TABLE XIV.-COLON HOSPITAL. REPORT OF DAYs LOST AN HOsPITAL. Class. American. Foreign. Black. Toa Panama Canal employees. ..87 27 205'i Panama Railroad employees. 69 57 364 Panama Government pay patients. 2 14 49 Soldiers. 55 25 Other pay patients. 301 216 178 Charity patients. 86 14 34) 550 353 817 LABORATORY REPORT. Blood examinations. Estivo-autumnal. Tertian.-.-. White blood counts.-. .. Red blood counts. Differential counts. Haemoglbbin estimations:. Stoolexamninations. Strongyloides.-:. Oxyuris vermiculosis. Ciliated monads. Blood.-. Pus. -------------

PAGE 54

53. U. ..245 Al er en ...........17 C~s$5.-.--------.---.---.-----------.-------. -. 15 B10 V". ....J1 Pu t .....s. ..........6 Sputmesainatons.3 Ne atv ...w. 85 Smer dam naton uetral. .1 Postie .r. .31 Smur thra a a n n ...-. 5 o. ..-. .-2 -gnr~a ---------------.-----------. 5 Au op is. ....2 SURGICvAL OPERATIONS. ti-l---------------------------------------------1 C D igis, ulti le. .....1; ...... Ce ..........-----g--~. ..-. ..2 e. ...2.-.-. .-. ..-. --.-. ..-. .Eoof1breast......-. H dids, radical cure..-. -. -. -. 4 A.-----------------------------------------------6 a~iiaJhyseretom--------------------------------1 ,uble. -------------------1 t wound of abdomen. ......-------------.-----------------------2 or operation, various (dispensary).----------------------------76 various-----------------------------------------------62 De U 4r'as .. TIBLE XV.-BANTO TOMAS HOSPITAL. Remain-RemainwAdDe. DisOct. I. Died, charged. Oct. 31. .40 114 2 110 42 Cases. -----414 812 82 741 403 .454 926 84 851 445 Americans. Other nItions. Cla. Number treated. White. Black. White. Black. 154 .3574 Pa ptens.:. -t4 3 .,. .57 94 1,226 3 .127 1,096 1,380 6 .184 1,190 per f dys elif frnihedpatent.1,4 e nuberof s onsanty 80&.,. 449 Seae afdtrearmitted. 10 .$0.56

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54 A DIsPENSARY REPORT. .WT Natives treated---.------. Foreigners treated.-. .34' Total.------------------------------------49 DISEAsEs TREATED. Malaria.-. Measles.---------------.-. ------------------------Scarlet fever.--.-. -.-. Diphtheria and croup. Influenza.-----. Dysentery.----------------------. Erysipelas Other epidemic diseases Purulent infection and septicemia. Beriberi.--.--------. Tuberculosis of the lungs Abdominal tuberculosis. Syphilis.----------------------------.-. Soft chancre Gonococeus infection. Cancer and other malignant tumors of the breast ...------Cancer and other malignant tumors of ether organs and of organs not p id Othertumors.-.-Acute articular rheumatism---------------------------------Anemia, chlorosis.---Alcoholism (acute or chronic)... Other chronic poisonings-. ---------------Other diseases of thespinal cord.-. Paralysis without specified cause Other forms of mental alienation. .--------.-.-. Epilepsy.-.-. Hysteria. Neuralgia and neuritis. Other diseases of the nervous system. Other diseases of the eyes and their annexa. Diseases of the ears.-. 1 Organic diseases of the heart. .. Diseases of the arteries. .---------. Diseases of the veins. Diseases 0f the lymphatic system. Chronic bronchitis.-. Pneumonia.--------------.-. Pleurisy ...Diseases of the pharynx. .. Diarrhea and enteritis. .-.-.-. Ankylosomiasis. ..7. Intestinalparasites. Appendicitis and typhlitis. .-----------------. .. Hernias, intestinal obstructions. Diseases of the anus and fecal fistula. Other diseases of the intestines. Cirrhosis of the liver". .. Other-diseases of the liver. Bright's disease chronicc neprtis).-. Other diseasesof the kdney and annexa. Diseases of thebladder. Diseases of the urethra. Nonvenereal diseases of the male genital organs. r~4 A A,9.

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No. cases. r (noncancerous). ...1 M rt .......................w. ......12 a ohe, a.ers .5 ther tumors of the ovary. 1 other diseases of the female genital organs ..3 p radiseasesof the breast. 3 or. 92 Ac id n s f r gna ny.---. 26 ...1 e. .1 Acteascss. ..2 ofthe skin and annexa. 32 thebones. .4 tejoints. 8 malformations ..4 discharged from hospital without disease. 87 ---g-debility. 1 tepoisonings. 1 .4 tism by cutting or piercing instruments. 9 ..1 Frac ures .'. .....a. h xterna violence ..11 s notepedified or ill defined. 4 e. 22 T discharges during month. .851 ong patients. 84 Pnaing in hospital at end of month. 445 nmber of patients treated during the month. 1,38& SURGICAL OPERATIONS. s. .1 I.g.s.g. ..W double .4 .4 l:e sin -radicalcure 2 g ...... .m ...4. Externa. ..2 ydD i.radicre .2 a~ioezciio~a f.2 y .2 .. P ryu .V. C a a ae ......o. .. S 17 en. ...,. .......,:. QY genersl pR60ni ost ...........*. Chole 0=y.'.,. 4S -yt Wym0 W

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4K< PA 56 Salpingectomy: Sing e. .......... S i n g l e -------Double Salpingo, oophoreetomy variay on -.Oophorectomy -. en. Major oprations various other Minor opratinS, various -. LABORATORY REPORT. UJrine examinations. Albumen Hline casts Granular casts .Mucusandpus Epithelium ceAls Phosphates------------------------------------~ Ow :Sool examiUncinaria -----------------------A Strongyloides. -. Tricocephalus dispar -----------------Ascari'des. ..>. ---------Mucus and pus Bilharzia Sputum examinations Positive for tubercle bailla Blood examinations Estvoauumnal --*2 Wasserman reactions.---------------------------Positive. 7Throat cultures----------------------------------------------'Positive for diphtheria.,-----------------------------------Blood cultures -. 7Positive ......-----------------.-------------------------ESmears exam ined. .....-. Positive for gonococci.-.------.-------------.-. Surgical tissues-----------------------.-----------------. White blood counts-.-. .--------bifferential counts. 2-Autopsies performed.-------... Autosie peformd

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57 LE .RE RT -OF ROUTINE SANITARY WORK PERFORMEDIANAL ZONE AND THE CITIES OF PANAMA AND COLON. Panama. Colon. Canal Zone. ofnew ditches constructed .--------------------3, 193 13, 879 Lnr a ites maintained. .---------------.148,800 1, 4$2 13,095 eationr6moved.---------------------108.47 .2 39.19of garbage removed. 10,259 2,790 s g removed daily.----------------------------------3,816 of streets cleaned daily.--------------600,000 155,207 ds ofpoolsoiled-------------. 350,865 268,520 .-.-. ddiring month.-. ..295C----s---ts-W ........--. ..-...331 trtrate d--------tr-----------------4,930 101,120 21,29W 4ontain.r with stegomyia larvae found ..6 reading places destroyed.----------------264 65 51 places destroyed---------------------92 19 S oye. -------------------------1,140 577 808 to abate nuisances. 205 521. tnsorviolation of sanitary code----------------3. rV pert es cleaned during month .--------------------7,782 ss ected or fumigated----------------------18 .21 of mosquitoes destroyed in dwellings: A. .-.-.-.-.-.-.-. .-. .--.-. -. 1,042 1,60 ya. .----------------------------------------------355 C----------------...-----.-.-. ......-.-. ...2,067 7,326 inspected. .3,572 10,039 5,943 traction and repair: for new buildings approved----------.--. -5 3. issued to repair old buildings.79 57 condemned. 3 demolished .----.3 D ilkvendors, etc.----------------------21 .. B s candy kitchens, ice cream parlors.I 28 Hubrestaurant. used dur montii: 71-------------oil gall .7,282 4,198 10,620" Lar---d-, gallons. 583 350 163 Keoen ~ alo s. ..300 .-.-. 447 -CONSOLIDATED REPORT OF QUARANTINE TRANSAT THE PORTS OF BALBOA-PANAMA AND COLON-CRIBscted and passed. 216 sarntine. 15 sed and transmitting canal in quarantine. .10 on medical officer's certificate.-. 1 T.esls entered.-. 242 onsof detained vessel. 98 arrival. 18 priortodeparture. I of1sue ..~. ...219 d d. ....134 rdr .....13,1W insectd o ariva. ...,5 away1q Tombd onbado noigvss. Tota peson insectd o arrval. 1,8 t~d1.

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58 Crew passed on medical officer's certificate Supplementary tuspections of passengers and crew. .., Persons vaccinated in port on arrival.-. -Persons vaccinated in port of departure or en route. ---------. Total vaccinations.-. .-.7 Persons detained at quarantine stations tozcomplete period of incubation Qf yellow fever or bubonic plague-.-------------------.-sons detained on board vessels---------------------.---------Per Total persons detained in quarantine. Persons landed from foreign ports: C ab in .....-. ..----.---Steerage-. ...........---------------------------------------n Total. ...-.-..------. Persons arriving from coast towns 1i smalllaunches and sailing craft. .,.4. Persons departing for coast towns in small launches and sailing craft. .,2 Persons in transit passing through the canal. 4 Persons in transit for Pacific ports not passing through canal. Persons in transit for Atlantic ports.-.381 Immigrants rejected and deported. .....-------------------------------2 IMMIGRATION REPORT FOR THE PORTS OF COLON-CRIT AND BALBOA-PANAMA. FromCabin. Stee United States-------. 782 4 Cuba. .14 Porto Rico. 11 Jamaica and West Indies (not shown above). -25 Salvador.--. .1. Guatemala. 2. Costa Rica .:. 21 2 Bocas del Toro, Republic of Panama-. Colombia.-. 103" Venezuela.;-. 4 Ecuador. 2 .. Peru.-. 6 Chile-------------------------------------1--C Tot. ..1 E urope. ..-.-. .13 Total. ..--. -. 1,008 8 1,594 Men. Women. -------------------Children. Total. QUARANTINE TRANSACTIONS AT THE PORT OF BOCAS DELTA PANAMA. Vessels inspected and passed---------------.:. Crew inspected and passed. Passengers inspected and passed------. Passengers, transit, inspected and passed. Persons held to complete period of incubation of yellow fever. No quarantinable disease has appeared in this port, and the health cnd the port and surrounding territory continue good.

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59 TABLE XVII.-EPRSONNEL REPORT. October, 1917. V~j. SeptemOctober, ber, 1917 1916 Gold Silver Total (total (total G d Semememememployees. ployees. ployees. ployees). ployees). Aij 3 Che elhoffica .3 .3 3 4 .tohouse-.-. 3 7 8 8 division-----------. 14 35 49 48 46 Panama.-. 12 138 150 147 152 l Mce Colon. 10 142 152 139 160 S. 132 214 346 334 1 367 o ..p. 19 26 45 46 41 SHospital. 6 ..6 56 .co LeperAsylum. 2 23 25 24 35 .5 136 -141 136 124 Cr~ozal Uospital and farm-. .-18 99 117 121 251 u saIes: a. 5 3 8 9 8 J2 44 3 PeroMine.l. 2244 .2 2 4 4 4 .1 1 2 1 1 .2 2 4 4 4 Total. 236 827 1,063 1,033 1,014 1 Includes Corozal Hospital. 'Corozal farm only. .2) ,2:Y jMA 'NA

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UNIVERSITY OF FLORIDA 3 1262 08896 2526 -.-.: -x x