Citation
Report of the Department of Health of the Panama Canal for the year ..

Material Information

Title:
Report of the Department of Health of the Panama Canal for the year ..
Creator:
Canal Zone -- Dept. of Health
Place of Publication:
Washington, D.C.
Publisher:
U.S. G.P.O.
Creation Date:
1914
Publication Date:
Frequency:
Annual
regular
Language:
English
Physical Description:
v. : ; 20 cm.

Subjects

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

Notes

Dates or Sequential Designation:
1914-1916.
General Note:
Each report prepared by a different official.

Record Information

Source Institution:
University of Florida
Holding Location:
University of Florida
Rights Management:
This item is a work of the U.S. federal government and not protected by copyright pursuant to 17 U.S.C. §105.
Resource Identifier:
31317330 ( OCLC )
ocm31317330
AA00006093_00001 ( sobekcm )
25402269 ( ALEPH )
Classification:
RA192 .I874 ( lcc )

Related Items

Preceded by:
Report of the Department of Sanitation of the Isthmian Canal Commission ...
Succeeded by:
Report of the Health Department of the Panama Canal.

Downloads

This item has the following downloads:


Full Text






7 tk i

ff j
vt
If
t

POR", T
1,1 f, 4, 1


1A ,f f




t"'ME"m 0


OF, THE,




NAMA-CANAL
7-71"'1 4



FOR'. 'HE,




YEAR,, im",











PIAS.-F. MASON
GIV,
c If i y
oldnel' Medlea drps,' iied,,$, taks,'Arm
f1f,46dih fbfflce, Balboa'Heik4ts Canil:ioue",l'

01

ffr t 41 f 6


ff


,A
VIO

q t
Y'A









I Mu
IT!
1i

A1
















11
I I

|n

























. :tena:o ,..: -. .'+ .' .:, .:;,; ,, ..
.:l- n ... ..... ... .... .. .

Mv!th$ D .0 2--f.ah... Al .. ............

h 4 o ....... T..--.
....." ...... .. .. ". .,... .. '... .. .:








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

S.... W ....
. .. ... ..
A A.; .. :- --.-.. .. .. .. :. ..... .. .:




:3 ...1. Tr. -.. .
I Z.- mrrip C



A BPn Slt iidy a n: l Z. .... ..-.... .


.. .... ..-.. .. ...... ... .. .....'. ...H.. : :. .
.I M a .a .. ..o D:"------ -".:.:., .. ,"" .












,-- --- P 4;f.ikr "I I .a1%
''""''.- '- .... -. -, --:'--:--- --:..'.. ". ... .. .'.F








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


""" :" :' ': 'P"".
A!' M.:- :, ::
iI I iI i i I iE i, I I I i IIi i i: 9 i I iI P gIg I ::I l :l IEI :E
: .. ... ." o : ". : ".. ..E::'. :. ::.: E. ... :...'.. Ep:
:" ." T .E : :.. :.:. .'.. +" .., :::E :..::4 H. ", ".. .::' .E! : i :




41tj t5`i
'ltt



4Q
't
1;4, itt

414 A i'T4, t t ,*,,, ',;,- s, ,
',tA llj T



tf V 'A

it Vr !"0
it
it'

141













xe I I
















i't
All


y:






, t It ,








1"411









fq I,, V
tj 4


tt ,N
Wo,- IL



"'l, t ", te t
- T t ,, t, 1 4 1 t V 1
*1 Oft,
t 'Al P'; te"I" y,
` "to
?d t ,-t 151 .*"t,
t. tj





I IA
t x4















.11, 71: i4 C n1
Bii ao iigt4 akV


M : .*5f e

r rnaaiRAL Canal : &qf.'


'Knmlwt of health f
ik dvurg theor, yt ear
.... .. i.. ... .













waal remod fromv the ?aciM b-.

sti n f4pope anri pefh fuedr
rIne for digmg the yeaC tp- il.9 l
T h '.. a "..i .; :.: : .'.
:"... :'.'.... .. "1:






A -JAM1-- -
.. :.. ": "" i .. : ." .. :" p. "

.. .. ... .e ..... .... ...


". ,"" ........ ......".'f.q "-
A t... ........ ;,,'j









e .. : 0 31 :: ,k ., .i" '' .. ;"

T ., ....... ... .... ..... ... .





op ... .. ,RIX -,W ill
X A R '::" ... .f" .. ....... ..".. "
..... ..E" N.< j< .
:,.: +t,. : :. ,. ." :.:' .: : ......' .+ .;,, .: ,. : :. ,!> i,.,, M "ME




op



"tq A

t,4i


'I T -bog 01


0%*,.y s LO for, -19A a"R)r
D'f4494
TV
or',
2
tt m
gp mot,
A4jiAolb-oiq4tals,- ejllllkivie

md "bitt the fwt that, 0 cleft
my
-1h 1-6grd -uia the &4th ftte
tWin 5 0 P, 1913 (0.161 in 1914, Q-37,
hovittals mote, 1,5 per ap*1-
:jot J9]L3). The-conotantly noneff mle, h
'in' thp last live mon
-here wim nodvathkilrlom. llmcigllph
:bar- there- Orlo (1'44ths n, 913,
W, 'WX *U
,,,tJ-u t at hW the year a sixon rt
elp, p 13'm to,
I Iffenjig
t 1110 ital forat leagt Allqn,
Af I An-qn"
P= SdEWnWon or htuga!
4d g9la
frOM UgdpLr
bf th' our dM ot,
alattendox
dd &ea, wl- cot me&v- LCO! hd
di*nq lwagclinival wily', In, I -400
IiM6n Tato for Ity-l-, 6* W
phqidl iiw092
m
arf -I'
Wf' of th
W
I *A-V
$41' y
Pt
-l" 4;, Ic 0 el
t- t6
LiJ44,Iff,
'ju
AP Ift
'*V4




IT"Pr AiZV

41


31

ild A, dhif
jv,,


2z g
124 111.


-mbovilijlg tho'bil bist numhoi4, floaths, fliq





_- ----------- '42 5,
-------------------------
'22



EFFECTS
,4A S'f "Idli, mo14jrfi of,
Ath Tlt'e 'o-f sease ocoltrod` in '6-
d the
Ipwos m, ovemb" aild The
to's, 'W''Ag'' -an incke;j, o, hi the deaths
U-to The big
on, Y di
UM Morch 'n 0, lowmt in
d' on Ma

EVF.m-vk 'oF RAc E,,
ft, 'te h Of am f6r,
b", And, d ;w f,
19f

mf"' UT c
14 't 23,2
ivi
f for, wiA,'04

W Na


mo_


W




vr-, V- -
In
'v 4"
L TV fW


I iWt
4,
T"t,

p MylMW


A eel 4WA
lota d

434601wi'toat
I
eru go of all mth6 woo,
d6av woes,
Oiltit Of', 6the
'dio -wow, A
bas 0 of+
Thii biAh, Uffe Wt, five lilo
d on Same
The + tfa h the Period,
mo#A
dtea imp er-1 ye fW 2 .0tl000"mdfor--
ve 9b + of 262, Of, the- totaj
IL-A a 'ra
howoct'Am ght m6kh of tho-year, the
p ao'Was,42.
PANA'AU

aiv+,empb, p-6pWaUo4 of the city f4l)r the yegx lwmra_*A'
wb,4tilherej&-eqtoW,0f 1-180 deatlits; of t6s"'
Trow disease ro;to of 32.85 per I to
P vmg
loir the The death rateg for -rnAqrjjk
+ _gyear.

The birth, baOd on the 1st five, moutls 0
Tbe iuf aiii m+0'ftWdjty' for thefulne penbd waA272,
Of + the toW deaths from diseme based on, the
of th the p &cievl r 5 Years of age-+ wow
we uja dc
d ne*,to gev
'er ,-ent 6 tjot 4"
beijiote4, iq p 14 w
occu" -4
VIP, )Y,
ms i6erm
X OjW-,+,- ffdt"OT igno differelice On
c"'Am
t diaricts 4e
mp.
ti6li bfflietAtTwAh16q,.t a e0yr, QUIP
w*
law'MX jot' P
0 a
,% "J4



+ A'
Z
+ M", t






















.. d"i .'. "u : ow. ." :" ":"


)maiderabie reduetionffiialh persla hoft1
ikt 2m
ofistwew duiiig8 ||t :. .,,L
,.. .






ity patients admiti i th a totl %9
hI ,40 paati,:ani


.. .. .. ..; ...

Vigp: I, SF:..
Ao ~iO$AN
':i' ;: )iai S~
f;I~. 1 p ii it;; : :..2. ;,































aetnsd qiandthe 1imand, Mubsisting prtt1
.. .: .. y r ..



h, ::' ~~ e of rifcuh n iaii ac 1



y matrial e om 0pii1 Afrie


Theof the athe i0ear f
: '". '
" .- .". .
;r.i.:1 ? 1' ": fl. : .:. '. .: .. ..?: : .'. E' E :. :' .
"'" :.. :.-. "' '" .']. :' ., ".. : .. : ..,' '': : ,:, "" ... .!": ':. !L. : .: :









:m
A`
'i'v
& P:
W MO-1 w-
17


co, ought it,
Jor I Aw
;,th; ben, thw"'
beg an, to 1eav6 the c awri3t'A4 ow is
btiertwo hour, I d,
f3,qjj 4 (3*,fi t; ii4 s the
The J*W 'VO7
JOHharhbt faurpr five'floas-,w.hA"o"o'ihe"rF;, W-1111iiVa
44 riitlfharbor(A but,,.jL 9 TiLu
7, rAtsharhi d,62 Ile,
Apr, i The llva8vti e
the TiRdiAn'rat 11m. .The mothod. of'eatching
coinbifi-,'and b tri d1hp, chltiroftiin box,,,,
tli,,rdt by"e'e
mg ovwr aa
Ust'w"Ovy left tbr' idkod6ft.iof.th,

iipoe
thblogioal tind''htological jW606r
pa i
eAarhi, anddmi*ranis
ln&,&Al''wo In the,
_piWffi( Expoktiolftj.
'INSAND DEPARTMENT.,
jjs 2
PP of pationia-itt -th6
r ort ilie inurvement,
Y ar




10

----------- Al's fq
2
JZ_


















V
Wffv mi
h'
4-9
ip-y
Th e th6,,
t JbIgAw, iadd,,edlfo1,"pw,-w",
*c
V"
PIMP A d hoil, z i "i,
W" -v ioxvm V-
viri:,q a* lo-,, yi 0 77
'Aaitblc iWe lite
use :,m a'so*tjog, 't
mg
CRRON
Qq S' L6bor'aj 1914 4b-e'chroAi%!* Wid-





`COAON HOSPML.

offpl g,*Ulu&
min -a, fqt
-6 Wit "A t -",eA
J1, TAft'g'rf' h:W- em6nd
an -0 M- orp tu na P1
acY, "Rofff,
-C -bip,6t-,d ft)r
41)v 04 Wly 'be
vVii0i"bo aE ved 't# u0i
h w6jiAio
0'.
f i ti4ic, IT% in, tat
I It
TAB 4Ak",

V
OW140" #*ry- A Ahe, ore-m-o
5a
(lip
"qpi

V
N




777' I,
7IT
KW
4p""4,
IT,
4
4".
"V
4Y;,




J
r'&z
TP 4 W01 C, K
W
'0; LAtk ',iLAyTji

1*6 'R],Owm M, a

'K,1 I
SA AS HAOIT'11' T

r, eda' He une,"nuin br f 'hdbiiAnts bf thci
613) a TO 7,( spqurdi.Agl
T 11'11,11`1-
$i1ti' q"' a -ell-no, nowmo h4ii oi c6it,
9're
T 0U, th"a yeaTl-
ar shown in Table XXII.
"I'



pe h beefi'tboiis6A. ThO ift-umber aUl Aig:
ltq -I'
Iof t me h
fi& 8 i6-Afii,
00, illo'"t 'Y'

el
Ill higft,68t adinisticra itea 14 "We're
Hl I withdii, average"We 1y:,perce-,u arg ,f,
iljlb- lowest,, Gatuw Gulebhi-m

C 'ayo sho" 'i"n Tab le: IX 1v




Of "Th"t
'd*ith`,J q'tih6 J, 3
Obj6t`a' U' vot'6*W 11111,
A tiiia df`
1$!, AU--Ok 8,2101, f5i"i"
P' I 1 il
a& dit bAs6d

d 4,
Y76,
W ok




pIx



r"" "V




W
Me rif "t,
P-P to -
Ain'# iil' b nt


le
tea Aux
tbk'bo."",d 'of W4ftii') to"'y to ,mak
ot, th,
WN
rers'm
4,
AjljlqffAIM

0, tapd gjrqwih'iji tho T) la
"p-Alromaj and the consequent conkid'"M
44wtd thq As, m c of the ne cons,
Maliriu' loca47-1 not hitherto'requmng,_.,,
v addMC!, Umpmwe 01, Eumbiumi'm, that
'6p,&m-ng of niany pew ktiwts andaUeyp haa,
sUv6 Ac aAd garb;w remo

GEN-ERA 'SAWJ(TATIOIWl.,,#*

OliAptit I %-reorgwnstion'wm, mad6 iii tho
ieiium--bler 6f distnict iii tbo'city, lroin"-
jitqry -e lrfw" or w" givon';19 gul"g
"hgim
y
4Rw
dep446i lavog,
70
ad iia


-b vi OnT W;ff
im crOw a,

W h
*W3 66
I




-i4
z' '







































01 tu&
wrere' i
.. i i ": ..." :, .'


. :Wt' r.. 3..-" .* ..i-..
,.: e .. L .. :v





















qj

V
r iT
N4
If k"M Vm

bboo
iih, AW: blesi qmovb`ixfg


ma,


'Of-
Ad
"blu lptr
Man te, J 10K, V",
ry tj
tc'w
Wa, I a, ,
I A A
sor ko a
K I
ap Y,

"R k, hold
a I
rw
"Am
IbA;e
iw






V;-

46


# 41




3 VV,
60ji AXWMISCHMAMBIOU0 CIP
"Y
the y 4:u, 6i'Am-ld n'.1 .,,f O'M o
iA, 1bAy, 6CO'60AIV ith- i lmwl
"Z4,
bott iii, tw
't1*4n#()'( ot
tin an Ruch 4o*
th

---------- -
At's
7
--- -
th iji M. supply,
o a ity,
beoo foan& that
I- do'rlhcapifarYL
quie4icnts, un
ina few i'ns't"ane, a-ii
th', i r UL-16
af e ki-ng

WBLL9.

Indlitlis it"W, afffonha that it wtmAbeco
o ertaLjj W'

Obo s6lld ,4
f uka Werev"losbd o
no selun-Ocwa Th"o
IhAji,, that-4f? the
U4 and a
V q-4

Wpn, Wthp '4qal
'kil '1 229 k jj,
am PM Vcey
V
1,e',-V, TiV







T

Vs

t'l

Al

Tn'
qT
to
9
WvO -a: hic,
NI' O,,p
a lea,
IT" WO 0 IT, Ace
V'A cmfu- 44
vijpw,,
Uih WaA p6aedWbA
-W
at!t twi, ""Pa' oe)c byAheAby, et
pld VacZe, Wij, ]Dmtl *as 641d,
V;p, I pf thf, P
d latformwete MtT`P'q0,40,-!
*0041 0
Thel, o Ar
mned,_ ti, the wafw_ in t
crt*i" 46"
ous a toftheNconstroci:6
7
YiW tht,,kit-6 atthe
0 The i)f
d, on v" bvedmi, pm
-b WON jo,
ced.`b iiew, stTucturaq th"
IftloAt I Wipg,,, d4t, oAToat tipp TA
es -n'h
otabl on N" th
Al
inso
b t
u-
7 j
h' TO
'N e" Qw of '48, A,;Aff
Ti
'o mf A
n

tw a w

"R
.VT 4 'd

rT;,_l "Al





-4

Y"


Vlr
r Ink,
0-0
6, Thig ka `W&11,Mft ko "U h diit
ohem TbiR ketion, lalo haA
land'Pthbuis paiecte4,k"q'.Iw`e of-tile,
'01on pea(+ was ea Iqd im
long-standing niigauoe, were bated.
ut for the 11 f Effi, T _t1jO
on the'docki eO ILP11
the &ck basins Vit
-to J- g garbage waa stopped
money. and tmio Wt 06w by an a
'4tpply, department by wliOx Alie, health offioe
,`,tq1,JeiAion of garbage andthegraw, entrtin In,0risto-1
m* tt Work.,with that done in'Colon.
8 and V4 OtS
premi es'' Ca'nt dop e,
0, 14MI by, one -tnspectbr -Vn th''-a PU-g.,of IaWerA 46
I ,, 'r I 'k a
ce all, ntu'isances requ ing, in8tan't This
theLlenioval, of an average bf abayt three loa& of.,
644ilyin-addition fo the garbage. It a1EfOiw-V-,o1ved--
to not-ice on -Al vio4toi-3 of, the ,,'4,ndm
Ve y ownets;the ey alif "s
Necittion. oft4q,'O Aii ,u -g-n, "'t
tic fowlo and birds in (fef alrOts, the
Overy, and repair of allse'w-er- connections auditiW
test of obst L lit
or inateoffeiWors,
'der; t4e A
pro of sueb msoa iuAh6 A1(!41die,%,bOuxt-
itary W's''
of Seeing that the -aii, u w4o fa d
-*ekly ihBpecto-n was* niade,:A 'hL'
Mg
&il -`.,Peefio7ri of the entikelv"ityli'MO
eMgr
C-61,61i ditectlyby an ins"pe'eto-r.
"0 4 a,06101f, aiih,-Ttiiwo-uif(lerwmitooi*-d *W
"A"file, initiative 'of this office, tho-, two, klieptiooo,
"Idies, ,Mve*ere emn
y6l'untAii, dbig tlloge:impo
0, 'eA Ln, -the, bake;4 *cr6 6 -64uo-
Ur Ahe `,tod,& O'Aiie,
IM, wqo dis&k -
P A,'
Teq k, ,X
uhibdI6 oe, hrmd,
-&iid, Wld
"rq r Jt W)M


















oand, oq M gt
991
ild
if
k 'Cupa in the
.,,,,a 6 V hb
A Avu
trif M. ek;
'00svio" W-
ij V1, p
ap J-iiio b 4tifincd bpocwe b,
Tj -,,ql4- e as h6` te'
"I w1l, 0 T_'l 11
'46h tot raw, per am, 0 'Wit
bel
i9eil wbprp in dffii
TV e drI ii, 4M',A6 .74r c'I'Ve
"T' I Tr e Q 'd
'M 3414i e
-ndth -I -,n,
-P "PO
wwm6r, lt" vu r,,
fe, i,Ubo 0", f
yl- 6m
!TTI
",TO 64* wo On
vll; 6 b tb
g
-7 T r
wo,
,T 0-
l TI
tv
It J i tT
Ara qj!
An
il mv
im 't J
Od pia
AM
-A,
iwi

1&vt




T"
ZI Y T"IT"I-14 'Z
T4 I


Lit,

TT--
77j








'4






i"17
1 4 3





IT, vvwt
4 -tl 1,
"aa

"DIOLT AIWb P10YEFF-UM,
OF, IAN
7-7-
L
4L, A
P
nuns,

3
Admilon`ti'
;A, u0sp
;Ion-




C3 4a 4A,


rjiu
whito,- 3,619 p029 6W 22
37;3,05 1,1(0 9,1109,5 2M 1
,j
"Tiowl. 44 329 10 Ug, AbW 2,745 310,1

Olt
5% 41478 41
447 '102 4jWS i 3" 14 0




4




F77 9
4UM t, 1wt
4, 44, 1
Y06



61 yl





















*; *-." ". ... ;..,' ,:" ." ." ;,. :"" : '.'."". f: l, :;' : ... **^WF s^ ^ &~ f
.-,.- i :k.,NI! ,E:



"S : "i : "i;8 i ..: e 0:11'.':
NO W' tau: :'" ;i, i









... ..... ... .. *4. :: *. **
!j .. ::T 9A... i. :.W.: ..,'J e i.i: ha,




T.ote 0 4...l;.... .
-..'" i ... ... : ,,. ; ,Y "i f"- N "
bi Et .







.. 7. .. ,... -4:. ,,:.,,:,..:,
'2A .M .' 5-0 1





:N.... ". .-... ...
SS..:..;.. ...... .. ..: .... .:,. ;...,

1'"04 7. 7A;: NE
13. 1.. .. .:n o :
.~,~:.i:lr c;.; .11P M .:.r. .
.. .. ..


8;I; ~r ~iili44
I~IL:3







4s




'ar

Ji
















Z7-7




_4
""t" j
T1, I 4,? ,o







A'- -lo



0
Al,











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






.. .


-- - --- -



- -- -
MdUia4-,


- - (A

ot- ..




- -to o 2'


r
4 It


1W




Sj_ o
Ol
04

4 A
,K








J,




4 jC

o-
44oo
'41


4,






























. r..:. ...-...-..











-
-.4.-"- -...-. .. -..' .' -..."-
0 o a k .... ;. .. ,...- .. .


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

aW :o-:ii^,, .e --,:-r.- ---


:* ; .. .. .. .. ..






i:- n-- *A -:.-







i-i
... 1.., ..
,i -.: a '. -. -.o.4 ;.-. :'--- :- -






", ....i. .


s .-" -...^I- .. : .. .




..:...: ...A:- :,l~ l "];S!-a..j^:l .^ : .: .: i
8 i ,4 ...-: ': .- i.. :- ..; .-
vr" % "" ., '!' .i".':
:" .. t.' ". .: : i ~ j:;.E."' .. ;'I: ':
i:. '.., d. > '' i .. ii ". .;' i'' ..,14"
t: : ;--':'-J :-! i<- ,; ,; :-:i :

.. : ;.,! r .. J~:. *~~i~* i4i L.:.. ).. .: ..., :.E. .


, '* *I. ,1- Y



aja a ;.* ,* i

^ -.'*-^ -









S';.* I *.
*^ "::. r:j, .

--^






9'r.J..
-^* -' ^-'


; :>. '<.. & ,
: .. *. ,?..,,i.4



'. i'' t:
/ -.. i .:f>
- ; .. .,i ,'W


,'.'.";'" *:';*"
.'. a

13



.' J I'*'
4 ; l *

11'it
'WI"


^**:


I i,:
I.:.;
I.i;.l .
i

~c II*


;;

8.




-11; -,M', I ,
4 Te
;K X
W4
i v
X




J" J -A
J44 t,


X 4 W-xw- tv

v c";
it, e, f 1,
YBI-11M WON
Ag
7' 7
6140-, ]HE -"7
Ue I 4 Monk -------

T c 47,
EAT W'SAMOWqA"RfCAN9X"
TABLE' HJZATL
EA(PLOYFEES


Cases. Cowe of dehh


A-ioage number of white, omw f Disease -
2 OYC S, 'from the ]ULTnIted 512
**orago number of wbi
W(imm 4nd children from cam-
"ho, Unltod A,-
Avo-rage nimb orof *11 iteem- ------
andthokfamilies 91wk Extorad causes_,_
,'ftomthc, United $tatos,, Ali P'ause,
Disease_
Total-ulmbor, of AA!iaricatls 11, 468 ExUr &%Im
the (%" A"If
-Avot white for-
(Mos 'Causos,


'-1 The rtkwcsropresp'nting the tokd'nurOcir pf
'Ingli 16 opi their koiAN ", and the
pl6yees axW es
and, their famillews the'
tatwn9d
Orp DVA'Tfff'0 F E I W RW Y,
A






A_ q
T


21 -71
























S- ... :. -, ... .. .




-7


~-X


i ,.. : ; : ..
--- -.-- 5 2





gans-^-a^---- ----- -. E.....



"LA, ...... 4
..B. i .......:. ,-
-' -:." -. :: : :.. :. "- '. :. '
:.':, ".. ..-^ ^ :, :.. -. .:- :.. :. < :;..!*,-^ ,









2. ::. .: ...3

*:. ;. w ..-' *. ... ;. .- :.: *. I^:?*:

' -.5E -^. T'5 -'"'"- -'- --- ",'.' *.; -";*. .--."

.... .. .. .... .. .,F




::" I .... i, : ," :, '. ,' 1. : I, "....:: "..




V
Yt



tz- NVs 141,



,t Al", "J"-
1, '4
"A
4I I j", %
l4q, 'l I .,
Y kv
"A
4, ,_,

A

Al

t
"a
-7 1, -7 "7 7,-
OW b uft
M- 0_0
of s za,,g&wo_


Rup aH
1 A4,
o""'Airb ---------------
gitiW
P_ -CUT
tliod s oft& j"* d -------------
AcawlblfiWfior pblltiykilitis_,.,_
*icbiiiluemoa169, app.lcxy_ 33,
44
the b ------- 31
--------------------
0( it
YSlS'Witholit4,6cifi ------
Othtr,-formsof
m_. ------------------- ------
Y -------------------
Zvu
Obil bfWAUCs(undpr,5 yews ofago)_ -
OthbrAlisrowpo-of theuervous-sv .......
IS048 Jo the Oars-' --------------- -

"Doe"es, the ciroulaiiy sykm.

M Ardi -----------
t ......... -------------- 3

Or 'I
T',
R
gma -- -------
w, o tbe, art&, ath&"M, aA4 etf,_

------------- 21
4
t nbblismVid thr()oibf)Js_ 3,
'U, C8 of 7,the O's 44

offiotAic of the birdaw-ory, 44,
7
MUM
7 7',
4 7

4 J,
4" 1 I 1 ,
bf l i 1 -11 1 1 1 1 1 1 I I I l l
C
4;

M40,
0, _IPM51
q
-jot,
4
77 7
p 7
la, x

P
Al
Old" 140
















av 4 Ka*..... V .. .L:.4. ..K *. ,
. :... .. .... ...... ... :.... ... : i '
a r %r E..:..'.:.":ak ;

:fqhiv h K : e' ., .. ii




:" -. '. ". ". ... : ". '' ": ... ; .. :.':. ., ,i -, :: .
pai..,. n.... ;... et.. ..::e:. *:.

"s"w ""io "s. ....... .....' ... :,::,, : ":: i ,ir: :::
. .. : ..... .... ... ... .. .. 1, i:: ... ; ,r* 4 .: : ;* *:: -.'-" ^
X". ... :. "e ........ : ...; m "




^ufly f th Oera ..... .... ... '.. .' .; ;







. ,.....:.. .. ; .. ...... .. .. ...:. 1': ; .,, :: ,. :.. l ... .S
... -... .. :. .. : .- *... .. .;
.... ; ....- .7 ::





"--- ... ': '4'"-" ';". l
.. ... .. ........ .. : :;: .


..... ....... ..,......... ,..1 ''..... :r". .""
"K,.*
J. .: .: .1.






li3) :,. ..... ,i3: :. -.:,;. ^i^ .^; ,


1.. [v .Wii

V K- .-. .- .K ,.)
t t---t-t-x- --- --- -- -- -- --
-ME I ..









B1----------^
Oiyn Ofthever. :A
... 1. .... ...

--4--
..=.-.... ... ... ...... .. ,

'T d 7' '


4 E.. Ki
""11 .... ...






...... '.. .. .. .. .A .. .. i E



: : : ".: : .:: .. .: .:.. ... .. .....: .. .. .: :. :. _,; ; ., ;
: ~ ~ ~ ~ "i """ ;..:::.













At
Ni



"N'
L V4
k -Pj

CPAl
91





ta9lofu&l,--

f "gamof lopo&-

Xq -',Os of the iicflm at"rew
---------- -----------

c 11 ",
bopY
he li- ft
tea) -------------------
CIO ,O
At

vougomtal walflDrWMjCPS'`,(Ai(lbirth not in-
----------

ancy-

IV W 0 Hit-Al lie *,,and siAproAa- -15,J 4,4



%i td
14 W- 41

ppre. T I
-P-RN,



A"'! Own
'Wit"
A"Mog

Oa

zo






X















-. .4. ..K41...:. r k,, .... W


K! .4" ;4 4, Y
!;'. -. .. ;l....: ,-" r,-. ,,,: [.:!:...: i i'.".
P W. LEj_:

!q"'jK .. 4. ..-.i.s



o1 -IM -'. P h
4.4
"1 ..' "g
A ..... 6; ...........X u Wt ,.,.. -

"'2u aae *." '' ..." .,,
.;: 1 i': i''. .. .
nil :; 2M








IT." Q K" .: *'O' hfl'
YT ".:..P. :;q., Y



.... w': ..... J V Y:
,,SO,,,. AM) D....., O. fP L.. :.
.:, :,. .,, ,.... .. .. ..:.. .. .. : .... .. ....



4/i rn.'.: .. ... .. :....1 "
i~ii !.F. .'" ,: :: : i' :. :::





: i r:*








.V4
A- K-'.:. -. ::
kh: T;:


it 01% O.S3 in
:" .,. .




.1. Kh 1
71 ...:Y .h....3::, :.. -








41'i '. K*
OR-. .:.:.:: -k!B M'P-:.:
i. .(' :I.: .,. ... :" ` .. ,.,.. : .. .. .. ,. ,. :,.,,, .
Io --I-..I-: ; "i..: "' : .:': l ; ,i ; i: i .
;;..'. I *. ": .. 1 ,,. .: ,v ',::.? i ':,

.. : .. ....': .. v '.. ..."" ".:" :,: '; ,:,,:'' l





n. A h '.O$ ".lb
:. :', .E::.: .". .:: "" ."".. '"'YL CYTi...~




.. :" .'.:".: .. : M: "
A m. % .: .-. "l : i ._ ". '. .. i ". :E :
..... .' ... .. .. .. ... :,.- .... ... ... .

4:::: ,:...:.i 4 ... ":'. ... ..
P;ii:.,.,.; .. .'' ....': '..


A:.-. -. :x .! .' ..p 0 A,''.:i 'I


T4 A'.Kk,: ;;i': ; r
5 ... ..:.;. F:;. .. "_..h ._!i,3:. ..: .: :!!
...e., _. .. ;., ;.. .. ; !.: :.
i. ;i:::ii .;,. '. :i :'' ;..' o ... :, .:I i : ,; : : :.. :. :::.:., "* .:; ..: : ,..;.:; ii : I : i::.:i, !. ,::: K ,!,. ,r:
i-. .:. ...:: .., ...... .,, ...........,....










1 14 t;AXII




TI




iT



PY

1- 40*
TT


pox
----------- JIG,
-eo W I iricjoyeruliqft
-----------
AN- ------- ---------
-------------- ----
nc (Wcil!; dtsew)
emic dimasc*t # -----------
xnd W,
------------------------- --------
----------
l*Pt PIE= pueuinDcome ---------- ---

---------- -------
Bpr --------------- -------------
l
of tbe, ItLugs': ----------------

T,4 lous ------------ ......
- -
WOOS.*
-------------- ----
OTgms- -----------------
7 7 ----------- j -------
-------------
-17
........... -------- ----

4
-J --- 32'

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

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


p ioidyi
MWO" qp


'ot ', ,I,'gjjjM
tum
live,
W v ompa 'k r

top# Aq


"qui lmft 4





. ........
al ,
v

rq
















wMed-1,




'v
4
3
23
+
It
4,

2j-





Is -------------- -------
spi mil wr d -------------
." AL'
'Poployy

14
A, - -

---------- -----------
---------- ----------
-9
3G
-----------

Vli

2
Ag 1


*V14


"ILI
alle,


4"N

45 t

t ltl SII uvl




W41 fJ
g
V
Al 0
!4 ") "f"- 1 -,,,I 1,'-



IV j

4"
q
I 7eIle
A





Al

nx
is"
Y W
Nis Oa ',s'Oftbe thy!,rp1 bodf
6 b, to ` his" 7 7 97"


hia ("qwNfi4d-
Jbar pkim'
Plow sy,----
----------
j L4, t
P. ----------------- ----
x T
-p-IjIm6nary e6ng64idn, p4monary apople. Y
Apgriie Of the, ltlhgs- ----------- --------
---------------------
Pulm6iaary e --------- ------ -- ---------
of t4e'rp ratorty sygtem (ttiber-'
u!Osi oxcopted) ------- ------ ------------
S ms ofILM S -------- -------- -------

f the dioestive syste,'M'.

Dieves of he''Moutband'Annexa ---------------
Djeaes, of the teeth --------- J8t
------------ -----
'of 6e'pharynx ---------- 4
',Pbaryn --------------------------
PIS [I o )Ii4lis ...............
,,so the
Foriggn body in gebsopbagw; ------------
krf-Iiii "agus-.:.
ie,6f, the ego,
ftlies, -------- --------
0 lw+ b to a',
'ffi6rtb,*ge, oftlilo stomach (,eall"T' eXeePted) 14 T
----------
Wtil, gastritl*S,4 ------- ------------ ----
-----------------
---------------
3
D laiih6'and.,onp--ritisO pars,404, over) 94w,
4

a as Z

yphii

'52, V`



Oifitz e 'iffteq


w 0,
K




1w)
A





Itm
k"II
tI

Ac I
orc V, |e
kofiv~
14
.
:TSV sstm(Cncr
4A!
ap .h ontoOrnry yI~
xa.,
... .. ..... ... ..
On' rili n-phits 2 4
"thliiwyan anex 0 10
.. .. ... .. .. ... ..

























01"
1 . t
Fro!
Saw-


Y 4 4
on W


Ai

'IM 1
son,
4ml ape




















SION
tl
ml







Inn




t 110 111 1,11 1. 1 11, I

Y
.4 'It
.4, -41,



A
1 7









W,_ G, Im 4




ok
V 340 2 -2A
0 -399
.8 286 Wo,' 3 63'

1,l 673,71012M 43 1173;61 1-J46, 23 24,.LV,
if 17T 3,11 545 6
24 8' 1 12 S- 49 5 15
2" 2 7 33 171 R. 4 1

4, 1 348 728 7,367 8,06 71 393 7,326 7', -674 7-3 2.51 04,-'

36 5 36,7 4 27 ",10 1,;, 35''

26--.-- 43 ---- -1-- 40
77 77,-



413 27 "'t
5 11 232 542 14

77 13, 69 217
.29 83 36
14 '15 32, 4
-M
-4 2' 26, 114 2 of w
-5,6 83,- 4 7, _;Z lf

10 26 614 14), 57 7

_4

,2
:2 43 21

4 41
T



44

2f A
'l
7 7-77- 7777

tJ f_,












T, T IN
TV,
,, A
T;I IT


qR
IT I,


Y!
'21TV
t TI
T
I TF
I, V` 4F1,41" T f*4 T It It I :l
T
VI IT
g "I't Q,Tlmt,,V 0 TI,
"IT T" I 11, I V I
TV I.
IT
V'
F411 I
IT ,T'p I" WA 11
TI, *7
bd'A*" 4 "1 i i4T
VI 9
k, Ob
,A 0 t Ak
I V,- 41
t 14
'T"
A
IT III
4
TI EMPL Y,
1, T 111
IT

to "IT 44
4dIiiiqn toTq*hm.

-C,

Whi-to. Colored. Tbtal.,,

IT
'AT
$87 47i j
J8-
730
I TV
183' .42Q
IT 'j, 178,, 1 11:14i

T, T, "It, All 61,11
1 11 1 -V,
'411t ma
451 iga, 639 4,24i

"120"
'N
It 4
88' T
0
TIP, I I I
't j-T 4,
AY IT IT

I I Tt
t", "''36"T- 30,

4`IW'j 2"IjW L I .... .
C,
It,
rj
I 1k,1
'T -11 Ik", N1
, -I T
'A
A'
OL Ji
VI It, t" A, 7i,
TV A I I I TO, qu
'T
TT
TILT T
A xt
Al'i

t it
t IT` -
IT, I
IT, it 1, 4" GT', I I I
T, V T4 14's
44
"N

IT "IT
It
TV n,
tV t4 I
77J
17- *3
*T T,
IT, t4


TT,1
It

ITT






















































'*1 I,

ALL BU~ TErATNELZ~
H -%


r4
~~ifl~BSS.
H -


'?';; i
;. .':t ;
I'
r .
. I ".: 1
























4M









t I


1, 14,


t'%'. Vl "4
At I








el- 'IJ
L L


2-9f



















1 04






'44q's
















14 4



-14
IT
'4



41144
TO























..:. ; : ;. : i *;:. :: i ;:. : .. .. : 3 '











h;;,. :' ''-..- 0..... 2
,: ..;... ...

Ji i '
'": '" "-" L .: ...y." ;.
il. ". .: ... .... .7

---:......... ~... : :1,
S ,.', .. .... ... ....;i. ...- ... ". ;'






... ^ :00 ,


Zx -A


':is i .. it i .. : : I : i "
... .. :: :
'.. .. *: "' ^": ..... : ... .. .'." d .' .. ^ : ." ..

i' "i:i :-- i : .: ",. ., .. '.;" .. ." "' .."



HK-;;;,^ -. .l:'.:"....K. ]^:;::.








"".. -I ".S ..
.... : .. .,







"Fit

4t




00
1,4, 1# Alt It



It

tA4Ws,

A -Ulav ------
W4

TA, faidim, 7
2

othiq-'W'', is wid ft'-O 7m --------- 14,
-------------
r r
Jn. 0 -r'
4* OU6, 'p, IDTO, --------
Nsip'', OW"Of garbago, oiwfR-ftn- m-T g P dnama
b pro
LDiq' of 3! Magm, ,, =oloftnm
-1 -601t, an al 6w ---------
Dis ote., cailal ZO'u
lA I dn l.aud et. of bufff(UAgs' J&'
pou -ofcoroyAlY=M-----",
Op 'r "Oli

'o ------- --------

T,*,figures s&own a6ovd f&"IM do m
t0serv
'C T" 1-8 omittad mi or&r to i
orgmi
6, 941 W)IM 00 gmltwty pay
TA]Rtu, -X, IV, PATIENTS OTHEFC, THAN EVI'Vo"RA
HOSP",AtS INCLUPING PALO SFWO 1,:VPjgjft
jjF,'CELrVED, FOR THEIR TU'E'ATUftT.,


log A(l-
Witted.

_%jd IV 3", M- 10-

173' 10*1

4 '
x,
,:t14 `11 30j
VOW
_0


V" -P, t A*-
'TA pt"
't 453-
Wit,


7
"u,
'4t 0
N t

Jj




















` .: Obs ..ea -l .......
Al... -t' 7".I ib ..

:. 1 .Lii. orqeps .
S Version. ..
.7.4..a : .
raditherax
; :**** -.J~ l i^ ::1' : ;':"



i:.:: -. .. i- :





11 4
S.i..
o a
.. ... ...... .. V......
r.psI :..:p:.,



4 .. ..4.. :
ri f'




















14
14
OR
0",6-
01I, Y1 'j, il, 1,
YR "My,
saeg,Iof Aiv
it IS qt
MI t r,
pal 9
Ta
JZ`77,
a`
,tereo my
t
Gu
ji
s tab w
lit,
y''
D th 'r

OM'Y,,
41


116fo's' reproserii t6:,:UMbii oi,
loWihces, two -prAnor iaro, I" f Ud uipoktoib,

QPE'1FtATfoxis ",_kxDl 'WOR
XP AND' TRER 0 A


n, ujnb qa -I


AAS '61"I"G, T181
Ab4c-es ar'-'_' 4
A --,, 4 P
JDWJT)M, sl, (I a bi on of aq-
YIII l6l
3,
4
CAjithO L` 4, ape,

u6t, seq ,qtfo

4, I
olridf Apo
I
at

Ole,

Jo


"It




'T





Ip
N,




-TT 4,


Stbolexamif, t
276760 cefiiMlonao, iAtesdh4if
Batfiii" IT
phallus.
-ukine'03t f f o I S 3,:,'*, 3
2 Albumen-,
Albumen 7it
721 Sugar-,
2 WS, Pusandblood__,,_- j T
1,20
41 10ficnn_'_ ------
2_
11 558
2, Bile -------- I --------
0 189 Miefoswpical exA
368
2M Trieltamonasvag _41
I v, I
IT Hemin 'ryst
------ 486,
2*100
IF 3U -T,,, IT,
43 Tubercle bac!W,,
34,1 Am3ba ---------
------- 185, Blood -------------- ------
------ Elastic tissue-
4126r, I Mise-eilancous Ions,
_1 8 pjej7jMj 6ff' uslom-
2- Various smears""d. Ai,
charges'-

Vagin4,aAd uretbtiddis-
0 IT ebarges-r-_ 149


1 0R TIOUTT WATIONALIT


Ar
wumter 4f
IT
'Wila,
'ITT- IT,



jo
MV TA
4k
MP
A"' Y,
41

6" U7

T"r
J4

Y
,tit Ut




































. i. : :: ,. r. 0 i k. :
i.,.h-'- *!,, ."- -*,.
.."T'. ^." ". '^ .: .':". .. : :."
." "';. I .. ; .


p .. .-. .K. .F. .. .., R; i


W ftl.. i .. '": .{. : iE.. ": :" ".:. :!*::. : ..r

iW7'.



S .. '.. ': O : .' ... '. i'
.. irgi... .. '. .. ... :. .
^ ff^'l^ l.^' ~'




.Y*.
: :. : ;,i.: ;: ,, :.. l : ."., :w' Mi : "
~~~..;.. ..,.

i:.iiPi ii :'' ... : i '
E~ ~ ~ ~ ~~~~i4 ":~ ::. :" ,: ':'.':. :""" ~, '.:'":'. .. "" "
:i, a ': i; ", :'.; .i i., ,':,. ,: .,." ..
'N : '1,";.' .' ., ;., :. i, ,.


::. .[ i .E .. :E't. :::. :. i B,: : i r ": ": : ...
:" ?' ':; A :'. "":' 1 .'" ::.", ] 2. ::.)' '; !i:7..i': :,7..;, "::I.:i,


~;tjmhori":;i
;trtit~

A1~~et


!.-. 4 ., ,,,

. '. : -
." l


..' ? ," : Z ..


_: i


. ,

















A, :i.N.:.,.,.,:.*4 -4- ,t
: ... :. i '*:. o ". '" ". .
.S .i ';: ".:. .. ".. *, ... .* %,,. ;:: :" ....'**:*. ^ .^ S i :.

l* 0 :... .. .... a i i



r:.d.,, *:..* :*te nt .i e .. .. .... .

..en, :perd. ,....rd .. .y. ....... .

'NATINALTY
.i .*. ;.. .. ....







al0 ATI :.
::.::.,: -: : b.... .... .... ...^ : ...
: i" ".":: ": "" ". *.l : .* "* .: i i ifc ^ ;""
...,



s. ^""' .:. ""







II ;.., ,...... .; ,. 4-a e -.. .. ::;: S
.. .....',t 1 ....


.. .. : ...
4... 'l".4 -NIL:
N ..


....; ..
.U !".::. ..-. .











..:" .. .. : ..... ;. : : ... .... .. .
::..'E: .. :. ... ,: : ." .,' :' "" ., "'. ".x .' '::',E .'': : u:" ;
:; : '< : Ei.: "" : "" ::' :., ..' .'. ::i" :: .:.. : ; ::!:.4

.. 2,:,.' ,',. ..:, ";.:,:;','.: ":.,. :i. : : :, ,'..%".:. :"..,., : : ['::k:,:, -:
,r ,r ii :i III : : i iII : ..... i .: .. .:..:, : ,,.:. ,.. ... .. .! < ,..:. .:,.-' .= r : .,,:..,
: i: :E :::::: i :"'.' .: ."' i` ::':.::: -T .': : '. "" :: ': # ". .i'
,,., ..., ,. ,., ... 7 "s, : : ,,, ..... .,a..,,,u. .., ..., 3 :.: .,.. : g :
.':E..:' E', ...:""' :: :': ": E'E: : ." :.'".:. : E .:" ..: i.: .: .: o. :E. : .. ':. .. .: .:E::: :!! .:'.A : : "
:.. :: :. .. .. .: I. c. 7li a.l ~ :: .. :. .. .q..
., M ., q :+ : : ... ." .U. ,&. .. .: ,. ., :., ... 4: .: .k : ., :
| -,."X v; S1i. .; :,! '".; ; ; ,:, .:; I ::; t, : "t ; : ,|T;: :;::?:',:' :! : iL
M R. : .. :. N. A..: # : : : :. .
.. ... .. ..;#;..;:;. / ::,,; ... .. .,: ..,;:..,.: .,, ,; ,, ,;., ,., ,'A,` ;: .
[ ... ,,. ., ,: ............ ..,.:..,: ,. .. ., .... ...W .EI : .], k Er ,











lot=



1A, -3 Z, -T-h'l
KTI f,7"4,. -7'

A

rx


les
id p ar,

'04'gA
A, j",
----------
-z, t o 'us"'

lb-I AM J3 Soo ''bhoff,
2Z

14 Y,
dia
A 0iii
ue sti; 'oe find
-d f -01 chost, 3
--- PU ------

I jo, 4` '3 'itd U I I-
1 2
-Tim gA bku 4
OP,*s oqlu-
2 -,U"Wide tO`,
py qV -,Offior
--- 21

fal ------------ L imeL A01

A4 (vetor-
Mary., Doi.



JI"
Agglathaquoi*'
4 11 A-1466M

64 4:f

040 1,04
"W 4v 114.,
40
Y- N'l
1 4
la
'A A"
"'t 4
I I*M







iT





























IP AIui WE.



A:4
..' ":. ... .. r:


i ,- -.. .. .. -]L .,-O ..


.u .... k. ... .
--:



-11- : --------------- *










c MV".- -- --.-
-. ... :. ,. ... .. ..
X .s
1 7. F, ,m p!\..::'.,. i

~ ffl S".;~'I l A.i. T. "



. .. :... .. .: .. e.. .

.. .., ... LC... .


: ?. : ". ." ". :E:.y ".-: .! "

"" "> -*^ :"" :I :i3* ?y ^**: ii~s :

.g. : .... .: :.-. ,; .. "-; ^' ..''.:
: ... .22. .. ,
... .s .. : ." ". :, :: E
," : "-'l ."" "E: ,. .. .:. .. .E: :
.." E, .' ':,.'' .-",' ', "' '.' ." "'"



: "'. .w .: .':: i: "::" : .
....:.. .:. .... ... ,. I ,. ... .. : .: ,. .. ..
.. i :' .''. '." ': :: ,. :i ." :'' :









































:4 : *. .. ,"' -:: ,..
led .. me. .....

I. .... .. ....... ...... .. :
Ifl. : ,... .. :: e. .-.: .'.> i
,, e- i^: :,, e:. "


"', .. '' ".












".4

S7, 2


'30 416
12-,

- --- -
",646 6npiohths)
d, (sev, fog
d, (seveiimT641sj -------- 439
0, use -----------


s,, Hirig n JbW plaOcs ---------- --------- 4,,40,4,
gp'"tat, 7 7- 20,90a
,df'ift ------------------ ----------- 7,727
'dit6hes maifitdined ------ ---------------- 830
--4,'C': 0 w''Emet6d ----- --------

CANAL Z 0.'M

sqaarWrhidstets department.
---------- I ------ 130
7 ------------
------------ ---------------
------------- -------------------- ---------
engmedring departihefit ---------- 208
----------------
Jber depaj7tDlents.,------ 7 ---------- 25
Oatemeiat of 'nuisahces ...... ------- -------- 7
dilpf sanitary"regul
T
---------------- ------ "36
32
yroved --------
----------- 33 195
----------------------- -------------------------- -------- 2 171
501
71 7
-------- 7825,
--------------------
7
68 746
7 ------------------ 7
------------------ 68


114 802'
e pyed at hbme
I I I
GYCA ft''t houses- ------------ 481 =5
'o'mv' 1 larvDe-
44
o-yedinloWes'.

------------ g Ons,' 42 0415
1663 4W,



"W'XI MV -QTJAUAlqltiNlF,

'IPIANAl3f 1341,H A"
t4




3&

V, W Y










e
"N'


or
Pik,
79,

*4 1
'h idin,

f
'Vor A"



'12 '49n


N
V ------ f -------

ftmx`#mb d-fo t_Teign ports--'-
4 ---------------- ----------- ----------
-------------- -------------
5,t7
OW 11 t
----------

Apj#rent deffeasefor thO, year from fbrciguports:
M it ---------- -----------
-------------


Total, ----------
t ............
IP Om cow towns On'sma" cran,
Omns areving fr 1 T 'i
Telmm OmbaTked for wast towus- on %mafl ffaft ------ -7

AVp=4#'jndeam for the yW fiom coasttowm

----------
p p-------------------------------------

Excesk ver *Piiiml)jbr landed_ --------------------------
Lew m-m for raclWe, ports---

-y
f(jr rojection-
zn,
re rkjivm W_ tes bmausbot tr
6111 ,Df I"& VISOd



30' cted and liaWed
And pa-


d, _j*tetlk"w of, um of yc
Peu held t6 W I&,*, j*06dpf HIM 3'



YAvq

#
#
4(
'Y
""Y*,A 'I,:-" '' i, 4- t,
1, 1-7

















rI: N In. 2 1





-. F : .i~... : i .l .


t-: .'. s14 A1 I-
*f -t-. --',, -.,..,. .: .:'' 3 ........ :; n -:" .. ........ i/'








'::: .4:. .
S ...... .. ..:


.l .. I ..
S.J: ;: ..: ..
: .. .... .. .. :. *:V





.: M F" ':
.: :. : : 1 ; .
"i"^::::.^







^ ,... i, .:,:, *?0 ., 0., ... ,* .. ..:.:;F.;, :,.; : ;
_, .y ...,. ; |:":: ," ii ':



.....":I:~ ..,,,..,.. .. ., .. .. .










4,
va ,l
-*,
11,


"JV

'1v T t

it,
"Tt 4*
Jkil
7'r 4,11,

T': Or r




J,
-a" ar r,
76'lll tt'201,
------ ol
......... 59 ,b12, 0,
I I I 1 -1 -1,
4 4, 0 113
44
"o o 199,

Tt 13 0 0 247
It
'o, o 39 10X`

-----------
JV2 0 0 20
SO" t ber- 44 V2'
Vol 0 2,,
59, 152 Ao
o k ber, 48, 133 -o, o -1si
-- 1 48 100- 0 0

Total 79 2i 124 1 2 8'84 "j,






Tll













T T





I IT 'T,











Tj

TIT
lVil l I fl,
1w

Tt

IT


Tr 4 l,







UNIVERSITY OF


3 1262 0854




Full Text

PAGE 1

r u TF TE EN'T HKE EL P, N AL ANA : IV 4j

PAGE 2

WXX F .7 AN .l% h 77 e ?14 % -5y; -J

PAGE 3

REPORT OF THE DEPARTMENT OF HEALTH OF THE PANAMA CANAL FOR THE YEAR 1914 CHAS. F. MASON Lieut. Colonel, Medical Corps, United States Army Chief Health Officer, Balboa Heights, Canal Zone WASHINGTON 1915

PAGE 4

IA ES4 Ap LA.

PAGE 5

CONTENTS. Page. Letter of iransmittal. .5 General remarks.--. 5 Vital statistics: Health of employees. ------------------6 Health of residents of the Canal Zone ....----------------------------8 Health of residents of the city of Panama --. ..-------------------------8 Health of residents of the city of Colon. ...---------------------------9 Division of Hospitals. .........-------------------------------------------9 Ancon Hospital ........--------------------------------------------9 Farm for disabled .---------------------------------------9 Board of health laboratory ......--------------------------------10 Insane department .11 Chronic ward. ........------------------------------------------12 Colon Hospital. ...........-------------------------------------------12 Taboga Sanitarium .----------------------------------------12 Palo Seco Leper Asylum. ......------------------------------------12 Santo Tomas Hospital. 13 District dispensaries..-----------------------------------------13 Sanitary division: Canal Zone. .........----------------------------------------------13 Health offices, Panama and Colon--------. ..----------------------14 Panama .---------------.------------------------------14 Colon---. ..........--------------------------------------------18 Quarantine division: Panama and Colon ..........-----------------------------------------22 Malarial chart -.-------------------------------.---------------21 Statistical Tables: Table I. Admissions, deaths, and noneffective rates for employees; deaths of residents of Panama, Colon, and Canal Zone. 23 II. Deaths by age, color, and sex. ....--------------------------23 III. Deaths by nationality. ......-------------------------------24 IV. Causes of deaths of employees----..---------------------25 V. Deaths of white Americans and white foreign employees-----26 VI. Causes -of deaths of employees and civil population and places where chargeable. 26 VII. Admissions and deaths of employees in hospitals of the Panama Canal. -------------------------------------------31 VIII. Consolidated hospital report. ....---------------------------37 IX. Consolidated sick camp and admission to quarters report. 38 X. Consolidated hospital, sick camp, and admission to quarters report. .........------------------------------------------38 XI. Employees: Constantly sick and noneffective rates per 1,000. 39 XII. Employees: Days' treatment per admission, hospitals, sick camps, and quarters.o.-----------------. 41 XIII. Subsistence and operating expenses and financial statement. 41 XIV. Patients other than employees treated-in hospitals and amounts received for their treatment. 42 XV. Surgical operations performed in hospitals.-----------------43 XVI. Operations and work performed in eye, ear, nose, and throat clinics. 44 XVII. Consolidated ward laboratory report of all hospitals. 45 XVIII. Report of Ancon Hospital. 45 XIX. Report of Colon Hospital. 46 XX. Report of Palo Seco Leper Asylum .----------46 XXI. Report of Taboga Sanitarium--. ------------------46 XXII. Report of Santo Tomas Hospital. 47 XXIII. Report of Board of Health Laboratory. 48 XXIV. Report of issues of quinine. 49 XXV. Sanitary work done in Panama, Colon, and Canal Zone. 49 XXVI Quarantine transactions. -51 XXVII. Personnel report. 53 XXVIII. Hospital cases of malaria among employees. 54 (3) T.

PAGE 6

N II 4 a. N -mI 23

PAGE 7

LETTER OF TRANSMITTAL DEPARTMENT OF HEALTH, Balboa Heights, Canal Zone, February 23, 1915. Col. GEO. W. GOETHALs, Governor of the Panama Canal, Balboa Heights, Canal Zone. Sm: I have the honor to submit the following report of the operations of the department of health for the calendar year 1914. Very respectfully, CHASE. F. MASON, Chief Health Officer. GENERAL REMARKS. One case of smallpox was removed from the Pacific Mail Steamship Newport on April 16, and recovered. With this exception, no cases of yellow fever, smallpox, or plague originated on or were brought to the Isthmus during the year. The department was completely reorganized on April 1, as set forth in detail in my annual report for the fiscal year. There has been a steady reduction in force and expenses throughout the year. The cost of the department for the year was $1,094,682.92, as compared with $1,484,941.09 for 1913. The average number of employees on the rolls during the year was 44,329, as compared with 56,654 for 1913. There has been a large shifting of population from all along the line toward the Pacific end of the canal. Two new towns, La Boca and Balboa, have come into being, the former with a population of about 4,000, and the latter about 1,200. A census of the Canal Zone has been taken three times during the year, the last showing a net decrease of more than 14,000 persons since January, 1913. More than half of our employees are now living in Panama. The census of Panama and Colon, taken in August and September, 1914, showed an increase in the population of these cities of 12,828 in Panama and 9,099 in Colon. During the year a general vaccination was done in all the schools of the Canal Zone, as well as those of jPanama and Colon; 117 children were vaccinated in the Canal Zone, 5,186 in Panama, and 1,097 in Colon. The percentage of "takes" in the Canal Zone was 67; in Panama, 80;and in Colon, 80. In addition to the vaccinations in the schools, 33,204 other vaccinations were done, with a percentage of 68 "takes." A plan for a thorough annual physical examination of all gold employees has been approved and the work was started in December. (5)

PAGE 8

6 VITAL STATISTICS. EiMPLOYEAS. The health of employees has been better than in any previous year. The total admission rate to hospitals for 1914 was 244.49, compared with 351.10 for 1913, and for disease alone 182.57, as compared with 246.91 for 1913. The total death rate for 1914 was 7.04, as against 8.35 for 1913; and the death rate for disease 4.40, as compared with 5.24 for 1913. The noneffective rate for 1914 was 12.22, compared with 15.97 for 1913. The changes in the regulations governing sick leave and admission to hospitals, which became effective soon after the reorgaization, no doubt had some influence in reducing the admission and noneffective rates, but the fact that the death rate has also fallen decidedly shows that other factors are more important. With regard to malaria, the death rate has been reduced more than 50 per cent since 1913 (0.16 in 1914, 0.37 in 1913), and the admission rate to hospitals more than 15 per cent (65 in 1914, 76 in 1913). The constantly noneffective rate, hospitals and quarters, which was only computed in the last five months of 1914, was 1.51. There were no deaths from hemoglobinuric fever throughout the year; there were six such deaths in 1913. In the latter half of the year a strong effort was made to compel employees suffering from malaria to continue the use of quinine after discharge from hospital for at least a month; failure to do 0 was punished by suspension or discharge. It is believed that this measure had had good effect. Of the seven deaths from malaria four did not occur in hospital; one died without medical attendance, and in three others the diagnosis was clinical only, and therefore questionable. The admission rate for typhoid fever 0.52 was more than 22 per cent less than for 1913, though the case mortality was higher, giving a death rate of 0.09 as against 0.07 for 1913. In the latter half of the year a periodic physical examination, including urine and feces, has been made of all food handlers in the kitchens, mess rooms, and commissaries of the Panama Canal, with the result that one typhoid carrier and a number of cases of contagious diseases were detected and eliminated. The admission rate for dysentery was 1.80 compared with 1O7 for 1913, but the death rate was slightly higher. The death rate from pneumonia has increased from 0.83 in 1913 to 0.95 in 1914; all the deaths but one were among the black eployees. The increase in the disease is probably due to unusual H prevelance of measles and the overcrowded conditions in w h the people live in Panama. The five diseases causing the highest number of hospital adm sions, with their rates, were as follows: ,. J

PAGE 9

Rate. sions. M.r.2,884 65.06 Venereal diseases .---.-.-.-.-.-. 1,001 22.58 Acute bronchitis. ..---------------------------------------197 4.44 Mumps. .-.----------------------------------------------122 2.75 Pneumonia .-------------------------------------------120 2.71 The five diseases causing the highest number of deaths, with their rates, were as follows: Deaths. Rate. -neumonia --------------------------------------42 0.95 Tuberculosis-------------------------------------------40 .90 N ep ritis. -. -.-. -. -.-. .-. -. -. -.22 .50 Her, organic disease of.----------.-----------------------16 .36 Malaria.-----------------------------------------------7 .16 EFFECTS OF SEASON. The highest death rates for disease occurred in thb months of March and May, and the lowest in November and August. The cause of the increased rates was an increase in the deaths from pneumonia and tuberculosis. The highest admission rates for disease were in January and March, and the lowest in November and May. EFFECTS OF RACE. The admission rate to hospitals and death rate for disease for black employees were 191.93 and 4.63 per thousand, as compared with 523.63 and 3.13 from disease for white employees. The noneffective rate for disease and injuries for black employees per thousand was 10.16, as compared with 23.20 for white employees. The admission rate to hospitals for malaria was 56.96 for blacks as ,compared with 108.06 for white employees. The total death rate for Americans was 5.72, compared with 9.53 for Europeans; for disease, 2.67 for the former and 4.48 for the latter. Thert were no deaths among Americans from malaria, dysentery, or typhoid fever during the yar. The death rates among Europeans and blacks for these diseases were as follows: Europeans. Blacks. Deaths. Rate. Deaths. Rate. Malaria.------------------------2 1.12 5 0.13 Dysentery. .-------------------4 .11 Typhoid fever ---------------------------------------4 .11

PAGE 10

8 DEPORTATIONS. The number of deportations was 176, divided as follows: Em. ployees, 115; nonemployees, 61; disease, 140; and injury, 36. CANAL ZONE. With an average population of 4,379 in the Canal Zone there were a total of 710 deaths during the year; of these 614 deaths were from disease, giving a rate of 13.24 per thousand, as compared with 14.43 for the year 1913. The death rate from tuberculosis was 1.5; the percentage of all deaths was 10. But for the enormous infantile death rate among the negroes due to ignorance and indifference on the part of mothers, the showing would be still more favorable. The birth rat3 based on the last five months of the year was 19. The infant mortality based on the same period was for white chiidren under 1 year of age 29 per 1,000, and for colored children 347, with a general average of 252. Of the total deaths from disease, based on the last eight months of the year, the percentage under 5 years of age was 42. PANAMA CrTY. The average population of the city for the year was 53,948, among whom there were a total of 1,863 deaths; of these, 1,772 deaths were from disease, giving a rate of 32.85 per 1,000, as compared with 30.21 for the preceding year. The death rates for malaria and dysentery were 1.91 and 0.69, respectively. The birth rate based on the last five months of the year was 54.52, The infant mortality for the same period was 272. Of the total deaths from disease based on the last light months of the year the percentage under 5 years of age was 50. The high death rate in Panama is due to several causes. It'will be noted that 50 per cent of the deaths occurred in children under 5 years of age; they were due principally to gastrointestinal diseases, the result of ignorance and indifference on the part of mother. Another factor of importance is the serious overcrowding in the tenement districts, the result of the rapid increase in the population of the city without a corresponding growth in housing facilities. In the recent census enumeration it was a frequent occurrence to find six or more persons sleeping in one unventilated room 10 by 10 feet. Tuberculosis gave a death rate of 4.26 and 12 per cent of the total deaths. There was a small outbreak of beriberi commencing on July 21, with 1 case; 2 more cases were reported in August, and 16 in September; inOctober there were 2; November 4, and December 2; about half of the cases were from Chiriqui prison, the remainder were scattered, and a number were brought in from outside localities. Out of 27 cases of typhoid fever which occurred in Panama, 20 were in the months of February to August, inclusive; nearly threefourths of all the cases in the zone and Colon occurred in these same months, and were traceable to sewage-polluted oysters obtain6e4 in Panama. n J

PAGE 11

9 COLON. The average number of inhabitants for the year was 23,265, among whom there were 590 deaths; of these, 563 were from disease, giving a rate of 24.20 per 1,000 as compared with 22.74 for the year 1913. The death rates for malaria and dysentery were 0.86 and 0.17, respectively. Tre death rate for tuberculosis was 3.69, 14 per cent of the entireldeaths from all causes. The birth rate based on the last five months of the year was 48.60. The infant mortality for the same period was 194. Of the total deaths from disease based on the last eight months of the year, the percentage under 5 years of age was 43. DIVISION OF HOSPITALS. There have been considerable reductions-in the personnel of this division and the cost of same during the year. The number of employees on January 1, 1914, was 570, and on December 31, 1914, 392. The cost of the division was $883,356.49 in 1913, and for 1914, $596,858.24. There were 919 charity patients admitted with a total of 49,939 days, as compared with 1,340 patients and 67,216 days in 1913. At a minimum average cost of $1 per day this represents an expenditure of about $50,000, of which $2,400 is returned by the department of ciN il administration. The number of soldiers admitted to hospital increased from 405, with 5,938 days, in 1913, to 1,481, with 17,704 days, in 1914. ANCON HospiTAL. The average number of patients constantly present in Ancon Hospital during the year was 929, as compared with 1,159 for 1913; the average number of employees constantly sick was 452 for 1914 and 674 for 1913. The gross cost of the hospital for the year was $461,056.64, as compared with $529,282.74 for 1913. Complete plans and estimates have been prepared for the reconstruction of Ancon Hospital on a permanent basis, but the necessary funds have not yet been appropriated. Two of the wards have been condemned and abandoned as unsafe. All the buildings to the west of the nurses' quarters have been removed to make the ground available for other purposes. FARM FOR DISABLED. A number of male insane of the hospital were kept at the farm during the year and employed at farm labor, with excellent results. The farm has continued to render a useful service. The net per capita cost for maintaining the disabled was $0.69, as compared with $1.93 for 1913. 85121-15---2

PAGE 12

10 BOARD OF HEALTH LABORATORY. The following is a summary of work of special interest undertaken by the board of health laboratory staff during the year 1914. An alleged outbreak of pneumonic plague in Colombia was inveotigated in May and found to be not plague but lobar pneumonia introduced into a susceptible native population. The death rate was high., and the epidemiologic features were somewhat similar to those seen in the outbreak of pneumococcus infections occurring among recently arrived West Indian and Colombian laborers in 1905-1907 in the Canal Zone. A sanitary survey of the town of San Miguel, Pearl Islands, Ba y of Panama, was made in November. Island malaria, entamebic and bacillary dysentery were encountered and data of medical and sanitary interest collected. The information was elicited that beriberi, which used to be rife among the pearl fishermen, was never encountered among the naked divers, who returned daily to the islands, but was met with exclusively among the contract divers, who used the helmet and were quartered and fed on boats which cruised around the islands, subsisting partly on canned provisions, and who frequently remained for months on the boats before coming ashore. The preparation of a satisfactory smallpox vaccine was begun during the latter part of the year. This has resulted in a very material increase m the number of successful vaccinations made here, as well as reduced the cost of vaccine to the department. The pathologic affinities of scurvy and beriberi were disclosed by the study of material from South Africa, and observations were made on infantile scurvy and infantile beriberi in two West Indian infants. The insusceptibility of the native deer and the susceptibility of tht sloth to Tr. hippicum-the trypanosome causing a fatal disease among horses in the Republic-was ascertained. The subject of the physical and bacteriological behavior of germicides in emulsion, particularly "larvacide,'" has been pursued. A series of microscopic examinations of smears from the placenta and peripheral blood of the mother has disclosed the interesting fact that the plhcenta sometimes affords an easy means of detecting malaria infection when the peripheral blood presents difficulties. Data of some interest and importance have been collected relating to the subject of the breeding and feeding habits of Stegomyia and the common anophelines of the Canal Zone. The tropical horse tick, Dermacentor nitens, undoubtedly the carrier of equine piroplasmosis of Panama, has been under observation and some facts of interest in its life history have been elicited. Special pathologic studies of vascular syphilis among laborers employed on the canal have been made as well as analyse of the incidence of such pathological conditions as gallstones, duodenal and gastric ulcers, pancreatitis, pellagra, and hookworm disease. Analyses of benign and malignant neoplasms encountered ang employees during the past 10 years disclose some interesting feaure among which may be mentioned a higher iincidence of carcinm and sarcoma among negroes than has hitherto been recognized. A

PAGE 13

R 611 Daily examination of rats caught in Panama Colon, and the Cana1 Zone have been made. During the last ine months of the year 8,104 rats were examined for plague and negative results were obtained in all. One suspicious bacterium obtained from the cer vical gland of a rat worked out bacteriologically as a paracolon baCillus. Determination of the species of rats examined disclosed the following proportionate-incidence of the different species: M. noregicus, 54; M. rattus, 38; M. alexandrinus, 7; M. musculus, 60. It was noted that rats caught alive when received at the laboratory harbored as many as from 0 to 84 fleas per rat; that when the rats were killed fleas began to leave, the cadavers as early as fifteen (15) seconds after death, and after two hours and eight minutes the bodies were free from fleas. The flea infestation is very inconstant-some rats will harbor four or five fleas while others will have none. In October 44 rats harbored but 1 flea; in September 9 rats harbored 42 fleas; in April 7 rats harbored 62 fleas. The fleas were Xenopsylla cheopsis, the Indian rat flea. The method of catching the rat fleas was by combing and by the use of the chloroform box, but preferably by killing the rat by cephalotripsy and immediately placing i$ on a glass-rod grating over a large shallow collection of water. The fleas as they left the rat were picked out of the water by means of a pipette. A number of pathological and biological specimens illustrative of local diseases as well as statistical charts and diagrams illustrating the Sanitary and medical work in the Canal Zone, have been prepared for the Panama-Pacific Exposition. INSANE DEPARTMENT. The following is a report of the movement of patients in the asylum during the year: EmNonemployees. ployees. Remaining January 1.-. 30 250 Admitted .---------------------------------------------36 204 Died.------------------------------------1 50 Discharged ..18 87 Transferred .-------------------------22 68 Remaining December 31.---------------------------------25 249 The total number of admissions, discharges, deaths, etc. maintained an average as compared with other years. Sixty inmates of both sexes, a majority of whom were West Indians, were deported, thereby relieving the department of a considerable expense for their maintenance. After taking intp consideration the therapeutic value of occupations for the insane, which practical experience has demonstrated to be the most powerful single means in the curative treatment of this class of patients it was decided to avail ourselves of this -measure, and to this end a'number of male inmates were transferred n w. R

PAGE 14

12 to the hospital farm at Corozal, and quartered in the buiuitg formerly used for Zone prisoners at that place. They were p Fed under the care of a male nurse and three attendants, and asigne to light work in clearing and planting about the gardens and fied. The -benefits accruing to these inmates through such occupational diversion in the open air have been obvious and very encouraging. When the institution at Ancon is ultimately removed to the new site at Corozal, where it will become an integral part of the far, it is planned to afford congenial employment to a greater percentage of the patients, both male and female. During the year the sewing and mending for the main hospital ,has been added to the work of the asylum sewing room, under the direction of an experienced seamstress, and has been very economically done. This, with the hand laundering, heretofore done at the asylum, whereby approximately all of the soiled linen of the insane is taken care of, provide regular employment for about 30 of the more tractable female patients, and many others of that sex are used in assisting in the ordinary routine work in the wards and dining room. CHRONIC WARD. On September 1, 1914, the chronic ward was transferred from Colon to Ancon Hospital. At the close of the year there were 28 chronic and incurable patients under treatment. Detailed statistics are shown in Table XVIII. COLON HoSPITAL. The old Colon Hospital grounds have been divided into two parts, the eastern end having been converted into a quarantine station, while the buildings in the western end are used for the maintenance of an emergency hospital of 50 beds. Plans and estimates have been completed for a new and permanent hospital on this site, but no appropriation has yet been made. The dispensary formerly located at Cristobal has been moved to and consolidated with Colon Hospital. Detailed statistics are shown in Table XIX. TABOGA SANITARIUM. On January 16 the forces of the health department were withdrawn from the Taboga Sanitarium and the institution was turned over to the supply department for use as a hotel. Detailed statistics ale shown in Table XXI. PALO SECO LEPER ASYLuM. A new building of four rooms has been erected by the paid of the patients in order to relieve the overcrowding among the lepers. A new water tank has been installed, which allows of the fre of water for all purposes at all times, whereas previously it essary'to restrict the use in some very important particular s.

PAGE 15

13 The isolation of the asylum, its lack of telephone connections, and its dependence on the Panama Canal for all necessities make a small power launch highly desirable, and one has been ordered. At the beginning of the year there were 44 inmates. Fourteen patients were admitted during the year. There were 6 deaths, 1 discharge, and 2 transfers, leaving 50 patients in the asylum at the close of the year. Detailed statistics are shown in Table XX. SANTo ToMAs HOSPITAL. With the large increase in the number of inhabitants of the city of Panama, Santo Tomas Hospital has grown correspondingly, the average number of patients being now more than 50 per cent greater than at the beginning of the year. Detailed statistics are shown in Table XXII. DISTRICT DISPENSARIES. All sick camps have been abolished. The number of line dispensaries has been reduced from 15, at the close of 1913, to 8, at the close of 1914, and 2 of the 8 do not require the presence of a physician. The stations having the highest admission rates for malaria were Corozal and Pedro Miguel with an average weekly percentage of 0.35 and 0.32, and the lowest, Gatun and Culebra, with 0.08 and 0.14. Detailed statistics are shown in Table IX. SANITATION-CANAL ZONE. The number of sanitary inspection districts at the close of the year was 6, as compared with 12 at the close of 1913. All the stations to the west of the Canal, except Culebra, have been turned over to the military. The total cost of the division in 1914 was $172,941.50, as compared with $343,085.82 for 1913. The percapita cost of Zone sanitation proper per day, based on the number of employees, was $0.009, as compared with $0.014 for 1913. The character of the work done has been of the same general nature as that in previous years. The great hydraulic fills on the west side of the old line of the Panama Railroad, between Balboa, Diablo, and Corozal, have been about completed, while new fills on the east side of the Panama Railroad in the same vicinity are approaching completion. These fills at first give us much trouble in controlling mosquito breeding, which occurs at the edges of the inundation; but eventually they will be of great assistance to us in the permanent control of the mosquito situation. The work which was done last spring in cutting down the borders of Pedro Miguel River and Lake has been highly successful both from the point of view of economy and efficiency. Detailed statistics are shown in Table XXV.

PAGE 16

14 HEALTH OFFICES, PANAMA AND COLON. A number of new and important sanitary ordinances, relating especially to rat-proofing against plague, and to the registratLon and reporting of births, deaths, and contagious diseases have been adopted and put into effect in Panama and Colon, and the old ordinances are being rigidly enforced. The Panama Government has made some objection to the ordinance relating to births ad deaths, but it is believed that this matter will be satisfactorily adjusted. In connection with the new ordinance relating to notification of infectious diseases, arrangements have been made with the board of health laboratory to make free examinations for all physicians to assist in the diagnosis of these diseases. All the piers at both ends of the canal are being rat proofed, and two large rat-infested piers in Colon have been destroyed. SANITATION-PANAMA. Owing to the rapid growth in the population of the city of Panama, and the consequent considerable extension of the city toward the suburbs, much of the new construction had been in A very malarious locality, not hitherto requiring treatment; this will largely add to the expense of sanitation in that city, while the opening of many new streets and alleys has greatly increased the expense of street cleaning and garbage removal. GENERAL SANITATION. On April 1 a reorganization was made in the sanitary forces, reducing the number of districts in the city from five to four. Each sanitary inspector was given a small gang of laborers under his supervision with instructions to make a house to house inspection of his entire district once every seven days. The routine work performed by these gangs consists in destruction of larvoe deposits, serving notices for correction of .varoua forms of nuisances, and removing from private premises such mate rial and rubbish as offer harboring and nesting places for rats. District No. 1, known as the Calidonia-Guachapali districtwhich. has a population of 18,000, and in which there is a good deal of antimalarial work to be carried on was provided with a larger force of men under the supervision of a sanitary inspector. One inspector was assigned to the work of supervising the reconstruction of buildings to observe the rat-proofing features. bOe inspector gives his entire time to the supervision of street chai and garbage collection and disposal. Another inspector has filling the position of pure-food man, devoting his time to ho1Y A bottling works, bakeries, and dairies. An additional man has spending his time chiefly in the work of vaccin-ation and g.erWl utility work.

PAGE 17

h 15 MOSQUITO, RAT, AND FLY WORK. Mosqtitoe.-Blue-print maps of the city have been put into use to determine the location of the occurrence of the greatest number of malaria cases. More than 90 per cent of all malaria for this city originates east of the Panama Railroad tracks. In that district adjacent to the exposition grounds 39,905 feet of new ditches were constructed since September 1, being on either side of the Calidonia Road. Drip barrels and oil-soaked waste were placed to take care of the small streams and ditches in this district, and the use of knapsack sprays with oil and larvacide were also found of value. Owners of lots who were holding same for speculation were notified in writing to perform the necessary work to prevent the breeding of mosquitoes, i. e., filling of pools and removal of vegetation from their property. Those failing to comply within a given time had the work performed by this office, and the expense billed to the%. Cattle found at large on such vacant lots were first tagged, giving the owner a warningagainst a repetition of the nuisance, and if subsequently found at large the cattle were impounded, which resulted in some expense to the owner. It has been found that the tracks of animals in the claylike soil afford very favorable breeding places for mosquitoes, and on this account a portion of the old unimproved Santa Ysabella Road was closed to use with barbed wire. Old gutters punched in previous years were found to be containers, and many of these have been systematically removed. The ever-present red water jar is frequently found containing mosquito larvoe. A lectu re in Spanish was given on the mosquito and bottles of larvae were placed in the public schools in an endeavor to awaken the interest of the Panaman youth, with undetermined results. It is proposed to carry o-t this plan each year, and sho. ld eventually have some effect on the mosquito situation in the city. Rats.--A monthly average of 445 rats were taken along the water front in this city for examination for plague, and all the laboratory reports for the year have been negative. The cost per rat was a little less than 6 cents, including the cost of the bait, but not of the wear and tear on the traps. Elevation of lumber in lumber yards was begun and the elevation of all scrap lumber on private premises was ordered as an antirat measure. One of our inspectors, with a 1-gallon oil can, constructed a formaldehyde-gas generator, which he used very successfully with the aid of a three-eighths-inch rubber tube, in "smoking out" rats from their burrows. All possible openings of the rat-infeted place were closed, with the exception of two, old sacking being stuffed into the holes. The potassium permanganate and formaline were placed in the generator, the tube inserted into one of the holes, and the men stood with clubs awaiting the exit of the rats, which was usually very prompt or not at all. This method is

PAGE 18

16 very effective, particularly about old stables and oldg walls which have become rat buirows. Flies.-Deposits of fly larvoe are reported daily by they inspectors, who destroy them with larvacide upon discovery. lowest find for any month for 1914 was 289, the highest find 1,336. In May flytraps of the Bath pattern were placed in the public market and proved very effective in the eradication of a number of flies at that place. Later these traps were removed to the public di mp and supplemented by additional traps of a large type, where they have been very successful in fly-catching. Au average of 15 traps were in operation daily, and for the last four months of the yeai 676 quarts of flies were taken. It was fouud that decaying fish proved to be the best form of bait. Ntmbers of fly larve around the dump were destroyed by raking down of hot ashes upon them, and when this was impracticable, by application of larvacide. Ants and chickens were very helpfi I in the destruction of large numbers of larvae, and after heavy rains 1$ was com only observed that many larve had been drowned. Manure from the city stables, amounting to twenty-odd tone, is brot ght to thepLblic di mp daily for disposal, andoi p to date all attempts at cremation have been unsuccessful. The best that cot ld be done was to place the mant re in a large pile and thoroughly burn the edges to which point the fly larvo woi ld migrate. Although the interior of these piles would be smoldering we found on the top of the piles live fly larvo, which wol ld go to the stage of pt pation, and large nr mbers of unhatched fly ppa woi ld be dis covered on these manure piles, which would seem to confirm the theory that it is necessary for the ppa to reach mother earth to HU ccessf Ily pupate. Manure heavily infested with fly larve wwaa placed on the top surface of a manure pile and covered with a large flytrap. Daily inspection showed that practically no adult flies had been taken in this way, and the small hotse-fly pupa remained unhatched around and under the edges of the trap. Manr re was placed in a zinc tub and permitted to become a dpositing place for fly eggs. This was then covered with a specially designed flytrap, and after the pl.pation period had passed it Wa. found that practically no fRies had pupated, althou gl large numbers of unhatched pupa were found remaining in the tub. GARBAGE COLLECTION. Eighty-five tons of garbage are collected daily in thi city d Mauled to the public dump for cremation. Cremation is suc in the dry months, but practically impossible during th rains. In the better residence sections and in the shop tricts.the garbage is collected at night. Since April 1, 1,537 garbage cans have been placed in the by this office, and of this number 856 have been provided self-closing wooden covers, which have been found of very tical u se in tenement houses. Many other cans were ply local dealers.

PAGE 19

17 STREET CLEANING AND SPRINKLING. The cleaning and sprinkling of streets has been very effectivey red on for the year, and the expense for this and the garbage service account is lower for December than for any month :uwe April 1. PURE FOOD AND MISCELLANEOUS INSPECTIONS. A board was appointed early in the year to decide upon a form of ,core cards for use in this city in connection with inspections of bakeries, hotels and restaurants, bottling works, dairies, and barber shops, and since the introduction of the scoring system, very marked improvement in all such establishments has been noted. Through this means the health office has under supervision the following: Bakeries. 30 Bottling works.10 Hotels and restaurants. .26 Bar r shops .61 Dairies. ..61 y An examination of the city milk supply is made at regular intervals and it has been found that generally the quality of the milk exceeds that of the requirements under the sanitary rules. A bacterial count was made in a few instances and found to be surprisingly satisfactory. The milk sale in the city is usually disposed of within a few hours after the milking hour. WELLS. During the last few months it was found that it was necessary as a sanitary measure to close certain wells in the city from which there had been water taken to 'be sold to the public. Six such wells and tanks were closed and two others likewise sealed from which there was no selling of water. The practice of selling water from sources other than that of the reservoir is a menace to the public health and is to be discontinued. BUILDINGS. In reviewing the work carried on by the building department of this office, it is noted that since April 1, 1,229 permits of all kinds have been issued, of which 82 per cent have been completed. The settlements of Trujillo and Pena Prieta were condemned and ordered to be removed, which work has almost been completed. This was undertaken on account of there being no water supply, streets, or sewers for these settlements, which had been for years a menace to the city. These houses were of the poorest type of construction and the occupants were constantly creating all forms of niasances. A great many of these houses have been reerected by the owners in the village of Pueblo Nuevo, and others along the beach near Old Panama. Permits for 216 new buildings have been completed since April 1, and the number of permits for repairs to old buildings amounts to 85121-15---3 f~

PAGE 20

18 793. This work has been systematically carried on with the aid a map of the city, and it has been the endeavor of the department to have all buildings in Panama placed in a sanitary condition with special reference to the rat proofing features, as provided in fanitary regulations. Detailed statistics are shown in Table XXV. SANITATION--COLON. During the past year the Colon health office has aimed at a comnprehensive plan of operation by systematizing the various classes of work done so as to insure a well-rounded scheme of sanitation. The inspection of all buildings, to secure conformity with the code has been carried out by one inspector covering the entre city of Colon daily. Cristobal was inspected weekly, as the quartermaster was also active there. The buildings in Mount Hope were inspected at least twice a week by the inspector there. In Colon the old Pacific Mail Dock was condemned and removed as well as Dock No. 1 of the Panama Railroad. The Panama Railroad Freight Depot and platform were rat proofed. The old Hamburg-American building near Battery Morgan was condemned, and the beach in fhat section was cleaned up, having become in bad shape as a result of the construction work at Battery Morgan. The rear of the kitchen at the Washington Hotel was concreted to prevent fly breeding and to promote cleanliness there. A large number of buildings in Colon were condemned and either rebuilt or replaced by new structures, the most notable improvement probably being that on Front Street near the corner of Eleventh. Colon stables' on Ninth Street were largely renovated, concrete sidewalks being installed in some cases and renewed in others, and the Arcia stables built in accordance with the regul*tions. The warehouse of the American Trading Co., on Broadway, which was badly rat infested was overhauled and made rat proof. Forty-three houses at Guava Ridge, 23 at Florencetown, and 16 Mount Hope were condemned as hopelessly insanitary and destroyed. An agreement was effected with the alcalde of Colon by which extensive repairs were effected in the sidewalks in many partR of the city. The destruction and disinfection of garbage and manure was carried on as to have reduced fly breeding in Colon to the irredueibip minimum. The horns and hides from the slaughterhouse wer cared for in such a way as to eliminate the fly breeding from that source which had formerly been a constant source nf annoyance. A successful experimental demonstration of the use of rd oil on one street in Colon during the recent dry month was and it is planned to extend this to other streets. The work of beautifying and of protecting the Broadway way, which is being done by the health office for the P Railroad, has been carried out. A number of specially intore ornamental and economic plants and trees are being esta there.

PAGE 21

19 I A considerable revenue has been derived from the sale of scrap and miscellany recovered at the dump. The section known as Folks River Village was greatly improved by the construction of a concrete sea wall along the shore of that arm of the sea, which has long been a veritable dumping ground for all kinds of refuse. This sea wall makes a landing place for the cayucas and small schooners. This section also had ciurbing and sidewalks installed and platforms erected fcr the use of the charcoal traders. The sewer system on Colon Beach was overhauled and improvements made by which lang-standing nuisances were abated. Garbage cans were put on the docks for the use of ships, and the old habit of polluting the dock basins with garbage was stopped. A great saving in money and time was effected by an arrangement with the supply department by which the health office took over the collection of garbage and the grass cutting in Cristobal, consolidating that work with that done in Colon. The examination of all premises and vacant lots was done by a weekly inspection by one inspector with a gang of laborers, to remove at once all nuisances requiring instant attention. This work resulted in the removal of an average of about three loads of trash and refuse daily in addition to the garbage. It also involved the serving of immediate notice on all violators of the code and on responsible property owners; the execution of the ordinance against stray dogs and domestic fowls and birds in the defined areas; the immediate discovery and repair of all sewer connections and installaticns found in bad order; the arrest of obstinate offenders against the code, and the prosecution of such cases in the alcalde's court. For the purpose of seeing that the sanitary laws were fully carried out at all times, a weekly inspection was made at night. Attention to food products and industrial establishments was carried out by daily inspection of the entire city, the commissary's various activities being handled directly by the health officer and the work in Colon directly by an inspector. Of-the 14 bakeries in Colon, all but two underwent considerable structural repairs at the initiative of this office, the two exceptions being two new bakeries. Five were condemned until the required repairs were made; two closed voluntarily pending these improvements. A number of employees in the bakeries were fined in the alcalde's court for violating the code and some were discharged by the bakers. Retail stores in bakeries were required to keep bread in glass cases. The proper wrapping of bread sold was made the object of special effort. Street vendors of food products were required to use glass cases. Some 300 or more glass cases for bread and cooked food were installed in shops in Colon. Fruit stands were made to protect those fruits requiring it with glass cases, some of them using transparent celluloid. Bottling works were inspected daily, and some changes were effected in their arragement. Samples of new bottled drinks weie sent to the laboratory for examination.

PAGE 22

20 The Colon market was inspected twice daily, some new tab were installed, and some fish and meat condemned. -A prvNte fish-storage place was condemned until Eatisfactorily a'bn Cattle for slaughter at the slaughterhouse were examined be being slaughtered, and better care of the turtles Eecured. The Folk's ], iver meat market was brought to a better state of cleanliness and quantities of meat in snops condemned for fly breeding. A model fowl coop was made and installed for the benefit ( of the keepers of fowls, and a number of others made to order. The ordinance in regard to the keeping of fowls in certain districts was carried out. A periodic examination of milk sold in Colon was instituted, a well as inspection of the dairies. The use of sanitary drinking cups in the Cristobal and Colon hotels was provided, and aho in the schools. In the work against rat-infestation experiments with different types of traps were carried on, with the result that a modification of the type known as the Marti trap was found the most effective. This trap could not be obtained because of the war. The E. Z. K. trap is a-o quite effective as a killing trap. The monthly catch ro.%e to 250 rats per month. There are both the Norwegian brown and the Englibh black rats here, the former predominating,. Poiton was aho used where indicated. It is noteworthy that coco-nuts proved an exceedingly attractive bait. Food boxes in stables were required to be metal lined against rats, and the fowl coops also. As regards mosquito eradication, the most notable work was the drairage of Mindi Island and the admission of sea water to places formerly full of fresh water. This work undoubtedly had much to do with the reduction of the mosquito catch from 1,000 to less than 50 daily. Other areas in Mount Hope district were also drained or flooded with sea water. The depopulation of certain places near old breeding grounds alfo Eeems to have led to a decrease in anopheles infestation and breeding. The filling in by dredges of some swamps in Mount Hope was commenced but had to be postponed on account of the construction of the east breakwater. Tne general effect of mosquito reduction may be discerned in the very low malarial rate in (olon for the latter part of the, current year, the lowest, in fact, yet recorded here. The cooperation of the principals of the schools has been obtained in the mb tter of reporting suspected cases of infectious diEease an in regard to the vaccinating of pupils, and plans are on foot special illustrated lectures on public health and hygiene, !s weA* for the inclusion of these subjects in the regular course of instrUion in the Panamanian Echools. All the Fchool children in pubic d private schools were vaccinated under the direction of th heal of ce. The cooperation of the physicians of Colon was secured in.ing all notifiable di eaFes. Arrangements were effected for the periodic disinfectiono city jailtL, and the central pri. on has been completely The allocation of landing places fcr Email vessels ha be carried out by conference with other divisions and with the,

PAGE 23

21 MALARIA CHART FOR 1911,1912, 1913 A1O 1914 Show inghe numberof malaria case (Hospital) each month among employees, expressed asa percentage of the entire working force. 4.*1 ----1 I-907 Ave age of Monthl rate 3. 11 I I Note relation, of Dry Season and Wet Season to Malaria in 1914 and previous Years. (Dry-Season -)anuary to April, inclusive) -1911 A\vera-ge of" monthly rates 1.54% 1)(2 ,, .,, 0.93% 1013 0 ,. .64/ 4 ...I EI4 -/. I~~~ E-IiE.:!%hrE EEE EE. I EPE R .....

PAGE 24

22 Government, leading to concentration of these craft at places venient for them and better arranged for sanitary purposem.T dredges.iR Colon Harbor have been regularly inspected and soe sanitary improvements effected in most of them. QUARANTINE DIVISION. During the year the quarantine station at Culebra Islandwas removed to .Balboa Dump, and the q uarantine station at Colon from its old site to the new location in Colon Hospital groundts. TABLE 1.--ADMISSIOYS, DEATHS, AND EFFECTIVE RATES FOR EMPLOYEES: DEATHS OF RESIDENTS OF PANAMA, COLON, AND THE CANAL ZONE. ABSOLUTE NUMBERS. I Admission to DNoneffective hospitals.1 fromsick"es. 4) g 0 Year 1914: g White. 7,024 3,678 3,028 650 47 22 25 69,480 162.96 Colored. 37,305 7,160 5,0651 2,095 265 173 92 138,350 379k.04 Total .44,329 10,838 8,093 2, 745 312 195 117197,830 642.00 Year 191A3: White .11,943 8,564 6,886 1,678 81 43 38138,0$0 378.30 Colored .44,711 11,327 7,102 4, 225 392 254 138 192,037 526.13 Total .56654 191,891 13,988 5, 903 473 297 176 330,117 904. 4a PROPORTIONATE NUMBERS.2 Year 1914: White. 7,024523.63431.09 92.54 6.69 3.13 3.56.23.2Q Colored. 37,305191.93135.78 56.15 7.10 4.63 2.47 .10.1 Total. 44,329244.49182.57 61.92 7.04 4.40 2.64.12. Year 1913: White.11,943717.07576.57140.50 6.78 3.60 3.18. 31.% Colored. 44,711253.33158.84 94.49 8.77 5.68 3.09. 11.7# Total.56,654351.10246.91104.19 8.35 5.24 3.11. 1 Z. I Admissions here mean discharges and deaths for 1913 and first 6 months of.14, and admissions since then. 'Annual average per 1,000.

PAGE 25

23. TABTE I.-ADMISSIONS, DEATHS, AND NONEFFECTIVE BATES FOR EMPLOYEES: DEATHS OF RESIDENTS OF PANAMA, COLON, AND TUE CANAL ZONE-Continued., DEATHS OF REsIDENTS OF THE CrIES OF PANAMA, COLON, AND THE CANAL ZONE Deaths. Annual average per 1,000. Place. PopUlation. ExterExter Total. Disease. nal Total. Disease. Tnal causes. causes. Year 1914: Panama. 53,948 1,863 1,772 91 34.53 32.85 1.68 Colon. 23,265 590 563 27 25.36 24.20 1.16' Canal Zone.,. 46,379 710 614 96 15.31 13.24 2.07 Total--------123,592 3,163 2,949 214 25.59 23.86 1.73 Yeari1913: Panama. 47,172 1;507 1,425 82 31.95 30.21 1.74 Colon. 20,232 489 460 29 24.17 22.74 1.43 Canal Zone. 61,700 1,047 890 157 16.97 14.43 2.54 'total.129,104 3,043 2,775 268 23.57 21.50 2.07 TABLE 11.-DEATHS BY AGE, COLOR, AND SEX. White. Colored. YelloW. Total. Age. 7 .... -y04 D -.' 4 2 y4 11 P7 &4 P -i Under I year. 51 39 90 560 428 988 3 1 4 614 4681.082.4 -to 4 years. 18 11 29 138 120 258 1 1 2 15 13 289 5 to 10 years. 7 4 11 24 IS 42 ..31 22 53 11 to 20 years. 10 6 16 46 58 1 .104 56 64 120 21 to 3G years. 41 12 53 326 196 522 .2 11 376 210 586 31 to 40 years. 41 16 57 209 127 336 12 .12 262 143 405. 41 to years. 28 10 38 122 82 204 6 1 7 156. 93 249' -lto 60years. 2 10 32 90 3 7 127 1 .1 113 47 160. 6 to 7years. 11 8 19 43 35 78 1 .1 55, 43 98" 71 to 8years. 3 6 9 12 23 35 2 .2 1729 46,. 31 to 9years. 1 5 6 4 S 12 2-. 2 7 13 20., 9l to 100 years. .I 1 1 ..2 2 Unknown. 6 1 7 41 5 46 ...47 6 537 Total. 239 129 368 1, 615 1,138 2,7531 37 5 421,891 1,272 3,163 -1k

PAGE 26

24 TABLE IlI.-DEATHS BY NATIONALITY. EmNonemNations. T-AtaL. ployees. ployees. Afr .2 Antiguai. 4 13 7 hmaIsland. Wiarbados. 90 299 389 TgOim.1 1 Bral. 1 1 C traJ America.I I C Ie. ..2 2 lina. 37 37 Colombia. 6 87 at Cmsta Ric. 1 67 Vuba. 1 4 5 Caracao. 1 2 3 Demerar ..4 DI nmark. ..2 2 Dio inias, ...-. .1 4 ECP. ...1 4 5 Eogiand. 1 4 5 Fortune Islands. 3 1 4 --ance. 13 13 Germanv.6 6 Okeece.2 2 4 Grenada. 5 9 14 Guadeloupe. 6 11 17 Guiana, B1ritish. 3 3 Guatemala. 1 1 Haiti .1 4 5 Honduras. .1 1 India. .4 4 Irel nd ..1. 1 Italy. 1 14 Is Jamaica. 97 544 641 Japa .....2 2 Martinique. 14 57 71 M exico .....5 5 Montserrat.5 8 Nassau. 1 2 Nicaragua.1 2 3 Panama. 11 1,479 1,490 Peru. 1 4 ,5 Portugal. '. 1 1 Russia. n2 Salvador .1 2 St. Domingo. .2 2 St. Kitts. 1 3 4 St. Lucia. 5 44 49 St. Thomas. 1 4 St. Vincent. .3 9 Spain. .6 30 36 Sweden. 1 2 Swvitzerland. 1 1 2 Trinidad. 3 21 24 Turks Island.1 .. United States. 32 51 83 Venezuela. .12 West Indies. .14 Unknown. 3 11 -14 Total. .312 2,851

PAGE 27

25 T wz IV.-CAUSES OF DEATHS OF EMPLOYEES OF THE PANAMA CANAL AND PANAMA RAILROAD. Causes of death. White. Colored. Total. Disease. Alcoholism, acute.---------------------------1 .1 A eurism .......3 4 Angina pectoris.----------------. ........----------------I I Apaplexy.-------------------------2 3 5 Arterio-selerosis. .1 1 Cancer of buccal cavity. ..--------------------------------1 1 Cancer and other malignant tumors of stomach and liver.----------------------------. 1 .1 Carbuncle.w. -----1 .1 Cerebro-spinal fever. .-1 Cholecystitis-----------. a ----------------------1 ..1 Diphtheria. ......-----------------------------------------1 Drug habit. 1 .1 Dysentery: Bacillary ---------------------------------. .1 1 lUn classified .-.:. ..3 3 Empyema.------------------------------------------1 1 Encephalitis. 1 .1 Endocarditis, acute and chronic.--------------------------3 3 FeVer: M malaria ...3 3 Malarial, estivoautumnal. 2 2 4 Typhoid. .4 4 Gangrene.-.--------------------------------. 1 1 Heart, organic disease of.-------.--------------2 14 16 Infection of unnown origin. .3 3 Intestinal obstruction. j3 3 Leuchemia, lymphatic.-. .1 1 Liver, abscess of. .1 3 4 Luns, gangrene of-------------. .2 2 Meningitis, pneumococcus.------3 3 NepAritis: A cute. ..1 2 3 Chronic. .----------------------------------2 17 19 Oesophagus, stricture of-. ..---------------------------1 1 Pericarditis. ....----------------------------------------1 1 Peritonitis, simple. .--------------------------------------2 2 Pharynx, disease of.1. .-1 1 Pneumonia---------------------------------------1 2 3 Pneumonia lobar. ...-----------------------------------39 39 Pyemia and septicemia, pneumococcic. .-----2 2 3 3 Septicenna. ...................------------------3-Septicemia purulent infection and .-2 3 Stomach, disease of-. .------------------Stricture of urethra. .1 1 Syphilis---------------------------------. .1 1 Sudden death .---------------------------------------2 Tetanus. 1 2 3 Tuberculosis: Abdominal.w. .1 1 Disseminated. .18 18 Genito-urinary organs. .1 1 Miliary .2 2 Pulmonary. 1 17 18 Uremia.w. 1 1 Ulcer,duodenal. 2 2 UretOra, ..1 1 Undiagnosed.-.1 85121-15----4

PAGE 28

4. 26 TABLE IV.-CAUSES OF DEATHS OF EMPLOYEES OF THE PANAMfA CANAL AND PANAMA RAILROAD-Continued. Causes of death. White. Colored. Total. Violence. Accidental traumatisms, various-----------------3 15 18 Drowning, accidental.---------------------------6 35 41 Dynamite explosions.--------------------------4 6 10 Electric shock.---------------------------------6 1 7 Homicides.-----------------------------------1 2 3 Lightning. .....------------------------------------------1 1 Railroad accidents. 2 26 Suicides. ...-------------------------------------2 3 5 Total. ...----------------------------------47 265 312 TABLE V.-DEATH RATES AMONG AMERICANS AND WHITE FOREIGN EMPLOYEES. Cases. Cause of death. Number Annual of deaths. average per 1,00. Average number of white emDisease----------14 2.67 ployees from the United 5,240 External causes. -16 3.05 States. JAil causes .30 5.72 Average number of white Disease----------17 4.48 women and children from 3,795 External causes. 2 .53 the United States. lAll causes. 19 5.01 Average number of white emDisease ----------31 3. 43 ployees and their families 9,035 External causes. 18 1.99 from the United States. All causes ..49 5.42 Total-number of Americans fDisease-----------31 2.70 Tothe Canal Zone.s 11,468 External causes 24 209 onteCnlZn. All causes -----55 4.79 Average number of white forDisease. -8 4,48 eign employees (mostly 1,784 1 External causes .9 5.05 Spaniards). All causes------17 9.53 I The figures representing the total number of Americans on the Canal Zone include employees and their families and the officers and men of the United States Army and their families stationed on the Isthmus. TABLE VI.-CAUSES OF DEATHS OF EMPLOYEES AND CIVIL POPULATION AND PLACES WHERE CHARGEABLE. Diseases. PanaColon. TotaL. ma. Zone. General diseases. Typhoid fever ..-----------------------------8 2 4 14 M alaria...-19 4 11 34 Malarial fever: Estivo-autumnal. .-----------------------31 7 16 4 Tertian----------. .---------------------4 ..-4 Quartan. ...---------------------.1-. Mixed.------------------------------------.1 Undetermined----------------------.--.15 --------1 Clinical------------------------------------28 8 5 Cachexia------------------------------4.

PAGE 29

27 T ABLE VI.-CAUSES OF DEATHS OF EMPLOYEES AND CIVIL POPULATION AND PLACES WHERE CHARGEABLE-Continued. PanaCanal Diseases. Colon. Total. ma. Zone. General diseases-Continued. Hemoglobinuric fever, malarial----------------1 .1 2 Whooping cough. I .1 2 Diphtheria and croup. 3 .2 5 Croup------------------------------------------------3 3 Influenza-------------------------------1 Dysentery-.-. 25 ...27 Ehtamebic. .------------------. ..-.5 .--. ..5 Bacillary. ..1 1 Unclassified.---------------------------7 4 3 14 Leprosy .------------.-.-. 2 ..2 Erysipelas -.-------------------------------. 5 Hemoglobinuric fever unqualified-. ..1 1 Acute infections jaundice (Weil's disease). 1 1 Purulent infection and septicemia .5 2 6 13 Pyemia-. ......-.-1 1 Septicemia. 9 4 4 17 Pyemia and septicemia, pneumococcic -----2 1 1 4 Tetanus. --------------17 2 4 23 Pellagra-.------.---------------37 9 3 49 Beriberi.-------------. -------------12 1 .13 Tuberculosis of the lungs.-------------------206 69 44 319 Acute miliary tuberculosis. .--------------3 .4 7 Tuberculous meningitis.---------------. 2 3 ..5 Abdominal tuberculosis. .-----------------7.7 Pott's disease.-------------------------------1 1 .2 Tuberculosis of other organs. .------------------------. .-1 Tuberculosis of the larynx. .--------------2 2 .4 Tuberculosis of the genito-urinary organs. .1 Disseminated tuberculosis.------8 11 24 43 Rickets. --------------------------.1 4 Syphilis: Secondary. ------------------------1 Tertiary.---------------4 5 2 11 Hereditary. .8 3 3 14 Period not stated.-.-.-.5 2 2 1 Gonorrheal orchitis and epididymitis ----------. -1. 1 Cancer and other malignant tumors: .Of the buccal cavity---------------------3 1 .4 Of the stomach and liver.---------------8 1 2 11 Of tbe-peritoneum, intestines, rectum. 1 1 .2 Of the emale genital organs-----------------9 2 1 12 Of the breast ...1 -----.1 Of othbr organs and of organs not specified .7 .1 8 Other tumors (tumors of the female genital orgns excepted).-----------.-1-...1 Acute articular rheumatism. 2 1 3 Chronic rheumatism and gout --.------------. .11 Sclurvy ..i. 2 2 15 b s .-----------------------------------2. 1 .. Exophthalmie goltre-.:.l. ..1 .1 Leuchemia, lymphatic.-. ..2 2 A1em ia, chloros.s. Chlorosis. .-I .. Primary, pernicious. -------3 1 1 5 Secondary, cause not determined-. ..2 2 Other general diseases.-.-.-.:. 1 ..1 Purpura hemorrhagica--..1 -. ..1

PAGE 30

TABL V.-CAUSES OF DEATHS OF EMPLOYEESAND CIVILPPEU. LATION AND ?LACESf WHERE CHARGEABLE-CJontinued. Diseases. I.Colon. Cona a, Zone. General diseases-Continued. Alcoholism: Acute or chronic. .------------------------4 2 1 7 Acute. ....--------------------------------1 1 1 3 Chronic. ...-------------------------------4 1 5 Drug habit. ...---------------------------1.1 --------2 Diseases of the nervous system and of the organs. of special sense. Encephalitis-----.-----------------------2 1 1 4 Simple meningitis.-----------------------15 3 1 19 Cerebrospinal feye. .-------------------------1 .2 3 Pneumococcus meningitis--------------------2 1 1 4 Other diseases of the spinal cord. .--------------------------1 1 Acute anterior poliomyelitis. 2-------------2 .,. 2 Cerebral hemorrhage, apoplexy.---------------23 19 9 51 Softening of the brain.-----------------------3 1 3 7 Paralysis without specified cause.-. 5 4 1 10 Other forms of mental alienation-. 1 ..-.-:. Dementia precox .11 Epilepsy .-2 2 5 Convulsions (nonpuerperal) (5 years and over). 1 1 2 Convulsions of infants (under 5 years of age) .7 0 3 15 Other diseases of the nervous system-----------1 .1 2 Diseases of the ears.-------------------------1 .1 2 Diseases of the circulatory system. Pericarditis. ------------------------------1 1 -----Acute endocarditis. ..-------------------------24 3 2 29 Malignant 6ndocarditis.----------------------3 1 .4 Organic disease of the heart.------------------45 32 36 113 Angina pectoris----------------------------1 2 1 4 Diseases of the arteries, atheroma, aneurysm, etc. I Aneurysm-. .--------------------2 4 7 Arteriosclerosis. ...---------------------------21 4 3 28 Embolism and thrombosis.--------------------3 .1 4 Diseases of the veins variese, hemorrhoids, phlebitis, etc.).:.-..-.-..-.--1 Hemorrhage; other diseases of the circulatory system. .---------------------------------2 2 .4 Diseases of the respiratory system. Diseases of the larynx.-.--. .. Acut brnchtis. ..4.4. Acute bronchitis .---------------------------43 46l 5 914 Chronic bronchitis. 5 6 .11 Broncho-pneumonia. ..-----------------------97 23 34 Pneumonia (unqualified). .-------------------62 5 87 Lobar pneumoma .----55 22 34 111 Pleurisy ..8 1 1 10 Empyema -------------------------------.1 1 Pulmonary congestion, pulmonary apoplexy. 5 1 -1 Gangrene of the lungs .3 -. -.4'7 Asthma. ----------------------------------5 .I Pulmonary emphysema ----------------------1 1 Other diseases of the respiratory system (tuberculosis excepted) -------------------------5 1 1 ..

PAGE 31

TABLE VL-CAUSES OF DEATHS OF EMPLOYEES AND CIVIL POPULATION AND PLACES WHERE CHARGEABLE--Continued. Diseases. PanaColon. Canal TotE. -~ma.Zn. Diseases of the digest.e system. Diseases of the mouth and annexa.2-.-.--.--.-.2 Stomatitis. ..1 1 Sof the harynx. 1 .1 Stricture of the esophagus. -.1 1 2 Ule? of the stomach. 2 .2 Other diseases of the stomach (cancer excepted). 1 .2 Acute gastritis. 4 9 4 17 Chronic gastritis. 1 4 1 6 Acute indigestion. 3 1 4 Diarrhea and enteritis (under 2 years). 303 27 66 396 Colitis. 21 ., 24 Diarrhea and enteritis (2 years and over). 12 6 4 22 Colitis. 4 .1 Ankylostomiasie. .1 .1 Ascaridiasis.1. .1 Appendicitis and typhlitis. -.1 .1 Acute appendicitis.--5 ..1 6 Hernia, intestinal obstructions. .1 2 2 5 Other hernias. 1 ..1 Intestinal obstruction.10 1 4 15 Other diseases of the intestines. 2 2 1 5 Duodenal ulcer. ..2 2 Acute yellow atrophy of the liver. 3 .3 Cirrhosis of the liver.15 6 -22 Biliarycalculi. -.--------.1. 1 Other diseases of the liver. .6 Abscess of liver (unqualified). 7 .-. 2 9 Abscess of the liver (entamebic). .2 2 Cholicystitis.2 3 Simple peritonitis (nonpuerperal). .-------------7 3 5 15 Other diseases of the digestive system (cancer andtuberculosis excepted).1NAcuveereaZ diseases the geito-urinary system Acute nep ritis. .31 16 8 55 Bright's disease (chronic nephritis). 97 -26 22 145 Other disease of the kidney and annexa. 4. 1 5 Pyelo-nephrosis. .2 4 Calculi of the urinary passages. .1 1 Diseases of the bladder. 1 1. ..2 Diseases of the urethra, urinary abscess, etc. 3. ...2 6 Hypertrophy of prstate. .1 Uterine tumor (noncancerous). 2 -. Other diseases of the uterus.1 2 Cysts and other tumors of the ovary.1 .1 Salpingitis and other diseases of the female genital organs. 1 6 T he puer peral state. Accidents of pregnancy. .-1 1 1 3 EItra-uterine pregnancy.~.uc. .1 2 eremesis graidarum.1 ..1 A ortio n. 2. .2 Puerperal hemorrhage. 2 2 1 5 iease of labor, other. ..1 Abscssltlier (nqulffed) -------------7. 2 Abscsosof he iver(en ame ic). 24

PAGE 32

30 TABLE VI.-CAUSES OF DEATHS OF EMPLOYEES AND CIVIL POU LATION AND PLACES WHERE CHARGEABLE-Contiiiued. Diseases. PanaColon. Cana T ma. Zone., iTotl The puerperal state-Continued. Puerperal septicemia.------------------------8 2 6 16 Puerperal albunminuria and convulsions. .. Eclampsia. ...--------------------------------7 2 1 10 Following childbirth (not otherwise defined) -----------1 2 Puerperal insanity. .1 I Diseases of the skin and of the cellular tissue. Gangrene. ...---------------------------------1 1 .2 Carbuncle-------------. ....------------------------1 1 Acute abscess.------------------------------.2--------------2 Pemphigus contagiosus.---------------------1 --------------1 Diseases of the bones and of the organs of locomotion. Diseases of the bones (tuberculosis excepted). 1 1 ..2 Osteomyelitis .-.3 ---------------3 Diseases of the joints (tuberculosis and rheuma tism excepted). ..------------------.--. 1 -----------.1 Malformations. Congenital malformations (stillbirth not included). ...---------------------------------5 2 2 9 Diseases of early infancy. Newborn child.---------------------------------. ....-------.1 Congenital debility, icterus, and sclerema .15 3 5 23 Premature birth. 34 4 14 52 Congenital debility.-. 20 26 15 61 Malnutrition .55 36 46 137 Other causes peculiar to early infancy (including various consequences of labor)-----------21 7 10 38, Lack of care----------------------------.1 1 2 Old age. Senility.---------------------5 6 9 20 Affections produced by external causes. Suicide byPoisoning. ...-----------------------------2 .2 4 Hanging or strangulation. ..----------------------------1 1 Drowning. .----------------------------------1 <2 Firearms. .-.-3 -Cutting or piercing instruments--------1 .2 Poisoning by food. -------------------------------------1 1 Other acute poisonings. 3 .1 Burns (conflagration excepted) ----------------4 1 Absorption of deleterious gases (conflagration excepted). ..1 Accidental drowning--------------. 12 11 29 52 Traumatism byFirearms.------------------------------4 .2 6 Fall---------. ----------. .2 5 4' 0 Mines and quarries. .2 Machines.-------------.-----------------4 2 Other crushings (vehicles, railroads, landslides, etc.). ...-------------------6 1 41.

PAGE 33

31 TABLE VI.-CAUSES OF DEATHS OF EMPLOYEES AND CIVIL POPULATION AND PLACES WHERE CHARGEABLE-Continued. Diseases. a. Colon. Zone. Total. Affections produced by external causes-Contd. Railroad traumatism. 11 4 21 36 Dynamite traumatism. 11 .6 17 Starvation. 2 .2 Lightning. ..1 1 Electricity (lightning excepted)-----------------.-------8 8 Homicide byFirearms. .-------------------------------11 1 .12 Cutting or piercing instruments-----------3 1 1 5 Other means-----------------------------1 1 4 6 Fractures (cause not specified).-----------------3 --------------3 Other external violence-----------------------1 .1 2 Ill-defined diseases. Ill-defined organic disease. -------------1 --. 1 2 Sudden death.-------------------------------4 1 1 6 Cause of death not specified or ill defined .16 2 18 36 Infections of undetermined origin.,.----4 2 3 9 Total. 1,863 590 710 3,163 Stillbirths. 216 80 83 379 Grand total. 2,079 670 793 3,542 TABLE VIL-ADMISSIONS AND DEATHS OF EMPLOYEES IN THE HOSPITALS OF THE PANAMA CANAL, FROM ALL CAUSES, FOR THE CALENDAR YEAR 1914. Admissions. Deaths. Diseases. White. Colored. White. Colored. General diseases. Typhoid: Fever--------------------------------13 10 .3 Bacillus carrier. .---------------------------------1 .. Prophylaxis. 1 ------------------. Malarial fever: Estivo-autumnal.-----------------------379 1,279 1 2 Tertian. ...-------------------------------108 172 .. Quartan. 1 22 .. Undetermined. 1 ------------------. Clmical. 261 647 .. Cachexia .5 4 -------------. Hemoglobinuric fever, malarial. 4 ... Vaccinia.-------------------------3 1. Measles. ..----------------------------. 2 39 .. Scarlet fever.-----.-----------2------------------2 ... Diphtheria and croup ------------------------------------------1 Influen-. 96 11 Dysentery ..7 .. Entamebic----------------------------10 7. Bacillary. 3 5 .1 Unclassified .3 45 .3 KUL-U9

PAGE 34

32 TABLE VII.-ADMISSIONS AND DEATHS OF EMPLOYEES IN HOSPITALS OF THE PANAMA CANAL, FROM ALL CAUSES, THE CALENDAR YEAR 1914-Continued. Admissions. Deaths. Diseases. White. Colored. White. Colored. General diseases-Continued. Erysipelas. .-----------------.---------------2 2 ----------. Dengue. ...-----------------------. .......3---------.. Chicken pox. .----------------. ----------. ..-8 .. Mumps.------------------------------10 112 Hemoglobinuric fever, unqualified --------------1 -2 .. Yaws -----------------------------------------2 Filariasis---------------------------------------2. Acute infectious jaundice (Weil's disease). 1 1. Other epidemic diseases----------------------2 -----. Purulent infection and septicemia-------------3 8 1 5 Pyemia--------------------------------------2. .. Septicemia ---------------------------------2 Pyemia and septicemia, pneumococcic. --------------------2 Tetanus ---------------------------------1 1 2 Pellagra.------------------------------. .-----, 5 --------.--Beriberi.--------------------------. 13 28 .U Tuberculosis of the lungs. ..----------------5 54 ..5 Acute miliary tuberculosis. --------1 --2 Tuberculous meningitis .------.------3 -------Abdominal tuberculosis.-----------------3 -----------Tuberculosis: Bones and joints. .-----------------------. Other organs. .....------------------------------1 -----Skin--------.--. .I .-----------. Genito-urinary organs. .1 .J Tuberculous abscess------------------------------------------Disseminated tuberculosis. .-3 -1-----.8 Syphilis: Primary.------------------. 4 6 -------Secondary. ...----------------------------32 42 ----Tertiary. ....-----------------------------26 so -------t1 Period not stated. .-----------------------22 215 -----Gonococcus infection.------------------------2 1 -------.. Gonorrhea.-------------------------------75 190 -----------Gonorrheal arthritis. 4 32 -----------Gonorrheal bubo. ..-----------------2 11 -------.-. Gonorrheal orchitis and epididymitis. 16 18 ----------. Gonorrheal ophthalmia. .---------------------------1 .------. Soft chancre. ....-----------------------------45 157 -----Adenitis chancroidal. 20 30 ------------Cancer and other malignant tumors: Of the buccal cavity.-1 1. Of the stomach and liver. ---------------.1 .1. Of the peritoneum, intestines, rectum ------1. Of the female genital organs. 1 1-.-. Of the skin. ..---------------------. 1 1 Of others organs and of organs not specified. 2 3 -----------Other tumors (tumors of the female genital organs excepted).-----------. .---------------14 6 Acute articular rheumatism.-. 6 2. Chronic rheumatism and gout----------------------1. Leuchemia lymphatic .-. Hodgkin's disease. ...------------------------------. 2 ... Anemia: Primary, pernicious----------------------2 Secondary, cause not determined ----------4-.-.

PAGE 35

7 VI.-ADWIsSIONS AND DEATHS OF EMPLOYEES IN THE TALS OF THE PANAMA CANAL, FROM ALL CAUSES, FOR THE CALENDAR YEAR 1914-Continued. Admissions. Deaths. Diseases. White. Colored. White. Colored. General diseaes-Continued. Other general diseases.7 5.-. Serum disease .... Purpura hiexnorrhagica. Alcoholism: Acute or chronic. 1 .3 1 Acute.6. .-----Chronic. Alcoholic chosis. 4 .. Chronic d poisoning. 1. Ot chronicpoisonmgs.2. Discean of the nervous system and of the organs of special sense. Pneumococcus meningitis. .1 .3 Other diseases of the spinal cord. .2 Coerebro hemorrhage, apoplexy.--23 1 1 Softening of the brain.2. Paralysis without specified cause. 3 5 .. Other formsof mental alienation. 5 21 .. Dementia precox. 4 16 .. y. .2. ys= .2 1 Neuralgia. Neuritis. 30 4 .. Other diseases of the nervous system. 9 10 Neurasthenia. 23 5 .. Diseases of the eyes and their annexa. 95 150 .. Follicular conjunctivitis. 6 7 Trachoma. 2 2 .. Diseases of the ears. 57 32 .. Diseases of the circulatory system. Pericarditis. .4 .. Acute endocarditis ..2 .I Malignant endocarditis. .I Organic diseases of the heart. 15 34 1 9 Aneurysm. .2 1 Arterio-sclerosis. 5 7 Diseases of the veins (varices, hemorrhoids, phlebitis. etc.). 15 3 .. Hemorrhoids. 44 38 .. Varicocele. Phlebitis. 2 .. Diseases of the lymphatic system (lymphangitis,et.). Lymphadenitis (nonvenereal). 4-. 36 58 .I Hemorrhage; other diseases of the circulatory system .1 7 ... Diseases of the respiratory system. Diseases of the nasal foss .104 12 Adenoids vegetations. .. Myasis of nasalfosse and sinuses. .1. E~hp

PAGE 36

TABLE VU.-ADMISSIONS AND DEATHS OF EMPLOYEES IN THE HOSPITALS OF THE PANAMA CANAL, FROM ALL CAUE, THE CALENDAR YEAR 1914-Continued. Admissions. Deaths. Diseases. White. Colored. White. Colored. Diseases of the respiratory vystem--Continued. Diseases of the larynx-----------------. Laryngitis. ..------------------------------1 3 Diseases of the thyroid body.--2 4-.-. Acute bronchitis.---. 97 100 .. Chroni. bronchitis. ...-------------------------11 5 Broncho-pneumonia. .------------------------5 4 1 1 Pneumonia (unqualified).----...------------1 2 Lobar pneumonia.-------------------------------103. 40 Pleurisy. 16 102 Empyema.--------------------------------. ..1 3 Pulmonary congestion, pulmonary apoplexy .1 ... Gangrene of the lungs.-------------------. ..2 Asthma ---------------------------------------7 18 .. Pulmonary emphysema--------------------------. Other diseases of the respiratory system (tuberculosis excepted).---------------1 .. Abscess of lungs. ..---------------------------3 1 Diseases of the digestive system. Diseases of the mouth and annexa -------------8 5 Diseases of the teeth and gums. 8 15 .. Stomatitis. .2.--------------------------2 Diseases of the pharynx. 97 42-.-Pharyngitis. 11 8 .. Follicular tonsillitis.------------------------32 23 .. Diseases of the esophagus1. .I Foreign body in the esophagus. .1 .. Strioature of the esophagus ------------------. .. Ulcer of the stomach .18 3 .. Other diseases of the stomach (cancer excepted). 24 3 .. Gastractasis1. I ... Acute gastritis-.---. --13 4 .-. Chroni. gastritis. 14 .. Acute indigestion. 13 18 .-.-. Colitis. 3 2 Diarrhea and enteritis (2 years and over)---.-24 12. Colitis------------.-.-.-. 6 11 .. Ankylostomasis------------w------------1-----Ankylostomlasis .4 31 .. Intestinal parasites. 2 ... Tem iasis. 2 ... Appendiitis and typhlitis--------. 12 1 .-Acuteappendltis-. 42 8-.-. Chronic appendicitis------------------------52 2. Ineuinal hiernia. 69 81 .. Other hernias .7 1 Intestinal obstiuction.w-. ... Other diseases of the intestines. 77 15 .. Constipation. 44 12 .--.-. D uodenal ulcer .--.-.-. .2 1 .2, Acute yellow atrophy of the liver-. .1 ------. Cirrhosis of the liver.------------3 1 -------Bilary caliuli.---. 4 ... Other diseases of the liver.-. 8 -.. Abscess of liver (unqualified). .2 2 1 Abscess of the liver (entameb) ----------------1 3 .011

PAGE 37

'35" T4P. VII.-ADMAIY9IOV3 AND DEATH3 OF EMPLOYEES IN THE ,% 3PITALS OF THE PANA'4A' CANAL, FROM ALL CAUSES, FOR HE CALENDAR YEAR 1914-Continued. Admissions. Deaths. D iseases. White. Colored. White. Colored. DPkeases of the digestive system-Continued. Cholecystitis. .14 1 1 Diseases of the spleen. simple peritonitis (nonpuerperal).1 other diseases of the digestive system (cancer and tuberculosis excepted). 1 ?n0venereal diseases of the genito-urinary. system and annexa. te nephritis. 2 3 1 1 I's disease (chronic nephritis). 23 41 1 16 tr ds -the kidney and annexa. 18 10 pable kidney. ... Pyelo-nepbrosis. 7. Calculi of the urinary passages. 8 -. Diseases of the bladder. 3 3 Cystitis. 6, 3 of the-uretha, urinary abscess, etc. 8 18 1 1 tricture ofthe uretha, nonvenereal. 9 36 Diseases of the prostate. 1 2. oniprostatitis. I enereal diseases of the male genital organs. 21 41. ydrocele. 13 34 terine hemorrhage (nonpuerperal). 2 1 erine tumor (noncancerous) .. ther diseases of the uterus.2 1. .. otritis. 2 .. iPlingitis and other diseases of the female genital organs. 2 4 .. Nonpuerperal diseases of the breast (cancer excepted).2. The puerperal state. Accidents of pregnancy. .1 Abortion. ..1. Other accidents of labor. 2 1 .. Diseases of the skin and of the cellular tissue. Gangrenoe. .. Fruncle.,. 32 21 .. Carbuncle. 7 .1. Acuteabscess. 72 .. Phiegmon and cellulitis. 37 30 .. abes. 1 1 PDmphigus contagiosus.1. Epntiasis.2 .. obie itch .14 3 ceroftheskin. 8 52 .. Tropical ulcer.1. Ulcerating granuloma of the pudenda. .1 .. MI.petiko contagiosa. 4 2 Urticarla. 2 1 .. growing nail. o Other diseases of the skin and annexa. 35 20 ..

PAGE 38

36 T$B.Z VT.-%AflM81IOSAND DA&TUS OF EMPLOYEE! R8 ~BOPITALS OF Ti P~AI4AA OANAL. FROM ALL CAU THE CALENDAR YEAR 1914-Continued. Admissions. Deaths, Dlssec. White. Colored. White. Colored. Disease. ofthe bones and of the organs of locomotion. Diseases of the bones (tuberculosis excepted). 23 11 .. Caries (nontuberculous) .. Mastoid abscess. .. Osteomyelitis. 1 Periostitis. 2 3. Diseases of the joints (tuberculosis and rheumatism excepted). 4 1 Ankylosls.2. 2 Arthritis. 11 18 Synovitis. Amputations. Other diseases of the organs of locomotion. 65 52 JLalformations. Congenital malformations (stillbirth not inluded). 3 Old age. Senility. ..2 Affections produced by external causes. Suicide by poisoning. ...1. Poisoning by food. 12 33 1 Other acute poisonings. 3 2 Conflagration. .. Burns (conflagration excepted). 9 47 Traumatism: By firearms. 5 10 By getting or piercing Instruments. 17 244. By fall. 25 228 Inmines and quarries. 1 56. By machines. 13 119 By other crushings (vehicles, railroads, landslides, etc.) .47 164 1 N Railroad traumatsm. 6 85 2 'Dynamite traumatism. 2 29 1. Traumatism by landslides. 4 11. Injuries by animals. .1. 1. Starvation. .. Heat exhaustion. .. Electricity (lightning excepted). 4 3 1 Homicide by cutting or piercing instruments. 1 1 .. Fractures (cause not specified). 54 50 Dislocations. .4. 5 .. Sprains. .. Other external violence. f. 386 948. Ill-defined diseases. Ill-de'fned organic disease .2 .. Infections of undetermined origin. 21 15 No disease. .11 21 Feigned disease. .2 Total .,. 3,r669 7,068 _21. NoT.-doThe admissions referred to aboverepresent disc14arges for frsVi p 01d admisslonw for the last six months of 1914.

PAGE 39

37 TABLE VIII.-CONSOLIDATED HOSPITAL REPORT. ReRemainA td d DisTransmain gid charged. ferred. ing Hospitals. Jan. 1. Dec. 31. W. C. W. C. W. C. W. C. W. C. W. C. Arwon Hoe pital. Panama Canal employ-s.-. 179 340 2,909 5,294 15 1213,000 5,288 28 49 45 176 Panama Railroad employees. 8 51 396 990 3 33 389 963 3 11 9 34 Panama pay patients----2. 5 .2. 5 Other pay patients. Ii 67 3,710 1,235 43 117 3,613 1,116 23 24 147 45 Charity patients. I 17 311 345 6 75 299 219 6 28 16 40 Insane employees. 6 24 8 28 .1 6 12 3 19 5 20 Insane nonemployees. 23 227 33 171 4 46 13 74 10 58 29 220 Total. 348 728 7,367 8,068 71 393 7,320 7,674 73 194 251 535 Corozal Farm: Panama Canal employees. 9 36 5 36 4 27 2 10 8i 35 Chronic ward: Charity patients.26.43. 1.40 .. Colon Hospital. Panama Canal employees. 5 11 232 542 2 14 203 413 27 115 5 11 Panama Railroad employees. 1 11 77 318 .13 69 217 6 87 3 12 Panama pay patients. ..29 83 2 14 15 32 11 36 1 1 Other pay patients. 4 2 220 114 2 9 185 77 29 29 8 1 .Charity patients. .2 56 83 4 7 35 53 16 25 1 Total. 10 26 6141,1 10 57 507 7921 89 292 18 25 Palo Seco Leper Asylum. Panama pay patients. 2 28 1 8 1 5 ...2 31 Charity patients. 2 13. 5. .2 2 15 Total. 4 41 1 13 1 5. 1. 2 4 46 Tdboga Sanitarium. Panama Canal employees. 22 .38. 60 .... Pay patients. .44. .51 .--Total. 29 .82 ....111. .. Grand totals. Panama Canal employs.215 3873,1845,87, 17 1353,2675,728 57 174 58 222 Panama Railroad employees .9 62 4731,308 3 46 4581,180 9 98 12 46 Panama pay patients. 2 30 30 9f 3 19 15 34 11 41 3 32 Otherpay patients. 127 69 3,974 1,34C 45 126 3,849 1,193 52 5. 155 46 Charity patients. 18 *58 367 47f 10 83 334 313 22 55 19 83 Insane employees.6 24 8 28. 1 6 12 3 19 5 20 insane nonemployees. 23 227 33 171 4 46 13 74 10 58 29 220 TotaL.400 857 8,069 9,300 82 456 7,942 N,534 164 498 281 669

PAGE 40

38 .TABLE IX.-CONSOLIDATED SICK CAMP REPORT. RemainAdd DisTransma6ning emitted. charged. ferred. Stations. Jan. 1. -Dec. 31. W. C. W. C. W. C. W. C. W. C. W. C. Gamboa. .5 5 65 ..4 65 1 5 Porto Bello. .1 17 88 ..13 82 4 Toro Point .1 .8 8 ..2 1 7 7 .. Total. 1 6 30 161. .19 148 12 '19. CONSOLDATED REPORT OF EMPLOYEES TREATED IN QUARTERS. Admissions to quarters. Days lost in quarters. White. Colored. Total. White.! Colored. Total. Naos Island. 11 158 169 24 307 331 Ancon. 887 471 1,358 1,929 1,730 3,659 Balboa. 581 158 739 1,199 296. 1,495Corozal. 916 53 969 1,518 96 1,614 Pedro Miguel. 183 .183 320 .320 Paraiso. 178 3 181 483 6 489 Culebra. 200 411 611 542 1,069 1,611 Empire. 451 188 639 1, 241 638 1,879 Gatun. 315 220 535 729 741 1,470 Colon. 1,120 882 2,002 2,478 4,574 7,052 Porto Bvllo. 19 19 30 .31 'Joro Point. 27 0 24 ,51 39 61 .100 Margarita Point. 3 36 39 6 35 41 Total. 4,891 2,604 7,495 10,538 9,553 20,091 TABLE X.--CONSOLIDATED HOSPITAL SICK CAMP, AND ADMISSION( TO QUARTERS REPORT. Re Re, DisTransRmaining Admitted. Died. charged. rr mailing Jan. 1. Dee. 31. W. C. W. C. W. C. W. C. W. C. W. C. Hospitals. 400 8578,0699,300 82 4567,9428,534 .164 498 281 Sickcamps. 1 6 30 161 ..19 148 12 Total. 401 8638,0999,461 82 4567,9618,682 176 517 281 0

PAGE 41

39 TABLE X.-CONSOLIDATED HOSPITAL, SICK CAMP, AND ADMISSION TO QUARTERS REPORT-Contnued. White. Colored. Total. Total admissions to hospitals and sick camps, excluding Corozal Farm and chronic ward. 8,094 9,382 17,476 Tqtal admissions of employees to quarters. 4,891 2,604 7,495 Total. 12,985 11,986 24,971 Less number of patients transferred from sick camps and quarters to hospitals, and between hospitals whose admissions are duplicated in above figures. 315 691 1,006 Net admissions to hospitals, sick camps, and quarters. 12,670 11,295 23,95 Net admissions of employees to hospitals, sick camps, and quarters. 8,356 9,444 17,800 Annual average per thousand of admissions of employees to hospitals, sick camps, and quarters. 1,189.64 253.16 401.54 CONSOLIDATED DISPENSARY REPORT ON ALL CASES TREATED BUT NOT EXCUSED. Employees. Nonemployees. Total. White. oW Total. white. Co Total. White. C Total. ored. ored. Wht. ored. Ttl Naos Island. 1,594 14,484 16,078 1 5 6 1,595 14,489 16,084 Ancon. 15,178 26,169 41,347 9,965 1,369 21,334 25,143 37,538 62, 681 Balboa. 42,107 45,860 87,967 2,024 2,013 4,037 44,131 47,873 92,004 Corozal. 21,778 19,540 41,318 7,368 1,177 8,545 29,146 20,717 49,863 Pedro Miguel. 5,587 11,519 17,106 4,621 1,194 5,815 10, 208 12, 713 22,921 Paraiso. 8,341 16, 166 24,507 3,993 4,815 8,808 12,334 20,981 33, 315 Culebra. 6,526 13,139 19,665 4,173 5,789 9,962 10,699 18,928 29,627 Empire. 8,187 10,278 18,465 4,135 3,420 7,555 12,322 13,698 26,020 Gamboa. 748 3,425 4,173 292 2,181 2,473 1,040 5,606 6,646 Gatun. 8,664 17,225 25,889 7,312 5,449,12, 761 15, 976 22,674 38,650 Colon. 10,876 23,673 34,549 5,893 4,66310,556 16,769 28,336 45,105 Porto Bello. 1,642 3,073 4,715 278 192 1,070 1,920 3,865 5, 785 Toro Point. 1,397 2,163 3,560 99 173 272 1,496 2,336 3,832 Margarita Point. 1,074 3,974 5,048 .1,074 3,974 5,048 Total. 133,699 210,688 344,387 50,154 43,040 93,194 183,853 253, 728 437,581 TABLE XI.-AVERAGE NUMBER OF EMPLOYEES CONSTANTLY SICK IN HOSPITALS, SICK CAMPS, AND QUARTERS. White. Colored. Total. Ancon Hosptal. '124.50 327.60 452.10 Colon Hospital. 7.59 22.37 29.96 TPaboga Sanitartuni. .1.64. 1.64 Total. 133.73 349.97 483.70 Or r.

PAGE 42

SH TAVrAX.-AVERAGE NUMBER OF EMPLOYEES CONSTANTJ IN HOSPITALS, SICK CAMP, AND QUARTER-Cotinued. Sick camps. Sick in quarters. White. Colored. Total. White. Colored. TotaL Naos Island ..-.-. ..0.07 0.84 0.91 Ancon. ..5.28 4.74 10.02 Balboa. ...3.28 .81 4.09 Corozal. ...4.16 .26 4.42 Pedro Miguel. ....88 ..88 Paraiso. ...1.32 .02 1.34 Culebra. ...1.48 2.93 4.41 Empire.-. ...3.40 1.75 5.15 Gamboa. 0.05 1.84 1.89 .. Gatun. .2.00 2.03 4.03 Colon. ...6.79 12.53 19.32 Porto Bello. .28 1.05 1.33 .08 ..08 Toro Point. .03 .02 .05 .11 .16 .27 Margarita Point. ....02 .09 .11 Total. .36 2.91 3.27 28.87 26.16 55.03 AVERAGE NUMBER OF EMPLOYEES CONSTANTLY SICK. White. Colored. Total. Hospitals. 133.73 349.97 483. 70 Sick camps. .36 2.91 3.27 Sick in quarters. 28.87 26.16 55.(i3 Total. 162.96 379.04 542.1* AVERAGE NUMBER OF EMPLOYEES CONSTANTLY SICK PER 1,000. White. Colored. Total. Hospitals.-. 19.04 9.38 10.RI Sick camps. .05 .08 Sick in quarters. 4.11 .70 1.24 Total. 23.20 10.1O 1.2 4

PAGE 43

'h: 9 .41 TABLE XII.AVERAGE LENGTH OF STAY IN HOSPITALS OR QUARTERS FOR EACH ADMISSION OF SICK EMPLOYEES. White. Colored. Total. Hospitals: Ancon Hospital. 13.18 18.40 16.59 Colon Hospital. 9.01 9.51 9.38 Taboga Sanitarium. ..9.98 .9.98 Total.-. -----12.80 17.37 15.82 Sick camps: Gamboa.-------------------------------3.80 9.61 9.23 PortoBello. 5.94 4.33 4.58 Toro Point. 1.33 1.12 1.24 Total-.---------------------------------4.26 6.39 6.06 Quarters: aos Island.--.2.18 1.94 1.96 ncon ........2.07 3.67 2.69 Balboa. 2.06 1.87 2.02 Corozal. 1.66 1.81 1.67 Pedro Miguel .1.75 .1.75 Paraiso. 2.71 2.00 2.70 Culebra. 2.71 2.60 2.64 Empire. 2.75 3.39 2:94 Gatun. 2.31 3.37 2.75 Colon. 2.21 5.18 3.52 Porto Bello--. 1.58.58 1.58 Toro Point. 1.44 2.54 2.00 Margarita Point. 2.00 .97 1.05 Total. 2.15 3.67 2.68 TABLE XIII.-SUBSISTENCE AND OPERATING EXPENSES. Hospitals. Sick camps. Total. SUBSISTENCE EXPENSES. Number of days' rations issued to patients. 378,653 3,359 382,012 Cost of rations issued to patients. .$97,386.56 $680.87 $98,067.43 Cost of subsistence per patient per day 80.257 80.202 -0.256 OPERATING EXPENSES. Number of days' relief furnished patients. 378,653 4,051 382,704 Cost of operation. $522, 411.77 $1,126.72 3523,538.49 Cost per capita per day. $1.379 $0.277 $1.367 Cost of operation with amount received from outside patients,etc., deducted. $295,703.38 $1,090.72 $296,794.10 Cost per capita per day with above deduction.----. 80.78 $0.269 80.775 Cost of dispensaries ...$80,084.68 44 .EMENP Z

PAGE 44

42 TABLE XII.-SUBSISTENCE AND OPERATING EXPENBEsg t. Financial statement. Health department expenditures calendar year1913 1914 Administration. $58,957.43 28,i06.95 Medicinal storehouse .6,556.87 61,99. 73 Ancon Hospital .529,282.74 461,056.64 Colon Hospital .164,822.73 34,099.71 Taboga Sanitarium. 29,455.62 867.39 Santo Tomas Hospital. 11,634.83 10,883.50 Other hospitals and dispensaries. .-----------------148,160.57 89,951.00 Quarantine service ...----------------------------58,414.68 51,107.31 Sanitation, proper-Panama. 34,874.31 34,904.10 Disposal of garbage, street cleaning-Panama. 21,001.49 54,215.05 Sanitation, proper-Colon ----.-----------27,578.62 26,368.42 Disposal of grabage, street cleaning-Colon----------18,838.14 21,940.62 Sanitation, proper-Canal Zone. 289,840.40 143,365.47 Disposal of garbage, etc., Canal Zone.--------------53,245.42 29,576.03 Construction and repair of buildings---------------22,587.96 87,378.55 Operation of Corozal Farm. 9,689.28 14,462.55 Total. 1,484,941.09 1,094,682.92 NOTE.-mhe figures shown above for 1914 do not include $39,486.64 obligation for gratuity reserve. Yhis is omitted in order to make comparison with expenditures for 1913, when no reserve for gratuity pay had been made. TABLE XIV.-PATIENTS OTHER THAN EMPLOYEES TREATED IN HOSPITALS, INCLUDING PALO SECO LEPER ASYLUM, AND AMOUNTS RECEIVED FOR THEIR TREATMENT. RemainNumber mg Ad Total. of days Amount,. Jan. 1. emitted. treated. Paid for by Panama Republic: Insane------------------173 128 301 65,527 $49,172.55 Colon Hospital.------------------112 112 651 1,197.71 Lepers------------------30 9 39 11,334 8,476.50 Total. 203 249 452 77,512 58,786.79 For whom department of civil government pays $2,400 per year (charity). 153 875 1,028 49,686 2,4002.0 Outside pay patients. 55 1,310 1,365 13,346 55,172.26 Families of employees, etc. (Zone),.-. 103 .2,432 2,535 44,537 45,938.9. Soldiers---------------------38 1,481 1,519 17,704 21,473, 11) Residents of Panama, emergency charity cases. 1 44 45 253 Oper tion 1. .......5,4 .7 Operations 1-----------------------------------35, Total. 553 6,391 6,944 203,038 219190. I The amount received for operations is for the first 10 months of the year, n which time the amounts received from this source are included in the received from the different classes of patients mentioned above.

PAGE 45

43 .Ai: TABLET X V.-SURGICAL OPERATIONS PERFORMED IN HOSPITALS. Num.DidNum-Did ber. ber. Amputations: Genito-urinary tract-Con. Shoulder.-2 2 Perineoplasty.-18 Forearm.-. Trachelorrhaphy -----21. oit-------Vaginal sections .. Thigh.---4 1 Vaginal punctures. 4. Leg.-6 2 Obstetrical: AFoot.-4 .Coesarian section, abDigits multiple ------38 1 dominal------------. 4 1 Log, doU~ie.5 5 High forceps .1. Arn and leg ---------1 1 Low forceps .29. Operations on bones: Version.--26.-A. CraniectomyPerineorrhaphy------7. Decompressive .8 2 Thorax: Exploratory .1 ---Thoracotomy.-11 2 Lamninectomy.3 2 Thoracoplasty. 2. ; 0tiectomy.--21 ---Excision ofECision of maxilla. 1 1 Breast.-1. ResectionofBreast and axilla. 2.Shoulder.-1. Rectum: Elbow.-1 1 Hemorrhoids, radical Ankle.-1 .1 Cure .119.Wiring of fracturesFistula in anus, exciAwSimple.--73 ----sion of.7 Compound .25 1 Prolapsus rectum, Adeiectomy: radical excision .3. Cervical.--38 .General: Axiliary.-3 ---Thyroidectomy.-11 higuinalAneurismorrhaphy. 1 Single.--252 ---Varicose veins,, exciDouble.--79 --sion of. 23. Femoral.--22 --Tenorrhaphy .17. :i. IHerniotomy: Excision of surface EIInguinalneoplasms .52. W.Single .133 .Gunshot wound of Double .--.48 ----soft parts, operation Feihoral.4 .for.1. Ventral.--16 ----Extensive injuries to, Strangulated. 14 1 soft parts, operation Genito-urinary tract: for.-9 Nephrotomy .2. Plastic operation forNephrectomy .2 .Congenital defect 3 Nephropexy .2 .Severe injuries 1. Perinephtritic abscess, Effects of disease. 14. drainage of .1 .Skin graft. 13. Ureterotomy .2.Laparotomy: Cystotomy .1I. For general peritonitis 3 1 UrethrotomyFor tub erciious periInternal .37 .tonitis.-2 1 External.--40 1 For intestinal obstrucProstatectomy ----3 .tion.-7 5 SiinAVaricocele, r a dic aI Exploratory .9 2 cue.25 .Gstrotomy.2 1 HydroceleGastro-enterostomy. -5 1 Single radicalcure. 43 --Entero-eterostomy3 1 KAi' DoubYe, radical Enterectomy.3 2 cure .8 -Appendectomy .213 1 A.Orchidectomny.4 .Appendectomy withEpididyotomy.--103 .Local peritonitis 27 1 Amputation of scroGeneral peritonitis 5 2 turn.27* .scostomy .1 1 Cuea~uei.92 .colostomy ..

PAGE 46

44 TABLE XV.-SURGICAL OPERATIONS PERFORMED IN 'O, ITALS-Continued. NumDied. NUm, Ie. ber. ber. Laparotomy-Continued. Laparotomy-Continued. Cholecystostomy. 16 1 Plastic operation for Cholecystectomy. 7 1 chronic pelvic periAbscess of livertonitis.------------43. Laparo -hepatotFor ectopic gestation. 3 omy for-------8 3 For trauma: Thoraco-hepatotGeneral peritonitis 2 1 omy for--------5 2 Hematoperitoneum. .2. Splenectomy---------2 1 Rupture ofPan-hysterectomy. 6 -----Liver -------------1 1 Supravaginal hysteSpleen ------------2. rectomy-----------47 1 Gunshot wound of Hysteromyomectomy. 38 1 al domen ----------1. Myomectomy--------6 .Stab wound of abdoSalpingectomymen------------2. Single-----------8 -----Major operations, various Dou e --------6 ------other -----------------65 tomy.-------------18 1 Suspensio-uteri ------44 1 Total. .----------4,060 60 The above figures represent the number of operations performed; in isome. instances two or more are performed upon one patient. TABLE XVI.-OPERATIONS AND WORK PERFORMED IN EYE, EAR, NOSE, AND THROAT CLINICS. Operation. Number. -Operation. Number. Adenectomy. 138 Removal of foreign body Abscess, alveolar-----------1 from esophagus----------2 Bowman's dilatation of lacResection, internal rectus. 1 rymal duct. 3 Rhino plastic. 2 Canthotomy. 1 Sarcoma of nose, excision Capsulectomy.------------8 Septal spurs. 1 Cataract, needling .1 Sequestrotomy. 1 Enucleation. 4 Sinusotomy. 7 Evisceration. 4 Sinusotomy, nasal.3 Excision of chalazion. 2 Submucous resection of nasal Expression for trachoma. 10 septum. 11 Extraction of cataract .16 Suture, lacerated sclera.1 Glaucoma, trephine .-. 1 Sublingual abscess, incised. Iridectomy. 21 Tarsalectomy for trachoma., 1 Lacrymal gland, excision. 1 Tenotomy.6 Lingual abscess. 1 Tonsillectomy.2 Mastoidectomy. 9 Tucking: Ossiculectomy. 1 Internal rectus. Plastic on ear .3 External rectus .10 Plastic on eyelid. 1 Turbinectomy. .4 Plastic on nose. .4 Various minor operations. 27 Polypoid growth tonsil removed. 2 Total. 1,71 Pterygium: Refractions. 2 Excision. 28 Outside cases treated., Transplantation .G. 35G----Resection, external rectus .2 Grand Removal of nasal polyp. 6

PAGE 47

45 T 'EXVI1.-COINSOLIDATED WARD LABORATORY REPORT OF ALL HOSPITALS. Number. Number. Blood examinations--------12,946 Stool examinatious-Contd. Estivo-autumnal ----------2,276 C6rcomonas, intestinalis45 Tertan-----------------497 Bathriocephalus----1 wMixedtertian and estiUrine examinations---------23, 883 -vo-autunual-----------29 Albumen ----------------7,026 Quartan-----------------44 Albumen and casts. 5,273 Differential blood counts, 727 Sugar-------------------60 Nn. .eucocyte counts----------2)098 Pus and blood----------4,917 Red blood counts .120 Gonococci----------------3 White blood counts 41. Indican-------------------27 Hemoglobin estimations1)558 Epithelium-------------1,586 Relapsing fever.----2 Bile--------------------123 8to eainations-----------9,189 Microscopical examinaAsearis lumbiicoides. 368 tions------------------12 Ijncinaria ova-----------1,2151 Trichomonas vaginalis. 8 Tricocephalus dispar --993 ilemin crystals ------11 HTStrongyloides intestiGualac tests ------------68 nais --------------------46Clae oas1 IM11Tenia saginata1 Sputum examinations ---------2,10 Ameba------------------43 Tubercle bacilli---------323 Entamneba---------------34 Ameba-----------------6 Ciliated monads----185 1 Blood-------------------0 Bilharzia -----------------9 Elastic tissue-------------2 Pus and blood -----------1,266 Miscellaneous examinations Pus and epithelial cells.1 ofBalantidium coi---8 Pleural effusions. -----. Oxyuris vermicularis -2 Various smears and dis 6 Entamneba, histolytica charges------------------349 wrand tetragena ------24 Spnlfui1-Guaiwtests----------------82 Vac inal and urethral disBismuth crystals ---54 charges~ -------------149 TABLE XVIII.-ANCON HOSPITAL-NATIONALITY OF PATIENTS. Americans. Other nations. Number_______________ Classtreated. White. Colored. White. Colored. H Panama Canal employees----------8,722 1,1804 6 1,9098 5,814 Ew Panama Railroad employees. 12445 223 1 152 1,069 Panama pay patients----------------7----------------------------7 -Other pay patients-------------5,128 2,823 1 930 1,374 M. Charity patients------------------.689 248 1 72 368 Insane employees------------------66 4 8 .54 Insane nonemployees--------------454 15340 NVTotal--------------------.16,511 5,1 47 2,5 9, 09 Number of days' relief furnished patients---------------. 8. 38,339 Caeitfsubsistence per patient per day-----------------------------.50.251

PAGE 48

46 TABLE XIX.-COLON HOSPITAL-NATIONALITY OF PATIENTS. Americans. Other nations. Class Number._ __.__ treated. White. Colored. White. Colored. Panama Canal employees. 790 99 .132 559 Panama Railroad employees. 407 47 .29 331 Panama pay patients. 112 '10 .21 81 Other pay patients. 340 128 .101 111 Charity patients. 141 33 .26 82 Total. 1,790 317 --------309 1,14 Number of days' relief furnished patients.a. 15,338 Cost of subsistence per patient per day.w. 50.336 NOTE.-Operations at Ancon and Colon Hospitals (see report of all surgical operations). Laboratory reports of Ancon and Colon Hospitals (see consolidated ward laboratory report). TABLE XX.-PALO SECO LEPER ASYLUM-NATIONALITY OF PATIENTS. Americans. Other nations, Class Number 's treated. White. Colored. White. Colored. Panama pay patients--.39 ..3 Charity patients.w. 20 ..2 18 TotaL. 59 ..5 Number of days' relief furnished patients7. 7,729 Cost of subsistence per patient per day. s0.274 TABLE XXI.-TABOGA SANITARIUM-NATIONALTITY OF PATIENTS. Number AmeriOther Class. treated. cans. nations. Panama Canal employees. 60 59 1 Pay patients. 51 50 1 Total. 11109 2 Number of days' relief furnished patients. 54 Cost of subsistence per patient per day. .92 NOTE.-No colored patients treated at Taboga Sanitarium. 'kiV

PAGE 49

A4 47 TABLE XXIL-SANTO TOMAS HOSPITAL. RemainA-RemainClass. in -Died.s Jan.Cs. emitted. charged. 31. Pay cases. ..-----------------16 1,323 26 1,263 50 Charity patients. 336 9,636 757 8,770 445 Total. 352 10,959 783 10,033 495 Average number of days' treatment-per patient. 13.10 Average number of patients constantly sick. ....------------------------388.22 Number of days' relief furnished patients. .....-------------------------141,702 Cost of subsistence per patient per day0. $.24 NATIONALITY. Americans. Other nations. Number Class, treated. White. Colored. White. Colored. Pay cases. 1,339 19 .537 783 Charity patients.---------------9,972 18 .1,037 8,917 Total. 11,311 37 .1,5749,700 OPERATIONS. Number. Died. Major. 1,188 34 Minor. .....-----------------------------------------------451 Total. 1,639 34 DISPENSARY. *Class. White. Colored. Total. Natives.--------------------974 4,116 5,090 Foreigners. 1,071 3,750 4,821 Total. ,045 7,866 9,911

PAGE 50

48. TABLE XXIII.-BOARD OF HEALTH LABORATORY. Number. Number. Bacteriological examinations Chemical examinationsW ater .-.--. 5 Continued, Milk-------------------15 Gallstones --------------1 Fluids and exudates. 36 Stomach contents -------1 Blood cultures---------230 Urine------------------99 Throat cultures (diphVarious liquids, fluids, theria suspects) .264 etc---------------Cultures from autopsies 57 Various metals .-.1 Cultures from eye. 4 Paste.------------------1 Stool cultures----------989 Sugar cane -------------2 Urine cultures----------1,157 0il, transformer-roomc. 5 Sputum -----------------8 Brass borings-----------2 Pus--------------------22 Cottonseed bulls and Hydrocele fluid .1 meal.-----------------2 Knee-joint fluid .13 Seeds of I plant, Cassia Spinal fluid. 25 occidentalis L. (coffee Various smears and senna) ---------------1 specimens -----------15 Pyrene (fire extinPleuial fluid-----------1 guisher).----------Plague suspect.-.-. 1 Drugs and chemicals, for Fluid from chest. 3 purity ----------------89 Hand lesion ------------1 Preparation of dark fluid Abdominal fluid. .3 and U-tube, for testing Fluid from pleural cavity 2 hydroelectric plant, Fluid from gall bladder. 4 Gatun.----------------1 Panama oysters (conVomitus. ---------------1 signments)-----------2 Larvacide, to determine For quarantine officer. 2 deterioration .1 Curetage. ---------------2 Milk-------------------145 Placenta. ---------------1 Limestone, Corozal Lymphnode. ------------1 Farm ----------------1 Autopsy material (veterLiquid s ub stance inary).----------------3 (poison), for division Oysters. ------------1 of police. --------------2 Feces for uncinaria .2 Dairy feed.--------------12 Rats.-------------------1 Flour.------------------2 Determinations: Moisture Agglutination reactions1 .77 and volatile matter in soil. 6 Autopsies 1 ------------------372 Examinations: Bodies embalmed 1 ---------6 Stomach contents .2 Pathological tissues preLeper suspects. 28 pared, frozen 1. 266 Animals----------------63 Pathological tissues preRats.------------------8,104 pared paraffin1.4,180 Microscopic, for chief Surgical pathological tissues quarantine officer-----17 and neoplasms reported 1. 306 Blood of employees, for Vaccinations, antipest malaria---------------158 Vaccination, smallpox -.-. -14 Provisions. --------------3 Vaccine inoculations, antiChemical examinations: typhoid ..--------.Pancreatic cyst.-----1 Vaccine treatment, autogeOleum rinci. 1 nous, prepared I. 3 Boric acid.------------1 Water, sanitary analysis of 1. Cbloral.-----------------1 Wasserman reactions 1.-, Carbolic acid-----------1 Microscopic examination of Specimen for division of stools ..------------------4 police-------------. 1 Preparations of salvarsanUrinary calculus -------2 sized serum for intraspinous Stools.------------------1 treatment 1. Sodium phosphate-----1 Medical legal investigations '. Alcoholic beverages-----4 Preliminary work on prepaPowder. -----------------1 ration of smallpoxvaccie. Not included under the heading "Chemical examinations."

PAGE 51

49 TABLE XXIV.-ISSUES OF QUININE. Pounds, Pounds, Month. avoirduMonth. avoirdugrams. grams. pois. pois. January.---------34.5 76.06 September--------37.00 81.57 February ----------47.00 103.62 October .----21.00 46.30 March---------. 29.2 64.38 November--------22.50 49.60 A ----.32.00 70.55 December.--------12.10 26.68 Va .---12.00 26.46 June-. -----------43.00 94.80 Total------321.30 708.36 July. -----------20.00 44.09 Average per month. 26.775 59.03 August -----------11.00 24.25 TABLE XXV.-SANITATION. CITY OF PANAMA. Mosquito, rat and fly work: Miles of ditches cleaned. 116.6 M iles of ditches dug...-.-. -. 7.4 Cess pools cleaned. .----------------------.-------------------11 Cubic yards of earth used in filling cesspools, wells, and holes. .4,035 Square yards pools oiled.1 587,784 Water containers treated.-. 524,610 Mosquito-breeding places found. 6,225 Fly-breeding places found. 6,277 Quarts of flies trapped. 676 Rats trapped. 1,952 Disinfection work: Houses disinfected for diphtheria. 2 Houses disinfected for chickenpox. 1 Houses disinfected for scarlet fever. 2 Houses disinfected for measles. .1 Houses disinfected for typhoid fever. 3 Houses disinfected for simple meningitis. 1 Cubic feet disinfected. ..-.108,700 Rooms disinfected. .32 Material used: Crude oil .--.gallons 3,116 Larvacide.do 6,784 Inspection of houses and yards: Houses and yards inspected. 45,690 Notices served and nuisances abated. -998 Old buildings condemned. .1,021 Buildig demolished. 290 Yards cleaned. 2,535 Loads of refuse removed from the city. 4,219 New buildings: Plans for new buildings approved. 375 Permits granted for repairs to old buildings. 1,064 Garbage collection: Loads of garbage removed to dump and burned.P. 49,807 Total number of cans of garbage emptied. 842,647 Total number of garbage cans placed. 1,537 Street cleaning: Square yards of streets cleaned daily. 566,667 Square yards of streets sprinkled daily. 92,222 Persons vaccinated. 13,111

PAGE 52

50 COLON, CRISTOBAL, MOUNT HOPE, AND ToRo POINT. Water and sewers: Connections made during the year .45 Total connections made to date. 1,166 Outstanding permits .-. 509 Houses in which extensions were made.50 Houses: Plans approved .44 Permits to repair issued Permits to occupy issued.-----------------------------.2 Temporary permits to occupy issued. .---------------. .Bills collected for work for private parties. 114 Sanitation of Colon: Loads of yard garbage removed .-. 5,594 Average number of cans of garbage removed daily. ,252 Acres of vegetation removed. 176 Acres of streets cleaned. 9,878 Private properties cleaned. 893 Square yards of pools oiled ..295,250 Mosquito-breeding places destroyed. 1,402 Water receptacles treated .312,469 Linear feet of ditches constructed. 383 Miles of ditches maintained. 14.1 Notice to abate nuisances served.m ..1,131 Nuisances abated. 1,717 Buildings inspected .43,199 Rats killed.-. 1,342 Square yards of alleys cleaned .6,730,433 Square yards of streets sprinkled --. 398,000 Fly-breeding places destroyed. 961 Gallons of larvacide used (7 months) .2,725 Gallons of crude oil used. 1,382 Doses of quinine issued. 38,999 Dogs killed. 170 Cubic feet disinfected. d7,824 Cubic feet fumigated .8,400 Colon and Cristobal garbage disposed of at dump, Colon. Sanitation of Cristobal: Square yards of pools oiled ..49,290 Water receptacles treated. 42,979 Mosquito-breeding places destroyed .208 Mosquitoes killed in barracks. .4,857 Fly-breeding places destroyed.108 Mosquitoes killed in cars.2,185 Buildings inspected .2,360 Gallons of larvacide used (7 months) .299 Gallons of crude oil used. 416 Loads of yard garbage removed. 273 Cans of garbage removed .31,869 Square yards of vegetation removed. 243,785 Sanitation of Mount Hope: Square yards of pools oiled .999,550 Water receptacles treated .215,100 Miles of ditches maintained.7.4. Mosquito-breeding places destroyed. 1,64 Miles of ditches constructed. ..6. Mosquitoes killed in outfit cars .4Q,932 Mosquitoes killed in barracks. 137,791 Gallons of crude oil used (7 months). 15,588 Gallons of larvacide used (7 months) .2,314 Rats killed. Cans of garbage removed .7,3O Square yards of vegetation removed.390,798 Mount Hope Cemetery maintained.

PAGE 53

51 Sanitation of Toro Point: Square yards of pools oiled.--------------------------------57,332 Water receptacles treated.---------------------------11,240 Mosquito breeding places destroyed.----------------------------60 Linear feet of ditches maintained. 39,470 Doses of quinine tonic distributed. 12,195 Cubic yards of old ditches reconstructed.-. -. 1,353, Adult mosquitoes killed. 5,700 Pit closets oiled. 12 Fly-breeding places destroyed. 4 Gallons of larvacide used (seven months). 108 Gallons of crude oil used (seven months).39 Persons vaccinated. 1,458 Mindi Island: Square yards filling in low places. 4,404 Square yards vegetation removed. .....---------------------------20,900 Linear yards of ditches constructed. 7,727 Linear yards of ditches maintained. ..----------------------------830 Wooden culvert constructed-------------------. .1 CANAL ZONE. Work requests on quartermaster's department: Grass cutting. ------------------------------------130 Screen repairing. ......------------------------------------------179 M iscellaneous.63 Work requests on engineering department.--------------------------208 Work requests on other departments. 25 Notice served for abatement of nuisances. 732 Arrests for violation of sanitary regulations --------------------------39 Convictions. 36 )Building permits approved. 32 Inspections of closets --,----------------------------------------33,195 Inspections of stores. 2,171 Inspections of restaurants. 501 Inspections of shops. 1,825 Garbage cans emptied. 1,495,260 Closets disinfected. .......-----------------------------------------68,746 Houses disinfected. 68 Rat traps used daily. 1,201 Water and sewer connections made. 2 Adult anopheles destroyed at houses. ---114,802 Adult culices destroyed at houses. .....-----------------------------181,385 Containers found with stegomyia larvae.-----------------------------45 Adult stegomyia destroyed in houses. 32 Material used: Larvacide.----------------.gallons. 42,945 Crude oil.--------------do. 263,459 Rats destroyed. 8,954 TABLE XXVI.-QUARANTINE SERVICE. PORTS OF PANAMA-BALBOA AND COLON-CRISTOBAL. Vessels inspected and passed.-. 1,496 Vessels detained in quarantine. 141 Vessels fumigated on arrival. 124 Vessels fumigated prior to departure. 38 Pieces of baggage handled and stored. 2,377 Crew inspected. 127,306 Passengers inspected .-. 64,695 Total persons inspected. 192,001 KJA4 MAD

PAGE 54

52 Persons vaccinated at ports of arrival because of compulsory vaccination Persons vaccinated at ports of departure or en route because of compulsory vaccination law ........15,967 Total persons vaccinated-.24,431 Persons held in quarantine at the detention stations to complete period of incubation of yellow fever or plague.-.-.-.4, 281 Persons held in quarantine on board vessels to complete period of incubation of yellow fever or plague.-.-.--.-.19,513 Total persons held in quarantine.-.23, 794 Persons landed from foreign ports: C ab in ........23 ,1 Steerage ........1 7,058 T otal. ....-..-. 40,069 Persons embarked for foreign ports: C abin ......-. ..24,352 Steerage ........26,243 T otal. ........50,595 Apparent decrease for the year from foreign ports: C abin ........1,415 Steerage .......9,185 T otal. .......10,600 Persons arriving from coast towns on small craft.29,000 Persons embarked for coast towns on small craft.24,708 Apparent increase for the year from coast towns.-.-.4,292 Total persons landed.-.-.-.-. .69,069 Total persons em barked. .....75,3j03 Excess over number landed.-.-.6,234 Less number for Pacifrc ports.-.-.3,247 Total apparent decrease for the year.9,481 Immigrants recommended for rejection.-.-.-.-. 90 Certificates issued to outgoing passengers.-.-. 334 Persons refused certificates because of traclioma.21 Bills of health visded .......1,122 Bocis DEL TORO. 411 Vessels inspected and passed.-.-.-. 343 Crew inspected and passed.-.-.-.17,151 Passengers inspected and passed.7,972 -Passengers, in transit, inspected and passed. 4,-Persons held to complete period of incubation of yellow fever.-37Persons held to complete period of incubation of plague.on Vessels fumigated -. .....----------------------------------------.

PAGE 55

TABLE XXVIL-PERSONNEL REPORT. [Average monthly number of employees at work during year.] December 31,1914. 1914 1913 officer Skilled and and emukild Total. ..un killed ployees. labor. Chiefhealthoffice. 13 33 4 .4 Meodicai store .8 94 4 8 Quarantine service. 40 40 23 19 42 Panama. .142 83 21 131 152 Colon. 130 127 18 102 120 Ancon Hospital .431 548 236 111 347 Coon Hospital.-30 166 12 11 23 a Tomas Hospital. 5 6 5 .5 T6bg Sanitarium ..1. PaloSeco Leper Asylum. 19 14 11 6 Zonesanitation. 125 224 19 78 97 Hospital farm. 47 22 2 41 43 Dispensaries: Ancon .5 5.---Balboa .6 4 6 KBas Obispo ..4. Corozal .6 Mi ~ Crlstobal .4 6.----Culebra .4. 7 3 3 Eminpre. 5 6.---Frijoles .-Gatun .4 4 Gorgona.--. .6.----Las-Cascadas ..---------MargaritaPoint.-1 1 1 Miraflores ..-----.-----------.Naos island .2 2 1 arais ..*4 4 4.4 Pedro Mguel. 3 4 3 .3 Porto Bello. 3 4 -------------Toro Point .2 3 -------------Gamnboa. 1 Total .1,00 13138 08 T, ------040 1371 33 50 WI.J4 "u:1

PAGE 56

54 TABLE XXVIII -HOSPITAL CASES OF MALARIA AMONG EMPLOYEE$. Discharges. Died. Annual Annual N m Total average average ber of Month. cases. death cases emrate per per ploy1,000. 1,000. ees. January------------115 371 0 0 486 0.00 118 49,328 February------------76 207 0 0 283 .00 69 49,459WMarch. 59 122 0 1 182 .26 47 -46,611 April .------44 99 0 0 143 .36 47,748 May.----------------56 143 0 0 199 .-50 48,039 June.----------------73 174 0 0 247 .62 47,579 A dmissions. July.----------------80 259 0 0 339 .87 46,616 August-------------57 192 0 0 249 .' 68 44,132 September. 44 172 0 0 216 .64 40,623 October-------------59 152 1 1 211 .62 66 38,416 November. 48 133 0 0 181 -. 58 37,172 December. 48 100 0 0 148 .49 36,224 Total----.759 2,124 1 2 2,884 .07 65 44,329 0 1A. a 1 a Sa

PAGE 57

*8 ** *U c I x .:

PAGE 58

I m f F 4 Aa 4 S9

PAGE 59

Y% 1:2 M a ki E 'o3 -1 A 3 4 H U A~U

PAGE 60

~% UNIVERSITY OF FLORIDA ~ ~t~7 3 1262 08543 7035 1 ( -n r ~ ~ 1 ------------~-.-~-; 4'4 S; I s~'


xml version 1.0 encoding UTF-8
REPORT xmlns http:www.fcla.edudlsmddaitss xmlns:xsi http:www.w3.org2001XMLSchema-instance xsi:schemaLocation http:www.fcla.edudlsmddaitssdaitssReport.xsd
INGEST IEID EBZI0MK04_ZWN6CU INGEST_TIME 2017-10-20T18:53:08Z PACKAGE AA00006093_00001
AGREEMENT_INFO ACCOUNT UF PROJECT UFDC
FILES