REPORT

OF THE

DEPARTMENT OF SANITATION

OF THE

ISTHMIAN CANAL COMMISSION

FOR THE

YEAR 1913

o » ., ^^ '' ,

H. C. GORCAS

Col

Chief Sanitary Officer, Ancon, Canal Zone

'> Colonel, Medical Cdpf, United Staccs Aimy

Cf^<o9^^

I ?7^

1914

WASHINGTON
• • « •• • • , •• ' - • • • * .. • • • • • • r • •• • • <
CONTENTS.

Page.

Letter of transmittal 6 Vital statistics: Deaths of employees of the Isthmian Canal Commission and Panama Rail- road 7 Deaths in the cities of Panama and Colon, and the Canal Zone 7 Deaths by age, color, and sex 8 Deaths by nationality , 8 Causes of deaths of employees of the Isthmian Canal Commission and Pana- ma Railroad Company 9 Deaths of white employees of the Isthmian Canal Commission and the Panama Railroad Company from the United States 11 Deaths of white women and children from the United States 12 Death rate among Americans on the Isthmus 13 Causes and places of deaths of employees and civil population 14 Discharges and deaths of employees in hospitals of the commission 19 Consolidated hospital report 24 Consolidated sick camp report 25 Consolidated report of employees sick in quarters 25 Consolidated hospital, sick camp, and sick-in-quarters report 26 Consolidated dispensary report 26 Average number of employees constantly sick in hospitals, sick camps, and

quarters 27 Average number of days' treatment per employee in hospitals, sick camps, and

quarters 28 Subsistence and operating expenses 28 Outside patients treated in hospitals, and amounts collected for their treat- ment 29

Surgical operations performed in hospitals 29 Operations and work performed in eye, ear, nose, and throat clinics 31 Consolidated ward laboratory report of all hospitals 33 Report of

Ancon Hospital 34 Colon Hospital 35 Culebra Hospital 36 Pale Seco Leper Asylum 36 Taboga Sanitarium 37 Santo Tomas Hospital 37 Board of Health Laboratory 38 Issues of quinine 40

Sanitation: Panama 40 Colon (including Cristobal, Mount Hope, and Toro Point) 41 Canal Zone 41 Quarantine service: Panama-Aucon and Colon-Cristobal 42 Bocas del Toro 42 Personnel report 43 Hospital cases of malaria among employees 43 (3)

LETTER OF TRANSMITTAL^

Isthmian Canal Commission,

Department of Sanitation,

Ancon, Canal Zone, January 24, 1914.

To the Chairman and Chief Engineer,

Isthmian Canal Commission, Culebra, Canal Zone.

Sir: I have the honor to submit the following report of the department of sanitation for the calendar year 1913.

Statistics as to the death rate among employees of the Isthmian

Canal Commission and Panama Railroad Co. for the calendar year

just closed, compared with similar figures for the previous years

since 1904, are as follows:

Number of employees. Deaths. Rate per

1,000.

1904 6,213

16,512

26, 547

39, 238

43, 891

47, 167

50, 802

48, 876

50, 893

56, 654

82 427

1,105

1,131 571 502 558

539 467

473

13.26

1905 25.86

1906 41.73

1907 28.74

1908 13.01

1909 10.64

1910 10.98

1911 11.02

1912 9.18

1913 8.35

The death rate among our white employees from the United States

from disease was 2.50 per thousand, while the total death rate for the

year for this class of employees was 5 as against 5.52 per thousand

m 1912. If we include American women and children, it will raise

the death rate of Americans from disease to 3.40. Including in the

above figures the officers and men of the United States Army and

Marine Corps stationed on the Canal Zone and their families, the

death rate from disease is lowered to 3.16 per thousand. The death

rate from disease in our Army for the calendar year 1912 was 2.37

per thousand.

Taking special diseases, the deaths among our employees have

been

1905 1906 1907 1908 1909 1910 1911 1912 1913

Typhoid fever 12

14

9386

42

69 413

233

98

48 328

154

191693

73

13s

7052

13

217350

10

1394

47

4

857

20

4 Dysentery 6 Pneumonia .... 47 Malaria 21

(5)
6

Among our 11,943 white employees there were no deaths during

the year from either dysentery or typhoid fever.

The improved conditions as regards deaths from malaria among

our employees continues, and the same is true of the admission

rate to hospitals, as is shown by the following table:

Per 1,000. 1904 125

1905 514

1906 ; 821

1907 424

1908 282

1909 215

1910 187

1911 184 1912 110

1913 70 Deaths among our employees from the other principal diseases were as follows: Abscess of liver, 4; organic disease of heart, 24; all forms of tuberculosis, 65; nephritis, acute and chi'onic, 26; leaving

100 deaths among employees from all other diseases and 176 deaths

from external violence.

Considering the death rate of the total population, including the

cities of Panama and Colon and the Canal Zone, we find the rates

for the different years to be as follows: Rate per 1,000. 1905 49. 94

190fi 48. 37

1907 33. 63 1908 24. 83

1909 18. 19

1910 21. 18

1911 21. 46

1912 20. 49

1913 23. 57 One case of smallpox on a ship from Callao, Peru, was isolated at Santo Tomas Hospital during the month of November and re- covered, being discharged from hospital the following month.

With this exception, no cases of yellow fever, smallpox, or plague

originated on or were brought to the Isthmus during the month.

Appended hereto is a chart showing the progress loeing made in

malaria control.

Very respectfully,

John L. Phillips,

Acting Chief Sanitary Officer.
MALARIA CHART

FOR 1911,1912 AND 1913.

Showing The number of malaria cases each

month among employees, expressed as a percentage of the entire working force.

4/.

A

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ra [age

tes

ofr

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riont

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l_9JI_ Ave C^9

tes 1.54

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Note relation of Dry Season and Wet Season to Malaria in 1913 and previous years. (Dry Season—January to April, taclusive.)
Digitized by the Internet Archive

in 2010 with funding from

Lyrasis IVIembers and Sloan Foundation

http://www.archive.org/details/annualreporto1913isth
ANNUAL REPORT OF THE DEPARTMENT OF SANITATION,

ISTHMIAN CANAL COMMISSION,

FOR THE YEAR 1913.

VITAL STATISTICS.

DEATHS OF EMPLOYEES OF THE ISTHMIAN CANAL COMMISSION

AND PANAMA EAILROAD CO.

Color. Average

number

of employees.

Total number of deaths from

Annual death rate per

1,000.

Disease. Violence. All

causes. Disease. Violence. All

causes.

White 11,943

44,711

43 254

38 138

81 392 3.60

5.68 3.183.09

6.78 Colored 8.77

Total....... 56,654 297 176 473 5.24 3.11 8.35

DEATHS IN THE CITIES OF PANAMA AND COLON AND THE CANAL

ZONE.

Place- Population. Deaths. Annual

average

per l,00a

Panama 47,172

20,232

61,700

1,507

489

1,047

31.95 Colon 24.17 Canal Zone 16.97

Total.... 129, 104 3,043 23.57

Note.—The figures relating to the number of employees are compiled from the pay rolls of the different months of the year. The population and deaths as given for the cities of Panama and Colon and the Canal Zone include employees and civil population. Total admissions of employees to hospitals and sick camps, including those

sick in quarters 29, 391 Average per thousand of admissions of employees to hospitals and sick camps,

including those sick in quarters 519

(7) 29283—14-
8

DEATHS BY AGE, COLOR, AND SEX.

V, hite. Colored. Yellow. Total.

Age. 0? O

6

a

"5o

r2a

"3o

'3

1^

"3i 3o

Under 1 year...

I to 4 years

5 to 10 years

II to 20 years...

21 to 30 j^ears . .

.

31 to 40 years . .

.

41 to 50 years...

51 to 60 years...

61 to 70 years...

71 to 80 years...

81 to 90 years .

54

18

39

4960

34

198

15

13

49

12

5

102422

115

5

32

10330

8

197382

45

24

13

47

13

529

11620

61 380

219

14562

41

8

440

372

112

1553

146

12662

25

1716

3

7

901 228

35

114 526 345

207

8758

24

747

1212 584

136

23

70 441 286

1878752

119

63

421

12420

63

170

149

7330

22

20

5

7

1,005 260

43

133

12

78

6

32

128

8

6

3

3

611 435

260

117

7431

14 Unknown .

.

60 Total 273 148 421 1,625 954 2,579 41 2 43 1,939 1,104 3,043

DEATHS BY NATIONALITY.

Nations. Employees. Nonemployoes. Total.

Africa 114

12 297

1

1 Antigua 10

1 24 Austria 2 Bahama Islands 2 Barbados 99 396 Belgium 1 Bermuda Islands 1 1 Bolivia 13

40

83

6

3

3

75

9

4

1 Chile 3 China 40 Colombia 14

13

97 Costa Rica 7 Cuba 6 Curasao 3 Demerara 3

1 10 Dominica 6 Ecuador .... 9 England 4 Fortune Islands • 32

6

98

2

3 Trance 8

7

15

15

12

3

1

10 Greece 13 Grenada 24 Guadeloupe 83 Guiana, British. . .. 3 Guatemala 2 Haiti 2

2

13

154

19

6 India 3

Ireland 1 Italy ie 49857

1010

19 Jamaica G52 Mart inique 70 Mexico 10 Montserrat 722

17 Nassau . ..... 2 Nevis 2

3 4 Nicaragua 3
DEATHS BY NATIONALITY—Continued.

Nations. Employees. Nonemployees. Total.

Norway 1 143

1 Panama 1,252

6

1

1

1,266 Peru 9 Porto Rico 1 Russia 1 Saba 1 1 Salvador . 1

12

51

2

4 32

13

1 46

4916

1 Scotland 1 St. Kitts 48

6

St. Lucia 59 St Thomas . 2

St. Vincent 17

29

42

34

1

21 Spain . . 61 Trinidad 17 Turks Island 3 United States 80 Venezuela 5 West Indies 9

16

473 2,570 3,043

CAUSES OF DEATHS OF EMPLOYEES OF THE ISTHMIAN CANAL

COMMISSION AND PANAMA RAILROAD.

Causes of death.

DISEASE. Alcoholism, acute and chronic Aneurism

Apoplexy

Appendicitis

Arteriosclerosis Biliary calculi Brain, softening of Cancer of intestines Cancer and other malignant tvunors of stomach and

liver Cancer of organs not specified

Cerebrospinal fever Diabetes Diarrhea and enteritis Diphtheria

Dysentery

Bacillary

Unclassified Empj'sma

Endocarditis, acute and chronic Epilepsy

Fever:Hemoglobtauric

Malaria

Malaria, estivoautumnal

Malaria, tertian Typhoid

Heart, organic disease of Hernia, intestinal obstruction

Indigestion, acute

Infection of mikno%vn origin

White. Colored. Total.

15

122

1

13

1

3

2

1

1

112

13

1

116

2

12

1424

3

13
10

CAUSES OF DEATHS OF EMFLOYEES OF THE ISTHMIAN CANAL

COMMISSION AND PANAMA RAILROAD—Continued.

Causes of death.

DISEASE—continued

.

Intestines, diseases of Lar}'ngitis

Larynx, disease of Liver:Abscess of Cirrhosis of Lungs, gangrene of Meningitis, simple

Mouth and annexa, diseases of Nephritis: Acute

Chronic

Other diseases of the kidneys and annexa.

Other diseases of the nervous system

Peritonitis, simple , Phlegmon and cellulitis Pneumonia

Pneumonia, lobar

Pott's disease , Pyemia

Pyemia and septicemia, pneumococcic

Pyelo-nephrosis

Senility

Septicemia, purulent infection and

Spinal cord, disease of , Stomach, disease of Syphilis Tetanus

Tuberculosis: Abdominal , Disseminated

Miliary

Pulmonary

Ulcer of the stomach

Ulcer, duodenal

Urethra, diseases of

White.

VIOLENCE.

Suicides Absorption of deleterious gases. .

.

Accidental traumatisms, various. Bums and scalds Drowning, accidental Dynamite explosions.

Electric shock Homicides

Railroad accidents Other external violence

Total.

11

Colored. Total.

81

2

1

1

3

12

5

1

223

1

15

12

44

15

22

14

1

12

2

1 198

36

2

3

1

246

323

15

1338

7 392

2

1

14

12

5

12

24

1

15

12

45

162

2

2

5

1

14

3

1 208

36

3

3

1

12

57

329

18

14

54

7 473
11

DEATHS OF WHITE EMPLOYEES FROM THE UNITED STATES

Name.

January, WIS. Cunningham, Leslie

C. Kallish, B. A

Mohen, Michael J Wood, Harold

February, 1913. Catto, John F

Division.

Evans. Charles E.

Mulligan, T.J...

.

Stem, Harry

Marcli, 1913. Mattimore, H. B

.

April, 1913. Dovers, Hughes

.

Edwards, Harvey

.

Johnson, Olaf W.

.

Modin, Harry

Swinehart, Charles . .

.

Wallace, Ross S May, 1913.

Sinclair, Joseph M

June, 1913. Allen, W.J

Myers, Thomas J Nicholson, John E

Stevenson, Olaf P

July, 1913. Guinther, John H

Kitchen. Andrew G .

.

August, 1913.

Gartrell, Frank D

Nylen, Charles A

Septemher, 1913. Emmett. Wm. P .

.

Hibben, James H..

Mechanical division. Panama R. R. Co. McClintic - Marshall Co. Atlantic division.

.

Quarterma s t e r's department.

Fifth division McClintic - Marshall Co. Commissary de- partment.

Time on

Isthmus.

Mechanical division.

McClintic - Marshall Co. do

Atlantic division.. Dredging division. Central division. .

.

McClintic - Marshall Co.

Sanitary depart- ment.

Atlantic division.. Fifth division American Cement

Tile Co.

First division

Atlantic division.. Dredging division.

Fifth division Atlantic division.

Atlantic division.. Sixth division O'Shauehnessy,

Philip.

1 Days.

Years. 19

20

2 ]0

7

Central division. .

.

2 Months.

Age.

2 14

4

11

7

11

6 35

26

53

2722

40

3326

33

50

4239

Cause of death.

Railroad traumatism.

Softening of brain. Traumatism by fall. Traumatism by machines.

Railroad traumatism.

Septicemia.

Cerebral syphilis.

Homicide by firearms.

Perforated gastric ulcer.

Traumatism by fall. Do.

Infection of undeter- mined origin. Organic disease of heart. Traumatism by landslides. Traumatism by fall.

Organic disease of heart.

Cerebral hemorrhage.

Carcinomatosis.

Malarial fever, estivo- autumnal.

Traumatism by machines.

Traumatism by machines. Diabetes.

Railroad traumatism.

Traumatism in mines

and quarries.

Chronic nephritis.

Organic disease of heart. Railroad traumatism.

3 Weeks.
12

DEATHS OF WHITE EMPLOYEES FROM THE UNITED STATES—Con.

Name. Division. ShmSs.|^g^- Cause of death.

October, WIS.

Jackson, Samiiel November, WIS. HiiL George F

Logan, Orren

Telfer, William

W^lLkins, John M., jr.

.

U. S. Steel Troducts Co.

Panama R. R. Co. T r a n s p ortation Division. Panama R. R. Co. T r a n s p ortation Division.

Years.

1 4

5 33

7,^ 33

8 63

6 39

21 I Organic

heart. disease of

Hemoglohinuric fever. Railroad traumatism.

Organic disease of heart. Railroad traumatism.

1 Month.

None in December, 1913. DEATHS OF WHITE WOMEN AND CHILDREN FROM THE UNITED

STATES.

Name.

February, WIS. Anderson, Mrs. Norman C. .

.

Lampson, Mrs. O . R

WueJper, Josephene

March, WIS. Browning, Mrs. W. S Keenan (infant), No. 1 Keenan (infant). No. 2 Kerr (infant)

May, WIS.

Grout, Mary A

Hanson, Herbert

June, WIS. Cameron, Mrs. John

Hess (infant) Watkins (infant)

July, WIS. Smith (infant)

September, WIS. Hem, Mrs. J. F

Johnson, Mrs. Axel

' Days.

Time on

Isthmus.

Years.

6 M7

149

11

86

18

12

ae

7 89

Age.

Years.

26

3429

49 147

149

2 11

64

14

45 18

12

Cause of death.

2 Hours.

Eclampsia.

Intestinal obstruction. Disseminated tuberculosis.

Cerebral apoplexy. Premature birth. Do. Do.

Cancer of peritoneum. In- testines, and rectum.

Pott's disease.

Malarial fever, E. A. Premature birth. Do.

Premature birth.

Accidents of pregnancy.

Typhoi'l fever.

8 Months.
13

DEATHS OF WHITE V^'OMEN AND CHILDREN FROM THE UNITED

STATES—Continued.

Name. Time on

Isthmus, Age. Cause of death.

October, 191S. Bernsee, Mrs. F. L

Haywood, Harry K

Years.

2

1 8

2i 21

39

1 6

21

Years.

43 18

5 21

3916

28

Cancer of uterus. Broncho-pneumonia.

Lenzen, Marv Jane Other acute poisoning.^.

Waterworth (infant) Premature birth. November, 1913. Severy, Dorothy -. Diarrhea and enteritis. Stawner, Sydney

December, 191S.

1-okerson, Mrs. AC

Broncho-pneumonia.

Septicaemia.

> Months. 2 Days. 3 Weeks.

No deaths in January, Aijri), and August, 1913. DEATH HATE AMONG AMEI.ICANS ON THE ISTHMUS.

Number. Cause. Number ^^^'^g

of deaths. p%7;^|fo

1

6. 408

i 4. 4b7

i 10, 875

1

12,344

[Disease 161632

21

1 22

37

1754

39

24

63

2.50 A verage number of white employees from the United States. Average number of white women

and children from the United

States. Average number of white em1 Violence

[All causes

(Disease

2.50 5.00

4.70

1 Violence

t-Vll causes

[Disease

.22 4.92 3.40 ployees and their families from

the United States.

1 Violence

[All causes

[Disease

1.56

4.'96 3.16 Total number of Amencans on the Canal Zone.i ] Violence

lAll causes

1.94 5.10

1 The figures representing the total number of Americans on the Canal Zone include employees and their families and the officers and men of the I'. S. Army and

Marines and their families.
14

CAUSES AND PLACES OF DEATH OF EMPLOYEES AND CIVIL

POPULATION.

Diseases. Ancon

Eospital.

Colon

Hospital. Pan- ama.

Colon. Zone. Total.

General diseases. Typhoid fever. 8

1

1 3 'is

6

"i"

12 Paratyphoid fever . I Malaria 3

7

25

38

28

2

i'

74 Malarial fever: Estivoautumnal 24

11

75 Tertian. 3 Undetermined

i"

4

I Clinical. 5 Cachexia 16

5 Hemoglobtnuric fever, malarial

Scarlet fever

7

3

I6

I1 21

1

3 Whooping cough ... 1 Diphtheria and croup 3 1 10 Croup

i"

I3'

2 Influenza I Dysentery

Entamebic

1 26

I Bacillary 2

6

2 Unclassified . . . 6 Leprosy . . 1 1

i

2 Erysipelas. 12

I Purulent infection and septicemia

Pyemia ... 8

115

5

45

U

11 Septicemia 4

2

4

1 28

2

2'

14

I 21

1413

163

1 4

2"

28 Pyemia and septicemia, pneimio6 Tetanus 29 Pellagra 23 Beriberi 14 Tuberculosis of the lungs 45

17

12

1

25 15

5

r

2

5

276 Acute miliary tuberculosis 24

I2I ? Abdominal tuberculosis (S Pott's disease 2 Tuberculosis of bones and joints I

I

2 2

L

I Disseminated tuberculosis 43

1

1

2

1

11

49

3 Syphilis:

Tertiary LI Hereditary 8

8

1

3 18^ Gonorrhea 1 I Gonorrheal arthritis ' i 2 \ Cancer and other malignant tumors: Buccal cavity. . I3

142

11

1

t"

I

r

1

) Stomach and liver. 7 2

1

123 Female genital organs 1

>

I Other organs and of organs not "thcr tumors (ttunors of the female

genital organs excepted)

i ^

1

I Acute articular rheumatism 2

I2

2

1 I Diabetes... 1 " i"

] Uodgktn's disea,sc
15

CAUSES AND PLACES OF DEATH OF EMPLOYEES AND CIVIL

POPULATION—Continued.

Diseases.

General diseases—Continued.

Anemia:

Chlorosis Primary, pernicious

Secondary, cause not determined.

Other general diseases Alcoholism: Acute or chronic Acute

Chronic

Alcoholic psychosis

Drug habit

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

Simple meningitis

Cerebrospinal fever Locomotor ataxia Other diseases of the spinal cord

Cerebral hemorrhage, apoplexy

Softening of the brain

Paralysis without specified cause General paralysis of the insane Other forms of mental alienation Epilepsy

Convxilsions: Nonpuerperal, 5 years and over

Infants, under 5 years of age

Neuritis Other disease of the nervous system

Tumor of the brain Neurasthenia

Diseases of the eyes and their annexa.

.

Diseases of the ears

Ancon

Hospital.

Diseases of the circulatory system. Acute endocarditis Malignant endocarditis Organic diseases of the heart Angina pectoris Diseases of the arteries, atheroma, aneurysm, etc Aneurysm

Arteriosclerosis Embolism and thrombosis

Diseases of the lymphatic system (lymphangitis, etc.) Lymphadenitis (nonvenereal)

Hemorrhage; other diseases of the cir- culatory system

33

Colon

Hospital.

?1:

Diseases of the respiratory system. Diseases of the larynx.

Laryngitis Acute bronchitis , Chronic bronchitis Broncho-pneumonia.

.

10

Pan- ama.

12

Colon.

27

4

14

72

1

1

1 47

426

Zone.

22

323

Total.

24

1

22

5

239

3

326

1

1 56

5

54

4

4

329

12

22

11

24

1 1046

2

15

144

11

43

749

110

29283-
16

CAUSES AND PLACES OF DEATH OF EMPLOYEES AND CIVIL

POPULATION—Continued.

Diseases.

Diseases of the respiratory system—Con. Pneumonia (unqualified)

Lobar pneumonia

Pleurisy

Empyema

Pulmonary congestion, pulmonary

apoplexy

Gangrene of the lungs

Other diseases of the respiratory sys- tem (tuberculosis excepted) Abscess of lungs

Ancon

Hospital.

47 "2

Diseases of the digestive system. Diseases of the mouth and annexa

Diseases of the teeth and gums

Stomatitis

Stricture of the oesophagus

Ulcer of the stomach

Other diseases of the stomach (cancer

excepted) Acute gastritis Acute indigestion

Diarrhea and enteritis (under 2 years).

.

Colitis (under 2 j'^ears) Diarrhea and enteritis (2 years and

over)

Colitis (2 years and over)

Ankylostomiasis

Intestinal parasites AscariasLs Appendicitis and typhlitis Acute appendicitis

Hernia, intestinal obstructions Other hernias

Intestinal obstruction Other diseases of the intestines Duodenal ulcer

Cirrhosis of the liver Biliary calculi Other diseases of the liver Abscess of liver (unqualified) Abscess of the liver entamcebic

Cholecystitis

Simple peritonitis (nonpuerperal)

Other diseases of the digestive system

(cancer and tuberculosis excepted) .

.

Nonvenereal diseases of the genitourinary system and annexa.

Colon

Hospital.

14

Acute nephritis

Bright's disease (chronic nephritis) — Other diseases of the kidney and an- nexa

Pyelo-nephrosis

Cystitis Diseases of the urethra, urinary abscess, etc Vesico-vaginal fistula Diseases of the prostate

Pan- ama.

62

9

55

Colon. Zone.

194

18

9

5

12

2

15

Total.

53549

3

3

3

10

79

83

7

710

6

3

1

3

12

13

3

145 296

37

208

6

3

153

5

1 12

7

4172

6

47

117

61 127

56

2

4

11
17

CAUSES AND PLACES OF DEATH OF EMPLOYEES AND CIVIL POPULATION—Continued.

Diseases.

Nonvenereal diseases of the genitourinary system and annexa—Contd.

Chronic prostatitis Uterine tumor (noncancerous)

Other diseases of the uterus Cysts and other tumors of the ovary..

.

Salpingitis and other diseases of the female genital organs

Ancon

Hospi

tal.

The puerperal state. Accidents of pregnancy

Extra-uterine pregnancy Hyperemesis gravidarum

Puerperal hemorrhage

Puerperal septicemia

Puerperal albuminuria and convulsions Eclampsia

Puerperal phlegmasio alba dolens, embolus, sudden death Followng childbirth (not otherwise

defined)

Diseases of the sMn and of the cellular

tissue. Gangrene

Carbuncle Acute abscess Phlegmon and cellulitis Other diseases of the skin and annexa.

Diseases of the bones and of the organs of

locomotion. Diseases of the bones (tuberculosis ex- cepted)

Caries (nontuberculous)

Malformations. Congenital malformations (stillbirths not included) , Diseases of early infancy.

Newborn child Congenital debihty, icterus, and scle- rema

Premature birth Congenital debility Malnutrition Other causes peculiar to early infancy

(including various consequences of labor)

Lack of care Old age. Senility.

Colon

Hospital. Pan- ama. Colon.

11518

41

20

1

Zone.

7

928

14

Total.

1217

14 105

2

1

15

11

1 18

25

5267

173

35

3

11
18

CAUSES AND PLACES OF DEATH OF EMPLOYEES AND CIVIL

POPULATION—Continued.

Diseases. Ancon

Hospital.

Colon

Hospital. Pan- ama.Colon. Zone. Total.

Affections produced by external causes. Suicide: Poisoning 1 4 5 Hanging or strangulation 2

2 2 Firearms 1 6 11 10 Cutting or piercing instruments.. . 1 Other acute poisonings 17

1

1 Bums (conflagration excepted)

Absorption of deleterious gases (confla- gration excepted)

2 2

240

1

1 18

116

444

8

6

113 Accidental drowning 5 4 49 Traumatism:

Firearms 1 2 Cutting or piercing instruments 1 Fall.. 7.. ." 13 3 1 1 36 Mines and quarries .... 11 Machines

4

17

1

1

12

12 Other crushings (vehicles, railroads, landslides, etc.) 3

i" 12 Railroad traumatism 64 Dynamite traumatism 9 Traumatism by landslides 6

Injuries by animals 1 1 Electricity (lightning excepted) 1

1

1

1 Homicide by firearms 1 7

1

2

1

10 Homicide by cutting or piercing instru-. ments .... 2 5 Homicide by other means 1 Fractures (cause not specified) 4 4 Other external violence 2 2 5

1

9

Ill-defined diseases. Hi-defined organic disease 1 Sudden death 3

13

5

3 Cause of death not specified or ill-de- fined 6

7 i' 83 27 Infecdons of undetermined origin 16 Total 586

4 204

15 1,263

158

32153 669

93 3,043

Stillbirths 323 Grand total 590 219 1,421 374 762 3,366

Note.—The deaths occurring in Ancon and Colon hospital s resulting from illness. Injury, or other causes admitted from the cities of Panama and Colon, or from the Canal Zone, are in the table of vital statistics, credited to the places from whence they were admitted.
19

TABLE SHOWING DISCHARGES AND DEATHS OF EMPLOYEES IN

THE HOSPITALS OF THE ISTHMIAN CANAL COMMISSION, FROM

ALL CAUSES, FOR THE YEAR 1913.

Diseases.

General diseases. Typhoid fever Rel ipsing fever Malaria fever: Estivoautumnal

Terti in Qu irtiin Mixed

Undetermined

Clinical C ichexi I Hemoglobinuric fever, malaria]

Vaccinia

Measles Sc irlet fever Diphtheri i and croup

Influenz i Dysentery

Ent imel)ic B icUl iry

Unci issified Leprosy

Erysipelas

Dengue

Chicken pox

Mumps

Hemoglobinuric fever, unqualified

Yaws

Filariasis Purulent infection and septicemia

Pyemia

Septicemia

Pyemia and septicemia, pneumococcic

Tetanus

Actinomycosis

Pellagra Tuberculosis of the lungs Acute miliary tuberculosis Tuberculous meningitis

Abdominal tuberculosis

Pott's disease Tuberculosis: Bones and joints

The skin The lymph glands

The genito-urinary organs Disseminated tuberculosis

SyphilLs:

Primary

Secondary

Tertiary Period not stated Gonococcus infection Gonorrhea

Gonorrheal arthritis Gonorrheal bubo

Gonorrheal orchitis and epididymitis. Gonorrheal ophthalmia

Soft chancre

Adenitis chancroidal

Dis- charged.

342

,531 60347

510 994

63

141222

78 347

5

213

83

415

610

13

5

1133

15

129

12

1102

1

11 133 206

117

51 394

4840

95

7 45892

Died.
20

TABLE SHOWING DISCHARGES AND DEATHS OF EMPLOYEES IN

THE HOSPITALS OF THE ISTHMIAN CANAL COMMISSION, FROM

ALL CAUSES, FOR THE YEAR 1913—Continued.

Diseases.

Qeneral <Ziscosc«—Continued. Cancer and other malignant tumors: Stomach and liver Peritoneum intestines, rectum Female genital organs Breast Skin

Other organs and of organs not specified

Other tumors (tumors of the female genital organs excepted). Acute articular rheumatism

Chronic rheumatism and gout

Gout

Arthritis deformans

Diabetes Anemia, primary, pernicious

Anemia, secondary, cause not determined.

Other general diseases Alcoholism: Acute or chronic Acute

Chronic

AlcohoUc psychosis

Chronic lead poisoning

Other chronic poisonings

Diseases of the nervous system and of the organs of special sense. Simple meningitis Locomotor ataxia Other diseases of the spinal cord

Cerebral hemorrhage, apoplexy

Softening of the brain

Paralysis without specified cause Other forms of mental alienation Dementia precox Epilepsy

Hysteria

Neuralgia

Neuritis Other diseases of the nervous system.

.

Neurasthenia

Diseases of the eyes and their annexa.

Follicular conjunctivitis

Trachoma

Diseases of the ears

Dis- charged.

Diseases of the circulatory system.

Pericarditis Acute endocarditis Malignant endocarditis Organic diseases of the heart Aneurism

Arteriosclerosis Diseases of the veins (varices, hemorrhoids, phlebitis, etc.) Hemorrhoids

Varices

Varicocele

Phlebitis Diseases of the lymphatic system (lymphangitis, etc.) Lymphadenitis (nonvenereal)

Hemorrhage; other diseases of the circulatory system

Died.

1133922

9

2485

21

178 430

77

5 177

77

3

718 139

846

545

1818
21

TABLE SHOWING DISCHARGES AND DEATHS OF EMPLOYEES IN

THE HOSPITALS OF THE ISTHMIAN CANAL COMMISSION, FROM

ALL CAUSES, FOR THE YEAR 1913-Continued.

Diseases.

Diseases of the respiratory system.

Diseases of the nasal fossae Adenoid vegetations

Myiasis of nasal fossae and sinuses Diseases of the larynx

Laryngitis

Diseases of the thyroid body • Acute bronchitis Chronic bronchitis Bronchopneumonia

Pneumonia (unqualified)

Lobar pneumonia

Pleurisy

Empyema

Pulmonary congestion, pulmonary apoplexy

Gangrene of the lungs

Asthma

Pulmonary emphysema • • •. - - - - - Other diseases of the respiratory system (tuberculosis excepted). Abscess of lungs

Hay fever

Dis- charged.

Diseases of the digestive system.

Diseases of the mouth and annexa

Diseases of the teeth and gums

Stomatitis . . . : Diseases of the pharjmx

Pharyngitis

Follicular tonsillitis Ulcer of the stomach

Other diseases of the stomach (cancer excepted)

,

Acute gastritis Chronic gastritis Acute indigestion

Diarrhea and enteritis (2 years and over)

Colitis Ankylostomiasis

Intestinal parasites

Taemiasis

Appendicitis and typhlitis Acute appendicitis

Chronic appendicitis

Hernia, intestinal obstructions Inguinal hernia Other hernias Other diseases of the intestines Constipation • Duodenal ulcer > Cirrhosis of the liver Biliary calculi Other diseases of the liver Abscess of liver (unqualified) Abscess of the liver entamebic

Cholecystitis Diseases of the spleen Abscess of spleen

Simple peritonitis (nonpuerperal) ;•:•;• —i'

' "• Other diseases of the digestive system (cancer and tuberculosis excepted)

37

19

1 265

58

150

21 12038

7184

137

1465

14

48

9490

10 275

2250

144

714

13

238

2

1122

13
22

TABLE SHOWING DISCHARGES AND DEATHS OF EMPLOYEES IN THE HOSPITALS OF THE ISTHMIAN CANAL COMMISSION, FROM

ALL CAUSES, FOR THE YEAR 1913—Continued.

Diseases.

Nonvenereal diseases of the genito-urinary system and annexa. Acute nephritis

Bright's diseases (chronic nephritis)

Other diseases of the kidney and annexa

Pyelonephrosis

Calculi of the urinary passages

Diseases of the bladder

Cystitis Diseases of the urethra, urinary abscess, etc Stricture of the urethra, nonvenereal Acute prostatitis

Chronic prostatitis Abscess of the prostate

Nonvenereal diseases of the male genital organs Hydrocele

Uterine hemorrhage (nonpuerperal)

U terine tumor (noncancerous)

Oth€r diseases of the uterus Cysts and other tumors of the ovary

Salpingitis and other diseases of the female genital organs. The puerperal state. Normal labor Accidents of pregnancy.

Diseases of the skin and of the cellular tissue. Gangrene

Furuncle

Carbuncle Acute abscess Phlegmon and cellulitis Trichophytosis

Scabies Chiggers ( Pulex penetrans)

Red bug

Pemphigus contagiosus

Ground itch Elephantiasis

Dhobie itch Ulcer of the skin Oriental sore (leishmaniosis)

Tropical ulcer Impetigo contagiosa

Urticaria Ingrowing nail Other diseases of the skin and annexa.

Diseases of the bones and of the organs of locomotion

.

Diseases of the bones (tuberculosis excepted)

Caries (nontuberculous)

Mastoid abscess Osteomyelitis

Periostitis Diseases of the joints (tuberculosis and rheumatism excepted)

.

Ankylosis

Arthritis Synovitis

Amputation

Other diseases of the organs of locomotion
23

TABLE SHOWING DISCHARGES AND DEATHS OF EMPLOYEES IN

T?T^ ^*°T?i'iJ^'^H ^^ ^^^^ ISTHMIAN CANAL COMMISSION, FROM ALL CAUSES, FOR THE YEAR 1913-Contmued.

Diseases.

Malformations. Congenital malformation (stillbirth not included) Old age. Senility.

Affections produced by external causes Poisoning by food Other acute poisonings

Venomous bites and stings

Snake bites Conflagration

Bums (conflagration excepted)

Traumatism:

Firearms

Cutting or piercing instruments.

Fall In mines and quarries

Machines

Other crushings (vehicles, railroads, landslides, etc.) Railroad traumatism

Dynamite traumatism

Traumatism by landslides

Injuries by animals ] Starvation Heat exhaustion .....[. Lightning

Electricity (lightning excepted).

Homicide by other means

Fractures (cause not specified).. Dislocations Sprains

Other internal violence

Ill-de'^ned diseases. Cause of death or disease not specified or ill defined

Infections of imdetermtned origin

No disease Feigned diease Total.
24

CONSOLIDATED HOSPITAL REPORT.

Hospitals.

Remaining

Jan. 1. Admitted. Died. Discharged. Transferred. Re- maining

Dec. 31. d<D

t-t O

3

a

S

3

to 3

8

3

i 2

3

•do

"o

Ancon Hospital. Employees

Nonernployees.. Insane

2118934439

74 282

6,553

3,31037

10,109

1,853 198

30

55

4

204

242

51

5,338

3,04725

9,875

1,546

132

1,209

165

3

785346187

13299

39186

?51 Total 324 795 9,900 12,160 89 497 8,410 11,553 1,377 177 348 728 Colon Hospital.

Employees

Nonernployees..

11139

7878 1,914

1,188

1,135 1,618

101651 127 1,626

1,183

1,121 1,529 38324

1936

64 224 Total 150 156 3,102 2,753 26 176 2,809 2,650 407 55 10 26

Culebra Hospital. Nonernployees.

.

3 6

12

23

1 11

6 17

151

9 Palo Seco Leper

Asylum.

Employees

Nonernployees.

.

3 45 9 1 1 4 41 Total 3 45 3 12 9 1 6 1 1 4 41 Tahoga Sanita- rium. Employees 34

9 1,7761,258

1,767 1,257

21

3 22 Nonemployees. 7

.

Total 43 3,034 3,024 24 29 QEAND TOTAL. Employees

Nonemployees.

.

Insane

356

14024

517 200

282

10,244

5,76437

11,245

3,505, 198

40

714

255 378

51

8,731 5,494

25

10,997 3,097

132

1,614

192

3

97

99

46

215

14729

413

131

?51 Total 520 999 16,045 14,948 115 684 14,250 14,226 1,809 242 391 795
25

CONSOLIDATED SICK-CAMP REPORT.

Stations.

RemainingJan. 1. Admitted. Died. Discharged. Transferred. Remaining Dec. 31.

s 1

O

•dO

oO

'6S

O

9

1 S

•d

Culebra 2 2 117

25 138

111

186

105 403

123

87

25 11640

14092

37138

32

'26* 70

488

33

85

....

1

5

1 Bas Obispo ...:. Porto BelJo 3 2 1 Toro Point

2

. ..

.

Total 5 391 817 2 1 268 641 122 174 6 CONSOLIDATED REPORT OF EMPLOYEES SICK IN QUARTERS.

Stations.

Naos Island.. Ancon

Balboa

Corozal

Miraflores Pedro Miguel.

Paraiso Culebra Empire

Las Cascadas. Bas Obispo..

Gorgona

Frijoles

Gatun

Cristobal Porto Bello.

.

Toro Point. .. Total.

Days excused for quarters.

White. Colored. Total

95 1,502

1,025 95369

413 360

841 2.461 437

160 2,057

1,078

2,341

152

51 13,995

419

1,474

52

42

42

924 419

69

172 1,776

21 569

819

6 6.759

514 2,976

1,030

955

111 455 360

1,765 2,880

506 332

3,833

21 1,647

3,160

15257

20, 754

New patients excused for quarters.

White. Colored. Total

42

611

434 535

43 212

150 342

1,134 219

81 875 589

1,0668038

6,451

197

287

5

2

31

7

321 178

23

75 647

10 242

222

2,250

239 898

439 537

74 219

150 663

1,312 242

156

1,52210

831 1,28880

41

8,701
26

CONSOLIDATED HOSPITAL, SICK CAMP, AND SICK-IN-QUARTERS

REPORT.

Remaining Jan. 1. Admitted. Died. Discharged. Transferred. Remaining Dec. 31.

io

o 2

'6£

o

oO

a3 2oOCD 2

•d£o

o

'xi

-dooO

S

•d2

oa

Hospitals Sick camps . .

.

520

2 999

5 16,045

391 14,948817

115

2 684

1 14, 250 268

14, 226

641

1,809

122 242174 3911 7956 Total... 522 1,004 16, 436 15, 765 117 685 14,518 14, 867 1,931 416 392 801

\Ahite. Colored. Total.

Total admissions to hospitals and sick camps

Number of employees sick in quarters

16, 436

6,451

15, 765 2,250

32, 201 8,701 Total 22, 887

1,931

18,015

416

40, 902 Less number of patients transferred from sick camps

to hospitals, and from hospitals to sanitarium,

whose admissions are duplicated in above figures.

.

2,347 Net admissions to hospitals and sick camps, and those sick in quarters 20,956 17,599 38, 555 CONSOLIDATED DISPENSARY REPORT.

Employees. Nonemployees. Total.

Stations. White. Col- ored. Total. .Vhite. Col- ored. Total. White. Col- ored. Total.

Naos Is- land .... 1,787 6,957

33, 494

22, 324

14, 107 16,319 6,321

14, 869

16,183 4,406

5,968

10, 402

45

22, 248

14,063 4,794 3,804

1, 131

12,078 24,214

39,018

19, 172 21,477

15,617 6,664

18, 764

22, 982

4,721

9,251 9,903

272 34,540

19,481

S, 141 6,179

3,927

13, 865

31,171 72,512

41,496

35, 584 31,936

12,985

33, 633

39, 165 9,127

15,219

20, 305 317

56, 788

33,544

12,935 9,983

5,058

1,787

11,233 34,994

28,934

14,381 18,633 9,283

19, 728

23, 889

8, 151 8,419

13, 626

45 27,318

20,021 5,890

4,462

1,132

12, 078

29, 223

39, 830

20, 881 21,820

17,272

9,026

24, 189

27, 945

7,975

12,621

12, 858

292

40, 237

22, 804

9, 769 6,712

3,927

13, 865 Ancon .... Balboa

Coro/al

Miraflores

.

Pedro Miguel Paraiso. .

.

Culebra. .. Empire. .. Las Cas- cadas . .

.

Bas Obis- Gorgona .

.

Frijoles. .

.

Gatun

Cristobal.. Porto

Bfllo.... Toro Point

Marcarita Point...

4,276

1,500 6,610

274 2,314

2,962

4,859 7,706

3,745

2,451 3,224

"5,'676" 5,958

1,096 658

1

5,009

812

1,709 343

1,655 2,362

5,425

4, 963 3,254

3,370

2,95520

5, 697 3,323

1,628 533

9,285

2,312

8,319

617 3,969

5,324

10, 284

12,669

6, 999 5,821

6,179

20

10, 767 9,281

2,724

1,191

1

40, 456

74, 824 49,815

36, 201 35,905

18,309 43,917

51,834

16, 126 21,040

26,484

337

67. 555 42,825

15, 659

11,174 5,059 Total. 199, 222 276, 401 475,623 52, 704 43,058 95, 762 251,926 319, 459 571,385
27

AVERAGE NUMBER OF EMPLOYEES CONSTANTLY SICK IN HOSPITALS, SICK CAMPS, AND QUARTERS.

Hospitals.

Ancon Hospital Colon Hospital Palo Seco Leper Asylum

Taboga Sanitarium

Total

White.

235. C8 70.26

.08 30.41

336. 43

Colored. Total.

438. 69 58.45

.25

497. 39

674.37

128. 71 .33 30.41 833.82

Sick camps. Sick in quarters.

White. Colored. Total. White. Colored. Total.

Nnns Island 0.26

4.11

2.81

2.61

.19 1.13

.99 2.30

6.74

1.20

.44 5.63

1.15 4.04

.01

.01 .12 .12

1.41 8.15 2.82 2.62

Miraflores .31 1.25 .99 Culebra 1.11 1.72 2.83 2.53

1.15

.18

.47 4.87

.06 1.56

2.24

4.83

7.89

1.38 Bas Obispo .55 3.53 4.08 .91 10.50

.06 2.95

6.41

.42

.14

4.51 Cristobal 8.65 Pnrtn Rplln 1.47

.41 4.52

.44 5.99

.85 .42 Toro Point .02 .16

Total 3.54 10.21 13.75 38.33 18.53 56.86

AVERAGE NUMBER OF EMPLOYEES CONSTANTLY SICK.

Hospitals Sick camps

Sick in quarters Total

W^hite.

336. 43 3.54

38.33

378. 30

Colored.

497. 39

10.21 18.53

526. 13

Total.

833. 82

13.75 56.86

904.43

AVERAGE NUMBER OF EMPLOYEES CONSTANTLY SICK PER 1,000.

Hospitals

Sick camps

Sick in quarters Total

WTiite.

28.17

.30 3.21

Colored.

11.12

.23

.41

31.68 11.76

Total.

14.72

.24

1.01

15.9^
28

AVERAGE NUMBER OF DAYS' TREATMENT PER EMPLOYEE IN HOSPITALS, SICK CAMPS, AND QUARTERS.

1 Hospitals. White. Colored. Total.

Ancon Hospital

Colon Hospital Palo Seco Leper Asylum

Tahnga Sanitarium

13.08

12.70 31.00

6.21

15.76

17.91 92.00

14.71

14.63 46.00

6 21 Total 11.82 16.00 14 00

Sick camps. Quarters.

White. Colored. Total. White. Colored. Total.

Naos Island 2. 26 2. 13 2.46 -'^14 2 15 Ancon 3 31 Balboa 2.36

1.78

1.61

1.95 2.40

2.46

2.17 2.00

1.98

2.35

1.00 1.00

1.35 6.00

2 33 Corozal 1 78 Miraflores 1 50 Pedro Miguel 2.08 Paraiso 2.40 Culebra 3.39 3.34 3.36 2.88

2.35 3.00

2.29

2.74 2.10

2.35 3.69

2 66 Empire 2.19 Las Cascadas 2.10 Bas Obispo 8.08 12.88 11.92 2.13 Gorgona 2.51

Frijoles 2.10 Gatun 1.83 2.20

1.90

1.34

1.98

Cristobal 2.45 Porto Bello 3.89

1.37 4.071.32 4.03

1.34 1.90 Toro Point 2.66 1 39 Total 3.30 4.57 4.16 2.17 3.00 2 38

SUBSISTENCE AND OPERATING EXPENSES.

Subsistence expenses. Number of days' rations issued to patients.

.

Cost of rations issued to patients Cost of subsistence per patient per day

Operating expenses. Number of dajs' relief furnished patients Cost of operation Cost per capita per day

Cost of operation, witti amount received from

outside patients, etc., deducted

Cost per capita per day, with above deduction

Cost of dispensaries

Hospitals.

546, 249

$135, 207. 69

$0. 247

546, 249

$699, 500. 3r) $1.28

$489,513.39

$0.90

$124, 124. 19

Sick camps,

5,021

$1,210. SI $0. 241

5,021 $3,101.49

$0.62

$3, 080. 39

$0. 61

Total.

551,270

$136,418.50

$0. 247

551,270

$702,601.84

$1.27

$492, 593. 78 $0.89
29

OUTSIDE PATIENTS TREATED IN HOSPITALS, AND AMOUNTS

COLLECTED FOU THEIR TREATMENT.

Number

of cases

treated.

Number

of days'

relief. Amount.

Patients for whom the Republic of Panama pays 75 cents per day

Patients for whom the Canal Zone government pays

30 cents per day

Patients paying 30 cents per day for themselves

Patients from the Republic ol Panama paying other

prices Patients from the Canal Zone paying other prices. .

.

Patients from the Canal Zone not paying

Patients from the Repubhc of Panama not paying.

.

Total

2,717 216

3,681 2,242

5,404

2,841 590

17,691

75,957

5,769

37,290

21,680

37, 473 55,013

6,434

239, 616

$56,967.75

1, 730. 70 11,187.00

64, 739. 37

42, 797. 46

177, 422. 28

Note.—Patients carried from one month to another are considered as separate

cases in above table. SURGICAL OPERATIONS PERFORMED IN HOSPITALS.

Number. Died.

Amputations:

Shoulder Arm

Forearm

Thigh

Leg

Foot

Digits, multiple

Thigh, double

Leg, double Arm and leg Operations on bones: CraniectomyDecompressive

Exploratory

Laminectomy

Ostiectomy

Excision of maxilla Resection of ankle Wiring of fractures

Simple

Compound

Adenectomy:

Cervical Axillary

. Inguinal

Single

Double

Femoral

Herniotomy:

InguinalSingle

Double

Femoral

Ventral Combined (any two of the above)

Strangulated

26

48

23

539

2

3

1

153

722

11 67

4420

15

493

10829

222

111

529

9

7
30

SURGICAL OPERATIONS PERFORMED IN HOSPITALS—Continued.

Number. Died.

Genitourinary tract: Nephrotomy

Nephrectomy

Nephropexy

Perinephritic abscess, drainage of Ureterotomy

Cystotomy

Urethrotomy—

Internal External Prostatectomy

Varicocele, radical cure Hydrocele—

Single, radical cure Double, radical cure Orchidectomy

Epididyotom'y

Amputation of scrotum Amputation of penis and scrotum

Curetage uteri Perineoplastj'

Trachelorrhaphy : Vaginal sections Vaginal punctures

Obstetrical: Cesarean section, abdominal

High forceps

Low forceps

Version Perineorrhaphy

Thorax:

Thoracotomy

Thoracoplasty

Pneumothoracotomy

Excision of breast Excision of breast and axUJa Gunshot wound of cliest, operation for Rectum:

Hemorrhoids, radical cure

FLstula in anus, excision of Prolapsus rectum, radical excision General: Thyreoidectomy

Aneurismorrhaphy

Varicose veins, excision of Tenorrhaphy

Excision of surface neoplasms

Gunshot wound of soft parts, operation for Extensive injuries to soit parts, operation for. Plastic operation for congenital defect

Plastic operation for severe injuries Plastic operation for effects of disease Skin gralt

Laparotomy

:

For general peritonitis For tuberculous peritonitis For intestinal obstruction Exploratory

Gastrotomy

G astro-en terostomJ' Entero-enterostomy

Enterectomy ." P'nterorrhaphy

Appendectomy

Appendectomy with local peritonitis

46

1 14

73

1413 122

34

3 138

5338

63

176

14293

9

4

1

1

1

1 172

15

18

1 33

10

67

3

1

1 37

25

416

8

616

1 143

32 340

24
31

SURGICAL OPERATIONS PERFORMED IN HOSPITALS—Continued.

Laparotomy—Continued.

Appendectomy with general peritonitis

Colostomy ' Sicmoidopexy

Resection of rectum

Cholecystotomy

Cholecystostomy

Cholecystectomy

Choledochotomy

Abscess of liver—

Laparo-hepatotomy for Thoraco-hepatotomy for Splenectomy

Pan-hysterectomy , Supravaginal hysterectomy

Hysteromyomectomy

Myomectomy , Saipingectoray

Single . .

.

". , Double

Salpingo-oophorectomy

Ovarian cystectomy . .". Oophorectomy

Suspensio-u teri Plastic operation for chronic pelvic peritonitis For ectopic gestation For trauma:

General peritonitis

Hematoperitoneum

Rupture of hver

Gunshot wound of abdomen

Stab woimd of abdomen

Major operations, various other Minor operations, various Total

Number.

112

123

19

3

1

14

4315

42

41

11

1722

22

9

270 120

6

2

3

4

13 164 3,319

6,858

Died.

67

OPERATIONS AND WORK PERFORMED IN EYE, EAR, NOSE, AND

THROAT CLINICS.

Operations:

Abscess, parotid

Adenectomy

Advancement of external rectus Bowman's dilatation of lacrymal duct

Capsulectomy

Cataract, needling

Cleft palate

Conjunctiva, papilloma

Conjunctivitis, follicular, grattage Corneal ulcer (cauterization)

Cysts

Cyst, sebaceous, excision Enucleation

Evisceration Excision of chalazion Expression for eyelid

Expression for follicular conjunctivitis

Expression for trachoma

Number. Died

2 266

1

17

2

1

1

13

43178

24

2

315
32

OPERATIONS AND WORK PERFORMED IN EYE. EAR. NOSE, AND

THROAT CLINICS—Ccntinued.

Operations—Continued.

Extraction of cataract IIolsrath-Kuhnt operation

Incision of chalazion Iridectomy

Iridotomy

Killian's operation—frontal sinus Lacrymal duct probed

Mastoidectomy

Mastoidotomy

Simp'o.

Piadical Paracentesis of cornea

Plastic on ear

Plastic on ej^eball Plastic on eyelid

Plastic, face Plastic on lip Plastic on mouth

Plastic on nose Ptorynum—

Ablation Transplantation

Reconstruction of nose Removal of aural polyp

Removal of nasal polyp

Removal of nasal spur

Resection

Inferior rectus Internal rectus External rectus Removal of stone from sublingual duct. Sclerotomy, posterior

Septal spurs Sequestrum, removal, lachrymal

Sinusotomy

MaxiUary

Nasal Submucous resection of nasal septum. .

.

Synechia anterior, needling

Tarsal tumors

Tattoo, cornea Tenotomy , Tonsillectomy , Tracheotomy

Tucking, internal rectus Tucking, external rectus Turbinectomy

Various minor operations

Number.

Total

R'»fractions Outside casps treated. Orand total

Died.

22, 659
33

CONSOLIDATED WARD LABORATORY RKPORT OF ALL EO&LIT^LS.

Blood examinations H'iil Estivoautumnal • 3, 218 Tertian »34 Mixed tertian and estivoautumnal 40 Quartan ^9

Differential blood counts »4i Leucocyte counts ' Toi Red blood counts }-^

White blood counts 19* Hemoglobin estimations ^'"^^

Filaria ^ Relapsing fever n =ni Stool examinations 14> ^^l Ascaris lumbricoides °^

Uncinaria ova 2, 304 Uncinaria worms 1^ Tricocephalus dispar 2, 117 Strongyloides intestinalis '01 Tenia | Tenia saginata ° Ameba 1? Mucus. 25

Ciliated Entamoeba

monads

^22d Bilharzia - o Pus and blood ^> ^^ Balantidium coli 17 Tubercle bacilli 5 Entamoeba, tetragena 20 Oxyuris vermicularis 2 Entamoeba, histolytica 30 Entamoeba coli 10 Guaiac and turpentine tests for occult blood 28 Bismuth crystals 98 Treponema pertenuis 1 Cercomonas intestinalis 54 Urine examinations 32, 580 Albumen o» 687 Albumen and casts 5, 266

Su^'ar - oo^ Pus and blood". !!!!!!!!!!! 4, 814 Gonococci . |

4 Indican \J^ Epithelium 1> 502 Bile i 66 Microscopical examinations 512 Trichomonas vaginalis t 21 Hemin crystals . 22 Guaiac and turpentine tests for blood 156 Red blood cells 44 Pus and epithelium 376

Ciliated monads 22 Sputum examinations 1,995 Tubercle bacilli • 419 Miscellaneous: Examinations of pleural effusions 20 Examinations of various smears and discharges 295 Examinations of spinal fluid 16 Examinations of vaginal and urethral discharges 141 Gastric analyses 55
34

ANCON HOSPITAL,

iRemain-

; ing

Jan. 1. Admitted.

Class.

Isthmian Canal i Commission em-|

ployees 1195 Panama R. R. I employees ! 16 Pay patients | 83 Charity patients Insane patients.. Total 324

o >> o 1. :> o

389 ,6,282 8,998 50 i 271 59 2,996

15 314 282 37

1,111 1,373 480

198

795 9,900 12,160

Died.

2 5

170

34

14498

51

89 497

Discharged.

5,129

209 2,758

289

25 8,410

O

8,806

r,069

1,189

357

132

11,553

Transferred .

1,142

67 162

. 3

3

1,377

O

177

Remain

ing Dec. 31.

179

116

1629 348

340

5169

17

251 728

Average number of days' treatment per employee for the year Average number of employees constantly sick during

the year Number of days' relief furnished patients Cost of subsistence per patient per day

White.

13.08

235. 08

Colored.

15.76

438. 69

Total.

14.71

674. 37

423, 251

$0. 217

NATIONALITY.

Class.

Isthmian Canal Commission employ

ees Panama R. R. employees

Pay patients

Charity patients Insane patients Total ,

Number

treated

.

15,864 1,448

4,511 815

541

23,179

Americans.

White. Colored.

3,100

163

1,931 214

16

5,424 38

Otlier nations.

White. Colored.

3,206

91 1,048

78

36 4,459

9,525

1,193 1,529 522

489

13,258

OPERATIONS.

(See report of all surgical operations.)

LABORATORY REPORT

(See consolidated ward laboratory report.)
35

COLON HOSPITAL.

Class.

Remaining

Jan. 1. Admitted. Died. Discharged. Jj^^^l

1

Remaining Dec. 31,

'62

o

oO

d

2o

oO

S

la

•d2

o

oO

S

-d2o

oO

4

-d2

d^

d

1

Isthmian Canal Commission employees.

.

Panama R. R. employees

94

1729

45

3347

526

1,564 350

1,016

16 156

637 498 1,132

129 357

7

3

73

6

25

26

71

1,349

277

634

487

1,096

105 328

297

86

21

'"3'

12

710

10

16

5

14

11

11 Private pay 2 Municipal pay 19 1.S Zone charity 10 37 157 ? Total 150 156 3,102 2,753 26 178 2,809 2,650 407 55 10 ''d

Average number of days' treatment per employee for the year Average numberof employees constantly sick during

the year Number of days' relief furnished patients Cost of subsistence per patient per day

WMte. Colored. Total.

12.70 70.26

17.91 58.45

14.63

128. 71 85.941 $0,282

NATIONALITY.

Class.

Isthmian Canal Commission employees

Panama R. R. employees

Private pay

Municipal pay

Zone charity Total

Number

treated.

2,340

898 2,224

150

549

6.161

Americans.

White. Colored.

1.257

236

64596 2,234

Other nations.

White. Colored.

370

96 366

1750

899

713 566

1,213

133 403 3,028

OPERATIONS.

(See report of all surgical operations.)

LABORATORY REPORT.

(See consolidated ward laboratory report.

)
36

CULEBRA HOSPITAL.

Class.

Re- maining

Jan. 1.

Admitted. Died. Dis- charged. Transferred.

Re- maining Dec. 31.

2 i

o

'oO

i

o

'oO 1

p

oO

•d

<u

iioO

•d«

O

'oo

9*

«^

•doO

Nonemnlovees 3 6 23 6 17

Number of daj^s' relief furnished patients 363 Cost of subsistence per patient per day SO. 267 NATIONALITY.

Number

Americans. Other nations.

Class. treated. White. Colored. White. Colored,

Nonemployees 32 1 1 5 25

OPERATIONS.

(See report of all surgical operations.)

LABORATORY REPORT.

(See consolidated ward laboratory report.)

PALO SECO LEPER ASYLUM.

Class.

Remaining

Jan. 1. Admitted. Died. Dis- charged. Transferred.

Remaining Dec. 31.

<u

-t-> d<u 1

o

i

IS d

i-i o

"oO

d

o

v2

?=

d

o

132

a3 1

1

d

%

2

d

.2oo

1

11

18

3 2

1 28

17

.... 5

4

1 2

2 28 Charity paKents .... 1 13

Total 3 45 3 12 .... 9 1 6 1 1 4 41

Average number of days' treatment per employee

for the year Average number of employees constantly sick during

the year Number of days' relief furnished patients Cost of subsistence per patient per day

Wliite. Colored. Total

31.00

.08

92.00

.25

46.00

.33 17,294 $0,278
37

PALO SECO LEPER ASYLUM—Continued.

NATIONALITY.

Class. Number

treated.

Americans. Other nations.

White. Colored. White. Colored.

Emploj^ees 239

22

1 1 Pay patients 22 37 Charity patients 20 Total 63 1 4 58 TABOGA SANITARIUM.

I p, ! Remain-

^'^^^- ingJan.l.

Admitted. Died. Dis- charged. Transferred. Remaining Dec.

31.

Employees 34

9

1,776

1,258

1,767

1,257

21

3

22 Families of employees

and others 7 Total 43 3,034 3,024 24 29

Average number of days' treatment per employee for the year. Average number of employees constantly sick during the year. Number of days' relief furnished patients Cost of subsistence per patient per day

6.21 30.41 19,400

$0. 676 NATIONALITY.

Class. Number

treated. Americans. Other

nations.

Employees 1,810

1,267

1,495 1,209 315 Families of emploj^ees and others 58 Total 3,077 2,704 373 Note.—No colored patients treated at Taboga Sanitarium,

SANTO TOMAS HOSPITAL.

Class. Remaining Jan. 1. Admitted. Died. Dis- charged. Transferred. Remaining Dec. 31.

Pay cases 39 223 1,015 6,890

37

396

1,001 6,381

16 Charity cases 336 Total 262 7,905 433 7,382 352

Average number of days' treatment per patient 14. 73 Average number of patients constantly sick 315. 28 Number of days' relief furnished patients 115, 079 Cost of subsistence per patient per day $0. 245
38

SANTO TOMAS HOSPITAL—Continued.

NATIONALITY.

Class. Number

treated.

Americans. Other nations.

White. Colored. White. Colored.

Pay cases 1,054

7,113 375845 679 Charity cases 6,268 Total 8,167 1,220 6,947

OPERATIONS.

Major

Minor

Total DISPENSARY

Number.

1,162

271

1,433

Died.

33

33

Class. White. Colored. Total.

Natives 640

217

3,683

1,137

4,323 Foreigners 1,354 Total 857 4,820 5,677 BOARD OF HEALTH LABORATORY.

Bactenoiogical examinations of—

Water 2 Cultures, various 6 Fluids and exudates 1 Fluids from tmnor 1 Blood cultures 317 Throat cultures (diphtheria suspects) 5C9 Cultures from aut ops!e,s 76 Cultures from eye 5 Stools 280 Urine 626 Sputum ; 6 Pus 5 Hydrocele fluid 1 Knee-ioint fluid 14 Spinal fluid 44 Various smears and specimens 76 Pleural fluid 3 Scrapings 1 Fluid from joint 1 Fluid from chest 3 Animal 2 Aspirated fluid 1 Abdominal fluid 1
39

Bacteriological examinations of—Continued.

Peritoneal fluid 1 Fluid from pleural cavity ....[..... 6 Fluid from gaU bladder '

' 5 Epithelial flakes \..\. ..[.".].. i Determinations of

Germicidal test

Proprietary disinfectant 1 Phenol oil 1 Examinations of

Leper suspects 29 Animals 42 Chemical examinations of

Preparations made 2 Brackish water 14 Kidney stone ....!..!!.!! 1 Gall stones 2 Kerosene [.[...[.[. 1 Red lead .[...... 1 Soap 1 Substance from valve stem \ ................

.

1 Gear grease 1 Stomach contents 5 Organs and contents (post-mortem) for poisons ..\..\[\ ......

.

1 Urine 32 Crude carbolic acid 1 Various liquids, fluids, etc 41 Various metals .\ ...\ .[....

.

2 Sugar cane ....[[[.[...]. 3

Oil, vaseline ........!!.!. 2 Coke ............[.. ..\ 1 Sugar, brown 2 Castor oil [.\\ ...........

.

2 Fire clay 1 Liver and urine for arsenic !.!.!! 1 Vomitus 1 Ether ' 3 "Pabst Extract" .....\....... 1 Whisky , " ' i Phenol oil 1 Test meal 1 Stool '..'..'.'.'.'.'...'.'..'..'. .]..'. '. 2 Water for detection of chlorin contents . 78 "Ambrew" 1 Agglutination reactions 173 Autopsies ..[.[...[[.[.... 567 Autopsies of cows 3 Bodies embalmed 73 Hydrophobia, preventative treatment ................]..

.

1 Medico-legal post-mortems 14 Sections of tissue prepared

Frozen 71 Paraflfin ........'..'..'.'.'..'.'. G, 422 Surgical pathological tissue and neoplasms reported 273 Vaccinations, antipest 7 Vaccination for plague f .[..[.[.....[. 3 Vaccine inoculations, anti-typhoid \.\.\..\\. "............ 13 Vaccine treatment, autogenous

Prepared 55 Administered 1 Wasserman reactions 3, 007 Widal reactions 29
40

ISSUES OF QUININE.

Month.

January

February

March

April

May

June

July

August

September

October

November

December

Total Average per month

Pounds

Kilograms. avoir- ^

dupois.

23.33 51.43 35.66 78.62 52.00 114.64 26.33 57.95

15.43 34.02

46.33 102. 14 33.59 74.05 38.33 84.50

40.73 89.80

36.50 80.46

17.00 37.48

39. 166 86.35 404.396 891. 44

33. 699 74.29 SANITATION—CITY OF PANAMA.

Anopheles brigade:

Linear feet of ditches cleaned 867. 548 Linear feet of ditches dug 2, 982 Square feet of weeds and grass cut and removed 3, 733, 600 Wells fllled 1 Cubic yards of earth used in filling cesspools, wells, and holes 5, 519 Loads of grass removed and burned 1 , 924 Disinfection brigade: Houses disinfected for diphtheria 35 Houses disinfected for tuberculosis « 2 Houses disinfected for chickenpox 14 Houses disinfected for cerebrospinal meningitis ^5 Houses disinfected for scarlet fever 74 Houses disinfected for measles 1 Houses disinfected for smallpox 1 Houses disinfected for typhoid fever ^11 Number of cubic feet disinfected 1, 407, 715 Number of rooms disinfected 329 Material used: '^ Crude oil gaUons.

.

756 Larvacide 4, 310 Destruction of rats: Number of rats caught and killed 1, 442 Average number of rat traps in use 98 Inspection of houses and yards: Houses and vards in£y;iected 826 Persons notified to keep premises in good condition 194 Warning notices complied with 189 Number of letters to alcalde requesting enforcement of sanitary rules m

and regulations 63 Number of old buildings condemned and demolished 85 Number of yards cleaned 3, 577 Loads of refuse removed from the city 5, 782 New buildings:

Number of plans submitted to health ofTicer and approved 282 Number of permits granted for repairs to old buildings 277 Garbage collection: Number of loads of garbage removed to dump and "^ •^ burned 10,894
41

SANITATION—COLON, CRISTOBAL, MOUNT HOPE, AND

TORO POINT.

Number of connections made during the year 100 Total number of connections made to date 'lit Number of outstanding permits ^^y

Number of houses in which extensions were made -s** Houses: .p. Plans approved ^ft^ Permits to repair issued °^

Permits to occupy issued ^^ Temporary permits to occupy issued - ^^ Sanitation of Colon: k iri Number of loads of yard garbage removed o> ioi Average number of cans of garbage removed daily -«, i^i Number of acres of vegetation removed »^ Number of acres of streets cleaned 'ri± Number of private properties cleaned

i -o ovn Number of square yards of pools oiled

T

' ono Number of mosquito-breeding places found i, zu^ Number of water receptacles treated ^-^U' °^

Number of linear feet of ditches constructed

oo Qm

Number of linear feet of ditches maintained i'orn Notice to abate nuisances served i'iui Number of nuisances abated ^o 971 Number of buildings mspected 'tni Number of rats killed ^"^ Number of square yards of alleys cleaned

1 oqo nnn Number of square yards of streets sprinkled 1> -^yA ouu Number of fly-breeding places found - l,6il Sanitation of Cris^tobal: __ onn Number of square yards of pools oiled li'fm Number of water receptacles treated 'vai Nmnber of mosquito-breeding places found : 1 r 1 1 o Number of linear feet of ditches constructed io 1 cc Number of mosquitoes killed in barracks ' 1 7q Number of fly-breeding places found ^'^ Sanitation of Mount Hope: ' 1 01 a 709 Number of square vards of pools oiled ' oi? Vm

Number of water receptacles treated ^^'y t^

Number of linear feet of ditches maintained ir nm Number of crab holes worked 1 vnc Number of mosquito-breeding places found rl' aot Number of linear feet of ditches constructed

n a 1 in Number of square yards of vegetation removed

1 a' tri Number of mosquitoes killed in outfit cars iy,bbi Sanitation of Toro Point: _„- Number ot square yards of pools oiled

1 7 qcc Number of wat^r receptacles treated '49

Number of mosqnito-breeding places found f^ Number of linear feet of ditches constructed , «' Iw Number of linear fpet of ditches maintained log' j^

Number of crab holes worked Jioin Number of doses of quinine tonic distributed -- ?e' 079 Number of adult mosquitoss killed 1», 87-i SANITATION—CANAL ZONE.

Work requests on quartermaster's department:

Grass cutting ^

Screen repairing j'' Miscellaneous. 486 Work requests on engineering department 561 Work requests on other departments ^^

Notice served for abatement of nuisances ^>^l^ Arrests for violation of sanitary regulations ^i

Convictions rSS Building permits approved ^'

Inspections of closets '"' "^^
42

Inspections of stores 5, 085 Inspections of restaurants 2, 364 Inspections of shops 2, 319 Garbage cans emptied 2, 301, 407 Closets disinfected 187, 254 Houses disinfected 87 Houses fumigated 1 Rat traps used daily 347 Water and sewer connections made 55 Number of adult anopheles destroyed at houses 403, 117 Numb r of adult culices destroyed at houses 364, 174 Number of containers found with stegomyia larvae 1, 103 Material used: Larvacide gallons.

.

113, 118 Crude oil do 607, 973 Rats destroyed 10, 617 QUARANTINE SERVICE.

PORTS OF PANAMA-ANCON AND COLON-CRISTOBAL.

Number of vessels inspected and passed 1, 342 Number of vessels detained in quarantine 118 Number of vessels fumigated on arrival 99 Number of vessels fumigated prior to departure 42 Number of pieces of baggage handled and stored 9, 520 Number of crew inspected 132, 558 Number of passengers inspected 87, 961 Total number of persons inspected 220, 519 Number of persons vaccinated at ports of arrival because of compulsorv

vaccination law ".

] 1, 939 Number of persons vaccinated at ports of departure or en route because of compulsory vaccination law 13, 636 Total number of persons vaccinated 25, 575 Number of persons held in quarantine at the detention stations to complete

period of incubation of yellow fever or plague 5,345

Number of persons held in quarantine on board vessels to complete period

of incubation of yellow fever or plague 17, 183 Total number of persons held in quarantine 22,530

Numl)er of persons landed from foreign ports: Cabin 23, 595 Steerage 26, 710

50, 305 Number of persons embarked for foreign ports: Cabin 26, 523 Steerage 28, 430

5-1,053 Apparent decrease for the year from foreign ports: Cabin 2, 928 Steerage 1, 720 4,648

Number of persons arriving from coast towns on small craft 36,003

Number of persons embarked for coast towns on small craft 32,393

Apparent increase for the year from coast towns 3,610 Total number of persons landed 86, 308 Total number of persons embarked 87, 346 Excess over number landed 1 , 038 Plus number for Pacific ports 3,295 Total apparent decrease for the year 4, 333 Number of immigrants recommended for rejection 59 Number of certificates issued to outgoing passengers 454 Number of persons refused certificates because of trachoma 69 Number of bills of health visaed 744 BOCAS DEL TORO.

Number of vessels inspected and passed 379 Number of crew inspected and passed 23, 55(i Number of passengers inspectea and passed 10, 336 Number of passengers, in transit, inspected and passed 7, 314 Number of persons held to complete period of incubaf ion of yellow fever.

.

97
43

PERSONNEL REPORT.

[Average number of employees at work during the year. ] Chief sauitury ollice 33 Property division y Quarantine service 40 Health ollice, Panama 83 Health office, Colon 127 Ancon Hospital 548 Colon Hospital 166 Santo Tomas Hospital 6 Taboga Sanitarium 21 Palo Seco Leper Asylum 14 Zone sanitation 224 Hospital farm 22 Dispensaries:

Ancon 5 Balboa * 4 Bas Obispo 4 Corozal 5 Cristobal 6 Culebra 7 Empire 6

Frijoles 1 Gatun 9 Gorgona 6 Las Cascadas 4 Margarita Point 1 Miraflores 3 Naos Island 2 Paraiso 4 Pedro Miguel 4 Porto Bello 4 'loro Point 3 Total 1, 371 HOSPITAL CASES OF MALARIA AMONG EMPLOYEES.

Month.

January . .

.

February.

.

March

April

May

June

July

August

September.

October. .

.

November.

December

.

Total

Discharged.

3

215

235

18582

88

87

91 10979

114

8598

1,468

O

281 355

248

152

88

149 239

255 216

295

285

236 2,799

Died.

o

Total

cases.

499

591 433

234

177 237

331 367

296 410

373 336

4,284

Annual

average death

rate per per 1,000.

0.69

.22

.20

.20

.21 .62

.20 .21

.67 .48

,30

Annual

average number

of cases per 1,000.

115

12892

4736

49

69

75

60

84

83

8076

Number

of employees.

52, 142

55,333 56,258

59,486

59,771

58,590

57,960

58,465

59, 192 58,344

53,942

50,357

56, 654 O



UNIVERSITY OF FLORIDA

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