REPORT

OF THE

DEPARTMENT OF SANITATION

OF THE

ISTHMIAN CANAL COMMISSION

FOR THE

YEAR 1910

W. C. GORGAS

Colonel, Medical Corps, U. S. Army

Chief Sanitary Officer, Ancon, Canal Zone

614.0386

WASHINGTON • GOVERNMENT PRINTING OFFICE

1911
UNIVERSITY

OF FLORIDA

LIBRARY
Digitized by the Internet Arciiive

in 2010 with funding from

Lyrasis IVIembers and Sloan Foundation

http://www.archive.org/details/annualreportofisthmOOisth

REPORT

OF THE

DEPARTMENT OF SANITATION

OF THE

ISTHMIAN CANAL COMMISSION

FOR THE

YEAR 1910

' " O J * «

^ W, C. CORGAS

Colon^^ Meo'icrl Cornsi V. ^.Arny

Chief Sanitary Officer, Ancon, Canal Zone

WASHINGTON

GOVERNMENT PRINTING OFFICE

1911
I 37^
COZSTTEISTTS.

Page.

Letter of transmittal 5 Vital statistics: Deaths of employees of the Isthmian Canal Commission

and Panama Railroad 9

Deaths in the cities of Panama and Colon and the Canal

Zone 9

Deaths by age, color, and sex 10

Deaths by nationality 10

Causes of deaths of employees of the Isthmian Canal

Commission and Panama Railroad Co 11

Deaths of white employees of the Isthmian Canal Commission and the Panama Railroad Co 14

Deaths of white women and children from the United

States 15

Death rate among Americans on the Isthmus 17

Causes and places of deaths of employees and civil population 17

Discharges and deaths of employees in hospitals of the commission 22

Consolidated hospital report 27

Consolidated sick camp report 28

Consolidated report of employees sick in quarters 29

Consolidated hospital, sick camp, and sick-in-quarters

report 29

Consolidated dispensary report 30

Average number of employees constantly sick iK hospitals,

sick camps, and quarters 30

Average number of days' treatment per employee in hospitals,

sick camps, and quarters 31

Subsistence and operating expenses 32

Outside patients treated in hospitals, and amounts collected

for their treatment 33

Surgical operations performed in hospitals 33

Operations and work performed in eye, ear, nose, and throat

clinics 35

Consolidated ward laboratory report of all hospitals 37

Report of: Ancon Hospital 38

Colon Hospital 39

Culebra Hospital 40

Palo Seco Leper Asylum 41

Taboga Sanitarium 42

Santo Tomas Hospital 43

Board of health laboratory 44

Issues of quinine 45

(3)
4

Sanitation: ^^^la

Colon (including Cristobal, Mount Hope, and Toro

Point) 47

Quarantine ser\'ice:

Panama-Ancon and Colon-Cristobal 48

Bocas del Toro 49

Personnel report ^^ Hospital cases of malaria among employees 50
LETTER OF TRANSMITTAL.

Isthmian Canal Commission,

Department of Sanitation,

Ancon, Canal Zone, January 25, 1911.

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 1910.

The improved health conditions shown in the report for 1909

continue, as is shown by the following table:

Number of employees. Deaths. Rate.

1904 6,213

16, 512

26, 547

39, 238

43,891

47, 167

50, 802

82

427

1,105

1,131

571

502

558

13.26

1905 25.86

1906 41.73

1907 28.74

1908 13.01

1909 10 64

1910 10 98

The slight increase in the death rate over that of 1909 is due to the

increased number of deaths from external violence, the death rate from disease being less than that of 1909.

The death rate among our white employees from the United

States from disease was 2.63 per thousand. If we include American

women and children, it will raise the death rate of Americans from

disease to 3.64 per thousand. This shows an improvement over

the year 1909, when the death rate for the above was 3.88 and 4.32

per thousand, respectively.

Taking special diseases, the deaths from typhoid fever among

our employees have been:

Deaths. 1905 12

1906 42

1907 98

1908 19

1909 13

1910 13

(5)
6

Considering dysentery, we have had among our employees from

this disease the following deaths:

Deaths. 1905 14

1906 69

1907 48

1908 16

1909 8

1910 21

Among our 13,021 white employees we had only 1 death from

this disease.

Considering pneumonia, we have had among our employees

from this disease the following deaths:

Deaths. 1905 95

1906 413

1907 328

1908 93

1909 70

1910 73

Considering deaths from malaria among employees, we see the

following figures:

Deaths. 1905 86

1906 233

1907 154

1908 73

1909 52

1910 50

This is the"smallest"number ofMeaths we have had from malaria,

and there is a marked improvement in the admission rate to our

hospitals, as shown by the following table:

Per thousand. 1904 125

1905 514

1906 821

1907 424

1908 282

1909 215

1910 187

Deaths from the other principal diseases were as follows: Abscess

of the liver, 9; nephritis, acute and chronic, 39; and from all forms

of tuberculosis, 74; leaving 102 deaths among employees from all other diseases and 177 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. 1905 49. 94

1906 48. 37

1907 33. 63

1908 24. 83

1909 18. 19

1910 21. 18
^ One death from yellow fever, in the person of a young Englishman, occurred at Ancon Hospital on January 24, 1910. The

deceased arrived in Panama on the 6th of the month and was taken

ill on the 8th. Information was received that he left the ship

while in the harbor of Cartagena and visited the native town, and

it was there that he undoubtedly got his infection.

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

occurred on the Isthmus during the year. Very respectfully,

W. C. GORGAS,

Chief Sanitary Officer. 78431—11 2

ANNUAL REPORT

OF THE

DEPARTMENT OF HEALTH, ISTHMIAN CANAL COMMISSION,

FOR THE YEAR 1910.

VITAL STATISTICS.

Deaths of Employees of the Isthmian Canal Commission

AND Panama Railroad Co.

Color. Average

number

of employees.

Total number of deaths fromAnnual death rate per

1,000 from—

Disease. Vio- All

lenee. causes.

1

Disease. Violence. All

causes.

White 13,021 64

37,781 317

1 55 i 119

122 j 439 4.92

8.39 4.223.23 9.14 Colored 11.62 Total 50,802 1 381 177 558 7.50 3.48 10.98

Deaths in the Cities of Panama and Colon, and the Canal

Zone,

Places. Population. Deaths. Annual

average per

1,000.

Panama 45, 591

19, 535

86, 465

1,446

514

1,251

31.72

Colon 26.31

Canal Zone 14.47

Total 151, 591 3,211 21.18

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, Colon,

and the Canal Zone include employees and civil population.

Total admissions of employees to hospitals and sick camps,

including those sick in quarters 45, 965

Average per thousand of admissions of employees to hospitals and sick camps, including those sick in quarters. . 905

(9)
10

Deaths by Age, Color, and Sex.

Age.

White. Colored. Yellow. Total.

M. F. M. F. M. F. M. F.

Under 1 year 93

16

61275

72

5130

5

3

2

59

214 "is"

17188

4

2

2

459

10926

352

118

20

2

2

2

2 55412732

121 493 312

228

117

39

23

8

11 48

413

1 to 4 years 141

5 to 10 years 24

11 to 20 years 108 61 1 15

12

4

64

2

61 21 to 30 years 403

228

173

8130

186

i 44

16895

5636

24

8

3

1

183

31 to 40 years 112

41 to 50 years 74

51 to 60 years 44

61 to 70 years 28

71 to 80 years 10

81 to 90 years 5

91 to 100 years 1 101 to 110 years Unknown 2 4 7 2 11 Total 367 154 1,687 949 50 4 2,104 1 107

Deaths by Nationality.

Nations. Employees. Noneraployees. Total.

Africa 18

111

1

2

Antigua 19

Argentina 1 Australia 1 1 Austria 1

1 188

1 Bahama Islands 3

163

1

1

4

Barbados 351

Brazil 1 Bulgaria 1 Canada 2

52

136

9

72

5

3

1

16

9

1

2

China 52

Colombia 16

2

2

152

Costa Rica 11

Cuba 9

Curacao 2

Demerara 2 7

Denmark 3

Dominican Republic 1 Dutch West Indies 1 Ecuador 11 7

England 10

Finland 1 Fortune Island 10 10

France 12

4

1 21

12

Germany 4

Greece 9

15

10

Grenada 36
11

Deaths by Nationality—Continued.

Nations.

Guadeloupe

Guiana, British

Haiti

India

Italy.

Jamaica

Martinique

Mexico

Montserrat

Nevia

Nicaragua

Norway

Panama

Peru

Porto Rico

Portugal

Russia

San Salvador

St. Domingo

Kitts

Lucia

Martins

Thomas

St. Vincent

Spain

Sweden

Syria

Trinidad

Turks Island

United States Venezuela - West Indies, British.

Unknown

St.

St.

St.

St.

Total.

Employees.

17

12

111

114

26

18

1

11

14

2

16

11

114

51

135

1

Nonemployees.

11

3

3

3

10

520

66

6

Total.

558

3

1

1,329

3

1

1

2

14

68

24

44

2

218

1 42

2

117

2,653

28

4

5

4

21

634

92

716

14

2

1,343

5

1

1

12

2

10

79

13

8

95

2

2

26

2

77

3

118

3,211

Causes of Deaths of Employees of the Isthmian Canal Commission AND Panama Railroad.

Causes of death. White.

Disease.

Alcoholism, acute and chronic

| 2

Ansemia ' Aneurism i 1 Apoplexy ; 3

Total.
12

Causes of Deaths of Employees of the Isthmian Canal Commission AND Panama Railroad- Continued.

Causes of death.

Disease—Continued

.

Appendicitis

Brain:

Softening of Tumor of Cancer of intestines, peritoneum,

and rectum

Cancer and other malignant tumors

of buccal cavity

Cancer of organs not specified

Cerebrospinal fever

Cholangitis superative

Colitis, acute and chronic

Congestion and hemorrhage of the

brain

Diabetes

Dementia praecox

Dysentery

Amoebic

Clinical

Emphysema, pulmonary

Empyema

Encephalomalacia, acute

Diarrhea and enteritis

Epilepsy

Fever:

Hemoglobinuria

Malaria

Malaria, estivo-autumnal

Typhoid

Heart:

Acute rupture of Organic disease of Hemorrhage, gastric

White.

Infection of unknown origin.

Intestinal obstruction.

Liver:

Abscess of Hydatid tumor of. Lungs:

Abscess of Gangrene of Meningitis:

Pneumococcus

Tuberculous

Simple

Myomalacia

Colored.

1

1 12

2

6

2

11

11

1 19

15

12

110

1 10

3

Total.
13

Causes of Deaths of Employees of the Isthmian Canal Commission AND Panama Railroad—Continued.

Causes of death.

Disease—Continued.

Nephritis:

Acute

Chronic

Other tumors (lymphoma)

Pellagra

Peritonitis, simple

Pneumonia

Pyaemia

Pyaemia and septicaemia, pneumococcic

Senility

Septicaemia

Septicaemia, purulent infection...

Splenic anemia

Syphilis

Tetanus

Tuberculosis

General

Pulmonary

Miliary

Abdominal

Disseminated

Ulcer, duodenal

Undiagnosed

White.

Violence.

Accidental traumatisms, various.

-Bums and scalds

Drowning, accidental

Dynamite explosions

Electric shock

Homicides

Railroad accidents

Suicides

Poisoning by food , Other acute poisonings

Other external violence

10

2

11

3

13

3

29

3

Total.

1

1

119

Colored.

5

30

1

15

63

4

2

113

9

37

4

4

16

2

3

30

117

6

6

59

111 439

Total.

5

34

12

5

73

6

2

1a

5

12

2

10

40

4

4

16

2

3

41

1

20

1

9

9

88

3

12

2

558
14

Deaths of White Employees from the United States dubING 1910.

JANUARY.

Name. Division. Time on

Isthmus. Age. Cause of death.

Brown, John E

Bork, Fred A

Engineering...

do

7 months..

33 months.

4 years

26

29

29

Railroad traumatism.

Cerebral hemorrhage.

Thome, Charles L.. do Suicide (firearms). FEBRUARY.

Obdrett, Ernest. Turner, Robert.Engineering...

do

2 years 30

38 Accidental traumatism.

Accidental trauma (dynamite).

MARCH.

Cole, W. R Engineering...

do

do

32 months.

4 years

32* months.

6 months..

39

51

2524

Suicide (firearms). Dysentery, amoebic.

Electric shock. Gardner, GeorgeMcGurn, H. D

McKenna, L. F Examinati o n

of accounts.

Tuberculosis, pulmonary.

APRIL.

Cottrell, R... Fake, L. E .

Geary, L. D.

Hart, F. W..

Engineering...

Mechanical

Engineering...

4 years...

1 month..

5 years...

3 years...

30

3153

38

Tuberculosis, pulmonary.

Accidental traumatism.

Septicaemia.

Liver, abscess of, amoebic.

Barry, John M.

Clark. James F

Healy, Anna

Howard, Robert E

.

Civil administration. Panama R. R. Examinati o n

of accounts.

MAY.

2^ years...

30 months.

1 year

16 months.

4124

3528

Organic disease of heart. Railroad traumatism.

Organic disease of heart. Railroad traumatism.

JULY.

Ames, Lamont. Atlantic division.

1 year. 60 ! Bright's disease.

AUGUST.

Ilobart, Joseph.

Jackson, John

Ridley, Arthur G.

Tinsley, EliasC,

Tafel, Harry

Engineering...

.do. .do. Panama R. R,

....do

7 weeks... 42

13 months. 13

4 vears, 2 38 months.

4 years 46 4 months.. 24

Accidental trauma (dynamite). Railroad traumatism.

Fall from cement wall. Railroad traumatism.

Poisoning by acid.
15

Deaths of White Employees from ihe United States during 1910—Continued.

SEPTEMBER.

Name.

Coit, John J

Haven, Fred B . .

.

Siegle, William

Haktead, W. S.... Ljmch, James

Schaberle, John A

.

Division.

Transp o r t a - tion depart- ment.

Mechanical de- partment.

Atlantic diviTime on

Isthmus.

5 years . .

.

7 months.

Age. Cause of death.

36 Railroad traumatism.

33

27

Syphilis of cerebellum. Traumatism by machines.

OCTOBER.

Chairman's office. Pacific division. Chairman's office.

4 years 28 ' Amoebic abscess of liver.

6 months.. 38 Acute alcoholism.

2 years 33 Homicide by firearms.

NOVEMBER.

Tate, Dexter j Quartermaster's depart- ment.

5 years .

43 Suicide by firearms.

DECEMBER.

Brady, Walter H.H.

Crawford, John

Dabbs, John S Evans, J. D

Sanitary de- 5 years, 7 partment. ' months.

Mechanical di- 5 years

vision. i Atlantic divi- { 16 months.

sion. Panama R. R. 18 months.

Murphy, A. R j Mechanical di- 4J years . .

.

vision.

32 Traumatism by fall.

51 Chronic nephritis.

21 Staphylococcus septicae- mia.

23 I Splenic anaemia.

56 Sarcoma of right parotid

gland.

Deaths of White Women and Children from the United

States during 1910.

JANUARY.

Name. Time on

Isthmus. Age. Cause of death.

Collins, Mrs. H. S 18 months.

Fox, Mrs. B. J Tucker, Richard B 3 months.

.

Walker, John

21 years . .

.

23 years . .

.

3 months..

7 years

Septicaemia, puerperal. Do.

Entero-cohtis. Meningitis, tuberculosis.

78431—11-
16

Deaths of White Women and Children from the United

States During 1910—CoDtinued.

FEBRUARY.

Name.

Metcalf, Betty

Wood (infant).

Time on

Isthmus. Age.

22 months . 22 months

.

3 days 3 days

Cause of death.

Paralysis, cerebral. Hemorrhage, cerebral. MARCH.

Claybom (infant) Stewart, Agnes Georgia

1 day i 1 day

17 months, i 47 vears . .

.

Asthenia. Convulsions of unknown origin

MAY.

Graham, Mrs. S. E...

Patterson, Mrs. J. A.

18 months . 74 years . .

9 months. . 45 years . .

Nephritis, chronic. Carcinoma of pelvis.

JUNE.

Lloyd, Mrs. H. M.

Russell (infant) . .

.

1 year.

3 days.

22 years .

3 days

Septicaemia. Malnutrition. JULY.

Arthur, Guy Everard

,

Monley, Solomon

Reidman, Karl , Thompson (infant)

19 months

3 months.

.

18 months

1 day

19 months.

3 months..

3 years

1 day

Malaria. Dysentery.

Diphtheria and nephritis. Premature birth. AUGUST.

Albright, Marion Ruth..

Murwin, Mrs. W. H

16 months. 19 months.

26 years... Pneumonia.

Bums; explosion of alcohol lamp.

SEPTEMBER.

Scribner, L. May 3 years 38 years... General peritonitis.

OCTOBER.

Harbinson, J 10 months. 34 years... Acute infectious jaundice.

NOVEMBER.

Butz (infant) 1 hour

4 years

1 hour

31 years...

.Vtelectasis, congenital.

Gibson, Bessie M Asphyxiation (accidental).

DECEMBER.

Smith, Mrs. R

Woodburn, Mrs. Effie, .

.

3 years 32 years . .

.

6 months. 42 years . .

.

1

Burns.

.Vcute nephritis.
17

Death Rate Among Americans on the Isthmus.

Number

of deaths.

Annual

average per 1,000.

Average number of white employees from the United States,

6,079:

T) i «;pasp 16

19 2.63 Violence 3.13

35 5.76 Average number of white women and children from United

States, 4,097: 21

3 5.13

Vinlpnpp. .73

All causes 24 5.86 Average number of white emploj-ees and their families from

the United States, 10,176: 37

22 3.64 Violence 2.16

A n ean5?p.s 59 5.80

Causes and Places of Death op Employees and Civil

Population.

Diseases.

I. General diseases. Typhoid fever Malaria

Malaria fever: Estivo-autumnal

Clinical Cachexia

Hemoglobinuric fever Measles Whooping cough

Diphtheria and croup

Influenza

Miliary fever Cholera nostras Dysentery

Amoebic

Bacillary

Clinical Yellow fever Leprosy

Erysipelas Purulent infection and septicaemia

Pyaemia

Septicaemia

Pyaemia and septicaemia,

pneumococcic

Tetanus

Pellagra Beriberi

Ancon

Hospital.

Colon Hospital. Pan- ama.

Colon.

10

1

46 10

10

13

2

131

33

Zone. Total.

5

66

21

1

11

1

2

17

1

25 20080

1612

4

92

1

12

68

10

1 26

13

2

110

20

3185

41
18

Causes axd Places of Death of Employees and Civil

Population—Continued.

Diseases. Ancon

Hospital.

Colon Hospital. Pan- ama.

Colon. Zone. Total.

I. General diseases—Continued.

Tuberculosis of the lungs Acute niiliarj' tuberculosis Tuberculous meningitis

Abdominal tuberculosis

Pott's disease

37

75

4

44

3

i'

1

179

12

3

27

122

42

12

329

13

912

11

1 Tuberculosis: Of bones and joints

Of the larynx..

1 2

1 2 Of other organs 71 Disseminated tuberculosis 46

1 5 51 Rickets 5

5

6

S\'philis 1 6

C. Tertiary 1 1 2 D. Hereditary 1

1

2

' 3

4 5 Gonorrheal ophthalmia 1 Cancer and other malignant

tumors: Of the buccal cavity 1

1

1

3 Of the stomach and liver.

.

Of the peritoneum, intes- tines rectum

2 6

1 Ofthe female genital organs 1 7 8 Of the breast 2

1

2 Other organs and of organs not specified 1

1

1 10

15

1

1

13 Other tumors (tumors of the female genital organs ex- cepted) "2 Acute articular rheumatism .

.

5 Chronic rheumatism and gout 1 Scurvv 1 Diabetes 1 1 2 Addison's disease 1

1

1 Anemia:

Chlorosis 2

i" 3 Primary, pernicious 1 Alcoholism: Acute or chronic Acute

Alcoholic psychosis

II. Diseases of the nervous sys- tem and of the organs of

special sense. Encephalitis

1.

1

1

1 I

1

1 104

1

1 1 2 Simp e meningitis 7 1 20

3 ! 27 Cerebrospinal fever 2

i' 5 Pneumococcus meningitis

Lateral sclerosis 2 2 a

1220

1 Otherdiseases of thespinal cord 1 3'4

3 Cerebral hemorrhage, apoplexy. [ 2 8 7 40

5 Paralysis without specified cause 1 6 7 Other forms of mental aliena- tion 6 Epilepsy ! 1 Convulsions (nonpuerperal). . . 1 Convulsions of infants .

2 2

11 7

2

19

73

17 Hysteria 1 1
19

Causes and Places of Death of Employees and Civil

Population—Continued

.

Diseases. Ancon

Hospital.

II. Diseases of the nervous sys- tem and of the organs of

special sense—Continued.

Neuralgia

Neuritis Tumor of the brain

Ottier diseases of the nervous system

III. Diseases of the circulatory system.

Pericarditis Acute endocarditis Organic disease of the heart... Angina pectoris

Aneurism

Arterio-sclerosis Other diseases of the arteries... Embolism, thrombosis

Varices Other diseases of the veins Pupura hemorrhagica

Other hemorrhages: other dis- eases of the circulatory system.

IV". Diseases o1 the respiratory system. Myiasis of nasal fossse and si- nuses Other diseases of nasal fossae.. Other diseases of the larynx.. Acute bronchitis Chronic bronchitis Bronclio-pneumonia

Pneumonia (unqualified)

Lobar pneumonia

Pleurisy

Empyema

Pulmonary congestion, pulmonary apoplexy

Gangrene of the lungs

Asthma

Pulmonary emphysema

Abscess of'lun;i-s .". Other diseases of the respiratory system (tuberculosis ex- cepted)

V. Diseases of the digestive sys- tem. Diseases of the teeth and gums.

Stomatitis Other diseases of the mouth

and annexa

Acute gastritis Chronic gastritis Acute indigestion

Other diseases of the stomach

(cancer excepted )

13

Colon Hospital. Pan- ama.

Colon.

19434

2

72

2

1

1 48

822

493

7

18

Zone. Total.

2931

10

1

32192

7G

112

6

]2

1

1

1 C8

107095

103

11420

33

29

1

12

10

22
20

Causes and Places of Death of Employees and Civil

Population—Continued

.

Diseases.

V. Diseases of the digestive sys- tem—Continued.

Diarrhea and enteritis (under 2 years)

Diarrhea and enteritis (2 years and over)

Ankylostomiasis

Ascariasis Other intestinal parasites

Appendicitis and typhlitis Hernias.intestinal obstructions. Inguinal hernia

Intestinal obstruction

Diseases of the anus and fecal fistulas Other diseases of the intestines. Duodenal ulcer Hydatid tumor of the liver Cirrhosis of the liver Abscess of liver (unqualified).

.

Amebic abscess of the liver Jaundice

Other diseases of the liver Other diseases of the spleen

Simple peritonitis (nonpuerperal)

Other diseases of the digestive

system (cancer and tuberculosis e.xcepted) VI. Nonvenereal diseases of the genito-urinary system and annexa. Acute nephritis

Bright's disease (chronic nephritis)

Pyelo-nephrosis

Diseases of the bladder

Cystitis

Other diseases of the urethra,

urinary abscess , etc Hypertrophy of prostate '. .

Uterine hemorrhage (nonpuerperal) Uterine tumor (noncancerous).

Cysts and other tumors of the

ovaries

Salpingitis and other diseases

of the female genital organs.. VII. The puerperal state. Abortion

Puerperal hemorrhage

Other accidents of labor Puerperal septicemia

Puerperal albuminuria and

convulsions Eclampsia

Ancon

Hospital.

Colon Hospital. Pan- ama.

243

65

Colon. Zone.

58

4

64

1

10

Total.

38652

94

2

3

5

1 16

3

2

3

1 176

9

4

7

1 29

31 159

6

2

4

1

1

12

1

1

8

1 14

48
21

Causes and Places of Death of Employees and Civil

Population—Continued.

Diseases.

VIII. Diseases of the skin and

of the cellular tissue. Gangrene

F"uruncle Carbuncle Acute abscess Ulcerating granuloma of the pudenda

IX. Diseases of the bones and of

the organs of locomotion.

Caries (nontuberculous)

Mastoid abscess Other diseases of the bones (tu- berculosis excepted)

Other diseases of the organs of locomotion

Ancon Colon Hos- I Hospital.

I pital.

X. Malformations. Congenital malformations (still- birth hot included) XI. Diseases of early infancy.

Congenital debility, icterus, and sclerema Prematiire birth Other diseases peculiar to early

infancy

Malnutrition

Lack of care Accidents at birth XII. Old age.

Senility. XIII. Affections produced by

external causes.

Suicide: By poisoning

By firearms By cutting or piercing in- struments By jumping from a high

place

Poisoning by food Venomous bites and stings. .

.

Other acute poisonings

Conflagration Burns (eonflagrationexcepted)

Absorption of deleterious gases (conflagration excepted)

Accidental drowning

Traumatism:

By firearms By cutting or piercing in- struments By fall

Pan- ama.

Colon.

15

15

923

2

Zone.

23

72

17

4

1

Total.

26

18

59

5

3

10

67

43

27

10214

6

21

12

1

3

1 11

131
22

Causes and Places of Death of Employees and Civil

Population—Continued

.

Diseases. Ancon

Hospital.

Colon Hospital. Panama.

Colon. Zone. Total.

XIII. Affections produced by

external causes—Continued.

Traumatism—Continued

In mines and quarries 32

23

125

73

29

3

5

2

15 By machines 3

22

10 By other crushings (vehicles, railroads, landslides, etc.).

.

1 1 120 Starvation 2 Electricity (lightning excepted) 9 Homicide:

By firearms 2 5 By cutting or piercing instniTrifints .... 1 6 By other means 1 3 Fractures (cause not specified). 6

1 6 Other external violence 1 1

1

1

3 Legal execution 1 XIV. Ill-defined diseases.

Ill-defined organic diseases 12

38

1 3 Sudden death , 9 Cause of death not specified or

ill-definpd 6

12

1 2 11 58

Infections of undetermined

origin 6 1 4 22 Total

Stillbirths 516

3 293 i 1,3566 152 33545

711 109 3,211 315 Grand total 519 299 ' l-.'iOS 380 820 3. 5?6

Note.—The deaths occurring in Ancon and Colon liospitals result from sick, injury, or other cases taken from the cities of Panama and Colon, or from the Canal

Zone, and in the table of vital statistics are properly credited to either Panama,

Colon, or the Canal Zone. Table Showing Discharges and Deaths of Employees in the

Hospitals of the Isthmian Canal Commission, from All

Causes, for the Year 1910.

Diseases.

I. General diseases. Typhoid fever Relapsing fever Malaria

Malarial fever: Estivo-autumnal

.

Tertian Quartan

Mixed

Undetermined

Clinical Cachexia

113 12

2 249 4,628 36

952

4347 1 202 3.268

20

Died.
23

Table Showing Discharges and Deaths of Employees in the

Hospitals of the Isthmian Canal Commission, from All

Causes, for the Year 1910—Continued.

Diseases.

I. General diseases—C!ontinued. Hemoglobinuric fever. Vaccinia

Measles Diphtheria and croup

Influenza Dysentery

Amcebic

Bacillary

Clinical Leprosy

Erysipelas

Chicken pox

German measles Mumps

Yaws

Other epidemic diseases Purulent infection and septicemia

Pyemia

Septicemia

Pyemia and septicemia, pneumococcic

Tetanus .' Pellagra Beriberi Tuberculosis of the lungs Acute miliary tuberculosis Tuberculous meningitis.

Abdominal tuberculosis

Pott's disease Tuberculosis: Of bones and joints

Of the lymph glands

Of the genito-urinary organs Tuberculous abscess Tuberculosis of other organs Disseminated tuberculosis Syphilis A. Primary

B. Secondary

C. Tertiary .

!^ D. Hereditary

E. Period not stated

Soft chancre

Adenitis chancroidal Gonococcus infection Gonorrhea

Gonorrheal arthritis Gonorrheal ophthalmia

Cancer and other malignant tumors: Of the bu3cal cavity

Of the stomach and liver Of the peritoneum, intestines, rectum

Of the skin Of other organs and of organs not specified

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

Chronic rheumatism and gout

Arthritis deformans

Muscular rheumatism

Diabetes Addison's disease

Dis- charged.

47

1115

1 307

10

512

126

154

4

65

3

9

5

1

2

1 134

9

6

2

1

19

72 120

117

231 464

98

33134

11

1

1

13

7

13136

15256

5

1

Died.

2

4

111

39

42

4

1

26

78431—11-
24

Table Showing Discharges and Deaths of Employees in the

Hospitals of the Isthmian Canal Commission, from all

Causes, for the Year 1910—Continued.

Diseases,

I. General diseases—Continued.

Anemia, chlorosis Chlorosis Anemia, primary, pernicious.

Other general diseases Alcoholism: Acute or chronic Acute

Alcoholic psychosis

Other chronic poisonings

II. 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 General paralysis of^the insane Other forms of mental alienation Epilepsy

Hysteria

Neuralgia

Neuritis Tumor of the brain Neurasthenia

Other diseases of the nervous system

Follicular conjunctivitis

Trachoma

Other diseases of the eye and its annexa

Diseases of the ear

III. Diseases of the circulatory system.

Pericarditis Acute endocarditis Organic disease of the heart Aneurism

Arterio-sclerosis Other diseases of the arteries Hemorrhoids

Varices

Varicocele

Phlebitis Other diseases of the veins Lymph adenitis (nonvenereal)

Other diseases of the lymphatic system

Other hemorrhages; other diseases of the circulatory system

,

IV. Diseases of the respiratory system. Adenoid vegetations

Inflammation of accessory nasal sinuses Myiasis of nasal fossae and sinuses Other diseases of nasal fossae Laryngitis

Other diseases of the larynx

Diseases of the thyreoid body

Acute bronchitis Chronic bronchitis

Died.
25

Table Showing Discharges and Deaths of Employees in the

Hospitals of the Isthmian Canal Commission, from All

Causes, for the Year 1910—Continued.

Diseases.

IV.

Diseases of the respiratory system—Continued.

Broncho-pneumonia

Pneumonia (unijualified)

Lobar pneumonia

Pleurisy

Empyema

Pulmonary congestion, pulmonary apoplexy

Gangrene "of the lungs

Asthma

Pulmonary emphysema

Other diseases of the respiratory system (tuberculosis excepted) . V. Diseases of the digestive system. Diseases of the teeth and gums

Stomatitis Other diseases of the mouth and annexa

PharjTigitis

Follicular tonsi litis Other diseases of the pharynx

Foreign body in the esophagus

Ulcer of the "stomach , Acute gastritis

Chronic gastritis. Acute indigestion

Other diseases of the stomach (cancer excepted)

Diarrhea and enteritis (2 years and over)

Ankjiostomiasis

Ascariasis Tapeworm

Strongyloides

Other intestinal parasites

Appendicitis and typhlitis

Hernias, intestinal obstructions Hernia, inguinal

Other hernias

Intestinal obstruction

Diseases of the anus and fecal fistulas Other diseases of the intestines Duodenal ulcer Hydatid tumor of the liver Cirrhosis of the liver Biliary calculi Abscess of the liver (unqualified)

Amcebie abscess of the liver Cholecystitis

Jaundice

Other diseases of the liver Other diseases of the spleen

Simple peritonitis (nonpuerperal)

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

Dis- charged.

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

Bright's disease (chronic nephritis)

Movable kidney

Pyelo-nephrosis

Other diseases of the kidney and annexa

28

10 176

122

11

4

19

64582

85

65

1926

35

76

17 16656

6

6

59 197

15 22527

Died.

45

95

740

5

30

183

4

32

1762

2

7

4

163(i

529
26

Table Showing Discharges and Deaths of Employees in the

Hospitals op the Isthmian Canal Commission, from All

Causes, for the Year 1910—Continued.

Diseases. Dis- charged. Died.

VI. Nonvenereal diseases of the genito-urinary system and

an nexa—Continued.

Calculi of the urinary passages Diseases of the bladder

Cystitis Stricture of the urethra Other diseases of the urethra, urinary abscess, etc Acute prostatitis

Chronic prostatitis Abscess of the prostate

Other diseases of the prostate , Hematocele , Hydrocele

Lymph scrotum and varix Other nonvenereal diseases of the male genital organs Uterine hemorrhage (nonpuerperal)

Metritis Other diseases of the uterus Cysts and other tumors of the ovaries

Salpingitis and other diseases of the female genital organs Nonpuerperal diseases of the breast (cancer excepted)

VII. The puerperal state. Normal labor Abortion

VIII. Diseases of the skin and of the cellular tissue. Gangrene

Furuncle

Carbuncle Acute abscess Phlegmon

Trichophytosis

Scabies Other diseases of the skin and annexa Pemphigus contagiosus

Mycetoma

Filaria medinensis

Elephantiasis

Myiasis of skin Dhobie itch Ulcer of the skin

Tropical ulcer Ainhura

Impetigo contagiosa IX. Diseases of the bones and of the organs of locomotion.

Caries (nontuberculous)

Mastoid abscess Osteomyelitis

Periostitis Other diseases of the bones (tuberculosis excepted)

Ankylosis

Arthritis Synovitis

Other diseases of the joints (tuberculosis and rheumatism ex

cepted)

Amputations

Other diseases of the organs of locomotion

14103389

14

2

4

112

72

5 173

12

5

2

11

11

1 79

22

164

72

335

1136

2

2(1 162

6

2

5

6

9

51426

389

4342

16185
27

Table Showing Discharges and Deaths of Employees in the

Hospitals of the Isthmian Canal Commission, from All

Causes, for the Year 1910—Continued.

Diseases.

X. Malformations. Congenital malformations (still birth not included). XI. Affections produced by external causes. Poisoning by food Venomous bites and stings

Snake bites Other acute poisonings Burns (conflagration excepted)

Traumatism:

Bj^ firearms By cutting or piercing instruments

By fall In mines and quarries

By machines

By other crushings (vehicles, railroads, landslides, etc.). Overexertion Heat exhaustion

Electricity (lightning excepted)

Homicide' bj' firearms Dislocations Sprains

Fractures (cause not specified)

Other external violence XII. Ill-defined diseases.

Ill-defined organic diseases Cause of disease or death not specified or ill-defined. No disease, feigned disease Infections of undetermined origin Total. Consolidated Hospital Report.

Hospitals.

Re- maining

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

Re- maining Dec. 31.

W.

244

5428

C. W. C. W. C. W. C. W. C. W. C.

ATicon Hospital.

Employees

Nonemployees

Insane

268

54 218

8,489

1,954

47

8,351 1,398

252

47

39

3

212

184

31

5,683

1,807

31

8,037

1,166

122

2,756

79

10

763450

24783

31

294

68

267 Total 326 540 10,490 10,001 89 427 7,521 9,325 2,845 160 361

83

629 Colon Hospital.

Employees 103 18S 3,184 706

2,613 910

32 ins 2,603

682

2,095 700

569

12 500

50 Q8

Nonemployees 39 50 17141 34i 69

1 Total 142 2.S.'? 3,890 3,523 49 244 3,285 2,795 581 550 117 167

r —
28

Consolidated Hospital Report—Continued.

Hospitals.

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

Re- • maining Dec. 31. W. C. W. C. W. C. W. C. W. C. W. C.

Culebra Hospital.

Employees 1417 3 100

1 262

296

1 239

2 1 Nonemployees 2 6 22 2 6

Total 5 8 103 263 2 98 240 8 :23 2

11

6

Palo Seco Leper

Asylum.

Employees 1 32

1 3

11 4 Nonemployees 1 3 6 34 Total 1 33 1 14 3 10 2 84 Taboga Sanitarium. Employees 57

5

... 3,191

761 3,164

756

332... 51 Nonemployees 8 Total 62 ... 3,952 3,920 35

577

10650

59

_ Grand total: Employees

Nonemployees

Insane

405

103

28

45314,868

143 3,521

218 47

10,968 2,581 252

79

56

3

31511,45210,137

330 3,341; 2,111

31 31 122

3,360

99

10

382 392 128177 31267

Total 536 81418.436 13,801 1381676' 14. 824' 12. 370 3,469 733 541836

1 '

1 Consolidated Sick Camp Report,

stations.

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

Re- maining Dec. 31. W. C. W. C. w: C. W. C. W. C. W. C.

Ancon 8 3 463 396 460 382 11 17 Balboa

Corozal 1123

'3'7

23

8

4

5

78 689

550

212

503 326

569

464

176

468 544

......

1,913 309

42929

103

150 568

667

355

659

692

462 545

590

533 1,152 302

99

51 521 397

186 326 265

445

367

138 347 410

86 465

524

290

333 545

386

430 455

417 907

236

28

167 14726

17154 12398

38

114 129

"'672' 96

11345

64

103 14565

323

150

74 109 126

122 243

70

42

1,062 338 155

1013

Miraflores Pedro Miguel

Paraiso

... 3

9 35

2 Culebra 1 1 7

73

1

"s10

5 Empire 5 Las Cascadas Bas Obispo

Gorgona

3

2

3

3

1

38 San Pablo 15

12

44

2

19104

1

6 Tabernilla 6

Frijoles

Bohio 1 Gatun 4 3,120 1

1

1

1,235 2,068

211 1 613 319 ! 434 25 1 150 96 156

102

4

8

Cristobal 951 9 Porto Bello Nombre de Dios

8 593

159

172

1 7 Toro Point 2 3 Total 38 91 7,826 12,165 2 13 5,800 8,936 1,996 3,231 66 76
29

Consolidated Report of Employees Sick in Quarters.

Stations.

Ancon

Balboa

Corozal

Miraflores Pedro Miguel...

Paraiso Culebra

Empire

Las Cascadas... Bas Obispo

Gorgona

San Pablo

Tabemilla

Frijoles

Bohio

Gatun

Cristobal Porto Bello Nombre de Dios Toro Point

Total

Days excused for quarters.

White. Colored.

736 423 466

109 733

710 1,057

1,616 835

452 2,898

233 306

69

26

1,975 3,664

479

126 274

17,187

45

New patients excuse(i for quarters.

5740

8

16133

3

14

738

2

3,806

272 242 4,755

White. Colored.

297

314 254

74 383

251 462

590

301

156 1,42289

13228

13 975

1,631 275

76 188

7,911

43

42

13

6

83

14

1

1347

6

1 799

130

189 1,378

Consolidated Hospital, Sick Camp, and Sick-in-Quarters

Report.

Remain-'

ing

Jan. 1.

W. C.

Admitted. Died.

W. w. c.

Dis- charged.

Vi.

Transferred.

W.

Remaining Dec. 31.

W.

Hospitals.

.

Sick camps

Total

536' 814 18,43613,801

38 91 7,826

574, 905 26,262

12, 165 138

2 25,966 140

676

13 14,82412,370 3,4691 733

5,800! 8,936 1,996 3,231 689 20,624 21,306 5,465

54166 83676

3,964 607 912

Total admissions to hospitals and sick camps

Number of employees sick in quarters Total Less number of patients transferred from sick camps

to hospitals, and from hospitals to sanitarium,

whose adm^lssions are duplicated in above figures.

Net admissions to hospitals and sick camps, and those sick in quarters '.

White.

26,262

7,911

34, 173

5,465

28,708

Colored.

25,966

1,378 27,344

3,964

23,380

Total.

52,228

9,289

61,517

9,429

52,088
30

Consolidated Dispensary Report.

Employees. Nonemployees. : Total.

White. Colored. White. Colored. | White. Colored.

Ancon 6,909

12,330

8,965

9,062

15,285

4,858

22,404

17,578

11,192

18,707

25, 125 7,193 7,499

1,703 372

36, 790

20, 182 9,223

1.163 3,854

11,838

16,394

5,809 10,955

13,242

3,870

19,277 20,946

7,623

16,381 22,807 6,692

7,415

7,109

4,392

46,064

22,405

12,262

2,780

3,972

2,207

2,921 2,666

207 2,137 2,930 9,352

9,146

5,881 3,110

7,409

851 1,540

22

106 3,577 6,910

242

31 117

1,868 ' 9,116

1,270 i 15,251 508 11,631

467 ' 9,269

1,268 1 17,422

1,283 7,788

7,252 31,756

6,390 26,724

3,274 17,073 2,146 21,817 4,785 1 32,534

1,382 8.044

13,706 Balboa 17,664 Corozal 6,317 Miraflores Pedro Miguel

Paraiso

11,422

14,510

5,153 Culebra Empire

Las Cascadas Bas Obispo

Gorgona

26,529

27,336

10,897

18,527 27,592

San Pablo 8,074 Tabernilla

Frijoles

Bohio

Gatun

Cristobal

1,499 334

3,097

2,263 4,189

261 2,021

66

9,039

1,725 478

40,367 27,092

9,465

1,194

3,971

8,914

7,443

7,489

48,327

26,594 Porto Bello Nombre de Dios... Toro Point

12,523 4,801 4,038 Total 240,394 262,233 61,362 45,623 301,756 307,856

Average Number of Employees Constantly Sick in Hospitals,

Sick Camps, and Quarters.

Hospitals.

White. Colored. Total

Ancon Hospital Colon Hospital Culebra Hospital Palo Seco Leper Asylum

Taboga Sanitarium

Total

316. 02

117. 13 .09

.17 66.32

499. 73

370. 37

139. 73 .09

.73

510.92

686. 39 256.86

.18 .90 66.32

1,010.65

Sick camps. Sick in quarters.

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

Ancon 3.08 2.47 5.55 2.02

1.16 1.28

.30 2.01

1.95 2.90

4.43

2.29

1.24

2.02 Balboa .12 1.28 Corozal .33 4.22 5.36 L91

4.27

2.96

5.21 4.78

.67 3.35

5.81 3.02

4.00

5.59

4.37

6.19

1.00 7.57

11.17 4.93

8.27

8.55 9.58

10.97

1.28 Miraflores .16

.11 .02

.44

.09

.01

.46 Pedro Miguel

Paraiso Culebra

2.12

1.97 3.34 Empire 4.52 Las Cascadas Bas Obispo

2.30

1.24
31

Average Number of Employees Constantly .Sick in Hospitals,

Sick Camps, and Quarters—Continued.

Sick camps. Sick in quarters.

White. Colored. Total. White.

7.94

.64

Ck)lored.

1 Total.

Gorgona San Pablo

1 34 r^Or, e, m 7.94 5.46 <i-4.T 11.91 .64 Tabernilla

Frijoles 4.86 10. 4-1 15. 30 . 84

1. 23 1. 23 . 19 .44 .44 i .07 19.04 31.40 5.41

.01 .20 .02

.01

10. 43

.85 .39 Bonio .09 Gatun 12.36 5.42

Cristobal Porto Bello

2.91 8.88 11.79 | 10.04

4 25 4.58 8.83 1..31 20.47

1.31 Nombre de Dios... Toro Point

.19 1.21 1.40

3. 78 5. 43 9. 21

.35 1.80

.75 1.59 1.10 3.39 Total 67.27 98.42 j 165.69 48.17 13.96 62.13

Average Number of Employees Constantly Sick.

White. Colored. Total.

Hospitals 499. 79 510. 92 1,010.65 Sick camps 67. 27 98. 42 165.09 Sick in quarters 48.17 13.96 62. 13 Total 615. 17 623.30 1,238.47

Average Number of Employees Constantly Sick peR 1,000.

White. Colored. Total.

Hospitals 38.38 5.16

3.70

13.52 2.61

.37

19. §9 Sick camps 3.26

1.22 Total 47.24 1 10. .50 24. 37

« Average Number of Days' Treatment per Employee in

Hospitals, Sick Camps, and Quarters.

Hospitals.

Ancon Hospital Colon Hospital Culebra Hospital

Palo Seco Leper Asylum.

Taboga Sanitarium"

White. Colored.

Total.

13.59 13.34

8.00

61.00

7.57

12.25

16.24

18.90

16.00

67.75

16.91

Total.

14.90

15.88

10.67 83.00

7.57 14.23
32

Average Number of Days' Treatment per Employee in

Hospitals, Sick Camps, and Quarters—Continued.

Sick camps. Quarters.

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

Aneon 2.39 2.26 2.35 2.48

1.35 1.83

1.47

1.91 2.33 2.29 2.74

2.77 2.90

2.04

2.62

2.32

2.46

2.00

2.03 2.25

1.74

1.66 1.46

... 2.48 Balboa 1.05 1.31 Corozal 1.51 2.24

3.60

3.29 3.14

3.39

3.34

3.75

1.64

2.15 3.17 3.09

1.60 2.20

3. 36

.*?.17

1.83

Miraflores 1. 36 1. 43 Pedro Miguel

Paraiso

3.08 1.95

1. 33 2. 79 Culebra 2.22 2.62

2.94 I 3.08

3.44 I 3.39

4.17 3.98

3.29 3.17

4.37 i 4.35 3.31 i 3.31 1.46 1 1.46

1. 94 2. 23 Empire 2.36 2.73 Las Cascadas Bas Obispo

3.00 2.77 2.90 Gorgona 2.78 2. 04 San Pablo 4.33 3.29

1.00 ' 2.60 Tabernilla 1.33 2.30

Frijoles 1.55 1.89 Bohio 1.00 Gatun 2.37 Cristobal 3.46 Porto Bello 1 3.58

1.58

2.22

3.41 2.83

2.77 2.96

1.58 2.28 3.42

3.15 2.70 3.14

1.33 1.79 2.00 2.02

4. 76 3. 07 1.74 Nombre de Dios... Toro Point

Total

2.34 3.452.09 [ 1.93 1.52 1.37 3.02 2.83 2.90 2.17 3.45 2.36

Subsistence and Operating Expenses.

SUBSISTENCE EXPENSES,

Number of days' rations issued to

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

.

OPERATING EXPENSES. Number of days' relief furnished patients Cost of operation Cost per capita per day

Cost of operation with amount received from outside patients deducted

Cost per capita per day with above

deduction

Cost of dispensaries

Hospitals.

565, 124

$145, 289. 01

$0. 257

565, 123

$705, 550. 19 $1.25

$587,278.83

$1.07

$170, 270. 12

Sick camps.

57, 976 $14,114.17

$0. 243

57,976

$25,921.33

$0.45

$25,921.33

$0.45

Total.

623, 099

$159, 403. 18

$0. 255

623, 099

$731, 471. 52 $1.17

$613,200.16

$0.98
33

Outside Patients Treated in Hospitals and Amounts Collected FOR Their Treatment.

Number

of cases

treated.

Patients for whom the Republic of Panama pays i 75 cents per day 2, 372 Patients for whom the Canal Zone government

pays 30 cents per day i 353 Patients paying 30 cents per day for themselves.

.

1,944 Patients from the Republic of Panama paying

other prices 1 1, 195 Patients from the Canal Zone paying other prices. 2, 959 Patients from the Canal Zone not paying [ 2, 672 Patients from the Republic of Panama not pay- j ing i 698 Total I 12, 193

Number

of days' I Amount,

relief. I

66,875

8,925

20, 355

10,622

22, 368

53, 575

10, 572

$50, 214. 50

2,669.40

6, 106. 50

22, 112. 30

31,367. 75

193,292 ! 112,470.45

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 Hand

Thigh

Leg

Foot

Digits, multiple

Thigh, double

Leg, double

Arm and leg

Operations on bones: Craniectomy, decompressive

Craniectomy, exploratory

Laminectomy

Ostiectomy .

." Resection of wrist Resection of hip

Wiring of fractures

Simple

( 'ompound

Adenectomy:

Cervical Axiallary

Inguinal

Single

Double : Femoral

Herniotomy:

Inguinal

Single

Double

Femoral

Ventral Combined (any two of the above)

Strangulated

18

420

28

763

1

1

1

18

2

5

29

2

1

36

25

27

13

43995

22

168

111

527

3

4

1

i6

4

1

14
34

Surgical Operations Performed ix Hospitals—Continued.

Genitourinary tract: Nephrotomy

Nephrectomy

Nephropexy

Perinephritic abscess, drainage of Urethrotomy—

Internal External

Prostatectomy

Variocele, radical cnre Hydrocele—

Single, radical cure Double, radical cure Orchidectomy

Epididymotomy

Vasectomy

Amputation of penis

Amputation of penis and scrotum

Curettage uteri Perineoplasty

Trachelorrhaphy

Vaginal sections Vaginal punctures

Obstetrical: Cyesa^ian section, abdominal

Accouchement force High forceps

Low forceps Version.. Perineorrhaphy

Thorax:

Thoracotomy

Thoracoplasty

Excision of breast Excision of breast and axilla Gunshot wound of chest, operation for Stab wound of chest, operation for Rectum:

Hemorrhoids, radical cure

Fistula in anus, excision of General: Thyroidectomy Nerve stretching

Aneurismorrhaphy

Varicose veins, excision of Tenorrhaphy

Myorrhaphy

Excision of surface neoplasms

Gunshot wound of soft parts, operation for .

Stab wound of soft partes, operation for... Extensive injuries to soft parts, operation for Plastic operation for

Congenital defect Severe injuries Effects of disease

Sivin graft . Laparotomy:

For general peritonitis For tuberculous peritonitis For intestinal obstruction Exploratory

Gastrotomy

Gastro-enterostoray

Enterectomy

Enterorrhaphj^

Number. Died.

3 1 2

12

47

65 1 5

9 42

8522

22

332

2

2 134

3118

49

(i 1

3 2 5

68

6 2

54

15

145

1

1

14734 1

4

3

210

75

8

6

1 11

9 1 1319

5115 5

6 3 8 2 29 4

1 1 5

1 1 3 2
35

Surgical Operations Performed in Hospitals—Continued,

Laparot omy—Cont inued

.

Appendectomj'

Appendectomy with

Local peritonitis. General peritonitis

Csecostoray

Colostomy.

Sig^noidopexy

Cholecystotofny

Cholecystostomy

Cholecystectomy

Choledochotomy

Abscess of liver

Laparo-hepatotomy for Thoraco-hepatotomy for Splenectomy

Pan-hysterectomy

Supravaginal hj'sterectomy

Hj'steromj'omectomy

Myomectomy

Salpingectomy:

Single

Double

Salpingo-oophorectomy

Ovarian cystectomy

Oophorectomy .' Suspensio-uteri

Plastic operation for chronic pelvic peritonitis. For ectopic gestation For trauma:

General peritonitis

Hematoperitoneum

R upture of liver Gunshot wound of abdomen

Stab wound of abdomen

Major operations, various other Minor operations, various

Number. Died.

19325

17 1 8 1

1 1 3

5

63

1

12 4

11 5

16

1925

9

158

1414

1 4436 1 8

1 1 2

3 2

2 1

1 32 3

i 3,791 1 Total. 6,574 68

Operations and Work Performed in Eye,

Throat Clinics.

Ear, Nose, and

Operations.

Adenectomy

Adenectomy and tonsillectomy.

Adenectomy and tonsillotomy.

Advancement of internal rectus, Amputation of uvulva

Advancement of external rectus Cataract:

Discission of Needling

Curettage of middle ear Dacryocystotomy

Dilation of lacrimal stricture . .

.

Drainage of—

Frontal sinus Maxillary sinus Sphenoid sinus Enucleation

8

6

13

5

710

110
36

Operations and Work Performed in Eye, Ear, Nose, and

Throat Clinics—Continued.

Operations. Number. Died.

Evisceration

Excision, dermoid, cyst, upper lid Expression for—

Follicular conjunctivitis

Trachoma

Extraction of cataract Grattage of eyelids

Holsrath-Kuhnt operation for trachoma

Incision and drainage of—

Abscess, Calvarian Lacrimal sac

Incision of—

Dacryocyst

Funmcle, ear Larynx

Peritonsillar abscess Postaural abscess Retropharyngeal abscess Iridectomy

Lacrimal canaliculus incised Lacrimal duct probed

Mastoidotomy:

Simple . ." Radical

Meato-mastoidotomy

Ossiculectomy

Osteoplastic, nose

Paracentesis of

Cornea Membrana tympani

Paraffine prosthesis of nose

Plastic: On ear On eyelid

On lip On nose Pharynx

Pterygium

Removal of—

Bullet from ear Bullet from jaw

Bullet from nose Aural polyp

Cyst, ear Nasal polyp

Nasal spur Screw worm from nose Necrosed bones Uvula polyp

Sinusotomy, maxillary exploratory

Submucous resection of nasal septiun .

.

Suture, lacerated sclera Tenotomy

Tonsillectomy

Tonsillotomy

Transplanting operation for pterygium

.

Turbinectomy

Various other minor operations Total

Refractions Outside cases treated Grand total

11

15

6

9

11

1223

114

1 21

3

10

8

122

4

3

1025

1

5

19

110

1 32

13

132

16

11

1

1

1 173

1787

1724

16 986

1,721 2,240

14,662

18,523
37

Consolidated Ward Laboratory Report of All Hospitals.

Blood examinations 23, 269

Estivo autumnal 6, 634

Tertian

Single 1, 741

Double 164

Mixed tertian and estivo autumnal 280

Quartan 223

Lepra bacilli 2

Differential blood counts 1, 520

Leucocyte counts 2, 700

Red blood counts 329

Red and white blood counts 11

Hemoglobin estimations 547

Filaria 29

Spirilla obermeieri 3

Crescents 3

Guaiac and turpentine tests for invisible blood 71

Stool examinations 10, 218- Ascaris lumbricoides 574

Uncinaria ova 1 ^ 380

Uncinaria worms 163

Tricocephalus dispar 1, 065

Strongyloides intestinalis 393

Tenia 16

Tenia saginata 2 Ameba 361

Ameba coli 26

Ameba dysenteria 1 Ciliated monads 374

Bilharzia 10

Pus and blood 789

Pus and epithelial cells 53

Balantidium coli 12

Tubercular bacilli 22

Lepra bacilli 2

Bacilli coli 1 Oxyuris vermicularis 1 Entomaoba, hystolitica 5

Thymol treatments 26

LMne examinations 33, 354

Albumen .'

.

9, 357

Albumen and casts 5, 853

Sugar 123

Pus and blood 812

Gonococci 15

Hemoglobin 12

Bile '....'.'.'. 3

Diazo reactions 35

Microscopical examinations 782

Urea estimations 117

Dyslococci 2

Tubercle bacilli 10

Hemin crystals 30
38

Urine examinations—Continued.

Guaiac test 75

Glucose 3

Red blood cells 4

Sputum examinations 2, 615

Tubercular bacilli 288

Pneumococci 6

Miscellaneous:

Examinations of

Pleural effusions 1 Spinal fluid 27

Vaginal and urethral discharges 44

Pus, blood, and tissue 324

Various smears and discharges 133

Gastric analysis 45

ANCON HOSPITAL.

Class.

Isthmian Canal Commission employees

Panama R. R. employees

Pay patients

Charity patients Insane patients Total

Remaining

Jan. 1.

W. C

244 "49

5

197

713420

281218 326540

Admitted.

W.

8,120

369

1,727 227

47

10,490

6,537

1,814 850 548

252

10,001

Died.

W. C

89 427

Dis- ! Transcharged, ferred.

W.

5,445 238

1,608

19931

7,521

W. C

6.276 2,637

1,761 119 754 73 412 6 122 10

9,325 2,845

Remaining Dec. 31.

W. C

239

8

64

1931

1601 361

229

653533 267

629

Average number of days' treatment per employee for the

year:

White 13.59

Colored 16.24

Total 14. 90

Average number of employees constantly sick during the

year:

^\Tiite 316.02

Colored 370.37

Total 686. 39

Number of days' relief furnished patients 394, 703

Cost of subsistence per patient per day $0. 225
39

Nationality.

Class.

Isthmian Canal Commission

employees

Panama R. R. employees

Pay patients

Charity patients

Insane patients

Total.

Number

treated.

15, 098

2,254

2,660

800

545

Americans.

White. Colored.

3,446

179

1,070

160

9

21,357 4,864

16

17

Other nations.

White. Colored.

4,808

140

599

111

51

5,709

6,828

1,935

991

528

485

10, 767

Operations.

(See report of all surgical operations.)

Laboratory Report.

(See consolidated ward laboratory report.)

COLON HOSPITAL.

Class.

Remaining

Jan. 1.

W. C

Isthmian Canal Commission

employees

Panama R. R. employees . .

.

Private pay

Municipal pay

Zone charity 14 Total 142

12162

10

733 233

Admitted.

W.

2,661

523

533

9 164 3,890

1,792

821 479

43 388

3,523

Died.

W. C.

Dis- charged.

W.

29 70 2,1981,464

3 33: 405 631

54i 5171 414

10; 8 28

77 157 258

49 244 3,285 2,795

Transferred.

W. C.

Re- maining Dec.

31.

W. C

449 3161 74

120 1841 9 4 4i 24

8 46 10

581 5501 117

633517

1240

167

Average number of days' treatment per employee during

the vear: White 13. 34

Colored 18. 90

Total. 15.88

Average number of employees constantly sick during the

year:

Wliite 117. 13

Colored 139. 73

Total 256. 86

Number of days' relief furnished patients 125, 503

Cost of subsistence per patient per day $0. 266
40

Nationality.

Class.

Isthmian Canal Commission

employees

Panama R. R. employees. . .

.

Private pay

Municipal pay

Zone charity

Number

treated.

4,663

1,420

1,047

59

599

Total 7,788

Americans.

White.

1,278

287

309

170

1,945

Colored.

Other nations.

White.

1,339

193

223

598

1,858

Colored.

2,039

939

515

53

430

3,976

Operations.

(See report of all surgical operations.)

Laboratory Report.

(See consolidated ward laboratory report.)

CULEBRA HOSPITAL.

Class.

Remaining

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

W. C. W. C. W. C. W. C. W. C. W. C.

Employees 1417 3

100

1 262

2961 239

261 Nonemployees .... 2 22 2 6

Total 5 8 103 263 -i ' 98 240. 8 23 2 6

Average number of days' treatment for employee for the

year:

White 8. 00

Colored 16. 00

Total 10. 67

Average number of employees constantly sick during the

year:

White 09

Colored 09

Total 18

Number of days' relief furnished patients 3, 647

Cost of subsistence per patient per day $0. 261
41

Nationality.

Class.

Employees

Nonemployees

Total....

Number

treated.

6 373

379

Americans.

White. Colored

Other Nations.

White. Colored.

284

2 267

20 86 269

Operations.

(See report of all surgical operations.)

Laboratory Report.

(See consolidated ward laboratory report.)

PALO SECO LEPER ASYLUM.

RematQJan. 1. Class.

Admitted. Died. Dis- charged. Transferred. Remaining

Dec, 31.

1|W. C. W. C. W. C. W. C. W. C. W.

1

1

C.

1 1 21 L...

11 j.... 33 1

3

6 4

24

10

.... 3 .... 22

12

Total 1 14 .... 3 .... 2 34

Average number of days' treatment per employee for the

year:

White 6L00

Colored 67.75

Total 83. 00

Average number of employees constantly sick during the

year:

White 0.17

Colored -73

Total 90

Number of days' relief furnished patients 12, 302

Cost of subsistence per patient per day $0. 337
42

Nationality.

Number

treated.

Americans. Other nations.

Class. White. Colored. White. Colored.

Employees

Pay patients

5

28

16

1 4

1 27

•Charity patients 16

Total 49 1 1 47

TABOGA SANITARIUM.

Class.

Remaining

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

31.

W. C. W. C. W. C. W. C. W. C. W. C.

Employees 57

5

3,191

761

3,164

756

... 33

2

... 51

8 Families of employees Totals 62 3,952 3,920 ... 35 ... 59

Average number of days' treatment per employee for the

year 7. 57

Average number of employees constantly sick during the

year 66. 32

Number of days' relief furnished patients 28, 968

€ost of subsistence per patient per day |0. 625

Nationality.

Class.

Employees , Families of employees.

Total

Number

treated.

3,248

766

4,014

Americans.

2,036

743

2,779

Other

nations.

1,212

23

1,235

Note.—No colored patients treated at Taboga Sanitarium.
43

SANTO TOMAS HOSPITAL.

Class.

Re- maining

Jan. 1.

Admitted. Died. Dis- charged. Transferred.

Re- maining Dec. 31.

Pav natients 14 220

1,227

5,014

19 390

1,200

4,607 22 Charity patients 237

Total 234 6,241 409 5,807 259

Average number of days' treatment per patient 15. 22

Average number of patients constantly sick 259. 13

Number of days' relief furnished patients 94, 581

Cost of subsistence per patient per day $0. 314

Class.

Nationality.

Number

treated.

Americans. Other nations

Class.

"WTiite. Col- ored. White. Col- ored.

T*Q'\7' nofiPTitfi 1,241

5,234

298

935

943

4,299

Total 6,475 1,233 5,242

Operations.

Major

Minor

Total

Number. Died.

614 : 18

1,275

1,889 18

Dispensary.

Natives

Foreigners..

Total

White.

275

139

414

Colored.

707

225

932

Total.

982

364

1,346
44

BOARD OF HEALTH LABORATORY.

Bacteriological examinations:

Municipal water supplies 99

Water from

Streams and springs 27

Condensers 210

Reservoirs, creeks and rivers 8

Filters 13

Cultures from pustules of arm 1

Blood cultures 333

Throat cultures (diphtheria suspects) 193

Cultures from autopsies Ill

Cultures fi'om eye 6

Stools 382

Urine 359

Sputum 13

Pus : .-.-. 15

Testicle 1

Hydrocele fluid 2

Kneejoint fluid 11

Gall-bladder fluid 3

Spinal fluid 7 Various smears and specimens 81

Milk for tubercular bacilli 13

Soil for bacilli coli 12

Pleural fluid 1

Cultures from nose and mouth 14

Quinine tonic (new formula) 1 Blood . 1 Treponema palladium 2

Scrapings from hands 1

Joint fluid 1 Ulcers on buttock, etc 2

Cultures from operating room 6

Fluid from patellar bursa 1

Determinations

Chlorine content in water 15

Specific gravity of metal 1 Specific gravity of sea water 1 Examinations:

Leper suspects 47

Mosquitoes, identification of 2

Post-mortems

Calves 1 Cows 5

Horses 1 Mules 2 Rats and fleas 2

Dogs. . . J 4

Yaws suspect 2

Sections 14
45

Chemical examinations:

Blood stains 3

Stomach contents 18

Urine 54

Water, reservoir 8

Various liquids, fluids, etc 90

Water, for determination of dissolved oxygen 23

Various metals 6

Deposit on boiler 1

Agglutination reactions 240

Autopsies 712

Bodies embalmed 62

Hydrophobia, preventive treatment 4

Medico-legal post-mortems 3

Sections of tissue prepared

Frozen '104

Paraffin 7, 345

Surgical pathological tissue and neoplasms re- ported - 159

Vaccine inoculations, antityphoid 79

Vaccine treatment, autogenous 32

WaterMicroscopical examination of 69

Sanitary analysis of 122

Urinemeter calibrated 1 Microscopical examination of lesions on feet 1

Wasserman reactions 158

Note.—Studies in relation to malaria. Preparation of typhoid

immune serum. Investigation of cases of illness at Gatun. Sanitary survey of the villages of Chame and Chorrera. Efficiency

test of trapo-ratin. Study of an antocthonaus can of oriental sore. Investigation of reported outbreak of smallpox in the towns of Chitre, Los Santos, and Guarare, Republic of Panama. Report

on rats and fleas in their relation to bubonic plague.

ISSUES OF QUININE.

Months.

January

February

March

April

May

June

July

August

September

October

November

December

Total Average per month

Kilograms.

61.20

23.25 38.10

239. 60

29. 50

56. 50

1.56. 10 74.70

66.30

204. 00

49.00

48.50

1, 046. 75 87.23

Pounds

avoirdupois.

134. 92 51.26

84.00

528. 22 65.03

124. 56

344. 14

164. 68

146. 16 449.74

108. 03

106. 92 2,307.66

192. 31
46

iSANITATION—CITY OF PANAMA.

Anopheles brigade:

Linear feet of ditches cleaned 1, 336, 440

Linear feet of ditches dug 5, 300

Square feet of weeds and grass cut and removed. . . 1, 408, 390

Cesspools cleaned 271

Cesspools filled 63

Loads of refuse removed from the city 7, 584

Wells filled 8

Cubic yards of earth used in filling cesspools, wells,

and holes 883

Number of houses on which gutters have been cor- rected 331

Linear feet of gutters repaired or punched 15, 031

Linear feet of gutters removed 5, 118

Disinfection brigade:

Houses disinfected and fumigated for

Beriberi 15

Diphtheria 2

Malaria fever 1 Pernicious fever 10

Tuberculosis 50

Chicken pox 8

Mumps 1

Scarlet fever 2

At request of Panama Government 4

Leprosy 2

Houses disinfected for tj^phoid fever. 1 Houses fumigated for

Yellow fever 5

Measles 2

Number of cubic feet disinfected and fumigated. . . 4, 879, 895

Number of rooms fumigated and disinfected 1, 021

Material used:

Crude oil gallons.

.

6, 180

Larvacide do 9,470

Destruction of rats: Number of rats caught and killed 12, 846

Average number of rattraps in use daily 445

Poisons placed 3, 300

Inspection of houses and yards:

Houses and yards inspected ] , 552

Persons notified to keep premises in good condition. 674

Warning notices complied with 581

Number of letters to alcalde requesting enforcement

of sanitary rules and regulations 115

Number of shacks, stables, and old buildings con- demned and demolished 28

New buildings: Number of plans submitted to health

officer and approved 387
47

SANITATION—COLON, CRISTOBAL, MOUNT HOPE, TORO

POINT. ' Medical inspection:

Number of cases reported by medical inspectors. .. 94

Number of cases inspected 94

Number of cases sent to hospital 94

Water and sewers: Number of connections made during the year 69

Total number of connections made to date 615

Number of outstanding permits 254

Number of houses in which extensions were made 70

Houses:

Plans approved 67

Permits to repair issued 308

Permits to occupy issued 58

Temporary permits to occupy issued 15

Number of houses in which defective plumbing

fixtures were found and reported to the superintendent of public works 1, 692

Sanitation of Colon:

Average number of cans of garbage removed daily

.

2, 368

Number of

Loads of yard garbage removed 2, 706

Acres of vegetation removed 421

Acres of streets cleaned 2, 644

Private properties cleaned 4, 823

Squai'e yards of pools oiled 180, 150

Mosquito-breeding places found 2, 534

Dogs killed 5 Water receptacles treated 388, 260

Linear feet of ditches constructed 7, 060

Linear feet of ditches maintained 206, 124

Nuisances abated 6, 833

Buildings inspected 67, 070

Rats killed 157

Alleys cleaned 25, 219

Square yards of alleys cleaned 133, 325

Acres of streets sprinkled . 276

Crab holes worked 38, 200

Notice to abate nuisances served 8, 714

Colon and Cristobal garbage disposed of at the Ninth

Street dump.

Sanitation of Cristobal (including Beach Island):

Number of

Square yards of pools oiled 42, 490

W^ater receptacles treated 58, 840

Mosquito breeding places found 398

Crab holes worked 1, 800

Linear feet of ditches constructed 11, 383

Linear feet of ditches maintained 6, 044

Square yards of vegetation removed 383
4$

Sanitation of Mount Hope:

Number of

Square j'ards of pools oiled 393, 600

Water receptacles treated 360, 704

Linear feet of ditches maintained 244, 948

Crab holes worked 10, 200

Mosquito-breeding places found 1, 925

Linear feet of ditches constructed 20, 047

Mount Hope cemetery maintained.

Sanitation of Toro Point

Number of

Square yards of pools oiled 320, 470

Water receptacles treated 52, 213

Mosquito-breeding places found 1, 110

Linear feet of ditches constructed 39, 663

Linear feet of ditches maintained 42, 345

Square yards of vegetation removed 1, 325

Crab holes worked 3, 000

Doses of quinine tonic distributed 28, 505

Cubic yards of ditches constructed 1, 893

QUARANTINE SERVICE.

Ports of Panama-Ancon and Colon-Cristobal.

Number of vessels inspected and passed : 1, 186

Number of vessels detained in quarantine 10

Number of vessels fumigated on arrival (one disinfected) .

.

65

Number of vessels fumigated prior to departure 27

Number of pieces of baggage disinfected 1, 417

Number of crew inspected 96, 689

Number of passengers inspected v. 58, 796

Total number of persons inspected 155, 485

Number of persons vaccinated at ports of arrival because

of compulsory vaccination law 11, 437

Number of persons vaccinated at ports of departure or en route because of compulsory vaccination law 16, 094

Total number of persons vaccinated 27, 531

Number of persons held in quarantine at the detention

stations to complete period of incubation of yellow

fever or plague 4, 540

Number of persons held in quarantine on board vessels to complete period of incubation of yellow fever or plague . . 6, 041

Total number of persons held in quarantine 10, 581

Number of persons landed from foreign ports:

Cabin 19, 600

Steerage 21, 851

41,451

Number of persons embarked for foreign ports:

Cabin '. 17, 530

Steerage 17, 319

34,849
49

Apparent increase for the year from foreign ports:

Cabin 2, 070 ^^^^^^^ -A^ 6,602

Number of persons arriving from coast towns on small craft. 31, 039

Number of persons embarked for coast towns on small craft. 25, 151

Apparent increase for the year from coast towns 5, 888

Total number of persons landed 72, 490

Total number of persons embarked 60, 000

Excess over number embarked 12, 490

Less number for Pacific ports 2, 404

Total apparent increase for the year 10, tlob Number of immigrants recommended for rejection 116

Number of certificates issued to outgoing passengers 725

Number of persons refused certificates because of trachoma 74

Number of bills of health viseed 511

BOCAS DEL TORO.

Number of vessels inspected and passed 410

Number of crew inspected and passed 15, 882

Number of passengers inspected and passed ?' fnl

Number of passengers, in transit, inspected and passed . . 2, 103

Number of persons held to complete period of incubation

of yellow fever 1> ^74

PERSONNEL REPORT.

[Average number of employees at work during the year.]

Chief sanitary office ^^ Property division ^ Quarantine service ^ Health office, Panama Yd

Health office, Colon 11°

Aeon hospital 5o8

Colon hospital 171

Santo Tomas hospital 5

Taboga sanitarium 24

Palo Seco leper ayslum ^^14 Zone sanitation ^-52 Dispensaries:

Ancon ^ Balboa.

^ Bas Obispo ^ Bohio

^

Corozal ^

Cristobal ^ ° Culebra j^ Empire 1^

Gatun 1°

Gorgona ^
50

Dispensaries—Continued.

Las Cascadas 8

Miraflores 5 Nombre de Dios 3

Paraiso 5

Pedro Miguel 5

Porto Bello 5

San Pablo .• 4

Tabernilla 5

Toro Point 3

Total 1, 397

HOSPITAL CASES OF MALARIA AMONG EMPLOYEES.

Discharged.

Months.

W.

January j 229 February : 199 March | 263 April i 248 May j 268 June ! 629 July ! 828 August I 746 September I 476 October ' 364 November | 316 December 305 Total I 4,871247

159 267

189 344

624 919

675 404

253

241 253

4,575

Died.

W. C

13 28

Total.

Cases.

480

358 532

438

613

1,261 1,757

1,424 883

619 561

561 9,487

Annual

average

per 1,000 of deaths.

0.96

.00

.47 .22

.23 1.85 2.31

.71

.71 .49

.99

.74

.81

Annual

average

per 1,000 of cases.

11585 12597

139 290 406

337

211

150

139 139

187

Number

of employees.

49,961

50, 725 51,199

54, 293 52,863

51,767

51,871

50,638

50,207

49, 460 48,260

48, 386

50, 802 O




UNIVERSITY OF FLORIDA

3 1262 08229 055 1

SGWSSL