Citation
Report of the Health Department of the Panama Canal

Material Information

Title:
Report of the Health Department of the Panama Canal
Creator:
Canal Zone -- Health Dept
Isthmian Canal Commission (U.S.)
Place of Publication:
Washington, D.C.
Publisher:
U.S. G.P.O.
Creation Date:
October 1918
Publication Date:
Frequency:
quarterly[1918-Mar. 1919]
Monthly[ FORMER <Nov. 1904>-1917]
quarterly
regular
Language:
English
Physical Description:
v. : ; 20 cm.

Subjects

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

Notes

Issuing Body:
Reports for <Nov. 1904>-Mar. 1914 issued by the Isthmian Canal Commission.

Record Information

Source Institution:
University of Florida
Holding Location:
Centers of Excellence at UF
Rights Management:
This item is a work of the U.S. federal government and not protected by copyright pursuant to 17 U.S.C. §105.
Resource Identifier:
29940569 ( OCLC )
ocm29940569
25402441 ( ALEPH )
Classification:
W 79.12/5 ( sudocs )

Aggregation Information

DLOC1:
Digital Library of the Caribbean
PCM:
Panama and the Canal
IUF:
University of Florida
IUFGOV:
Centers of Excellence at UF
UFPANCAN:
Documents of the Panama Canal

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Full Text






REPORT
OF THE
DEPARTMENT OF HEALTH
OF THE
ISTHMIAN CANAL, COMMISSION
FOR THE
MONTH OF APRIL, 1905
W. C. GORGAS
Colonel, Medical Corps, U. S. Army
Chief Sanitary Officer
WASHINGTON
GOVERNMENT PRINTING OFFICE
1905







ISTUMIAN CANAL ZONE, DEPARTMENT OF HEALTH,
OFFICE OF CHIEF SANITARY OFFICER, Ancon, Canal Zone, May 25, 1905.
SIR: I have the honor of inclosing herewith sanitary report for the month of April, 1905. The report shows, in considerable detail, the amount of work done and the results accomplished thereby. I would like to call to your attention, however, a few points in particular.
The health of the employees continues unusually good. The number of employees on April 30 was not quite as many as the preceding month. On April 30 we had 9,100 men on the rolls. Of this number 338 were taken sick, which would give us an admission rate of 445.71 per thousand. During the. month we had 178 constantly sick, which would give us a constantly sick rate of 19.74 per thousand for the year.
Among these 9,100 laborers we had 12 deaths, an annual rate of 15.82 per thousand. The French during their first year had a death rate of 66.80 per thousand, a very favorable showing for our side.
The total population for the Zone, including Panama and Colon, is 39,684; of this population 165 died during the month, giving an annual rate of 49.88 per thousand. A comparison of the death rate of the population at large and that of the canal employees will show that the mortality among the latter is only about onethird of that of the population at large, and this is principally due to the sanitary precautions which were taken with regard to the laborers.
A great deal of alarm has been caused by an outbreak of yellow fever occurring during the latter part of April. The administration building, in which some 300 nonimmune employees are at work, became infected. Nine cases of yellow fever occurred during the month-2 in Colon and 7 in Panama. Of these 9 cases
3 died.
From July 1, 1904, to April 30, 1905, we have had 66 cases of yellow fever, all told, on the Isthmus. During this same period (ten months) we have had 8 deaths from this disease among the employees of the Commission. While any deaths from this disease are to be regretted, still such a number among so considerable a population does not count much in the mortality rate.
Very respectfully,
W. C. GORGAS,
Chief Sanitary Officer.
To the GOVERNOR, Canal Zone(3)




t




REPORTS FOR APRIL, 905.
VITAL STATISTICS.
Number of employees of Isthmian Canal Commission on
Isthmus -------------------------------------- 9,100
Number of employees admitted to hospital during April 338 Sick in hospitals April 30 --------------------------- 178
Constantly sick rate per thousand for April ------------ 19.74
Admission rate per thousand per year ----------------- 445.71
Number of deaths among employees on Isthmus during
April ---------------------------------------------- 12
Employees, annual death rate per thousand if rate keeps up 15.82 Population of Zone, Panama, and Colon --------------- 39, 684
Numberof deaths in this population during April -------- 165 Annual death rate per thousand ---_------------------ 49.88
SANITARY WORK IN PANAMA CITY.
[he street-cleaning work has been proceeding under rather trying circumstances, due to the tearing up of streets by the waterworks department. A good amount of work has been done, how ever. With a maximum of 50 men and a minimum of 24 men 1,055 loads of sweepings have been removed. The sweepings are being used to fill in the old gas tank at" Asilo de Bolivar,'" which was a breeding place for mosquitoes.
The garbage collection has also been impeded by the condition of the streets.
Seven hundred and ninety-six loads of garbage bave been removed during the month with a force of 25 men and 7 carts. Yard cleaning has gone on steadily, and all yards in the western and northwestern sections have been cleaned thoroughly. Five hundred and fifty-six loads of yard dirt have been carted away with a force of 14 men and 4 carts.
Seven cases of, beriberi were sent to Ancon, and the houses from which they were removed were thoroughly cleaned and fumigated.
Between 20 and 30 cases were sent to Ancon Hospital during the month, and Santo Tomas Hospital was inspected 23 times.
(5)




6
MOSQUITO WORK AND FUMIGATION IN CITY OF PANAMA.
Anopheles brigade.-Drainage work has been started near the Panama Railroad station and vicinity, as this region produces many anopheles, even in the dry season. A force of 10 laborers and 1 subforeman has been employed, and satisfactory results are being obtained. During the coming month a larger brigade will be employed, and as the rainy season advances the amount of work to be done will increase.
Stegomyia brigade.-The daily house-to-house inspection has been continued, and a total of 1,738 houses were visited by the sanitary inspector and foreman.
Two hundred houses were found to contain deposits of water in which mosquito larve were present. That is an average of 8.6 per cent.
Attention is called to the fact that the poorer houses generally have more deposits of water and hence more mosquito-breeding places. Some of the blocks in the city were found to be entirely free from mosquito-breeding places.
The house yards and balconies are all being carefully inspected .about every nine days for containers. The hotise tenants are being made to strain all water in small containers when larve are present. This is being done in the presence of the sanitary Sinspector.
It should be remembered that when I first took charge of the work, from Januarv 15 to 30, Stegomyia were found to be breeding in small 'containers and barrels in nearly all of the 'patios' in the city of Panama."
We have also had a force of carpenters at work making mosquito-proof covers for the tanks and wells inthat part of the city to the eastward of the Santa Ana Plaza, where the larger portion of the nonimmune people live and where most of the cases of yellow fever have occurred.
During the month 61 tanks and 120 wells have been made mosquito proof.
Also a large number of houses and wells, tanks, and other deposits have been oiled several times during the month.
Fumigation brigade-.The fumigation has been continued and every house in the city has been fumigated at least once. An average of 197 laborers were employed.
Also the fumigation has been extended out into the suburbs. After each house is fumigated, the floors of the rooms are at once liberally sprinkled and thna ne swept out.. After such treatment mosquitoes are hardly recognizable. The hoilses are all cleaned and all traces of the fumigation, paper, pasting, etc., removed.




Four hundred and sixty-nine houses were fumigated during the month, and such buildings as the canal building and the cathedral are classified as a single house.
A summary of the work done is given below:
Summary of work of anopheles brigade.
Ditches cleaned and regraded ------------ linear feet.. 1, 840
Ditches lined with stone and channels restricted,.do. -- .d- 318
Summary of work of stegomyia brigade.
Number of houses inspected ------------------- ---- 1,738
Number of tenants who were allowing mosquitoes to
breed in their houses ---------------------------- 200
Number of tanks made mosquito proof by sanitary
department ------------------------------------- 61
Number of wells made mosquito proof by sanitary
department ------------------------------------- 120
Summary of work of fumigation brigade.
Total number of houses fumigated ------------------- 469
Average number of houses fumigated per day 1-------8 Capacity of houses fumigated -----------cubic feet. 13, 181,360
Sulphur used ----------------------- ounds- 7,865
Pyrethrum used ---------------------------- do ---- 8,047
Alcohol used._..--------------------------- gallons - 125
Flour used ------------------------------- pounds. 3,900
Newspaper used -------------------------- do---- 4,000
Manila paper used ------------------------- reams - 30
Tacks used. ------------------------------ pounds- 31
Nails used.--------------------------------- do-.- 30
VITAL STATISTICS FOR PANAMAL.
DEATHS BY NATIONALITY.
Americans------------- 1 Panamans ---------------- 65
Chileans --------- --------1I Spaniards ---------------- 1
Chine ----------------- Venezuelans------------ 1
Colombians -------------- 5 West Indians ------------- 4
East Indians -------------1 Nationality not stated -------1
English -------------------1
French------------------1. 88
Mexicans ----------------- 2




8
DEATHS BY AGES.
Oto 1------------ -27 60to 70-----------------2
Ito 4------------.. .. 6 70to 80 --------- --- 1
4to10.-............ ,. 1 80to 90 ........,,,,... 1
10to20 ----------------- 2 90 to100---- --.. .. -. 1
20 to 30.-.._..-............. 16 Age not stated--.--.--,....... 1
30to40- ..... ...-.....,. . 10
40 to 50--.................. 13 88
50 to 60 --------- -7
DEATHS BY DISEASES.
I. General diseases.
Alcoholism --------- .---.--..-.... ................. .1
Alcoholism and nephritis. ..................................
Beriberi ---------- ------------- .................. 4
Cancer ------- --------------------------------2
Fever ----.. : ., . .. . 15
Fever------------------- ---------1
Fever, pernicious --- ------------------------------ 5
Fever, yellow -------------------- --------- ---------- 2
Malaria------- -------------------------- --------- 1
Phthisis ----- -----------------------------------Rheumatism -------- --------- ----------- --------Tetanus--- -------------------------II. Diseases of the nervous system and organs of special senses.
Apoplexy ------------ ----------- ----------------Meningitis ----------------------------------- 2
III. Diseases of the circulatory system.
Blood --------- --------- ........ .-------------Heart (m---------------------- ------1I
Pericarditis ---- ----------------------------------3
IV. Diseases of the respiratory system.
Asthma, infantile --------------- -------Bronchitis -- m-------------- ---- ------------------- 1I
Bronchitis, chronic ---------------------------------1
Bronchitis, tubercular- ------------------1
Congestion, pulmonary, sudden ------------ ...-.
Pneumonia ------ --- ------- -.. ,-------------5
Pneumonia, lobar--- m------------------------------Tuberculosis, pulmonary ------ ------------------------ 1




9
V. Diseases of the digestive system.
A bscess, liver -- . ---------------......................-. 1
Attack, liver --------- 2
C oli c -- - - - - - - - - - - - - - 6
D iarrhea I ..--.,.....--- ................ 2
D y sen tery -------------------------------------------------- 3
Enteritis, febrile. -- - - - - -- - - - -
Enterocolitis --- ------------ --------------- 3
Enterocolitis, acute ---------------------------------------- 1
Enterocolitis, chronic 1 - -- I Indigestion-------------------------------------------1I
VI. Diseases of the genito-urinary system and adnexa.
Nephritis, parenchymatous. ----------------------------- 1
Teething XI. Early infancy.. 1 T eeth in g ---------------------------------------------...... -,; i: : -. I
XIII. Affections produced by external causes.
Fracture of skull -- - -- - -- - -- - ----. 1
XIV Ill-defined diseases
A sphyxia 1-- - -- - - - - - - - -
Dropsy- - - - -- - - - -- - - --- 4
Pain on side 1-- - - - - -- - - - -
Sudden death --- - - - - - - - - - - 2
Stillbirth 4-- o -- 4
Total --- I - - - 92
Population of Panama--------- .......20,262
Deaths -------I------------------------------------- 88
Death rate per 1,000 per annum. ---------------------- 51.62
YELLOW FEVER.
During the month of April there were 7 cases of yellow, fever in the city of Panama. The first case occurred on April 17, and the others rapidly followed. Two of these cases died, both being employees of the Isthmian Canal Commission.
The cases in detail are as follows:
1. R. B. Ellicott, American, not employed by the Isthmian Canal Commission, taken sick April 17, reported and admitted to Ancon Hospital April 19, 1905. Recovered.
2. David Wilkes, Englishman, employee of the Isthmian Canal Commission, appointed in the United States, taken sick April 539A-07-2




10
24, reported and admitted to Ancon Hospital April 16, 1905. Died April 29, 1905.
3. M. 0. Johnson, American, employee of the Isthmian Canal Commission,' appointed in the United States, taken sick April 25, reported and admitted to Ancon Hospital April 27, 1905. Died April 30, 1905.
4. Charles Leask, American, not an employee of the Isthmian Canal Commission, taken sick April 15, reported and admitted to Ancon Hospital April 29, Under.treatment.
5. N. M. Barrett, American, employee of the Isthmian Canal Commission, appointed in the United States, taken sick April 28, reported and admitted to Ancon Hospital April 28, 1905. Under treatment.
6. A. Phillpotts, Englishman, an employee of the Isthmian Canal Commission, taken sick April 28, reported and admitted to Ancon Hospital April 29. Under treatment.,
7. Robert Stewart, Scotchman, employee of the Isthmian Canal Commission, appointed on the Isthmus, taken sick April 30,, reported and admitted to Ancon Hospital April 30, 1905. Under treatment.
Two cases occurred at Colon, J. T. McStarvich, American, not an'employee of the Isthmian Canal Commission, taken sick April 2, 1905. Recovered April 5.
John Wickham, nonermployee, taken sick April 28, admitted to Colon Hospital April 28. Recovered.
SANITARY WORK, COLON AND CRISTOBAL.
The work in Colon and Cristobal has been steadily pushed, and every effort is being made to get the town in good sanitary condition before the outset of the rainy season.
Rapid progress has been made in street cleaning and draining, and large amounts of trash have been cut and burned. One thousand seven hundred and forty-nine loads of garbage have been removed, and 120 loads of niglt soil. The slaughterhouse was visited nine times for purpose of examining cattle and hogs.
Seventy-six indigent sick were visited, and 12 post-mortem examinations were made.
WORK DONE DURING THE MONTH.
Hotels and restaurants inspected daily ------------------ 19
Number of blocks of street cleaned -------------------- 1,214
Number of lineal feet of drains repaired ---------------- 830
Number of lineal feet of new drains constructed --------- 000 Number of blocks of streets reopened, vegetation removed, and streets newly constructed -------- feet- 2, 100 Number of cartl6ads of garbage removed -------------- 1, 332




Number of railroad tanks oiled --------------------- 42
Number of lineal feet of ruts filled in- --------------- 250
Number of houses cleaned on account of municipality .. 162
NOTE.- Lands included within the Panama Railroad reservation were thoroughly cleaned of vegetation and sewered.
Special care was also taken with regard to cleaning and digging drains through the lower part of the city.
FUMIGATIONS.
Total number of houses fumigated ---- ---------------- 56
Total number of rooms in above houses ---.---..---1,246
Number of houses inspected ------------------------- 144
Number of barrels covered ------------------- ----- 203
Number of barrels uncovered -- ------------------- 524
Number of tanks covered---- --------------------- 31
Number of cubic feet in houses fumigated ----------- 743, 685
VITAL STATISTICS FOR COLON AND CRISTOBAL.
Estimated population of Colon and Cristobal 09,680 Number of deaths reported during month of April .-- 40 Death rate per 1, 000 per annum ----------------------- 49.58
MORTALITY.
I. General diseases.
9. Diphtheria ------------ -------- t.------------14. Dysentery----------------------------- ------------ 3
16. Yellow fever ------w---------- w---------------------- 1
27. Tuberculosis of lungs ----------- ---------------. 2
56. Alcoholism------------------------------------ 1I
36. Syphilis -------- ------------------------------------ I
II. Diseases of the nervous system.
61. Meningitis.---------------- w-------------------------1I
63. Other diseases of the spinal cord ----------------71. Convulsions ------------------------------------ 1
4. Intermittent and malarial cachexia --------------------- 2
Neuritis ------------------- --------------- ------1I
79. Organic disease of the heart --------------------------III. Diseases of the circulatory system.
None.




12
IV. Diseases of the respiratory system.
93. Pneumonia ---------------------------------- --------- 1
Phthisis t.-------- -----------------....... 3
97. Asthma -1 90. Bronchitis -------------------------1
V. Diseases of the digestive apparatus.
Gastroenteritis -------- ----------------------------1
Enterocolitis .. . ..---------------------------- ---------- 1
Bilious fever -------------------------------------- 3
Diarrhea --------------------------------------- 5
XIV. Ill-defined diseases.
Lumbricus ------- f-------------------------------------- 1
Dropsy -------------........ -----------------------------5
Stillborn -----.---------------------------------7.-------- 2
Total ---------------------------- .---------- 40
DEATHS BY NATIONALITIES.
Female. Total.
African ------ .-..........----------- 14 6 20
Colombian --------------------------- 0 3 3
Panaman -- ... .---------------------- 7 3 10
Santa Lucia --------------------------- 0 1 1
Antigua ------- 0 1
Barbados ----------- ----------------- 0
Portugal -------------------------------1 0' 1
Trinidad ..---------------------------- -1 0 1
Unknown ----------------------------- 0 0 2
Total ------------ --------------------------- 40
DEATHS BY AGES.
From 1 month to 1 year --- 10 From 40 to 50 years-----.. 2 From 1 year to 5 years 8 From 50 to 60 years-------- 2 From 5 years to 10 years -... 1 From 60 to 70 years --------- 2
From 10 to 15 years------. 0 Unknown and stillborn 4 From 15 to 20 years --------- 2
From 20 to 30 years --------- 6 Total ............. 40
From 30 to 40 years --------- 3




13
DEATHS BY COLOR.
White. Black. Unknown.
Male --------------------------- 2 24 0
Female .----------------------- 0 11 0
Unknown --------------------- 0 0 3
Total, 40.
REPORT OF ANCON HOSPITAL FOR THE MONTH. Number of patients in hospital first of month:
Canal employees -------------------------------123
Nonemployees ---------------------------------60
Panama Railroad employees ------------.----------- 6
189
Admitted during month:
Canal employees- ------------------------- 228
Nonemployees ----------.--- --------------- 51
Panama Railroad employees -------- -------- 13
292
Died during month:
Canal employees ----------------....... .... -10
Nonemployees ---------------------------------4
Panama Railroad employees ------------- .......- 0
14
Discharged during month:
Canal employees --------------.-------------191
Nonemployees --------- ------------------ 50.
Panama Railroad employees ----------- -......... 9
250
Remaining:
Canal employees --------------------------- 191
Nonemployees- . .--------------...... ----57
Panama Railroad employees .........----------- 9
257




14
DIED AND DISCHARGED.
Average number of days' treatment for each patient-..... 21.4
Medical cases ------------------------------------ 184
Surgical --------------- ----------------- --------- 72
Eye --------------------------------------------------8
264
Americans ------------------ ------------------- 49
Whites ------ -------------------------------------54
Negroes ---------------------------------------- 159
All others- --- ----------------- -----------------2
264,
DEATHS.
Causes of death:
Pneumonia, lobar -------------------........... .
Yellow fever ----------------------------------- 2
Anchylostomiasis ------------------------------- 2
Pericarditis ------- ------------------------- -- 1
Chronic suppurativenephritis ---------------------- 1
Asthma ------------------------------------------- 1
Capillary bronchitis --------------------------- -- 1
Abscess of liver --------------------------------Fracture of skull -------------------------------Senile debility. --------------------------------Total ----------------------------------- ---- 14
Admitted from .
Panama ---------------------------------------- 7
La Boca -------------------------------------- 3
San Pablo ---------------------------------------- 2
Bohio ------------------------------------------1I
CDulebra ----------------------------------------1I
Total ---------------------------------------- 14
Colombian ----------------------------------------- 3
Panaman -------------------- t --------------------- 2
American------------------------------------------- 2
West Indian.-------------------- i-------------------- 2
English ---------------------------------------------1I
Chilean -- - -- - - - - - - - - - 1
African--------------------------------------------- 1




15
Venezuelan---.-.--------- . ---------------------1
Hindoo -------------------------------1
Total ...---.. ... .----------- 14
Color:
Black.......... ... ... ........... .. ....... .... 9
White .... ..... -------------------...... -. 5
Total ---------------- ........ 14
I.C. C. employees ------------- .... ------------ 10
Nonemployees... ----------------------------------- 4
Total---------------- ------------------------ 14
OPERATIONS.
There were 58 operations during the month, of which the most important were forInguinal hernia ........ 5 Perineal urethrotomy------Inguinal hernia with appen- Hemorrhoids ------------- 2
dicitis ---------------- 1 Skin graft --------------- 1
Appendicitis -------------3 Sareoma, parotid ----------1
Adenitis inguinalis ...,... 6 Fracture base of skull ------1
Hydrocele ------ --------- Abscess of liver ----------- I
'Suspensio uteri- ...,'....., 2 Operations on the eye------Internal urethrotomy .. 2 .....
PRINCIPAL DISEASES.
1. Typhoid fever --------------------------------- 1
4. Malarial fever ------------------------------- 11
Estivo-autumnal ------------------ ----------- 37
Single tertian -------------- ........ -------Double tertian ------------------------------9
Quartan, double -------------------------67
14. Dysentery:
Amebic- ----------------------4 .. .....
Bacillary ------------------------- ---------- 2
Chronic 1-- - - - - - - -
Acute ------ M ------------------------------- 2
-9
16. Y ellow fever... .,.. .-- ..- .-- ........ .,. . 7
Beriberi----------------------------------------- 3
Febricula ------------------------------------- 3
Coryza --------------------------------------Dengue ------------------------------------------1I
Vaccinia-------------------------------------.... .1




16
27. Pulmonary tuberculosis --------------------------- 4
36. Syphilis -------------------------------------------- 5
37. Gonorrhea of the adult -----------------------------2
Gonorrheal rheumatism- -----------------------...... 4
Epididymitis --------------------------------------- 4
47. Rheumatism, acute ----------.------------------- 1
chronic ------------.------------ 3
4
56. Alcoholism ------------.----------------------. 1
57. Plumbism- ----------------------------------- 5
75. Diseases of the eye ----------.----------------------- 8
77. Pricarditis, purulent ------.---------------------------- 1
83. Hemorrhoids ------------------------------------------- 2
84. Adenitis inguinalis ---------------------------------- 1
90. Bronchitis --- ------------------------------- 6
92. Broncho-pneumonia ------..--------------------------- 2
93. Pneumonia ... . .. ..----------------------------------- 7
94. Pleurisy ----. ..-------------------------------------- 3
97. Asthma --------------------------------------- 3
101. Diseases of the pharynx --------------------- 6
104. Gastritis, acute -------------------- .-------------------- 2
106. Diarrhea, acute ----------------------------------- 7
chronic ---..--------------------------- 2
9,
107. Anchylostomiasis ------------------- ----------------- 5
108. Hernias -------- ---------------------------- 5,
112. Cirrhosis of liver ---------------.---------------- 1
114. Abscess of liver ---------------------------------------1
115. Splenomegaly -------- f ..------------------ ------- 1
118. Appendicitis --------------------------------------- 2
120. Nephritis, chronic --------- f ..------------------- 2
chronic interstitial --- ----------------chronic suppurative ------------------- 1
6
124. Stricture of urethra ----------------------------- 5
125. Prostatitis -------------------------------- ------ 1
126. Hydrocele ---------------- --------------............... 3
129. Sarcomyoma uteri ----------------- ----------- 1
130. Retroflexio uteri, ------ -------------- --------- I
145. Cellulitis and dermatic -------------------------- 6
ulcers -------------------------------- 5
1
154. Debility -------------. ..-------------------------------- 4
164. Fractures.- . . . .. . . . .. ..-. 1
164. Fracurs-----.------------------------------- 11
166. Wounds and contusions ----------------- ---------- 17 -




17
SUMMARY.
Re- ReClass. main- Admit ... Dis- maining ted. Died. charged. ing April 1. May 1.
Canal employees (from United
States) ------------------15 49 2 39 23
Canal employees, elsewhere 108 179 8 152 127 Panama Railroad employees 6 13 9 10 Pay'patients ----------------14 26 20 20
Panama charity ------------- 19 20 2 15 2.2
Zone charity -.----- 27 5 2 15 15
Total --------------- 189 292 14 250 217
Average number of patients in hospital each 'day, 199.33.
Number of patients treated in out-patient department, 253.
Cost of subsistence per patient for each day, 46 cents.
COLON HOSPITAL REPORT.
Cost of subsistence per capita per day, 39 cents.
Patients in hospital April 1 -. -------------- 62
Patients admitted during the month of April -------------- 142
Total treated during April ------------------------- 204
Patients discharged during April------------. ..... 137
Deaths during April ------------------------------ 9
Remaining in hospital April 30 ---- ------------------ 58
Total to be accounted for---------------------- --- 204




18
CASES CLASSIFIED.
Re- Re- Total Classfmain- Admit- Dis, otl
Class.' an Amt Dimed. main- treating ted charged. ing. ed. April 1.
Canal employees -------22 50 57 1 14 72 Railroad enmloyees 9 33 34 1 7 42 Pay. .--- -----------3 12 11 4 15
Colon charity ---------- 17 18 12 4 19 35 Quarantine ------------ ------ 3 3 ------ 3
Zone charity -----------11 26 .20 3 14 37
Total ------------62 142 137 9 58 204
NATIONALITY.
American. Other nations.
Class. -____ ___-____-__Number. White. White. Colored. Others.
Canal employees ---------72 25 1 46.--Railroad employees..... 42 5........37
Pay --------------------15 1 6 8.
Colon charity ------------35 2 3 29.--Quarantine -meri- h2 1o 1 Zone charity......... .37 1 2. 34.
Total --------- ----204 36 12 155 1
SPECIAL DISEASES TREATED.
Cases.
Malaria--------------------------------------------- 78
Dysentery ------------ ------------------------------ 4
Beriberi--------------------------------------------1I
Yellow fever --------------------ft------------------- 2
Pulmonary tuberculosis....................... .......4




19
DEATHS DURING APRIL.
Inflammation of the spinal cord ---------------------- 1
D ysentery . ..... . ... .. .. .... . ,
Dysentery------ -----------------------------------1
Malaria ------------------------------------------ .....
Pulmonary tuberculosis -------------------------------- 2.
Meningitis (Canal employee, negro) --------------Peripheral neuritis- ............ 1------------- 1
Total ....----------------------- ---------9
SURGICAL OPERATIONS.
Wiring fracture.--------------- --------- -----------Strangulated hernia, inguinal .---------------------Inguinal hernia ------ ----------- ----------- -------Suprapubic cystotomy -. -----------------------------Hydrocele ---------------------- m ------------------- 1
Gunshot wound (thigh)---------------------------Minor cases:
Amputation of finger ---------------- ------------- I
Resection of thumb -------------------------------- I
Circumcisions ------------------------------.---Abscesses (2 breast, 2 foot, 1 back, 1 hand)------------6
Fistula and ischio-rectal abscess --------------------Skin grafts -----------------------------------Total ---------------------------------------- 21
REPORT Or OUTDOOR DEPARTMENT.
. New Total
cases. treated.
Canal employees--------------------- ------ 138 142
Railroad employees-------- ---------------- 73 150
Nonemployees------------------------------ 66 84
Total---------------------- --------- 277 376
NUMBER OP VACCINATIONS IN CANAL ZONE DURING APRIL, 1905.
Gorgona-------------- ------------------------------ 79
Empire .--------m----------------------------------- 461
Culebra------------------------- ------------------- 205
Paraiso ---------------------------------------- --- 39




2o
Pedro Miguel ------------------------------------------ 14
Corozal ------------------------------------ ------- 77
Ancon -------------.------------- m.-----.------------ 18
L a B oca. .................................................. 145
Total ------------------------------------------ 1, 038
REPORT FROM CULEBRA HOSPITAL DISPENSARY.
REPORT OF PATIENTS IN CULEBRA HOSPITAL, MONTH OF APRIL, 1905.
Patients in hospital April 1 ---------.------------------8.8
Patients admitted during the month --------------------- 60
Patients died during the month *---------------------- 2
Patients during the month -----------------------. .42
Patients transferred during the month -------------------- .10
Patients remaining --------------------------------- ---- 14
NATIONALITY OF THE PATIENTS ADMITTED DURING THE MONTH.
Americans -------------------------------------------- 12
Arabians ------------.--------------------------.------- 1
Natives of tropical countries speaking English:
Colored ---. ..--------.------------------------------ 45
White ---------------------------------.. . .---- 0
Natives of tropical countries speaking Spanish:
Negroes .. . ..------------------------------- .------- 2
White -------.-------------------------------------- 0
Total ------------------------------------------- 60
REPORT OF OUTDOOR DEPARTMENT.
Number of consultations -------------------------......... 1 35
Number of individual patients -----------------------674
Sent to Ancon -----------.--------------------------- 27
Treated at Culebra. -------------------.-----------------.60
REPORT OF MIRAFLORES HOSPITAL.
Number of insane admitted during the month ------------- 18
Number of discharges during the month -----.-- ---------- 3
Number of deaths during the month ..---------------------1
Total number of insane remaining in the hospital- -.-7----.- 31 Total number of lepers -----.-----------.--------.--------9
Total number of patients in the hospital ------------------ 40




21
GORGONA.
This district now extends from Bas Obispo to San Pablo.
Malarial fever seems still on the decline, this month's report showing a percentage of 15.5 per cent against 22.3 per cent for March and 31.6 per cent for February.
The repairs to the hospital are about finished.
ACCOUNT OF WORK DONE IN GORGONA DISTRICT FOR MONTH.
Abscess ------------------ 6 Hepatic disease ----------- 4
Anemia -----------------2 'Herpes ................ 3
Ascaris lubricoides --------- 8 Hysteria----------------1
Boils ----------------- 8 Influenza ---------------- 10
Bronchitis -------------- 23 Malarial fever ------------- 79
Bubo, simple ------------- 4 Measles ---------------- 2
Burns ---------------- 6 Neuralgia -----------------10
Cardiac disease -----------3 Neuritis --------------- 2
Catarrh ----------------9 Nervous prostration -------1
Chancroid --------------- 2 Onychia-.......-1
Colic ------------------ 22 Piles ---------------- 1
Constipation., --------- 23 Phthisis--------------- 5
Cystitis ------------------ 1 Rheumatism ------------ 30
Dementia --------------- 1 Sprains ------ ---------- 8
Diarrhea ------.--------- 38 Syphilis --------------- 1
Diseases of the eye -------- 12 Tonsilitis ----------------- 3
Diseases of the teeth ------- 6 Ulcers- ------ ------- 15
Dislocation ....-.---------- 1 Uterine disease ----------- 3
Dyspepsia --------------- 29 Urticaria ...... ---------- 1
Eczema ..----------------- 8 Vaccine ulcers --------- 17
Epilepsy ..----------- 1 Vertigo ----------------- 2
Erysipelas --------------- 1 Wounds....------------ 62
Extractions -- --------- 6
Fracture ----------- 1 Total --------------- 484
Gonorrhea,--.-. ..... .2
This district includes the towns of Bohio, Frijoles, Tabernilla, San Pablo, and Gatun.
TOTAL TREATED IN DISTRICT.
Canal employees -- --------------------------------35
Nonemployees --- ------------------------------ 20
Railroad employees ---------- ------ ------ ------ 3
Total ------. ..-------------------.------------------------ 58




.22
Number of consultations............. ,.......... ........- 102
Number of cases treated in Bohio Hospital --------------Number of cases sent to Ancon. Hospital- ----------------1
Number of cases sent to Colon-- --------------------5
Deaths reported in district ------------------------------ 4
DISEA sEs TREATED..
BOHIO.
Bronchitis, subacute -------2 Lacerated wounds --------- 2
Confused wounds --------- 2 Malaria ----------------- 2
Contusion------------ 1 No diagnosis made-------- 5
Diarrhea ---------------- 6 Rheumatism ------------Dropsy --------------- 1 Sprained ankle andalcoholDysentery ---------,-1 ism ----- -------------Dyspepsia ---------------1 Syphilis ---------------Eczema ---. ------------- 1 Teething ----------------- I
Erysipellas---------------1I Tonsilitis------------- -----1I
Furuncles ------------ 1 Tropidal ulcer ------------1
Infected wound ----------- 1 Urethritis. --------------- 2
Indigestion---------------1I
Intestinal parasites -------- 2 Total ------------- 38
FRIJOLES.
Dermatitis -----------------------------------------1
Nephritis -------------------- -------------------Tropical ulcers ----------------------------------------1
Total ----------------------------------------- 4
GATUN.
Chondritis --------------------- ------------------Diarrhea --------------------------------------------1I
Malaria --------------------------------------------- 2
Ringworm ---------------------------------------- 1
Total -- ------------------------------------5AN PABLO.
Bilious ----------------- I Pharyngitis ------ I
Conjun'ctivitis ------------1 Syphilis -----------------1
Elephantiasis ------------1 I
Indigestion -------------- 1 Total--,-.6




23
TABERNILLA.
Chronic alcoholism ---------------------------- ---------- I
Dysentery ------------ ------------ ------------------3
Malaria -------------------- --------------------------1I
Total --------------------------------------- 5
Total in district ------------------------- -------- 58
DEATHS IN CANAL ZONE.
La Boca----------------- Gatun --------------- 3
Empire ----------------- 5 Tabernilla --------------- 1
Bohi ------------------ I Frijoles.----------------Culebra --------------- 2 Miraflores --------------- 1
Buena Vista --------------1 IGorgona ---------------- 4 Total ------------- 27
CAUSES OF DEATH.
Accident ------ --------- 3 Pneumonia --------------3
Anchylostomiasis---------2 Senility -----------------1 I
Assassination ------------- Ulcer------------------1
Apoplexy ---------------2 Unknown---------------3
Bronchitis---------------- Deaths in Ancon Hospital
Cerebral hemorrhage------ 1 of Zone patients -------- 7
Chronic nephritis --------- I Deaths in Colon Hospital of Drowning --------------- Zone patients ----------- 3
Heart disease -------------1I
Malarial fever ------------5 Total ----------- 37
Phthisis -----------------1I
Population of Zone ------------------------------ 9742
Actual death rate per thousand --------------------- 45.57
QUARANTINE TRANSACTIONS AT THE PORTS OF
ANCON AND PANAMA.
Number of vessels inspected and passed ----------------- 15
Number of vessels detained in quarantine ------------ ---- 0
Number of vessels fumigated -------------------------- I
Total number of crew inspected---------------------1, 355
Total number of passengers inspected:
Cabin ----------------------------- ----- 35
Steerage------------------------- ---------- 216
451
Number of persons vaccinated-------------------------.35
Number of persons held in quarantine at the -detention
house to complete period of yellow fever -------------- 5
. ...




24
Number of persons held in quarantine at the detention
house to complete period of plague _.---.-,..-.,--- .
Number of persons held under observation on board ship
to complete 5 days (Chinese) ------------------------ 6
Number of passengers landed at Ancon and Panama from
foreign ports for residing on the Isthmus:
Cabin ---------------------------------- 31
Steerage ------------------------------------ 53
- 84
DEATHS, BY COLOR.
Males. Females. Total.
White-------------- -----------------1 1---Black ------------------------------ 26 i2 38
Mongolian------------------------- I---- 1
Unknown----------------------------------- 1
Total--------------------------- 28 13 41
Cost of subsistence, per capita, in Colon Hospital during the month was 41 cents.
SUMMARY OF MARCH REPORT.
Patients in hospital March 1 --------------------------- 34
Patients admitted during March 130
Total treated during March ------------- --------- 164
CASES CLASSIFIED.
Re
Clas.main- Ad i- ReClas. in Ad- Dis-Died, main- Total.
March nutted. charged. ing.
Canal employees ---------9 45 32 0 22 54 Railroad employees --- 7 17 13 2 9 24 Pa ------------------ 0 11 8 0 3 11
Colon charity ---------- 12 29 21 3 17 41 Quarantine -------------1 3 4 0 0 4
Zone charity -----------5 25 17 2 11 30
Total ------------ 34 130 95 7 62 164




25
NATIONALITY.
Americans. Other nationalities. Class.
No. W. C. W. C. Others.
Canal employees-.... 4 21 1 5 27 0 Railroad employees ....- 24 1 0 0 23 0 Pay_ ... .......... 1. 01 0 0 5 6
Colon Charity ......... 41 4 0 11 25 1 Quarantine........... 4 1 0 1 2 0
Zone charity .... 30 4 0 7 19 0
Total_ ........164 31 1 24 101 7
RESUME OF WORK AT PORTS OF ANCON AND PANAMA,
ON THE PACIFIC, AND COLON, ON THE ATLANTIC.
Number of vessels inspected and passed ------------- 78
Number of vessels detained in quarantine ------- -------- 0
Number of vessels fumigated -------------------------- 4
Number of vessels partially disinfected........-.........-. 1
Total number of crew inspected ------------- ------4, 233
Total number of pa- sengers inspected --------------- 4,050
Number of persons vaccinated 54-----------------------Number of persons detained in quarantine at the detention
house ---------------------------------------- 6
Number of persons held under observation to complete
period of incubation of yellow fever (not in detention
house) --- -------------------- .............. ........ 102
Number of bills of health viseed ---------------------- 12
Number of bills of health issued ------------------------ 2
Number of circulars relative to malarial fever distributed .. 3, 720 Number of passengers landing from foreign ports:
Cabin ----------------- ....... .... 886
Steerage ... 2,515
3,401
Number of passengers leaving, for foreign ports:
Cabin ....................... --------- 588
Steerage---------------------------. 1 662
1,250
Number of persons arriving from small coast towns on small sailing vessels (steerage passengers) .........., ........... 1,504




26,
Number of persons departing for coast towns on small sailing vessels (steerage passengers) --------------------1, 036
Immigration for the month, foreign ports:
Cabin passengers ------------------- ------- 298
Steerage passengers ----------- ---------- 1, 853
2, 151
From coast towns on small sailing vessels:
Steerage passengers -------------------- -------- 468
Total immigration ---------------------------- 2,619
Number of certificates issued to outgoing passengers- --. ---193 Excess of immigration over emigration ... -------------- 333
During the month the construction of the detention barracks at Colon was started, and minor improvements have been made around the detention house at Panama.
SANITATION IN ZONE.
Work has been carried on at twenty-two different points in the Zone between La Boca and Gatun; draining, ditching, filling, cutting and cleaning brush and grass, collecting and disposing of garbage and night soil, fumigating, street cleaning, covering and oiling water containers, digging night-soil pits, building water-closets, etc. Especial effort is being made to complete drainage work and to abolish all breeding places of mosquitoes before the rainy season sets in.
Work done is as follows:
LA BOCA.
Brush cut and cleared ---------------square yards-- 60, 945
Old ditches cleaned and graded ---- linear feet- 4,040 Night-soil pails emptied ------------------- number. 48
Garbage cans emptied --------------------do --- 3930
Night-soil pits dug----------------------------------- 6
Closets constructed --------------------------------ANCON.
Brush cut and cleared -------------- square yards - 232
Grass cut and burned --------------------- do---- 514
New ditch dug ----------------------linear feet 96
Night-soil pails emptied -----------------number 279
Houses fumigated ------------------ I ------------ do-.---,
(Ward No. 11, and annex, Ancon Hospital.) (Cubic measurements, 42,720 feet.)




27
COROZAL.
Brush cut and cleared ----- ---------- square yards 20,000
Ponds and old ditches drained'. (average depth 2 feet),
area, square yards --------------------------------- 650
Swamp drained (average depth Ifoot) area, square yards 110,000 Ponds drained (averagedepth 11 feet)-- ,.do- 1 600 .Grass cut and burned- ---------------- ---- do 70, 100
Brush raked up and burned (cut last month). -do.---- 42,000 New ditch dug (average width on top, 3 feet; average
depth, 2 feet)--------------------- linear feet 2, 525
Old ditches cleaned and graded --------------do-- 600
Night-soil pails emptied ------------------ number - 450
Garbage cans emptied ---------------------- ---- 60
Houses, fumigated (cubic measurement, 44,000 feet),
number ------------------------------------------ 4
PEDRO MIGUEL.
Brush cut and cleared,----------area, square yards. 8,566
Old ditches cleaned and graded ----------- linear feet 2,505
PARAISO.
Bush cut and cleared --------------- square yards 668
Ponds drained, (average depth, 4 feet) ------------ --- 376
New ditch dug (average width on top, 4 feet; average
depth, 3' feet) ------------------------- linear feet-. 92
Old ditches cleaned and graded------------------ 1,052
Night-soil pits dug (and closets erected over them, 10 by 7
by 10 feet)---------------------------- number - 4
Garbage cans emptied ---------------------- do --- 249
Night-soil pails :emptied. ------------------------ 300
Water tanks and ponds have been kept oiled.
CUCARACHA.
New ditch dug (average width on top, 4 feet; average
depth, 3-1 feet)----------------------- linear feet 536
New ditches stoned ----------------------------- -- 536
Old ditches cleaned and graded ------- --------- o --- 252
RIO GRANDE.
New ditch dug (average width on top, 6 feet; average
depth, 4 feet) ---------------------- linear feet 350
New ditches stoned -------------------------do. do 350




28
CULEBRA.
Brush cut and cleared... ,- ...-,..--square yards., 1,100
Swamp filled in (average depth, feet),.......... do .-- 100
Swamp drained (average depth, 4 feet) --------do 88 New ditch dlug (average width on top, 4" feet; average depth, 4 feet) ---------------------- linear feet. 822
Old ditches cleaned and graded. ........... .do 19, 951
Night-soil pails emptied -----------------number.. 4, 740
Garbage cans emptied -........................ do ---- 2,935
EMPIRE.
Brush cut and cleared---------------square yards.. 55,185
New ditch dug (average width on top 2 feet; average
depth, 1 foot)_. ------------------ --- linear feet. 575
New ditch stoned --------- --------------- do ---- 10
Old ditches cleaned and graded -------------do ---- 5,488
Cleaning banks of rivers ----------------- square yards.. 6,464
Tanks oiled .... ------------- number..- 133
Barrels oiled ---------------------------------- do ---- 544
Filling holes ----------------- ------ cubic yards,.
LAS CASCADAS.
New ditch dug (average width on top 2 feet; average
depth, 2 feet)----------------------linear feet 1,535
Old ditches cleaned and graded --------------do ---- 950
Cleaning river banks ---------------- square yards.. 8,458
BAS OBISPO.
Brush cut and cleared ----------- ----square yards 3,898
New ditch dug (average width on top 1 foot; average
depth, 1 foot) ----------------------- linear feet-. 1, 995
Cleaning banks of Obispo River .. ..square yards 36,388
MATACHIN.
Brush cut and cleared...............---square yards. 36,150
Old ditch cleaned and graded ......... linear feet.. 4,200
Garbage cans emptied....... ............number. 176
BAS MATACHIN.
Brush cut and cleared...............square yards.. 29,390
Grass cut and burned ................. do.... 10,226
New ditch dug (average width on top, 31 feet; average
depth, 2 feet)......................---linear feet.. 86
Old ditches deepened (averagewidth, 2 feet; average depth,
I feet). ........--........ linear feet 500
Old ditches cleaned ......................_do....- 17, 830-




29
Night-soil pails emptied ---------------- ..... number., 480
Garbage cans emptied -----_------- ----------- do. -- 312
Tanks covered (average diameter, 5 feet) ---------- do 4
GORGONA.
Brush cut and cleared ----------- area, square yards ..12, 062
Grass cut and burned ---------------------......... do-- 4,065
New ditch dug (average width on top, 2 feet; average
depth, 1 feet)- --------------- linear feet. 375
New ditch stoned. ------------------------ do. 115
Old ditches cleaned and graded ---- ------------- do.--. 535
Old ditches (cleaned only) ------------------------ do... 14,280
Night-soil pails emptied ---------------------- number. 1,650
Garbage cans emptied --------------------------- do .... 2,424
Night-soil pits dug (and closets erected over each) do --- 2 Tanks covered (average diameter, 54 feet) -------do---- 6
MAMEI.
Brush cut and cleared ---_-------------- square yards. 24,133
Grass cut and burned --------------------------- do.. 12,105
Garbage cans emptied ---------------_------ number. 32
Night-soil pit dug --------------------------do--- 1
SAN PABLO.
Brush cut and cIeared ---------------.. -- square yards. 4,266
New ditch dug (average width on top, 15 feet; average
depth, 7 feet) ----------------------linear feet 340
New ditches stoned (average width on top, 7 feet; average
depth, feet) ---------------------- inear feet. 254
Garbage cans emptied --------------- ----number. 450
TABERNILLA.
Brush cut and cleared ---_-------------- square yards.,. 7,411
Swamp filled in --------------------------------- do. --- 2,400
Swamp drained -------------------------------- do. --- 1,500
Grass. cut and burned..-.----------------------do --- 16,510
New ditch dug (average width on top, 5 feet; average
depth, 2 feet) --------------------------- near feet.. 1,685
New ditches deepened ------ ---------------, do---- 1,150
Old ditches deepened (average width on top, 2 feet; average depth, 1 foot) ------------------- ft - linear feet.. 2,400
Old ditches cleaned and graded.--------------- do-..- 3,171
Garbage cans emptied ------------------------ number. 362
Springs boxed and cleaned-------_-------------.do-.-- 1




30
FRIJOLES.
Brush cut and cleared ------------------ square yards.- 50, 860
Ponds drained -----------.--------------------. .do- .... 360
New ditch dug (average width on top, 3 feet; average
depth, 1 foot) --------------------- linear feet. 4, 032
Raking and burning brush-----.------square yards. 43, 385
BOHIO.
Brush cut and cleared ----------------- square yards.. 86,079
Grass cut and burned ------------------------ do .-- 18, 426
New ditch dug (average width on top, 7 feet; average
depth, 2 feet) ------------------- -- linear feet.- 1, 356
Old ditches cleaned and graded --------------- do.---- 8,987
Garbage cans emptied --------------------- number. 900
GATUN.
Brush cut and cleared -----_---------- square yards.. 91,000
Swamp drained (average depth, l1 feet) ------ do-- 4, 250 Grass cut and burned --------------------- do-. 87,000
New ditch dug (average width on top, 2 feet; average
depth, 11 feet) ------------------------- linear feet. 11, 10
New ditches stoned ----------------------------- do..., 30
Old ditches cleaned and graded -------------- do. --- 1,170
Garbage cans emptied ----------------------- number. 160
Houses fumigated (cubic measurement, 9,000 feet) .do.... 1 Wire fence built about swamp ...............yards'. 100
Wire fence built about inspector's office..-....... do.... 75
Storehouse for oil constructed (32x9) ,..-.....,.number.. 1
Bridges built over ditches (12x6) ................ do. --. 1
Springs boxed and cleaned ...................do..... 1
Wells cleaned... --..--......................... do.... 1
Night-soil pits dug (I2x8x0 each) ............. do. ,.. 2
Pits boxed ............................... .do ...- 1
RECAPITULATION OF WORK DONE IN THE CANAL ZONE.
Brush cut and cleared..--.--....... .square yards.. 491,945
Swamp filled in.. ....-...:.............. do-... 3, 500
Swamps drained. -.. .................. do... -202,588
Ponds drained -................-.........do,... 1,386
Grass cut and burned -...-....'.....-....... do---- 218,94,6
New ditch dug..-....-.... -......, :.....linear feet.. 15, 975
New ditch stoned..,............. ....do. ... 1,295
Old ditches cleaned and graded. -.......-...do.... 85,471
Streams cleared of vegetation ...........square yards.. 51,310




Houses fumigated (cubic measurement, 95,700 cubic feet),
n u m b er --------------- .............. ... 6
Night-soil pits dug --------------------- number. 13
Closets erected over pits ---- ---------------- do - 7
Water tanks covered ---------------------. - ---do ---- 10
Water tanks oiled ----------------------------- do- - 133
Barrels oiled --------------------------------- do --- 554
Storehouses constructed ------------------------ do. -- 1
Bridges constructed ---------------------------- do I
Springs boxed and cleaned ------------------- do - 2
Wells cleaned _----------- .------------------- do 1
Brush collected and burned (cut last month) square yards 42,000
The average number of laborers working full time during the
month was 257 each day.
Total
Name. Number Total em- : salaries,
ployees. gold.
Chief Sanitary Office ------------------------ 9 $849. 62
Director of Hospitals ------------------------ 3 283.75
Health Department, Panama --------------- 362 9,451.60
Health Department, Colon ------------------ 135 2, 758.20
Ancon Hospital -----_---------------------- 266 8 123. 79
Colon Hospital ---------------------------- 77 2,017.55
Culebra Hospital ---------------------- - - 11 847. 16
Gorgona Hospital -------------------------- 6 345.00
Bohio Hospital ---------- ----- 2 45.00
Miraflores Hospital ------------------------ 21 509. 17
Taboga Sanitarium- ------------------------ -1 26.25
Quarantine Service ------------------------- 17 701.91
Sanitation, Canal Zone --------------- ----- 408 7602.71
La Boca Dispensary ------------------------- 1 150.00
* Total ------------------------------1 319 33,711.71










UNIVERSITY OF FLORIDA
32II 6 1I!J 111111 I09 II5
3162 09052 5022




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