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order and judgment as shall secure to the United States the title to the corporate stock and to the defendant or defendants just compensation for the property so taken and the title transferred and the judgment shall require payment to the dafendant or defendants or into court of the amount fixed as compensation before the United States can appropriate said stock to the public use. Upon payment by the plaintiff to the defendant or defendants, or deposit in court, of the amount of compensation as fixed by the judgment of the court and the deposit of a sufficient amount to be fixed by the court for the payment of the costs of the proceedings, the court shall enter final judgment and decree transferring the title of said stock to which the proceedings relate, from the prior owner or owners to the United States, and further ordering and decreeing the proper officers of the Panama Railroad Company to issue to the United States new certificates for the stock so transferred to the United States, and said court is hereby authorized to enforce such order by proceedings as for contempt. When the amount of such appraisal so determined shall have been paid or deposited, as provided in this section, the stockholder or stockholders whose stock shall have been so appraised shall cease to have any interest therein and shall surrender all certificates for such stock, with duly executed powers of attorney for tranfer thereon, to the United States. In case the compensation is deposited in court, the payment shall be made to the clerk of the court and shall be retained by him subject to the order of the parties entitled thereto upon the delivery to said clerk of the original stock certificates for the stock to which the proceeding relates. And the clerk of the court shall be compelled to receive such deposit of money and shall be responsible on bis bond therefor. If the judgment of condemnation shall be given as to stock which is subject to a mortgage, annuity, or other lawful lien, the amount of compensation shall be apportioned between the owner and the lien holder, as the court shall determine their several interests require.

Sec. 7. That to enable the United States to secure at all times a sufficient supply of money to meet the necessities of the Government on said Canal Zone, the President is hereby authorized to deposit such sum of money as he may deem sufficient for said purposes, not to exceed one million five hundred thousand dollars, of any sums appropriated for canal purposes, in some bank or banks in the United States having a fiscal agent on the Isthmus of Panama, to be selected by the President: Provided, That such deposit shall be on terms which shall preserve the title to said money in the United States, enable the United States to withdraw said funds from said deposit at any time, and proper and sufficient security be given by the bank of deposit for the return of said money or the lawful accounting therefor.

[S. R. 114, Fifty-eighth Congress, third session.] } JOINT RESOLUTION to continue in force the provisions of section two of "An

Act to provide for the temporary government of the Canal Zone at Panama, the protection of the canal works, and for other purposes,”' approved April twentyeighth, nineteen hundred and four.

Resolved by the Senate and House of Representatives of the United States of America in Congress assembled, That the provisions of section two of “An Act to provide for the temporary government of the

Canal Zone at Panama, the protection of the canal works, and for other purposes," approved April twenty-eighth, nineteen hundred and four, be, and are hereby, continued in force until the expiration of the session of the Fifty-ninth Congress beginning the first Monday in December, nineteen hundred and five, unless other provision be sooner made by Congress.


INSTRUCTIONS. You will proceed to Panama and investigate the sanitary conditions obtaining on the canal strip.

For any deficiencies, as measured by the standard of sanitary accomplishment in Habana in 1901, you will endeavor to fix the responsibility.

In so doing you will endeavor to ascertain to what extent any sanitary shortcomings which may be found to exist are due:

(1) To mistakes or shortcomings of the sanitary personnel.

(2) To defective organization of the sanitary department, including possible lack of sufficient autonomy.

(3) To lack of necessary cooperation or assistance in plans or supplies on the part of the Commission or its agents.

You will on your arrival report to General Davis, show him these instructions and call on him for whatever may be necessary in the way of information or assistance in obtaining the same.

Excepting General Davis, the chief engineer, and Colonel Gorgas, you will neither exhibit these instructions nor acquaint anyone with the true object of your mission.


Surgeon, U. S. Army, War Department, Washington, D. C.


Washington, February 17, 1905. The SECRETARY OF WAR,

Washington, D. C. SIR: I have the honor to report that in compliance with your instructions I sailed from New York for the Isthmus of Panama on January 24, and arrived there Tuesday, February 2. I again left Panama Thursday, February 9, having carried out the instructions confided to me.

In making this report I shall endeavor, as far as possible, not to go over again ground which is familiar to you and which is covered by official reports, except when necessary to elucidate my remarks.

The present condition of health of the canal employees is good; with a total of about 5,000 employees less than 3 per cent are in hospital.

With regard to the present outbreak of yellow fever, the following remarks are submitted :

The statistics regarding yellow fever in the city of Panama prior to American occupation show deaths only, as other cases were not reported : Deaths from yellow fever in Panama1901

11 1902

182 1903

48 In the first six months of 1904 (before American occupation) there were 6 deaths.

In the second six months of 1904 (after American occupation) there were 13 cases and 3 deaths.

In January, 1905, there were 18 cases with 6 deaths (including 2 on the Boston and 1 in Colon).

Of the total 33 cases, 30 originated in Panama, 3 in Colon.

Of the total 33 cases, 14 were American and 11 were canal employees.

There were no secondary cases, each focus of infection having been promptly stamped out.

The distribution of the Panama cases showed widely scattered infection; all the Colon cases originated at one hotel. The three Colon cases occurred on shipboard en route to Habana and in the persons of steamer passengers detained at Colon on account of smallpox. Had there been proper detention facilities at that point these cases should not have occurred.

The cases on the Boston are believed to have been due to a mild and unrecognized case having visited the ship on the occasion of an entertainment given there on the night of December 31, which was largely attended by nonimmunes from Panama. Yellow-fever mosquitoes were breeding abundantly on the ship and probably became infected at that time. The fumigation of the ship promptly stopped the outbreak.

While, considering the previous history of Panama in regard to yellow fever and the large influx of nonimmunes since July 1, the number of cases and deaths has been small, the outbreak becomes important on account of the effect upon public opinion in relation to work to be done on the canal.

The sanitary department of the Canal Zone government is subdivided as follows: A department of hospitals, a maritime quarantine service, a sanitary service for the Canal Zone, and the health departments of Panama and Colon.


This includes at present actually in operation the hospitals at Ancon and Colon and one emergency hospital at Calebra, the three having a total capacity of 254 beds, all of which are occupied. Additional beds are needed, to supply which the chief sanitary officer has asked for a 100-bed convalescent hospital at Taboga Island and another hospital of about the same capacity at Miraflores. The former has been disallowed for the present; the latter was authorized by Governor Davis about December 1, but through delay in construction and supplies it is not yet ready for use. The Commission has authorized construction at Ancon and Colon, which will give 600 beds, but there is no immediate prospect of the work being done nor any material or personnel available for utilizing them.

Along the line of the canal, at convenient points, are stationed four medical officers with medical supplies, each having charge of a district for emergency work among canal employees.

While the hospital department has about reached the limit of its present capacity, the sick are well cared for, though for lack of wire screening they are not adequately protected against malarial infection.


At Panama the arrangements, while not all that could be desired, are believed to afford adequate protection against the introduction of quarantinable diseases from without.

At Colon the arrangements are not so far advanced nor so satisfactory. Though plans have been approved for a detention building, construction has not been commenced. The surveillance of detained suspects at hotels, etc., is difficult and somewhat risky. Notwithstanding these shortcomings, which it is hoped to soon remedy, it is believed that the quarantine service to date has been effective and that no infectious diseases have been introduced through either port.

Immigration.—In this connection the laws of the Canal Zone provide that the chief quarantine officer shall prevent the entrance to the Zone of any person who is likely to prove a menace to the public health or welfare or who is likely to become a charge upon the public. Nothing, however, has been actually done under this law to restrict undesirable immigration.


This service, under a chief sanitary inspector, employed on January 31 about 275 men.

In general it is charged with the duty of cleaning up the settlements of laborers along the Zone, the removal of night soil and garbage, surface drainage, and other antimosquito work. A great deal of valuable work has been done

along the line, but much remains to be done, especially in the matter of screening the dwellings of the canal employees and covering their water barrels with wire gauze. No screening has been done, and while a large number of barrels in some localities have been covered and covers prepared for many more, the work is very far from completion, because no more spigots are available to permit the use of the water.

PANAMA HEALTH OFFICE. The chief sanitary officer of the Commission has been appointed by the Republic of Panama its health officer for the cities of Panama and Colon. In Panama he has taken charge of the matter of street cleaning, removal of garbage, and general antimosquito work on the lines of that carried out in Habana. Just now the whole city is being fumigated for the destruction of mosquitoes, and the work is expected to be completed by the end of the present month. The cleanliness of the streets, yards, and interior courts has been greatly improved.

COLON HEALTH OFFICE. Here sanitary work has been confined to garbage removal, a small amount of street cleaning, and a little oiling of water tanks; the results thus far are not very apparent, the city being in a very dirty and unsanitary condition,

In Cristobal, however, where most of the canal employees live, very much more has been accomplished in the way of surface drainage, removal of garbage, and night soil, antimosquito work, etc.

In making a comparison of sanitary accomplishment with that at Habana in 1901 the differences in condition must be fully understood. In Habana we had a compact city, with waterworks, which had been under American control for more than two years at the time the antimosquito work was begun; which had been thoroughly cleaned ; in which the health and other departments were efficiently organized, and with the chief sanitary officer possessing complete autonomy in the matter of construction, material, and supplies. In Panama everything was different. The sanitary work had to be done in two cities some 50 miles apart and along the intervening strip containing numbers of native villages. There was no organization anywhere, everything had to be started. The two cities at either end of the strip were without adequate water supply, without sewers, without organization of any sort for municipal sanitation, and in an extremely filthy condition. Being at the very commencement of a vast engineering enterprise in which sanitation was only one of the features, it was perhaps natural that it should receive only what was considered its due share of attention, instead of being the principal feature as at Habana.

Colonel Gorgas, the chief sanitary officer, arrived permanently on the Isthmus and began his work about July 1 last. The preliminary plan for sanitary work submitted by him was already in operation to a limited extent. In the months which have followed much has been accomplished as pointed out under the separate headings. In Habana in the same period of time yellow fever was wiped out; here it has not been, though I believe that end will soon be accomplished. In my opinion the diseases would have been eradicated before this time had it been found practicable to adopt in its entirety and carry out promptly the scheme proposed by the chief sanitary officer.

The two diseases which more than any others threaten the success of the canal project are malaria and yellow fever. While malaria is far more important in the amount of disease, death, and invaliding it is likely to cause on the Isthmus, yellow fever is no less important in its indirect bearing. While 50 deaths from malaria might occur without attracting much attention, one-tenth as many from yellow fever would cause a panicky feeling, which would keep away thousands of persons whose services are needed or cause them to demand much higher pay for their services.

In the preliminary plan of organization of the sanitary department submitted in April by Doctors Gorgas, Ross, and La Garde, and which in its general features was approved by the Commission and went into effect in July, 1904, it was proposed to keep out infectious diseases by a quarantine system, to get in touch with all cases of malaria and yellow fever by assuming charge of the sick at Panama and Colon and the canal strip, to detect them early by a system of inspection, and, by screening all acute cases and keeping others under treatment until they were no longer capable of infecting mosquitoes, to prevent the spread of these diseases.

On July 26 the chief sanitary officer, after two months' experience as such, submitted to the Commission a permanent scheme of sanitary organization and read to the Commission an explanatory statement which I deem of so much importance that it is hereto appended, marked "A." In this statement he takes the ground that the cities of Panama and Colon can and should be freed from yellow fever by January, 1905, and the Zone from malarial fever in the same period and before the arrival of the main force of canal employees, but that to accomplish such a result he must be able to work more rapidly than was possible with the delay in material, construction, etc., which had occurred and must occur under the present organization. He further stated that while the health conditions on the Isthmus, with its present small nonimmune population, were about normal, the conditions existed which, if not radically changed, would in time give us the heavy mortality of the French régime. He suggested a remedy in the shape of greater autonomy, with a view to more rapid work, his idea being that the great work of the sanitary department should be done before the active work began in digging the canal. The scheme of organization submitted was an exceedingly able and comprehensive one, and if carried out in its entirety would no doubt have accomplished all that its author hoped for.

To control malaria and yellow fever, besides the general features already outlined, he provided for treating all the sick of the Canal Zone and for the administration of quinine to all those infected with malaria, even though not sick, and this for both employees and nonemployees. This plan, with the antimosquito work, would probably have eradicated these diseases. The plan provided for 20 small emergency hospitals, with dispensaries attached, and 20 sanitary inspectors, with the necessary subordinates, distributed in the villages along the Canal Zone, the inhabitants of which were proven to be widely infected with malaria and ready to infect, through the mosquito, the employees of the Canal Commission.

The action taken on this proposed plan and the organization finally adopted is shown in the proceedings of the forty-second meeting of the Isthmian Canal Commission, dated August 28, 1904. In a general way the proposed organization was adopted, but the details were modified in certain very important particulars. The idea of the Commission seems to have been that conditions should be met as they arose, while the vital point in the plans of the chief sanitary officer was prevention rather than cure.

Instead of 20 emergency hospitals and dispensaries and 20 hospitals along the Zone, 3 hospitals and dispensaries, 2 additional dispensaries, and 8 inspectors were allowed, with the proviso for extension when deemed necessary by the Commission. No reference was made to the plan of treating with quinine all the inhabitants of the Zone infected with malaria, and this recommendation was subsequently disapproved by the Commission under date of November 5, 1904. On December 21 the chief sanitary officer explained the importance of this provision in a letter to the Commission, in which he stated that if it was not allowed his ability to combat malaria would be reduced one-half.

In regard to assuming complete sanitary control of the cities of Panama and Colon there was certain legal difficulties of which you know and which were not settled until very recently.

Thus the success of the scheme for the prevention of malaria has been seriously endangered by doing away with one of its most important features, that of treating with quinine all persons dangerous to others by harboring the malarial parasites in the blood. (See Appendix C.) That part of the scheme which provided for the protection of the canal employees by screening their dwellings appears to have received no definite action; nothing has been done toward carrying it into effect.

The defects in the sanitation of the Isthmus, then, are, in my opinion, as follows:

1. Inadequacy of the scheme for the protection of the canal employees against malaria. The scheme as submitted by the chief sanitary officer was adequate, but its modification by the Commission in cutting off the free issue of quinine, not authorizing the screening of the dwellings of canal employees along the strip, and reducing the number of physicians, hospitals, and dispensaries along the line has diminished its value at least one-half.

2. Defective organization of the sanitary department in the lack of sufficient autonomy to carry out its work effectively.

Under the first heading no serious results have followed as yet, but that they will follow all tropical experiences of like undertakings certainly indicates. Under the second heading the result has been to greatly delay the work of the

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