the supervision of the superintendent. One of the old ward buildings was reconstructed and fitted up as an infirmary, operating room, and dispensary, thus providing accommodations for the most serious cases requiring the constant care of an attendant. A new well for water supply for the asylum has been sunk to a depth of 147 feet, providing an ample supply of water.

SANTO TOMAS HOSPITAL.

This hospital is owned by the Government of Panama, but is operated under the supervision of the health department of The Panama Canal, the canal furnishing, at its cost, the superintendent, 2 physicians, 1 interne, and 3 nurses. The present building is inadequate in size and arrangement, and there is a great necessity for a separate building for tuberculosis cases. The Panaman Government is now considering the project of building a new hospital in the exposition grounds and abandoning the present hospital group. This is very desirable, but in the meantime there is urgent need for temporary alterations and additions to the present hospital.

DISTRICT DISPENSARIES.

Five dispensaries, not including those at Ancon and Colon Hospitals, have been maintained throughout the year. A new dispensary building of permanent type is nearing completion at Pedro Miguel; the concrete dispensary building for Gatun has been authorized and will be constructed during the coming year.

SANITATION.

Besides the maintenance of sanitary work in and around the towns in the Canal Zone, there has been extensive sanitary work done in the Mount Hope-Cristobal district. This district was formerly a center of malarial infection, and the keeping down of mosquitoes by temporary ditching and by spraying with oil was expensive and in*ffective. The swamps have been reclaimed and graded by fill pumped from hydraulic dredges. The result of this work is the almost complete disappearance of the Anopheles mosquito and the practical elimination of malaria from employees living at the Atantic terminal. Fill of a similar kind and for a similar purpose s nearing completion in the swamp areas between the old and new Ancon-Corozal roads.

A model oil-burning incinerator of 120 tons daily capacity is being erected on Gavilan Island, where it will serve the districts of Ancon, Balboa, and Fort Grant, as well as the city of Panama. The abandonment of the present insanitary garbage dumps will materi

ally reduce the fly and rat nuisance. A similar incinerator, of smaller capacity, has been authorized and will be erected at Colon during the coming year.

The sanitary work in the cities of Panama and Colon is under the direction of the health officers of the respective cities, who are employed by the canal and are under the immediate supervision of the chief health officer. They are charged with the enforcement of the sanitary regulations and health ordinances prescribed by official decree of the Panaman Government at the request of the canal. These regulations provide for meat inspection, the supervision of building construction as to sanitary and structural conditions, the vaccination of the school population, the recording of birth and death statistics, the inspection of food, street cleaning, garbage collection and disposal, and the extermination of rats and flies, and, in general, preventive measures against the incidence and spread of disease.

QUARANTINE DIVISION.

The quarantine officers board and inspect all incoming steamers for the purpose of detecting and isolating persons affected with a quarantinable disease. Vessels arriving from certain ports against. which a quarantine is enforced are kept in quarantine until the quarantine period has lapsed. The plague situation along the west coast of South America remains practically unchanged, and it is still necessary to enforce quarantine against the small northern Ecuadorian ports and other ports as far south as Valparaiso, Chile. Guayaquil, Ecuador, has shown the heaviest infection of both bubonic plague and yellow fever of all the coastal cities.

For further details attention is invited to the report of the chief health officer, Appendix J.

WASHINGTON OFFICE.

Unusual difficulty was experienced in securing an adequate supply of skilled mechanics in the United States for duty on the Isthmus, especially in the shipbuilding and repairing trades, due to the abnormal activities in the various manufacturing plants and ship yards. Fifty-four per cent of those tendered employment failed to accept. as against 48 per cent during the preceding fiscal year. One thousand four hundred and seventeen persons were tendered employment in grades above that of laborer, of which 767 accepted and were appointed; no decrease was experienced in the work of the correspondence and record division.

In the office of the assistant auditor of the canal on duty in the Washington office, 15,664 vouchers for payment, amounting to $10,853,282.68, and 274 collection vouchers, amounting to $508,257.69, and

1,249 settlements by transfer of appropriations, aggregating $665,317.90, were given administrative examination. These figures show an increase in disbursements made amounting to $678,688.66, an increase in collections of $138,191.14, and an increase in transfer settlements of $248,317.90, as compared with the corresponding figures of the preceding year. One hundred and sixty-nine contracts were prepared, involving an amount of $5,096,989.48, an increase of 37 in number and of $723,192.26 in amount over the figures of the preceding year.

The purchasing department at the Washington office is responsible for the filling of all requisitions forwarded from the Isthmus for materials and supplies. The assistant purchasing agents have been continued at New York, New Orleans, and San Francisco, who have in addition acted as receiving and forwarding agents of such materials as have been purchased for delivery to the Isthmus on ships sailing from their respective ports. Medical and hospital supplies for the Isthmus have been purchased, as heretofore, through the Medical Supply Department, United States Army, New York City. The preliminary inspection of materials purchased has been made under the supervision of the inspecting engineer, under the direction of the general purchasing officer. The work of inspection has been facilitated, as heretofore, by assistance rendered by district officers of the Corps of Engineers and by the Bureau of Standards, Bureau of Mines, Bureau of Chemistry, and the Medical Department, Ordnance Department, Signal Corps, and the Quartermaster Corps of the United States Army. A total of 8,890 orders was placed through the Washington office of the canal during the year, as compared with 8,856 for the preceding year, the total value of the orders being $10,403,996.08 for 1917, as compared with $8,495,099.59 for 1916. For further details attention is invited to Appendix K. Respectfully submitted.

Hon. NEWTON D. BAKER,

CHESTER HARDING,

Governor, The Panama Canal.

Secretary of War, Washington, D. C.

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