The district physician had the authority to send any employee he thought best to the hospital. If the employee preferred to stay at home for treatment he was charged one dollar for each visit of the physician. These fees reverted to the Commission. The physician was paid a fixed salary by the Commission, and was not allowed to make any charge for his services. Members of families of employees were charged one dollar a day for hospital care, and could be admitted on the order of the district physician. Families of employees who received less than fifty dollars a month were charged only thirty cents per day for hospital treatment. As a rule, both employees and their families preferred to come into the hospital when sick, rather than to be treated at home. The class of employees receiving less than fifty dollars a month was almost exclusively Jamaican negroes. During the earlier years of our Isthmian work the negroes were afraid of the hospitals and did not like to come in. This applied particularly to the women and children. But as years went by we gained their confidence entirely, and during the last years of construction, the hospital accommodation for negro women and children was always full, though we were constantly extending this branch of our hospital. In each district one or more dispensaries were maintained. In immediate charge of the dispensary was a competent druggist who had one or more men under him for assisting him about the dispensary. The district physician presided over the dispensary and advised without charge anyone who applied for treatment, and furnished him with medicines if he were unable to pay. Quinin was given at the dispensary to anyone who applied. In some of the larger districts where the population amounted to eight or ten thousand, the district physician had as many as four assistants. All the doctors on the Isthmus had to be graduates of medical schools in good standing, and, except for the first few years of construction, had to pass a civil service examination. There was a very great sanitary advantage in our giving in this way to the whole population free medical service and medicines. It kept the district physician accurately informed of what character of sickness was occurring in his district. The sanitary authorities thus had the very earliest information with regard to such diseases as yellow fever and plague, and they were enabled to take the proper sanitary precautions at the time when they would be most efficacious. Many times information obtained in this way enabled us to stamp out these diseases in their incipiency and before they could get started as epidemics.