This book gathers in one volume all the articles published in "Proceedings of the Canal Zone Medical Association" from its inception in 1908 to its last year of publication in 1927. During these two decades, the "Proceedings" faithfully recorded the medical activities and sanitation efforts of a team of American doctors who confronted yellow fever, malaria, typhoid fever and many other tropical diseases in Panama. The fifteen volumes of the "Proceedings" contain 3,215 pages and 426 articles that reflect not only the constant fight against tropical diseases, but also the struggle of expatriate groups mainly from the West Indies, Panama, Spain, Greece and China, who toiled under ethnic discrimination, overcrowded housing and suboptimal nutrition. The poor living conditions contributed to the high prevalence of pneumonia and tuberculosis in these groups. The workers also were victims of "external trauma" from heavy machinery, railroad accidents, cutting and piercing injuries and dynamite explosions. Between 1881 and 1914, more than 28,000 laborers died during the construction of the Panama Canal. Although the American effort was hailed as an engineering and sanitation triumph, this was only possible by the sacrifice of many who paid the ultimate price to complete the interoceanic canal.