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Show 20 COMMISSIONER OF INDIAN AFFAIRS. southern Caiifoluia at least 10 per cent of the Indians have this dread disease. In addition to these scourges and the special lowering of vitality wbich exists in these sections where the Indians can procure intoxicants, they are more sub-ject than the average white man to the whole list of acute diseases. Few Indian homes anywhere have proper sanitary conditions, and in many in.stances the had condition of their domestic surroundings is almost beyond belief. As guardians of the welfare of the Indians, it is our immediate dub'to give to the race a fair chance for an unmaimed birth, healthy childhood, and a physically acient maturity. The most vigorous campaign ever waged against diseases among the Indians i8 now under way. It began in 1909. Prior to that time little attention had been given to the hygiene and health of the Indians. On some reservations, equal in area to a State, there were not more than two physicians, frequently only one. In 1909 tens of thousands of Indians were substantially without any chance to reach a doctor. The Government was startled into a reform in this matter through the discovery that at the Phoenix Indian School, Arimna, more than 65 per cent of the children were infected with trachoma. In response to the showing then made, Congress immediately appropriated an emergency sum of $12,000. Physicians sparsely scattered over the Indian country were then organized as the nucleus of an mcient fighting force, and the fight has been conducted not only on curative but on preventive lines. As the need for this work has become more apparent, cowressionai au-D- ro-n riations have steadilv increased: but even to-daythe effective fighting force of the service is so d i i proportionate to the ground to be covered and the Droblems to be met that it is impossible to make even a medical survey of the whole field. The Indian service has under its general supervision 296,000 Indians, and of these it is a conservative estimate to say that 160,000 are still entirely dependent on the Federal medical Service. This service has 160 physicians, over a third of whom, under their terms of employment, devote onlr a part of their time to Indians. When it is remembered that Indians are so scattered that a physician frequently has to drive a day or more out and a day or more back to reach one family, the inadequacy of mch service is plain. While there are many efaclent and self-sacrificing physicians in the service, the smallness of the sal-mie8, which average only $1,186 a year, necessarily affects the quali5cation and ability of the physicians engaged. In spite of adverse conditions, thousands of cases of tuberculosis and trachoma are being systematically treated, and serious epidemics of diphtheria, measles, cerebrospinal meningitis, and other infectious diseaies have been cheeked. Hundreds of lives have been saved, and a distinct start has been made in getting fresh alr and generally better sanitary conditions into the homes. The Indian medical service should therefore be substantially increased in size and should be lifted into efsciency through the better men whom, as a rule, only better salaries can command. Of course this, change should take place along carefully .planned business lines and without extravagance and after a com-parative study of other medical services--National, State, snd local. Through the proper channels is now submitted to Congress an estimate for 'the Indian medical service for $263.350. accom~aniedb y a detailed statement of the expenditures required. This sum, together with an addition to the amounts which will probably be available in the Indian aD..D ro.D riation bill for the current year, and wbich were asked for in that bill before all the data now available were at band, will enable the Indian service to make a comDIete medical and sanitary survey of the whole field, with a view to curing existing troubles and to the Prevention, so far as may be, of their recurrence. With this additional |