OCR Text |
Show HRDLICKA] TUBERCULOSIS AMONG CERTAIN INDIAN TRIBES 27 formerly seen by the writer among the Indians, and others of which he learned personally on the reservations, are of very rapid course, terminating within a few weeks or two or three months. Subacute cases, with more moderate symptoms and a duration beyond three months, were well represented in all of the tribes. A decided majority, however, of the cases of consumption encountered were of the chronic type, with slow and irregular progress, and in many instances of more than a year's duration. Such cases often show a tendency toward recovery, and in every locality more than one individual was met with in whom symptoms of the disease, after lasting for years, had been followed by complete recovery. The subacute cases often become chronic and may progress to recovery. In many more instances, however, judging from past experience and the information obtained during the investigation here dealt with, such cases become aggravated and speedily result in death. Tuberculosis of the cervical glands has been observed among the Indians in individuals of all ages, from early infancy to middle age. The youngest patient seen with this disorder was a girl one year old, in whom the glands had already suppurated. The oldest cases were two women, each about 45 years of age, and another woman who gave her age as 46. In the two former the swollen glands were clearly tuberculous, though not yet pointed; there were at the same time other signs of tuberculous infection, one being classed with the positively established cases of phthisis, the other with the doubtful. In the woman of 46 the glands were still suppurating, while lung^ symptoms indicated, at the same time, chronic consumption. Among the Mohave two moderately enlarged cervical glands, not suppurating, were seen in an old man about 85 years of age. The nature of these swellings could not be exactly determined, but the patient, whose sputum contained tubercle bacilli, had, so far as could be ascertained, no other disorder which might account for the glandular enlargements. In the Indian tuberculosis of the bones usually attacks the spine, hip joint, ribs, or tibiae. One case was seen in which the wrist was involved, and another in which a discharging sinus led to either the malar bone or the malar process of the superior maxillary bone. Of the other forms of tuberculosis, it was found that in the young children the disease is especially apt to manifest itself in the meningeal form. Intestinal tuberculosis seems to appear only as a complication of tubercular process in other parts of the body. The prevalence of tuberculosis in its various forms, among the tribes visited, is especially illustrated in the last two items in the tables, giving the proportions of individuals and of family groups totally free from any suspicion of the disease. Such family groups among the full- blood Oglala fall as low as one- third of all of those examined. In at least two- thirds, then, of the families of the Oglala Sioux there are some indications of tuberculous infection. |