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Show 26 BUREAU OF AMERICAN ETHNOLOGY [ BULL. 42 of consumption. Two others of the same group of 28 children are among the above- mentioned 5 suspicious cases, showing a gradual f ailing, with slight cough. From the above tables it is seen that the cases of phthisis positively established in these tribes amounted to from 3 to 5 per cent of then-whole population- an appalling proportion. In addition to this, large numbers, particularly of the young, had at the time of examination, or had had in the past, tuberculosis of the cervical glands or of the bones. Among the Indians the pulmonary form generally involves both sexes in nearly equal proportion; nevertheless, all of these tribes show a slightly greater frequency of the infection in the females. This presents a contrast to the case of the American whites, in whom the males are the greater sufferers. As to the ages of the patients, it is seen that a large majority of the afflicted were above 20. A much smaller proportion of cases was found in children under 14 years of age, as was true also of those between 14 and 20. If, however, similar statistics were gathered during the latter part of the winter and in the early spring, the proportion of adolescents and young adults attacked by the disease would probably be higher than that of the children or than that of the adults in excess of 35 years of age. For at that time of the year would be found a greater number of acute cases, which appear mostly in subjects between 16 and 35 years of age, and the majority of which before the advent of summer have been eliminated by death. Again, if tuberculin tests could be applied to the children it is very certain that a larger proportion of cases would be found in this group. Considering the adults alone, it was found that a greater number of cases of pulmonary tuberculosis existed among those in early and late adult life than among those between 35 and 55 years of age. In all these conditions among the Indians as compared with the whites no radically different features exist. The cases in which positive diagnoses of phthisis could not be established, and which therefore are classed as doubtful, embrace, in all probability, instances of bronchitis of long duration, due to other causes than tuberculous infection. But they certainly include also" cases of pulmonary tuberculosis of mild or very irregular character or encountered in the early or late stages of the disease. It is well known that under the latter conditions the tubercle bacillus is often absent from the sputum, or can be detected only after repeated examinations. Some of these doubtful cases presented many symptoms and some physical signs of pulmonary tuberculosis, yet, in addition to a negative sputum examination, other distinguishing features were absent, necessitating a reserve in diagnosis. As to the varieties of phthisis encountered, the tables show but one truly acute case. As has been mentioned, such cases occur principally during the winter and spring and terminate in death or become subacute or chronic before midsummer. Some of the acute cases |