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Show 3 0 BUREAU OF AMERICAN ETHNOLOGY [ BULL. 42 have not kept equal pace with the changes in his dwelling. In consequence he sees no harm in overheating his house in cold weather, and closing all cracks in it to prevent the entrance of cold air, destroying in that way nearly all ventilation. He visits freely dwellings where there are consumptives, and is in turn visited by such patients, in his house. It is not uncommon to find, especially in some of the tribes, a closed and heated room filled with visitors, all of whom expectorate on the floor, about the dwelling, and wherever they happen to go. Subsequent cleansing is always more or less imperfect, and thus, in the course of time, even the best dwellings are almost sure to become infected with tubercle bacilli. In dwellings of the less advanced types the conditions are even worse. But the danger of infection from expectoration is particularly great in houses provided with earthen or sand floors, such as are still common among the Sioux and the Mohave. The healthy and the unhealthy spit freely on these floors, the sputum being usually covered with a pinch of sand or earth and thus remaining. Its removal is at best rare or incomplete, and often, as in the pole- and- brush shelters built on sand, impossible. Various articles, as bags, quilts, blankets, etc., used alternately by different members of the family, and occasionally given away, are never washed or otherwise cleaned. In the course of time these must bscome impregnated with the infected dust, if not soiled with direct expectoration, and in this way propagate the disease. The tuberculous are in no way isolated. They eat with the same utensils as the rest of the family, and these utensils are not properly cleansed. They sleep with others until the symptoms of their disease become too annoying. Their soiled clothing is in no case washed separately. They visit their neighbors freely, and with rare exceptions they are permitted to expectorate anywhere without restriction. During these visits various articles, as pipes, spoons, and dishes are passed around, without cleaning, from the mouth of the consumptive to healthy mouths. Pipe passing is particularly in vogue among the Sioux. White consumptives come freely into contact with the Indians. Finally, bugles or other wind instruments and sometimes water cups, never sterilized, pass from mouth to mouth. Infection through these last- named sources is amply proven by the finding of numerous tubercle bacilli in most of the mouthpieces of the musical instruments examined on the expedition. Infection through actual contact of the lips need not be considered, because of the rarity of kissing among Indians. On the other hand, danger from utensils is greater than among whites, for the Indians still have here and there wooden spoons and basket or gourd dishes, which are more difficult to clean than metal or porcelain articles. All these conditions create, even among those Indians who live in the most modern dwellings, chances of infection unequaled in whole communities among the white people. |