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Show HBDLICKA} TUBERCULOSIS AMONG CERTAIN INDIAN TRIBES 33 to the diagnosis, on the way to recovery or actually recovered. Such cases, which embrace all ages except perhaps the senile, were found in all the tribes, and in a number of instances had been watched for years by the local physicians. They prove clearly that pulmonary tuberculosis is by no means always fatal in the Indian, and justify any adequate measures that may be taken for the cure of the Indian consumptive. The writer will now briefly state such measures, particularly in the line of prevention, as appear to him of especial importance. The first, most important, and most difficult must be the combating of ignorance. The Indian must be taught how to live, how to prepare his food, how to take care of the young, of the old, and of the sick, and what precautions to use against the spread of consumption. His antiquated, erroneous notions concerning disease must be gradually dispelled, and be replaced by actual knowledge and a clear understanding of the nature of tuberculosis, as of that of other contagious infections. The teaching must be applied not only to the Indian adults, by means of lectures, demonstrations, special bulletins, and through the physicians, but, above all, by means of regular instruction to the children from the time of their entrance into the schools. For the children are free from many of the prejudices of the adult Indian, and what is imparted to them in a proper way will become a stable part of their mental equipment, regulating their actions throughout their lives. Not only that, but the children thus instructed would themselves influence their parents and relatives more than an outsider would. Care must be taken, however, to make these teachings not a burden of rules to be blindly accepted, but a part of the clear understanding and common sense of the Indian. It is believed that instruction in this line, on most of the reservations and in the larger schools, is exceedingly desirable, and should be furnished as soon as possible. There is urgent necessity for the general introduction of a simple and practicable method for the disposal of the infected sputum. Make the Indian fear the sputum of the consumptives as it should be feared, and then provide him, or teach him to provide himself, with the simplest means possible for its isolation. Cheap and easily destructible articles, as toilet paper, are far preferable to the use of spittoons, the contents of which, in the absence of sewers, would ? be apt to prove a dangerous source of infection. The Indian should be taught to destroy the receptacles by burning, since fire is always to be had. The exclusion of flies, which disseminate the infected matter, particularly over food, is another necessity. A further and very important step will be the isolation of all cases, under the care of the nurse and the physician. There will be |