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Show HRDLICKAI TUBERCULOSIS AMONG CERTAIN INDIAN TRIBES 35 important phase will be to provide all the able- bodied men with suitable and remunerative work, which should be, above all, of a nature to be enjoyed. The Indian is not inherently lazy. Alcoholism should be repressed. The inclination to drink is, however, often due, as among the whites, to a deficiency in proper nourishment. Another and most important cause of drunkenness is the utter ignorance of the Indian as to its deleterious effects on his health. No effort should be spared to bring the Indian medical service to the highest degree of efficiency and dignity. Special precautions are called for in the large schools, particularly the nonreservation schools. In the first place, the tuberculin test should always be applied to those who are to be taken to such schools, and all cases where the reaction points to tuberculosis should be denied admission. Introduction of the child into the changed conditions of life should be very gradual. There should be ample opportunity for out- of- door play, and for the systematic exercise needed. Swimming pools must not be allowed to become polluted. Excursions away from the school, particularly into the hills, have shown very encouraging results and should be frequently undertaken. Other important desiderata for the pupils are nourishing food, eaten under the most enjoyable conditions, attention to individual cases, and care as to their general mental tone. The mouthpieces of musical instruments, cups for water, and faucets at which children drink, should be regularly disinfected, and the indiscriminate use of musical instruments should be discouraged. Weekly weighings of all the pupils should be practised, for a continuous loss of weight is one of the first and most important indications of failing health. The children should have no contact with consumptive teachers, employees, or outsiders and should be well instructed as to the dangers of tuberculous infection. Finally, all pupils who become seriously ill, without delay and without being made to feel that they are very sick, should be separated from the others, relieved of regular duties, and given special attention, particularly in regard to food and outings. If the child is kept until it has a well-developed case of phthisis and is then sent back to the reservation, the results are certain to prove unfortunate. Opportunity is given the child to infect objects with which it comes in contact, and possibly other pupils; it is deprived of a chance of cure, and is sent back at the height of the disease to infect the camp of the family. The schoolrooms are generally good, yet the open- air schools about to be introduced by the authorities of the Indian Office must certainly be regarded as a further step in the right direction. The principle should be extended also, where possible, to the workrooms and dining rooms for the children. Extermination of flies at the schools would aid in preventing infection. |