OCR Text |
Show COMMISEIONER Ok INDIAN AFFAE8. 37 signs leading to the existence of pulmonary tuberculmis. Such children as present these symptoms are not to he enrolled. Periodical examinations of pupils after enrollment shall also be made, and upon the discovery of the first positive signs of the disease the ones affected are to be immediately sent home. In csaes of doubt in reservation schools the suspected pupil should be sent home temporarily in order ' that the symptoms may either clear up or become sufficiently pronounced to admit of positive diagnosis. Suspected esses in uonreservation echools are to be subjected to the most careful observation by the physicians. They should he excused from the schoolroom and other duties of a confining nature and allowed to be in the open air as much as po&hle. They must be amigned to Beparate sleeping apartments, and in all casea to separate beds. Good nutritious and easily digestible foods should be provided and such further advantages given them as are available and as the physicians deem advisable in individual cases. If, despite these measures, the aymptoms pereiat, they mwt be returned home. It must be borne in mind that tuberculosis is an insidious disease, and its early recognition, fallowed by prompt and intelligent action, affords the only hope of benefiting those afflicted, as well as the only means of protecting others from the diseaee. 2. The schoola should be provided with cuspidors, which should he made of metal and furnished with removable tops to facilitate cleanin-e These should be mrtiallv filled with same simple antiseptic fluid. , 3. Since the germ of tuberculosis are rapidly destroyed by exposure to direct sun-light, and since they resist drying to an extreme degree and are consequently dis-seminated by means of the dust, superintendents are directed to see that dormitories are kept clean and free from dust andare provided with all the ventilation consistent with health, together with as much sunlight as possible. The grounds also must be kept clean and free from refuae of all kinds. 4. There must be no overcrowding in dormitories. Thia rule must be enforced remrdless of averwe attendance, and inspectine officials will be instructed to mort unfavorably on both the superintendentsand physicians where this condition exists. 5. Physicians will be required to give weekly Mks on hvgiene to the pupils at such honrs ss the superintendents may designz&. These shal<embrace simile stste-ments of the laws of health and their practical application. 8. The water supply, food supply (especially its preparation), bathing facilities, heating and lighting,ventilation,and all matters pertaining ta the sanitary conditions of the schools are to be studied by the physicians and such reports made as they see fit 7. Eye diseases are to receive proper attention, and no children should be required to do schoolroom or other work whose eyes are likely to be injured thereby. It must be borne in mind that many of these conditions are contagious, and precau-tions, such as the furnishing of individual towels, etc., should be taken to prevent their spread. In conclusion, physicians are urged to interest themselves in the health conditions of the Indians. They should study their cases, keep histories of same, and report the more interesting ones to this Office, together with such pmtical suggestions as to treatment ss may he of service in the preparation of subsequent circulars and other literature for distribution to the physicians in the service. Earnest effort is ljaing made to have the provisions of the above circular enforced. Inspecting o5cials are required specially to make note of the same at every school visited. Hospitals are being provided as rapidly as funds will permit. Health conditions are gradually being improved and employees urged to carry out carefully every |