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Show REPORT OF THE COXMrSSIONER OF INDIAN AFFAIRS. 5 our service hopes to solve its health problems largely through the instruction of Indian children in both hygiene and sanitation. PRINCIPDAILSE ASEB.-T~d~i seases taxing every resodrce of this bureau are trachoma, tuberculosis, and pneumonia, the last too largely augmenting the death rate. Trachoma is not a direct cause of mortality, but produces considerable suffering and incapacity, and the estimate of 30,000 cases of this disease among the Indians in-cludes follicular conjunctivitis which clinically resembles trachoma but is distinguished by its mildness, its freedom from danger, and its spontaneous cure in early adolescence. There are, however, enough cases of true trachoma to constitute a formidable problem. Tuberculosis by causing much incapacity and death in every age group from childhood to old age is the most discouraging and dec-imating disease with which we have to contend. I t is estimated that there are about 25,000 cases of tuberculosis in all forms, mostly pulmonary and glandular, among the Indians. But this is not astonishing because few of any race escape infection in childhood; resisting forces are, however, often lacking in the Indian's home life and progress of the disease is less arrested there. For the treatment of this disease we have five sanatoria schools and six sanatoria with a combined capacity of about 800. Many cases are treated by agency and school physicians in our general hospitals and in the homes of the patients. Pupils in Government schools are instructed upon the nature and treatment of the disease, and improve-ment of the situation through these measures is encouraging. Pneumonia, always a dangerous disease, is also favored by the Indian's way of living and its prevention and treatment are largely a matter of better sanitation, but it is doubtful whether, propor-tionately, more fatalities occur from it among Indians than among whites. INFAMNOTRT ALITY.-A study of this subject, another problem of special concern, includes everything that pertains to child life; and every successful means employed to reduce the number of deaths gives collateral assurance of better living conditions and better chances to promote child welfare. Our facilities for reducing In-fant mortality and furthering a campaign for better babies are inadequate to meet the demands. The number of hospitals and field matrons is insufficient. With enough well-e uipped hospitals, it would be an easier matter to gain the confi 3 ence of the Indians where it is wanting, for, through the Indian mothers and their babies, an appeal could be made to which the whole tribe would eventually respond. The hospital nurse and the field matron can do more to win over those who array themselves against approach-ing enlightenment than any other class of employees. The mothers and the babies that have passed through the hospital at Keshena, an Indian settlement on an unalJotted reservation in Wisconsin, have been the means of dissipat~ng every shadow of opposition to physicians, hospitals, and nurses in that jurisdiction What has been accomplished there is possible for other communities. NEEDS OF TRE SEBVIDE.-There is need of more sanatoria schools for the children, a hospital for incurable patients suffering from tuberculosis, and another for adult curable patients. It is not advisable, as a rule, to hospitalize together adults and children. Our |