Page:LewisMeriam-TheProblemOfIndianAdministration.djvu/220
The amount of tuberculosis is not known. Estimates supplied by the Indian Office based on figures for the Indians, exclusive of the Five Civilized Tribes, place the number with tuberculosis either active or arrested at over 25,000, or approximately one in ten.
The sanatorium or the sanatorium school has been the main line of attack on this problem. Both types of institutions, as developed in the Indian Service, are, as has been said, generally below a minimum standard of efficiency in plant, equipment, and personnel. For reasons to be discussed at length later, it has generally proved difficult to get the Indians to go to these sanatoria. The number of physicians and nurses on the reservations is not sufficient to aid the Indians in their own homes in fighting the disease and in avoiding contagion. Children in advanced stages of the disease are sometimes returned from the boarding schools to their own homes, where no adequate provision is made for their care or for the protection of other members of their family from contagion. Neither in the boarding schools nor on the reservations is enough done in examining the Indians periodically to detect cases in their incipiency, a procedure that is obviously imperative in a population wherein tuberculosis is so prevalent.
The Indian Service has for a number of years conducted an active campaign against trachoma, a disease which is serious chiefly because it causes blindness. The cause of trachoma is not yet definitely known. Two hypotheses have been advanced, one that it is an infectious disease, the other that it is due to dietary deficiency. Obviously from the practical standpoint, both hypotheses may be correct. The primary cause may be a specific organism which has a chance to develop and do damage in the presence of a deficiency in diet. As in tuberculosis, the best available means of combating the organism may be in building up the general resistance through diet and a strict regimen.
Whatever the facts regarding cause may prove to be, the Indian Service in the past has directed its preventive campaigning against trachoma practically entirely on the theory of contagion and has not experimented with dietary control. Even at the school at Fort Defiance, which is now exclusively a school for children with trachoma, the diet is not superior to that at other boarding schools. In fact, several schools with better farms have much better diets. The diet at Fort Defiance is notably lacking in the two great pre-