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ventive foods, milk and fresh vegetables and fruits. The preventive work thus far undertaken has consisted primarily of instruction, some control over the use of towels and lavatory facilities, and limited isolation. The complete isolation now practiced at Fort Defiance and one other school is a very recent innovation.

The curative work in trachoma will be discussed at some length in the following pages. Here it will be sufficient to say that some evidence led the Service to believe that a radical operation had been discovered which would cure the disease. Proceeding on this belief, it employed special surgeons to perform this operation and to instruct agency and school physicians in its performance. The inadequacy of the medical personnel made it impossible to follow up the cases which had been operated, to give any after treatment or to observe the final effects. In fact, according to the beliefs entertained at the outset, the operation was in itself a complete cure and no after treatment was needed. The results, however, have not borne out the theory, and the Service has now taken steps to prevent the use of the radical operation except in extreme cases. As trachoma is a very difficult disease to diagnose, especially in its early stages, and as the Service attempted to make its regular medical officers responsible for the treatment of trachoma after a very brief period of training, it naturally followed that the radical operation was performed in some cases when it should not have been, even in some cases where it is doubtful if the Indian actually had trachoma at all.

Accurate data regarding infant mortality among the Indians are lacking, but all available information indicates a high birth rate and a very high infant death rate. Among many tribes primitive, crude, and unsanitary methods are used in childbirth, and with few exceptions infants are not properly fed when weaned. In a few jurisdictions Indian Service physicians and nurses have made marked progress in getting the women to accept skilled professional care in childbirth, and some instruction has been given in infant care, both in the homes and in the schools. Pamphlets on infant care have been distributed. What has been done, however, is only a beginning, significant chiefly as indicating the possibilities of success of a more wide-spread, more determined effort, better financed.