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dealing with its transmission. The installation of the Pullman towel system in some schools, and the partial segregation of the trachomatous child from those with apparently normal eyes, are the two chief preventive activities.
Chemawa was the only school visited in which the Pullman towel system was not used in all dormitories. Even this system as it is applied apparently constitutes a source of danger, because not all schools have locked containers for soiled towels. Where containers are unlocked, several children may use the same towel. A more serious fault, perhaps, is the practice of dispensing a specified number of towels three times a day. This means that if the child wishes to dry his face and hands at some time other than the designated hour, he must make special request of the matron, use soiled linen, or not dry them at all. It is not infrequent to see children use soiled linen and, on several occasions, piles of readily available soiled towels were seen on the floors of the wash rooms.
In 1913, the United States Public Health Service, in its report on contagious and infectious diseases among the Indians, recommended the strict segregation of trachomatous pupils from healthy pupils. So far as could be ascertained on visits to these schools, the only effort to carry out this recommendation was being made at the Fort Defiance School, and it was started in 1927. The Indian Office reports another special trachoma school at Tohatchi, Arizona, started in the fall of 1927. At certain schools some pupils found in separate dormitory rooms were allowed to mingle with other pupils in practically every other school activity, thus nullifying the limited attempts made at segregation. Just how much infection is spread through the schools is not known, although frequently reports were heard in the positive.
The Indian Office has recently issued an order to agency superintendents requesting them to send children with trachoma to specified schools where the best hospital facilities are available and the trachoma-free child to those less well equipped from a hospital standpoint. This measure should be a temporary expedient only. Every school should have adequate facilities because the Indian child is so generally below par that all are in need of expert care.
The diet deficiency theory of trachoma has its advocates. Stucky, in his work among the mountaineers of Kentucky, has found splendid results following dietetic management of his cases. Other