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Apparently the most commonly used drug is peyote, often used in a religio-therapeutic manner. It is derived from a small cactus found along the lower Rio Grande and southward into Mexico. The Native American Church in Oklahoma is said to be founded on the use of peyote in its ceremonials. The habit-forming character of this drug has not been definitely determined, although many Indians were reported to use it-constantly, notably the Kiowa and Comanche, Cheyenne and Arapaho, Potawatomi, Winnebago, Sac and Fox, Omaha, Osage, Kaw, Ponca, Tonkawa, Shoshone, Northern Cheyene, Uintah, and Ute tribes. The drug does not come within the Harrison Narcotic Act, though it can be detained at custom houses under the act of June 30, 1926.

Opium and its derivatives are reported used by individuals in some tribes. The tribes in Nevada and California were reported as perhaps the worst offenders, though a trace of its use is reported in other places.

To what extent intermarriage with whites has affected the health of the Indian is uncertain. Some writers contend that long continued inbreeding within a single tribe has pernicious results, but others hold that such imbreeding is often desirable where the stock is pure and strong. Other factors than inbreeding that would account for Indian poor health are that they have been subject to new diseases against which they have not had time to build up an immunity ; they have been starved or fed inferior food; they have been poorly cared for, nursed, hospitalized, and guided. The result is a weakened race. A constant inbreeding may bring additional disastrous consequences, biologically or through forced association with persons educationally inferior. This is a condition that needs immediate attention, for no palliative measures can overcome conditions of inferiority created by too complete tribal segregation.

Special Difficulties of the Indian Health Situation. A number of special difficulties are present in the Indian health situation.

The medicine man is still a potent factor among many tribes. In some tribes the general impression gained is that his influence is gradually diminishing, but many still practice the same old incantations and religious rites. “The white public thinks the practice of the medicine man should not be used, but many of us still rely on this practice today,” said a California Indian. On some reservations the physicians are called in for consultation by the medicine