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gone out of existence by 1886, 14 discontinued between 1908 and 1918, and one in 1926. Two were fraudulent and two others were not classified by the American Medical Association.

The Indian field service physician who has had post-graduate medical work prior to entering on duty or during his time in the Service is the exception. Generally the Indian Service physicians are not members of the state or local medical societies and rarely attend such meetings. Several of the physicians are anxious to take special work and to attend current medical meetings, but it is not possible for them to leave their respective stations without securing some one to fill in during their absence. Many times this is difficult if not impossible and until recently physicians have had to pay for this substitute service out of their own salaries. As district conferences have been held only in rare instances the physicians have had little or no opportunity, much less incentive, for contacts to improve their practice or knowledge. The Service has suffered seriously as a result and the outside practitioner has often looked down on the Indian Service physician as at least uninterested in medical problems.

The work of keeping abreast of developments in the medical field has never been encouraged by the Indian Office which does not allow travel expenses or subsistence for its specialists, much less its field personnel, to attend such meetings. The only exceptions found have been in trachoma work. The modern practitioner must have these outside contacts if he is to keep abreast of the times.

Practically no provision has been made for supplying agency physicians with medical literature. Only rarely were recent editions of any of the standard texts on medicine found at any of the reservations or hospitals. The meagre salaries paid have not permitted the physicians to secure medical literature at their own expense. Certainly a few standard texts and copies of current medical journals should be available to physicians on every reservation.^[1]

The territory assigned to most of these physicians is usually too extensive for effective work. No generally applicable figure for a