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on the present allowances, Note infrequently the hospital lacks a competent cook capable of preparing special diets.

The administrative records and practices in these hospitals have been poor. In many places this defect is recognized by the Indian Office and attempts are being made to remedy it.

Occasionally an entire Indian family is at the hospital, although only one member is ill. To induce the family to send the sick member it was necessary to take them all. It would seem that for the time being there is excuse for this practice, but it is believed that with the development of the medical and public health nursing service, it can gradually be discontinued. Contrary to statements made by some Service employees, it is not believed that this factor works a serious handicap in “tying-up” the hospital beds. It does, however, give a false picture as to the use of hospital beds and administratively is unsound.

It is desirable to consider at this point the use made of non-reservation hospitals in a fairly close proximity to some of the reservations. At Carson City, Nevada, the medical service is rendered by a contract physician who does not attempt major surgery. Indians in need of such service are sent to Reno, about thirty miles distant by hard surface road or railroad. The hospitals used are thoroughly modern and are equipped to give expert service. The patient has the additional advantage of the available consultation service the average city hospital affords. When his case has reached the point of convalescence he is discharged and allowed to complete that phase of his cure at the reservation hospital. This seems to be a very happy solution in the city hospital, and it precludes the necessity of trying to maintain a completely equipped hospital at an isolated point.

Most of the surgical treatment rendered the Oneida Indians at Keshena, Wisconsin, is obtained at Green Bay, Wisconsin. The same benefits result as at Carson City Hospital. A similar service is to be found occasionally on other reservations.

A somewhat different plan has been started at Cloquet, Minnesota, under the Consolidated Chippewa Agency. Under this jurisdiction are four general hospitals and one sanatorium. Cloquet is to be made the surgical hospital and is to receive all such cases from the various points on the reservation, excepting perhaps those too