Page:LewisMeriam-TheProblemOfIndianAdministration.djvu/326

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Health
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he is discharged. Although there is doubtless an element of truth in both statements, this method has not been given a real trial. The Sac and Fox Sanatorium has been able to keep its patients on an average of 385 days. Much could be accomplished in that time, and it is not improbable that a longer length of stay could be secured if other facilities were available, such, for instance, as an up-to-date occupational therapy department. No well developed program of occupational therapy is being carried out in these sanatoria, important as it is, considering the economic condition of the Indians.

  • Treatment through exercise is not scientifically applied in the Indian Service sanatoria, for it requires an intimate knowledge of the case. Exercise properly administered has an important place in the treatment of tuberculosis, because it prepares the patient nearing an arrest of the disease to withstand the strain of returning to his ordinary life.

    • The medical records kept of patients reflect the general conditions described above. A careful examination of available records in Indian Service sanatoria shows that the forms on which to chart clinical data are meagre. Not a single institution maintains a complete case record of its patients. A beginning could be made by completing the present meagre forms but better ones are necessary for good work.

    The very minimum standard record requirements include forms providing for the following data:

    1. Social report
    2. Medical history
    3. Physical examination
    4. Chest examination
    5. Re-examination
    6. Laboratory report
    7. X-Ray report
    8. Special reports (eye, ear, nose and throat, dental, etc.)
    9. Temperature chart—graphic
    10. Weight chart—graphic
    11. Nurse’s progress report
    12. Physician’s progress report
    13. Physician’s orders
    14. Record of daily activities
    15. Report to agency

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