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discussed more at length in the recommendations relating to schools, the first step in this direction should be the maximum possible elimination of young children from boarding schools. They should be left with their families and be provided with local school facilities.

Also as a health measure, the amount of routine production, as distinguished from educational labor, in boarding schools should be materially decreased. Now that Indian children are entering boarding schools at a comparatively early age, the half-day work plan for children above the fourth grade results in too much work for children even in normal health. The physician should in every instance have authority to order that a child below normal in health be relieved from even the small amount of work that may properly be required of well children. This recommendation involves increasing the amount of hired labor at Indian boarding schools, the introduction of more modern labor-saving devices, and possibly the purchase of factory-made clothing to take the place of that now made in the production sewing rooms of the schools.

The medical relief work, like the preventive work must be materially improved. Here again, more and better trained doctors and nurses are required. The plants of hospitals and sanatoria should be brought up at least to the recognized minimum standards for such institutions elsewhere. The practice of salvaging old buildings and converting them into hospitals should be discontinued unless they are in suitable locations and after alteration and repair will fully satisfy at least minimum standards and furnish facilities for efficient operation. The equipment should be reasonably complete. Hospitals and sanatoria should be administered by persons fitted by training and experience for that class of work. The per diem expenditure for maintenance should approximate what is spent in other federal hospitals, with due allowance for the additional costs that sometimes result from isolation. Patient labor should be utilized only when the physician certifies that it will not injure the patient and retard his cure. Additional expenditures for labor will be necessary not only to replace patient labor but also to provide for higher standards in maintenance. The salaries and the entrance qualifications for cooks in hospitals and sanatoria should be raised so that each institution has a good one, competent to prepare special diets and to serve well-prepared meals, often an