Chewing tobacco is declared by scientists to contain the hac~illua tuberculosis, or consumption germ, in vast quantities.

Sophia Coulon, one of our nice, good, quiet ) girls, died yesterday morning of Tuberculosis of bladder and kidneys. She was quite a sufferer during a part of her illness which began six or eight weeks ago but which; did not take a serious turn until ten days ago. She rested quietly during the last few days and passed away into what seemed to the watchers a natural sleep so that they did not realize the moment of death. Sophia was a member of the Whatsoever Circle of King’s Daughters who with all who Knew her will mourn the

Dr. F. B. Futcher, a specialist from the Johns Hopkins University and hospital has been visiting our school in the interest of his profession. Sixty-eight pupils out of the 6UO present, were handed over to him for examination. They were regarded as suspicious cases having possible germs of consumption. Specimens of sputa were examined from each and in only 4 of the 68 cases were tuber& bacilli found. Sixteen showed enlargement of the cervical glands, which in several instances are undoubtedly tubercular, although the lungs of these pupils at present are clear. The Doctor says in his report: “1 take pleasure in expressing my surprise at the comparative freedom of the institution from tuberculosis at present.”  We found Dr. Futcher very pleasant socially, and he made many friends in his few days at Carlisle.

We are grieved to be obliged to record the death of one of our number-Cora Price, of Cheyenne River Agency, Dakota, who died of Tuberculosis. The funeral servicea occurred last Friday, Rev. Dr. Wile officiating. Cora has a sister here, who, in her great bereavement has the sympathy of the entire school.

  We have only just heard of the death of Annie Lockwood, who passed away from tuberculosis of the lungs a few weeks since at the Albuquerque Government school, New Mexico.  Miss Annie has had a struggle for three or four years to live and was delicate as a child, but was always cheerful and happy.  She was a Pueblo and one of the sweetest characters, young or old, that we have ever known.  None knew her but to love her, and all mourn the loss of a dear friend.

      A medical gentleman namhd Parker Murphy, writing to the Albany Medical Annals, is responsible for the following
statements in regard to the effect of high altitude in the treatment of consumption :
     "It is self-evident, then, that the forced llstention of the lungs and bronchi in those who live in high altitudes alone confers immunity against the disease.” The Native American, published at the Phoenix, Arizona, Indian School has this to say on the subject:
     It is not the purpose of the writer to enter into a controversy on medical subjects concerning which he is only a layman.
He simply wants to call attention to a fact learned in a recent visit to Ft. Defitnce, Arizona, which goes to show that, the writer mentioned to the contrary notwithstanding) there is no real immulity from attacks of bronchitis and lung trouble.
     Dr. C. K. Smith is agency phyeician at Ft. Defiance.
     He was asked the question: “What diseases attack the Navajos?”
     He replied by enumerating them, concluding with bronchitis and tnberculoeis.
     The writer then expressed surprise that the Navajos are not practically immune to these diseases.
     A negative answer from the physician convinced the questioner that high altitude, out-door life and freedom from contact with the whites (conditions surrounding the Navajos) do not prevent an appearance of the “great white disease.”
     Stanley, in his travels through central Africa, among tribes to whom the sight of a white man was unprecedented or rare
found that tuberculosis is one of the prevalent diseases.
     No race or tribe of people inhabiting any portion of the earth seems to be entirely free from ailments of this character.
There is no such thing as immunity, just as there is no immunity from epidemics of measles, diphtheria, small-pox, etc.


At the ~t~rnpwt. Owgon, Conrontion me of the ~llogt wn~plste and instructirr papers was read by E. A. Pierce. M. I).,
of Salem, Physician to the Chemawa Indian School. Dr. Pierce is also Icctorer on Physical Diagnosis and Diseases of
the chest at the Medical Department of Fllnmette T’niversity st Halanl and lectyrer in Hygiene at the Salem Training
School for uur8~8.
He took for his subject Diseases of the Lymphatic Glands, which is so prevalent ~m”u~ the Iodisna, and treated the text
in R plsiu, easy manner, bringing II &cienti5c thesin within the nnderstandiug of everyday folk. 88 t,he following estrtlota
will show:
* ‘i * * x
The lymphstics are minute, delicate
and trnusparent vensele, of tolerable uni-
formity in size, and remnrkable for their
knotted nppearance which in due to the
presence of numerous valves. They col-
lect the products ?f digeslion and the
products of worn out tiaeuea, and canvey
them into the venous circulation near
the heart. They are fonnd in nearly
every texture snd organ of the body. The
lymphatic8 are arranged in superficial
and deep sets. The superticinl vessels on
the surface of tbe body lie immedi?rtely
beneath the skin. and join the lymphat-
its at certsinpoiuta through perforatious
of the deep fascia, while in the interior
of the body they lie in the 8ubmucoUs
and sub-serous serols tiesue. They arlee
in the form of network. from which they
pass to lympbetic gland9 or to a larger
truok The deep lymphatics are larger
than the fioperfioial, and aceompauy the
deep blood vessels.
The structure of the lymphatic8 is sim-
ilar to that of veius and arteries. The
lymphatic or absorbent glands are small.
solid glandular bodies varying from size
of & hemp seed to tb&t of au almond, sit-
uated iu the coume of the lymphatic VZ?R-
sels. They are found in the neck where
they often become enlarged and inflamed,
especislly in tubercular and syphilitic
subjecta, in the aaile or armpit, in the
groin, where when inflamed they give
rife to the condition known as hub”.
while deep glands are found abundantly
in the abdomen and chest.
These glands verve 88 resnrvoirs iU the
c”Ume of the lymphatic vessels, through
which any irritants or infections mUBt
pees, henceitmay readily be 8een that
any cause that changes the uormnl
bealtby condition of the blood current.
may essily CILUB~ ILL inflamed and irritst-
ed condition of the glands.
Cold and over.aaertion act 88 local de-
Often oU euteriug B crowded ~8sem.
blage, particularly iucold weather, the
muoo~u membranes being blanched by
the axfer sir, the germs of disease are in-
haled, clinging to the mucous surfscea,
and “U poiog out into the oold the mem-
breues are again blauched and, before re-
actioo h&e agaiu set iu, the germs 0nd
lodgemsut beneath the ““tar lsyerofaelta
and the cireulstiou is thuR invaded and
disease follows. I believe the time is
near st hand when the80 meetings must
receive careful attention from boards of
health, and the dark, dust-bade” PkeB
of assemblage. with their abundance of
carpets and draperies, must give wry to
well-lighted and well-ventilated build-
ings, where au abuudaoce of sunlight and
air CRO enter, and where the upholstery
and carpets must he replac4 by plain
walls snd well-polished bsrdwond floor@,
with rugs and mattings that CBO be ease-
Iy removed and cleansed. Whatever
dusting is done should be flnisbed many
hours before the crowd is to assemble. J
beg to call attention to tbe fact that pusu-
mania is “II the increaee all over the civ-
ilized world, while tuberculosis, by the
herculean efforts that are beiugput forth,
is being gradually checked. and I plead
for the 88me precautions against pneu-
monia, 88 tbe disease is conveyedin the
BIL~R m~uner a8 in tuberculosis.
The sputum of patients with influenas, pressants, and these CBIIBBB may indireet-
ly favor the development of glandular pneumonia or bronchitis should be disin-
diseaee. Qeueraldebility has the fame fected 88 thoroughly a8 that of tnbsrcu-
effect: Disease oi the lympbstic glsndR losis. They all contain inieptina! germ&
msv ~cc”m”~nv or follow carbuncles. and should be guarded against by disio-
the inng~. I believ?, I~owever, that chii-
drpn born “l pxrenla or impnired brsllh,
whrt,hrr tubrraolnr or iron1 n11.v other
~HIIHC. have impnrted to them a wenkened
world. not in R diaessPd condition, hnt
nnnble to withstand snd tn repel dinease
germs, a8 are the children horn of strong
Ae the Iudians are prone to ttrke on
glanduhir and p~imou~rp disease, it be-
hooves ne to strive in every thing that
tends tomake children strong, happy and
hearty, for &asmuch 88 we build up their
hodies, we strengthen and increfux their
resistive power.
We should remember than au nhun-
dnuce of t,he fresh sir with plenty of out
of door plsy and occupation, witb R large
and varied diet thot is plain and substan.
tisl, i8 of the utmost importance.
They should have large and airy sleep.
jug and stndy roome, close attention to
personal clenniinese, coupled with judi.
cious clothing, both in wearing apparel
and bed clothing.
In bhese way8 we can domuch to insure
robust constitutioos and general power to
resist disease.
l i * * *
Causes of Nasals Disease.
boils, vscciiation, erysipelas and any of
the eruptive or infectious fevers, gonor-
rhea, tuberculosis, syphilis. Bright’s dis-
ee.8”. infected wounds, or any skin sbra-
sion, tonsilitis, cntnrrh, whooping
cough, or in fact any abnormal condition
that alters the general health is‘ often B
factor in producing disease of the lym-
phatic glands.
t x * l I * * l
Tuberculosis Qlands.
The 88” xlt which tuberculosis of the
glands is usually 8een ia from thrre to ten
years, although my observations have
been tbstst from Rix to eighteen years
mnst ~~8~18 are found, dud that local eon.
ditions fnvoring infection *re enlarged
tonsils, chronic catnrrh of n+and throat,
disease of ear, eye and teeth. That the
throat is the seat of primary infection is
ahown by t.he fact that the deep glands iu
close proximity are generally 5rst affect-
nd. My “pinion is that, jn most CDB~S “f
Rlandulnr enlargement. the process is B
tnborcoions one from the beginuing, and
in my experience nil so-called 8cr”fUi”U8
plandsnre tobercuirlr. Duriugmyservlee
at Chemawa nnd in privnte practice I
have demonstrated to my own sntisfac-
tion, with the aid of the micromope, that;
of t.ho chronic inflamed @and8 that end
in suppurntiou, t.hat I have treated, nine-
tg-five percent were of tuborculnus origin.
Tubaroularglaude mey be dividedint”
two groups. In one the process is more
rapid, nod teode to early boftenlng and
suppuration. In the other the coume is
slower, softening and huppernlion heiug
Personally, I do not believe in heredi-
Tory tuberculous, either glandular or of
It bail been my practice, [LB 80011 ILL B
glandular involvement hae been discover-
Iad, to put the patient on syrup of iodide
of iron in full doses to correct the diaes-
tion, and in all wags possible to increase
the resistive power. The gland is not
painted with iodine or irritaed in nny
way. If softening takes place, 88 soon 88
fluid is formed it is opened by B small iu-
cision at the most dependent portion, the
fluid evacuated zrnd the cnvity washed
“otwith peroxide of hydrogen and follow-
ed by pure carbolic acid, this being im-
mediately followed by slcohol. The c&vi-
ty i8 theI! lightly packed with gauze to
insure iroe drsinnge snddsily. afterward
the gauze remuvsd, t.he cavity washed
out with peroxide of hydrogen aud sterii-
iced water sod again packed with gauze.
lo thie manosr ench snccseding gland
is treated as it softens, care being taken
that the cavity is alwayti drained at its
moat dependent portiou. I have found
that siuoa adopting this lius of treatment
my ~8888 have improved much faster,
in that there has beennolnvolmeut of the
skin and while there have been R rlumber
oi smsll ioaisions there are no large, un-
sightly. BCBPS, aud I believe that the
patient has lessdisflgurement and 8s good
geuer~l results 8s wlt;h the extensive
operation for complete removal.
* \I l l l l * l
From my limited eqpsrieoce with the
disease, I am couadent that a very lilrge
per oeut of these “8888 oaq be “sred with
B miuimum nmolmt of BC%TB. I believe
it to be B large preventable disease, sod
I beg of you earneatly to consider this
all-importaut subject and to vie with one
another in B determined efiort to arrest
this Unsightly disfigurement and loss of
life and strength to 8” many of oUr stu-

_..._-.. The-(freat-Chief;-~ ~- - -
On one “acsslon, when Red Jaoket wae
oalled to give his testimony in a court, be
was asked if he believed In future rewards
and punishmeote, and above ‘all, in the
existence of a God.
He a.88 indlnnadt at tbe qoestion, and
replled, “Yee, much more than thin white
men, il we am to judge by thelx LoUon~.”
tUtiOn among natives of Alaska.
Gee. Funston eags bia~in~esti~atl
made in the mummer 8888”~ and that, a8
the destitution aOmplained of occura only
in atoter, tbe dstwhe obtairxed~-naa me&
ly from conversation with traders. mia-
elonsries, miners and c$tger residents of
Lhe country.
hIoat of the natlves along the coast of
Alaska, @en. Funston ~aye, belong to tbe
Thlinket race.
They are InOiada, not Eakimoa, and he
says there never has be&, any general
destitution among them. But despite
their general prosperity, Qen. Fuostou
88~6, there are somedisoooraging features
regardiux their oouditioo, the principal
ones being tuberculosis and liquor.
The Yukon Indians are deecrlbed to be
in-a primitive state, bnt are hone& .and
About the only reports of destitotlon
amcmg the nativees ot the interior of
Alaska fiave been regarding those on
Copper rive& but hir&formation wan that
thee0 Indian8 were trlfllog and worthlane.
Concerniug the Alaskan Eskimo, Qen.
Funston %ays, bla exi@eoce has always
been a PreoarioUs one, dependent upon
hie *ucoe88 in huuting and fishing.
After the Eskimo obtained breeah-load-
ing rifles from the whalers in the 703,
caribou Were alaugbtmred in the m”Bt
reckless fashion.
There is now, Qen. Funs@m saps, a cer-
tain amount of destitmion and OCCSS~OU-
al etsrVati”n among the E*kimoe of Ber_
ing sea and Kotzeboe sound, but it is due
to wnditious whioh prevailed years be-
fore the miners oame to the shore of Ber-
ing 8tlb.
Toe natives all bat extmr&nated tbe
caribou and ala” killed the walrus with
thessme reoklese disregard for thefuture.
Qen. Funtnon saya ttiat Under favoi:
able conditiona the reindeer enterpri~ ia
AhsiX& Will remoVe any ,,,,“a~@ whioh
may now exist for deatitotion among the
Eskimos, but that they are triflfllg and
He reoommends that they be pot under
oontrol of the Department ot the Iotsrlor
and their ailnleaa wauderlng aod visits to
the mlning toann and all eottlementa of
wbltt) men be prevented.
He advisers that under U” p~rcumstane~s
should rallona be dlstribpted to them
gratuitously.-[The HaIt Lake Tribune.

In THE Rsn Marr ~HII HELPDR for
Feb. 5th. I flnd the following:
“Exluninecarefully the interdims of the Ilrdian
80 far 88 “th6 intentions of the lndian
Bureau” *m conoerned, there is muoh
that I heve seen and known, which goes
to con&m what is there said. In faot,
the methods of the Indian Bureau, 88
seen In prsatlse here *re B” contrary to
what I consider proper and right, that I
have felt it my duty to raise my voiae,
again and *gal” against the nuwiae and
wrong methods. But that “the mission-
aries at work among the Indisns” *re
blqmeworthy in the w*y suggested, this
r feel to be *n err”nBo”a stetement.
AS the various religious bodies *re
l,,dependent of each other, they must
be judged separately, and not in mame.
As * miesionsry of the Episoopsl
Churuh let me speak of “ur own work.
So far d the shaping of any policy of
misaionsrgwork in Oklahoma ie concern-
ed, it lies largely with the bishop. in-
fluenced in * large me88ure by the mis-
sionury in charge of the work among In-
di*ns, who in this ease has been myself.
What then ha;8 bee” the policy th*t the
Episcopal Church has pursued in Okl&
I have opposed the present methoda of
ieaaing Indian lands. In the letter, I
.eaid, “It would be far better that the In-
disn shouldbe allowed to manage his
own affairs and to lease his own lands.”
I might go on, and quote from another
letter from me whioh appeared in THE
RED MAN END HELI’EB forNov. 7th19G2.
showing how “I do not +mand * oontin-
U*OCB, of mass conditions,” how “1 *m
strongly opposed to’ *ny suoh system,
holding the Indians tngether *I@ keep-
ing them-us wards.”
&So a&oh in regard to ?uy;own actions.
But wbst has been the course of the
Bis@p u:der whom I k*ve been work-
ing: :’
Often in phblio addresees, he h&s spok-
en in part years againebthe ration system,
that bulwark and exc”8e for t,he re~erv*-
tiou system. In various w*y& he has
endorsed what I have said bnd written,
on Indian matters. His last annual ed-
dress contained these words: “The mia-
taken and wrong management udder gov-
ernment methods among Cheyennes a;ud
So muoh in reg*rd to our position here
in Oklahoma.
But what *bout other mission*ries ?
Another bishop in another part o? the
country haa written me saying, “I’ will
write *gain to Commissioner Jones, but I
doubt if it will avail. The doors *re clos-
ed to &, in politioai circles.”
He further says that we do not have
“the political pull.”
These word8 iudictrte the wideepresd
hopelessness of obtaining needed reforma
in Indian matters. Meny missionaries
seeing the uselessness on their part of
trying to reform prevailing evils. find
that the’only thing for them to do is to
quietly acquiesce in the prevailing
lat, In reqard to myself:
Have I not bee” in favor of giving In-
Sometime *go, I consulted with * cer-
tain missionary, asking him to join with
me in exposingcertain evils. He aaknowl-
edged the truth of the evils, of whioh I
complained. but would not /o!n in *ny
efforts td eeforti the evils.’
It evidently seemed to him useless to
oppose the prevailing methods. Itwould
bring upon UB * storm of opposition and
abuse from government employees. They
would influence many Indians against us,
end we oould not hope to do tbe good
*mong them thst we otherwise might do.
In home such way: I think, many mie-
sionariea have acquieeaed in prevailing
government methods. They hnve tried
t” do their best under the oiro~mstsnoes,
-not attemptlny to’reform government
methods but preaching’the gospel, *B
their own special work.
I cannot feel that those missionsries
among Indiana *re to be’apeoielly blamed
for these condlttone. The blame rather
is with that alass of mep [see my letter
above referred to] who *re In the United .
dlana * full chanoe to become “USBf”1 .
Ststes Indian Servioe,, “not for the goon
of the Ihdian but for the m”nev in it for
to the prevslence of tuberculosis and one talent that made him .fsmous in
drunkenness. after ysers.
My letters in the RED MAN AND H&P-
EK had recently appeared,-portions of
which had been copied *nd published in
other w*y&
My statements, 88 contained therein,
seemed to have aroused the ill will of
thig United Ststea India” Inupeotor, for
his report ssys that I “recently resorted to
Such American generals, 8s Hull and
Harrison. found Teoumseh 8 brave foe on
the bsttlefleid. Though utterly defeated
at Tippeoanoe lsta-, 8% a commander of
British troop, he proved himself worthy
of his rank 8s *n “fU.cer.
As an orator his magnetic power *t
tracted the administration of the civil-
ized world. His life W*B wholly spent
in W*rs. never ceasing from activity.
With the exception :of Pontiao, he w*s
the only one who ever snceeeded in unit-
ing the.Northwestern Indians.
Sitting Bull, the monarch of the Sioux
nation, ~~18 forever * terror to the whites
in modern times. Without doubt. we
can place him 88 * great leader .*;“ng
bin people.
His name first c*me into prominence’
athe Custer _MaB~c&_~here. like
Oseeola, hein deeperatlon defeated *
lost cause. Time fails n8 to consider
King Philip, Pontiac, Black Hawk snd
other truly noble Red Men distinguished
for bravery, pntriotism, and * high order
of intelligence.
If theee leeders in the past, in spite of
adverse oiroumetances, gained 8” much
distinotion, how much more should be
expected of the Indian, r*c.e of the pres-
ent end the future.
oitizens, untrnmmeled either by Indl&n
tribe. or Indisn Rureru?” See mv letter -----, in the Rnrn MAN *ND HELPER f”“r Oct.
l’fth, 1!302, in *nawer to the question.
I quote * few parsgraphs:
“~l,“tted I odluna tihould be put LLL oncu OL &he
I)i~ne “1 c,~b.eo~hl” lrod trelrted LLS citlaons,”
“The &I,&0 oi CltlPeriBhll) b the only remedy qtlilt
I can 8ee. DO nwn9 wltb Indim. -resorvrWm~,
,lg.3Lw,e8 lvntl sveryr~lng +Alirt b’iv@n mgloymant
IrE Ln ,~dllLO Ilgeocy.”
do.not these words indi&.te e “purpose
that the individual Indlen sbsll have a
ob*ace to 8ee and know‘ and learn nnd
live oqtside of *nd.begond the tribe?”
5 have ndvoalrted the placing of the
sm*ller Indian ohildreu in aohool
themselves.” who *re perverting it from
ie noble purpoee.*nd making it vlle and
Reoauae I have bebn outspoken *gainat
prevailing evils, I have met the ill will of
many in the Un,itrd Rtates Indian Servioe.
Thet Ill will has become 8” ~Iro?g that I
beve been de&d,many privileges usual-
ly *coordbd to miqsiooaries. I luwe bseu
writina * lot of rubbish to the Department
88 well 88 to newepapers” whicd”certsin
newspaper8 imprudently published with-
out ascertaining the truthfulness,” of the
That report further ssys that my letters
“are rambling, illogical and not condu-
oive to the peace and welfare of the Iu-
diims of this reservation.”
The former Cheyenne aud Arepshoe
reeervstion w*8 opened to white settle-
meut * dokexyears xo._l’he &_dj*ns
have been declared citizens. Yet these
Indians *r‘8 in mnny respects still treated
88 wards, and any assertion of indlvid-
ual rights is repulsed. To the men who
wish to ~1111 perpetuate the reservation
system over those Indians, any talk about
oitizenahip, or individual rights is “not
Fouduaive to the peaoe and welfare of the
Indi+ns” from that atend point.
The rights of the individual Indian *re
trampled under foot. Snob things lead
one tathmk. that so far au the Indian
Bureau. is concerned, the reoent stste-
plents in the RQD MAN AND HELP~B
**a ciorreot.
Bnt do not 8” &DOUBB the missionaries
among the Indians. Some of them *re *B
outspoken *gain& these things, 88 your.
self. Many more reoognize these evils,
put o&x *coonut of their apparent sifsnas,
ycai &em tb have misunderstood tbeir*t.
tltude. ,
Yours faithfully,
Misstonsry to Cheyenne and Arapahoe

The Handling of Tuberculosis at One
Indian School: By E Shoemaker, AZ. D.
II 131i~IiC‘L~ I ,OSIS is ;I disease that for \.ears IIns“ been
a \\,idesl’i-cd scourge atllon~ the North American
Inrlinns 3s. incleed. it is- ;11i1011~ the \\.hite race.
‘l‘liis is, no rloul,t, due to the ditierence in the
niotle of life, hnl~itations, etc., made necess’nr~~ b\v
the acI\Tetlt of ci\.ilizntion. It 113s also G&l
thought that it is detrinlental to the Indian to take
him from the en\.ironment of l101ne xnd WIIIO\-e hinl to distant non-
i-esen’ation schools. \Yll:~te\-er iiixv he the cme in less healthful
climqtes or less \\,ell-equipped institutions, the records of the Car- - .
lisle school she\\ thnt durin q the pmt eight ve;u-s there have been _
tn.0 hundred crises dinqiiosed 3s tulwrculosis, or nn average 0
tnwlt\‘-ti\re \Wl. \‘eal- o11t of :1
opulntion of o\-er 3 th6>nsand. As
these students come front a I sections of the LJnited States, and
from nil conditions, of life, it does not :ippe;ir to he ;i large percentqp
of crises---no lnrqr thnn \\,ill he found in their o\\‘n homes on the
different i-esen’ations fi-oni \\,liicli the\, come.
‘1‘1112 outing+ s>.steili \\ hicli is in \;,QI~ at this ,scliool is condu-
. . ,
ci\.e, in 2 large iiiexui-e, to the qeiieral ~WOC~ he;~lth of our pupils .r
and to the comparative y small number of cases of tuberculosis.
The change of scene, f J od and air which it gives them is of untold
It is not our purpose to send tubercular cases to the country
to work, as in fact, they are always examined as to the condition of
their health before being sent out. Owing to the large number of
philanthropic friends this system has made for the school it has
been possible, in a number of suspected incipient cases, to send them
out to some quiet country home solely for the benefit of their health
without any systematic work being expected of them. This has re-
sulted in ‘marked improvement in health in most cases. I
It has been the rule during the past four years that every student
on entiring the school is given a thorough physical examination and
a record kept of the same. If the student is found on arrival to be
afflicted with tuberculosis he is returned to his home, but this does
not often occur. In some instances we have received students in
whom the disease was undoupedly latent and the co-nfinement inci-
dent to school-life has seemed to light up an active process. This
I consider the correct explanation of those few cases that manifest
,themselves within a short time after coming here, rather than that
the disease is contracted after entering school. The fact that every
.precaution is taken to properly ventilate the domitories, school rooms,
and other places where the students congregate, and the immediate
isolation of every case as it appears, makes them no more liable to
contract it here than if they had remained at home.
Tuberculosis cases are treated here as any other infectious
disease. When a case manifests itself it is immediately placed ia
the school hospital and, whenever possible, isolated in a separate
When there is no’ marked rise of temperature the patient is
made to spend as much time as possible out of doors. At night
his windows are kept open. He is given a nourishing diet of three
meals a day in addition to several eggs and as much milk as it is .
possible to get him to take. It is sometimes a difficult matter to l
get an Indian patient to take eggs or milk, but this is rather, the
exception. If fever is present the patient is made to rest in b@, l
Very few drugs are given except with a view of building up the sys-‘-
tern and increasing the resistance the individual, and to meet dis-
agreeable symptoms as they arise. He is furnished with individual
eating utensils and also with sputum cups that are burned every day
These cups are carried about with the patient if he is in the ambu-
lant class and he is cautioned not to expectorate anywhere in the
buildings or on the grounds. Under this general line of treatment,
if the patient continues to grow worse, it is the custom to return him
to his home. This procedure, though not often curative, at least
has the effect of prolonging the patient’s life and, in a fair propor-
tion of cases, arresting the progress of the disease. It is also due to
the inadequate facilities for handling cases of this kind and the con-
sequent danger of infecting others that it is deemed advisable to send
them to their homes.
The method of having the patient sleep out of doors both day
and night has been tried here with poor success. It seemed im-
possible to convince the patient, in the cases in which it was tried,
that it is for his best interest and that we were not purposely work-
ing a hardship upon him.
When a tubercular patient is sent to his home he is invariably
instructed in regard to the best way of living-to the necessity of
an out-of-door life, good food, etc.
This winter a series of papers on the
the subjects of which will be as follows:
1. Early History of Tuberculosis in
2. Nature of Tuberculosis.
3. Mode of Invasion and Spread.
4. Symptoms and Clinical History.
5. Methods of Prevention.
6. Treatment.
subject will be prepared,
the Indian.
j This is directly in line with the crusade that is everywhere be-
ing waged against it at the present time, and it is hoped it will result
in a better understanding of the disease.

revention of Preventable Diseases:
E Shoemaker, M. . *
‘SUBJECT w K is of vast importance and which con- h’ h
cerns us all is the matter of the prevention oqdis- ,
ease. It is now known that a great many of the
best known and commonest diseases, and those<
which annually carry off the largest number of
people, are wholly preventable diseases. It is due
to the wonderful advances that have been made in recent years in the
science of bacteriology that we have learned of the causation of the
various infectious diseases and, once knowing the causes, it is but a
natural seqence to determine the best means of their prevention.
Typhoid fever, tuberculosis, small pox, pneumonia and, in fact, the
whole list of communicable diseases can, with due regard to the
ordinary laws of health and with a little thought and trouble upon
our part, be largely prevented and untold misery averted.
As individuals it is well known that we should keepburselves in as
good physical condition as possible in order to render ourselves
better able to resist the invasion of disease-germs, and less suscepti-
ble to diseased conditions in general. We should eat an abundance
of wholesome and digestible food at regular intervals, which should
be thoroughly masticated in order to render it more easy of diges-
tion. A due regard should be paid to regular daily exercise and in
the open air if possible. An abundance of fresh air both by day
and by night is an absolute essential to the maintenance of good
health. This can be readily had by a proper arrangement of the
openings in the rooms we occupy without exposing ourselves to the
disagreeable effects of draughts. The importance of the matter of
ventilation and an abundant supply of fresh air, which is as necces-
sary for the healthy as for the sick, cannot be too strongly emphasized
specially in regard to our sleeping-rooms where most of- us. spend
at least one-third of our lives. It matters not how cold the air, is
that we breathe so long as it is pure and our bed coverings are suf-
ficent to maintain bodily warmth.
One of the most important problems that has forced itself
upon the attention of the scientific investigator and sanitarian in re-
cent years is the relation of certain common and well known insects
to disease. It is now known, thanks to the labors of the late Dr.
Walter Reed of the U. S. Army Medical Corps, and his co-workers
Doctors Carroll and Agramonte, that yellow fever, a disease which
for centuries has been a scourge of the tropics, and occasionally of
Northern cities as well, destroying many thousands of lives annually,
could not exist without a certain species of the mosquito-the
Stegomyia fasciata. In 1900, soon after the Spanish-American war,
Dr. Reed and his associates made a series of remarkable experi-
ments in Cuba which proved beyond a doubt that yellow fever was
conveyed from man to man by the bite of the female Stegomyia
mosquito. No successful experiments have since been made with
any other kind of mosquito and the accepted belief today is that this
is the only active agent concerned in the transmission of yellow
Malarial fever, which a few years ago was as much a mystery
as cancer is today, is now known to be conveyed by the bite of
another species of mosquito known as the Anopheles. It was not
until a number of years ;after the discovery of the malarial parasite
by Laveran, a French army surgeon, that Manson and Ross, Eng-
lish investigators, and others, showed by experiments that the An-
opheles mosquito is the sole means as yet known by which the
malarial fevers can be transmitted to man.
Knowing that the mosquito is responsible for the existence of
these diseases in man it is only necessary in order to prevent their
ravages to destroy, as far as possible, the disease-carrying mosqui-
tos and their breeding places, and protect against their bite by
* thorough screening. The recent magnificent work of Col. Gorgas
in the .I’anama canal region, practically ridding that section of
yellow fever and malaria stands out as excellent proof of the truth
of the above.
The mosquito has also been accused of being the means of in-
fecting the human body with a small hair-like worm known as the
filaria, of which a great many kinds have been described. These
filarial worms invade and live in great numbers in the lymphatic
vessels and glands which they sometimes completely block, pro-
ducing the unsightly and disfiguring disease known as elephantiasis.
The very important part which the common house-fly, one of
the most constant companions of man, plays in the causation of di-
sease is now familiar to all. Typhoid fever is the best known exam-
pie of the diseases that are transmitted by flies though tuberculosis
is also frequently so conveyed. Some epidemics of Asiatic cholera
have also been traced to this insect. In Egypt the eye disease known
__. . -.. .,.
as trachoma is conveyed by a particular kind of fly, as is also the
mtich dreaded sleeping sickness, or “African Lethargy” whit has
recently been thoroughly studied in Africa by the German commis- ?
sion under the supervision of Prof. Koch. The specific cause of
sleeping sickness is a small animal parasite, or protozoan, the try-
panosome, which is conveyed by the bite of the Tsetse fly. This fly
is a little larger than our common house-fly and has a large piercing
proboscis with which it inocculates its victim with the parasite in
much the same manner that the malarial mosquito does in causing
malaria. _.
The usual way. in which flies convey disease is purely a
mechanical one. They light upon filth and infected matter of all
ich adheres to their feet and legs and, as they swarm in and
about tchens, restaurants and other places where food is prepared
for the able, they light upon the food and contaminate it with the
poisonous matter clinging to their feet. Exposed fruit and foods
of various kinds in stores and markets are in the same way
rendered unfit for food. It was largely in this way that typhoid
fever was spread through the camps of the American army during
the late war with Spain in 1898, when hundreds of young soldiers.
needlessly lost their lives.,
Besides the agency of flies there are, of course, many other well-
known means of causing typhoid fever. The drinking of water
which has been contaminated by infected sewage, polluted milk,
oysters that have been found in sewage-contaminated water, and the
washing of celery and other raw vegetables with infected water are
all well-known ways of contracting this disease. So frequently is a
polluted water supply the starting point of an epidemic of typhoid
fever that the number of cases of the disease in a community has
come to be considered an index of the purity of its water supply.
Although the matter of purifying the water supply lies in the hands
of the municipal authorities yet it is within the power of each indi-
vidual household to render its drinking water absolutely safe. by the
simple expedient of ,boiling.
The preventive measures as regards flies would be first, the de-
struction of the insect and the prevention of, as far as possible, their
,breeding. As the house-fly, as a rule, breeds in and about stables
and barnyards it is necessary that all stables should be kept clean
and the refpse matter treated with chloride of lime which is effective
and yet will not destroy its fertilizing properties, or sprinkle it once
or twice a week with kerosene oil; second, decaying meat and
spoiled foodstuffs of 811 kinds should also be promptly disposed
of that they may not afford a breeding place for this insect; third, the
thorough disinfection of infected sputum and excreta from the sick,
and lastly, the exclusion of flies by screening from all kitchens,
stores, markets, restaurants, and other places where food is exposed.
This brings to our attention the important fact that screening our
houses is not only a matter of comfort but a protection to our
health as well.
The flea is another well known, and at times, troublesome lit-
tle pest ‘that livesunder the same stigma as the house-fly and mos-
quito. It is a well established fact that this insect is largely re-
sponsible for the spread of the dreaded bubonic plague or “black
death” of India, and is harbored by another ever present but unwel-
come guest the common house-rat. This little rodent is an espe- !
cial favorite of the plague-carrying flea and during epidemics dies ;
by the thousands. This flea also readily turns its attention to hu- /’
man beings and, if it happens to be infected with the germ from’
having previously bitten an infected person or rat it inocculates it si
victim by its bite. This disease is not infrequently transported to1
distant ports by means of ships carrying plague-infected rats. It
was in this way that it was lately introduced into San Francisco.
Since May, 1907, there have been 159 cases and 77 deaths record-
ed there but owing to a’ vigorous campaign that has been waged
against it during the past year and a half by the U. S. M. H. Ser-
vice the epidemic has been practically brought under control. This
has been accomplished by an expenditure of nearly $400,000 and it
is estimated that before the task has been entirely completed it will
cost upwards of $800,000. Millions of rats have been killed in
San Francisco and Oakland within the last year orso. Traps,
poison anda certain virus (Danysz’s), which is harmless to people
but produces in the rat a fatal disease similar to typhoid fever, have
been the principal means used. Large sums of money have also
been spent in destroying rat nests and runs and in making rat proof
hundreds of bakeries, stables, restaurants, markets, etc. The im-
portance of this work can be better appreciated when we consider
that the plague, which is one of the oldest diseases known to man,
has destroyed entire nations. In 1334 A. D., it swept from China
to Norway and caused the death of 25,000,OOO people. In 1665 it . c
killed 70,000 people in London in a single summer and in
ndia, .
since 1895, it carries off 400,000 people annually.
The ground squirrel is also under suspicion as several cases of
the plague have recently been traced to this source.
There is reason to believe that certain other fleas as of the dog,
cat and hog are sometimes concerned in the spread of leprosy.
This has not been proven but is believed by many to be true. Bed-
bugs, roaches, and ticks have also been thought to be occasionally
responsible for the spread of lupus, tuberculosis, leprosy and other
We cannot close a discussion of this kind without touching
more or less briefly upon the subject of toxins, anitoxins and
immunity, all of which have been so thoroughly studied by scien-
tists throughout the world during the past few years.
By immunity is meant an insusceptibility to diseise which may ’ .
be either natural or acquired. The white race has for centuries
been afflicted with tuberculosis but is gradually becomiig less sus-
ceptible to it through the slow development of this condition known
as immunity. It is well known that the Indian race, which it is be- a
lieved was free from tuberculosis prior to the advent of the whites,.
is still highly susceptible to this disease but, as time goes on, it, too,
will probably gradually acquire somewhat the small degree of
immunity to it that is seen in the white race. A toxin is a posion- vr
ous substance produced in the blood by the growth of bacteria.
This toxin produces in the blood in some mysterious way a
substance which combats the action of the toxin itself and is known
as an antitoxin. These antitoxins are formed in the blood serum .
during the course of all specific infectious diseases, such as typho,id
fever and small pox, and when they have been formed in- sufficient
amount to completely neutralize the toxins present the disease
comes to an end and is said to have run its course.
Artificial antitoxins which are used by physicians both in the
prevention and treatment of disease are obtained by injecting the
toxin of the disease germs into perfectly healthy animals, usually
the horse. These injections are made at frequent intervals in
gradually increasing doses until the animal has reached a high degree
of immunity and its blood is surcharged with the antitoxin. The
animal is then bled into sterile containers and, after coagulation of
the blood has taken place, the serum or liquid part of the blood
which contains the antitoxin, is drawn off and made to conform to a
certain standard for use. These antitoxins are introduced into the
blood of the patient by hypodermic injection in sufficient doses to
completely neutralize any toxins present. The action of an anti-
toxin is a specific one, being only efficient against the same disease
from which it was originally obtained. This method of treatment
has been especially successful in diphtheria, having reduced the
mortality from this dread disease during the past dozen years from
40 or 50 per cent to about 9 per cent, and practically robbed the
disease of its horrors, It has also given excellent results, not only
as a curative agent but also as a preventative, in such diseases as
tetanous, bloodpoisoning, bubonic plague, cerebra-spinal menin-
gitis, typhoid fever, etc. Many cases of tetanous or lockjaw after
Fourth of July injuries are prevented every year by the timely use
of antitoxin, while a few years ago this treatment was unheard of
and many deaths followed. During the past year or two an anti-
toxin has been in use in the English army in India for the pre-
vention of typhoid fever with considerable success. Many in-
vestigators, including such names as Koch, Behring, Yersin,
Calamette, and Flexner and Welch in our own country, are
constantly working in this field and it will not be surprising if, in a
comparatively short time, the whole list of contagious diseases will
* be placed in the preventable column.
For several years the creation of a National Department of
Health has been urged by the American Medical Association and
other medical bodies throughout the United States. Clauses
favoring such a proposition were included this year in the platforms
of both of the great political parties and it is hoped that, within a
short time, its establishment may be accomplished. The county and
city health boards should be directly under and responsible to the
state boards and they, in turn, to the national department, and in
this way every case of obscure or dangerous disease could be kept
under scientific observation and control until its close. It is impos-
sible to estimate the value to the nation of such a department of
health. Under its general direction the crusade which is being waged
against tuberculosis could be carried on more successfully than it is
at present. Under the proper federal authority this disease which
it is estimated will cause the death of 8,000,OOO of our people that
are living today, can in time be surely stamped out of existence. The
establishment of free laboratories for the scientific investigatio of
disease, free distribution of antitoxin, betterment of municipal $ ilk
supplies,, examination of school children, extermination of flies and
mosquitobs, purification of water supplies, and the general dissemi-
nation of knowledge concerning the preservation of health could all
come under the province of such a department. For years our
government has spent vast sums of money in the investigation of di-
seases of cattlei, hogs, and other domestic animals, and the different
parasitic diseases peculiar to the products of the soil. While this
is useful and has great value is it not of more importance to protect
its citizens from the ravages of disease?
- I

EVELYN Pmmca. Seneca.
(Results of Dr. Shoemaker’s talk in the audi-
torium, April 5.1
Tuberculosis is a disease of the
lungs that is now known to be
common to any climate, whether hot
or cold.
The symptons of consumption are,
loss of appetite and interest in en-
joyments, sweating during the night,
loss~ of color and weight, coughing,
---- 1Jriqingnpsputumandbeing tired
out easily.
A person having these symptons
should be .given a large airy room all
to himself. The windows should be
left open all the time to allow the
pure air and sunshine to enter and
circulate throughout the room.
Good nourishing food should be
given to consumptive patients and
milk and raw eggs have been eon-
sidered the best.
Patients too weak to exercise
should be out in the open air all the
time, but should not be allowed to do
School rooms, sleeping rooms, etc.,
should always be well ventilated, and
persens~living in cities should leave
their windows open at night as well
as in the daytime.

There has been begun a systematic campaign to stamp out tuberculosis, and, though battling against dreadful odds, it appears that the plans adopted are making progress. One physician, an expert in tuberculosis, is kept constantly in the field, moving from school to school, his duty being to sift out the diseased pupils and those under suspicion from those obviously unaffected. The diseased are sent home; the suspects are segregated and put under surveillance, and the sound remnant are surrounded by every safeguard against infection. The physicians attached to all the agencies have, been clothed with the powers of health officers and put in charge of the sanitary conditions in the Indian camps and cabins. The work done in this line has been complicated recently by the discovery of the ravages of another serious disease- trachoma- which. is liable to result in blindness if disregarded or unwisely treated. Thanks to the completeness of his sanitary organization in the field, the Commissioner was able to present such an array of’details soon after the first notice of the progress of this pest, that within fifty-six hours

The porches being built at the hospital for the tubercular patients are nearly finished.