26 BUEEAU or AMERICAN ETHNOLOGY [bull. 42 



of consumption. Two others of the same group of 28 children ore 

 among the above-mentioned 5 suspicious cases, showing a gradual 

 failing, mth slight cough. 



From the above tables it is seen that the cases of phthisis positively 

 established in these tribes amounted to from 3 to 5 per cent of their 

 whole population — an appalling proportion. In addition to this, 

 large numbers, particularly of the young, had at the time of exami- 

 nation, or had had in the past, tuberculosis of the cervical glands or 

 of the bones. Among the Indians the pulmonary form generally 

 involves both sexes in nearly equal proportion; nevertheless, all of 

 these tribes show a slightly greater frequency of the infection in the 

 females. This presents a contrast to the case of the American whites, 

 in whom the males are the greater sufferers. 



As to the ages of the patients, it is seen that a large majority of the 

 afflicted were above 20. A much smaller proportion of cases was 

 found in children under 14 years of age, as was true also of those 

 between 14 and 20. If, however, similar statistics were gathered 

 during the latter part of the winter and in the early spring, the 

 proportion of adolescents and young adults attacked by the disease 

 would probably be higher than that of the children or than that of 

 the adults in excess of 35 years of age. For at that time of the 

 year would be found a greater number of acute cases, which appear 

 mostly in subjects between 16 and 35 years of age, and the majority 

 of which before the advent of summer have been eliminated by death. 

 Again, if tuberculin tests could be applied to the children it is very 

 certain that a larger proportion of cases would be found in this group. 

 Considering the adults alone, it was found that a greater number of 

 cases of pulmonary tuberculosis existed among those in early and late 

 adult life than among those between 35 and 55 years of age. In all 

 these conditions among the Indians as compared with the whites no 

 radically different features exist. 



The cases in which positive diagnoses of phthisis could not be 

 established, and which therefore are classed as doubtful, embrace, in 

 all probability, instances of bronchitis of long duration, due to other 

 causes than tuberculous infection. But they certainly include also 

 cases of pulmonary tuberculosis of mild or very irregular character 

 or encountered in the early or late stages of the disease. It is well 

 known that under the latter conditions the tubercle bacillus is often 

 absent from the sputum, or can be detected only after repeated exami- 

 nations. Some of these doubtful cases presented man}^ symptoms 

 and some physical signs of pulmonary tuberculosis, yet, in addition 

 to a negative sputum examination, other distinguishing features were 

 absent, necessitating a reserve in diagnosis. 



As to the varieties of ])hthisis encountered, the tables show but one 

 truly acute case. As has been mentioned, such cases occur princi- 

 pally during the winter and spring and terminate in death or become 

 subacute or chronic before midsummer. Some of the acute cases 



