HRDLicKA] TUBERCULOSIS AMONG CERTAIN INDIAN TRIBES 3 



peared. Since 1900 inquiries as to the disease have also been made 

 among the various tribes of the Southwestern states and northern 

 Mexico by the writer. In 1904, under the auspices of the Indian 

 Office, he collected from its physicians information as to the mor- 

 bidity due to tuberculosis among all the Indians of the United 

 States. The results of these studies have recently appeared as 

 Bulletin 34 of the Bureau of American Ethnology. At the beginning 

 of last summer a further step was taken by the Indian Office in call- 

 ing on its physicians for statistics as to the morbidity and mortality 

 due to tuberculosis among the Indians during the fiscal year 1907-8. 

 Finally, in preparation for the Sixth International Congress on 

 Tuberculosis, the Indian Office and the Smithsonian Institution 

 united in asking the writer to formulate a plan for a brief, direct 

 research into the subject in a numl^er of selected tribes, and detailed 

 him, with Dr. P. B. Johnson, bacteriologist, to carry out the inves- 

 tigation. The results of this were presented to the congress in the 

 form of an exhibit and a preliminary communication, and are detailetl 

 more fully in this paper. 



II. IMORBIDITY AND MORTAI.ITY 



The most extensive data concerning the prevalence of tuberculosis 

 among the Indians are (1) the census reports, (2) the above-men- 

 tioned statistics on the morbidity due to tuberculosis, collected by 

 the writer from physicians in the Indian Service in 1904, and (3) the 

 statistics on mortality from the disease gathered by the Indian Office 

 during the present year (1908). No one of these series of data is 

 perfectly accurate, particularly with regard to the larger reserva- 

 tions, where it is impossible for the physician to know of all the cases. 

 Still, they are sufficiently valuable to deserve publication in this con- 

 nection. 



The data on the morbidity due to tubercular conditions included 

 91 acceptable reports, dealing with an Indian population of 107,000 

 individuals. These reports recorded 2,836 cases of the disease, 

 divided as follows: pulmonary tuberculosis, 1,038; tuberculosis of 

 bones and joints, 208; glandular tuberculosis, 1,590; or to every 100 

 cases of pulmonary tuberculosis there were 20 cases of tuberculosis 

 of bones and joints and 153 of the glandular variety. 



The proportion of the several forms of the disease to the popula- 

 tion was as follows: 



Cases per 

 1,000. 



Pulmonary tuberculosis 9. 7 



Tuberculosis of bones and joints 1. 95 



Glandular tuberculosis 15. 



The detailed data are subjoined. Following these are the 1908 

 statistics on the mortality from tuberculosis, which are doubtless of 

 greater accuracy than the previous ones. The two series, however, 

 sliow a fair general agreement. 



