HRDLicKA] PHYSIOLOGICAL AND MEDICAL OBSERVATIONS 175 



whicli was to briiij? needed provisions. No precaution is taken against 

 coinnumication of the trouble to others in the dwelhng. Unless a 

 white physician interferes, such cases are generally allowed to run their 

 course, the end being often total blindness. The percentage of 

 blind in some of the tribes is appalling. As to pulmonary tubercu- 

 losis, a patient with the disease lies in the hut which is common to 

 the family, and often in immediate proximity to other members. 

 Next to him is usually placed a piece of a broken vessel, into which 

 he expectorates, but often he expectorates simply into the ashes on 

 the floor of the dwelling or out of the door. In eating and drinking 

 he uses the same utensils as the other members of the family, and 

 his food is the same. The family feels the gravity of the disease, 

 but it is usually in absolute ignorance as to its nature and the 

 danger of contagion. 



In general, ignorance among the Indians, as elsewhere, must be 

 regarded as the most potent pathogenic agency. 



Diseases among the Indians of the Southwest and of 

 Northern Mexico 



The subject of diseases among the Indians was approached through 



•direct observation and inquiries and, near the conclusion of these, 



through an official circular requesting information on a number of 



important pathological conditions from all the physicians of the United 



States Indian service. 



Direct investigation into disease among the Indians met with numer- 

 ous difficulties not ordinarily encountered elsewhere. There is much 

 distrust of the white man and shyness, especially on the part of the 

 women, in his presence. Other impediments are the antagonism of 

 the Indian medicine-men; the scattered condition of the people; the 

 limited time for observation; and the difficulties of language and of 

 obtaining accurate descriptions of symptoms. Besides it is very often 

 impracticable to make the chemical tests and microscopical examina- 

 tions essential to the proper recognition of numerous morbid condi- 

 tions. These limitations prevented more or less effectually in the 

 different tribes many desirable and detailed observations. Yet in 

 numerous instances at least some of the distrust was overcome, and 

 the writer visited the sick in their houses and had others come for 

 medicine. Other sources of information were individuals who con- 

 sented to be measured and the chiefs, resident physicians, or other 

 authorities, from whom much was learned in response to interroga- 

 tions. The records concerning the various tribes, though made in the 

 , main without preconceived opinions, and some of themgathered several 

 years apart, show not a little uniformity. There are also special fea- 

 tures with certain of the peoples, and these are likely to be increased 

 in number and accentuated with the increase of knowledge. It is 



