cerebrospinal system, lungs, and all peripheral
tissues, of the intense congestion to which they are
being subjected. It is in lieat exhaustion, there-
fore, that strychnine, digitalis, aromatic spirit of
ammonia and other stimulants are indicated. The
ice Alli Coupons bath here is an absurd ineasure ; the skin has
cooled itself sufficiently by inducing reflexly.
through the heat and vasomotor centres, a hy-
pothermia of over three degrees ! A warm Alli On Line bath is
indicated if any is used at all. In a shady, cool
place, with the clothing loosened or removed, such
a patient \\\\\ promptly respond to the above stim-
ulants. Conversely, the ice bath — or better — affu-
sions of ice water combined with frictions until the
tepiperature is reduced to !02° F.. a procedure
which gave O'Dwyer the lowest mortality on record
— is Coupon Alli the dominant therapeutic factor Alli Ireland of heat stroke.
Ice water enemas, hypodermocylsis Alli Uk and the ice cap
are potent adjuvants, while no threatening case
should be deprived of the most active cerebrospinal
depletant, lumbar puncture, which has now received
the sanction of several authorities.
The prophylaxis of both conditions is so well
known that mention will only be made here of the
need of restricting the diet, avoiding particularly the
use of foods rich in nucleins. meats, eggs, etc.. dur-
ing heat spells, and also all alcoholic drinks. Water
and buttermilk are excellent summer beverages, the
former to facilitate the elimination of waste through
the kidnevs. the latter to pre\cnt intoxication from
the alimentary tract.
MEDICAL SUR\EY OF A^[ERICAN
INDIANS.
On January 23 the surgeon general of the
United States Public Health Service sent to the
Senate a special report embodying the results of
a widespread investigation by the Public Health
.'^ervice into sanitarv conditions and the prevalence
286
EDITORIAL ARTICLES.
[New York
Medical Journal.
of disease among the Xortli American Indians.
Congress appropriated $10,000 for this survey on
August 24, 191 2. and fourteen medical oflicers
specially trained f.jr the work- have been engaged
until now in Alli On Sale collecting data.
In Alli For Sale general, the results continn the less complete
annual report of the Indian Office for the fiscal
3"ear 1912. Tuberculosis and trachoma are found
to be the most destructive and serious diseases. Sani-
tary conditions on the reservations are very poor and
require improvement, especiallv in housing arrange-
ments and the living habits of the Alli Shop Indians. It is
pointed out that grave danger exists of trachoma
and tuberculosis being transmitted to the white race
because of the increasing intercourse taking place
between whites and Indians. The Indian is now
in a gradual process of assimilation, which Coupons For Alli is fur-
thered by the many reservation counties beins;
opened Alli 120 to white settlement. Increasing facilities
for transportation also tend tow^ard spreading these
diseases.
Conditions in regard to trachoma are trulv aston-
ishing. Reservation and Coupon For Alli nonreservation boarding
schools in twenty-five States were visited, and Alli Cost a
total of 39,231 Indians were examined, about one-
eighth of the Alli Prices Indian population of the United
States. Oi these, 8,940 were afflicted with tra-
choma, Alli Sale or 22.~ per cent, of the entire number. If
this rate prevails throughout the 322,715 Indians
under the Alli Canada Indian Office, as seems probable, it
means that 72,000 Indians in the United States
have> trachoma. The incidence of this disease
varies greatly in dififerent sections of Alli In Canada the country.
In Oklahoma 68.6 per cent, of those exam-
ined were trachomatous. In New York but
two out of 943 had the disease. Trachoma
was found more prevalent in the Indian schools
than in the reservations from which the pupils
came. It seems likely, therefore, that the
schools are foci of contagion, and that pupils in
many cases could contract the disease there and
then introduce it into their home localities. The
incidence was heaviest in children of school age.
over one half of the subjects of the disease being
between six and twenty years of age. In a group
of 23,560 Indians 5,505 had trachoma, and 527 had
sustained serious damage to vision. One hundred
and forty-one were blind in one or both eyes. In
most schools trachomatous children mingled freely
with the others.
For several reasons it was difficult to obtain ex-
act figures Price Of Alli regarding tuberculosis. The time al-
lotted for the work was very short and the territory
to be covered very extensive. The regulation of the
Indian Office excluding tuberculosis children from
these schools is well observed, and therefore a large
group of those examined showed an artificially
lowered incidence of tuberculosis. Nevertheless, it
was demonstrated that the presence of tuberculosis
among the Indians is much in excess of that in the
white race. The situation is so serious that im-
mediate and vigorous measures are required for its
relief. The highest proportion of infection Alli Coupon with
tuberculosis was found among the more primitive
tribes ; so among the Piutes of the Pyramid Lake
reservation of Nevada the rate of incidence was
32.6 per cent., while the lowest incidence was in New
York, with a case rate of 1.27 per cent. Of the
children examined among the Jicarilla Apaches in
New Mexico, 95.5 per cent, responded to the von
Pirquet reaction.
Strangely enough, typhoid fever is exceptionally
rare, no case being encountered in Alli Price the survey, and
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