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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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