That the Indians of the present time are in a deplorable condition as to
health, no person familiar with Indian affairs will deny. It is
incomprehensible to me that the appropriations for combatting disease
are so meagre, and the appropriations for allotting and education so
lavish. As a western friend of mine, who had observed Indians for more
than thirty years says, “Of what use is education to an Indian with
consumption? An Indian child learns to read and write, contracts
trachoma, is sent home and goes blind. How does education benefit the
blind Indian?”
Doctor Ales Hrdlicka of the Smithsonian Institution recently made an
investigation of health conditions among the Indians. His report is
statistical in character, and will be found in Bulletin 42, Smithsonian
Institution, 1909.
Following this, the Public Health and Marine Hospital Service made a
thorough investigation in 1912–13 of health conditions among the Indians
and published another statistical report, “Contagious and Infectious
Diseases Among the Indians”, Document No. 1038, 62nd Congress, 3d
Session. Investigations were conducted in twenty-five states by
competent corps of medical observers. No trachoma was found in Florida.
Among the New York Indians there was but .2 of one per cent; Wisconsin
6.86 per cent. In the other states the percentages rise rapidly,
reaching 15.5 per cent in Minnesota; 22.38 per cent in New Mexico; 24.9
per cent in Arizona; 68.72 per cent in Oklahoma.
As to tuberculosis, but 1.27 per cent was observed among the New York
Indians. But the investigation set forth in the Public Health report
related mainly to trachoma and there were limitations placed on
tuberculosis research.
[Illustration:
SANATORIUM SCHOOL, FORT LAPWAI, IDAHO
No. 1. Superintendent’s house, employees, mess, and official guest
room. No. 2. Commissary. No. 3. Laundry and Carpenter shop. No. 4.
Employees’ dormitory (not completed when picture was taken). No. 5.
Residence of physician, Nez Perce Agency. No. 6. Engineer’s
residence. No. 7. Nez Perce Agency. No. 8. School building and
chapel. No. 9. Girls’ building and dining-room. No. 10. Boys’
building. No. 11 and 12. Buildings belonging to school district No.
57. Nez Perce County. No. 13. Top of chimney, barely seen, office of
the Sanatorium. No. 14 Employees’ quarters, Nez Perce Agency.
]
Although the Commissioner of Indian Affairs states that there are 25,000
Indians suffering from tuberculosis, the number is probably greatly in
excess of that figure. In Minnesota alone, in 1909, I found the greater
majority of the Indians suffering from tuberculosis, trachoma, or some
form of scrofulous disease. It is not necessary to go into this subject
in any detail. That disease among these poor people is rampant, is
inexcusable. It is heart-rending. It is a blot on our escutcheon, and
should have been removed long ago. Whether the delay in establishing
preventive measures, until trachoma and tuberculosis became widespread,
is due to ignorance, incompetency or carelessness, it is not my purpose
to state. I have high respect for the personnel of the medical branch of
the Service. The fault is not theirs, but solely due to meagre
appropriations, and lack of proper reports from the inspection corps. I
simply desire to cover this unpleasant subject with a blanket statement
of facts that the condition is intolerable, and all of us have been
criminally negligent. We introduced tuberculosis, trachoma, smallpox,
measles, diphtheria and most of the other diseases. If any man or woman
doubts the statement, let him or her read the narratives of travelers
among Indians two centuries ago and compare the condition then, with
that today. There is no earthly excuse why instead of three or four,
there should not be fifteen or twenty doctors on every reservation.
There is no reason why our rich, powerful Government does not
appropriate two or three million dollars a year to put an end to the
miseries we ourselves have introduced.
Persons of prominence have called attention to the spread of disease in
past years. Commissioner Leupp first noted that health conditions were
bad, and increased his medical corps. But his successor, Honorable R. G.
Valentine, made a health campaign the chief thing of his administration.
He went before Congress and plead for increased appropriations. Great
credit is due him for his humane efforts, which are continued by the
present Service head, Mr. Sells.
Before the Government awoke to the need of health protection, a
gentleman in California was a pioneer in the fight against disease. He
has lived to see the fruits of his planting, but for many years his
voice was that of one crying in the wilderness, and few there were who
thought of repentance. I refer to Charles F. Lummis, Esq., an authority
upon the Pueblo and California Indians. Mr. Lummis has written me a long
letter in which he sets forth the difficulties under which he labored,
and how that he was roundly denounced because he opposed the scheme of
taking children accustomed to open-air life, shipping them East,
crowding them into contract schools—thus making of strong, healthy boys
and girls, consumptives. Lummis fought—not education, but this
pernicious and wicked policy. Some of his experiences were interesting.
He speaks of the former school conditions, and I take it that his
strictures do not apply to the past two or three years.
“It is obvious that to take children from the high, dry climate of New
Mexico and the general Southwest, back to the Eastern winters and to
steam-heated halls, can have but one effect. That is no theory. I have
seen the practical workings for more than a quarter of a century; and it
is my sincere conviction that Carlisle and similar schools away from
home have graduated more consumptives and more sons and daughters
forever alienated from their parents and kin, than they have produced of
scholars or other people seriously useful in any walk of life.
“I do know that thirty years ago consumption was almost unknown in most
of the Pueblos in New Mexico. I do know that the first consumptive
Pueblo I ever saw was from Carlisle; and that most of the consumptive
Indians that I have known in my thirty years acquaintance with New
Mexico have come back thus infected from these Eastern Government
Schools”.
“At a meeting of the National Educational Association in this city in
July, 1899, I had a serious clash with a distinguished Indian educator.
An Indian convention was held in conjunction with the N. E. A. I was
busy; but seeing the daily reports finally became so incensed at the
inhuman and stupid proceedings, that on the last day I went to the
Convention and took the floor almost by force, after listening to most
of the afternoon’s proceedings.
“This man had with him two very charming and well-schooled Indians—a
young man and a young woman, who were called up by him to answer some of
my strictures as to the Carlisle methods. And they made eloquent and
loyal defences. The audience (being as unobservant as American audiences
generally are) were very much surprised when in my reply I called
attention to the fact that the two model students that Mr. Educator
brought with him were both consumptives, and I asked him point blank if
they were consumptive when they entered Carlisle.
“Of course I got no answer—and I was lucky in getting out of the hall
alive.”
LOS ANGELES, SEPT. 14TH, 1914.
Doctor Ales Hrdlicka, in the year 1908, acting for the Indian Office and
the Smithsonian Institution, investigated health conditions with
reference to tuberculosis among five selected tribes of the United
States. On page 7 of the report Doctor Hrdlicka states:—
“The investigations on which this report is based were pursued in five
of the tribes, shown in the above-mentioned data to be most afflicted
with tuberculosis, and in one of the large non-reservation schools. The
tribes in question are the Menominee in northeastern Wisconsin; the
Oglala Sioux in South Dakota; the Quinaielt on the seacoast and along
the river of the same name in northwestern Washington; the Hupa in
northwestern California; and the Mohave, on the Colorado river between
Needles, Cal., and Yuma, Ariz. These tribes were selected not only
because of the prevalence among them of tuberculosis, but also because
they live under widely differing conditions of climate, environment,
civilization, and contact with the Whites. The school visited is the one
at Phoenix, Arizona. The investigation was carried on during the two
months of midsummer when people everywhere are most free from the
various bronchial and pulmonary affections that might complicate a
diagnosis.
“On account of the short time available, and the extensive ground to be
covered, the study had to be limited to what was most essential toward
obtaining reliable statistics. In the smaller tribes, as the Hupa and
the Mohave, nearly all the dwellings were visited, and all the members
of the tribe who were not far distant were studied. In the larger
tribes, as the Menominee and the Oglala, the examinations were limited
to one hundred families. Among the Oglala, these one hundred families
included only full-bloods, who in this tribe suffer more from
tuberculosis than do the half-breeds.
[Illustration:
AGED WOMAN NEARLY BLIND FROM TRACHOMA
]
“The actual work consisted in visiting the dwellings consecutively and
making a personal examination of each member of every family, healthy or
not healthy. In many families absent members were brought from many
miles away by the Indians themselves for examination. This examination
embraced the lungs, heart, glands of the neck, and skeleton, and was
supplemented by inquiries. * * *
“The investigation was everywhere promoted by the Indians themselves,
who welcomed an inquiry into the disease which is decimating them, the
gravity of which they well appreciate, but against which they feel
utterly helpless.” * * *
He found the Oglala Sioux, of Pine Ridge reservation, numbering 6,663,
very susceptible to tuberculosis; the number of individuals in a
thousand affected with pulmonary tuberculosis being 30.8, bones and
joints 6.8, and glandular 57.7. The highest number of persons suffering
from this disease was found among the Hupa Indians of California, where
the number of individuals per thousand arose to 60.4, pulmonary
tuberculosis.
“In regard to civilization, the Oglala are in the transition period,
which generally means partial degeneration. They live in small or
fair-sized log houses of one room, each provided with one or two small
windows that are never opened. The houses have earthen floors and sod
roofs. In summer almost every family constructs from poles and boughs,
or from young pine trees, a more or less open shelter in which, while it
is warm, they spend most of their time. Usually, each family has also a
light, easily portable tent, which represents the ancient tipi. These
tents are erected near the house and are occupied by the aged, by some
relative or visitor of the family, or serve to sleep in. When the family
leaves home, such a tent is packed, together with bedding, kitchen
utensils, etc., into the wagon, and is pitched whenever a stop is made
for the night. Indeed, there will be at times one or more villages of
these tents near the agency, or about a house where some particular
feast is being given. In summer these tents are oppressively hot during
the day, though they become cool if the sides are raised. As they are
made of very light fabric, they are cold at night, and afford but poor
protection during a severe rain or hail storm, as the writer personally
experienced. * * *
“As to clothing, the Oglala now dress like the Whites in most respects,
though the majority still persist in wearing moccasins. The women wear
leggings and always a blanket or shawl when going about. A tendency to
wear too much clothing, even on the hottest day, was again noticed and
is very prevalent. This is due partly to ignorance and partly to vanity.
The garments are usually far from clean. The writer learned of several
instances in which the clothing of tuberculous persons was given or sold
to others.
“In diet the Sioux are chiefly meat eaters, the principal kind of meat
consumed being beef. They cook this fresh, or cut it into strips and dry
it on cords stretched outside their dwellings. Other common articles of
diet are badly made wheat bread and large quantities of coffee. When
they have money they purchase crackers and canned foods. They eat very
irregularly, both as to time and quantity. During feasts and when
visitors are present, they not infrequently use the same wooden spoon or
other utensil, one after another, and eat from the same dish, the bones
and other remnants being freely strewn over the floor.
“In many of the dwellings it was seen that the denizens lack in both
quantity and quality of food on account of their poverty. * * * Numerous
cases were seen where the whole meal consisted of a few crackers and
black coffee. In several instances cattle which had died of disease had
been consumed, both flesh and viscera. According to the resident
physician, Doctor Walker, the Oglala eat not only cattle but even horses
and dogs that die of disease. The people are not emaciated; in fact,
many look well nourished. Yet there is no doubt that many do not
receive, except on rare occasions, all the nourishment they require.
This doubtless induces indolence and disease. It would also strongly
promote the spread of alcoholism, but fortunately there are very few
chances for obtaining liquor on or near the reservation.
“Few of the Oglala men have any steady occupation. They do very little
farming. During the summer they cut some hay in the valleys, which
brings fair prices. Cattle and horses are being distributed by the
Government to the different families, and stock-raising is being
encouraged with some success. * * *
“The people of this tribe are quite shrewd, tractable, and glad to be
instructed, though the instruction given does not always have practical
results. Their most striking peculiarities are the above-mentioned
tendency to a seminomadic life and the disinclination to steady manual
work. They are very ignorant of all matters regarding hygiene. One of
the most reprehensible customs among them is the so-called ‘passing of
the pipe.’ Whenever a number of men have gathered in a house, there is
passed from mouth to mouth a lighted pipe, the mouthpiece of which is
never cleaned. As there is often in such a group an individual in the
earlier stages of consumption, the habit must be regarded as providing a
direct mode of infection with the disease.”[50]
This description of the Oglala Sioux by Doctor Hrdlicka, who is one of
our most expert and competent scientists, might well be applied to other
bands and tribes of Indians in the transition period. As has been
suggested elsewhere, it emphasizes the immediate need of larger
appropriations, the employment of numerous physicians and sanitary
officials, if we would save the full-blood Indians.
[Illustration:
A TUBERCULOSIS PATIENT. BEDDING COVERED WITH FLIES
]
Dr. Joseph A. Murphy is medical supervisor of the Indian Service, and a
more competent man cannot be found. I have received a number of reports
covering his activities the past two years. That the Indians are
suffering, is no fault of Dr. Murphy’s, or his assistants. He has
recently established hospitals and increased the medical corps. If the
present ratio of increase in physicians and buildings continues, much
alleviation will result.
Dark as is our picture, recently it has become brighter. The past two
years conditions have greatly improved. There are more adequate
appropriations. But this realization of our responsibilities at a late
day, does not absolve us from past responsibility. We had been
repeatedly told—nay, warned of the consequences, yet we continued our
“same old story, in the same old way,” until the white people living in
Indian communities complained. Now, when Indians complain we pay little
heed, but when the representatives of the white people cry, “menace to
public health”, we heed and we speedily send help to allay the fears of
the good and substantial citizens. The appeal from Macedonia is not
uttered in vain.
We now have hospitals building, and they may take care of a third of the
sick. We also enforce stricter sanitary laws. So we may look forward to
saving some of those who suffer from the “coughing sickness”, and as to
the other scourge, it is so contagious that heroic measures have been
adopted, and the light will not go out forever from Indian children’s
eyes.
I present two field reports, sent by competent observers who traveled
extensively in Wisconsin and Oklahoma, and both of whom have long
resided among Indians there.
“When I came to the Lake Superior country in 1878, I found the Indians
of Lac Courte Oreille Reservation and of Lac du Flambeau, living almost
entirely in birch-bark wigwams, also in Bad River Reserve, near Ashland,
Wis. In Courte Oreille, I counted about six log houses, mostly inhabited
by French half-breeds. In Bad River Reserve (now Odanah) perhaps about
the same number; in Lac du Flambeau also about six log houses. But as
soon as the Indians got their pine-money and their allotments, they
immediately began to build houses, many of which were large and
commodious. Others were of hewn logs, rather small and low and very
unhealthy on that account, as there was very little ventilation, and in
the winter they would be huddled together, most of them sleeping on the
floor in a blanket, or poor bedclothes. The stove was very hot until
after the fire went out, when, of course, towards morning they would be
shivering with the cold. Cooking, smoking, living, in such a small room
would naturally cause colds, and consumption. This may be justly called
_the Indian’s Disease_, as it is the most common sickness of which they
die; they generally die of consumption, brought on by their total
disregard of the laws of health. Sugar-making early in spring, when they
used to gather the maple-sap in the woods, walking in the wet snow and
cold water, shod with soft moccasins, made of deerskin, and not much
better than common stockings; then went the whole day with wet feet—this
no doubt laid for many, the seeds of future consumption. Then, gathering
cranberries in swamps, wading in the water for hours and hours, was also
highly unhealthy. Their cooking was also very poor. Bread, tea, and pork
their principal food, the bread badly made, hard and heavy. The Indian’s
natural home is the woods, like that of the deer; the white man’s
natural home is the clearing, in open country. Civilization is coming on
the Indian too fast—it effeminates and weakens him. The Indian woman is
naturally industrious, the Indian man is lazy; that’s about the way to
put it.
“The Franciscans in California solved the Indian problem in the best and
most practical way: they first made Christians—and then civilized the
people.”
Correspondent, Bayfield, Wis.
“Surrounded by wretched conditions, it is not surprising that the
incidence of tuberculosis, trachoma, and other diseases is large among
these Indians. Although tuberculosis can hardly be considered as
prevalent here as among some of the other reservation tribes, it
nevertheless occurs to an alarming extent. It appears to be more
prevalent in some localities than in others, and, in some sections,
seems to be on the increase. The home conditions of many of these
Indians are such that, if a case of tuberculosis or other infectious
disease occurs in a household, the probability is that the disease will,
in time, go through the entire family.
“During my drive among the Cherokee full-bloods, probably forty families
were visited, many of which either have, or have not, one or more cases
of tuberculosis. In the vicinity of Barber, twenty miles from Talequah,
there occurred three deaths from tuberculosis within three weeks of the
time of my visit. Two of the cases, one a baby in the arms and the other
a woman, the head of the family, were seen by me. The latter case was
particularly pathetic and deserves special mention. The sick woman,
dying of tuberculosis, was found in the one room of the house, which,
though small, illy ventilated, and poorly lighted, was occupied by nine
other people, including six small children. Being wholly ignorant of the
dangerous and infectious nature of the disease, this condition continued
until the death of the patient, which occurred two weeks later. Another
family visited, had lost three members from tuberculosis within the past
few years.
“When the housing conditions encountered here are taken into
consideration, it seems remarkable that tuberculosis does not spread
among the people even more rapidly than it does. This can be partially
explained, however, by the fact that they are sometimes widely
scattered, the houses, in many instances, being several miles apart.
[Illustration:
NATIONAL INDIAN ASSOCIATION HOSPITAL AT INDIAN WELLS, ARIZONA
]
“In another family near the little village of Eucha, a girl fourteen or
fifteen years of age was seen to wipe her trachomatous eyes with the end
of a shawl, worn about her mother’s head. The mother held a young baby
in her arms, and it would seem that a failure to infect the baby’s eyes
with the contaminated shawl would be nothing short of marvelous.
“The civilizing influences that surround these people are far from good.
The class of people that are frequently found as neighbors are a
shiftless, undesirable class. These Whites live amidst unsanitary,
meagre surroundings. It is due to this class of citizens that the use of
cocaine has of recent years assumed alarming proportions. This habit has
become quite common among the full-bloods in some sections, and I heard
of several deaths that were attributed directly to this cause.
“The use of alcoholic liquor is, no doubt, a positive detriment to the
Choctaw Indians, particularly in those districts close to the Arkansas
border. Many crimes have been committed among the Indians that can be
attributed directly to the use of liquor, given to them by unscrupulous
bootleggers from across the border.
“Trachoma appears to be even more universal among the Creeks and
Seminoles than it is among the Indians farther south, and many cases are
observed. Trachoma is, no doubt, a positive menace to the usefulness and
well-being of many of these people, and should be met by a vigorous
campaign for its control.
[Illustration:
INDIAN CABIN, NORTH DAKOTA
Six of the seven inmates had trachoma.
]
“The native medicine man appears to play a more important part among the
Creeks and Seminoles than among the other Indians of the Five Civilized
Tribes. The full-blood Indians seldom call on the local white physician
for treatment, but depend almost entirely upon their own medicine men,
and the use of patent remedies, purchased at the local country stores.
Several bottles of a patent consumption “cure” were seen in a number of
homes visited.
“After a careful survey of the conditions existing among the full-blood
Indians of the Five Civilized Tribes, it seems highly important that
there should be a well-organized system of medical treatment provided.
Tuberculosis and trachoma, the two most important diseases to be
combatted among Indians generally prevail among these people to an
alarming extent, and both appear to be steadily on the increase. It is
unquestionably true that many of these Indians sicken and die without
any medical aid whatever. Many of them are too poor to employ white
physicians, with the result that the physician is either not called at
all, or only when it is too late to be of any avail.
“Too much emphasis cannot be placed upon the need for hospital
facilities for these Indians. There is, at present, no place available
in which to place the needy sick except in local city hospitals. This
necessarily entails considerable expense on the individual and, in many
instances, there is a prejudice against going away from their homes to
enter a strange hospital. The several sanitariums throughout the Service
are usually already filled beyond their capacity, and it is seldom
possible to secure their admission to the institutions.
“In view of the extremely unsanitary conditions existing in many of the
full-blood homes throughout the Five Civilized Tribes, it would appear
that field matrons would here find a large field for usefulness. The
people with whom she comes in contact are easy of approach and
tractable. They are also readily susceptible to teaching, and would, no
doubt, welcome the assistance that the field matron would be able to
give.”
Correspondent, Muskogee, Okla.
Five Civilized Tribes. Reports of the Commissioners of Indian
Affairs, 1893–1905.
Health Conditions Among Indians.—_Edgar B. Meritt._ The Red Man.
May, 1914. P. 347.
Tuberculosis, Saving Indians from.—_Frank H. Wright._ Twenty-fifth
Annual Report Lake Mohonk Conference 1907. P. 38.
Sanitary Homes for Indians.—_Edgar B. Meritt._ The Red Man. June,
1912. P. 439.
Sanitorium Schools: Fort Lapwai, East Farm, Laquna (Tuberculosis
Sanitorium), Toledo. From Articles pp. 356, 362, 368, 385, The Red
Man. May, 1914.
Indian Medical Service, Organizing the.—_J. A. Murphy._
Twenty-seventh Annual Report Lake Mohonk Conference, 1909. P. 23.
“White Plague” of Red Man.—_George P. Donehoo, D.D._ The Red Man.
September, 1912. P. 3.
The Trachoma Problem.—_W. H. Harrison, M.D._ The Red Man. May, 1914.
P. 377.
Tuberculosis Problem, Important Phases of.—_Dr. F. Shoemaker._ The
Red Man. May, 1914. P. 351.
Indian Tuberculosis Sanitarium and Yakima Indian
Reservation.—_Congressional Record_, 63rd Congress. Dec. 20, 1913.
[Illustration:
REV. SHERMAN COOLIDGE; ARAPAHO
Missionary at Fort Washakie, Wyoming.
]
-----
Footnote 50:
Bureau of American Ethnology, Bulletin 42, Washington, 1909. Pages
11–14.