Does Pulmonary Consumption tend to Exterminate the American Indian? BY THOMAS J. MAYS. M. D., REPRINTED FROM SOc Ncte ¥orfc jjttctiical journal for May 7, 1887. Reprinted from the New York Medical Journal for May 7, 1887. DOES PULMONARY CONSUMPTION TEND TO EXTERMINATE THE AMERICAN INDIAN? By THOMAS J. MAYS, M. D., PHILADELPHIA, PA. In an article published in " The New York Medical Journal" for January 1, 1887, entitled "Pulmonary Con- sumption among the Indians," Dr. Washington Matthews adduces evidence which " goes to show that consumption increases among the Indians under the influences of civiliza- tion," and that "wherethe Indians have been longest under civilizing influences the consumption rate is the highest." That the first proposition is quite in harmony with the op- eration of the law of adjustment between living bodies and their environment no one will, we think, call into question ; but that the second proposition rests on an equally firm foundation neither follows from the truth of the first, nor is substantiated by facts as gleaned from the medical statistics reported by the commissioners of Indian affairs. Dr. Matthews roughly divides the Indian population into two classes: («) those living on reservations, and (6) those not living on reservations, or those at large. The latter constitute the class which has been most fully brought under the influences of civilization, two thirds of whom reside in the States. The former, or the reservation Indians, chiefly DOES PULMONARY CONSUMPTION TEND TO 2 reside in the Territories, and have been most recently sub- dued and brought under civilizing influences. Following this he gives the consumption rate of 1880 among the In- dian population in thirteen different States and Territories thus : " Nevada, 45 ; California, 70 ; Arizona, 83 ; Colo- rado, 107; Nebraska, 150; Montana, 176; Dakota, 200; Oregon, 240; Idaho, 250; Washington, 302 ; Michigan, 333 ; Wisconsin, 361; New York, 625." He concludes as follows: "It is seen in the foregoing table that in the States east of the Mississippi-the oldest States, where the Indians have been longest under civilizing influences-the consump- tion rate is the highest." These figures reveal a startling condition of things, and, if true, would clearly show that the extermination of the In- dian by natural means is only a matter of a comparatively short time, and they at once raise the question, Why should the fate of the Indian in respect to pulmonary consumption be harder than that of the white man ? for we have * else- where given what we consider satisfactory proof that this disease is on the decrease among the white population in this country, owing to an adjustment of internal to external relations. Before proceeding any further it is important to con- sider the methods which Dr. Matthews employed in getting the above-mentioned results; and this will serve to explain the variations in the calculations which each of us obtains. His " consumption rate is the number of deaths from con- sumption in a thousand deaths from all known causes." This obviously may become a very unreliable standard for comparison, especially when our estimates are to cover the statistics of a number of years. If the number of deaths from all causes were unvarying, or very nearly so, from * " Study of Pulmonary Consumption in the City of Philadelphia," " Trans, of the College of Physicians," Nov. 3, 1886. EXTERMINATE THE AMERICAN INDIAN? 3 year to year, or would necessarily bear a proportionate re- lation to the number of deaths from consumption, the plan would answer admirably. This not being so, results vary in accordance with the prevalence or absence of other diseases than consumption ; hence more reliable results can be ob- tained when the number of deaths from any given disease is compared with the whole population or class among which it prevails. This latter method is the one which we adopted here. In looking up the data for this paper we encountered a great many obstacles. In the first place, we found that up to 1882 the reports of the Indian Commissioners gave no sta- tistics in regard to consumption among the Indians, for prior to that time consumption and scrofula were classed together under the heading of tubercular diseases; and at no time do these reports furnish the number of deaths from consump- tion-only giving the number of those suffering from this disease in each agency. Imperfect as the work therefore is, and brief as the period is over which it extends, we think sufficient information may be gathered to show that con- sumption pursues the same general course among the In- dians as it does among the white race-viz., first contact with the influences of civilization increases its death-rate, and prolonged contact diminishes it. For the sake of clearness and comparison we subjoin a table, in which are given the population, the proportionate average number of deaths from all causes, and the manner in which the Indians were brought into civilization, in each of twenty Indian agencies. These agencies are divided into three groups : (1) those which existed prior to 1863, (2) those which were established from 1863 to 1880, and (3) those which have been established since 1 880. This divis- ion is made for the purpose of showing the different de- gree of effects produced by civilization on the Indian race. 4 DOES PULMONARY CONSUMPTION TEND TO This is very natural, for, if civilization has any deteriorat- ing tendency in this respect, it must be granted that a few years are necessary for its development: hence the third group should manifest no or very little deterioration ; the second group more ; and the first group, if prolonged contact with civilization increases deterioration, should show most of all ; while, on the other hand, if there is any tendency of adjustment between the constitution of the Indian and the causes which generate consumption, the first group should be comparatively free, or at least more so than the second group. NAMES OF AGENCIES. Population. Proportionate no. of deaths f'm all causes to population in 1886. How and when they were brought under the influ- ences of civilization. « O ft® g « C s .2 " .2 .2 §- o | § Ph First Group. 1. Mission, Cal .. 2,958 1 to 1,494 1 to 73 By treaty with Hidalgo. 2. Mackinac, Mich 4,000 1 to 896 1 to 93 By executive order in 1855. 3. White Earth. Minn 5,885 1 to 840 1 to 49 By treaty in 1855. 4; Nevada, Nev 3,757 1 to 535 1 to 79 By executive order in 1859. 5. Navajo, New Mex 23,000 1 to 1,200 1 to 82 By treaty in 1863. 6. Pueblo, New Mex 7,762 1 to 1,500 1 to 46 Received under old Spanish grant in 1848. 7. New York, N. Y 4,960 1 to 681 1 to 34 By treaty ni 1797. 8. Umatilla, Or 902 1 to 301 1 to 54 By treaty in 1855. 9. Green Bay, Wis 3,036 1 to 303 Ito 41 By treaty in 1848. Second Group. 10. Colorado River, Ariz 1,012 1 to 253 1 to 23 By congressional act in 1865. 11. Round Valley, Cal 602 1 to 120 1 to 33 By congressional acts in 1864 and 1873. 12. Cheyenne River, Dak.... 3,288 1 to 125 1 to 20 By treaty in 1868. 13. Pine Ridge. Dak 7,000(?) 1 to 100 1 to 30 By treaty in 1868. 14. Fort Half, Idaho 1,432 1 to 238 1 to 45 By treaty in 1868. 15. Osage, Ind. Ter 1,582 1 to 258 1 to 20 By congressional act in 1872. 16. Colville, Wash. Ter 3,568 1 to 298 1 to 46 By executive order in 1872. 17. Shoshone, Wyom 1,800 1 to 267 1 to 50 By treaty in 1868. Third Group. 18. Pima and Maricopa, Ariz. 5,050 1 to 2,500 None. By congressional act in 1883. 19. Papago, Ariz 7,300 None. None. By executive order in 1882. .20. Sac and Fox, Iowa 380 One case reported. 1 to 48 By purchase deeds. 1876, 1882. EXTERMINATE THE AMERICAN INDIAN? 5 From this tabular arrangement it will be perceived that the Indian follows the same law of adjustment concerning consumption as that which is followed by his white neigh- bor. The Indians of the first group may be divided into two classes-those belonging to the Mission, Navajo, and Pueblo agencies, and those belonging to the rest of the agencies. Those of the first division are socially of a higher type than those of the second division. They bear a strong resemblance to. the Mexican Indians, from whom they ac- quired many arts, and they are principally engaged in civil- ized pursuits. The Mission Indians arc said to be the longest-lived people in the world-one per cent, of them are reported to be centenarians. As a rule, they live now as they have lived during the last three centuries. The Na- vajos are like the Pueblo and Zuni Indians. They pursue ■agriculture, spin wool, and weave cotton, and are famous for the fine blankets which they manufacture. On account of the higher state of their civilization, the Indians of this division never underwent that marked transition which those of the second division encountered when confronted by the higher plane of civilization. The Indians of the second division of the first group more definitely represent that type of the savage with which we are familiar at the present day, and are the descendants of those with whom our Indian wars were carried on in ear- lier times, and they are analogous in nature to the Indians of the second group. An examination of the table shows quite a uniformity in the death-rate of nearly all these agencies. Thus, among the New York Indians, which have been longest under the jurisdiction of the Government, the consumption rate is exceedingly low (1 to 681). So is the consumption rate of the Mackinac (Michigan), White Earth (Minnesota), and Nevada (Nevada) Indians, while that of the Umatilla and Green Bay Indians is higher, but 6 DOES PULMONARY CONSUMPTION TEND TO still makes a remarkably favorable showing. The conclu- sion, then, which can be drawn from these statistics, unless they are entirely unreliable, is that the influence of civiliza- tion on the American Indian in the long run is not detri- mental to his well-being, so far as pulmonary consumption is concerned. The agencies of the second group represent those In- dians who have been brought under civilizing influences in more recent times-from 1863 to 1880-and, in contradis- tinction to the first group, the reports show that their con- sumption rate is high. Group third represents those Indians who have been sub- jugated most recently. They are still leading a very primi- tive life, in many respects they bear a strong resemblance to the second division of the first group of Indians, and their consumption rate, as shown by the table, is almost n«Z. The Pimas are agriculturists and vegetarians, and live in adobe houses. The Papagos are Catholics, industrious and friendly, and their form of government is much like that of the Mexicans and Pueblos. The Sac and Fox tribe of Iowa are said to be physically as fine a class of men and women as it is possible to find. They live in the rude huts of their ancestors, cook their food on the ground floor, and leave the smoke to escape through the roof, thus securing good ventilation. While it is much to be regretted that the reports of the Indian Commissioners contain no medical statistics con- cerning the Cherokee, Choctaw, Chickasaw, Creek, and Seminole Indians, who probably represent the highest grade of civilization yet attained among this race, these statistics show that the Indian in his primitive condition is almost free from pulmonary consumption ; that his first contact with civilization vastly increases his liability to the disease, and that a prolonged contact diminishes this liability. And EXTERMINATE THE AMERICAN INDIAN? 7 we see, therefore, that the Indian follows the same law of adaptation as that which is followed by the white and col- ored races, and does not occupy that exceptional position in this respect which is ascribed to him by Dr. Matthews. Probably one of the chief causes of disintegration among the Indians when first coming in contact with civili- zation consists in an entire reversal of their previous habits and customs. The life of physical open-air activity, which invigorates the Indian's respiratory organs as well as his whole body, is now exchanged for a reservation life, where his nomadic instincts are curbed and his wants are fully satisfied, and in consequence he sinks into a state of lethargy and idleness from which he soon merges into pulmonary disease. After having endured the first shock of the con- flict, a reaction begins to show itself. He gradually becomes accustomed to his new relation, assumes an industrious and peaceful life, and so elevates himself out of his physical and moral degradation. It is not true, as is often stated, that the Indian only acquires the vices and not the virtues of the white man. It is no doubt true that he acquires his vices first, and conse- quently sinks early into disease and crime; but his history shows, too, that after he is adjusted to his new condition he also becomes capable of leading a highly moral and virtu- ous life-a life which compares very favorably with that led by his white neighbor. Another important factor which tends to bring the In- dian into harmony with his surroundings is a blood mixture with the white race. Mixture with white blood, which is already adapted to a higher plane of civilization, will cer tainly improve the Indian, and serve to increase his resist- ance to disease ; and there is sufficient proof to show that this process of conservation, or blood adjustment, is going on at a rapid rate among those Indians who have been 8 PULMONARY CONSUMPTION AND THE INDIANS. longest in contact with the white race, like those of New York and Michigan, who are largely composed of mixed bloods. There can be no doubt that this influence contrib- utes largely to the greater immunity of these Indians from pulmonary consumption. This observation is full of mean- ing when it is linked with the opinion of one who has had a wide experience among the Indians, that " the half-bloods resist disease and death from pulmonary troubles better than full-bloods." * 1716 Chestnut Street. * Captain Pratt's report of the Indian school at Carlisle, Pa, See " Report of Indian Commissioner for 1886," p. 22.