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at confinement, and usually it is only after the women, the midwives, and medicine men have exhausted their primitive crude methods that the physician is called in. In spite of so great a handicap, the physician is often able to complete the delivery and save both mother and child. The frequency of instrumental deliveries among Indian women is not known, but from the scanty facts available it would seem that cases requiring such treatment are fairly common. The number of cases in which the physician has to be called after primitive methods have failed, suggest that there must be many more where much pain and suffering could be avoided if delivery were made by a skilled physician. The Indian Service physician is deserving of the highest credit and commendation for the large number of lives he saves under exceptionally difficult conditions.

Some Indian women, however, are more and more placing themselves under the agency physicians. They are the women in the younger generation who have been away to schools and learned something of modern methods, the mixed bloods, and those who have lived for long periods in contact with the whites.

Some of the most encouraging medical work was found in the field of obstetrics. Several physicians are particularly interested and are doing splendid work. The work of one in particular is worthy of mention. The physician has been at this station for about twenty years. As there is no hospital on the reservation, all deliveries were made in the homes. The physician had to travel through wind and snow and frequently to cross the river at high water, when even some of the Indians refuse to make the attempt. From 1911 to June, 1927, the total number of births on this reservation was 996. This physician delivered 391 or 39 per cent of them. The percentages througout the years showed a decided increase. In 1927, 68.1 per cent of all births were delivered by the physician, as compared with 9.2 per cent in 1912. Three per cent of the deliveries between 1917 and 1927 were instrumental. As the Indians on this reservation are mainly full blood, and it is definitely isolated, these results are remarkable. The high percentage of work among full bloods would indicate that with the proper personnel, such service could be rendered on other reservations if the agency physicians