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hospital the operating room is situated between the men’s ward and the dining room. As the ward has no outside exit, the men patients must pass through the operating room. The nurses’ quarters, too, are located off the operating room. Similar evidence of crowding can be found in practically every Indian Service hospital. Often the objectionable condition is due to poor planning, because in place after place a re-arrangement of space with slight additions would correct the difficulties.

Sterilizing equipment is often hadedtate At the Rosebud Agency a high pressure sterilizer has been installed for years, with no possibility whatever of supplying high pressure steam to operate it. Plumbers’ blow torches were utilized instead. No imagination is required to understand the difficulties under which the operator must work with such an arrangement in the operating room. This equipment is to be replaced by a type meeting the needs of the hospital.

Special hospital equipment, such as X-ray, clinical laboratory, and special treatment facilities is generally lacking. At the present time no hospital has an X-ray unit. Requests have been made for several portable units, and undoubtedly some of them will be installed in the near future. Clinical laboratory equipment, an essential of any well organized hospital, is not provided. In some few instances, one may find a microscope that is usable and a few test tubes and reagents, but ordinarily their appearance indicates infrequent use. This observation is further substantiated by the universal lack of records of such work on the meagre clinical sheets. The Indian Office has recently purchased from the Veterans’ Bureau forty microscopes, which are being put in excellent condition and will be distributed to several of the hospitals. Others will be required in the near future. Special treatment equipment, such as diathermy and quartz light, is not found in this class of hospital.

The American College of Surgeons’ standards for clinical laboratory work include chemical, bacteriological, serological, and pathological examinations. All tissues removed must be examined pathologically and the gross and microscopic findings recorded. Such service is not rendered in Indian Service hospitals. The serological work would be done gratis at most state board of health laboratories, but it was reported in those state laboratories visited that this service was seldom requested. The State Board of Health