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The water-wagon, St. Stephen's Hospital, Fort Yukon.before the white man came to the countryseems uncertain, physicians with experienceamongst the natives, and eventhe oldest natives themselves, holdingcontrary opinions; but it is certain that ifthe disease be indigenous its ravages havegreatly increased since the white man'scoming; for which there is sufficient explanationin the change of habits whichintercourse with the whites has broughtabout.Tuberculosis in the arctic regions isfostered and is checked by the samecauses that foster or check it elsewhere;and a people of wandering tent-dwellerschanged by the introduction of edge-toolsinto a people of more stationary log-cabindwellers, a people of fur-wearers changedby the constantly increasing market forpelts and the introduction of manufacturedclothing into a people, in the main,of cotton-wearers, present as favorableconditions for the growth and disseminationof this disease as do those who havemigrated from the sunny vineyards ofSicily to the slums of New York.Resumption of the primitive Indianconditions of life, however desirable itmight be from an exclusively hygienicpoint of view, is out of the question; theinfluences against it are entirely toostrong. The remedy must be sought inimproving the new conditions rather than40in a return to the old. That improvementgoes on, slowly but surely; thecabins become more commodious andbetter ventilated; personal habits morecleanly; the rules of health more generallyknown and observed. If there beany way in which such improvement maycome other than slowly and gradually,those who are working for the Yukon Indianshave not discovered it. It is onlyin theory, I think, that such things aredone out of hand.Meanwhile the hospital performs afunction of very great value to the upbuildingof the general health in receivingcases of incipient tuberculosis and subjectingthem to a regime of recuperationsuch as cannot be carried out save in aninstitution of this sort. Children whogive early warning of pulmonary lesion,children with broken-down and suppuratingneck-glands—that common and offensiveevidence amongst Indians oftuberculous invasion—improve often intoperfect health; and there are already anumber whose lives have thus been saved.One of our two wards is set aside for suchcases, and at the present writing has fivechildren in it.There are great and special difficultiesin conducting a hospital in the arcticregions. It is, of course, well understoodby those read in geography, though not