American Indian Culture and Research Journal

In December of 1924, Charles Burke, the commissioner of Indian Affairs, received a letter from H. J. Hagerman, a former governor of New Mexico Territory who had been appointed by the Office of Indian Affairs (OIA) as “Special Commissioner to the Navajo.” Hagerman reported that he had received a troubling piece of correspondence from an OIA physician headquartered on the Navajo Reservation. This physician, Polk Richards, had found some disturbing after-effects among Navajo patients who had been treated by government doctors for trachoma, a painful, infectious eye disease that produced damaged vision or even blindness. Two of these patients could no longer close their eyelids completely, a condition known as lagopthalmos, and at least two others were suffering from entropion, in which the eyelashes had turned inward and were scratching the surface of the eyeball. All of these patients had been treated as part of a national campaign by the OIA to eradicate trachoma from Indian communities. Their condition, Hagerman told Burke, suggested that perhaps the OIA needed to rethink its strategy. The trachoma campaign was based on the use of a radical surgical technique known as tarsectomy, in which the surgeon attempted to treat the disease by simply cutting out the tarsus, the supportive tissue underneath the eyelids. Unless patients were selected very judiciously, Hagerman warned, and unless those who performed the operation were highly skilled surgeons, it was quite possible that the trachoma campaign would produce “very harmful results,” potentially causing Indian patients to lose all confidence in OIA doctors.