In this fashion, Armstrong, representing the United States Public Health Service,
and in association with Indian Affairs physicians, was able, by utilizing crude and
improvised methods, to arrest the progress of a typhus epidemic before it assumed
catastrophic proportions. He showed sensitivity and respect for Navajo traditions in
modifying conventional epidemiological standards for quarantine and isolation of cases.
In later years when the author was present in the NIH Building 7 small conference and
luncheon room, he heard Armstrong on several occasions describe, in starker terms than
in the published report, the unsanitary and primitive living conditions on the Navajo
Reservation in the 1920s. Prevention still remains important in the avoidance of body lice
secondary to crowding, unsanitary living conditions, wars, famines and natural disasters.
At the present time, the infection responds readily to many broad-spectrum antibiotics.
Fortunately, living conditions, although still not ideal, have improved markedly for the
Navajo whose economic status has benefited from a variety of profitable income
producing activities. The Navajo also has the advantage of improved access to better
educational facilities (6).
Dengue Fever.
The Hygienic Laboratory, from time to time, assigned its Commissioned Officers
to write reviews and informative reports on illnesses of public health importance in order
to disseminate current knowledge to the practicing medical profession. Dr. Armstrong
wrote an extensive review in August 1923 providing updated information about dengue
fever (7). Armstrong gained much of his knowledge of this disease from personal
experience. The Laboratory sent him to Monroe, Louisiana to study an outbreak of