摘要:By 1850 the United States government already had a half century's experience providing health services to its Indian population. During the first halfof the nineteenth century, however, these services were focused primarily on containing epidemic diseases, especially smallpox. By mid-century, the rise of intemperance and venereal diseases among Indians convinced the government that more control over Indians' health was necessary. Professionally trained physicians, bolstered by advances in medical knowledge, led this interventionist effort at improving Indian health care. Government health care providers increasingly came to believe that success depended on undermining traditional lifestyles and leadership.