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This book focuses on the Spanish Influenza and its affects on four tribal reservations located in the Pacific Northwest, Colville, Yakama, Spokane, and Nez Perce. In addition, this manuscript will study the local and social issues that affect the overall mental and health state of the inhabitants. Over the years, a myriad of disases have decimated the Native Americans espcially in the Pacific Northwest. According to the Bureau of Indian Affairs, the last epidemic that affected these tribal communities was the Spanish Influenza which dates from 1918 to 1919. According to the Bureau's records, the nine largest reservations in the region showed that deaths exceeded births by 249 during that period. Due to poor documentation and bias, it is difficult to determine the exact number of deaths or the mortality rate. Evidence indicates that the Bureau was soon overwhelmed by the disease.