The territory most specifically observed by Romig is Temperate Zone southwestern Alaska, south of the Yukon River and west of a line drawn north from Seward and Anchorage to Fairbanks. The Europeanization of these parts started in the 1740's, soon after Bering's visit, and was intense in the Aleutians and along mainland Alaska's south coast and the southern west coast. There were little-touched sections, particularly the west coast farther north than the Kuskokwim; and then the interior, which is forested and chiefly inhabited by Athapaska Indians. So there were districts and families that had been “modernized” even before Romig first came; but there were others still so primitive that we might consider them untouched by such influences as those of European foods and food-handling methods. Which these little-influenced spots were, the medical missionary, when of sympathetic temper, would soon know. The total population, before the 1900 measles epidemic, would have been considerably more than 10,000; after the measles, considerably less.

During his first seven years, 1896-1903, Romig worked from Bethel, the Moravian mission on the lower Kuskokwim. He traveled considerably, by dog team in winter and canoe or launch in summer. His patients were chiefly Aleuts, Eskimos, and Athapaskans; but there was a scattering of Russian and other European whites, and of Chinese, Japanese, and Negroes. Some native women were married to these immigrants. They and their children were the chief modernized elements among whom — as among the immigrants themselves — Romig was now and then discovering malignancy cases.