DISEASES OF THIS PART OF AFRICA, TREATMENT, HYGIENE, ALIMENT
Diseases, Face of the Country, Spring Water
The diseases in this part of Africa are still more simple than those of Liberia; and even the native fever, for known causes, generally is much less severe. In Liberia, and all that part of Africa, the entire country (except the cleared farms in the republic and the limited rice-fields of the natives) is a dense, heavy-wooded, primitive forest, rank with the growth and putrified vegetation of a thousand ages. But the entire Aku country, throughout the second plateau, presents a very different phase. Here, one is struck with the beautiful clear country which continually spreads out in every direction around; and (except the thickets or forests left as defences, ambuscades, and arbors of rest, rugged hilltops, and gullies), there is nothing but recent timber to be found growing on the lands. Timber in Africa is reproduced very speedily; hence may be found in some parts designedly left very heavy timber; but the greatest unbroken forest through which we passed at any one time, of this description, never exceeded, I think, ten miles. All the spring (shallow wells generally) and other living water, as perennial streams, is both good-tasted, and if the constant use of running stream water be a fair test, I would decide as wholesome. There are some good springs in Africa, and good water doubtless may everywhere be obtained by digging suitable wells.
To Keep Water Cool. Kind of Vessels
Drinking water in the tropics should always be kept in large vessels of crockery ware (usually termed "stone" and "earthen ware") and smaller bottle or decanter-shaped jugs or vessels for table convenience. If earthen or crockery ware cannot be obtained for table use, by all means use glass bottles—the more globular, or balloon-shaped, the better.
Cool Water
To make and keep water cool in any crockery or glass vessel, wrap around it a cloth or any kind, but especially woolen—flannel or blanket being the best—which keep simply wet, and the water in the vessel, by evaporation from the cloth, can be made or kept almost ice cool.
To Keep the Cloth Wet. Apparatus
A most simple method by which the cloth may be kept wet, and evaporation thereby kept up, is to have a large vessel, with the water in for common use, so placed that a small vessel with water can be suspended over it in such a manner that a drip can be kept constantly on the cloth. The cloth being first saturated, it will readily be seen that a very small drip is required to keep up the dampness. The drip may be arranged, where convenient, with a small faucet so as to regulate the drop, or the more primitive method of a little spiggot or sharpened stick put into a hole made in the vessel, so regulated as to keep up a sufficient dripping to keep the cloth of sufficient dampness. Simple as this may appear to the reader, it is an important sanitary measure, besides adding greatly to the immediate comfort of the traveler or resident in those regions.
Atmosphere
The atmosphere in this region of the continent is much purer than that of Liberia and the region round about; and, although incorporated with odors, these are pleasant and seem familiar to the sense, and not obnoxious with the rich rank fragrance so sensibly experienced in that country. There is little, comparatively, of the decayed vegetation, which sends up malaria from the surface in Liberia; and the immense fields and plains of grass not under cultivation at the time, are burnt down during the dry season, thereby bringing to bear, though probably unawares to them, a sanitary process throughout that extensive country at least once every year.
Kinds of Disease
Intermittent fever, as described in section vi., page 280 on Liberia, though generally of a mild type, diarrhoea, dysentery (neither of which is difficult to subdue by a little rational treatment), opthalmia, and umbilical hernia, and sometimes, but not frequently, inguinal hernia, are the principal diseases. The opthalmia I suspected as originating from taint, probably having been primarily carried from the coast, as it was not so frequently met with as to warrant the idea of its being either a contagion or the effects of poisonous sands or winds, as supposed to exist. The hernia is caused by the absence of proper umbilical attention and abdominal support to the child after parturition. Umbilical hernia is fearfully common all through Africa, I having frequently seen persons, especially females, with the hernial tumor as large as their own head, and those of little children fully as large as the head of an infant a month old.
Guinea Worm
A singular disease affects some persons, though I have never seen this upon a native, and believe it to be peculiar to the region round about Liberia. The person whose case I examined had formerly resided in Liberia, where, doubtless, the disease commenced, but for the last three years previously had resided at Ijaye, in the capacity of cook, for the American Baptist Missionaries, Revs. A. D. Phillips and J. R. Stone and lady, and then resided at Abbeokuta. This is a peculiar ulceration of the leg, immediately above the ankle-bone, where they say it usually commences; the edges of the ulcer, and the cuticle quite up to the edge, and all the surrounding parts, having a healthy appearance, as though a portion of the flesh had been recently torn out, leaving the cavity as it then was. The most peculiar feature of this singular disease is a white fiber, which, coming out from the integuments of the muscles of the leg above, hangs suspended in the cavity (ulcer) the lower end loose, and somewhat inclined to coil (and when straightened out, resuming again the serpentine curves, of course from the elasticity with motion), is supposed to be a worm; hence its name—Guinea worm. The fibre seems in color and texture to be in a normal condition; indeed, there appear to be little or no pathological symptoms about the parts at all, except a slight appearance of vermillion inflammation over the surface of the ulcer, which is more apparent sometimes than others.
What Is Guinea Worm?
I have examined closely this fibre, and from its appearance, color, size, and texture, especially as it is sensibly felt high up in the leg near the tuberosity of the tibia, when pulled by the dangling end, my own impression is that the so-called "Guinea worm" is nothing more than the external saphenus or communis tibiae (nerve) exposed in a peculiar manner, probably by a disease, which, by a curious pathological process, absorbs away the muscular parts, leaving the bare nerve detached at its lower extremity, suspended loose in this unnatural space. I have never seen but this one case of Guinea worm, but had frequent opportunities of examining it; indeed, the patient consulted me concerning it, and by the advice and consent of the very clever native gentleman, Samuel Crowther, Esq., who received his professional education at the Royal College of Surgeons, Lincoln's Inn Fields, London, insisted on my taking the case, which I declined, partly for the want of time to do justice to the patient, and aside from courtesy and equity to the surgeon who had the case in hand, mainly because I knew nothing about it—the best reason of all. The patient was an American quadroon, black nearly in complexion, of one-fourth white blood, from North Carolina. This, of course was a black quadroon.
I should add, that the fiber at times entirely disappears from the cavity (by contraction, of course), when again it is seen suspended as before. This is one reason why it is believed to be a worm, and supposed to creep up and down in the flesh.
Treatment of Diseases—Diarrhoea
The treatment of fever in this part of Africa should be the same as that in Liberia, given on page 280. The best remedy which I have found for diarrhoea is:
℞. Pulv. Rad. Rhei. ʒj.; Syr. Simp. ℥ jv.; Spts.
Terebinth, ʒj.; Tinct. Opii., gtt. x. M. ft.
Pulverized rhubarb, one drachm, (or one-eighth of an ounce); simple syrup, four ounces (or eight large tablespoonfuls); laudanum, ten drops; spirits of turpentine, one spoonful. Mix this well together to take.
Dysentery
For dysentery the recipe is:
℞. Pulv. Rad. Rhei. Pulv. C. Catech. a. a., ʒj.;
Syr. Simp. f. ℥jv.; Spts. Terebinth. Spis.
Ammon. Arromat., a. a. f.ʒj.; Tinct. Opii. gtt. x.M.ft.
Pulverized rhubarb and pulverized gum catechu, each, one-eighth of an ounce; simple syrup, eight large tablespoonfuls; spirits of turpentine and aromatic spirits of ammonia, of each one teaspoonful; laudanum, ten drops. Mix this well together to take. Of this take one teaspoonful (if very bad, a dessert spoonful) every three hours, or four times a day (always beginning at least one hour before breakfast), till the symptoms cease.
Fever Antidote
During the presence of febrile symptoms, in the absence of all diarrhoea and dysenteric symptoms, even when the person is not complaining, an excellent simple antidote to be taken at discretion, not oftener than once every hour during the day, is:
℞ Syr. Simp., ℥jv.; Spts. Ammon. Arromat. ʒjss. M. ft.
Simple syrup, eight large tablespoonfuls; aromatic spirits of ammonia, one and a-half teaspoonfuls. Mix this well together. Take a teaspoonful of this preparation in a little cold water, or a glass of lemonade if preferred, and the condition of the bowels will admit, as often as thought advisable under the circumstances.
I have thus thought proper to simplify this treatment, that it may be in the reach of every person going to the tropics, as I am certain that there has been a great deficiency in the treatment and discovery of remedies in diseases of that continent especially. These prescriptions, as compounded, are entirely new, originating with the writer, who has only to add that he is in hopes that they prove as advantageous and successful in other hands as they have been in his.
Regimen
Persons laboring under fever should eat moderately of such food as best agrees with their appetite; but frequently, if required or desired, that the system may be well supported. When there is diarrhoea or dysentery present, there should be no solid food taken, but the patient or ailing person should be confined strictly to a thin milk porridge of fine Guinea-corn flour, which is always obtainable in Africa, crumbled crackers or soda biscuits, light (leavened) wheat bread if to be had, or well-done rice boiled to a pulp. The soda-biscuit as a porridge with milk rather aggravates the bowels of most persons; therefore, whenever it is found to have this effect, its use should be immediately abandoned. In many instances, where there is either diarrhoea or dysentery present, without other prominent symptoms, I have found the mere use of cooked milk (merely "scalded," as women usually term it—being heated to the boiling point without permitting it to boil), taken as food alone, to be the only remedy required.
Hygiene—Eating
The laws of health should be particularly observed in going to Africa. In respect to eating, there need be no material change of food, but each individual observing those nourishments which best agree with him or her. When there is little inclination to eat, eat but little; and when there is none, eat nothing. I am certain that a large percentage of the mortality which occurs may be attributed to too free and too frequent indulgence in eating, as was the case with the Lewis family of five at Clay-Ashland, in Liberia—all of whom died from that cause; as well as others that might be mentioned.
Coffee, Air, Fruits
So soon as you have taken your bath and put your morning wrapper, even before dressing, you may eat one or more sweet oranges, then take a cup of coffee, creamed and sweetened, or not, to your taste. Make your toilet, and walk out and take the cool air, always taking your umbrella or parasol, because no foreigner, until by a long residence more or less acclimated, can expose himself with impunity to a tropical sun. If preferred coffee should always be taken with cream or milk and sugar, because it is then less irritating to the stomach. One of the symptoms of native fever is said to be nervous irritability of the stomach; hence, all exciting causes to irritation of that part should be avoided as much as possible. Such fruits as best agree with each individual should be most indulged in; indeed, all others for the time should be dispensed with; and when it can be done without any apparent risk to the person, a little fruit of some kind might be taken every day by each new comer. Except oranges, taken as directed above, all fruits should be eaten after, and not before breakfast. The fruits of the country have been described in another place.
Drinks
Let your habits be strictly temperate, and for human nature's sake, abstain from the erroneous idea that some sort of malt or spirituous drink is necessary. This is not the case; and I am certain that much of the disease and dire mortality charged against Africa, as a "land of pestilence and death," should be charged against the Christian lands which produce and send bad spirits to destroy those who go to Africa. Whenever wine, brandy, whisky, gin, rum, or pure alcohol are required as a medical remedy, no one will object to its use; but, in all cases in which they are used as a beverage in Africa, I have no hesitation in pronouncing them deleterious to the system. The best British porter and ale may, in convalescence from fever, be used to advantage as a tonic, because of the bitter and farinaceous substances they contain—not otherwise is it beneficial to the system in Africa. Water, lemonade, effervescent drinks—a teaspoonful of super-carbonate of soda, to a glass of lemonade—all may be drunk in common, when thirsty, with pleasure to the drinker as well as profit. Pure ginger-beer is very beneficial.
Bathing
Bathing should be strictly observed by every person at least once every day. Each family should be provided with a large sponge, or one for each room if not for each person, and free application of water to the entire person, from head to foot, should be made every morning.
Early Rising—Breezes
Every person should rise early in Africa, as the air is then coolest, freshest, and purest; besides the effect upon the senses, the sight and song of the numerous birds to be seen and heard, produce a healthful influence upon the mental and physical system. The land and sea-breezes blow regularly and constantly from half-past three o'clock p.m. till half-past ten o'clock a.m., when there is a cessation of about five hours till half-past three again.
Never Sultry
The evenings and mornings are always cool and pleasant, never sultry and oppressive with heat, as frequently in temperate climates during summer and autumn. This wise and beneficent arrangement of Divine Providence makes this country beautifully, in fact, delightfully pleasant; and I have no doubt but in a very few years, so soon as scientific black men, her own sons, who alone must be more interested in her development than any other take the matter in hand, and produce works upon the diseases, remedies, treatment, and sanitary measures of Africa, there will be no more contingency in going to Africa than any other known foreign country. I am certain, even now, that the native fever of Africa is not more trying upon the system, when properly treated, than the native fever of Canada, the Western and Southern States and Territories of the United States of America.
Dress, Avoid Getting Wet
Dress should be regulated according to the feeling, with sometimes more and sometimes less clothing. But I think it advisable that adults should wear flannel (thin) next to their person always when first going to Africa. It gradually absorbs the moisture, and retaining a proper degree of heat, thus prevents any sudden change of temperature from affecting the system. Avoid getting wet at first, and should this accidentally happen, take a thoroughly good bath, rub the skin dry, and put on dry clothes, and for two or three hours that day, keep out of the sun; but if at night, go to bed. But when it so happens that you are out from home and cannot change clothing, continue to exercise until the clothes dry on your person. It is the abstraction of heat from the system by evaporation of water from the clothing, which does the mischief in such cases. I have frequently been wet to saturation in Africa, and nothing ever occurred from it, by pursuing the course here laid down. Always sleep in clean clothes.
Sanitary Measures
I am sure I need inform no one, however ignorant, that all measures of cleanliness of person, places, and things about the residences, contribute largely to health in Africa, as in other countries.
Ventilation of Houses
All dwellings should be freely ventilated during the night as well as day, and it is a great mistake to suppose, as in Liberia (where every settler sleeps with every part of his house closely shut—doors, windows, and all) that it is deletereous to have the house ventilated during the evening, although they go out to night meetings, visit each other in the evening, and frequently sit on their porches and piazzas till a late hour in the night, conversing, without any injurious effects whatever. Dr. Roberts, and I think Dr. McGill and a few other gentlemen, informed me that their sleeping apartments were exceptions to the custom generally in Liberia. This stifling custom to save themselves does not prevail among the natives of Africa anywhere, nor among the foreigners anywhere in the Yoruba country, that I am aware of, and I am under the impression that it was the result of fear or precaution, not against the night air, but against the imaginary (and sometimes real) creeping things—as insects and reptiles—which might find their way into the houses at night.
Test of Night Air
While in Liberia, I have traversed rivers in an open boat at night, slept beyond the Kavalla Falls in open native houses, and at the residence of Rev. Alexander Crummel, Mount Vaughan, Cape Palmas, I slept every evening while there with both window and door as ventilators. The window was out and the door inside. In Abbeokuta, Ijaye, Oyo, and Ogbomoso, we slept every night with ventilated doors and windows, when we slept at all in a house. But in Illorin we always slept out of doors by preference, and only retired to repose in-doors (which were always open) when it was too cool to sleep out, as our bedding consisted only of a native mat on the ground, and a calico sheet spread over us. And I should here make acknowledgments to my young colleague, Mr. Campbell, for the use of his large Scotch shawl when I was unwell, and indeed almost during our entire travel—it being to me a great accommodation, a comfort and convenience which I did not possess.
Test of Exposure
I have started two and three hours before daybreak, laying on my bed in an open canoe, ascending the Ogun river, at different times during the six days' journey up to Abbeokuta; Mr. Campbell and myself have frequently slept out in open courts and public market-places, without shed or piazza covering; and when journeying from Oyo to Ibaddan, for three successive evenings I lay in the midst of a wilderness or forest, on a single native mat without covering, the entire night; and many times during our travels we arose at midnight to commence our journey, and neither of us ever experienced any serious inconvenience from it.
Improved Window and Door Ventilation
That houses in Africa may be properly ventilated during the night without annoyance, or, what is equally as bad, if not worse, the continual fear and imagination of the approach of venomous insects, creeping things, and reptiles, the residents should adapt them to the place and circumstances, without that rigid imitation of European and American order of building. Every house should be well ventilated with windows on opposite sides of the rooms, when and wherever this is practicable, and the same may be said of doors. And where the room will not admit of opposite windows, or windows at least on two sides of a room, whether opposite or otherwise, a chimney or ventilating flue should be constructed on the opposite side to the window—which window should always be to the windward, so as to have a continual draught or current of fresh air. Persons, however, should always avoid sitting in a draught, though a free circulation of air should be allowed in each room of every house.
Instead of window-sashes with glass, as in common use, I would suggest that the windows have a sash of four, or but two (if preferred) panels, to each window (two upper and two lower, or one upper and one lower—or one lower and two upper, which would make a neat and handsome window), each panel or space for panes being neatly constructed with a sieve-work, such as is now used as screens during summer season in the lower part of parlor windows. To prevent too great oxydization or too rapid decay of so delicate a structure as the wire must be, it should be made of brass, copper, or some composition which would not readily corrode. Inside or outside doors of the same material, made to close and open like the Venetian jalousies now in use in civilized countries, would be found very convenient, and add much to the comfort and health of dwellings as a sanitary measure. The frames of the panels or sashes should be constructed of maple, cherry, walnut, or mahogany, according to the means of the builder and elegance of the building—as these articles seasoned are not only more neat and durable, but, from their solidity, are less liable to warp or shrink. This would afford such a beautiful and safe protection to every dwelling against the intrusion of all and every living thing, even the smallest insect—while a full and free circulation of fresh air would be allowed—that a residence in Africa would become attractive and desirable, instead of, as now (from imagination), objectionable.
Sanitary Effects of Ants—Termites, and Drivers
A word about ants in Africa—so much talked of, and so much dreaded—will legitimately be in place here, regarding them as a sanitary means, provided by Divine Providence. The termites, bug-a-bug or white double ant, shaped like two ovals somewhat flattened, joined together by a cylinder somewhat smaller in the middle, with a head at one end of one of the ovals, is an herbivorous insect, and much abused as the reputed destroyers of books, papers, and all linen or muslin clothing. They feed mainly on such vegetable matter as is most subject to decay—as soft wood, and many other such, when void of vitality—and there is living herbage upon which they feed, and thereby prove a blessing to a country with a superabundance of rank vegetable matter. It is often asserted that they destroy whole buildings, yet I have never seen a person who knew of such a disaster by them, although they may attack and do as much mischief in such cases at times as the wood-worms of America; and, in regard to clothing, though doubtless there have been instances of their attack upon and destruction of clothing, yet I will venture to assert that there is no one piece of clothing attacked and destroyed by these creatures, to ten thousand by the moths which get into the factories and houses in civilized countries, where woolen goods are kept. In all my travels in Africa, I never had anything attacked by the termite; but during my stay of seven months in Great Britain, I had a suit of woolen clothes completely eaten up by moths in Liverpool.
Drivers
Drivers, as every person already knows, are black ants, whose reputation is as bad for attacking living animals, and even human beings, as the termites' for attacking clothing. This creature, like its white cousin, is also an instrument in the hands of Providence as a sanitary means, and to the reverse of the other is carnivorous, feeding upon all flesh whether fresh or putrified. Like the white, for the purpose of destroying the superabundance of vegetable, certainly these black ants were designed by Providence to destroy the excess of animal life which in the nature of things would be brought forth, with little or no destruction without them; and although much is said about their attacking persons, I will venture the opinion that there is not one of these attacks a person to every ten thousand musquitoes in America, as it is only by chance, and not by search after it, that drivers attack persons.
How They Travel
They usually go in search of food in narrow rows, say from half an inch to a hand's breadth, as swiftly as a running stream of water, and may in their search enter a house in their course—if nothing attract them around it—when, in such cases, they spread over the floor, walls, and ceiling; and finding no insect or creeping thing to destroy, they gather again on the floor, and leave the premises in the regular order in which they entered. Should they encounter a person when on these excursions, though in bed, does he but lie still and not disturb them, the good-hearted negro insects will even pass over the person without harm or molestation; but, if disturbed, they will retaliate by a sting as readily as a bee when the hive is disturbed, though their sting, so far from being either dangerous or severe, is simply like the severe sting of a musquito. An aged missionary gentleman, of twenty-five years' experience, informed me that an entire myriad (this term is given to a multitude of drivers, as their number can never be less than ten thousand—and I am sure that I have seen as many millions together) passed over him one night in bed, without one stinging him. Indeed, both the black and white ants are quite harmless as to personal injury, and very beneficial in a sanitary point.
How to Drive Them Out of the Houses
There is much more in the imagination than the reality about these things; and one important fact I must not omit, that, however great the number of drivers, a simple light set in the middle of the floor will clear the room of them in ten minutes. In this case they do not form in column, but go out in hasty confusion, each effecting as quick retreat and safe escape for himself as possible, forming their line of march outside of the house, where they meet from all quarters of their points of escape.
How to Destroy Them
Chloride of sodium or common salt (fine), slightly damped, will entirely destroy the termites; and acetum or vinegar, or acetic acid either, will destroy or chase off the drivers. These means are simple, and within the reach of every person, but, aside from this, both classes or races of these creatures disappear before the approach of civilization. In a word, moths, mice, roaches, and musquitoes are much greater domestic annoyances, and certainly much more destructive in America and Europe than the bug-a-bug or driver is in Africa.
Their Pugnacious and Martial Character
I cannot endorse the statement from personal knowledge of the desperate hostility which the drivers manifest towards the termites, as given by Dr. Livingstone, who, calling them "black rascals," says "they stand deliberately and watch for the whites, which, on coming out of their holes, they instantly seize, putting them to death." Perhaps the whites were kidnappers, in which case they served the white rascals right. Though I have never seen an encounter, it is nevertheless true, that the blacks do subdue the whites whenever they meet. In fact, they go, as do no other creatures known to natural science, in immense incalculable numbers—and I do not think that I exaggerate if I say that I have more than once seen more than six hogsheads of them traveling together, had they been measured—and along the entire line of march, stationed on each side of the columns, there are warriors or soldiers to guard them, who stand sentry, closely packed side by side with their heads towards the column, which passes on as rapidly as a flowing stream of water. I have traced a column for more than a mile, whose greatest breadth was more than a yard, and the least not less than a foot. It is inconceivable the distance these creatures travel in a short time. Should anything disturb the lines, the soldiers sally out a few feet in pursuit of the cause, quickly returning to their post when meeting no foe. The guards are much larger than the common drivers, being about the length of a barley-corn, and armed with a pair of curved horns, like those of the large American black beetle, called "pinching bug." There are no bed-bugs here.
Cesspools
One important fact, never referred to by travellers as such, is that the health of large towns in Africa will certainly be improved by the erection of cesspools, whereas now they have none. With the exception of the residences of missionaries and other civilized people, there is no such thing in Africa. Every family, as in civilized countries, should have such conveniences. Our senses are great and good faculties—seeing, hearing, tasting, smelling, and feeling—God has so created them, and designed them for such purposes; therefore, they should neither be perverted nor marred when this can be avoided. Hence, we should beautify, when required and make pleasing to the sight; modify and make pleasant to the hearing; cleanse and purify to make agreeable to the smelling; improve and make good to the taste; and never violate the feelings whenever any or all of these are at our will or control.
Wild Beasts and Reptiles
A single remark about these. The wild beasts are driven back before the march of civilization, I having seen none, save one leopard; and but four serpents during my entire travels, one three and a half feet long (a water snake); one fourteen inches long; and another ten inches long; the two last being killed by natives—and a tame one around the neck of a charmer at Oyo. During the time I never saw a centipede, and but two tarantulas.
X MISSIONARY INFLUENCE
To deny or overlook the fact, the all-important fact, that the missionary influence had done much good in Africa, would be simply to do injustice, a gross injustice to a good cause.