The European residents of Kabul have much pleasure in presenting this testimonial to Mrs. Kate Daly, as an expression of gratitude for the medical services rendered us and admiration of the successful medical and surgical work she has carried out during the past eight years, particularly during the epidemics of cholera, small-pox, etc.; when her devotion to her work, self-denial, and untiring energy won her the respect of all here. She carries with her our sincere wishes for her future welfare and success.

There are several degrees of native “practitioners.” There is first the class who professes to dress wounds and ulcers, to set fractures and to probe for bullets. These men have no ability and very little real knowledge of their work. They are quite ignorant of anatomy. The mischief perpetrated by these “dressers,” as they are called, is equalled by the class who practise the art of surgery and are described as “barbers.” These men are specialists in the extraction of teeth, and in “bleeding”—a cure used equally for liver complaints, fevers, indigestion, rheumatism, and gout. In addition to these two there is a third expert, the oculist, who, like his colleagues in the previous classes, is entirely deficient in any knowledge of his work. These three medical authorities are distinct from the hakims, who practise as physicians simply. These latter do not use the knife or even have recourse to bleeding. Their principal method of treatment, which is without pathological relation to cause and effect and lacks recognition of the malady from which the sick may be suffering, is by the administration of purgatives, in the healing properties of which they place great faith. They provide for their own existence by preying upon the superstitions and credulity of the public. These four classes—dressers, barbers, oculists and hakims are responsible for at least 70 per cent. of the annual death-roll of the city. From time to time, particularly under the régime of Dr. Gray, energetic attempts were made to combat these evils; in place of these so-called curative remedies, courses of elementary instruction in the art of medicine, in the science of physiology and in anatomy were suggested. These schemes were entirely fruitless and aroused an actively hostile and violent propaganda, which was directed against the foreign physicians.

REMAINS OF THE ROBERTS BASTION AT SHIRPUR

Unfortunately, ministrations of European medical officers in Kabul are handicapped very seriously by the injudicious liberty of practice which is allowed to any wandering hospital assistant who, after a few months’ casual acquaintance with some Indian hospital, sets up in the Afghan capital. These men, in whom a little learning is as dangerous as the more complete ignorance of the Afghan self-appointed leech, use foreign medicines without distinguishing the properties of the several ingredients. It is not to be supposed that the Afghan doctor fails to make capital out of the repeated failures of the Hindustani quack; and, as the hakim finds his patients among the better classes of the residents, the prejudice, emanating from his unceasing denunciation of the methods of foreign practitioners, is stronger among the upper ranks of Kabul society than among the very poor. It is, indeed, among the latter that lively appreciation of the skill and experience of the foreign physicians is found. The ignorant, ill-kempt Afghan, tempted by the promise of free rations and treatment, has sufficient raw intelligence to discard the remedies of his own doctors and to consult the foreigner, even, upon occasion, placing such faith in him that he will swallow a week’s medicine in a single draught.

The most recent medical attendant to the Amir is Major Cleveland, one of the leading authorities of his rank in India, and selected specially for service in Afghanistan by the Government of India at the direct invitation of Habib Ullah. A more suitable candidate for the post it would be difficult to find. Aside from his wide experience of natives, he is a distinguished linguist, speaking French, German, Persian, Pushtu and Hindustani with fluency. It may be added, too, that modesty is his most distinguishing characteristic and that he knows nothing of this reference to his abilities. The full list of those whose medical services have been retained by the Amir from time to time is as follows: Mr. O’Meara, dentist, 1887; Mr. J. A. Gray, surgeon, 1889; Miss Lillias Hamilton, physician, 1894; Mrs. K. Daly, who, in 1895, accompanied Miss Hamilton as assistant when that lady returned to Kabul with Nasr Ullah Khan, after his visit to England; Major Cleveland, who took up the duties of physician to the Amir in 1904, and the Misses Brown, who, in 1904, replaced Mrs. Daly. In addition to these there have been numerous technical advisers: Sir Salter Pyne, Sir Acquin Martin, Monsieur Jerome, Messrs. McDermot, Cameron, Thornton, Clements, Fleischer, Middleton, Stewart, Walter, Grant, Donovan, Edwards, Tasker, Riches, F. Martin, Finlayson and others who, each and every one, have added to the dignity and prestige of the white races in Afghanistan by their devoted and unceasing service at the Court of the Amir. Their duties have not always been rewarded, and at certain times the Amir has done without the services of any European medical adviser. In this direction Major Cleveland followed upon Dr. Gray, but the interval, which was a wide one, was filled by Miss Hamilton and, at a later date, by Mrs. Daly. Further gaps ensued when the retirement of Mrs. Daly followed the withdrawal of Miss Hamilton, who now has set up in practice in this country. In the interval Abdur Rahman entrusted his health to the scanty knowledge of an Indian hospital assistant, whose ignorance was as profound as the superstitions of the Amir and his successor were unyielding. The crisis came with the injury to Habib Ullah’s hand: it was because of the speedy relief which Major Bird brought to the august sufferer that the Amir reconsidered his absurd objections and applied to Lord Curzon for the services of two lady doctors, in addition to those of a physician.

This subject has always received close consideration at the hands of the Government of India, and there should not be any insuperable difficulties in the way of arranging that an Indian medical staff should be permanently established in Kabul. A doctor is practically always safe, even among the most fanatical tribes beyond our border-line. A few successful operations, even though they are of the simplest order, make him the friend of the people. His fame rapidly spreads and patients come from long distances to visit him. No one dare interfere with him, and not even the jealousy of the local hakims can render his position altogether precarious. In a big city like Kabul, the headquarters of the Afghan Court, the conditions are somewhat different. Admittedly Doctor Gray, who was physician to Abdur Rahman for several years, had no easy task to discharge. His experiences show that he was often driven to the verge of exasperation by the intrigues of his native rivals. But a Court physician in a semi-civilised country will always have his detractors and he can only confound them by pointing to the success gained by his treatment. In future if any medical mission were stationed in Kabul they should not be attached to the personal retinue of the Amir, but should have their headquarters in a public hospital, which his Highness should provide for them and all classes of the people should be able to avail themselves of their knowledge and skill. Their time should not be wasted by frequent summonses to the palace at all hours of the day and night, with the inevitable long delays in ante-rooms; they should rather be busily engaged with the common run of patients of whom there would certainly be no lack. There is a very wide field open for the skilled surgeon, and if the Amir is in earnest in desiring the services of medical officers in his capital, they might ultimately be welcomed by every class of the population.

The Europeans, who have found employment in the service of Afghanistan, have belonged to many trades. The majority, in some way or another associated with the Ordnance Department of the Amir’s Government, have supervised the different branches of the magnificent arsenal with which the late Amir equipped his capital. Lately, there have been difficulties over the fuel question, the great demands for fuel made by the works having caused a fuel famine in the Kabul district. Habib Ullah proposes to surmount this problem by developing certain coal deposits which have been located in Afghan Turkestan, and through an electric power installation for the workshops. Tentative attempts in this direction have been in hand since 1903, when the fuel bill was represented by eight lakhs of Kabuli rupees. Snider and Martini rifles; Hotchkiss, Gatling and field guns; swords, sabres and knives; ammunition; transport carts; bits, bridles and saddles; boots and uniforms, are all turned out from the Kabul works, twenty-five rifles per diem, two guns and 20,000 rounds of Martini ammunition per week being the estimated capacity of the factories. The workshops, the growth of the first fifteen years of Abdur Rahman’s reign, were due solely to the initiative of the late Amir, assisted by Sir Salter Pyne. This well-known engineer was personally responsible for their introduction, besides doing much to familiarise the Afghans with the mechanical implements and improvements of the West. As the result of these efforts the workshops now occupy an extensive range of buildings, situated outside the town on the banks of the Kabul river, where 1500 natives under the superintendence of 100 Hindu artificers, who have been trained in the factories and workshops of India, are daily employed. The mint where the plant possesses a possible output of 20,000 coins per day, the tanning yards, the candle factory where 100,000 candles can be turned out weekly, and the soap works where ten tons of soap can be made up in the same period, are all located in buildings adjoining the Ordnance compound.