I am myself the possessor of a fetish. The most important objects in it are two fragments of a human skull, of a longish oval shape and dyed with some sort of red colouring matter; they seem to me to be from the parietal bones. The owner was ill for many months, and his wife also, both suffering tortures from sleeplessness. Several times, however, the man heard in a dream a voice which revealed to him that they could only get well if they took the family fetish he had inherited to Mr. Haug, the missionary in N'Gômô, and followed Mr. Haug's orders. Mr. Haug referred him to me, and made me a present of the fetish. The man and his wife stayed with me several weeks for treatment, and were discharged with their health very much improved.
The belief that magical power dwells in human skulls which have been obtained expressly for this purpose, must be a quite primitive one. I saw not long ago in a medical periodical the assertion that the supposed cases of trephining which have often been recognised during the excavation and examination of prehistoric graves were by no means attempts at treatment of tumours on the brain or similar growths, as had been assumed, but were simply operations for the securing of fetish objects. The author of the article is probably right.[[2]]
[[2]] In Keith's "Antiquity of Man" (Williams and Norgate, 1915), p. 21, is a picture of a prehistoric skull in which there is a hole made by trephining, as is shown by the fact that the edges are bevelled off. The condition of the bone shows further that the wound had healed prior to death.
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In the first nine months of my work here I have had close on two thousand patients to examine, and I can affirm that most European diseases are represented here; I even had a child with whooping-cough. Cancer, however, and appendicitis I have never seen. Apparently they have not yet reached the negroes of Equatorial Africa. On the other hand, chills play a great part here. At the beginning of the dry season there is as much sneezing and coughing in the church at Lambarene as there is in England at a midnight service on New Year's Eve. Many children die of unrecognised pleurisy.
Chills and nicotine poisoning
In the dry season the nights are fresher and colder than at other times, and as the negroes have no bed clothes they get so cold in their huts that they cannot sleep, even though according to European standards the temperature is still fairly high. On cold nights the thermometer shows at least 68° F., but the damp of the atmosphere, which makes people sweat continually by day, makes them thereby so sensitive that they shiver and freeze by night. White people, too, suffer continually from chills and colds in the head, and there is much truth in a sentence I came across in a book on tropical medicine, though it seemed at the time rather paradoxical: "Where the sun is hot, one must be more careful than elsewhere to avoid chills." Especially fatal to the natives is the camp life on the sandbanks when they are out on their summer fishing expeditions. Most of the old folk die of pneumonia which they have caught on these occasions.
Rheumatism is commoner here than in Europe, and I not infrequently come across cases of gout, though the sufferers cannot be said to bring it on by an epicurean diet. That they eat too much flesh food cannot possibly be alleged, as except for the fish-days in summer they live almost exclusively on bananas and manioc.
That I should have to treat chronic nicotine poisoning out here I should never have believed. At first I could not tell what to think of acute constipation which was accompanied by nervous disturbances and only made worse by aperients, but while treating a black Government official who was suffering severely I came to see clearly, through observation and questioning, that the misuse of tobacco lay at the root of it. The man soon got well and the case was much talked of, as he had been a sufferer for years and had become almost incapable of work. From that time, whenever a case of severe constipation came to me, I asked at once: "How many pipes a day do you smoke?" and I recognised in a few weeks what mischief nicotine produces here. It is among the women that cases of nicotine poisoning are most frequent. Joseph explained to me that the natives suffer much from insomnia, and then smoke all through the night in order to stupefy themselves.