Tobacco comes here from America in the form of leaves, seven of which form a head (tête de tabac). It is a plant which is frightfully common and also frightfully strong (much stronger than that which is smoked by white people), and it largely takes the place of small coins: e.g., one leaf, worth about a halfpenny, will buy two pineapples, and almost all temporary services are paid for by means of it. If you have to travel, you take for the purchase of food for the crew, not money, for that has no value in the forest, but a box of tobacco-leaves, and to prevent the men from helping themselves to its valuable contents you make it your seat. A pipe goes from mouth to mouth during the journey; and anybody who wants to travel fast and will promise his crew an extra two leaves each, is sure to arrive an hour or two sooner than he otherwise would.
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Teeth. First operation. Hippos
The teeth also give the natives much trouble. Many of my patients suffer from shrinking of the gums together with purulent discharges (pyorrhoea) caused by accumulations of tartar. Then, in course of time, all the teeth get loose and fall out. Strange to say, these cases get well more quickly here than in Europe, where the complicated treatment often fails to attain its object. I have obtained successful results from regular painting with an alcoholic solution of thymol, only the patient has to be careful not to swallow any of the liquid, which is, of course, very poisonous.
It seems to the natives almost incredible that I can extract teeth which are not yet loose, but they do not all trust the polished forceps! A chief who was plagued with toothache would not submit to their use till he had gone home again to consult his wives. Presumably the family decision was unfavourable, as he did not present himself again. On the other hand, some request me to take all their teeth out and to get them new ones from Europe. A few old folk have, through the missionaries, actually got some double sets, "made by the white people," and they are now an object of much envy.
Abdominal tumours are very common here with the women.
My hope that I should not need to perform any major operation before the medical ward was ready for use was disappointed. On August 15th I had to operate on a case of strangulated hernia which had been brought in the evening before. The man, whose name was Aïnda, begged me to operate, for, like all the natives, he knew well enough the dangers of his condition. There was, in fact, no time to lose, and the instruments were brought together as quickly as possible. Mr. Christol allowed me to use his boys' bedroom as an operating theatre; my wife undertook to give the anæsthetic, and a missionary acted as assistant. Everything went off better than we could have expected, but I was almost staggered by the quiet confidence with which the man placed himself in position on the operating table.
A military doctor from the interior, who is going to Europe on leave, tells me that he envies me the excellent assistance I had for my first operation on hernia! He himself, he said, had performed his with one native prisoner handing him the instruments and another administering the chloroform by guesswork, while each time they moved the fetters on their legs rattled; but his regular assistant was ill and there was no one who could take his place.
The aseptic precautions were, naturally, far from perfect, but the patient recovered.
January 10th, 1914. I had scarcely finished writing the above paragraphs this afternoon when I had to hurry off to the landing place. Mrs. Faure, the wife of the missionary at N'Gômô, arrived in a motor boat, suffering from a severe attack of malaria, and I had scarcely given her a first intramuscular injection of quinine when a canoe brought in a young man who had had his right thigh broken and badly mutilated by a hippopotamus in Lake Sonange. In other respects, too, the poor fellow was in a bad condition. He and a friend had gone out together to fish, but not far from the landing place of their village a hippopotamus had come up unexpectedly and hurled their boat into the air. The friend escaped, but my patient was chased about in the water by the enraged beast for half an hour, though he was able at last to get to shore in spite of his broken thigh. I was afraid there would be serious blood poisoning, for they had brought him the twelve hours' canoe journey with his mutilated thigh wrapped in dirty rags.