The diseases most prevalent are the following: pneumonia, produced by sudden changes of temperature, and other inflammations, as of the bowels, stomach, and pleura; rheumatism; disease of the heart—but these become rare as the people adopt the European dress—various forms of indigestion and ophthalmia; hooping-cough comes frequently; and every year the period preceding the rains is marked by some sort of epidemic. Sometimes it is general ophthalmia, resembling closely the Egyptian. In another year it is a kind of diarrhoea, which nothing will cure until there is a fall of rain, and any thing acts as a charm after that. One year the epidemic period was marked by a disease which looked like pneumonia, but had the peculiar symptom strongly developed of great pain in the seventh cervical process. Many persons died of it, after being in a comatose state for many hours or days before their decease. No inspection of the body being ever allowed by these people, and the place of sepulture being carefully concealed, I had to rest satisfied with conjecture. Frequently the Bakwains buried their dead in the huts where they died, for fear lest the witches (Baloi) should disinter their friends, and use some part of the body in their fiendish arts. Scarcely is the breath out of the body when the unfortunate patient is hurried away to be buried. An ant-eater's hole is often selected, in order to save the trouble of digging a grave. On two occasions while I was there this hasty burial was followed by the return home of the men, who had been buried alive, to their affrighted relatives. They had recovered, while in their graves, from prolonged swoons.
In ophthalmia the doctors cup on the temples, and apply to the eyes the pungent smoke of certain roots, the patient, at the same time, taking strong draughts of it up his nostrils. We found the solution of nitrate of silver, two or three grains to the ounce of rain-water, answer the same end so much more effectually, that every morning numbers of patients crowded round our house for the collyrium. It is a good preventive of an acute attack when poured into the eyes as soon as the pain begins, and might prove valuable for travelers. Cupping is performed with the horn of a goat or antelope, having a little hole pierced in the small end. In some cases a small piece of wax is attached, and a temporary hole made through it to the horn. When the air is well withdrawn, and kept out by touching the orifice, at every inspiration, with the point of the tongue, the wax is at last pressed together with the teeth, and the little hole in it closed up, leaving a vacuum within the horn for the blood to flow from the already scarified parts. The edges of the horn applied to the surface are wetted, and cupping is well performed, though the doctor occasionally, by separating the fibrine from the blood in a basin of water by his side, and exhibiting it, pretends that he has extracted something more than blood. He can thus explain the rationale of the cure by his own art, and the ocular demonstration given is well appreciated.
Those doctors who have inherited their profession as an heirloom from their fathers and grandfathers generally possess some valuable knowledge, the result of long and close observation; but if a man can not say that the medical art is in his family, he may be considered a quack. With the regular practitioners I always remained on the best terms, by refraining from appearing to doubt their skill in the presence of their patients. Any explanation in private was thankfully received by them, and wrong treatment changed into something more reasonable with cordial good-will, if no one but the doctor and myself were present at the conversation. English medicines were eagerly asked for and accepted by all; and we always found medical knowledge an important aid in convincing the people that we were really anxious for their welfare. We can not accuse them of ingratitude; in fact, we shall remember the kindness of the Bakwains to us as long as we live.
The surgical knowledge of the native doctors is rather at a low ebb. No one ever attempted to remove a tumor except by external applications. Those with which the natives are chiefly troubled are fatty and fibrous tumors; and as they all have the 'vis medicatrix naturae' in remarkable activity, I safely removed an immense number. In illustration of their want of surgical knowledge may be mentioned the case of a man who had a tumor as large as a child's head. This was situated on the nape of his neck, and prevented his walking straight. He applied to his chief, and he got some famous strange doctor from the East Coast to cure him. He and his assistants attempted to dissolve it by kindling on it a little fire made of a few small pieces of medicinal roots. I removed it for him, and he always walked with his head much more erect than he needed to do ever afterward. Both men and women submit to an operation without wincing, or any of that shouting which caused young students to faint in the operating theatre before the introduction of chloroform. The women pride themselves on their ability to bear pain. A mother will address her little girl, from whose foot a thorn is to be extracted, with, "Now, ma, you are a woman; a woman does not cry." A man scorns to shed tears. When we were passing one of the deep wells in the Kalahari, a boy, the son of an aged father, had been drowned in it while playing on its brink. When all hope was gone, the father uttered an exceedingly great and bitter cry. It was sorrow without hope. This was the only instance I ever met with of a man weeping in this country.
Their ideas on obstetrics are equally unscientific, and a medical man going near a woman at her confinement appeared to them more out of place than a female medical student appears to us in a dissecting-room. A case of twins, however, happening, and the ointment of all the doctors of the town proving utterly insufficient to effect the relief which a few seconds of English art afforded, the prejudice vanished at once. As it would have been out of the question for me to have entered upon this branch of the profession—as indeed it would be inexpedient for any medical man to devote himself exclusively, in a thinly-peopled country, to the practice of medicine—I thereafter reserved myself for the difficult cases only, and had the satisfaction of often conferring great benefits on poor women in their hour of sorrow. The poor creatures are often placed in a little hut built for the purpose, and are left without any assistance whatever, and the numbers of umbilical herniae which are met with in consequence is very great. The women suffer less at their confinement than is the case in civilized countries; perhaps from their treating it, not as a disease, but as an operation of nature, requiring no change of diet except a feast of meat and abundance of fresh air. The husband on these occasions is bound to slaughter for his lady an ox, or goat, or sheep, according to his means.
My knowledge in the above line procured for me great fame in a department in which I could lay no claim to merit. A woman came a distance of one hundred miles for relief in a complaint which seemed to have baffled the native doctors; a complete cure was the result. Some twelve months after she returned to her husband, she bore a son. Her husband having previously reproached her for being barren, she sent me a handsome present, and proclaimed all over the country that I possessed a medicine for the cure of sterility. The consequence was, that I was teased with applications from husbands and wives from all parts of the country. Some came upward of two hundred miles to purchase the great boon, and it was in vain for me to explain that I had only cured the disease of the other case. The more I denied, the higher their offers rose; they would give any money for the "child medicine"; and it was really heart-rending to hear the earnest entreaty, and see the tearful eye, which spoke the intense desire for offspring: "I am getting old; you see gray hairs here and there on my head, and I have no child; you know how Bechuana husbands cast their old wives away; what can I do? I have no child to bring water to me when I am sick," etc.
The whole of the country adjacent to the Desert, from Kuruman to Kolobeng, or Litubaruba, and beyond up to the latitude of Lake Ngami, is remarkable for its great salubrity of climate. Not only the natives, but Europeans whose constitutions have been impaired by an Indian climate, find the tract of country indicated both healthy and restorative. The health and longevity of the missionaries have always been fair, though mission-work is not very conducive to either elsewhere. Cases have been known in which patients have come from the coast with complaints closely resembling, if they were not actually, those of consumption; and they have recovered by the influence of the climate alone. It must always be borne in mind that the climate near the coast, from which we received such very favorable reports of the health of the British troops, is actually inferior for persons suffering from pulmonary complaints to that of any part not subjected to the influence of sea-air. I have never seen the beneficial effects of the inland climate on persons of shattered constitutions, nor heard their high praises of the benefit they have derived from traveling, without wishing that its bracing effects should become more extensively known in England. No one who has visited the region I have above mentioned fails to remember with pleasure the wild, healthful gipsy life of wagon-traveling.
A considerable proportion of animal diet seems requisite here. Independent of the want of salt, we required meat in as large quantity daily as we do in England, and no bad effects, in the way of biliousness, followed the free use of flesh, as in other hot climates. A vegetable diet causes acidity and heartburn.
Mr. Oswell thought this climate much superior to that of Peru, as far as pleasure is concerned; the want of instruments unfortunately prevented my obtaining accurate scientific data for the medical world on this subject; and were it not for the great expense of such a trip, I should have no hesitation in recommending the borders of the Kalahari Desert as admirably suited for all patients having pulmonary complaints. It is the complete antipodes to our cold, damp, English climate. The winter is perfectly dry; and as not a drop of rain falls during that period, namely, from the beginning of May to the end of August, damp and cold are never combined. However hot the day may have been at Kolobeng—and the thermometer sometimes rose, previous to a fall of rain, up to 96 Deg. in the coolest part of our house—yet the atmosphere never has that steamy feeling nor those debilitating effects so well known in India and on the coast of Africa itself. In the evenings the air becomes deliciously cool, and a pleasant refreshing night follows the hottest day. The greatest heat ever felt is not so oppressive as it is when there is much humidity in the air; and the great evaporation consequent on a fall of rain makes the rainy season the most agreeable for traveling. Nothing can exceed the balmy feeling of the evenings and mornings during the whole year. You wish for an increase neither of cold nor heat; and you can sit out of doors till midnight without ever thinking of colds or rheumatism; or you may sleep out at night, looking up to the moon till you fall asleep, without a thought or sign of moon-blindness. Indeed, during many months there is scarcely any dew.