Flesh wounds heal well, causing less constitutional disturbance than among Europeans, but fractured bones do not so soon re-unite. I have found lime water, a pint or more given daily, promote their union. Lime is scarce here, and the shells of eggs are correspondingly thin.
Lung disease is more frequent among natives than white settlers, unless the latter bring the seeds of disease with them; but I doubt whether it is true phthisis. I suspect that the lungs of both natives and settlers are more liable to become hepatized or otherwise disorganized than tuberculated. In examining the lungs of cattle who have died of lung sickness, I have found large portions of lung degenerated into an impervious muscle-like substance resembling beef, while in other portions the disease has shown itself to be of so anemic a character as to have proceeded without much pause to suppuration. I believe that in this climate, subjects of phthisis, who had only small tubercles in their lungs, would find their further development arrested; indeed this has been, in many cases, proved to have occurred.
The lung disease, called lung sickness, in cattle, does not, with regard to the organ attacked, affect human beings, but the tendency of the present race of mankind is to anemic rather than acutely inflammatory diseases. The most destructive modern diseases, influenza, cholera, and diphtheria, are of an anemic character; other diseases are now, more than formerly, inclined to assume this character. It is not that medicine and doctors, but that human constitutions, vary. The rule laid down by Pinel that bleeding confirms mania is good now; but 50 or 70 years ago, as, perhaps, 50 or 70 years hence, more exceptional cases did and may again occur than are at present met with. {55}
Vide Tables P. and Q., pp. [44] and 45.
The mortality from fever will be seen to have been great; but of the seven deaths recorded, six came into the hospital in a dying state. One, admitted November 25th, died five hours after admission; another, admitted at noon, December 11th, died at half-past four a.m. next morning; another, admitted on the 5th, died on the 6th; another, admitted on September 19th, died on the 20th; other two rallied by the administration of wine, sago, &c., but died from two to five days after admission, again sinking. They received shelter and attention, and had what chance there was of recovery; and some others, beyond all reasonable expectation, recovered. The number of Kafir and druggist-doctored patients thrown upon my hands in a moribund state is great. Of the cases of fever that I attended throughout, most did well. The hospital has been occupied somewhat more than three years and a half, but I have held office as district surgeon in the service of Government eight years and a half, and I speak of my experience during the whole term of such service.
In giving names to complaints, I have not set down diarrhœa or even tænia, of which many instances have occurred, but these instances have been incidental or symptomatic. Tænia has been discovered and treated in cases of patients who had wounds, &c., and this frequently. There is no complaint so generally prevalent among both natives and settlers. The tapeworm of South Africa is about two-fifths in width[†] narrower than that of Europe. The most effective treatment has been 1 1⁄2 oz. sp. terebinth, early in the morning, and one drop of croton oil, or a dose of other aperient medicine, four or five hours after, nisi prius soluta sit alvus. A less dose than 1 1⁄2 oz. more disturbs the system than this quantity, and fails to act. I procured some ethereal extract of male fern in one case, of which I gave one scruple early in the morning, and a black draught some hours after. It caused no nausea or other apparent constitutional disturbance, and a piece of tapeworm was expelled, still alive, which measured 22 feet long. Turpentine generally expels them dead.
[†] The English assumed as 1 in width, the South African 0·6.
The fracture that ended fatally was a compound fracture of the left thigh, and compound comminuted fracture of the tibia and fibula of the right leg, from a waggon accident. He sunk at the end of two days, never rallying from the shock to his system, and refusing to submit to the not very hopeful operation of amputation of the more seriously injured limb. I have had two cases of injury among the aborigines in which amputation was necessary, one a little above the ancle, the other four inches above the knee. In the latter case the leg had been torn off by the machinery of a flour mill, the knee stripped of its integuments, and the muscles above the knee stretched and contused, so that I felt myself obliged to operate high up, lest a second amputation should become requisite. The case occurred a few months ago. Both cases did well. I have represented my wish in both cases that an artificial leg and foot should be sent for to England, as it would be a convenience to the parties, and also have a good sanitary and social effect upon the natives. The cost of the cork or other artificial two legs, black imitation toes inclusive, would not, I should think, exceed 30l. Their aversion to operations necessary to save life would thus be in some measure overcome or lessened.
The natives who have become Christians evince some of the uncomfortableness and maladroitness that are incidental to a state of transition, but, perhaps, less than might have been expected. The premises I go upon are, perhaps, scanty and insufficient, but I am inclined to think that among Christian Kafirs more children die in infancy than among the unchristianized natives. This is not to be depended upon, nor can I, generally speaking, say much that is definite upon the subject of physical or other differences between Christian and other natives.
The natives hitherto, as the rule, have not shown the appetence for alcohol which the North American Indians so early, and so fatally for themselves, acquired. There are cases of elephantiasis among them; they are subject to skin diseases. These and other trifling diseases or cases of injury seldom appear at the hospital, or only as accompaniments of injury or other disease.