THE next (though not a dangerous complaint) has a very terrible appearance. Small tubercules or swellings appear all over the body, but thickest in the thighs, arms, and legs. These swellings go and come for weeks together without pain; though the legs often swell to a monstrous size as in the dropsy. Sometimes the patients have ulcers in their noses and mouths, not unlike those which are one of the malignant consequences of the venereal disease. The small swellings or eruptions, when squeezed, very often yield blood; in other respects the patient is generally in good health, saving the pain the ulcers give him, and the still greater uneasiness of mind which he suffers from the spoiling of the smoothness of his skin; for all the nations in Africa within the tropics are wonderfully affected at the smallest eruption or roughness of the skin. A black of Sennaar will hide himself in the house where dark, and is not to be seen by his friends, if he should have two or three pimples on any part of his body. Nor is there any remedy, however violent, that they will not fly to for immediate relief. Scars and wounds are no blemishes; and I have seen them, for three or four pimples on their bracelet arm, suffer the application of a red-hot iron with great resolution and constancy.
These two last diseases yielded, the first slowly, and sometimes imperfectly, to mercurials; and sublimate has by no means in these climates the quick and decisive effects it has in Europe. The second is completely and speedily cured by antimonials.
The next complaint I shall mention, as common in these countries, is called Farenteit, a corruption of an Arabic word, which signifies the worm of Pharaoh; all bad things being by the Arabs attributed to these poor kings, who seem to be looked upon by posterity as the evil genii of the country which they once governed.
This extraordinary animal only afflicts those who are in constant habit of drinking stagnant water, whether that water is drawn out from wells, as in the kingdom of Sennaar, or found by digging in the sand where it is making its way to its proper level the sea, after falling down the side of the mountains after the tropical rains. This plague appears indiscriminately in every part of the body, but oftenest in the legs and arms. I never saw it in the face or head; but, far from affecting the fleshy parts of the body, it generally comes out where the bone has least flesh upon it.
Upon looking at this worm, on its first appearance, a small black head is extremely visible, with a hooked beak of a whitish colour. Its body is seemingly of a white silky texture, very like a small tendon bared and perfectly cleaned. After its appearance the natives of these countries, who are used to it, seize it gently by the head, and wrap it round a thin piece of silk or small bird’s feather. Every day, or several times a-day, they try to wind it up upon the quill as far as it comes readily; and, upon the smallest resistance, they give over for fear of breaking it. I have seen five feet, or something more of this extraordinary animal, winded out with invincible patience in the course of three weeks. No inflammation then remained, and scarcely any redness round the edges of the aperture, only a small quantity of lymph appeared in the hole or puncture, which scarcely issued out upon pressing. In three days it was commonly well, and left no scar or dimple implying loss of substance.
I myself experienced this complaint. I was reading upon a sofa at Cairo, a few days after my return from Upper Egypt, when I felt in the fore part of my leg, upon the bone, about seven inches below the center of my knee-pan, an itching resembling what follows the bite of a muscheto. Upon scratching, a small tumour appeared very like a muscheto bite. The itching returned in about an hour afterwards; and, being more intent upon my reading than my leg, I scratched it till the blood came. I soon after observed something like a black spot, which had already risen considerably above the surface of the skin. All medicine proved useless; and the disease not being known at Cairo, there was nothing for it but to have recourse to the only received manner of treating it in this country. About three inches of the worm was winded out upon a piece of raw silk in the first week, without pain or fever: but it was broken afterwards through the carelessness and rashness of the surgeon when changing a poultice on board the ship in which I returned to France: a violent inflammation followed; the leg swelled so as to scarce leave appearance of knee or ancle; the skin, red and distended, seemed glazed like a mirror. The wound was now healed, and discharged nothing; and there was every appearance of mortification coming on. The great care and attention procured me in the lazaretto at Marseilles, by a nation always foremost in the acts of humanity to strangers, and the attention and skill of the surgeon, recovered me from this troublesome complaint.
Fifty-two days had elapsed since it first begun; thirty-five of which were spent in the greatest agony. It suppurated at last; and, by enlarging the orifice, a good quantity of matter was discharged. I had made constant use of bark, both in fomentations and inwardly; but I did not recover the strength of my leg entirely till near a year after, by using the baths of Poretta, the property of my friend Count Ranuzzi, in the mountains above Bologna, which I recommend, for their efficacy, to all those who have wounds, as I do to him to have better accommodation, greater abundance of, and less imposition in, the necessaries of life than when I was there. It is but a few hours journey over the mountains to Pistoia.
The last I shall mention of these endemial diseases, and the most terrible of all others that can fall to the lot of man, is the Elephantiasis, which some have chosen to call the Leprosy, or Lepra Arabum; though in its appearance, and in all its circumstances and stages, it no more resembles the leprosy of Palestine, (which is, I apprehend, the only leprosy that we know) than it does the gout or the dropsy. I never saw the beginning of this disease. During the course of it, the face is often healthy to appearance; the eyes vivid and sparkling: those affected have sometimes a kind of dryness upon the skin of their backs, which, upon scratching, I have seen leave a mealiness, or whiteness; the only circumstance, to the best of my recollection, in which it resembled the leprosy, but it has no scaliness. The hair, too, is of its natural colour; not white, yellowish, or thin, as in the leprosy, but so far from it that, though the Abyssinians have very rarely hair upon their chin, I have seen people, apparently in the last stage of the elephantiasis, with a very good beard of its natural colour.
The appetite is generally good during this disease, nor does any change of regimen affect the complaint. The pulse is only subject to the same variations as in those who have no declared nor predominant illness; they have a constant thirst, as the lymph, which continually oozes from their wounds, probably demands to be replaced. It is averred by the Abyssinians that it is not infectious. I have seen the wives of those who were in a very inveterate stage of this illness, who had born them several children, who were yet perfectly free and found from any contagion. Nay, I do not remember to have seen children visibly infected with this disease at all; though, I must own, none of them had the appearance of health. It is said this disease, though surely born with the infant, does not become visible till the approach to manhood, and sometimes it is said to pass by a whole generation.
The chief seat of this disease is from the bending of the knee downwards to the ancle; the leg is swelled to a great degree, becoming one size from bottom to top, and gathered into circular wrinkles, like small hoops or plaits; between every one of which there is an opening that separates it all round from the one above, and which is all raw flesh, or perfectly excoriated. From between these circular divisions a great quantity of lymph constantly oozes. The swelling of the leg reaches over the foot, so as to leave about an inch or little more of it seen. It should seem that the black colour of the skin, the thickness of the leg, and its shapeless form, and the rough tubercules, or excrescences, very like those seen upon the elephant, give the name to this disease, and form a striking resemblance between the distempered legs of this unfortunate individual of the human species, and those of the noble quadruped the elephant, when in full vigour.