Travels in West Africa: Congo Français, Corisco and Cameroons

by Mary Henrietta Kingsley

The net results of laboratory investigation, according to the French doctors, is that the mycetozoic malarial bacillus, the microbe of paludism, is amœboid in its movements, acting on the red corpuscles, leaving nothing of them but the dark pigment found in the skin and organs of malarial subjects. [{517}] The German doctors make a practice of making microscopic examinations of the blood of a patient, saying that the microbes appear at the commencement of an attack of fever, increase in quantity as the fever increases, and decrease as it decreases, and from these investigations they are able to judge fairly accurately how many remissions may be expected; in fact to judge of the severity of the case which, taken with the knowledge that quinine only affects malarial microbes at a certain stage of their existence, is helpful in treatment.

There is, I may remark, a very peculiar point regarding hæmaturic disease, the most deadly form of West Coast fever. This disease, so far as we know, has always been present on the South-West Coast, at Loando, the Lower Congo and Gaboon, but it is said not to have appeared in the Rivers until 1881, and then to have spread along the West Coast. My learned friend, Dr. Plehn, doubts this, and says people were less observant in those days, but the symptoms of this fever are so distinct, that I must think it also totally impossible for it not to have been differentiated from the usual remittent or intermittent by the old West Coasters if it had occurred there in former times with anything like the frequency it does now; but we will leave these theoretical and technical considerations and turn to the practical side of the question.

You will always find lots of people ready to give advice on fever, particularly how to avoid getting it, and you will find the most dogmatic of these are people who have been singularly unlucky in the matter, or people who know nothing of local conditions. These latter are the most trying of all to deal with. They tell you, truly enough no doubt, that the malaria is in the air, in the exhalations from the ground, which are greatest about sunrise and sunset, and in the drinking water, and that you must avoid chill, excessive mental and bodily exertion, that you must never get anxious, or excited, or lose your temper. Now there is only one - the drinking water - of this list that you can avoid, for, owing to the great variety and rapid growth of bacteria encouraged by the tropical temperature, and the aqueous saturation of the atmosphere from the heavy rainfall, and the great extent of swamp, etc., it is practically impossible to destroy them in the air to a satisfactory extent. I was presented by scientific friends, when I first went to the West Coast, with two devices supposed to do this. One was a lamp which you burnt some chemical in; it certainly made a smell that nothing could live with - but then I am not nothing, and there are enough smells on the Coast now. I gave it up after the first half-hour. The other device was a muzzle, a respirator, I should say. Well! all I have got to say about that is that you need be a better-looking person than I am to wear a thing like that without causing panic in a district. Then orders to avoid the night air are still more difficult to obey - may I ask how you are to do without air from 6.30 P.M. to 6.30 A.M.? or what other air there is but night air, heavy with malarious exhalations, available then?

The drinking water you have a better chance with, as I will presently state; chill you cannot avoid. When you are at work on the Coast, even with the greatest care, the sudden fall of temperature that occurs after a tornado coming at the end of a stewing-hot day, is sure to tell on any one, and as for the orders regarding temper neither the natives, nor the country, nor the trade, help you in the least. But still you must remember that although it is impossible to fully carry out these orders, you can do a good deal towards doing so, and preventive measures are the great thing, for it is better to escape fever altogether, or to get off with a light touch of it, than to make a sensational recovery from Yellow Jack himself.

There is little doubt that a certain make of man has the best chance of surviving the Coast climate - an energetic, spare, nervous but light-hearted creature, capable of enjoying whatever there may be to enjoy, and incapable of dwelling on discomforts or worries. It is quite possible for a person of this sort to live, and work hard on the Coast for a considerable period, possibly with better health than he would have in England. The full-blooded, corpulent and vigorous should avoid West Africa like the plague. One after another, men and women, who looked, as the saying goes, as if you could take a lease of their lives, I have seen come out and die, and it gives one a sense of horror when they arrive at your West Coast station, for you feel a sort of accessory before the fact to murder, but what can you do except get yourself laughed at as a croaker, and attend the funeral?

The best ways of avoiding the danger of the night air are - to have your evening meal about 6.30 or 7, - 8 is too late; sleep under a mosquito curtain whether there are mosquitoes in your district or not, and have a meal before starting out in the morning, a good hot cup of tea or coffee and bread and butter, if you can get it, if not, something left from last night’s supper or even aguma. Regarding meals, of course we come to the vexed question of stimulants - all the evidence is in favour of alcohol, of a proper sort, taken at proper times, and in proper quantities, being extremely valuable. Take the case of the missionaries, who are almost all teetotalers, they are young men and women who have to pass a medical examination before coming out, and whose lives on the Coast are far easier than those of other classes of white men, yet the mortality among them is far heavier than in any other class.

Mr. Stanley says that wine is the best form of stimulant, but that it should not be taken before the evening meal. Certainly on the South-West Coast, where a heavy, but sound, red wine imported from Portugal is the common drink, the mortality is less than on the West Coast. Beer has had what one might call a thorough trial in Cameroon since the German occupation and is held by authorities to be the cause in part of the number of cases of hæmaturic fever in that river being greater than in other districts. But this subject requires scientific comparative observation on various parts of the Coast, for Cameroons is at the beginning of the South-West Coast, whereon the percentage of cases of hæmaturic to those of intermittent and remittent fevers is far higher than on the West Coast.

A comparative study of the diseases of the western division of the continent would, I should say, repay a scientific doctor, if he survived. The material he would have to deal with would be enormous, and in addition to the history of hæmaturic he would be confronted with the problem of the form of fever which seems to be a recent addition to West African afflictions, the so-called typhoid malaria, which of late years has come into the Rivers, and apparently come to stay. This fever is, I may remark, practically unknown at present in the South-West Coast regions where the “sun for garbage” plan is adhered to. At present the treatment of all white man’s diseases on the Coast practically consists in the treatment of malaria, because whatever disease a person gets hold of takes on a malarial type which masks its true nature. Why, I knew a gentleman who had as fine an attack of the smallpox as any one would not wish to have, and who for days behaved as if he had remittent, and then burst out into the characteristic eruption; and only got all his earthly possessions burnt, and no end of carbolic acid dressings for his pains.

I do not suppose this does much harm, as the malaria is the main thing that wants curing; unless Dr. Plehn is right and quinine is bad in hæmaturia. His success in dealing with this fever seems to support his opinion; and the French doctors on the Coast, who dose it heavily with quinine, have certainly a very heavy percentage of mortality among their patients with the hæmaturic, although in the other forms of malarial fever they very rarely lose a patient.

But to return to those preventive measures, and having done what we can with the air, we will turn our attention to the drinking water, for in addition to malarial microbes the drinking and washing water of West Africa is liable to contain dermazoic and entozoic organisms, and if you don’t take care you will get from it into your anatomy Tinea versicolor, Tinea decalvans, Tinea circinata, Tinea sycosis, Tinea favosa, or some other member of that wretched family, let alone being nearly certain to import Trichocephalus dispar, Ascaris lumbricoides, Oxyuris vermicularis, and eight varieties of nematodes, each of them with an awful name of its own, and unpleasant consequences to you, and, lastly, a peculiar abomination, a Filaria. This is not, what its euphonious name may lead you to suppose, a fern, but it is a worm which gets into the white of the eye and leads there a lively existence, causing distressing itching, throbbing and pricking sensations, not affecting the sight until it happens to set up inflammation. I have seen the eyes of natives simply swarming with these Filariæ. A curious thing about the disease is that it usually commences in one eye, and when that becomes over-populated an emigration society sets out for the other eye, travelling thither under the skin of the bridge of the nose, looking while in transit like the bridge of a pair of spectacles. A similar, but not identical, worm is fairly common on the Ogowé, and is liable to get under the epidermis of any part of the body. Like the one affecting the eye it is very active in its movements, passing rapidly about under the skin and producing terrible pricking and itching, but very trifling inflammation in those cases which I have seen. The treatment consists of getting the thing out, and the thing to be careful of is to get it out whole, for if any part of it is left in, suppuration sets in, so even if you are personally convinced you have got it out successfully it is just as well to wash out the wound with carbolic or Condy’s fluid. The most frequent sufferers from these Filariæ are the natives, but white people do get them.