West African studies

by Mary Henrietta Kingsley

I think this communication of Mr. Dennett’s is of much interest, and I hastily beg to remark that, if you have not got a devoted friend to hold you down all night, call in an apothecary in the morning time, and then hand you over to a Princess—things that are not always handy even in West Africa when you have been stung by a scorpion—things that, on the other hand, are always handy in West Africa—carbonate of soda applied promptly to the affected part will save you from wanting to drown yourself and much other inconvenience. The sting should be extracted regardless of the shedding of blood, carbonate of soda in hot water washed over the place, and then a poultice faced with carbonate of soda put on.

Although I do not say these West African doctors possess any specific for rheumatism, it is an undoubted fact that the South-west Coast tribes, with their poultices and vapour baths, are very successful in treating it, more so than the true Negroes, with their clay plaster and baking method. Rheumatism is a disease the Africans seem especially liable to, whatever may be the local climate, whether it be that of the reeking Niger Delta, or the dry delightful climate of Cabinda; moreover, my friends who go whaling tell me the Bermuda negroes also suffer from rheumatism severely, and are “a perfect cuss,” wanting to come and sit in the blood and blubber of fresh-killed whales. Small-pox is a vile scourge to Africa. The common treatment is to smear the body of the patient with the pulped leaves of the mzeuzil palm and with palm oil; but I cannot say the method is successful, save in preventing pitting, which it certainly does. The mortality from this disease, particularly among the South-west Coast tribes, is simply appalling. But it is extremely difficult to make the bush African realise that it is infectious, for he regards it as a curse from a great Nature spirit, sent in consequence of some sin, such as a man marrying within the restricted degree, or something of that kind. Mr. Dennett mentions small-pox patients being sent into the bush with more or less accommodation provided. Mr. Du Chaillu gave Mr. Fraser the idea that the Bakele tribe habitually drove their small-pox sick into the bush and neglected them, which certainly, from my knowledge of the tribe, I must say is not their constant habit by any means. I venture to think that this rough attempt at isolation among the Fjort is a remnant of the influence of the great Portuguese domination of the kingdom of Congo in the fifteenth, sixteenth, and seventeenth centuries, when the Roman Catholic missionaries got hold of the Fjort as no other West African has since been got hold of. Nevertheless the keeping of the sick in huts you will find in almost all districts in places—i.e. round the house of a great doctor. My friend Miss Mary Slessor, of Okÿon, has the bush round her compound fairly studded with little temporary huts, each with a patient in. You see, distinguished doctors everywhere are a little uppish, and so their patients have to come to them. Such doctors are usually specialists, noted for a cure of some particular disease, and often patients will come to such a man from towns and villages a week’s journey or more away, and then build their little shantie near his residence, and remain there while undergoing the cure.

There is a prevalent Coast notion that white men do not catch small-pox from black, but I do not think this is, at any rate, completely true. I was informed when in Loanda that during an epidemic of it amongst the natives, every white man had had a more or less severe touch, and I have known of cases of white men having small-pox in other West Coast places, small-pox they must either have caught from natives or have made themselves, which is improbable. I fancy it is a matter connected with the vaccination state of the white, although there seem to be some diseases prevalent among natives from which whites are immune—the Yaws, for example.

Less terrible in its ravages than small-pox, because it is far more limited in the number of its victims, is leprosy; still you will always find a case or so in a district. You will find the victims outcasts from society, not from a sense of its being an infectious disease, but because it is confounded with another disease, held to be a curse from an aggrieved Nature spirit. There was at Okÿon when I was there a leper who lived in a regular house of his own, not a temporary hospital hut, but a house with a plantation. He led a lonely life, having no wife or family or slave; he was himself a slave, but not called on for service—it was just a lonely life. People would drop in on him and chat, and so on, but he did not live in town. There was also another one there, who had his own people round him, and to whom people would send their slaves, because he was regarded as a good doctor; but he also had his house in the bush, and not in town.

Undoubtedly the diseases that play the greatest continuous havoc with black life in West Africa are small-pox, divers forms of pneumonia, heart-disease, and tetanus, the latter being largely responsible for the terrible mortality among children; but the two West African native diseases most interesting to the European on account of their strangeness, are the malignant melancholy and the sleep sickness, and strangely enough both these diseases seem to have their head centre in one region—the lower Congo. They occur elsewhere, but in this region they are constantly present, and now and again seem to take an epidemic form. Regarding the first-named, I am still collecting information, for I cannot tell whether the malignant melancholy of the lower Congo is one and the same with the hystero-hypochondria, the home-sickness of the true Negro. In the lower Congo I was informed that this malignant melancholy had the native name signifying throwing backwards, from its being the habit of the afflicted to throw themselves backwards into water when they attempted a drowning form of suicide.[24] They do not, however, confine themselves to attempts to drown themselves only, but are equally given to hanging, the constant thing about all their attempts being a lack of enthusiasm about getting the thing definitely done: the patient seems to potter at it, not much caring whether he does successfully hang or drown himself or no, but just keeps on, as if he could not help doing it. This has probably given rise to the native method of treating this disease—namely, holding a meeting of the patient’s responsible relations, who point out elaborately to him the advantages of life over death, and enquire of him his reasons for hankering after the latter. If in spite of these representations he persists in a course of habitual suicide, he is knocked on the head and thrown into the river; for it is a nuisance to have a person about who is continually hanging himself to the house ridge pole and pulling the roof half off, or requiring a course of sensational rescues from drowning.

The sleep disease[25] is also a strange thing. When I first arrived in Africa in 1893 there had just been a dreadful epidemic of it in the Kakongo and lower Congo region, and I saw a good many cases, and became much interested in it, and have ever since been trying to gather further information regarding it.

Dr. Patrick Manson in his important paper[26] states that it has never been known to affect any one who has not at one time or another been resident within this area, and observes on its distribution that “it seems probable that as our knowledge of Africa extends, this disease will be found endemic here and there throughout the basins of the Senegal, the Niger, the Congo, and their affluents. We have no information of its existence in the districts drained by the Nile and the Zambesi, nor anywhere on the eastern side of the continent.” As far as my own knowledge goes the centres of this disease are the Senegal and the Congo. I never saw a case in the Oil Rivers, nor could I hear of any, though I made every inquiry; the cases I heard of from Lagos and the Oil Rivers were among people who had been down as labourers, &c., to the Congo. What is the reason of this I do not know, but certainly the people of the lower Congo are much given to all kinds of diseases, far more so than those inhabiting the dense forest regions of Congo Français, or the much-abused mangrove swamps of the Niger Delta.

Dr. Manson says, “The sleeping sickness has been attributed to such things as sunstroke, beriberi, malaria, poison, peculiar foods, such as raw bitter manioc, and diseased grain; it is evident, however, that none of these things explains all the facts.” In regard to this I may say I have often heard it ascribed to the manioc when in Kakongo, the idea being that when manioc was soaked in water surcharged with the poisonous extract, it had a bad effect. Certainly in Kakongo this was frequently the case in many districts where water was comparatively scarce. The pools used for soaking the root in stank, and the prepared root stank, in the peculiar way it can, something like sour paste, with a dash of acetic acid, and thereby the villages stank and the market-places ditto, in a way that could be of no use to any one except a person anxious to find his homestead in the dark; but Dr. Manson’s suggestion is far more likely to be the correct one. Against it I can only urge that in some districts where I am informed by my medical friends that Filaria perstans is very prevalent, such as Calabar, the Niger, and the Ogowe, sleeping sickness is not prevalent. Dr. Manson says “the fact that the disease can be acquired only in a comparatively limited area, suggests that the cause is similarly limited; and the fact that the disease may develop years after the endemic area has been quitted, suggests that the cause is of such a nature that it may be carried away from the endemic area and remain latent, as regards its disease-producing qualities for a considerable period; even for years.” He then goes on to say, “Filaria perstans, so far as is known, is limited in its geographical distribution to Western Equatorial Africa—that is to say, it can be acquired there only—and it may continue in active life for many years after its human host has left the country in which alone it can be acquired. We also know that similar entozoa in their wanderings in the tissues by accident of location, or by disease, or injury of their organs, not infrequently give rise to grave lesions in their hosts. I therefore suggest that possibly Filiaria perstans may in some way be responsible for the sleeping sickness. I know that this parasite is extremely common in certain sleeping sickness districts, and moreover, I have found it in the blood of a considerable number of cases of this disease—in six out of ten—including that described by Mackenzie. There are many difficulties in the way of establishing this hypothesis, but there is a sufficient inherent probability about it to make it well worth following up.”

The most important statement that I have been able to get regarding it so far, has been one sent me by Mr. R. E. Dennett; who says “The sleeping sickness though prevalent throughout Kakongo and Loango is most common in the north of Loango and the south of Kakongo, that is north of the river Quillou and among the Mussorongo.

“What the cause of the sickness is, it is hard to say, but it is one of those scourges which is ever with us. The natives say any one may get it, that it is not hereditary, and only infectious in certain stages. They avoid the dejecta of affected persons, but they do not force the native to live in the bush as they do a person affected by small-pox.