Small pocket cases containing all the requisite instruments are to be obtained of any surgical instrument maker. Among medicines quinine stands pre-eminent as an effectual, though perhaps not always an infallible, febrifuge; it is, however, so excellent a tonic that its moderate and occasional use may safely be recommended, and we do not know of a better remedy in case of fever. It is best dissolved in wine, if the traveller should be fortunate enough to be able to carry any. It may be given in rum or other spirit, which is more portable and likely to be at hand, and which is also useful for preserving insects; but if a man wants any peace while passing through most wild countries, or is doubtful of his own powers of self-denial, we would recommend him to convert all his wine into a strong solution of quinine before starting, and to do the same with half his rum or spirit of wine, having the rest strongly methylated for use, either in a spirit lamp or preservation of specimens. Let both these be labelled with a death’s head and cross bones, such as is used by chemists in the Cape and other countries, where many of the native population cannot read, or do not understand, English, to signify poison.
A proportion of wine or spirit may, of course, be reserved for prudent and moderate use, as a glass, or even a bottle judiciously given may go very far to gain the good will of a native chief, or to induce either the proper servants or occasional assistants of the traveller to work heartily in helping him out of some difficulty. We have generally found a good pannikin of hot coffee accepted readily enough by the people after a long night journey; but there are times when a fire could not be made, and a drop of spirit, imparting a momentary sensation of warmth, even if it produces no other good effect, has, at least, that of showing that their employer cares for them, and does what he can to cheer them after their labour.
In most tropical rivers there are extensive deltas, intersected with netlike labyrinths of shallow impracticable channels, alternated with shoals, which the advanced guard of mangroves is just reclaiming from the sea, and where tangled, dank, and unwholesome wildernesses and swamps are formed, there fever, in its most deadly forms, is sure to prevail.
The delta of the Zambesi is also a place of danger from this cause; and persons of a full stout habit are said, and we believe with some reason, to be more liable to fever than others of a spare and meagre build; indeed, the Portuguese, when they see a well-framed athletic man, in prime condition, enter the river, prophetically mark him as one of the first victims. We have ourselves suffered severely and continuously from this malady, which generally came on with a cold shivering or ague, and was succeeded by the fever, accompanied by intense perspiration, prostration of strength, nausea and inability to eat, or even to retain the necessary medicine or cooling drink; an immoderately exaggerated idea of the length of time; short uneasy slumbers, disturbed by incongruous dreams—generally of some difficulty previously experienced—or total want of sleep, total failure of memory, and in bad cases delirium while awake.
When the “Pearl” first entered the Zambesi Dr. Kirk ordered that a glass of spirit with quinine in it should be served to the men every morning; and we would frequently, as the large doses administered were intensely bitter, make up the quinine into pills, with chocolate or cocoa paste, or sometimes place the quinine powder dry on the tongue, and then swallow a copious draught of water to wash it down.
We give, first, Dr. Livingstone’s remedy for fever; but, useful and effective as it really is, we cannot say, from experience, that it is infallible; and the fatality among the gentlemen of the mission proves that we do not, as yet, possess a remedy for the fever that will supply the place of a sufficient and generous diet, total cessation of exposure to the malaria, and removal to a more elevated and healthy country, even though it be but a few hours’ journey from the infected district. The doctor’s receipt is as follows:—
“Linyante, 12th of September, 1855.
“A pill composed of three or four grains of resin of jalap, three or four of calomel, and an equal number of quinine; a drop or two of tincture of cardamoms to dissolve the resin to form the bolus.
“I have had a great many cases in hand, and never met with a single case of failure; it ought not to purge; the quantity of resin must be regulated to produce only a gentle movement, which, when felt, is accompanied by perspiration and a sound sleep. A check to this perspiration has, in my own experience, given rise to vomiting large quantities of pure blood.”