Hernia.
Ruptures are common in Egypt, chiefly among the lower orders, particularly the boatmen, few of whom are seen without a greater or less degree of this dangerous accident, and to many of whom it is fatal. Their life is almost amphibious, and it may in some measure be the effect of the pendent situation of the parts; but it seems chiefly to arise from the exertions they are obliged to make in lading and unlading their boats, and propelling them, as frequently happens, by applying their shoulders. In the people of this city, who carry heavy loads on their backs, and raise great weights, it is also common. Clumsy and ineffectual trusses are made in Kahira, which rather distress and embarrass than relieve or secure the patient. The scrotum is sometimes cauterized, and with effect, if the intestines be not incarcerated. In Dar-Fûr this disease is uncommon; yet it is sometimes seen there.
Hydrocele.
The hydrocele is remarkably frequent in Syria, and, above all, in the town of Beirût. It is also frequent in Egypt, but most among the Christians of both countries. Some attribute it to the Nile water; others to the air; others to the use, or rather abuse of aqua vitæ; others to food of a particular kind: none of which seems to be the real cause. The natives of both countries have a method of inciding securely, which discharges the water, and of course produces temporary relief: but the malady is rapidly regenerated. The only radical cure is the actual cautery, which, though unskilfully, is yet successfully applied to such patients as are bold enough to encounter the danger.
Hæmorrhoides and Fistula in ano.
The hæmorrhoides (bowasîr) are very common both in Egypt and Dar-Fûr. In the latter, they cure them by the cautery. The Fistula in ano is also seen there, and is cured by a topical application, but without incision.
Apoplexy.
I have known two instances in Dar-Fûr of what appeared to me to be apoplexy. The one was of a male slave, about sixteen years of age, the other of a man about forty; both of them of plethoric habit. The boy dropped down senseless, after having been standing near a large fire in cool weather. Pulsation ceased, and a great hæmorrhage took place from the nostrils. After one hour and a half he expired. Bleeding was recommended to the proprietor, but the by-standers would not consent, saying it was Sheitân, the devil had possessed him. The man was dead before I saw him; much extravasated blood appeared about him. He had been at work in the sun. The coup-de-soleil, properly so called, does not often occur. When much exposed in walking or at work, they protect their head from the ill effect of the rays descending perpendicularly, by winding their shirt round it, and leaving the trunk uncovered.
Umbilical ruptures.
Among the slaves, and even free persons in Dar-Fûr, prominencies of the navel, and umbilical ruptures, of greater or less magnitude, are very common. Though the chord be remarked to be larger in the negroes than with us, this circumstance must probably be occasioned by ignorance, carelesness, or some mismanagement at the birth. It does not appear to be attended with positive inconvenience. The chord, when divided, is here cauterized as in Egypt.