The Satires of A. Persius Flaccus Part 10

A most simple method by which the cloth may be kept wet, and evaporation thereby kept up, is to have a large vessel, with the water in for common use, so placed that a small vessel with water can be suspended over it in such a manner that a _drip_ can be kept constantly on the cloth. The cloth being first saturated, it will readily be seen that a very small drip is required to keep up the dampness. The drip may be arranged, where convenient, with a small _faucet_ so as to regulate the drop, or the more primitive method of a little _spiggot_ or _sharpened stick_ put into a hole made in the vessel, so regulated as to keep up a sufficient dripping to keep the cloth of sufficient dampness. Simple as this may appear to the reader, it is an important sanitary measure, besides adding greatly to the immediate comfort of the traveler or resident in those regions.

Atmosphere

The atmosphere in this region of the continent is much purer than that of Liberia and the region round about; and, although incorporated with odors, these are pleasant and seem familiar to the sense, and not obnoxious with the rich rank fragrance so sensibly experienced in that country. There is little, comparatively, of the decayed vegetation, which sends up malaria from the surface in Liberia; and the immense fields and plains of gra.s.s not under cultivation at the time, are burnt down during the dry season, thereby bringing to bear, though probably unawares to them, a sanitary process throughout that extensive country at least once every year.

Kinds of Disease

_Intermittent fever_, as described in section VI., page 280 on Liberia, though generally of a mild type, _diarrhoea_, _dysentery_ (neither of which is difficult to subdue by a little rational treatment), _opthalmia_, and _umbilical hernia_, and sometimes, but not frequently, _inguinal hernia_, are the princ.i.p.al diseases. The opthalmia I suspected as originating from taint, probably having been primarily carried from the coast, as it was not so frequently met with as to warrant the idea of its being either a contagion or the effects of poisonous sands or winds, as supposed to exist. The hernia is caused by the absence of proper _umbilical attention_ and _abdominal support_ to the child after _parturition_. Umbilical hernia is fearfully common all through Africa, I having frequently seen persons, especially females, with the hernial tumor as large as their own head, and those of little children fully as large as the head of an infant a month old.

Guinea Worm

A singular disease affects some persons, though I have never seen this upon a native, and believe it to be peculiar to the region round about Liberia. The person whose case I examined had formerly resided in Liberia, where, doubtless, the disease commenced, but for the last three years previously had resided at Ijaye, in the capacity of cook, for the American Baptist Missionaries, Revs. A. D. Phillips and J. R. Stone and lady, and then resided at Abbeokuta. This is a peculiar ulceration of the leg, immediately above the ankle-bone, where they say it usually commences; the edges of the ulcer, and the cuticle quite up to the edge, and all the surrounding parts, having a healthy appearance, as though a portion of the flesh had been recently torn out, leaving the cavity as it then was. The most peculiar feature of this singular disease is a _white fiber_, which, coming out from the integuments of the muscles of the leg above, hangs suspended in the cavity (ulcer) the lower end loose, and somewhat inclined to coil (and when _straightened_ out, resuming again the serpentine curves, of course from the _elasticity_ with _motion_), is supposed to be a _worm_; hence its name--_Guinea worm_. The fibre seems in color and texture to be in a normal condition; indeed, there appear to be little or no pathological symptoms about the parts at all, except a slight appearance of _vermillion_ inflammation over the surface of the ulcer, which is more apparent sometimes than others.

What Is Guinea Worm?

I have examined closely this fibre, and from its appearance, color, size, and texture, especially as it is sensibly felt high up in the leg near the tuberosity of the tibia, when pulled by the dangling end, my own impression is that the so-called "Guinea worm" is nothing more than the _external saphenus_ or _communis tibiae_ (nerve) exposed in a peculiar manner, probably by a disease, which, by a curious pathological process, absorbs away the muscular parts, leaving the bare nerve detached at its lower extremity, suspended loose in this unnatural s.p.a.ce. I have never seen but this one case of Guinea worm, but had frequent opportunities of examining it; indeed, the patient consulted me concerning it, and by the advice and consent of the very clever native gentleman, Samuel Crowther, Esq., who received his professional education at the Royal College of Surgeons, Lincoln's Inn Fields, London, insisted on my taking the case, which I declined, partly for the want of time to do justice to the patient, and aside from courtesy and equity to the surgeon who had the case in hand, mainly because I _knew nothing about it_--the best reason of all. The patient was an American quadroon, black nearly in complexion, of one-fourth white blood, from North Carolina. This, of course was a black quadroon.

I should add, that the fiber at times entirely _disappears_ from the cavity (by _contraction_, of course), when again it is seen suspended as before. This is one reason why it is believed to be a _worm_, and supposed to _creep_ up and down in the flesh.

Treatment of Diseases--Diarrhoea

The treatment of fever in this part of Africa should be the same as that in Liberia, given on page 280. The best remedy which I have found for diarrhoea is:

[TN: symbol: Rx]. Pulv. Rad. Rhei. [TN: symbol: drachm] j.; Syr.

Simp. [TN: symbol: ounce] jv.; Spts. Terebinth, [TN: symbol: dracm] j.; Tinct. Opii., gtt. x. M. ft.

Pulverized rhubarb, one drachm, (or one-eighth of an ounce); simple syrup, four ounces (or eight large tablespoonfuls); laudanum, ten drops; spirits of turpentine, one spoonful. Mix this well together to take.

Dysentery

For dysentery the recipe is:

[TN: symbol: Rx]. Pulv. Rad. Rhei. Pulv. C. Catech. a. a., [TN: symbol: drachm] j.; Syr. Simp. f. [TN: symbol: ounce] jv.; Spts.

Terebinth. Spis. Ammon. Arromat., a. a. f.

[TN: symbol: drachm] j.; Tinct. Opii. gtt. x.M.ft.

Pulverized rhubarb and pulverized gum catechu, each, one-eighth of an ounce; simple syrup, eight large tablespoonfuls; spirits of turpentine and aromatic spirits of ammonia, of each one teaspoonful; laudanum, ten drops. Mix this well together to take. Of this take one teaspoonful (if very bad, a dessert spoonful) every three hours, or four times a day (always beginning at least one hour before breakfast), till the symptoms cease.

Fever Antidote

During the presence of febrile symptoms, in the absence of all diarrhoea and dysenteric symptoms, even when the person is not complaining, an excellent simple antidote to be taken at discretion, not oftener than once every hour during the day, is:

[TN: symbol: Rx] Syr. Simp., [TN: symbol: ounce] jv.; Spts. Ammon.

Arromat. [TN: symbol: drachm] jss. M. ft.

Simple syrup, eight large tablespoonfuls; aromatic spirits of ammonia, one and a-half teaspoonfuls. Mix this well together. Take a teaspoonful of this preparation in a little cold water, or a gla.s.s of lemonade if preferred, and the condition of the bowels will admit, as often as thought advisable under the circ.u.mstances.

I have thus thought proper to simplify this treatment, that it may be in the reach of every person going to the tropics, as I am certain that there has been a great deficiency in the treatment and discovery of remedies in diseases of that continent especially. These prescriptions, as compounded, are entirely new, originating with the writer, who has only to add that he is in hopes that they prove as advantageous and successful in other hands as they have been in his.

Regimen

Persons laboring under fever should eat moderately of such food as best agrees with their appet.i.te; but frequently, if required or desired, that the system may be well supported. When there is _diarrhoea_ or _dysentery_ present, there should be no solid food taken, but the patient or ailing person should be confined strictly to a thin milk porridge of fine Guinea-corn flour, which is always obtainable in Africa, crumbled crackers or soda biscuits, light (leavened) wheat bread if to be had, or well-done rice boiled to a pulp. The soda-biscuit as a porridge with milk rather aggravates the bowels of most persons; therefore, whenever it is found to have this effect, its use should be immediately abandoned. In many instances, where there is either diarrhoea or dysentery present, without other prominent symptoms, I have found the mere use of cooked milk (merely "scalded," as women usually term it--being heated to the boiling point without permitting it to boil), taken as food alone, to be the only remedy required.

Hygiene--Eating

The laws of health should be particularly observed in going to Africa.

In respect to eating, there need be no material change of food, but each individual observing those nourishments which best agree with him or her. When there is little inclination to eat, eat but little; and when there is none, eat nothing. I am certain that a large percentage of the mortality which occurs may be attributed to too free and too frequent indulgence in eating, as was the case with the Lewis family of five at Clay-Ashland, in Liberia--all of whom died from that cause; as well as others that might be mentioned.

Coffee, Air, Fruits

So soon as you have taken your bath and put your morning wrapper, even before dressing, you may eat one or more sweet oranges, then take a cup of coffee, creamed and sweetened, or not, to your taste. Make your toilet, and walk out and take the cool air, always taking your umbrella or parasol, because no foreigner, until by a long residence more or less acclimated, can expose himself with impunity to a tropical sun. If preferred coffee should always be taken with cream or milk and sugar, because it is then less irritating to the stomach. One of the symptoms of native fever is said to be _nervous irritability of the stomach_; hence, all exciting causes to irritation of that part should be avoided as much as possible. Such fruits as best agree with each individual should be most indulged in; indeed, all others for the time should be dispensed with; and when it can be done without any apparent risk to the person, a little fruit of some kind might be taken every day by each new comer. Except oranges, taken as directed above, all fruits should be eaten _after_, and _not_ before breakfast. The fruits of the country have been described in another place.

Drinks

Let your habits be strictly temperate, and for human nature's sake, abstain from the erroneous idea that some sort of malt or spirituous drink is necessary. This is not the case; and I am certain that much of the disease and dire mortality charged against Africa, as a "land of pestilence and death," should be charged against the Christian lands which produce and _send bad spirits_ to destroy those who go to Africa.

Whenever wine, brandy, whisky, gin, rum, or pure alcohol are required as a medical remedy, no one will object to its use; but, in all cases in which they are used as a beverage in Africa, I have no hesitation in p.r.o.nouncing them deleterious to the system. The best British porter and ale may, in convalescence from fever, be used to advantage as a tonic, because of the bitter and farinaceous substances they contain--not otherwise is it beneficial to the system in Africa. Water, lemonade, effervescent drinks--a teaspoonful of super-carbonate of soda, to a gla.s.s of lemonade--all may be drunk in common, when thirsty, with pleasure to the drinker as well as profit. Pure ginger-beer is very beneficial.

Bathing

Bathing should be strictly observed by every person at least once every day. Each family should be provided with a large sponge, or one for each room if not for each person, and free application of water to the entire person, from head to foot, should be made every morning.

Early Rising--Breezes

Every person should rise early in Africa, as the air is then coolest, freshest, and purest; besides the effect upon the senses, the sight and song of the numerous birds to be seen and heard, produce a healthful influence upon the mental and physical system. The land and sea-breezes blow regularly and constantly from half-past three o'clock P.M. till half-past ten o'clock A.M., when there is a cessation of about five hours till half-past three again.

Never Sultry

The evenings and mornings are always cool and pleasant, _never sultry_ and oppressive with heat, as frequently in temperate climates during summer and autumn. This wise and beneficent arrangement of Divine Providence makes this country beautifully, in fact, delightfully pleasant; and I have no doubt but in a very few years, so soon as scientific black men, her own sons, who alone must be more interested in her development than any other take the matter in hand, and produce works upon the diseases, remedies, treatment, and sanitary measures of Africa, there will be no more contingency in going to Africa than any other known foreign country. I am certain, even now, that the native fever of Africa is not more trying upon the system, when properly treated, than the native fever of Canada, the Western and Southern States and Territories of the United States of America.

Dress, Avoid Getting Wet

Dress should be regulated according to the feeling, with sometimes more and sometimes less clothing. But I think it advisable that adults should wear flannel (thin) next to their person always when first going to Africa. It gradually absorbs the moisture, and retaining a proper degree of heat, thus prevents any sudden change of temperature from affecting the system. Avoid getting wet at first, and should this accidentally happen, take a thoroughly good bath, rub the skin dry, and put on dry clothes, and for two or three hours that day, keep out of the sun; but if at night, go to bed. But when it so happens that you are out from home and cannot change clothing, continue to exercise until the clothes dry on your person. It is the abstraction of heat from the system by evaporation of water from the clothing, which does the mischief in such cases. I have frequently been wet to saturation in Africa, and nothing ever occurred from it, by pursuing the course here laid down. Always sleep in clean clothes.