_Special Remarks._―Of seven of the eight cases of syphilis (native),
Hottentots were the subjects. Here, as elsewhere, they copy European
vices very readily. The Kafirs adhere to their own vices, but are more
slow in copying European manners and habits, good or evil.
I have met with one decided case of scrofula among the Zulus, and one
only.
The ages of infants are reckoned by moons, but adult Kafirs (as the
rule) do not know how old they are; the ages given are therefore only
surmised, and cannot be depended on.
The tendency of disease among the Kafirs is to collapse and paralysis.
No year goes round without deaths from cold and wet, which they bear
less well than European settlers. They are apt to sink under any
serious form of disease.
Flesh wounds heal well, causing less constitutional disturbance than
among Europeans, but fractured bones do not so soon re-unite. I have
found lime water, a pint or more given daily, promote their union. Lime
is scarce here, and the shells of eggs are correspondingly thin.
Lung disease is more frequent among natives than white settlers, unless
the latter bring the seeds of disease with them; but I doubt whether
it is true phthisis. I suspect that the lungs of both natives and
settlers are more liable to become hepatized or otherwise disorganized
than tuberculated. In examining the lungs of cattle who have died of
lung sickness, I have found large portions of lung degenerated into
an impervious muscle-like substance resembling beef, while in other
portions the disease has shown itself to be of so anemic a character
as to have proceeded without much pause to suppuration. I believe that
in this climate, subjects of phthisis, who had only small tubercles in
their lungs, would find their further development arrested; indeed this
has been, in many cases, proved to have occurred.
The lung disease, called lung sickness, in cattle, does not, with
regard to the organ attacked, affect human beings, but the tendency
of the present race of mankind is to anemic rather than acutely
inflammatory diseases. The most destructive modern diseases, influenza,
cholera, and diphtheria, are of an anemic character; other diseases are
now, more than formerly, inclined to assume this character. It is not
that medicine and doctors, but that human constitutions, vary. The rule
laid down by Pinel that bleeding confirms mania is good now; but 50 or
70 years ago, as, perhaps, 50 or 70 years hence, more exceptional cases
did and may again occur than are at present met with. {55}
[Sidenote: Vide Tables P. and Q., pp. 44 and 45.]
The mortality from fever will be seen to have been great; but of the
seven deaths recorded, six came into the hospital in a dying state.
One, admitted November 25th, died five hours after admission; another,
admitted at noon, December 11th, died at half-past four a.m. next
morning; another, admitted on the 5th, died on the 6th; another,
admitted on September 19th, died on the 20th; other two rallied by
the administration of wine, sago, &c., but died from two to five days
after admission, again sinking. They received shelter and attention,
and had what chance there was of recovery; and some others, beyond
all reasonable expectation, recovered. The number of Kafir and
druggist-doctored patients thrown upon my hands in a moribund state
is great. Of the cases of fever that I attended throughout, most did
well. The hospital has been occupied somewhat more than three years and
a half, but I have held office as district surgeon in the service of
Government eight years and a half, and I speak of my experience during
the whole term of such service.
In giving names to complaints, I have not set down diarrhœa or even
tænia, of which many instances have occurred, but these instances have
been incidental or symptomatic. Tænia has been discovered and treated
in cases of patients who had wounds, &c., and this frequently. There is
no complaint so generally prevalent among both natives and settlers.
The tapeworm of South Africa is about two-fifths in width† narrower
than that of Europe. The most effective treatment has been 1 1/2 oz.
sp. terebinth, early in the morning, and one drop of croton oil, or
a dose of other aperient medicine, four or five hours after, _nisi
prius soluta sit alvus_. A less dose than 1 1/2 oz. more disturbs the
system than this quantity, and fails to act. I procured some ethereal
extract of male fern in one case, of which I gave one scruple early in
the morning, and a black draught some hours after. It caused no nausea
or other apparent constitutional disturbance, and a piece of tapeworm
was expelled, still alive, which measured 22 feet long. Turpentine
generally expels them dead.
† The English assumed as 1 in width, the South African 0·6.
The fracture that ended fatally was a compound fracture of the left
thigh, and compound comminuted fracture of the tibia and fibula of the
right leg, from a waggon accident. He sunk at the end of two days,
never rallying from the shock to his system, and refusing to submit
to the not very hopeful operation of amputation of the more seriously
injured limb. I have had two cases of injury among the aborigines in
which amputation was necessary, one a little above the ancle, the
other four inches above the knee. In the latter case the leg had been
torn off by the machinery of a flour mill, the knee stripped of its
integuments, and the muscles above the knee stretched and contused,
so that I felt myself obliged to operate high up, lest a second
amputation should become requisite. The case occurred a few months ago.
Both cases did well. I have represented my wish in both cases that an
artificial leg and foot should be sent for to England, as it would be
a convenience to the parties, and also have a good sanitary and social
effect upon the natives. The cost of the cork or other artificial two
legs, black imitation toes inclusive, would not, I should think, exceed
30_l._ Their aversion to operations necessary to save life would thus
be in some measure overcome or lessened.
The natives who have become Christians evince some of the
uncomfortableness and maladroitness that are incidental to a state
of transition, but, perhaps, less than might have been expected. The
premises I go upon are, perhaps, scanty and insufficient, but I am
inclined to think that among Christian Kafirs more children die in
infancy than among the unchristianized natives. This is not to be
depended upon, nor can I, generally speaking, say much that is definite
upon the subject of physical or other differences between Christian and
other natives.
The natives hitherto, as the rule, have not shown the appetence for
alcohol which the North American Indians so early, and so fatally
for themselves, acquired. There are cases of elephantiasis among
them; they are subject to skin diseases. These and other trifling
diseases or cases of injury seldom appear at the hospital, or only as
accompaniments of injury or other disease.
Prior to the completion and occupation of Grey’s hospital, a row of
cottages was rented as a hospital; prior to this the gaol and hospital
were under one roof.