DISEASES.
In all my travels I never met with any country where the climate
is so unhealthy, and where there is such a variety of disease as in
Kordofan. Every one in the province, natives and strangers, more or
less succumb to this scourge, but the Europeans are the first who
fall victims. Two thirds of the white men who visit these regions
may be with certainty regarded as sacrificed. The Turks and Egyptians
ordered there in Mehemed Ali’s service, dwindle down perceptibly,
and must be continually replaced by fresh supplies. Of the sixteen
European medical men and apothecaries employed in Kordofan, within
the space of seventeen years seven have died, and of eight Englishmen
sent into this province to work iron mines, six perished in less
than two months, and the remaining two only escaped with their
lives by making a rapid flight from this unhealthy district. Captain
Woodfall, an Englishman, who visited this country in the year 1831,
fell a victim to the climate.
All diseases show themselves with redoubled vigour during the rainy
season; no house, no hovel is then free from sick, and the whole
of Kordofan may be regarded as one large hospital. The total want
of European medical men who are only to be found attached to the
army at Lobeid—during my residence in this town, there were none
at all there, for the only one I met with very soon died—is a
circumstance deeply to be regretted; and it has generally happened
that those sent into the province have paid their tribute to the
climate, or were soon thus far disabled that they could be of no
assistance to other sufferers. There is, indeed, no lack of native
doctors, but it may be easily imagined to what system of treatment a
patient is subjected under their hands. Add to this the favourite,
_“Allah kerim”_ (as God will) of the Mahommedans, and we may
readily understand the reason why they never resort to means for
suppressing a slight indisposition until it increases to a frightful
disease. Before parents offer their children relief in sickness, or
before the children attend to their parents, they consult Fakéers
and writers of amulets, and the like fanatics and fortune-tellers,
and their advice must have proved useless.
The chief diseases are fevers, dysentery, abscesses about the neck
(named _durore_), dropsy, small-pox, jiggers, skin diseases, and
lues. Every resident in the country is attacked with fever, and all
precautionary measures to avert the evil, such as a regular life,
etc., are generally speaking futile. I found, on the contrary,
that those persons who indulged in ardent liquors, such as brandy,
merissa, or bill-bill, remained far more free from fever and
dysentery, than those who endeavoured to escape these complaints
by the observance of rigid diet, and other prophylactic means;
for the latter were not only sooner attacked, but sooner fell
victims to these scourges. I myself observed this mode of life;
but, unfortunately, experienced the contrary to what I might have
expected, under similar circumstances, in Europe, or in any more
healthy climate; for, out of the eleven months of my residence in
this country, there were but few weeks during which I could consider
myself free from fever and dysentery. All the drugs, with which I had
provided myself for my journey, proved of no avail, until I followed
the advice of several old people, and drank brandy and merissa,
in moderation, when both diseases left me. The chief causes of the
two maladies named, are the sudden changes of temperature, and,
more especially, the use of water. The greater part of the water
is putrescent, much of it is filled with animalculæ, if it be
not previously boiled; and unfortunately for the adoption of this
precaution the opportunity is not always at hand; in this case it
should be mixed with brandy. Where these rules are not observed,
fever, or dysentery, are sure to be the infallible consequence.
The methods of treatment, customary among the natives of Kordofan,
are various, and consist in the employment of the common domestic
quack-remedies of Europe, in addition to the above-mentioned
superstitious aids. Thus, those attacked with fever, after the
amulets and other mystic charms have proved useless, drink, for
three or four days, a cup containing about a pound of melted butter
daily, or a large quantity of milk, in which sandal-wood has been
steeped during twenty-four hours. Both these remedies produce a
powerful alterative effect, and I saw several persons cured of
fever by them. For allaying dysentery, they make use of sour milk,
in which _dabaldia_, the fruit of a tree, causing constipation, has
been steeped over night. The same fruit, taken in small quantities,
acts as a gentle purgative; but these modes of treatment are only
adapted to the natives, and always prove fatal to Europeans. For
dropsy they know of no remedy, and persons attacked with this
disease die, with but few exceptions.
As soon as the jiggers show themselves, the part inflamed is
burnt with a red-hot iron, and a small opening made, when the
worm immediately presents itself. The treatment is now the same
as that of tapeworm: thus the natives seize the portion of the
animal protruding through the opening, wind it carefully round a
small piece of wood, and proceed in this manner until they have
gradually extracted the whole. If it tear before it is entirely
eradicated, the disease is reproduced. When attacked with small-pox,
the natives rub their whole body with earth, or roll in the sand,
until the pustules are broken, and the entire surface is covered
with an incrustation, which they allow to remain adherent until the
period of desiccation. A negro, who has suffered from small-pox,
presents a very ridiculous appearance when the scabs fall off, for
his body is speckled with white spots, which gradually become red,
but resume, subsequently, the original black colour,—he is, in
fact, for the time being, pie-bald. They suffer greatly with this
disease, for they cannot keep themselves warm for want of clothing,
or other covering, and are thus put to inconceivable torture. A great
number of natives fall victims to this complaint, but the majority
are cured. The form of disease presenting itself with abscesses
about the neck, named durore, is indigenous to the country, and
frequently shews itself during the rainy season; it is said by the
natives to originate in colds. In the treatment of this affection,
they open the abscesses with the potential cautery, and when the
matter is discharged, dress the wound with an ointment prepared of
butter and clay. Syphilis was totally unknown in these regions during
the preceding century, and the natives have only been inoculated
within recent years, through the intermediation of the Egyptian
troops quartered in the province. It may be easily imagined what
ravages this disease commits, as these simple people, unacquainted
with its nature, frequently neglect it for a considerable time. They
are certainly at present rather more enlightened on the subject, and
resort to a few remedies, which, however, prove of slight avail, and,
during the rainy season more especially, all endeavours to arrest
its progress are in vain. The disorder assumes a very obstinate
character in this country; for though cured in the dry season,
it generally presents itself again at the period of the rain,—a
circumstance very easily explained, if we consider that the cure,
what with their inacquaintance with the nature of the disease, and
defective treatment, is generally palliative, or temporary, and never
radical; hence many of these patients remain cripples for life. They
mostly employ in the treatment an earth, named traiba,[50] which has
a purgative action. The lavements are administered in the following
manner:—They take the thighbone of a fowl, and clearing away the
marrow, fasten it to a portion of the intestines of a sheep, into
which they pour a decoction of garra,[51] and then insert the pipe
into the anus, compressing the gut until the whole of the contents
pass into the abdomen. If to the want of medical men, and scarcity
of remedies, we add the state of uncleanliness in which these people
live, we may form some slight idea of the sufferings they endure
in sickness. It is, in fact, impossible to form a conception of the
misery to be met with in their hovels, which are sometimes crowded
with patients; nursing and all attention is out of the question;
every man is left to himself, hence many of course perish, who, with
but slight care, might easily have been saved, but—Allah Kerim!
There are no prophylactics against all these diseases, and I know
of no better advice to give to Europeans travelling in this country
than to caution them against drinking new milk or water; the latter
they should always boil, and ought moreover to be careful to keep
themselves, and more especially their feet, warm during the rainy
season; they should further use a large quantity of pepper with
their food, and rather eat too little than too much. In cases of
dysentery, for which rice and gum-water are generally prescribed in
Egypt, the traveller should by all means avoid these same remedies,
for he would only debilitate his digestive organs the more. For
my own part I resorted latterly to the shells of the pomegranate
steeped for a few hours in cold water, and found this remedy very
successful. It is quite a mistake to imagine the use of spirituous
liquors pernicious in tropical climates, for I convinced myself,
but unfortunately too late, of the contrary. On my own personal
experience I can assert that a moderate quantity of brandy (in defect
of wine) or Merissa taken daily is an excellent prophylactic. All
those natives, moreover, who possess the means of procuring it,
enjoy health, and are not so easily attacked with fever or dysentery;
it will of course be understood that every excess is hurtful.