Chapter XI: 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.