It Is Too Much To Hope That Medical Men Out At Work
On The Coast, Doctoring Day And Night, And
Not only obliged to
doctor, but to nurse their white patients, with the balance of their
time taken up by
Giving bills of health to steamers, wrestling with
the varied and awful sanitary problems presented by the native town,
etc., can have sufficient time or life left in them to carry on
series of experiments and of cultures; but they can and do supply to
the man in the laboratory at home grand material for him to carry
the thing through; meanwhile we wait for that man and do the best we
can.
The net results of laboratory investigation, according to the French
doctors, is that the mycetozoic malarial bacillus, the microbe of
paludism, is amoeboid in its movements, acting on the red
corpuscles, leaving nothing of them but the dark pigment found in
the skin and organs of malarial subjects. {517} The German doctors
make a practice of making microscopic examinations of the blood of a
patient, saying that the microbes appear at the commencement of an
attack of fever, increase in quantity as the fever increases, and
decrease as it decreases, and from these investigations they are
able to judge fairly accurately how many remissions may be expected;
in fact to judge of the severity of the case which, taken with the
knowledge that quinine only affects malarial microbes at a certain
stage of their existence, is helpful in treatment.
There is, I may remark, a very peculiar point regarding haematuric
disease, the most deadly form of West Coast fever. This disease, so
far as we know, has always been present on the South-West Coast, at
Loando, the Lower Congo and Gaboon, but it is said not to have
appeared in the Rivers until 1881, and then to have spread along the
West Coast. My learned friend, Dr. Plehn, doubts this, and says
people were less observant in those days, but the symptoms of this
fever are so distinct, that I must think it also totally impossible
for it not to have been differentiated from the usual remittent or
intermittent by the old West Coasters if it had occurred there in
former times with anything like the frequency it does now; but we
will leave these theoretical and technical considerations and turn
to the practical side of the question.
You will always find lots of people ready to give advice on fever,
particularly how to avoid getting it, and you will find the most
dogmatic of these are people who have been singularly unlucky in the
matter, or people who know nothing of local conditions. These
latter are the most trying of all to deal with. They tell you,
truly enough no doubt, that the malaria is in the air, in the
exhalations from the ground, which are greatest about sunrise and
sunset, and in the drinking water, and that you must avoid chill,
excessive mental and bodily exertion, that you must never get
anxious, or excited, or lose your temper. Now there is only one -
the drinking water - of this list that you can avoid, for, owing to
the great variety and rapid growth of bacteria encouraged by the
tropical temperature, and the aqueous saturation of the atmosphere
from the heavy rainfall, and the great extent of swamp, etc., it is
practically impossible to destroy them in the air to a satisfactory
extent. I was presented by scientific friends, when I first went to
the West Coast, with two devices supposed to do this. One was a
lamp which you burnt some chemical in; it certainly made a smell
that nothing could live with - but then I am not nothing, and there
are enough smells on the Coast now. I gave it up after the first
half-hour. The other device was a muzzle, a respirator, I should
say. Well! all I have got to say about that is that you need be a
better-looking person than I am to wear a thing like that without
causing panic in a district. Then orders to avoid the night air are
still more difficult to obey - may I ask how you are to do without
air from 6.30 P.M. to 6.30 A.M.? or what other air there is but
night air, heavy with malarious exhalations, available then?
The drinking water you have a better chance with, as I will
presently state; chill you cannot avoid. When you are at work on
the Coast, even with the greatest care, the sudden fall of
temperature that occurs after a tornado coming at the end of a
stewing-hot day, is sure to tell on any one, and as for the orders
regarding temper neither the natives, nor the country, nor the
trade, help you in the least. But still you must remember that
although it is impossible to fully carry out these orders, you can
do a good deal towards doing so, and preventive measures are the
great thing, for it is better to escape fever altogether, or to get
off with a light touch of it, than to make a sensational recovery
from Yellow Jack himself.
There is little doubt that a certain make of man has the best chance
of surviving the Coast climate - an energetic, spare, nervous but
light-hearted creature, capable of enjoying whatever there may be to
enjoy, and incapable of dwelling on discomforts or worries. It is
quite possible for a person of this sort to live, and work hard on
the Coast for a considerable period, possibly with better health
than he would have in England. The full-blooded, corpulent and
vigorous should avoid West Africa like the plague. One after
another, men and women, who looked, as the saying goes, as if you
could take a lease of their lives, I have seen come out and die, and
it gives one a sense of horror when they arrive at your West Coast
station, for you feel a sort of accessory before the fact to murder,
but what can you do except get yourself laughed at as a croaker, and
attend the funeral?
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