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The following is from "Medical history of the expedition to the Niger during the years 1841-2" by James Ormiston McWilliam, M.D.

CASE XIII. On the passage from the Confluence of the Niger and Tchadda to Egga.

John M'Clintock, Stoker, anno aetatis 23. Complexion fair, temperament leucophlegmatic. Is well formed, and has in general enjoyed good health; has never before been in tropical climates.

Was yesterday affected with the usual symptoms of the prevailing fever, which he says remitted towards the evening, but have returned this morning with severity. He has now headach and pain of back; tongue foul, indented at the edges. Has vomited a quantity of bile. Bowels slow. Eyes suffused; heat of skin with dyspnoea.
Totum corpus aquâ tepidâ cum aceto abluatur.
R. Calomelanos, Scruplej.
Opii, gr. iv. M. que divide in pilulas decem, quarum capiat aeger unam quâque secundâ horâ.

Sept. 25th. Passed a good night. To-day there is a decided remission of the symptoms. Skin cool. Pulse regular. Tongue loaded. Bowels freely opened. No complaint, except of the back, which is weak in the lumbar region.
Affricr. spina ung. antim. tart.
Hab. marantae arundinaceae pro re natâ pauxillum.

Sept. 26th. Return of febrile action yesterday forenoon, which remitted towards the evening. Was troubled with vomiting during the day. Slept badly from general uneasiness. Has no headach, but is giddy on attempting to rise. Countenance anxious; tongue furred in the centre, moist round the edges. Is thirsty. There is slight mercurial fetor of mouth. Pulse 88. Skin cool. Bowels have been freely opened.
Capiat pulv. Jacobi veri, gr. iv. omni secundâ horâ.
Capiat nitratis potassae, Scrupless. ter in die.

Sept. 27th. There was no remission of symptoms until yesterday at noon. Pulse 76, of good volume, and regular. Slept well during the night. Has no complaint of pain, and the vomiting has ceased. Skin cool and moist; tongue cleaning. Bowels opened this morning.
Affric. spina in toto cursu ung. antim. tart.
Abradatur capillitium.

Sept. 28th. Return of rigors yesterday at 4 P.M., the effects of which continued until early in the morning. Slept at intervals; was slightly incoherent during the night. Pulse 90. Skin clammy. Bowels opened this morning. Tongue cleaner. Vomiting has returned.
R. Pulv. Jacobi veri, gr. iv.
Quinae disulph. gr. vj, M. ft. pulvis sumendus ter in die.

Sept. 29th. Was troubled a good deal with nausea and retching yesterday. To-day he has no complaint, but feels languid and weak. Countenance however improves. Bowels slow. Skin moist, clammy. Pulse 72, soft and regular. Tongue loaded in the centre; moist.
Capiat olei ricini, dram vj.
In aquae menthae, ounce j.
Continr. pulveres quinae.

Sept. 30th. Experienced an accession of fever last night of short duration. Had a dose of the muriate of morphia at 10 P.M., which produced sleep. Has no pain except from the eruption along the spine, caused by the ointment of tartarized antimony. Is giddy on attempting to rise. Countenance still oppressed. Conjunctiva yellow. Profuse diaphoresis. Bowels opened last night. Tongue clean but rather dry. Pulse 78, soft and of uniform strength.
Continr. pulv. quinae, &c.
Hab. marant. arund. pro re natâ.

Oct. 1st. Had no fever yesterday, but he was restless during the night. No complaint of pain; feels weak. Pulse 70, regular. Tongue foul, moist. Skin clammy. Bowels slow.
Capiat pilulas purgantes, ij.
Repr. maranta arundinacea.
Omittr. pulveres quinae.

Oct. 6th. General improvement, although he still continues very weak, and takes only a little nourishment.

Oct. 7th. Was suddenly seized last night with a fit of vomiting, which exhausted him much. The feet and hands became quite cold, and the pulse was scarcely perceptible at the wrist or temples. Warm applications were put to the feet. Brandy with hot water was given, and he rallied in the course of the night. To-day there is slight fever.
Repr. pulveres quinae.

Oct. 18th. Is still very weak, but is upon the whole improving, and takes nourishment with relish. Functions of bowels and bladder regular. Urine very copious.
Continr. pulveres.

Oct. 24th. Complains much of debility. Has no local pain. Skin cool and moist. Fainted this morning on attempting to rise from his hammock. Bowels open. Tongue clean. Pulse 80, moderate.
Capiat cerevisiae, Hj. in die.
Continr. maranta arundinacea et jusculum gallinae.
Capiat quinae disulph. gr. x. bis in die.

Oct. 30th. Gets strength daily.
Continr. omnia.

Nov. 20th. Was advancing rapidly in convalescence, having been in the habit of taking a short daily walk; on the 18th he was sent on board of the ship from the hospital at Fernando Po, and on the evening of the 19th I was horrified to hear that he had met with his death in a scuffle.

CASE XIV. On the passage from the Confluence to Egga.

George Syme, Quarter-master, anno aetatis 40, of a stout make; sanguineo-bilious temperament. Has been some years on the coast of Africa, and has suffered there from fever.

Sept. 25th. First felt the approach of fever yesterday after a heavy shower of rain. To-day he has heat of skin, foul tongue, headach, and a sensation of cold along the spine. Pulse small, hard. Bowels slow.
Capiat magnesiae sulphatis, dram vj, repetendas si opus sit.

Sept. 26th. Febrile accession yesterday of only short duration. Complains of slight epigastric pains. Tongue loaded in the centre, moist round the edges. Is restless.
R. Tinct. opii, gtts. xxx.
Spts. aetheris nitrosi, dram ss.
Aquae menthae, ounce j. M. ft. haustus statim sumendus.

Sept. 27th. Did not sleep in consequence of an accession of fever, which lasted until the morning. Complains of headach and a sense of heaviness about the stomach. Skin dry. Pulse 96, soft and regular. Tongue loaded in the centre, moist, and indented at the edges. Bowels slow.
Applicr. sinapisma epigastrio; postea capiat pilulas purgantes, ij.

Sept. 28th. Slept well during the night, and has had no return of fever since last report. Has no complaint but of debility. Gentle diaphoresis. Bowels freely opened. Pulse 74, soft and regular.
Sumat jusculum gallinae pro re natâ.
Capiat quinae disulphatis, gr, viij. bis in die.

Sept. 29th. Was disturbed during the night by one of the patients near him, therefore he did not sleep well. Countenance improves. Has no complaint of pain, but he is weak and giddy on attempting to rise. Tongue cleaning. Pulse 72.
Continr. jusculum.
Rept. quina.

Sept. 30th. Experienced a return of fever yesterday early in the afternoon, which lasted only three hours. Slept well; no complaint. Pulse 80, soft, of good volume. Skin cool. Bowels open.
R. Pulv. Jacobi veri, gr. iv.
Calomelanos, gr. iij. M. ft. pulvis statim sumendus.

Oct. 1st. Fever returned last night, and lasted until the mornrng with considerable severity. To-day he has no complaint. Pulse regular. Skin cool.
Reptr. quinae disulphas.

Oct. 2d. Was suddenly seized yesterday with general tremors followed by great depression. He is still low, and the surface of the body, particularly towards the extremities, became cold. The natural heat was restored by friction and hot applications, and the administration of internal stimulants. The pulse is now gradually rising. Has beeft troubled with diarrhoea.
Reptr. marant. arund. cum vino.

11 A.M. The feet and hands have now become of a livid colour, which is extending upwards. No complaint but of diarrhoea. Pulse small, feeble. Countenance cadaverous.
Contr. vinum, &c.

4 P.M. Continued sinking, the lividity continuing to extend until this hour, when he expired; declaring to the last that he felt well.

Sectio Cadaveris.

The examination of the body was conducted by Dr. Stanger and myself. As we were at Egga, and afraid of offending the prejudices of the people, the operation was gone through rather hurriedly.

The exterior presented no unusual appearance, except of lividity over the extremities and part of the chest.

The thorax was opened in the usual manner. There were considerable old adhesions between the pulmonary and costal pleurae of both sides. Portions of the depending parts of the right lobes were indurated.

Abdomen. There was a biliary tinge over the peritoneum and the surface of the intestinal canal. Liver gray-coloured, of the usual size, anemious. Gall-bladder filled with bile, of the colour and consistence of tar. Mucous lining of the stomach softened and abraded; livid patches surrounding the pyloric orifice; some of inferior size were dispersed over the great curvature. The duodenum exhibited the same lesion and one ulcerated point. Ileum presented a livid dark appearance, about a foot in extent of its lower end. Several small bloody coagula under the mucous tissue near the caecum. Some livid marks, with slight abrasion of surface, were also seen in the colon. Spleen was large, soft, gorged with blood. Kidney rather larger than usual, otherwise healthy.

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