Medical History of the 1841 Niger expedition
Medical History of the 1841 Niger expedition

1841 Niger expeditionMedical historyChapter 2 ◄► Section 2


Section I.

State of Medicine in the Niger.

The practice of medicine throughout Africa, although in the lowest state of degradation, and clouded with superstitious bigotry, obtains for its professors emolument, respect, and even veneration. In the Nufi, Eggarra, and Kakanda countries, the Mallams, chiefly from Rabba and Sokatoo, travel about teaching Mahomedanism, and practising the healing art. Charms, consisting of scraps from the Koran, are resorted to in all cases of great difficulty. There are certain operations which the religion and custom of the country enjoin, and for which the Mallams are remunerated according to the circumstances of their patients.

Circumcision being nearly universally adopted throughout the Niger must alone afford considerable employment. At Egga I was informed that a sheep, a goat, and several thousand cowries, were not unfrequently the "fee" for one operation of this kind. At Iddah, in the kingdom of Eggarra, the principal officers of the Attah’s household were eunuchs, who had been operated upon by the Mallams. One of the eunuchs told me that the only instrument used on the occasion was a common razor-shaped knife, and that compression was employed to stop the bleeding. The Mallams make scarifications over the parts complained of during fevers. They all said that during the dry season bad bellies (dysenteries), fevers, and smallpox proved extremely fatal, and were beyond all measure delighted when the protective power of vaccination was explained to them.*

* In the river Congo, or Zaire, the native doctors scarify in fevers, and in many local affections. When the incisions or punctures are made, a large horn with a niche cut in its side is applied over them, and the operator exhausts the air by applying his mouth to the opening, and thus forms a tolerable substitute for the cupping-glass.

At Aboh all curative means are performed through the influence of Fetiches or Ju Jus. I have seen very few people in England submit so willingly and quietly to medical or surgical treatment as the Africans do. Ajimba, the son of the chief of Muyé, the owner of the slave canoe taken by us on the passage to Egga, came on board the Albert, accompanied by two Mallams. One of their boys had cataract of the right eye, which I had no sooner offered to remove, than he sat down and submitted without murmur to the operation of depression: he was astonished at being able to count his fingers with an eye which had previously been of no use, and after it was bandaged up he walked coolly into the canoe, as if nothing had happened.

Previous to the sailing of the expedition from England the medical officers were well supplied with vaccine lymph, for which they were indebted to the National Vaccine Institution, to Dr. George Gregory, to Mr. Ceely, of Aylesbury, and to Dr. Tripe, of Devonport. At St. Vincent, in the Cape de Verds, upwards of forty children were vaccinated. At Cape Coast Castle we remained sufficiently long to enable me to obtain fresh lymph from a child vaccinated on the first day of our arrival, which was in about a fortnight afterwards transferred to the infants of Emmery’s village, on the left bank of the Niger. At Egga, Muyé, and other places, the Mallams were shown the operation and instructed how to perform it. Lancets and lymph were also given them, and Mamansa, the son of the chief of Muyé, vaccinated several children himself in our presence. Had it not been for the disasters that befel our expedition, I had great hopes of the extension of vaccination throughout the Niger, by means of the Mallams. Desirous as they no doubt are to add to their importance, they will ever be found ready to practise a new operation which is in itself so simple. In process of time the people themselves will become convinced of its beneficial effects.

It is true that when I first proposed vaccination to the Africans as a remedy for one of their most direful scourges, many of the mothers listened with doubt, and some of them, on witnessing the operation, even ran away with their children; but at the same time we must not forget the bitter animosity that was entertained by enlightened men of the day in our own country against one of the greatest medical discoveries ever promulgated to the world. Nearly half a century has since passed away, and the prejudice against vaccination has not wholly disappeared with time. I have said that many of the African mothers were suspicious of this new remedy, but on the other hand great numbers staid and cheerfully submitted themselves and children to the operation, when its simplicity and after-benefits were clearly explained to them.

While on this subject I may state the result of vaccination on Africans, which fell under my own observation while in charge of the Royal Hospital at the island of Ascension, in August and September, 1842.

The benefits of vaccination may be extended to the Africans along the whole line of coast visited by H.M. cruizers on the west coast of Africa, by establishing a depôt for lymph at one of the principal places of resort. Ascension is pre-eminently that best fitted for this purpose: the vessels of war refit there; it contains an hospital; and its comparatively cool climate is more favorable to the preservation of the lymph than other parts of the station; and as there are constantly a number of unvaccinated blacks being brought to the island, a means of increasing the quantity of matter to any desired amount is thereby afforded. Thus a store of vaccine lymph may always be kept up, sufficient to enable the medical officers of the ships to vaccinate the Kroomen and other Africans on board, by which means the lymph could be conveyed to the various parts of the coast in the living subject, and its prophylactic power communicated to thousands of the natives of Africa.

June and July are perhaps the best months for the arrival of lymph from England at Sierra Leone, whence it could be sent to Ascension in H.M.S. Prompt, which nearly constantly runs between the two places.

The surgeon of the hospital at Ascension, and the surgeons and assistant-surgeons of Her Majesty’s ships on the coast, will, I am assured, feel amply compensated for their trouble, by the conviction of the vast benefit which the diffusion of vaccination in Africa is calculated to bestow upon her people.

In the month of August, H.M.S. Prompt brought a supply of vaccine lymph from Sierra Leone to Ascension, which was said to have been very recently sent from England by the National Vaccine Institution. As a great proportion of the white children, and the whole of the Africans, on the island had not been vaccinated, I at once commenced by inserting the matter into the arms of six children, and in due time beautiful pearly vesicles were produced on all of them. The rest of the children, all the Africans on the island, and several from the ships, were now infected with vaccine matter fresh from the vesicle, with only a single instance of failure. The white children experienced the usual slight fever attending vaccinia, which in all cases yielded to a little mild medicine. The white adults complained only of itching round the vesicle while it was in the stage of decline. But among the whole of the blacks the disease assumed a more decided form, and run a regular course; the eruption was preceded by severe headach, pain of back and loins, and general fever, which did not disappear for several days. The eruption in several cases was dispersed over the neck, chest, and abdomen, and the bases of the vescicles were, in general, much inflamed. All of them were confined to bed for some days, and several required rather active treatment.

The Numbers vaccinated were as follows:
Adults, male7
Children of both sexes19 = 26
Adults, male, including convalescents, in hospital27
Adults, female3
Children, female1
Adults, H.M. B. Dolphin12 = 43
Grand total69

I am not aware that this greater severity of the vaccine disease in blacks has been elsewhere or generally observed. If such is the case, the fact that the fever consequent upon vaccination assumes a decided and sometimes active form among them, while its effects are little if at all manifest in the white race, is worthy of note; inasmuch as it furnishes another link in the chain of analogical evidence, proving that smallpox and other eruptive diseases act with more energy, and consequently are more destructive of life among the former than the latter.

The direful ravages committed by smallpox among the Africans are but too well known, and call loudly upon us to extend to them, by all possible means, the protective power of vaccination.

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