Why do the natives of East Africa prefer mission hospitals to those of the government? Why will they often refuse the free feeding and gratuitous professional services that government institutions offer them, and go to similar institutions carried on by missions where they will have to pay for their food and medical attention? The cost may be a nominal fee, often below the cost, but they are willing to pay it. Why is it that a number of the natives will pass by even another mission hospital in order to reach the place where homoeopathy is practised?.
Many reasons may be given, but here are few of the main ones. “Is not this the place where the good medicine is”? they will often reply when asked. Another reason that has been given by white and brown and black patient is that they receive more personal attention.
As homoeopathy requires the personal questioning and examination by the doctor himself, the patient feels that he is receiving more attention than he is accustomed to at the hand of any sub-assistant surgeon [Asiatic] of native helper that tries to make a diagnosis or give a prescription. Then there is this factor of human nature to be reckoned with: what is paid for is valued more than that which is received free. Undoubtedly the results achieved with the homoeopathic remedies have had some result in drawing patients to our institution.
Homoeopathy, though unknown as such to the black people, has great opportunities in this dark continent, and it has been able to give relief to many needy people of many tribes and races. One does not have to hunt for the sick and diseased-they are everywhere. Ignorance of hygiene and the common rules of proper living, gross superstition compelling and impelling them to all kinds of injurious practices, fear on all sides rendering life an almost continual nightmare, and the great, though waning, power of the witch-doctors, all these and other factors combine to render human mortality high indeed.
Instead of writing about homoeopathy in tropical diseases, it has seemed wiser to write about homoeopathy and its work in tropical conditions. As our hospital is situated 7,500 feet above sea level, we are not living and working in true tropical conditions. We are in the tropics, being situated less than two degrees south of the equator, yet this high altitude does not favor the distinctly typical tropical diseases which are so prevalent and flourish so well in the lower and warmer areas. Having a colder atmosphere and an almost continuous cool wind, insect life is not as well favored here and we are saved somewhat of that scourge, though we have enough of them as it is.
As to the tropical diseases, some of them are rarely seen. I have met only one case of relapsing or tick fever. An occasional case of elephantiasis is seen and that always of the leg variety. Little can be said of the homoeopathic treatment, though now with my experience with Sulphur I believe that it may be of value if used for a sufficiently long time.
Two cases of what I considered black water fever were in our hospital and in both cases Phosphorus seemed to be the remedy, and both recovered. Four cases of anthrax have been under our care and two of these died, one having two areas of infection.
Yaws is occasionally seen in the acute stage, but too infrequently and for too short a period of time to really know what homoeopathy alone can do for it. It is my rule to ask all new patients if they have had yaws, and if they reply in the affirmative, then I expect a stubborn case of some kind to deal with. Arsenicum album and especially Sulphur are often thought of as possible remedies in such patients.
Trachoma has been met a number of times, usually in the early stages. I have found Sulphur to give the greatest help in such cases. A few patients afflicted with leprosy have come to us for treatment, the tubercular and anaesthetic varieties being the common kinds seen here. Different homoeopathic remedies have been tried with uncertain results. “Alepol”, the drug supplied by the British Leprosy Association, does seem to help.
Amoebic dysentery is another occasional visitor that is never welcome. Arsenicum album and Sulphur seem to give some relief. Just today I prescribed Colocynth for a case that may be amoebic, though a positive diagnosis is not been made.
Liver abscess is not a pleasant case to have about and in the native death is a common sequel. We have in the hospital at present one young man whose liver reaches down to the iliac crests; 782 ounces of purulent liver fluid were removed from the abdomen before drainage was instituted.
Malaria and its complications and sequel are much more common now that the natives travel about the country so much more and contract the disease even when they do not live in directly infected areas which may be few. The spleen is not enlarged as a rule in the form of malaria seen among the people about us, but it is a noticeable feature in those coming from the lower-lying districts. Liver trouble is common to all of them. In this disease homoeopathy does much good and gives relief more cheaply and more satisfactorily than the bitter, deafening, corpuscle- destroying quinine and its derivatives.
Many remedies have been tried for malaria and I have come to consider Arsenicum album and Natrum muriaticum of the greatest help and the chief and almost the only needed medicines. Of late I have been seeing Sulphur indicated in many of t he chronic conditions and have had good results with it in this disease and its liver complications. The common modalities and generalities seem to be the reasons for using these polychrests.
Diarrhoea and dysentery are common among these people, especially when the rains and the cooler weather come, as they go insufficiently clad for the changing evening temperature, and also eat so unwisely. After many experiences I have come to rely on Mercurius vivus as of inestimable value, and when it or some other form of Mercury does not give relief, then Sulphur generally suits the case and clears it up nicely.
In the warmer districts jiggers are a great pest and many a child is seen with one or more toes missing as a result of the infection that resulted from the neglect of the jiggers. More than one European patient has told me of the benefit of Sulphur for insect bites which all of us suffer from at sometime or other.
Of course ulcers are very common in this land, generally the result of neglect of a small scratch or sore. They are difficult to treat and require much patience. We had one patient, a woman, who had had a leg ulcer even before her marriage, and they marry early here.
When she came here she had a married daughter. The leg was amputated well above the ulcer, but laboratory examination showed epithelioma and she subsequently died.
With the great variety of intestinal parasites to be found in the tropics we may be confident of seeing our share of cases afflicted with these creatures. Eating meat insufficiently cooked, so prevalent a habit in many of the tribes, is the source of the tapeworm after which I inquire in all new patients. Here Sulphur again comes to our help, and a patient under treatment with Sulphur will eventually show whether or not he has tapeworm in his system. The removal of a tapeworm has caused the removal of many complaints, even of a paralysis of the lower limbs, as was recently told me by another physician.
In many years of medical work in East Africa there have been some experiences that I might pass on for what they are worth to others. I came out here with the idea that enlarged epitrochlear glands formed one of the evidences of syphilis. This may be true in America, but I have learned that they are generally associated with a tubercular infection, and so with enlarged glands almost anywhere, in the absence of a definite and apparent reason.
Somewhere I learned that the black people are sensitive to Mercury and it should be given to them carefully. This I have found to be true from many experiences with the lower potencies, but in the higher potencies it is one of their best friends.
The common experience of having a remedy act for three to six months, as at home, has not yet come to me out here. The remedy seems to need more frequent repetition, especially in the native, and it seems to act for a short period of time, even Sulphur. One missionary who had received some training in homoeopathy told me that the effects of Sulphur 200 in her own case lasted only nine days.
There are many conditions that are peculiar to the tropics and that are seen so often by us. The natives of the tribe where we work have a habit of piercing the lobe of the ear and then enlarging the hole and stretching it until a large block of wood or an empty condensed-milk tin can be inserted. The tin may serve a useful purpose as a receptacle, but it does not add to the beauty of the human body created to serve a nobler purpose when the natives really are converted and want to separate themselves from the evil ways of the past, they come to us to have their ears sewed up to remove this evidence of their old life.
A large number of natives, when they come to us, show fresh or old marks of incisions that have been made on their bodies, a dozen or more cuts into the skin, even in tiny babies. This is done to let out the evil spirit that is supposed to be causing the sickness.
Some of the tribes desire to improve their personal appearance by pulling out their eyelashes. You may be sure that this brings in business for the doctors, on account of the resulting conjunctivitis. Another pernicious practice is that of chipping the upper incisors to a sharp point. This brings premature decay. Pulling teeth is a part of the work of physicians and of any one else who is able and willing to undertake it. Pyorrhoea is a very common disease and the source of much trouble.
The removal of the lower two first incisors may have arisen from an epidemic of lockjaw, but there is doubt of the explanation. There are too many foolish customs to apply that reason. At times babies of six months of age will have their four eye teeth drug out to cure diarrhoea. It is said to be a good cure.
Superstition being so rife in this land, one may naturally expect some peculiar actions in the life of these people. Twins are considered as bringing bad luck and often have to pay the penalty with death. One woman brought to us who had given birth to twins. Following the birth of one child, there was found to be another, so she was carried out into the bush to die alone. Three nights she lay out in the damp, cold, black African night, the wild animals about, her only companion being her mother who did have sufficient concern to stay with her. When they were compelled by the European owner of the farm where this took place to bring her here, she was too far gone to recover and another life paid the penalty of going contrary to the dictates of superstition.
A breech presentation is considered also be bad luck and it may be in more ways than one. Similarly a babe born in the caul is looked on with disfavor and the caul and babe will be buried together, no effort being made to remove the child and resuscitate it. Thus cheaply is life held in this land. Among the Agikuyu with whom we are working it has been the custom to carry the dead or seriously ill out into the bush to become food for the hyenas and other denizens of the bush and forest. One tribe says that to bury a person defiles the ground.
So we might go on enumerating many sad and strange and unpleasant happenings that are all too common in this land of heathen darkness. These are not conditions to be cured by homoeopathy, though it will wonderfully relieve many of the resulting afflictions. They require moral and spiritual teaching and instruction, and we are rejoicing in seeing some of the teachings of years bearing fruit, slowly and timidly, but surely.
For the young man or woman who is seeking to make his life useful and to serve the greatest number of suffering mankind, here is a unique opportunity. The fear of the white man has passed. We can operate on almost any condition or disease we are care to undertake. The inmates of a hospital do not now want to leave when another dies. They are building better homes, wearing nicer clothing, using some sanitary measures, and beginning to see the benefits of some of the innovations brought in by the white man. There is much yet to be done and everywhere there is need for efficient medical and surgical men and women. KIJABE, KENYA COLONY, AFRICA.