► Royal Navy ► 1841 Niger expedition ► BookChapter IV ◄► Chapter VI
A NARRATIVE
OF THE
EXPEDITION TO THE RIVER NIGER.
VOLUME II, CHAPTER V.
The 'Albert's' sick landed at Fernando Po - Death of Mr. Willie - Condition of the sick - Captain Trotter's sufferings - Doctor McWilliam attacked with river fever - Death of Commander Bird Allen - Tribute to his memory - Kru sympathy - An interesting scene - Death of Lieutenant Stenhouse - Further mortality - Departure of Mr. Carr for the Model Farm - Captain Trotter leaves for England - The smokes - Agreeable effects of tornadoes - Death of Doctor Vogel - His unwearied exertions and zeal in the cause of science - Kind attentions received by the Expedition from Mr. White and the other residents at Clarence - The 'Albert' leaves Clarence Cove for Ascension - Passage - A short account of the Niger fever - Modes of treatment - Quinine strongly recommended - Probable causes of the fever - Influence of diet.
On the arrival of H.M.S.V. 'Albert' at Clarence Cove, Fernando Po, Dr. McWilliam lost no time in having the sick removed on shore, the large store-rooms above the houses of the West African Company having been at once adapted for the reception of the seamen and marines, by Mr. White, the agent, who, with Mr. Hensman, the medical resident, most considerately gave up their own private dwellings for the use of the sick officers. Captain Trotter, still in a state of extreme debility, Commander Bird Allen and Lieutenant Stenhouse evidently both far beyond all hope of recovery, were taken to the so-called Governent House. Several of the junior officers were also in great danger, especially Messrs. W. H. Webb, mate, and W. Wilmett, clerk. Mr. Willie, mate, who had for some days been in a most critical state, gradually sunk, in spite of all the means used, and expired the evening of his landing. He was deeply regretted, being not only of an amiable frank disposition, but an excellent officer. Poor fellow! the fever seized him when all the other executives were prostrate, and feeling that much depended on his exertions, he continued at his duty in spite of the remonstrances of his medical friends, and it was only when both strength and reason forsook him that he yielded. He never complained of pain, always saying he felt quite well; while the symptoms - continued heat and dryness of the skin, anxious manner, and nervous tremors - shewed too clearly the course the malady was taking. His remains were buried near those of kindred spirits.
Immediately on the arrival of the 'Soudan,' Mr. Thomson, acting-surgeon of that vessel, was sent on shore, to assist Dr. McWilliam, who was beginning to feel the effects of his late extraordinary exertions; and situated as the sick now were, in three different houses, at some distance from each other, it required no ordinary amount of strength to visit them as frequently as their cases demanded. The climate, too, was then extremely variable; the sun at one moment bursting out with a truly African force, then as quickly succeeded by heavy showers, while at night the latter, and the noxious land-breeze offered but an indifferent exchange for the noon-day heat.
Mr. Woodhouse, acting assistant-surgeon of the 'Albert,' was added to the list of fever cases. He had lately been serving for a few days in the 'Soudan.'
22nd.- This evening Robert Milward, purser's steward, expired after a rather protracted illness. Some of the sick were beginning to improve, but many were still in extreme danger, particularly Commander B. Allen and Lieutenant Stenhouse; both of these were, however, in a most satisfactory state of mind, and whenever the absence of delirium permitted, the Rev. J. Schön read to them, and awarded spiritual consolation. Dr. Prince and Mr. Clarke, Baptist Missionaries, who had formerly known Captain B. Allen in the West Indies, were also unremitting in their attentions.
Captain Trotter continued to be much debilitated, worn to a shadow by his late attack, and the anxiety of all the past distressing circumstances preying on his mind. To add to his danger, his case was complicated with a painful inflammatory complaint, which required active cupping; but throughout his trying illness he never lost sight of those intrusted to his care; his own sufferings seemed to be altogether forgotten in his anxiety for the welfare of the Expedition, and in the hope of yet being able to carry out the great designs of its originators.
23rd.- All those who were not in a hopeless state on their arrival seemed to have benefited by the change; several of the others were however, hovering between life and death. Dr. McWilliam, who had so unceasingly exerted himself for the welfare of others, was to-day obliged to relinquish his duties. It seemed as if the exciting circumstances under which he had been placed, by keeping both mind and body so much engaged, had tended to ward off for a time the threatened fever. He had evidently been suffering from the premonitory symptoms of the attack for several days, but he was averse to lay up as long as he could be of any assistance. The medical duties now devolved on Mr. Thomson.
25th.- This morning Commander Bird Allen departed this life, to the deep, deep regret of all who knew him; and those only could justly appreciate the many admirable qualities blended in his character. As an officer,- brave, talented, and enterprising,- he united the fullest decision of purpose with the utmost gentleness of disposition, and with all his zeal for the public service he never overlooked the happiness of those who were under his command. In all his sufferings not a murmur or expression of complaint escaped his lips, and his conversation, during rational moments, turned more on the state of others than himself. Strong in the faith of those promises which had been his guide in the time of health, he breathed forth his gentle spirit, awarding another memorable instance that a man may be a brave, efficient officer and a sincere Christian.
We must not forget to mention that prior to entering the river Nun, Commander B. Allen had expressed to one of his officers his presentiment that he was never to come out of it alive: he did so however, but only to mingle his dust with others who, like himself, had staked all in their desire to serve "the land of the negro." Yet, while there survives one of the number concerned with him in that perilous enterprise, his memory will be revered and beloved.
His remains were deposited in the quiet secluded spot near Lander's, Mr. Schön performing the burial service. In consequence of the general sickness only two or three white persons were enabled to pay the last sad tribute of respect; but his name as "a friend of Africa" had become known to the black residents of the settlement, and numbers of them followed the little procession, evidently sensible of their loss.
27th.- Lieutenant Stenhouse and Mr. Wilmett continued in a most critical state, Dr. McWilliam was in a high state of fever, and Captain Trotter decidedly worse, the loss of Commander Bird Allen having given him a severe shock. Messrs. Webb and Fairholme were very slowly recovering strength, and some of the others, beginning to clamour for increased diet,- a sign of convalescence. To-day the Krumen, who had hitherto been employed on board the vessels, were allowed to come on shore, and one of their first acts was to visit the sick officers and men at the different houses. They walked quietly into the several apartments, kneeling down near those they were acquainted with, gently pressing the sufferer's hand, and whispering, in their broken English, a word of comfort, or the sympathy so plainly written on the countenance. It was, indeed, a most interesting sight to witness such a display of considerate feeling on the part of these untutored children of nature, whose almost naked, stalwart, black figures were in strong contrast to the gentleness of manner, and commiseration evinced on that occasion. In all the difficulties of the Expedition how nobly these fine fellows behaved; even amid the absence of discipline unavoidable by the sickness of all their superiors, not one case of insubordination or neglect of duty occurred among them; and truly their conduct showed how sincere were their expressions, "Kru-boy like white man too much," "where white man go, Kru-boy must go, only he too much sorry, see good white friend die."
28th.- Lieutenant David Hope Stenhouse breathed his last early this morning, after an illness of upwards of a month, throughout which he manifested the same excellent disposition that had distinguished him in health, and caused him to be appreciated among all his naval friends. In his death, he did but exchange bright earthly prospects, for the imperishable honours of another world. His remains were interred near those of Commander Bird Allen: the fever in both cases having run almost an identical course: low and typhoid in its character, with scarce any remission, and resisting every method of relief. The death of Lieutenant Stenhouse was another sad blow to Captain Trotter, whose health was still in a most precarious state.
30th.- Assistant-Surgeon Woodhouse, in whom the fever presented from the first, the insidious symptoms of a dangerous state, was fast drawing to the conclusion of his earthly career. This morning, being evidently dying, he received the solemn ritual of the sacrament, administered by the Rev. S. Schön, and a few hours afterwards the fatal disease terminated his existence; he too, no doubt, benefited by the great change, and rose above all earthly promotions. The sun, whose rising beams at morning fiickered in the sick man's chamber, threw his evening rays over the newly-made grave of another far beyond the reach of care. He was buried the same day before sunset. It may be interesting to his numerous friends to know, that those amiable and generous qualities which had endeared him to them prior to entering the service, never deserted him.
November 2nd.- Except Captain Trotter, Doctor McWilliam, and Mr. Wilmett, who vere still dangerously ill, the sick generally were convalescing slowly, under more generous diet, and a moderate quantity of light, bitter ale; the difficulty was, however, to procure sufficient quantity of fowls or fresh meat for them: and even then, the preparation of food for so many in a way suited to the fastidious taste of sick people, was no easy matter,- there being no white man capable of the occupation,- so that the cuisine became an unavoidable addition to the medical duties; fortunately Mr. Mouat, clerk, had been under a professional gentleman for some years, knew a good deal about dispensing and the use of medicines, and being now convalescent, rendered the greatest assistance to Mr. Thomson. Morgan Kinson, one of the three belonging to the 'Albert' who had hitherto escaped, was added to the long list of the sick.
On the 5th November, H.M. steam-vessel 'Pluto,' arrived at Fernando Po, bringing back Lieutenant Fishbourne, and Mr. Bowden, secretary, both of whom had improved so much by their trip at sea in the 'Wilberforce,' as to be enabled to return. The former was now appointed acting-commander of 'Soudan,' by Captain Trotter, in the vacancy occasioned by the death of Commander Bird Allen. Mr. Carr, agent and superintendent of the model farm, having recovered his health, requested Captain Trotter to allow him again to proceed up the river, to resume his duties, which was very unwillingly granted on account of the dangers attendant on the route suggested. Mr. Wilmett, clerk, was buried to-day, near his former companions, having been fairly worn out, poor fellow, by an incessant watchfulness and delirium, which had, for the last fortnight particularly, kept him without repose; it had latterly become so distressing to all the other sick officers, that it was necessary to remove him to a separate house.
7th.- H.M. steam-vessel 'Pluto,' sailed last night for the mouth of the Brass River, with Mr. Carr, who, in spite of all the advice of Captain Trotter and Mr. Beecroft to the contrary, still persisted in his resolution of returning to the model farm, and, moreover, trusting himself in the native canoes, with different packages of clothing, &c.; the sequel was not to be wondered at {Mr. Carr and his servant were taken into the Brass River by one of the 'Pluto's' boats, where he engaged a canoe, in which he placed all his luggage. Mr. Browne, a native of Cape Coast, who had accompanied him thus far, knowing a little of the language, and suspecting the natives had evil intentions towards Mr. Carr, apprised him of these suspicions, and earnestly implored him to return on board the 'Pluto.' Even after the canoe had started, both Mr. Duffield, one of the 'Pluto's' officers, and Browne, advised him strongly not to trust himself in such hands. He persisted, however, and from that time nothing has been seen of him; but there is every reason to believe he was robbed and murdered soon after commencing his voyage}. The remains of Morgan Kinson, who expired last night, were this morning committed to the grave. His disease was more symptomatic of inflamed stomach than fever, which an examination proved. On inquiry, we learned that for some time previously to the attack, he had been in the habit of using a great quantity of hot peppers in his rations of coffee and rum; that the very morning of his first complaining, he had taken a large spoonful of Guinea pepper; and it is very probable that the extreme irritability of stomach which resisted all active means, had brought his illness to a termination, before it was possible for the fever to develop itself perfectly.
12th.- The sick were for the most part going on satisfactorily. Doctor McWilliam was very much improved, but still confined to bed. On the other hand, Captain Trotter, whose anxiety for the future operations of the Expedition continually excited him to physical and mental exertion, quite beyond his enfeebled state, was clearly losing ground, and it was evident that unless speedily removed from all responsibility, there would be no hope of his recovery. Under these circumstances, Mr. Thomson wrote, urging on him in the strongest manner the absolute necessity of disconnecting himself for the present from the causes which were endangering his life, and to return to England immediately. In this view Doctors McWilliam and Stanger also coincided; and it was at last, with great reluctance, acquiesced in by Captain Trotter.
21st.- Most of the sick were now in a fair way of recovery; but such miserable objects! they looked like men risen from the grave, as they crawled about morning and evening, to take advantage of the cool refreshing breezes.
The worst cases were now those of Mr. W. Merriman, gunner; William MacClaughlin, sailmaker, and John Duncan, master-at-arms {Since so well known by his travels in Dahomey}. This enterprising person was for some weeks in a very critical state; and when the fever declined, he was attacked with sloughing ulcer of the foot, which long kept him on the verge of eternity. John M'Clintock, stoker, was committed to the grave to-day, having expired very suddenly yesterday on board the 'Albert.' The unfortunate man had quite recovered from the fever, and had embarked again; while scuffling with a number of others on the forecastle of the ship, he fell down dead.
22nd.- The 'Warree' schooner, the property of R. Jamieson, Esq., of Liverpool, touched in at Clarence to take Captain Trotter's luggage on board, it having been arranged that he was to proceed to England in her. The Master had unfortunately been drowned, a few days previously, by the upsetting of a boat in the breakers, which suddenly set in on a reef of rocks near Shark River, where he was procuring oysters. Mr. Saunders, second master of the 'Albert', was therefore appointed to command her; and, on the following morning, having embarked the sick, except a few who were too weak to be removed, the 'Albert' got up steam, and left Clarence, taking the 'Warree' in tow. Doctor Stanger and the Reverend J. Schön, were also passengers with Captain Trotter, whose departure was deeply regretted, and accompanied with the sincere wishes of all parties, for his restoration to health, and future welfare.
Nor was it with any ordinary feelings that the two former gentlemen said adieu to their numerous friends, who could not readily forget that Stanger, besides his professional aid so cheerfully rendered, had also generously and unremittingly worked at the engine, on which exertions, together with those of Dr. McWilliam, probably so many lives depended, while Mr. Schön in his unwearing ministerings to the spiritual comforts of the sick, had given them cause for grateful remembrance.
Mr. Merriman, gunner, and W. MacClaughlin, sail-maker, both of whom were in a most emaciated state, and getting worse under the influence of the climate, had also been removed on board the 'Warree,' to afford them the only chance of recovery - change of air {The latter died on the passage}.
24th.- The peculiar condition of the atmosphere, styled at Fernando Po the "Smokes," commenced early this morning, in the form of a dense vapour, which floated sluggishly over the sea, enveloping portions of the land, and quite obscuring the opposite coasts; the wind was unusually light, westerly and south-westerly, with an average temperature of 84° Fahrenheit's thermometer; this, which corresponds to the health-reviving harmattan of the other parts of the west coast, only resembles it in one point - the extreme dryness of the air. It is the most unhealthy season of the year at Clarence, and no one escaped its effects. Messrs. White, Hensman, and Lindsleger, old and well-seasoned residents on the island, were laid up with active fever; Mr. Roscher the mineralogist, and Dr. Vogel the indefatigable botanist, who had remained behind, determined to brave all dangers in prosecuting their respective departments of science, were also sufferers, the latter from a severe attack of dysentery in its worst form: John Huxley, the sick attendant, commenced with fever; and even Mr. Thomson, left in charge of the sick, whose constitution had been proof against the climate of the river, his service in the fever-impregnated 'Soudan', and a continued residence of two months on shore, did not escape without a febrile attack of an intermittent character.
Nothing could be more debilitating than the effect of these "smokes" on European constitutions; and the feeling of unconquerable anxiety and nervousness was very distressing.
December 2nd.- Last night the incessant flashing of vivid lightning portended the coming tornado, which early this morning broke over the island with terrific force, threatening to tear down the crazy wooden buildings, which rattled in anything but an agreeable manner, especially Mr. Hensman's, situated as it was, rather too close to the high cliffs: with the exception of the window-shutters, however, which retreated inwards before the violence of the wind, no injury was done; and all the sick, save poor Vogel, were benefited by its purifying influence on the air, which to-day became cooler, and less oppressive. Those only who have suffered for days and weeks under the overpowering influence of the West African climate at the periodical changes from wet to dry season, can appreciate the feeling conveyed by the premonitory signs of the "war of elements," when, after perhaps a series of sleepless nights, he notices in the evening sky the arched cloud, illumined at intervals by the fitful glance of the electric fluid, and hears the distant thunder draw nearer and still nearer; what in temperate climes is indeed a subject of dread, only raises in his heart a mingled sentiment of happiness and thankfulness. He says "Thank God there is a tornado coming," makes all secure, jumps into bed, and, favoured by the diminished temperature of the turbulent atmosphere, sleeps through all the chaotic strife of rain, wind, thunder, lightning, which rages round him; he rises calm and refreshed, with a buoyant, elastic feeling, which puts him on his way rejoicing in the goodness and wisdom of Him who can cause even the terrific storm to be productive of blessing to the sojourner in that "dry and weary land."
On the evening of the 3rd, the 'Albert' returned to Fernando, having accompanied the 'Warree' as far as the island of Rollas. Most of the sick were benefited by this little change to the sea air, having an advantage over those who had been steeped of late in the pestiferous "smokes" at Clarence.
14th.- Every preparation was being made prior to leaving the island; getting stores on board the 'Albert,' dismantling the 'Soudan,' and working up patent fuel out of the small coal, there being scarcely any fuel left.
16th.- This morning, Doctor Theodore Vogel - whose constitution,- which never rallied from the attack of river fever, rapidly broke down under the continuance of the uncontrollable dysentery - breathed his last, adding another to the long list of those who have given themselves to the cause of Africa and the inquiry of science. Of Dr. Vogel's acquirements as a botanist, it is unnecessary to speak; his reputation was European, and had he been spared to complete the task he had undertaken, and was so ably fulfilling under numerous difficulties, no doubt he had left but little undone for future investigators of Africa in that branch of natural history. It may indeed be said he sacrificed himself on the altar of science, inasmuch as he had preferred remaining at Fernando Po, to continue his labours, when in a most wretched state of health, rather than lose that opportunity, by proceeding on to Ascension in the 'Wilberforce,' where the change of air might have prolonged his days. On examination, the lungs were found to have all the characters of consumption in an advancing stage, and had he even recovered from the dysentery, he would not have been long spared to his numerous admiring friends. The remains of this eminent botanist were interred at night near those of other fellow-sufferers in the Expedition; and as the feeble glimmering of the stars did not suffice, it was necessary to use torches, which threw a lurid blaze over the solemn scene. His resting-place was at least characteristic of the occupant, for there nature had asserted the mastery, and surrounded the spot with a dense, almost impenetrable, mass of dark green underwood, above which the guava, the graceful palm and broad leaved banana, struggled to display their forms.
On the evening of the 18th December, the sick being all now on board, and the preparations necessary for the voyage completed, the 'Albert' got up steam and left Clarence. In passing along the coast, here and there, a collection of moving lights, pointed to the different little sandy nooks, where the native Edeeyahs were busy in pursuit of the land-crabs. These indications of life soon disappeared, and ere long, even the broad outline of the island itself, was lost in the dark shades of night.
Few on board felt any regret at having left a place connected with so many sad recollections, but it may be presumed that gratitude and thankfulness were feelings common to all, at having escaped, even though with broken constitutions, and enfeebled energies; and it is to be hoped that many poured out their hearts to their Almighty deliverer, in the words of Hezekiah - "The living, the living he shall praise Thee, as I do this day." It would be ungrateful not to record the kindness and attention of several persons connected with the West African Company at Fernando Po: Mr. White, the agent, had considerately thrown open his own residence to the reception of the sick, and provided for the comforts of those who were in attendance; Mr. Hensman, the medical officer, had also laid the officers of the Expedition under an obligation, by giving up his house to their use, and thus putting himself to great discomfort and inconvenience. Mr. Lindsleger, the merry, good-natured clerk, too, had cheerfully rendered his assistance, and had been of continual service in procuring the comforts necessary for the sick; nor must the kind sympathy and aid of many of the "dark daughters" of the place be forgotten: The recollection of acts of kindness under such circumstances can never be obliterated, while the recipients remember aught of the scene of their sufferings.
On the 20th December, the 'Albert' reached West Bay, in the delightfully picturesque Island of Princes, whence, having procured fuel, and some stock for the convalescents, she steamed round to Church Bay. Here Madame Ferreira entertained, in her usual hospitable style, the officers who had an opportunity of visiting the shore.
Touching in at St. Anna, de Chaves, the capita1 of St. Thomas' Island, on the 24th, thence skirting along the coast,- which for diversity and luxuriance of landscape can hardly be surpassed,- the 'Albert' anchored near the Island of Rollas. H.M.S. 'Pluto' was lying there in a sickly condition, having a number of her crew laid up with fever. Poor Duffield, the second master, who had accompanied Mr. Carr to the inside of the Brass river, had already fallen a victim, and some of the others were in a critical state. Three or four of the sick were sent on board the 'Albert,' for passage to Ascension, one of whom, Tom Davis, a Kruman, died soon after of consumption. After wooding and watering, the 'Albert' proceeded to Annobone, thence on to Ascension, where she arrived on the 28th January. During the passage the sick improved rapidly, particularly after having passed to the southward of the Equator, when the alteration became almost daily apparent. Even Duncan, who had suffered so terribly from mortification of the foot,- succeeding his attack of fever,- was beginning to rally from his protracted illness; and the refreshing sea breezes at Ascension together with the quiet of an hospital gradually restored him, and many others, who had been reduced to the verge of the grave.
[illustration: Church Bay, Prince's Island]
The fatal character of the fever which had thus frustrated the objects of the Expedition, and disappointed the bright hopes of its philanthropica1 originators, will no doubt have invested it with an interest - even to the general reader,- which medical subjects seldom possess; we have therefore ventured to collate an outline of it from the official report transmitted October 8th, 1841, by Mr. Thomson to Sir W. Burnett, Medical Director-General of H.M. Navy.
In attempting a general description of the disease as it manifested itself on board H.M.S.V. 'Soudan,' some difficulty occurred from the dissimilarity of the symptoms not only at the commencement but during the progress of most of the cases. In nearly all however, premonitory symptoms were found on inquiry to have existed at least one day prior to the attack, either in form of languor, general debility, or sensation of chilliness, but from the anxiety of the patients to impute those feelings to any other cause than that of fever, medical assistance was avoided until the following day, when the symptoms were less equivocal. At first the head was not so severely affected as in most forms of remittent fever, a sense of fulness and constriction nevertheless was always complained of; the eyes were suffused, the conjunctiva having a yellow tinge; general pains, especially of the lower extremities and loins, this last mostly aggravated on the third day. In all cases the heat and dryness of skin were very great. Bowels irregular. The tongue covered with a thin white clammy fur, changing into a yellowish or brownish coating, with edges of deep red colour, and in all tremulous, on protrusion. The pulse generally averaged 96 at commencement, but it varied a good deal in different cases, both as to number and momentum, the change being from 96 to as much as 120 during the severity of the accession. About the third day, the irritability of stomach came on; the fluid ejected being either yellowish, or green and bilious. Tenderness over the stomach was not invariably present, and in no case did it amount even on pressure to any indication of acute inflammation. The general impression produced on the system at the outset merits the most attention, in some there being great nervous depression with rapid prostration of strength and despondency of mind; or high excitement with full pulse, again succeeded by exhaustion; while in others, the disease advanced slowly and insidiously without development of any urgent symptoms until about the sixth day. These latter were certainly most intractable. On questioning such patients, they would reply in a languid sort of tone, that there was nothing whatever the matter with them; that they were quite well; and wondered why they were obliged to take medicines, or be placed under any restriction. In scarcely any two cases treated on board 'Soudan,' was the malady exactly similar; in all, however, the remission was somewhat longer and more distinct on the alternate days, the accessions becoming stronger and more aggravated until the seventh or eight day, when the symptoms became less severe, with favourable remissions, or advanced to a fatal termination. In the height of the fever, the exhalation from the skin had a peculiar odour, not unlike the disagreeable mustiness of dirty wet clothes which have been kept in a confined place. The vessels were absolutely saturated with it at last, and it was so powerful on board 'Soudan,' that the officers of the 'Pluto' employed on a survey of her stores, detected at once the presence of it, and could scarcely believe that it proceeded from the fever. In the fatal cases and those of greatest intensity, this effluvium was most appreciable.
The state of the atmosphere was found to modify the stage of the disease very much; a close, sultry condition without breeze augmented the fever greatly, causing restlessness, and converting what would have been the day of clearest remission into a day of continued violent febrile action. In this way the 12th and 20th of September, being of such a nature, had a most pernicious effect on the cases.
In conducting the treatment of this insidious disease, the principal objects kept in view were as follows: - To establish, if possible, a more healthy state of the secretions, in the use of remedies, anticipating as it were, the accessions of fever at night, and endeavouring, especially during the remissions, to induce such a change in the system as might tend to lessen the duration of the malady.
After a brisk purgative of the chloride of mercury, followed by neutral salts, the mercurial chloride was given, in combination with James's powder, five grains of the former with two of the latter, every three hours, until moderate ptyalism was induced; while saline draughts were used as common drink, but chiefly just before and during the evening and night, at which time the thirst and heat of skin were most aggravated; a slight excess of the bicarbonate of potass seemed to lessen the tendency to irritability of the stomach, and if this failed, total abstinence from fluids for a short time, had often the desired effect.
The head symptoms were chiefly treated with cold evaporating lotions, the hair being altogether removed, and in most cases by blisters to the neck or temples. One disadvantage of this species of counter-irritation, either applied as above, or in cases of tenderness over the stomach with continued vomiting, was the certainty of their aggravating the dysury or suppression of a most important secretion, which already obtained as a feature in the disease. Cupping was found to be decidedly more useful. The remedy which may be considered to have the most manifest power in controlling the disease was calomel in moderate doses; but even that required caution in its administration, as it seemed to increase the irritability of the system, unless ptyalism succeeded. We saw no case which ended fatally, where its effects could be established; and in some where it was beginning to act, and suddenly ceased its operations, the fever as certainly progressed without any possibility of checking it. James' powder was not found to be of the benefit expected from its general character in fever. In large doses, it seemed to make the stomach more irritable, and in small ones, was not so effectual as saline mixtures in promoting perspiration. During the decline of the disease, the hydrochlorate of morphia was a valuable medicine; a good night's repose doing as much towards restoration to health as diet.
As soon as favourable remissions came on and the tongue tolerably clean, the disulphate of quinine was most serviceable; and from subsequent experience, we believe, that if used boldly and in full doses, it may be used most beneficially at a much earlier stage. In the secondary attacks of pure remittent fever, which we witnessed on our subsequent visit to the Bights and Fernando Po, it was given in cases where the tongue was even foul and dry, in doses of six to ten grains once or twice daily, and it acted more like a specific than anything else {Dr. Thomson has also found this confirmed by practice in the eastern coast of Africa}.
Judging from the experience of the two expeditions, we find that, irrespective of season, the river fever, from whatever cause, will develop itself about the fifteenth day. Thus the 'Quorra' and 'Alburkah' in 1832, commenced the ascent on the 28th October, and on the 11th November the disease manifested itself; while in the last expedition, the vessels began their progress upwards on the 20th August, and on the 3rd September, the first case of fever occurred on board H.M.S.V. 'Soudan,' exactly the fifteenth day in both; but when Lieutenant Webb ascended the river in July, 1842, the first sickness evidenced itself on the sixteenth day.
Of the predisposing causes arising out of the condition of the atmosphere, it would be impossible to speak with any certainty, since the most delicate chemical tests have failed. to elicit the presence of any of the deleterious gases supposed to exist in those regions. From the date of entering the river, we examined both air and water several times during each day and night with the greatest care, and could not detect sulphuretted hydrogen in either, and only a slight trace of carbonic acid gas in the air. Still there can be no doubt there obtains at some seasons - especially about the conclusion of the rainy and beginning of the dry period - a certain peculiarity of atmosphere,- call it miasm, malaria, or any other name,- which, though inappreciable by chemical agency, operates most powerfully on Europeans. Even on those of the most robust frame, and those who escaped the river fever, the climate gave rise to an indescribable languor and want of nervous energy, under which the strongest constitution must have yielded.
We can speak with greater confidence of the effects of solar heat as acting in three ways; first, in evolving, after the rains, those emanations from the soil, which are probably the predisposing causes; secondly, in its influence in developing the disease on those directly exposed to its power, which in nearly all those so situated, was followed almost immediately by an attack of fever; thirdly, in its pernicious effects on those in whom the malady has commenced; as was most clearly exemplified on the 12th and 20th of September, when an unclouded sky, enabled the sun's rays to operate with the greatest intensity. In confirmation of these opinions, we quote some interesting remarks from the journal of the pious and gifted Bishop Heber. Speaking of the pestiferous jungles of Tandah and Terai, between Sheshgur and Kulleanpoor, in the East Indies, lat. 28° 30' N., long. 79° E., he says, that "during the heaviest rains, while the water falls in torrents, and the clouded sky tends to prevent evaporation from the ground, the forest may be passed with tolerable safety. It is in the extreme heat, immediately after the rains have ceased in May, the latter end of August and beginning of September, that it is most deadly; that during the sickly season, from the 1st of April to October, even the animals desert them; but in the latter month they return." He says further, that "the people dwelling in the neighbourhood of these woods, call the white mists which emanate from the marshes, 'the essence of owl,' the native name for the jungle or malaria fever." {Heber's Journal, vol. i., p. 251}
We have previously called attention to the good effects of quinine in the treatment of fever; we must also speak of it as a prophylactic. It had long been observed by medical men on the west coast of Africa, that persons subject to ague or intermittent fever, were exempt from the more serious remittent form. Mr. Thomson therefore reasoned, that if the use of quinine could control a disease which granted this immunity from the more fatal one, might not the free administration of it in the healthy subject induce such a change in the system as would keep both away? On the return of the Expedition to the Bight of Biafra in 1842, he commenced the experiment in his own person in large doses - six to ten grains daily; and although very much exposed on shore in the woods of Fernando Po, Bimbia, Cameroons, &c., he escaped the remittent altogether; but on the recall of the officers and men to England, he gradually left off the quinine, and on reaching Plymouth, discontinued it entirely, when, strange to say, tertian ague attacked him at regular intervals for some months, and even recurred on the following year at the same period {Medical readers are referred to the Lancet; date 28th February, 1846.}
As regards the influence of diet in the prevention of fever, we had the clearest proofs that tolerably good living, with a moderate proportion of wine and Bass's ale, was the most proper course to be adopted. We found that those who used the good things of this life, without abusing them, continued the longest exempt from an attack, and some escaped altogether; while of those who had followed the opposite plan, or total abstinence from wines and fermented liquors, not one had an immunity from the fever, or recovered, and their cases were among the earliest fatal. We wish this to be particularly marked, as some persons from mistaken views have recommended, a course quite opposed to these facts.
Above all we must add, the encouragement of cheerfulness and innocent recreation, with suitable protection from the sun. We have seen the good effects of such a system, and cannot too highly recommend it {As the character of this narrative precludes the possibility of going further into medical details, we refer our readers to the works of Doctors McWilliam and Pritchett.}
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