Medical statistics of Anamaboe.

Dysentery and diarrhoea of the most fatal kind are of frequent occurrence; virulent types of fever are very prevalent and deadly. It is the worst month of this season.

The months of February, March, and April, although the hottest in the year, especially in the Gambia region, are the most healthy. The heat is only uncomfortable, and produces great laxity of the constitution, yet it is the most healthy period; there is scarcely any record of deaths, especially in the interior countries, where the ground is parched and dried up, and no swamp is anywhere to be seen. It is the ground-nut

season, and the time at which each merchant performs a great deal of labour, and yet there is scarcely any case of fever, dysentery, or diarrhoea; there may be now and then a little derangement of the liver, but otherwise there is very little necessity for a doctor. At M'Carthy's Island, where I acted as physician to the natives, the dispensary was generally crowded during the whole of the year, commencing in June, until the hot winds began to blow, when there was scarcely a case in for months. This proves without a doubt that the higher the temperature, unmixed with humidity, the more healthy is the climate; but if the temperature is high and surcharged with moisture, the climate becomes very deadly.

At Sierra Leone, Liberia, the Gold Coast, and Bights, the weather not being so hot, and being mixed with moisture from their close proximity to the sea, the season is not so very healthy as in the Gambia region, although in the two former places it is comparatively so; and in the latter places the inhabitants suffer much from diarrhoea and dysentery.

The following is the medical statistical report of the Anamaboe station (Gold Coast), forwarded by me to the civil authorities whilst acting as physician to the natives in 1861

During the quarter ending the 31st March there were no less than 920 patients in daily attendance in the dispensary for medical aid. These present heterogeneous diseases, which, for the sake of convenience, I have classified under four great divisions, viz. :—

I. ZYMOTIC DISEASES.

II. CONSTITUTIONAL DISEASES.

III. LOCAL DISEASES.

IV. VIOLENCE AND ACCIDENTS.

"The number of zymotic cases treated were 503: there were three very common diseases, viz., ophthalmia, numbering 98; rheumatism, 89; and gonorrhoea, 50. Of the constitutional diseases there were 78 treated: the most frequent was debility, numbering 38. There were 312 cases of local diseases: the most frequent being constipatio, 58; and ulcers, 47. Of violence and accidents there were only 27 cases.

"The average daily number receiving relief from the dispensary for the quarter ending March 31st, less 16 days of illness, was 12.29.

"The following is the number of cases treated by daily attendance in the dispensary in extensio :

"ZYMOTIC DISEASES.-Ophthalmia, 98; dysenteria, chronica and acuta, 30; diarrhoea, 12; febris intermittens, 32; hemicrania, 20; rheumatisma, 89; syphilis secondaria, 1; bubo, 15; gonorrhoea, 50; orcheitis, 40; stricturæ urethræ, 12; chancræ, 3; scabies, 20; dysmenorrhagia, 20; menorrhagia, 38; amenorrhoea, 5; elephantiasis Græcorum, 6; dermaphyta, 15; dracunculus, 5.

"CONSTITUTIONAL DISEASES.-Debility, 38; aphthæ, 14; yaws, 5; phthisis pulmonalis, 6; anæmia, 10; anasarca from renal disease, 5.

"LOCAL DISEASES.-Otitis, 20; pericarditis, 8; influenza, 3; bronchitis, 18; gastritis, 3; enteritis, 9; dyspepsia, 3; hernia strangulata, 8; hydrocele, 25; hæmorrhoides, 8; constipatio, 58; arthritis, 26; bursitis, 30; odontalgia, 9; tumours, 18; sphacelus, 2; cataract, 2; psoriasis, 12; eczema, 3; ulcers, 47.

"VIOLENCE AND ACCIDENTS.-Vulnus incisus, 3; contusio, 24. In the foregoing are stated the daily number treated, but not the daily number of new cases treated."

The places where dysentery and diarrhoea are most prevalent in Western Africa, are at Accra and the Bight of Benin,

Lightning, thunder, and electricity.

principally Badagry and Lagos. In the month of October, in
M'Carthy's Island, and St Mary's at Sierra Leone, and Liberia,
diarrhoea and dysentery are of occasional occurrence during the
commencement of the rains, from the water being contamin-
ated with dead animal and vegetable matters which are washed
down into it, but they are only occasional diseases in these
places.

The air during this period, especially from Sierra Leone to
the leeward coast, is highly charged with electricity; lightning
vivid and of long duration, and distant roars of thunder, are fre-
quent and constant. These fill the atmosphere with increased
quantities of ozone, which, as I shall hereafter prove, possess con-
siderable influence in checking the manifestation of fever.
is now a well-known fact, that the best time for Europeans to
arrive on the coast so as to be exempt, at least for a time, from
fever is in November. This rule is strictly observed by the
Gambia merchants and the Church Missionary Society.

In November, on the coasts leeward of the Gambia, viz., from
Sierra Leone to the Bights, we have the acme of thunder-
storms, which are generally accompanied by fearful flashes of
lightning, thus filling the atmosphere with large quantities of
electricity.

The following are the observations of M. Pallas, of the French Army in Algeria, as to the effects of electricity in health and diseases (Martin):

"1. That just as light and air are the essential agents of vision and respiration, so electricity is the functional agent of innervation.

"2. That the greater number of diseases, and especially those which belong to the class of neurosis, are occasioned by the exaggerated influence of general electricity, of which clouds, storms, and marshy regions are the most fruitful sources.

"3. Marshes in their geological constitution, and in the effects which they produce upon the economy, present the greatest analogy to the galvanic pile. Thus their action is much the more baneful, as they contain certain proportions of

water, and their activity is considerably increased when the water contains organic or saline matter in a state of solution. This explains why salt marshes, and such as are near marantine rivers, are the most insalubrious. The drying up or submersion of marshes produces analogous conditions to those of a galvanic pile deprived of humidity, or which is under water, and the effects of which are then insignificant.

4. The researches of philosophers and physiologists have shown that the electricity produced by our machines exerts a special action upon the nervous system. Experience and vigorous observations of facts prove that the diseases which are produced by marshy atmospheres are primarily nervous, and become inflammatory only by the reaction of the nerves upon the vascular system, inducing consecutive, local, or general irritation."

The neuroseo are occasioned generally by the effects of electricity, and intermittent fevers have a similar origin; that is to say, they are due to the electrical emanations of the marshy pile, which are very active in hot countries, and not to miasmata, which have never been met with.

in tropies.

I have before stated that in tropical climates the temperature Perspiration of the body rises from 2° to 31° beyond its natural temperate standard, but this increase does not go on in any proportion to the increase of the atmospheric temperature. When this is 90° or 112° in shade, the temperature of the animal heat is about the same, and this superabundance, which might accumulate through the increased heat of the surrounding medium, the all-wise Creator has supplied animate beings with an apparatus for carrying off. The great sweat glands remove from the system, by means of the perspiration, all excess of heat. "To obtain an estimate of the length of tube of the perspiratory system of the whole surface of the body, 2800 may be taken as a fair average of the number of pores in the square inch, and 700, consequently, of the number of inches in length. Now, the number of square inches of surface in a man of ordinary height and bulk, is 2500; the number of pores therefore 7,000,000,

Prickly heat.

Physical cffects of hot climate.

and the number of inches of perspiratory tube, 1,750,000—that is, 145,833 feet, or 48,600 yards, or nearly twenty-eight miles." This is a most important calculation, and shows what mischief to the system will be the result when the functions of such an extensive surface are obstructed.

The perspiration, therefore, is the great regulator and moderator of the internal heat of the body. Through it, an individual can live in the hottest weather; and by the power inherent in him of generating heat, he is able to live in the coldest clime. Mr Erasmus Wilson, in his "Treatise on the Skin," has most truly stated that man can support the intense heat of the tropics without much elevation of his inward heat, and that he can live where the mercury is rendered a solid mass like lead, by cold, without the most trifling depression of his vital warmth. "But," writes he, "it must not be supposed that the constitution of man is the same in these two opposite conditions; it is, indeed, widely different; in the one he enjoys what may be termed a summer constitution; in the other a winter constitution-the first harmonising with the summer heat, the second resisting the winter cold.

At this time of the year prickly heat is found to be very troublesome, especially amongst new comers-the red pimples or eruptions appearing in the breast, arins, neck, and sometimes all over the body, producing the most disagreeable and annoying sensation which none can understand except those who have suffered from it. It is, however, a sign of good health, and there is no remedy as yet that could be regarded as specific. Cold and acid lotions, lime juice, sulphuric acid lotion, cold baths, cooling drinks, have all been used, but in vain. The only remedies are palliative, consisting of "light clothing, temperance in eating and drinking, avoidance of all exercise in the heat of the day, open bowels," and the use of a large fan at night.

Sir R. Martin gives the following able summary of the physical effects of hot climate on the human economy :

"The air being expanded, less oxygen is taken in at each