54 GENERAL ROUTINE WORK 



for the head and spinal regions is effective. The small tight skull cap affected 

 by the Arabs is said to be an excellent preventive when worn under the helmet. 



Poisoning. — Infrequent. The blacks employ senna as a purge, followed by a 

 large dose of a native salt called " gardugga." I have analysed this, and found it 

 to consist of the carbonate, cliloride, and sulphate of sodium. It caused the 

 death of a Greek, a weakly man, to whom it had been given. The ^jo.s< nwrtevi 

 appearances were like those met Avith in poisoning from a corrosive alkali. I 

 believe the large dose of sodium carbonate was what killed him. It is said that 

 datura is fi-equcntly employed as a poison. I have not seen a single case of death 

 resulting from this drug. 



Alcoholic Poisoning from the drinking of excessive quantities of merissa, a 

 beverage made from dura (Sorghum vulgar e), now and again occurs. 



VII. — Local Affections 



Liver Abscess (Khorag Kabid). — Not uncommon. Apparently imassociated 

 with dysentery. I have found the Amoeba coli in the pus in one case — a 

 European. Is it possible that liver abscess may be the forerunner and not 

 the sequel of an acute dysentery\ Two out of four cases seen were multiple. 

 In one a superficial abscess was successfully opened nud drained, but the 

 patient died from a deeply-seated abscess, which had apparently formed 

 subsequent to operation, and was not detected during life. 



Ainhum. — Is said to exist amongst the natives in the south. I have seen 

 one case under the care of Dr. Christopherson. 



Goitre (Gioatre). — Occurs. I have a photograph of one case (from 

 Dr. Christopherson), associated Avith exophthalmos, in which the huge goitre has 

 ulcerated and looks as though it were undergoing malignant changes. The 

 patient was an Egyptian woman resident in the Sudan. (As regards water 

 conditions, see under Calculus.) 



Hypertrophied Mammce in Males. — This curious condition exists,' but I am 

 told is not so common as in Central Africa. The possessor of tliese abnor- 

 malities has been known to excise them, being angered at the chaffing to 

 which he had been subjected. 



Guinea Worm (Erk Medain, Farranteet). — Fairly common, and not confined 

 to natives. There are certain pools in both Niles (charted by Major Bray) wlience 

 infection may be obtained. It is most common in the foot, but I have seen a 

 Sudanese with multiple infection in the arm. 



Cancrum Oris. — Already mentioned. The disease occurred in a chimpanzee, 

 Anthropopithecus troglodytes (Schweinfurth), confined in the Zoological Gardens 

 in Khartoum. 



Mycetoma ( Napt Hindi Nahit). — Exceedingly common for such a rare 

 disease. The form due to the black variety, of Streptothrix is most frequently 



■ Jyancet, November 21s(, '03 



