310 
MEDICAL TKACTICES AND SUPEIISTITIONS OF KOKDOFAN 
M idwifery 
Treatment of 
difficult 
cases 
of sunstroke in a Nuba following exposure after a debauch on meat and marissa. 
The native treatment is to put salt in the ears and bathe the head with water, to 
which may have been added the Huyar-et-dam or Jlagar-el-Akhdar . 
The Arab (except of the very lowest class—camel men, etc.) recognises that loss 
of mental power, intellect, and activity follows on constant cranial exposure to the 
sun. He is therefore more careful of his head. As regards the contented, unclad 
and lethargic Nuba, I imagine it would take centuries of straw hats to raise him 
above the intellectual status of his simian relatives. 
Mid wiFEKY 
Many of the following details having been given me by partially instructed midwives, 
it is difficult to determine whether some are purely local in origin or introduced. 
The ease with which the ordinary Arab and Sudanese woman jiarturates renders the 
presence of a midwife almost unnecessary. At a birth, however, marissa is provided free, 
and the local matrons therefore appear in full force. They are after their fashion all more 
or less expert midwives, and apparently delight to discuss the pros and cons of each case 
at great length. The ease of head presentations, as compared with arm, and leg, etc., 
presentations, is well recognised, the more enterprising endeavouring to correct these 
positions by manipulation. In cases of maternal death, contracted pelvis, etc., 1 believe 
caesarian section has sometimes been performed ; more often, how’ever, the child is crudely 
dismembered and removed jiiecemeal. This procedure caused not only the decease of the 
child but also that of the mother during a labour a few months ago at Kadugli, the woman 
being so severely mutilated that death from hcemorrhage occurred. 
To assist labour, manual pressure is applied over the uterus, especially during the 
“ pains,” as also pressure over the sacral region from behind. 
A piece of rope tied tightly round the woman’s waist is another method to this end. 
Before the iiresentation of the head in the vulva it is almost ahvays necessary to enlarge 
the aperture by cutting with a razor. When the head is emerging it is retarded manually, 
so as to prevent more extensive rupture. After child-birth the woman, if young, usually 
undergoes another restorative operation. 
When the foot presents, it is either restored, in hopes that the head will take its place, 
or else the other foot is caught and brought down, traction being then applied vigorously 
together with pressure from behind and above. 
If the hand presents, it is either restored or else left ir/ situ and traction exerted. 
Massage of the abdomen and slapping the abdominal wall is resorted to in cases of 
delayed pains and inertia ; in cases of retained placenta, squeezing and pressure from 
above are adopted, as also, in post-partum haemorrhage, pressure exerted over the abdomen. 
The cord is tied four fingers’ breadth from the umbilicus and cut one finger’s 
breadth further down. It is said to fall from the baby in three days if the mother is 
giving much milk, otherwise in seven days. 
Little or no after-treatment is employed, binders, douches, and the like being 
unheard of. This neglect of the baby accounts, I imagine, for the great frequency of 
umbilical hernia amongst Arab and Nuba children, a deformity popularly attributed to 
the witch Um-El-Sibian. 
One inidwufe claimed to be able to prognose a girl or a boy by the fact that, if 
there be a girl in ntero, a blue vein appears on the mother’s abdomen, extending from 
the umbilicus to the pubes. If a boy this vein extends from the epigastric region to 
the pubes. 
