HISTORY OF MADAGASCAR. 
219 
inflammatory symptoms increase instead of diminishing, little 
hope of recovery is entertained, and nature sinks rapidly; 
delirium, deafness, insensibility ensue, and death terminates 
the scene. 
Among the diseases to which the Malagasy are exposed 
in common with the natives of the adjacent continent of 
Africa, and other parts of the world, the small-pox, which 
they call nendra , is the most formidable. How long this 
fearful scourge, whose ravages are so fatal among uncivilized 
communities, has existed in Madagascar, is not known, but 
it was found there by the early missionaries, was reported 
to have been known long before that period, and has 
recently prevailed to an alarming extent; many of the 
natives, of every period of life, and of all ranks, from the 
highest in authority, to the lowest slave, bearing in their 
persons the unquestionable marks of the virulence with 
which it sometimes prevails. Apoplexy, epilepsy, and 
paralytic diseases but seldom occur, nor are pulmonary 
disorders frequent. Inflammatory affections of the bowels 
prevail at certain seasons, while, as might be expected from 
the free use of unripe fruits and vegetables, and unsuitable 
meat, few of the natives are exempt from stomach disorders, 
produced generally by the crude and unwholesome nature, 
and the large quantities, of their food. Dropsical complaints 
frequently occur, and many are afflicted with a hard and 
painful internal swelling in the diaphragm. Leprosy, which 
they call boka , prevails, though the unhappy victims of this 
hopeless disease are not numerous.* 
* A restriction respecting lepers prevails in Madagascar, resembling that 
enjoined by the Mosaic code. They are not allowed to mix with other 
portions of the community, or to live in the towns or villages of the people, 
but in separate houses erected expressly for them at some distance from all 
others. 
