Folios 218 to 228 discuss the value of pathology and the findings of post mortem...

ADM 101/82/2/9

1840-1842

Folios 218 to 228 discuss the value of pathology and the findings of post mortem examinations of those who died from the fever. The symptoms and progress of the disease are related to the state of the internal organs, particularly the irritability of mucous linings in African diseases. The effects of chronic inflammation or ulceration of the gastro enteric mucous membrane are discussed, and the effects in cases of colic, rheumatism, dysentery and intermittent fever. The surgeon debates whether an attack of Niger Fever gives any immunity against a second attack and concludes it does not. The opposite is more true but the second attack may not resemble the first, being remittant or intermittent in nature depending on a number of causes.

Folios 229 to 239 discuss the possible causes of the fever. Climate, marshes, decomposition of animal and vegetable matter, sea water entering marshes and the presence of sulphuretted hydrogen are mentioned. Professor Daniell's theory on the production of sulphuretted hydrogen and Sir William Burnett's order to measure the amount in the waters off West Africa, the means of doing so and the results, are all mentioned. Letters from Surgeons John Tait of the Buzzard and Mr Goodridge of the Iris are quoted, the first saying there was no trace of sulphuretted hydrogen in a sample when it was taken but after it had been corked for two months there was. The surgeon's own observations in mangrove swamps are noted. A large chart is inserted between Folios 236 and 237 showing the results of tests for sulphuretted hydrogen at various places, recording the temperature and specific gravity of the water, date and season and remarks, no sulphuretted hydrogen was found. A case is related by the Captain of HMS Dolphin of a stage alongside his ship being the source of a terrible odour believed initially to be coming from the hold and to which a case of fever seems to have been attributed. Sulphuretted hydrogen was found by the surgeon in the water of his shower at Ascension Island and the surgeon wonders how it may be formed in such conditions but not on a grand scale in the estuaries of the African rivers. He concludes that fermentation or putrefaction must play a part but that the process remains an object of inquiry.

Folios 240 to 242 discuss prophylactic measures, such as wearing flannel, reducing the numbers on deck at night, issuing quinine, and atmospheric conditions, heat, humidity and ventilation. The surgeon thinks the germs of disease were contracted in the delta but did not develop until they reached Idah where the air was stagnant, roughly 16 days after 'the miasmatous poison was first imbibed'. The black crew mostly escaped with the exception of those who had been in England for some years, demonstrating that their comparative immunity could be lost. The best time to enter African rivers is discussed. Folios 243 to 245 discuss treatment. Removal from the source of the fever is recommended. General bloodletting is not so effective in African as in West Indian fevers but local bleeding may be useful. Blisters were of great service. Mercury was in most cases ineffective. The best diaphoretics were the James' Powders. Purgatives were needed in the early stages. Quinine was given 'when the tongue began to clean at the edges and other symptoms indicated that the functions were returning to a normal condition' but in some cases had to be given almost immediately. No medicine was more effective in diminishing the severity of the paroxysms than quinine.

Folio 246 has a table showing a 'Statistical account of the cases of fever that occurred on board HM Ships Albert, Wilberforce and Soudan, while in the Niger'. The Amelia and the Model Farm are included in the figures for the Albert. Separate statistics are given for 'white' men and 'men of colour'.

Folio 247 has a table summarising the table on page 245 and also a table showing a 'Return of the total mortality, stated under the respective ships to which the officers, seamen, marines etc belonged: Form the time the expedition left England to its completion'.

Folios 248 and 249 have two tables, a 'Statement of the number of officers, seamen, marines and sappers and of Kroomen and liberated African boys, including agriculturists, composing the crews of Her Majesty's Ships, Albert, Wilberforce and Soudan: on entering the River Nun on the 12th August 1841' on page 248, and 'An analysis of the cases of fever: that occurred on board the steam ships Albert, Wilberforce and Soudan', on Folios 248 and 249.

Folios 250 and 251 discuss; the cases of the 'men of colour' affected and whether they had recently lived away from their respective countries; the fatal cases and which ships they originated on; the different routes taken by the three ships.

Folios 252 to 253 have a discussion 'On the latency of the poison' and suggests the possibility of a steam vessel, with a minimum of white men among the crew, reaching the confluence and returning to the sea in 14 days and the importance of reaching the city of Rabba. Nothing certain can be said about preventing the fever but the surgeon recommends 'the daily use of quinine with a good diet and a moderate allowance of wine' so that 'the body should be an exhaling rather than an absorbing surface'.

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