The man's legs and feet particularly were dreadfully swollen, and he was in great misery lying in the open canoe under the hot rays of the tropical sun. I did not try to combat the man's idea, but I was sure that his condition was caused by some of the malicious insects which abound in that part of the world. It certainly was a strange way to treat a patient, for I had to get in my canoe and lean over the edge into the other boat, which was a small, narrow one, and only large enough to hold the sick man and the one who was paddling. The man said that he was taking the patient down to the coast to me, and seemed quite relieved to find me in the interior, six hours' journey from the place where he expected to find me. I gave the man a fourth of a grain of morphin, and swathed his swollen limbs in a solution of bichlorid, and took one of our water bottles and made another supply of the bichlorid wash and told him to keep the cloths wet with it. (I always carried a solution of Hg.Cl.,, I in 20, with me, and from this I made my solutions of different strengths.) I also gave him two C.C. pills to take that night, and told the man to take him on down to the coast to a native town near our station, and if he was not better the next day to come after me.

I then started again for the town of Jurnee, and after about twenty minutes' walk through an African forest (fortunately there was a foot-path through it) we emerged into an open space and here we found a collection of forty or fifty of the typical native huts, made of mud wattled over a framework of bamboo or mangrove saplings. Their houses have neither doors nor windows, though necessarily a doorway through which to enter. Some of these doors are closed at night by dropping a mat in front of them. Immediately on reaching the town I asked to be taken to the sick woman, and was shown to a hut, rather larger than the usual ones, being about double the size, and about eight

feet in one direction and about fourteen in the other, and in this case a doorway was opposite to the one through which I entered. Lying on a so-called bed (which was an elevated platform about a foot higher than the floor of the rest of the hut, and was made of hardened earth) was a woman about thirty years of age, and it did not take me long to find out that she was dying as the result of the much-talked-about sleeping-sickness, which up to date seems to have defied all efforts made by the medical profession to conquer it. The patient, I was told, three years before, had had the enlarged glands at the side of her neck (the natives call them kernels) removed, and soon after that this trouble developed, first evidencing itself by suppression of the menses, and afterward a condition of somnolence came on, at first only a drowsiness, which increased month by month, until now she slept most of the time. I was able to arouse her and she was "propped up in bed" for a short time, but as she was inclined to sleep even when sitting up, after giving her some food she was placed in a reclining position again and allowed to go to sleep. Aside from the condition which caused the sleepy state, she seemed dying from starvation, for she was very much emaciated. I asked what they had been giving her to eat and was told the usual food, when they could get her to take it, which was not very often. The usual food consists of rice and palm-oil, or rice and fish-soup, with occasionally some cassada and tubers from which they make several preparations, and from which I believe the tapioca of this country is made, although the natives do not know how to prepare tapioca. It did not seem to me that the patient could live many days* and I told Paul and her people that I could do nothing for her, but they begged me to give her some medicine. As I had no Fowler's solution with me (arsenic has been

*The patient lingered for nearly two months and finally slept herself away.

said to be beneficial, if any drug is) I gave her some quinine and left a few small doses of ergot to be given each day for a few days, leaving also a laxative for her bowels, which naturally were in a constipated condition.

When I left the patient's hut it was after four o'clock and I knew then that we could not return to Cape Mount that night, because it would not be moonlight, and, as I have said, the Moffah River in places is very narrow and shallow. I decided, therefore, to make no attempt to start, but to spend the night in Jurnee. The women of the town killed a chicken and cooked some rice, and some of our boys made a fire and boiled some water and made a cup of tea. As they frequently do the cooking for us at the station they become adepts at making a cup of tea. When the chicken and rice were brought to us in a china wash basin (they had brought it the basin-up from the coast, where they had exchanged some native produce for it) the question was, where were we going to eat it? Fortunately, we had put a couple of spoons in our kit, with other things, so we were not reduced to the necessity of putting our hands in the dish and carrying our food in our clenched fists to our mouth, as the custom of the natives is, but as there was not a table or chair in the town we were in a quandary; however, a bath-towel was spread on the earth in the quadrangular space in the centre of the town and our supper was spread on that, and we sat down on the ground and quite enjoyed it; the boys going into different huts and eating with the people in the native fashion. After our meal was over I made inquiry as to how we would be disposed of for the night, as it was getting dark. In the tropics, the nearer you go to the equator, the closer nature follows the rule of the sun dipping quickly below the horizon at six o'clock, leaving us in darkness long before seven. As we were seven degrees north of the equator, we timed our watches by the disappearance of the sun, although we should have

made it about quarter-past six for the difference in the degrees. We found that Mr. M. and the twelve boys were to be lodged in the palaver-house of the town, in the central part of it, while I was to be lodged in what is considered the travelers' house and is usually built on the outskirts of a town. Every principal town has its palaver house, which is a building sometimes enclosed with three walls and sometimes open on all sides, and covered with a thatched roof, and is capable of holding a great many persons, according to the size of the town, whenever they have a palaver, which is quite frequently, womenpalavers seeming to occur more frequently than any others. The travelers' house is something like a long cage of wickerwork or bamboo-work; the dimensions are something like that of a church pew and about six feet high, with a thatched roof; a bamboo platform keeps the sleeper from resting on the ground. There are no windows, but that need not distress one, as there is plenty of ventilation through the interstices of the bamboo-sapling walls. A doorway on one side has a mat to drop over it when the guest is inside. As the people in that part of the country wear very little clothing, and what little they do wear they never take off, there is no provision made for a dressing-room and there was nothing for meto do but to goin the bushes and after undressing plunge into this berth, as you would in a berth on a railway car. I did not like this arrangement, as there are many wild beasts in that part of the country, and I did not like to be alone out there, away from my boys, so I told Paul, on whose account I had come to the town, that I wanted to sleep farther in the town, and then the head-man, or chief, gave up his palace (?) to me. This was an improvement on the guest house, for it was ten feet by six, and I could go inside to prepare for the night. The walls were made of the usual wattled mud but they had many large cracks in them, and covering the doorway was a mat, which was

in rather a dilapidated state, so that I had to blow out my lantern while I was getting ready for rest, but lit it again, after I had settled myself on the mud platform which did duty for a bedstead. I could hear the bush-rats scurrying through the thatch overhead, so thought it wise to have a light in my hut.

Before retiring for the night I thought that I would visit my patient, and with my lantern stole forth. My lantern was the only light in the town, except a few dying embers in some of the houses, as I passed them. When I reached my patient's house I pushed aside the mat hanging in front of the doorway and attempted to step over the threshold, but could not, for lying around in all directions were men, women and children; just as they had been in the daytime so they had lain down when darkness came, without any attempt to fix a bed of any kind; one or two of the older ones had a log of wood for a pillow, and one of two had a thin grass mat under them, but the majority lay on the bare earth. I saw that I could not step over the sleepers, they were

SO

crowded together, without wakening many of them, so I peeped around the corner and saw that my patient was apparently sleeping (as there were the remains of a fire in the centre of the hut I could see the interior very thoroughly.) I dropped the curtain and left them to their night's repose, which was more than I had, for I could not sleep very much, as I could not help watching the mat, which separated me from what?

Early the next morning the boys brought me a bucket of water for my bath and several of the native women came in to see a white woman get ready for the day's performance. They did not seem surprised when I washed my face and they watched me intently as I put on my different articles of clothing, but I created the greatest sensation when I began to comb my hair, as they had never seen a long-haired creature before, as the day before I had kept my hair coiled on the top of my head, in my usual way. One of the women

flew excitedly out of the hut and returned in a short time with other native women, and there was much chattering and exclamations. I did not know if it meant admiration or commiseration, but they certainly were astonished that such creatures as straight-haired women existed, and as my hair is rather long that seemed extra strange to them, for their hair is very short and kinky.

After a breakfast of tea and biscuits and hard-boiled eggs, we prepared for our homeward journey. After going through the forest we were just about to embark in our canoe when I heard a shriek of terror and found that it came from a boy about fourteen years of age, who had not seen me the day before, and who was frightened at my appearance. No white woman had ever visited that part of the country before, and he did not know what to make of me. I tried to make advances to him, but every time I drew near him he ran shrieking into the bushes. I finally pushed away from the shore and then the little fellow ventured out and watched us until we were out of sight. We were a little slower in returning, on account of the tide, but I was glad that I had responded to the call, for although I had not been able to help Paul's foster-mother much, still I had helped the man with the poisoned foot and some other people at a town at which we stopped on the way home. Still, I was glad to have a bath and lie behind a closed door to rest, where I need not watch the door to see if a leopard or some other gruesome beast was coming to visit me.

It is interesting to know that whereas in some parts of the country the people believe that if their "kernels" are removed they are apt to have the sleeping-sickness, in other parts quite near they believe the other way, that unless the "kernels" are removed they are bound to have sleeping-sickness, and this accounts for the readiness with which they submit to the operation at the hands of the mandingo-man.

I

WISH to tell my sister nurses who read the TRAINED NURSE of a very interesting and unusual case I had some time ago. The physicians who had the case at the time said it was the first one of the kind they had ever seen. Patient, male, 28 years of age, laboring man, who claimed that he had suffered much for some months with great pain in the back and limbs. The physician he called in told him he was in a general rundown and overworked condition and needed rest, good nourishing food, etc., gave him tonic of iron, quinin and strychnin-3. t.i.d., A.c. The poor fellow was not able to stop work for financial reasons, just then, but some few weeks after was forced to do so by pain caused from an abscess which appeared below the right shoulder blade, about an inch and a half from the spinal column, and another on the inside of the left leg, above the knee, some six or seven inches; the edema was great about both wounds and they were very painful, discharging profusely all the time. Each abscess was as big (about) as a ten-cent piece. Temperature at first ran from 98.4° to 98.8°A. M. and from 99.4° to 100° P. M., only taken b.i.d. then. Pulse remained about 100 during first few weeks. Treatment, irrigation of both wounds t.i.d. by sterile normal saline solution.

One day, several weeks after abscesses first appeared, I found that by putting irrigating tube to wound in back that the pus and water was not coming back but was running freely out of the wound at the inside of the knee, and as I got more of the pus out I could get a free flow from the wound in the shoulder by putting tube into abscess in leg. Physician stopped iron, quinin and strychnin and gave iodid of potassium-mx, t.i.d., P.C.; light diet. Some weeks passed in this way, but patient got no better, in fact, was getting

much weaker and pus was growing more and more profuse. We could then hold a pus basin to either wound and in a few minutes it would be filled with pus alone. Temperature began to rise till it would run from 101.2° to 103° P. M., with an A. M. temperature of 100° or 101°. It was quite impossible to keep any dry dressings on him at all, or the bed clean, as the bed would even be wet through inside of an hour after the wounds were dressed. Changed to bichlorid dressings wet and wounds cleansed with peroxid hydrogen after first irrigation with sterile water, followed by normal saline solution irrigation before bichlorid dressings were applied. Temperature kept getting higher and higher till it had reached 102° A. M. and 104° or 105° at night. Pulse remained 118 to 124. Strychnin, 1-60 gr. hypodermic, was given g.4.h. The doctor made a careful and close examination of both wounds and spine, and said it was necrosis of the eighth and ninth (I believe he said eighth and ninth) vertebræ and that he had no hope of his being better. He could do no more, keep up same treatment, etc. Patient got very blue and discouraged. One day, when his wife of only a little over a year called, he asked the doctor with tears in his eyes if he was to die and when. The doctor answered that he was not getting any better, but that he might even yet get the best of it. The poor fellow seemed to understand that the doctor had given him up. He begged and begged that the doctor would try to save his life for his little baby, for his wife, that they would not be left alone without friends or money in this big, strange country. Could he do nothing, nothing at all, more for him? Something, anything to make him well? It was so sad we almost all cried. He had fought so hard to live, had been so patient. Dr. B. said he would think it over

and try to find something to help him. Next day he came again and told the patient what the trouble was and that unless some change came at once he feared he would not get well. Of course, he had some little chance to, but very little. He offered to operate on the spinal column the next week, remove the dead bone and try in some way to fasten the healthy vertebræ together with silver wire, or place two silver pieces, which he would have made, to take the place of the dead bone, if he found it possible to do so after the dead parts were taken out. In fact, he told him frankly he did not know just what he could do till he got him on the table. He pointed out that it was a last chance and a great risk, with very little or no gain for him beyond the hope of bettering his condition or saving his life. He also told him that as far as he knew it had never been done before. But operate or not, he had one chance in a hundred to live. Dr. B. explained all this in the nicest way and left after telling him to think it over before he told him if he wanted to try it. The poor patient lay awake all that night, talking it over with his wife, and when Dr. B. came in the morning he cried as he told him that he was afraid to have the operation done; that he would try to live as he was. Dr. B. told him it might all be for the best; that he could promise him but little good from the operation, and that he might get well as he was,

etc.

Three days after patient's temperature went up to 106° P. M., pulse 138, respiration 44, and we knew the end was not far off. Five days more passed before he passed

quietly away one afternoon-just slept out. We thought it a rather remarkable case in many ways and we shall always remember and respect Dr. B. for his kindness to one poor soul, without friends or money, far away from his own country, in his great trouble and death-Dr. B.'s courage in being willing to undertake an unknown operation which would cost him great labor, skill and much expense in the hope of saving one poor life, which many would not consider worth anything at all, for which he could not get one cent of money and, no doubt, would receive blame should the man die during the operation.

We had all grown to love the poor fellow, who had lain for so many weeks on that little bed, fighting, always fighting, till the last little hope was taken away from him, suffering day by day without one word, till God closed his eyes in sleep from which he did not have to wake for another day of pain, but only let us hope on a brighter, happier place than this can ever be. We were all sorry Dr. B. was not able to try the operation on him, for we hoped with his great skill he would be able to save him and show a new and wonderful work to the world, which might help many others some time in years after. But it was not to be that way, and I can only say that I am glad he did not stay here longer, to suffer that awful pain day after day, with no hope ahead to look to. Good-night, good sleep, good rest from sor

row,

To those to whom's no good to-morrow. -Swinburne.

Rules of the Buffalo Nurses' Association 1. Do your part.

2. Pay your dues promptly.

3. Attend all meetings if possible.

4. If you accept office, perform the duties of that office as faithfully as if you were receiving compensation.

5. If you have criticisms make them known at the meetings. Remember that she who finds fault and offers no remedy sinks to the common level of a scold.

6. Inform the corresponding secretary of changes of address.

7. Think for yourself.