This Last Mentioned Complaint Appears, At The Beginning, In Scurfy Spots Upon Different Parts Of The Body, Which Finally Settle Upon The Hands Or Feet, Where The Skin Becomes Withered, And Cracks In Many Places.

At length, the ends of the fingers swell and ulcerate, the discharge is acrid and foetid; the nails drop off, and the bones of the fingers become carious, and separate at the joints.

In this manner the disease continues to spread, frequently until the patient loses all his fingers and toes. Even the hands and feet are sometimes destroyed by this inveterate malady, to which the Negroes give the name of _balla jou_, "incurable."

The _Guinea worm_ is likewise very common in certain places, especially at the commencement of the rainy season. The Negroes attribute this disease, which has been described by many writers, to bad water, and allege that the people who drink from wells are more subject to it than those who drink from streams. To the same cause they attribute the swelling of the glands of the neck, (goitres,) which are very common in some parts of Bambarra. I observed also, in the interior countries, a few instances of simple gonorrhoea; but never the confirmed lues. On the whole, it appeared to me that the Negroes are better surgeons than physicians. I found them very successful in their management of fractures and dislocations, and their splints and bandages are simple, and easily removed. The patient is laid upon a soft mat, and the fractured limb is frequently bathed with cold water.

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