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. All abscesses they open with the
actual cautery; and the dressings are composed of either soft leaves,
shea-butter, or cows' dung, as the case seems, in their judgment, to
require. Towards the Coast, where a supply of European lancets can be
procured, they sometimes perform phlebotomy; and in cases of local
inflammation, a curious sort of cupping is practised. This operation is
performed by making incisions in the part, and applying to it a bullock's
horn, with a small hole in the end. The operator then takes a piece of
bees-wax in his mouth, and putting his lips to the hole, extracts the air
from the horn; and by a dexterous use of his tongue, stops up the hole
with the wax. This method is found to answer the purpose, and in general
produces a plentiful discharge.