to time there can be no question: at Fernando Po in 1862 and 1866, in Senegal pretty frequently, and at least one epidemic at Bonny was true yellow fever. But in the case of each of these outbreaks it is said to have been imported from South America, into Fernando Po, by ships from Havana, and into Bonny by a ship which had on her previous run been down the South American ports with a cargo of mules. The litter belonging to this mule cargo was not cleared out of her until she got into Bonny, when it was thrown overside into the river, and then the yellow fever broke out. But, on the other hand, South America taxes West Africa—the Guinea Coast—with having first sent out yellow fever in the cargoes of slaves. This certainly is a strange statement, because the African native rarely has malarial fever severely—he has it, and you are often informed So-and-so has got yellow fever, but So-and-so does not often die of it, merely is truly w retched and sick for a day or so, and then recovers.
Regarding the hæmaturia there is also controversy. A very experienced and excellent authority doubts whether this is entirely a malarial fever, or whether it is not, in some cases at any rate, brought on by over-doses of quinine, and Dr, Plehn asserts, and his assertions are heavily backed up by his great success in treating this fever, that quinine has a very bad influence when the characteristic symptoms have declared themselves, and that it should not be given. I hesitate to advise this, because I fear to induce any one to abandon quinine, which is the great weapon against malaria, and not from any want of faith in Dr. Plehn, for he has studied malarial fevers in Cameroon with the greatest encergy and devotion, bringing to bear on the subject a sound German mind trained in a German way, and than this, for such subjects, no better thing exists. His brother, also a doctor, was stationed in Cameroon before him, and is now in the German East African possessions, similarly working hard, and when these two shall publish the result of their conjoint investigations, we shall have the most important contribution to our knowledge of malaria that has ever appeared. It is impossible to over-rate the importance of such work as this to West Africa, for the man who will make West Africa pay will be the scientific man who gives us something more powerful against malaria than quinine. It is too much to hope that medical men out at work on the Coast, doctoring day and night, and not only obliged to doctor, but to nurse their white patients, with the balance of their time taken up by giving bills of health to steamers, wrestling with the varied and awful sanitary problems presented by the native town,
