AND THIS TIME, NO ONE DIED

The Scottish doctor William Balfour Baikie led the first expedition up the Rivers Niger and Benue in which not a single European succumbed to malaria.

The expedition was sent out in 1854 by a previous explorer, Macgregor Laird, who was supported by the British Government. There were 12 Europeans, and 54 “persons of colour” on board the river steamer Pleiad, and while there were some cases of “the African fever,” there were no deaths. The Fernado Po-based Consul John Beecroft, was originally expected to lead it, but he died before Baikie arrived from the UK, and Baikie, appointed surgeon and naturalist for the expedition, took over command.

William Balfour Baikie
Dr. William Balfour Baikie, leader of the 1854 expedition up the Niger

The key to Baikie’s success in avoiding the known ravages of malaria lay in his daily administering of the right dose of quinine to the Europeans on board the river boat. The discovery of the dose for keeping Europeans alive was one of the key factors that made it possible to colonize the Western part of the continent, the home of Anopheles Gambiae, the mosquito vector for the deadliest strain of malaria, plasmodium falciparum. It was a long slow process of medical discovery.

Anopheles Gambiae 2
Anopheles Gambiae mosquito

Malaria was not the only disease that killed white men in West Africa. There was also dysentery. Emetine, a solution to that particular problem, especially amoebic dysentery, was isolated by French chemist Joseph Pelletier in 1817. The South American Cinchona bark was found to be effective against malaria, and Joseph Pelletier and Joseph Caventou isolated quinine from the bark in 1820.

Cinchona bark
Cinchona bark, found to cure malaria

After this, the use of quinine spread around the malarial world. It was found that the drug could be used to prevent malaria by taking a daily dose. But because the drug tasted unpleasant, people were reluctant to take it, and many did not take the required dose. While he was in Africa, the Royal Navy surgeon T.R.H. Thompson experimented with the dosage recommended for the Royal Navy, and eventually arrived at the dosage of 6 to 10 grains. He had no symptoms while he was in Africa but got malaria when he returned to England and stopped taking it.

There was also a long battle against dangerous forms of treatment. The French professor of medicine, Francois Broussais was a leading figure in the treatment of malaria in the early 1800s. He is said to have strongly believed that fevers were caused by inflammation, and advocated a “light diet, heavy blood-letting, and heroic doses of mercury and opium.” The British doctors similarly believed in bleeding and purging.

220px-BloodlettingPhoto from 1860 in Wikipedia
Photo of bloodletting from 1860 (from Wikipedia)

 

According to the book Disease and Empire, by Philip Curtin, the practice in West Africa was to take 20-50 ounces of blood when the fever began, and take more as time went on up to 100 ounces. It should be noted that the human body contains about 180 ounces of blood.  Much of this ignorance passing as the best scientific medicine was likely to have contributed to the high death rate from “African fever.”

But by the 1850s, a move away from these dangerous practices to more effective cures began to happen, and doctors began to stop recommending bleeding and the use of mercury. By the time Dr. Baikie embarked on his expedition, he seems to have known what dose of quinine to administer. He followed the prescriptions of Royal Navy Doctor Alexander Bryson who studied the medical records of British ships on the African coast and made recommendations that were published and sent out as circulars to British stations in West Africa.

Baikie wrote in his journal at beginning of the trip up the Niger:

“Being now fairly in the river we commenced giving morning and evening to all the Europeans on board two thirds of a glass of quinine wine which contained about five grains of quinine believing that this would act as a prophylactic or preventive, while exposed—as everyone must be while in the Delta—to  the influence of malaria.”

But even as Dr. Baikie was administering an effective cure for malaria, he and his compatriots held onto misguided beliefs about the disease and its cause, and some of these views persisted until the 20th century. It will seem strange to 21st century readers that medical science was able to find a cure for malaria without knowing the cause or even understanding how the disease worked, but that is what happened.

Baikie wrote while in Britain after his successful first exploratory trip that “African fever has nothing specific about it…it is merely an aggravated form of the disease known in this country as ague.” He added that quinine was useful for preventing the disease, and that the “other means of avoiding the disease are such as reason and common sense would suggest, namely, avoiding night exposure, sleeping in the open air, or delay in sickly spots, etc., and for Europeans a rather generous diet, with the frequent use of the shower bath.” It was a confused combination of right and wrong ideas: sleeping in the open air and night exposure brought on mosquitoes, so he was right—without really understanding why—about avoiding such practices. A generous diet and frequent baths did nothing to cure the disease.

Baikie traveled with the African missionary and ex-slave, the Reverend Samuel Ajayi Crowther, who was interested in setting up Christian outposts among the “pagans” encountered on the trip. From the evidence of their letters, both seem to have gotten along very well, and seem to have been in agreement that Christianity would bring “civilization” to the Africans.

Samuel-Crowther-e1414707411287 second pic
Samuel Ajayi Crowther, freed slave and first bishop of the Niger

Baikie was a dedicated observer and recorder of the peoples and languages he encountered. He appears to have taken the time to ask as many questions as he could of the Africans. Many of his observations about the Igbos he encountered are spot on. His surname is immortalized in the Southern Igbo dialects, where the word for “White Man” is “onye Bekeh,” or one of “Bekeh’s” people.

There is no doubt that the information gathered by explorers like William Baikie, Macgregor Laird and the Landers was very useful in the colonization of West Africa.

SOURCES

Narrative of an Exploring Voyage up the Rivers Kwora and Binue (commonly known as the Niger and Tsadda) in 1854, by William Balfour Baikie

Disease and Empire: The health of European troops in the conquest of Africa, by Philip D. Curtin

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