There is a prevalent Coast notion that white men do not catch small-pox from black, but I do not think this is, at any rate, completely true. I was informed when in Loanda that during an epidemic of it amongst the natives, every white man had had a more or less severe touch, and I have known of cases of white men having small-pox in other West Coast places, small-pox they must either have caught from natives or have made themselves, which is improbable. I fancy it is a matter connected with the vaccination state of the white, although there seem to be some diseases prevalent among natives from which whites are immune--the Yaws, for example.
Less terrible in its ravages than small-pox, because it is far more limited in the number of its victims, is leprosy; still you will always find a case or so in a district. You will find the victims outcasts from society, not from a sense of its being an infectious disease, but because it is confounded with another disease, held to be a curse from an aggrieved Nature spirit. There was at Okÿon when I was there a leper who lived in a regular house of his own, not a temporary hospital hut, but a house with a plantation. He led a lonely life, having no wife or family or slave; he was himself a slave, but not called on for service--it was just a lonely life. People would drop in on him and chat, and so on, but he did not live in town. There was also another one there, who had his own people round him, and to whom people would send their slaves, because he was regarded as a good doctor; but he also had his house in the bush, and not in town.
Undoubtedly the diseases that play the greatest continuous havoc with black life in West Africa are small-pox, divers forms of pneumonia, heart-disease, and tetanus, the latter being largely responsible for the terrible mortality among children; but the two West African native diseases most interesting to the European on account of their strangeness, are the malignant melancholy and the sleep sickness, and strangely enough both these diseases seem to have their head centre in one region--the lower Congo. They occur elsewhere, but in this region they are constantly present, and now and again seem to take an epidemic form. Regarding the first-named, I am still collecting information, for I cannot tell whether the malignant melancholy of the lower Congo is one and the same with the hystero-hypochondria, the home-sickness of the true Negro. In the lower Congo I was informed that this malignant melancholy had the native name signifying throwing backwards, from its being the habit of the afflicted to throw themselves backwards into water when they attempted a drowning form of suicide.[24] They do not, however, confine themselves to attempts to drown themselves only, but are equally given to hanging, the constant thing about all their attempts being a lack of enthusiasm about getting the thing definitely done: the patient seems to potter at it, not much caring whether he does successfully hang or drown himself or no, but just keeps on, as if he could not help doing it. This has probably given rise to the native method of treating this disease--namely, holding a meeting of the patient's responsible relations, who point out elaborately to him the advantages of life over death, and enquire of him his reasons for hankering after the latter. If in spite of these representations he persists in a course of habitual suicide, he is knocked on the head and thrown into the river; for it is a nuisance to have a person about who is continually hanging himself to the house ridge pole and pulling the roof half off, or requiring a course of sensational rescues from drowning.