a. w. howlett 301 - bmj military health · a. w. howlett 301 effect is blocked or satisfied by...

A. W. Howlett 301

effect is blocked or satisfied by previous combination witb thc glucose which is presellt in this preparation.

Habut and Oury (Presse Medicale, September 20, 1922) record two fatal cases of hmmorrhagic purpura after novarsenobiIlon. In discussing this forlll of A.l'seno-benzol poi soning they draw at.tention to the occurrence of purpura in wOl'kers exposed to ben zol, and suggest tbat the benzol combinatJOD rather than the arsenic is a possible c.lllSe.

A recent case has been reported by C. M. Smith (A1·ch. Denn. and Syph., F ebruary, 1\:)25), following the administration of arsphenamin and mercury. Tn thi s case there was bleeding from the nose and gUlus after the twenty·thil'd injection, and flofter the twenty-fourth profound collapse, cyanosis, weakness, and more severe bleeding from the nose, gl11llS and rectum. rJ.1h e case sur ived.

I am indebted to Major F. Casement, D.S.O., R.A.M.C., (or permission to use extracts from hi s report on the post-mortem examinatioll , and to Major F. C. Sampson, D.S.O., R.A.M.C., for permission to record the case .

• trra\lel.

A VISI'l' '1'0 HONDURAS-AND RETUl{N. By ::liAJon A . -W. HOWLE'!"r.

Royal Arnty Medica,l. Co'r)18.

(\V ITIT PnOTOGRAPHS HY 'fU R A V'l'H OK.)

'1'uEnE are no R.A.M.C. in Honduras, but in spite of this defect it considers itself a civilized country and counts itself in the cOlllity of nations. r!'he Honduranians know, for instance, that Llo:yd George is King of Engbnd. Tbey have also heard of Mary Pickford. They told me this themselves, not in any spirit of display, but as men of the world talking to another man of the world. Altbough on first landing and seeing everyone a miniature walking arsenal, Olle might form the impress ion that the life insurance companies were Dot out to do big business bereabouts, one would be wrong to jump to the idea tbat lawlessness is prevalent. Tbere is no crime in Honduras except being on the wrong side in politics. 'l'hat is indeed a serious misdemeanour.

To give you an instance. On our first arrival we were lIledically inspected by a coloured gentlemen of the name of Dr. Jameson, and after he had been duly regaled by the cbief steward, and I had sought in Illy most interested manner to exploit bis vi ews on yellow fever, of whicb he appeared never to bave heard, we shook bands and parted with mutual hopes of seeing Olle another next tilne. I never saw Dr. Jarneson again ; nOlO was it any defect in his appreciatiou of yellow fever tbat bad lost him

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302 A Visit to Honduras- and Retnrn

his job . 'Nhen I came back, some six weeks later, there was a new port doctor. When I inquired 01 the new port doctor what !had happened, he smiled, much as a child might smile when asked by a suspicious mother what had become of the jam, and then replied with a touch of irritation at tbe colossal stupidity of tbe foreigner: " '.rhere has been a revolution since you were here."

Railway sidi ngs for asoembly of ba.Ulm!\. trains.

A bl\uaua-loaded t.ruck.

So apparently my friend Dr. Jameson had to go on the dole, or, what is tbe same thing in Honduras, retire to the forest where doubtless, though hi s professional acquirements may become 11 littl e rusty and even snffer a total eclipse, he will possess himself in patience until word comes that the " right side 11 is up again.

H onduras is the most backward of th o Central American republics. Tt bas fJ O roads and the only means of getting about is by the railways with which the great United Fruit Company has interpenetrated the hush. The coast is of a s>lvagely tropical aspect with a low littoral frmged with




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A. W. Howlett 303

palms, like the tassels on an .. nhmacassar, and in the hinterland an uplift of rocky heights clad in tangled masses of verdure . When I first beheld it, it was in the grip of a tropical storm, it being near Christmas and the season of th e rains. The palm trees along the shore were writhing like bacchanals, and gigantic swathes of woolly mists rolled and unrolled adown the mountain sides. Nevertheless, I went ashore having all the curiosity of a scboolboy to ex plore tbis encbanted land where, as it seemed, real pirates migbt be lurking in every busb. I bave never been a pirate and no one except tbe paymaster has ever credited me with piratical instincts ; but if wild nature can be held guilty oC impelling to piracy, if it is ever morally justifiable to be a pirate, th en, tbought I, tbis is the venue. 'I'he rain came

Up·country ranch sbowing ra.in·wa.ter buLts.

down as if from a thousand hoses, and the long wooden jetty, where tbe train· loads oC bananas come roaring and rattling down to tbe sh ip, was all awash with puddles up to the knees.

The town was in two balves, a muddy creek which slid in slimy shallows over the beach dividin g them. On the left was tbe old Spanish town, inaccessible at tbe time as tbe revolution was going on in it and the streets were not healthy; on the rigbt was tbe new foundation of the fruit company. And tbis was a creation worthy of a little study by those interested in tropical architecture. It may be taken as an axiom tbat the American in " Littl e Ole Noo Yorl, " kllows tb e art of living, and be does not lose much of it wben be goes abroad. Not for him tbe old Indian bungalow with its mud walls and cracked doors at an annual rental of ooetbird its original value, its asylum for old and infirm snakes in the roof and




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304 A Visit to Hondums--and Retum

its shelter for working centipedes in tbe cracks of the plaster. I made my way to tbe bouse of the padre, whither I bad been invited, and, albeit it was a spot lately reclaimed from tbe clamant jungle, whicb bere will engulf an Olympia if it is left to it for a fortnight, I found trim paths 01 asphalt witb tbe grass and berbage nicely clipped and channels for tbe escape of surface water. Tbe house itself was built ou piles some four feet above tbe ground. Like all the otber buildings in tbe settlement, it was painted a dirty mustard yellow, a hue unbeautiful enougb, but one wbich I was a.ssured bad been found after lUuch experimentation to reduce the temperature two degrees below auy other. A verandah ran all round the house closely gauzed in against mosquitoes. Witbin tbis again doors and

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Hondura.s coast in a. ga.le.

windows were similarly protected. A mosquito did not stand a dog's cbance. Indeed, those insects seemed to have gone out of business. I never even saw one in this locality tbough there were plenty up-country.

'1'0 one familiar with the barnlike structures in whicb the European lives in India the comfort of this dwelling was amazing. Inside was an electric stove, and the kitchen replete with ice chest, milk pail, meat safes, etc., would have delighted a Kensington flat-wife. There was a sort of communal cold store so that fresh meat and vegetahles could be drawn as required. Altogetber I could not belp tbinking that here was a model of wbat a tropical cantonment should be, and I am bound to say it left me with a sense of no little bitterness to recall tbe conditions under whicb tbe British officer, whether military 01' civilian, is expected to cn.rry on the great traditions of bis race and stand as "ma-bap" to a population of




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A. W. Howlett 305

dependent millions. I think I can see one of the officials of the great fruit company being asked to hang up his bat in a typical Indian bungalow. "Say Bud, I don't reckon to be over-partic'!er, but I ain't a caveman. Ever hear of mosquitters? Maybe yer can't help one or two in yer bunk now and tben, but I don't reckon to marry tbem," and so on.

One wonders if tbe world at large realizes that America is rapidly committing herself to tbe establisbment of an empire, and tbat in spite of berself. Tbe expansion of a great people seeJUs inevitable wbatever tbeir predilections towards self·centrement. As tbe Britisb Empire grew out of tbe fierce rivalries of the spice trade, so before many decades are overpast an American empire, in fact if not in name, will bave sprung out of tbe banana trade. Tbe magnitude of this fruit business is bewildering; practically tbe whole being of Central America depends on it. And the West Indies themselves, even tbose under nominal British suzerainty, are coming rapidly under the domination of United States finance.

It is no very hazardous prediction tbat tbe close of this century will see tbe whole of America, from tbe Canadian frontier to Ecuador, a congeries of closely-knit States indistinguishable from an empire in all but the name.

The railway track, which appeared to be about metre gauge, as it is in all tbe republics hereabouts, wbicb owe their railways to American enterprise, threads all tbe coastal lowlands and the valleys up-country. Save where tbe land has been cleared for bananas, it is hedged in closely by the jungle. A special apparatus like a "Flalllmenwerfer" is attached to a railway truck, and once a fortnight or so is drawn through the forest to scorcb with its dragon breatb the ever.encroaching growth whicb, but for tbis, would speedily engulf the track. 'rhe train rocks and sways on pile-built viaducts over morasses wherein lies buried the decay of centuries; and it is no exaggeration to say that if it were to stop anywbere except at a clearing it would be impossible to get out of it, Ba dense are the forest walls around it.

It is a wonderful thing to sweep on through the mystery of these forest walls, and to know that bundreds of furtive eyes are watching you from the sun·sbot sbadows, eyes of j~guars, pumas, ocelots, pythons, deer and monkeys; to count the parasites tbat hang from the boughs, and the magnificent trumpet-flowers that waste tbemselves in a prodigality of unrecorded splendour; to experience that entbralling sense of trespass into domains that were never meant to be sullied by tbe footsteps of mankind. I spent a day in a rancb up country. It was like walking into a book of old adventure stories, such as we were regaled with in our young days by "Kingston or Ballantyne the Brave." It was the mess of about adozen cowboys, and eacb one as he cawe in unslung his revolver and belt of cartridges and bung it on a bat-stand beside tbe table. Tbe JUeal was served by a coal-black rnarnrny of prodigious proportions who went by tbe name of Doris. We drank rain·water, which was collected off the roof into

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306 A Visit to Honduras-and Retu17'

a great water-butt, and though it was brown and sligbtly mawkish, it appeared to do nobody any harm. Water there was in plenty in the pools and swamps, but that, of course, was nnfit to drink, and was only used for washing. Like the bungalows on the coast the whole hacienda was mosquito proof. After luncb we sat in the verandah in easy chairs enjoying

Bana.na loading quay.

the soft caresses of the sea breeze which set the palms astir with a murmurous somnolence. In the evening we repaired again to the ship which during her stay in the bay was converted into a sort of palais de dance. There were American schoolmisses tbere who, though they had been two or three years in the settlement, might have just stepped off a street-car in Broad way, so fresh and unspoiled were their complexions. In that equatorial climate no further proof was needed of the completeness and eflieacy of American methods of tropical hygiene.




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A. W. Howlett 307

On the shore were miles of railway sidings, with many repail' shops and workmen's dwellings, all painted the same dull monochrome, where the long banana trains gathered overnight. All day long the tireless locomotives were picking up tbe lines of laden trucks and rushing them on to the quay. They were loaded with all speed, for speed is everything in tbe banana trade, and stowed away in the holds . \Vehad a hundred thousand bunches on bO:1rd wben we sailed. Nothing could exceed tbe care lavished on them. Special bolds were arranged for their bestowal, carefully ventilated, and kept at a uniform temperature of .,8 degrees all the voyage. Every three or four hours the temperature of tbe sea was taken -for one is apt not to realize that the beat inside a sbip is closely affected by that of the sea, more than balf of tbe ship being under water-and the refrigerating m~chinery adjusted accordingly. '1'he walls of the cabills and corridors used to sweat so that pools collected all tbe floors with the condensa.tion of the humid, tropical air against their cbilled surfaces.

"\Vith mernories of terrible days and nights in India., when men used to die out of hand under the flaming sun and the creeping pre-monsoon humidity, I wondered if it would not be possible to iustal in Indian stations some similar devices, if, in short, it might be possible to expend on human beings SOlUe of the tenderness which is lavished on bananas. I went iuto the question with the chief engineel', but callle to the conclusion that under the present regime in India the expense would he prohibitive. Nevertheless, 1 "m still of opinion that" modification of the system would be feasible. A powerful engine, quite independent of the machinery of the ship, compressed air to a pressure of ~OO pounds to tbe illcb, and the sudden release and expallsioll of tbis produced b'l.'eat cold. It was strange to puss frow the sweltering mid-day heat into that room and find snow lying on the deck and pipes swatbed in ice. 'l'he cold air was driven through all the holds by powerful fans, beillg further cooled or l<ept cool by passing. over sets of pipes filled with sal ammoniac.

It would not be needful or desirable to bring the temperature down to 58°, but even jf one could attain to 75° much would be gained, and it shou ld not he beyond the capacity of eugineers to produce a modified forw of the plant which could do tbis. It does seem strange tbat men have had to wait for tbe development of the banana trade to evolve a method tbat might have saved tbem an infinity of suffering, or that they sbould let themselves perish for want of the attention which they call give to a fruit.

Looking over the ship's side on to tbe qu",y was like" glimpse into filmland. Only bere it was tbe real thing. All who could afford tbew wore revolvers with miniature ammullition dumps attached to their persons, 'rhose less well~to·do wore (' rnacbetas," an instrument between a bowie knife and a bayonet. Probably this was the 1110re useful of the two, as it was indispensi1ble for hacking a way tbrough tbe forests and was useful hesides for cbopping firewood. A" sold.do" (anglice soldier) represented the migbt and majesty of Honduras. Every time I stole" glance over




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308 A Visit to Hondu1'as- and Betm·1t

the bulwarks I found his ancient Remington poilltillg at my face, which discouraged me from any but cursory investigations. I should say he had not drawn any clothing allowance for the last ten years, nor had his laundry been any serious burden on the public funds. However, the cost oC living in Honduras, so far as mere living is concerned, is not gloeat, a few banana leaves for a habita.tion and bananas for sustenance being all

Banana tra.in passing ranch.

that are required. Down the coast I was told of a certain old castle into the vaults of which the sea came at high tide. This fulli lied the dual purpose of a condemned cell and execution dOCK. People who are so improvident as to be executed in Honduras-and you must be peculiarly friendless and penniless to run such a risk-are committed to this duress, and the first high tide does the trick. 'l'hus the State is saved the expense

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A. W. Howlett 309

of an executioner. And it ma) be remarked that the State is not unduly exuberant in its outlay on the processes of justice. The agent who ran the experimental gard'ens of the company was telling me how he ran in a man whom he found stealing his coconuts, He was present in court when the commissary sentenced the delinquent to a term 6f imprisonment, and; such thefts having been common of late, congratulated himself on securing the conviction. His satisfaction was much damped by running across the convict the same afternoon strolling at large in the street of the native town. He complained to the commissary, who appeared to be much

. annoyed at his interference, and told him with some acerbity that he could ,hardly expect the State t.o be put .to the expense of keeping a man in prison for 'stealing a foreigner's coconuts, but that if he liked to make himself responsible for his charges he ,would see the man jailed for as long as he liked. '

As in all these Central and South American republics, the popul~tion is made up of three elements so insensibly graded that the colour bar ceases to have any meaning, and black, brown and white intermingle promiscuously. There are the old Caribs who still contrive to maintain a certain tradition of race purity, ,the 'negroes and the Spaniards, or Lusitanians. Possibly some of .them indulge secret dreams of ancestry and tell theIr grandchildren stories of forebears who came over with the conquistadores; but they make no parade of it.'

~o, Honduras is splendidly democratic in the way 'that only Latin peoples seem capable of understanding the term. The Anglo-Saxon race can never rise to the full conception of it. Your Hyde Park orator damning the whole crowd of bloated aristocrats, would accept a coronet to-morrow if it were offered him, and his whole turgid flood of InveCtive, had he the brains or patience to analyse it, is nothing, but the unconscious expression of his repressed jealousy. But I must not forget there is a small quota which calls itself British, and takes a not unreasoriable pride in its shadowy nationality. -

We passed a small island out in the Caribbean about four hours before we terminated our voyage at the door of Honduras, It was called Utila, a charming blot on the seascape, for it appeared a very Utopia for Robinson Crusoes, and might have been Juan Fernandez itself. It had crescent beaches of white saud and dipping palm trees, and inland, criss-cross valleys filled with verdure and i1 miniature mountain range. My heart warmed to it, and the more when I learned ·thatithad belonged not mq,ny years ago to Britain. The inhabitants still nourish a great bitterness at our abandonment of them. 'There is this much to be said of them, the fruit company are very eager to enlist their services on the mainland.

But I found many young Englishmen in Honduras in the service of the great fruit company, most of them public schoolmen. For the astute American knows the market value of the English public schoolboy, and one of them freely admitted to me that they could get no similar product




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310 OurrentLiterature'

from America, capable of handling the native population with the same tact and efficiency.

It struck me as a delicious irony, that I had . to wait to hear this encomium from an American, even though one has grown a little hardened to the diatribes of half-educated Indians and Egyptians, and the malignant aspersions of some of our own countrymen upon those of our race who have- given their days to the thankless burden of· Empire .

•

<turrent literature. Dysentery in Federated MaJay States. (No. 19.) Abstracted from

"Studies from the Institute for Medical Research," Kuala Lumpur. Federated Malay States. By William Fletcher and Margaret Jepps, i924-.

The Vitality of Dysentery Bacilli in the Fteces.-The prejudicial effect of delay in the examination of ~ysentery stools is notorious; yet delay is sometimes unavoidable. The following experiments were undertaken by us in England, during the year 1918, to determine how long dysentery bacilli will live in the freces.

Shiga's Bacillus.-Fifteim samples of freces, from five patients with acute dysentery of the Shiga type, were kept at room temperature in glass vaseline pots with screw tops, and examined every day. The result was that, in ten of the fifteen samples, dysentery bacilli disappeared within twenty-four hours; in four they were present on the second day, and, in one, they survived until the third.

Flexrier's Bacillus.-Flexner's bacillus· lived considerably longer in the freces than the Shiga type of organism. Thirty-two samples of freces, from five patients, were examiried. In more than half the specimens the organisms persisted for more than a week, as compared with a maximum of three days for Shiga's bacillus. The longest period during which they survived iii any stool was twenty-seven days.

But though the bacilli persisted for more than a week in most of the specimens, they were not found at· every examination which was made during the time they remained alive in the freces; the reason for this was a sudden drop in the proportion of dysentery bacilli during the first thirtysix hours, which, in the case of twenty~five specimens examined, amounted on an average to about 60 per cent. This shows how important it is that bacteriological examinations should be made with as little delay as possible. Moreover, it should' be noted that the specimens of freees with which we were working were not whole stools containing much frecal matter, but they were samples of mucus, or of blood and mucus, which had been specially selected from them. The presence of frecal matter' and the resulting acidity qilickly destroy dysentery bacilli. In a hot climate delay




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