One of the compounders at the hospital was a Hafiz and a moolah; a Hafiz is one who from memory can repeat the whole Koran. He was a tall handsome young man with courtly manners. He lived at my house, and at daybreak I was often dreamily roused by his fine tenor voice as he was chanting his prayers. Once his early prayer was of considerable worldly service to me and the neighbourhood, for he found that the bathroom of my house was on fire; the beams were already alight. He summoned assistance, the fire was soon put out and the matter ended. If the house had been burnt the affair would have reached the ears of the authorities, and the neighbours would have had a fine imposed upon them unless they could produce the incendiary! This young man had asked permission to live at my house because he could do so cheaply. He was saving money to pay off a debt incurred in Peshawur, his native town. I thought, What an honest worthy young man! but I found the money had been borrowed to pay off a fine imposed upon him for a murder he committed in Peshawur. He escaped hanging because there was an element of doubt in the case, and possibly for the reason that his elder brother had been some years in the British service. He admitted to me that he had stabbed the man, but he did not regret it. The man was a “bad man” and had injured him.

“Surely the Koran does not tell you to commit murder,” I said.

“No,” said he, “the Koran is God’s book, but we are all sinners.”

One of the hospital assistants, a Hindostani, working under me, was also a Hafiz and a priest. He was a very gentlemanly man of about forty-six, and well educated. He had been in the Bengal cavalry. I liked him very much, but, unlike most Mahomedans, he was a dipsomaniac. For a fortnight or so he would be miserably drunk. He drank the native spirit made from raisins, methylated spirit, or any kind of intoxicant he could get hold of. He explained his condition to me by saying that “Shâitan” came to him occasionally and said, “You have drunk no shrâb for so long, now is a very good time to drink,” and so he listened to Shâitan and drank. He afterwards gave up alcohol and took to chloral eating and opium smoking. I was very sorry for the man. I think he was not such a scoundrel as some of them.

When I first entered the service I picked up a man in Kabul who could speak a little English, and had him to look after my clothes and wait upon me—my valet. He was a short thick-set man, with a shaven head, on which he always perched a little red fez. He was wonderfully gentle with sick children, who were brought to me to prescribe for. He was very lazy, but was cowed at once if I were angry. I found he was a hired assassin who had escaped from Peshawur into Afghanistan. When I discharged him he made a large sum of money by gambling in the bazaar, and then returned to Peshawur. The last I heard of him was that he had been apprehended and was in jail.

At one time, after I returned from Turkestan, I used often to go and dine at the workshops with the other Englishmen, and two of the military police who guarded my house came at ten o’clock with a lantern to escort me home. My interpreter did not like my doing this at all, because I had to ride through some narrow winding streets and across the large orchard or garden before I reached the shops. He said, “It is known that you often come home at that time of night, and you might easily be shot, and there be no possibility of finding the man who fired at you. In that case your guard would be killed, and probably I as well for not warning you.” However, it was too depressing to be always alone, and no one ever shot at me. One of these soldiers who came for me was a big, very handsome man, but he had a curious furtive look in his eyes. He used to pull my riding-boots off when I got home, and put out the candle. I remarked once upon the curious look in his eyes, and was told that all in his particular profession had that look.

I enquired what he did besides guarding my house. They said, “Have you not noticed that on some nights another man takes his place?” I had noticed it. I was then informed that he was one of the official executioners, whose duty it was to strangle certain of the prisoners in jail. The unfortunate is told one day that he will have the privilege that night of sleeping in a separate room. He is conducted there, and finds there is one other occupant of the room. As soon as he is asleep the other occupant—my friend!—secretly placing a noose round the neck of the sleeper, suddenly draws it tight and throws his whole weight upon the chest, striking the victim violently over the heart.

The late Governor of Kabul and chief of the police, Naib Mir Sultan, whom the Amîr hanged recently for his iniquities, largely employed this means of getting rid of prisoners. An anxious woman would come to him with perhaps a thousand rupees, and implore his intercession on behalf of her husband who was in jail. The Naib would say, “Yes, he would do what he could, he knew the case was coming on directly, but it was an expensive business; if she could bring another thousand perhaps the thing could be done.” And he would keep her dangling on some time, squeezing out of her all the money he could get, and then she would be informed officially that her husband had died in jail of an illness!

Sometimes a prisoner who was sick would ask permission to see the doctor, and he would be brought to me at the hospital with chains round his ankles, in charge of a soldier with fixed bayonet. But I was very careful about prescribing for a prisoner, for the Naib was an adept in the use of poisons as well as of stranglers, and a death might be imputed to me. Another way he had of removing objectionable men who were not prisoners. Some night two of the police knock loudly at a man’s door, saying, “Get up at once, Amîr Sahib calls you.” This is quite likely to be true, for His Highness often continues at his work late into the night, and the man hurries on his clothes and goes out with the police. He is never seen again; but some days afterwards his head is found in one place and his body in another. Then the widow in great distress goes before the Amîr and tells her story.

The Amîr naturally enquires, “Who is your husband?” The woman explains, saying, “Amîr Sahib sent for him on such and such a night.” The Amîr, of course, tells her that he did not, and enquires if she can identify the soldiers who came for her husband. She cannot, for it being night and she a woman, she has never seen them. The natural conclusion is that some enemies of her husband have personated soldiers and murdered him.

I have, however, heard other explanations of these incidents.

The Naib was not a bad-looking man: he had a dark skin, but rather an agreeable expression than otherwise. He never dared go out without a large guard of his police, the townspeople would have torn him to pieces. Prince Habibullah disliked him even when I first entered the service in 1889, and, finally, his iniquities were proven to the Amîr. I forget what the particular charge against him was, but he was fined, they said, a hundred lacs of rupees to begin with, somewhere about half a million! He paid it, and another fine was imposed which necessitated his selling up everything. Brought before the Amîr soon after this, he was insolent, and His Highness in exasperation seized him by the beard and struck him in the face. The soldiers then hurried him away to a tree outside. Someone suggested his praying. “Pray!” he said, with a laugh, “after a life like mine? No, I’ll die as I have lived;” and they hanged him on the tree.

This is the story as I heard it at the time. I did not see him hanged, for there was a cholera epidemic in Kabul, and I was there. The Amîr was at Paghman in the mountains.

Though Friday is the Sabbath, the shops are open on that day as well as on other days in the week. Somewhat less work is done, especially at the time of the priests’ oration in the principal musjids, about two in the afternoon. In Kabul the Amîr’s workshops are closed, and the Out-patient Hospital also. The Amîr himself, too, does less work on that day, otherwise there is no great difference between the Sabbath and other days in the week.

I spoke just now of fees to a priest for a “burial” service, but, perhaps, that is hardly a correct term to apply, for I never saw any service or ceremony performed at the actual time of burial. However, it is possible there may be, though I never saw one, but I have seen the service performed at a death bed.

When I was in Turkestan a young officer, a cousin of the Sultana’s, was ill. The Hakims, who were attending him, not knowing the use of the stethoscope, could not diagnose the case, and after some days I was sent for. I found that he had had Pneumonia, or Inflammation of the lung, and that instead of clearing up, the inflamed lung had become tubercular, and a cavity could be detected in it. He had developed consumption. I did what I could, but it was too late for any permanent relief to be afforded him.

He became worse, and one day when I called, he was manifestly dying. I found several men sitting on the ground by the bedside reciting prayers continuously. I enquired why they were doing so at this time, and was told they would continue praying till he died, for he was then passing to Paradise over the narrow bridge whose edge was sharper than a razor, and that the continuous prayers kept away the evil spirits who were endeavouring to drag him down into the abyss.

The men praying were his nearest relations, and with them was a priest; for although it is the Mahomedan custom for the nearest relatives to recite the prayers on this occasion, a priest is generally sent for also.

The graves of the richer Afghans have upright headstones of marble or slate carefully shaped and ornamented. The writing on them is in relief, the stone being chipped away from the letters. The tomb of an illustrious man is bricked round, about two feet high, and covered with a slab of marble. Occasionally one is surrounded by a fence: trees and flowers being planted in the enclosure. The grave of the Amîr’s father near Kabul is cared for in this way. Others have a sort of small mosque or musjid built over them; and the deceased, when his name is forgotten, becomes a holy man and a saint.

The grave of a poor man has a flat stone, the largest his friends can find, planted upright to mark the place of burial: many have no mark at all, but the collection of mounds is not to be mistaken. The graveyard is not walled in or enclosed. The tombs of the kings are, some of them, imposing. That of Timour Shah in Kabul (son of Ahmed Shah, founder of the Durani Empire) is a very fine piece of brickwork. A huge central dome is surrounded by a series of flat-roofed rooms, the ground plan of the structure being octagonal. No care is taken of it, and it is becoming dilapidated by time. The tomb of Babur Shah, just outside Kabul, is also becoming dilapidated. It is smaller and of marble, in the style of the smaller musjids, with pillars to support the roof. Another tomb just outside Kabul is built in the shape of a musjid. It is that of a grandson of Amîr Dost Mahomed. I knew his son very well, Sirdar Abdul Kûdus Khan. The latter once was of great service to the Amîr. In one engagement, by a brilliant charge, he completely turned the fortunes of the day. Success was too much for him, and he became presumptuous. He was accordingly ordered into honourable confinement. Some time afterwards he was allowed to appear at court, but for many years no appointment was given to him. Quite recently, he received office, being made Governor of the province of Bamian.

The marriage ceremony differs very much from ours in England. Firstly, the young Afghan does not see his sweetheart till she becomes his wife—at any rate he is not supposed to. He hears that such a man has a very pretty daughter, and that she is likely to have so much dowry. He therefore sends his mother or sisters on a visit to the harem. The ladies, properly veiled, are conducted there by their servants in a closed palanquin. On their return they give their opinion, and all the information they have managed to glean. If everything is satisfactory to the young man, he approaches the father or guardian, and makes his proposal. If he is accepted as a suitor, an opportunity is given to the young lady to see the swain herself, unobserved. She can, if she like, refuse him, and if she be a girl of strong character, may be successful in her refusal: but I know that sometimes considerable pressure is brought to bear, if her wishes are contrary to those of her father or guardian. Sometimes the young man, if he holds a subordinate position, will prevail upon his superior officer to make the proposal for him to the father or guardian. It may have more weight. I once had this onerous and pleasing duty to perform. I marshalled all my servants, and rode off with as much ceremony as possible, to the house of the young lady. I had a vague sort of an idea I might see her; but I did not: she saw me, which was not so satisfactory. When I arrived at the house, I was conducted through the courtyard into an upstairs room, where the guardian—her brother in this case—received me. A party of gentlemen were in the room, and they all rose as I entered. After the usual salutations a chair was offered me: the rest seated themselves cross-legged round the room. I made a formal proposal in the name of my subordinate, and a discussion followed. I was surprised at the free and open way in which they said the man for whom I was making the proposal was a rascal and a liar, and that he had not the money he said he had. There was no delicate hinting that, perhaps, they had erred in assuming his fortune was such and such. I naturally anticipated a refusal; no, out of respect for me, he was accepted! Then a large tray of loaf sugar broken into pieces was brought in, and first I and the guardian, then the others, ate a little, and the rest was given to the servants. After that we had tea, and I rode off home again, where the anxious lover was waiting for me. I said,

“They called you very bad names.”

“That matters little;” said he, “did you eat the sugar?”

“Yes,” I said.

“Ah! then all is well! the other is a custom.”

The actual ceremony of marriage is performed at the house of the bridegroom, though there is often a reception at the bride’s house afterwards—not that you see the bride or any other ladies. The father, guardian, or brothers receive you.

At the marriage ceremony the amount of dower is first discussed and settled, and then the priest formally enquires, first of the bridegroom then of the bride’s legal representative, whether they each agree to the marriage. On receiving an answer in the affirmative he pronounces a few short prayers and blessings, remaining seated while he does so, and the ceremony is concluded; sometimes, also, rings are exchanged. Then comes the reception of guests at the bride’s house.

I was invited to the wedding of Prince Habibullah. I did not see the ceremony, where the priest blesses the union, but I attended the reception at the house of the bride’s father. It happened to be in the suburbs, near where I was living, and I walked there escorted by my servants and guard. I was shown into a large flower-garden where several tents were erected. A great many guests had arrived, but not the Prince. Presently, I heard the “Salaam-i-Padshah”—the representative of our National Anthem—being played by a brass band. It is a solemn and slow chant, reminding one of a dead march: it is very impressive and by no means unmusical. I was told it was composed by an Englishman—who he was I do not know. Then the Prince rode into the garden, followed by his brother, Nasrullah Khan. Both were dressed in scarlet and gold uniforms. Prince Habibullah wore a military helmet with plumes, and Nasrullah Khan a grey astrakhan hat. I bowed as the Prince went by, and he pulled up to enquire why I had not taken possession of the tent prepared for me, and he pointed out a very gay one. There were people in it, but they turned out at once. The Prince gave orders to one of the chamberlains for tea and cigarettes to be served for me there, and then rode on to another tent, where he dismounted. Taking his seat he received the salaams of the assembled guests. I sat in my tent, and people came in and chatted, and then went on to other tents. I drank tea, ate fruit, and smoked, while musicians and nautch women went through their performances. Then large trays of sweetmeats and sugar were brought to each of the tents, and when I had eaten a little I departed, for it began to rain. The servants of each of the guests carried away their master’s tray of sweets, for it was the fast of Ramazan, when Mahomedans cannot eat nor drink till night. The father of the bride was the Shaghassi, or Master of the Ceremonies in Mazar, and when we left there he was made governor of Turkestan. Soon after we left, however, he had sunstroke—mania, the hakims said—and the Amîr recalled him to Kabul.

I found my horse waiting for me at the gate of the garden. In spite of the rain, the streets were crammed with people, and I had some trouble in the crowd, for my horse was restive, and plunged; however, we got home without accident. I went also to the wedding of Prince Nasrullah, but I will describe that later.

Some of the priests have gained a certain amount of reputation as healers of the sick; not by the administration of medicines, for that is a privilege reserved for the hakims and doctors, but by the employment of the “faith cure.” It is an axiom in the Mahomedan religion that to utter the name of God a great number of times is of inestimable benefit to both body and soul; also that if a part of the body be diseased, it is an efficient cure to bind on it the written name of one of the attributes of God, “the Merciful,” “the Compassionate,” “the Restorer.” The sick, therefore, go first to the priest for help, and by the payment of a fee obtain the written scroll. This is rolled up in silk or leather, or, if the patient be wealthy enough, is enclosed in a little cylindrical box of silver made for the purpose, and bound on the diseased part of the body. If the patient recover, great credit is given to the priest, and other sick people seek his aid. If recovery does not ensue, either the patient is resigned, considering that his “Nasîb” is thus written in the book of fate, or else by the payment of a larger fee he engages the medical skill of the hakims, or native physicians.

Every patient with chronic disease of any kind who came to me had one of these little packets fastened by a string round his arm or neck.

Many of the children, even those in good health, have similar charms fastened to them. I noticed that the Sultana, or her women, fastened one in a gold cylindrical box on the arm of the little Prince Mahomed Omar, soon after he was born. This was to protect him from accident or other evil. Sometimes, for the same purpose, a piece of string only, over which a few prayers have been recited, is tied round the child’s limb. This is done by the poorer people. Against the “Evil Eye”—which, as far as I could understand, is the eye of “envy, hatred, and malice”—something blue is a great protection. Men wear turquoise rings, children and woman turquoise ornaments or blue beads. When a man buys a new horse the servants at once fasten a blue bead or ribbon among the hairs of his tail. It is not necessary for the blue to be seen: it is just as sure a protection when it is hidden. The Evil Eye is a dangerous weapon, so many possess it, and it works silently and secretly. Paralysis, wasting, rickets in children, impotence, and sudden death, the illness of cattle and horses—all these are imputed to the evil eye.

Just outside the house I occupied, after my return from Turkestan to Kabul, there was an open space with a small pond in the middle; this was a favourite playground for the boys of the neighbourhood. I rode through it as usual one morning on my way to the hospital. When I had finished my work and returned home again, my interpreter, who seemed rather upset about something, said to me—

“Sir, I very sorry you kill that boy to-day.”

“What do you mean?” I said; “I’ve not killed any boy.”

“Oh, yes, sir; you remember he called you Feringhi this morning.”

I remembered then that while riding through the playground, one of the boys, a good-looking lad of about twelve, had attracted my attention by calling out something, and he laughed as he ran away. I looked up carelessly and then rode on, thinking no more about it. I said—

“I remember a boy saying something, but I didn’t hear what it was.”

“Sir, he very fool boy to call you Feringhi, but he is dead now.”

“That is very sudden! What did he die of?” I asked.

“Oh, sir, I poor man—what I know? You looked at him, and he died; perhaps trouble come for us.”

“Nonsense,” I said, “he must have died of something. Boys don’t die because you look at them.”

“Sir, in this country often it is they do!”

I indignantly said, “What do you mean! I haven’t got the evil eye!”

He looked at me meaningly, then looked on the ground and shook his head dolefully: I couldn’t persuade him that the thing was a ridiculous impossibility. As there is a kind of vendetta in Afghanistan I rather wondered what would happen next. I told my interpreter to make enquiries and find out what the boy really died of. He said,

“Why for we make enquiries? Better it is we keep quiet for a few days and say nothing.”

I never heard what was the cause of death, and the matter blew over.

Besides the evil eye the Afghans believe in other forms of magic; in certain days of the week being lucky, and others unlucky; in ghosts, and jins, or devils. A man told me one day that the house he lived in was formerly occupied by the three sisters of one of the kings, Shah Shujah, I think it was, and that they were evil women. One night on his return home, just as he entered the house he heard sound of women’s laughter in the bath-room on the ground floor. Wondering who could be there, he opened the door. Three women, whom he did not recognize, sprang up and rushed, laughing, through the further door into the inner bath-room. He slammed the door to, and fastened it, and hurried upstairs, where he found his wife and the women of the household. He enquired who were the women in the bath-room. They said there could be no women. The house was of the usual kind—only one door leading from the street into the courtyard, and every one entering could be seen. Lights were procured, and he descended to the bath-room, unfastened the door, opened it, and peeped in—no one was there. He went across to the further door and found it fastened with a chain and padlock on the outside in the usual way. He thought, “The women cannot have fastened themselves in.” He took the key from his pocket, unlocked the door and looked in: this room also was empty. He is convinced he saw the wraiths of the women who formerly occupied his house.

Almost every house in Kabul has its ghost or jin. The house I had on my return from Turkestan had a reputation. The soldiers who were put to guard it in the winter while I was at the Palace at last refused to sleep in one of the ground floor rooms. They said it was haunted, that jins and devils came and pinched them, and moved their rifles and belts from where they had placed them. So in spite of the intense cold they moved out into the porch of the big gate opening from the courtyard into the street, and there they took up their quarters permanently. One day, just before sunset, after I had returned, the syce came out of the stable, which was under the room I occupied, and called one of the other servants. The latter came to me afterwards and said that just as it was beginning to get dusk he went to look into the stable, as the syce had called him. To his astonishment he saw what seemed to him to be two small children running round the legs of the bay horse, and jumping on its neck and off again. He went forward to gain a clearer view, and the children, or jins, as he called them, disappeared. He searched the stable thoroughly, and found nothing out of the way, except that the bay horse was trembling and covered with sweat.

Many similar stories were related to me at different times, but though for months I slept alone in the “haunted wing” I never saw any ghost, jin, or devil—except those clothed with flesh and blood; doubtless it was a privilege reserved for “True Believers.” There was, however, one incident; but I will relate that by and bye.

CHAPTER VIII.
Afghan Surgeons and Physicians.

One morning soon after our arrival in Kabul, when I was at the Erg hospital, a messenger arrived in a great hurry to say a man had been injured at the Workshops. I jumped on my horse, which was waiting, and galloped off. Just outside the Workshop garden, on the road by the river bank, I saw the heavy portable engine with a crowd of people round it. Mr. Pyne was there in the middle of the crowd, and a man, one of the Afghan workmen, was lying on the ground. I examined the patient and found he was dead. Mr. Pyne was very upset and at first refused to believe it. He sent off a man to the shops for whisky, and begged me to send someone to the hospital for ammonia. I did so, though, of course, it was useless. They were moving the engine to the Salaam Khana or Durbar Hall to work the dynamo for the electric light there, but no one in the crowd seemed to have seen how the accident occurred, whether the man was crushed under the wheel or whether he had been struck on the head. There was no inquest, and post mortem examinations were not viewed with favour.

Later on, when the machinery was put together and some of it was in working order, accidents and deaths were, as might be expected, of frequent occurrence. In stepping over the shafting which ran across the entrance to one of the shops, about a foot above the ground, the long sheepskin postîn or coat would catch, and the wearer be whirled round and killed. Familiarity breeds contempt, and in spite of accidents it took a long time to educate the ordinary Afghan, after he had got over his first awe, up to the point of learning that machinery in motion should be approached with circumspection.

They had a way of putting their fingers under the punches of the cartridge machines, forgetting that the punch would inevitably come down at its appointed moment. It took one man in the palm, I remember, and I had to amputate his first and second finger and his thumb. Another got his hand between some steel rollers in motion, and but for the fact that Mr. Pyne was on the spot and at once threw the machine out of gear, the arm would have gone too. As it was, the skin was taken neatly and cleanly from the wrist and turned backwards like a glove over the finger tips. The bones of the hand were crushed, and I wished to amputate in the lower forearm; but the man, who was brought to the hospital, refused to have the hand taken off because he could move the fingers a little. I pointed out the danger he was running of further serious results, but he would not consent.

As he refused the only treatment that I felt was suitable, I could not undertake to treat him, and he was removed to his home in the city. I do not know who attended to his hurts, probably one of the native “dressers,” but four or five days afterwards he sent a friend to beg that I would come and remove the hand. Unfortunately, it was too late; “tetanus,” or lockjaw, had set in.

The “dressers” of wounds in Afghanistan are a body of men—natives—whose duty it is to dress wounds and ulcers, set broken limbs, and probe for bullets. They have no knowledge of even the groundwork of their profession. Never having dissected, nor studied anatomy, they are quite ignorant of the position and shape of the bones, to say nothing of the course and distribution of the larger arteries of the human body, so that the abscess knife and the scalpel put into the hands of one of these men work grievous harm. They carry about with them a flat tin box, with partitions inside, something like a paint box; and in it is a collection of most filthy looking ointments of different colours. These they plaster on indiscriminately; if one does not cure an ulcer perhaps another will. For dislocation of joints a mixture of flour and yolk of eggs smeared on is a certain specific; they have no idea of reducing the dislocation. For a broken bone, flour and yolk of eggs again comes in. Say the bone of one arm is broken between the shoulder and elbow, the following treatment is adopted. Some narrow strips of calico, smeared with the flour and egg mixture, are bound tightly round the limb at the seat of injury; thus breaking the first law of surgery, that no bandage be put on under a splint. Over this bandage are arranged longitudinally four or five narrow pieces of wood about five inches long, very like those you buy in a bundle for firewood, and utterly useless as splints, and another bandage is wound firmly over these; there is no padding with cotton wool. The patient is then left. The result is, of course, that the limb below the bandages becomes exceedingly swollen and painful.

When the pain has reached such a pitch that it is no longer bearable, the patient releases his arm from the bandages, and the dresser is sent for to readjust them, so that the unfortunate limb is relieved for a time before it is tortured afresh. In spite of the dresser the bone sometimes unites, usually at a more or less obtuse angle; but not uncommonly, especially in compound or comminuted fractures, the pressure is taken off too late, and the whole limb mortifies. The patient, after months of suffering, may or may not recover. I have had them brought to me with the broken end of the bone protruding from a hanging mass of stringy and sloughing muscle and tendon, the rest of the limb being hidden from sight by unclean rags.

Such “dressers” as I could get hold of I put through an examination at the hospital, to try and find out what they knew, and endeavoured to teach them some elementary facts in anatomy and one or two common sense rules in surgery, but only one of them would even pretend to learn, and he was a humbug. They all knew better than I did how to treat wounds and ulcers, and set broken limbs, and they received any suggestions of mine in offended silence. I showed up one or two, pointing out the disastrous results of their treatment, but it did no good. I only had an extra enemy or two to consider, for they were very venomous.

Besides the comparatively modern “dressers,” there is another body of men in Kabul who practise the noble art of surgery, namely, the “barbers.” The line they specially take up is that of bleeding and tooth drawing. They have very rough forceps for the latter operation, and when, as not infrequently happened, they snapped the crown of a tooth off instead of extracting it, they passed the patient on to me. It is annoying for a surgeon to have to extract broken but firmly-fixed fangs from an injured and bleeding jaw. It is not a pretty operation at all.

For fevers, dyspepsia, gout, headache, or any feeling of malaise, the barbers bled their patients—but besides these, which may be called the irregular bleedings, there are regular bleedings every spring and autumn. These are generally done out of doors by the road side. The barber, squatting down by the side of his patient, makes his incision at the bend of the elbow: fortunately, not into the vein immediately over the great artery of the arm, the one usually bled from in England, but into one adjoining. The patient holds out his arm and allows the blood to drip on to the ground till he thinks enough has run away. There is not the slightest attempt made to measure the quantity of blood lost. The only precaution taken is to avoid drinking any water for twenty-four hours afterwards, lest it should mix with the rest of the blood in the vein and make it thin; or if they do drink any they hold the wounded arm above their heads to prevent the water running into it! Wet cupping, too, is performed by the barbers and dressers, and is a very popular means among the townsfolk of getting rid of their blood. It is a common thing to see an Afghan scarred all over the shoulders and loins. Cupping is employed generally as a remedy for muscular rheumatism. The custom was introduced some years ago by the Hindustani hospital assistants, who, after having had in India some slight training in the European system of medicine, found their way into Afghanistan under the guise of “doctors.” The majority of these were unqualified men, and were quite unfit to be anything but hospital assistants. Let loose upon the people they have worked as much havoc among the sick as a similar number of the hakims could have done.

There are also native “eye doctors!” These may do good sometimes by accident, though I never heard of a case, but they do an incredible amount of harm: for eye diseases, on account of the glare and the dust, the absence of proper treatment and ordinary care are very common in Afghanistan.[1]

Finding out that I sometimes used sulphate of copper—an astringent and caustic—of which there was plenty to be had in the bazaars, they would put this powdered into any eye—say, of a child who had ulcer of the cornea! The Hindustani hospital assistants were not much wiser, for they sometimes used solutions of sulphate of zinc, a similar remedy, for the same purpose. The eye being irreparably damaged the patient is then handed on to me, and the Hindustani, like the dresser, smugly says that “If he couldn’t cure the patient, neither could the Feringhi.”

However, the people and the Amîr judged, I found, according to general results. I remember in Turkestan a soldier getting leave of absence, travelling down to Kabul, and bringing his old mother on a donkey the two hundred odd miles over the mountains, for me to cure her eyes. They were past all hope.[2] The painful part of the affair was that they would not believe I could not, but that I would not restore her eyes; and the old woman went down on her knees to implore.

There was one old fellow, an “eye doctor,” in Kabul, whom I used to notice on my way to the hospital. He sat in a hut of rushes and mud by the roadside, with his medicines in little packets before him. I often wished he would come and have a little elementary instruction in the “eye.” But he had such a sour expression when I went by, and he never would look at me, that I did not suggest it to him.

The hakims—the physicians of Afghanistan—practise purely as physicians; they do not use the knife surgically, rarely even for bleeding. When they find it necessary to treat an abscess, they apply an irritating ointment which causes ulceration of the skin. Since the introduction of European drugs into Afghanistan some of the hakims have made use of them; but as they do so in ignorance of their therapeutic properties, the results are rarely satisfactory, and, in some cases, are disastrous. They have great faith in the healing properties of a purge, but do not consider it has had any effect unless it acts at least twenty times. The way is prepared by administering every day for a week a large bowl of laxative mixture; afterwards, one or more bowls of a drastic purge are given. Some of the people seem to establish toleration of this class of medicine, and require a large dose before they are acted on; but with a vast number this mode of treatment, combined with the custom of eating largely of ripe and semi-ripe fruit, certainly predisposes them to the obstinate and often fatal bowel affections that are such a scourge in the spring and autumn.

These bowel troubles, according to a popular native idea, are caused by drinking tea immediately after having eaten fruit, particularly mulberries. There is no doubt, however, that some of the cases are due to the debilitated and enfeebled state of the digestive organs, produced by the malarial poison, the immediate exciting cause often being the sudden change in temperature experienced when climbing a mountain after a residence in the hot valleys. Other cases are due to the presence of minute intestinal parasites, the ova of these being ingested during the drinking of impure water, a common custom among the careless Afghans.

The hakims practise, I was informed, according to the Yunani or ancient Greek system of medicine. The only books I could obtain on this system were written in Arabic, and this was an obstacle to my studying them; but, whatever the teaching of their books may be, the hakims I found knew nothing whatever about anatomy, physiology, or pathology. Their treatment of disease is entirely empirical. They act according to “authority.” Studying disease, not in the living subject, but in their books only, they have made no progress whatever upon the teaching of their ancestors. A sick man is brought to them, and some prominent symptom forces itself upon their notice. This is at once diagnosed as the disease. For instance, pain in the abdomen is to them “colic.” It is described in their books and a certain line of treatment is directed. They do not examine their patient, or attempt to find a cause for his pain; nor do they differentiate between different forms of colic, for they have not noticed that pain in the abdomen is sometimes unconnected with the bowel. As an example, Perwana Khan, the Deputy Commander-in-Chief in Kabul (“Dipti Supersala”), was for some weeks attended by the hakims, who, reporting him to be suffering from colic, administered purge after purge. As, however, he did not seem to be getting any better, the Amîr desired me to examine him. I found he had acute pain in the left loin, shooting downwards; the attacks of pain came on, he said, after he had been riding on horseback, and he had other symptoms, all pointing unmistakably to stone in the kidney. I administered suitable medicine for the relief of the pain, and he was overjoyed, imagining himself cured. I explained, however, to His Highness what was wrong.

To the hakims dropsy is a disease, and can be cured by the treatment set forth in their books. No attempt is made to discover the cause of the dropsy—whether it is due to kidney disease, heart, liver, lung or blood disease—it is simply an accumulation of gas (bâd) in the tissues! In diseases of the chest, they do not, of course, employ auscultation with a stethoscope, nor percussion; and bronchitis, pneumonia, and phthisis are classed together under the name of sûrfa, or cough. This, they say, is due to an accumulation of “slime” (balgham) in the body. In some cases the sûrfa is accompanied by dard i sîna, or pain in the chest, and occasionally blood as well as slime is coughed up: these are recognized as bad cases. I have related the case of the young brigadier in Turkestan, cousin of the Sultana, whom the hakims were treating for sûrfa, and who was dying of an improperly treated pneumonia, which had, eventually, become tubercular. As I did not want to have the credit of killing him, I sent in my report to the Amîr at once. The hakims did not in the least mind my being sent for to their cases, after they had become hopeless; for, like the dressers, they said, “Behold, the Feringhi doctor cannot cure them any more than we.”

Malarial fevers are diagnosed as “cold fever” or “hot fever” (tap i larza—tap i gurrum), according to whether there is a shivering stage or not. They are treated by copious bleedings and purgings, and by very low diet. Malarial fever, however, being due to the presence in the blood corpuscles of a microscopic animal, an amæba, the treatment that the hakims adopted was not likely to be very successful. Quinine in sufficient dose destroys this organism, but the hakims would rarely give it, or if, following my plan, they did so, they gave it in doses so small as to be useless, for they said, “Quinine is hot, and, therefore, bad for fever.”

What they meant I do not know.

The hakims divide not only malarial fevers into “hot and cold,” but they arrange all diseases into these two classes, and I was asked of almost every disease that came under my notice whether it were hot or cold; for instance, whether dyspepsia were hot or cold. The reason for the classification in the case of malarial fevers is obvious enough, but for the other diseases I never was able to find out upon what they founded their conclusions. It certainly was not simply whether the patient had fever or not.

It was particularly embarrassing when the Amîr asked the question, and I once told His Highness that in Europe we did not speak of diseases as being either hot or cold, that it was often impossible to consider them as either one or the other. His Highness was quite indignant at my denying what apparently seemed to him such a self-evident fact, so much so that he doubted if my interpreter had translated what I had said correctly. After that, when I was asked, I told the interpreter to class the disease as hot or cold, according to the custom of the country.

In the distant villages, where there is no hakim, and the priest’s amulet has failed to cure, the people either go untreated or treat themselves. A popular mode of treatment for diseases of bones and joints, and also for almost any pain in the chest, abdomen, or back, is the employment of the “actual cautery.” A piece of live charcoal is placed against the skin until a deep burn is produced; this is done in two or three places, the scars, of course, remaining till the end of the patient’s life.

Another custom, mostly for diseases accompanied by fever, is to kill a sheep, skin it rapidly, and at once wrap the patient in the hot skin. I do not know that it does any harm. The Amîr himself, when suffering from gout, and when the hakims had failed to relieve him, employed this essentially Afghan mode of treatment for his leg and foot. Afterwards he sent for me.

For wounds, ulcers, or abscesses the villagers bind on either a piece of fresh sheepskin, which they leave on till it stinks, or a piece of an old water bag (mussack), which they soften afresh by soaking. Sometimes they plaster on mud or clay. In the case of ulcers, the fact that they never heal under these circumstances does not seem to strike the Afghans, and they continue in the old custom. If the discharge oozes from under the clay they plaster on a little more. Cover a sore, get it out of sight, is the golden rule of hakims, dressers, and people. The condition of the ulcer when the clay is removed is indescribable. In some cases the only possible treatment is the removal of the limb.