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BRIEF CONTENTS
SECTION 1 Preparatory 2
CHAPTER 1 Introduction to EMS Systems 4
CHAPTER 2 EMR Safety and Wellness 21
CHAPTER 3 Medical, Legal, and Ethical Issues 51
CHAPTER 4 Medical Terminology 70
CHAPTER 5 Anatomy and Physiology 82
CHAPTER 6 Life Span Development 113
Section 1 REVIEW 130
vii
SECTION 4 Medical Emergencies 330
CHAPTER 14 Cardiac and Respiratory Emergencies 332
CHAPTER 15 Altered Mental Status 354
CHAPTER 16 Medical Emergencies 391
Section 4 REVIEW 408
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DETAILED CONTENTS
SECTION 1 Preparatory 2
ix
Stress 35
Dealing with Stress 36
Death and Dying 37
Dealing with Grief 38
Lifting and Moving Patients 38
Body Mechanics 38
The Lift 41
Positioning Patients for Safety and Comfort 41
Stop, Review, Remember 45
Patient Restraint 47
The Last Word 48
Chapter Review 48
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The Human Body 84
The Skeletal System 84
The Muscular System 87
Stop, Review, Remember 90
The Respiratory System 91
The Cardiovascular System 93
The Nervous System 96
Stop, Review, Remember 99
The Integumentary System (Skin) 100
The Digestive System 101
The Urinary System 101
Stop, Review, Remember 103
The Lymphatic/Immune System 104
The Endocrine System 104
The Reproductive System 104
Life Support Chain 107
The Last Word 108
Chapter Review 108
DETAILED CONTENTS xi
SECTION 2 Airway and Cardiac Resuscitation 136
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Alternative Compression Technique for Newborns and
Small Infants 200
Complications of Pediatric CPR 201
Stop, Review, Remember 202
Automated External Defibrillators (AEDs) 203
Lethal Arrhythmias 203
AED Safety 204
AED Use with Pediatric Patients 206
Continuing Quality Assurance and Call Review 206
Putting It All Together 208
Adult Resuscitation Sequence 208
Return of Spontaneous Circulation 208
Ethical Considerations of Cardiac Arrest 209
The Last Word 209
Chapter Review 210
Section 2: Review and Practice Examination 212
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Communicating with Your Patient 306
Accurate and Efficient Communication 306
Patient Interview Techniques 309
Stop, Review, Remember 311
Communicating Patient Information to Other Providers 312
Radio Communication 313
Special Communication Situations 314
Stop, Review, Remember 315
Documentation 316
Components of the Prehospital Care Report 318
Special Reporting Situations 319
The Last Word 320
Chapter Review 321
Section 3: Review and Practice Examination 323
DETAILED CONTENTS xv
Stroke 364
EMR Patient Assessment: Stroke 364
EMR Emergency Care: Stroke 367
Seizure 367
EMR Patient Assessment: Seizure 368
EMR Emergency Care: Seizure 368
Stop, Review, Remember 369
Poisoning 371
EMR Patient Assessment: Poisons 373
EMR Emergency Care: Poisons 374
Specific Types of Poisons 376
Ingested Poisons 376
EMR Patient Assessment: Ingested Poisons 376
EMR Emergency Care: Ingested Poisons 376
EMR Patient Assessment: Drug or Alcohol Emergency 378
EMR Emergency Care: Drug or Alcohol Emergency 378
Inhaled Poisons 379
EMR Patient Assessment: Inhaled Poisons 379
EMR Patient Assessment: Carbon Monoxide Poisoning 380
EMR Emergency Care: Carbon Monoxide Poisoning 380
Absorbed Poisons 381
EMR Patient Assessment: Absorbed Poisons 381
EMR Emergency Care: Absorbed Poisons 381
Injected Poisons 382
Stop, Review, Remember 382
Behavioral Emergencies 384
EMR Patient Assessment: Behavioral Emergency 384
Assessment for Suicide Risk 385
Methods to Calm Behavioral Emergency Patients 385
EMR Emergency Care: Behavioral Emergency 387
The Last Word 387
Chapter Review 388
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The Last Word 404
Chapter Review 405
Section 4: Review and Practice Examination 408
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CHAPTER 21 INJURIES TO THE HEAD AND SPINE 504
Objectives 504
Introduction 505
Anatomy 505
Head Injuries 508
Closed Head Injuries 508
EMR Patient Assessment: Concussion 508
Open Head Injuries 509
EMR Patient Assessment: Open Head Injuries 509
EMR Emergency Care: Head Injuries 510
Stop, Review, Remember 510
Special Circumstances 512
EMR Patient Assessment and Care: Penetrating Wounds 512
EMR Patient Assessment and Care: Face, Ears, Nose,
and Throat 512
EMR Patient Assessment and Care: Soft Tissue Injuries of
the Face 512
EMR Patient Assessment and Care: Neck Injuries 513
EMR Patient Assessment: Eye Injuries 514
EMR Emergency Care: Eye Injuries 515
EMR Patient Assessment and Care: Foreign Objects in
the Eye 515
EMR Patient Assessment and Care: Impaled Objects in
the Eye 515
EMR Patient Assessment and Care: Globe Injuries and Extruding
Eyeballs 515
EMR Patient Assessment and Care: Orbit Injuries 516
EMR Patient Assessment and Care: Chemical Burns to
the Eye 516
EMR Patient Assessment and Care: Removing a Contact Lens 516
Stop, Review, Remember 518
Spinal Injuries 519
Assume Spinal Cord Injury 519
Mechanism of Injury 519
Spinal Precautions 521
EMR Patient Assessment: Spinal Cord Injury 521
EMR Emergency Care: The Spinal Cord Injury 522
EMR Emergency Care: The Seated Patient 527
Helmet Removal 529
The Last Word 531
Chapter Review 532
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SECTION 6 Special Patient Populations 588
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CHAPTER 27 SPECIAL POPULATIONS AND SITUATIONS 677
Objectives 677
Introduction 678
Technological Advances 678
EMR Patient Assessment: Special Patient Populations 679
Congenital Diseases and Conditions 679
Acquired Diseases and Conditions 679
End of Life and Terminal Illness 680
Stop, Review, Remember 680
EMR Emergency Care: Physical Impairments 681
Hearing Loss 681
Mobility 682
EMR Emergency Care: Medical Devices 682
Tracheostomy Tubes 682
Insulin Pumps 683
Implanted Defibrillators 683
Left Ventricular Assist Device 685
Feeding Tubes 685
Indwelling Catheters 685
Urinary Catheters 685
Ostomy Pouches 685
Stop, Review, Remember 686
Abuse 687
EMR Patient Assessment: Abuse 687
EMR Emergency Care: Abuse 689
The Last Word 689
Chapter Review 690
Section 6: Review and Practice Examination 692
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CHAPTER 31 TERRORISM AND NATURAL DISASTERS 749
Objectives 749
Introduction 750
Personal Safety 751
Mind-Set 751
Personal Protective Equipment (PPE) 752
Time, Distance, and Shielding 752
Responders as Targets/Secondary Attack 752
Patient Care Priorities 752
Inform the Patient of Your Actions 752
Protect from Harm 753
Greater Good 753
Treatment of All Patients 754
Stop, Review, Remember 754
Scene Size-Up 755
Determine Number of Patients 756
Evaluate Need for Additional Resources 757
Initial Actions—The “No Approach” Method 757
Secondary Events 758
Communicate with Other Responders 758
Stop, Review, Remember 759
The Last Word 760
Chapter Review 761
Section 7: Review and Practice Examination 763
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PREFACE
xxix
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ACKNOWLEDGMENTS
Books are a huge undertaking. A new book created to accompany new education stan-
dards raised the bar even further. Fortunately a tremendous team of people were as-
sembled to put the book you see before you together.
I would like to thank the contributors to this book, especially Dan Batsie, who gave
invaluable assistance in the development of this second editon. I also would like to of-
fer my sincere thanks to Tony Crystal, Andy Stern, Richard Belle, Daren Potter, Melissa
Alexander, Marc Minkler, and Eric Mayhew.
Ed Dickinson, MD, FACEP, is a personal friend and medical editor for this and many
other books. I consider myself so incredibly fortunate to know Ed and to be able to work
with him on projects such as this. Ed brings the true nexus of medical brilliance and street
practicality into his work which results in the streetwise, medically accurate text you have
before you now.
Brady has a wonderful group of people I have had the good fortune to work with over
the years. The team assembled for this edition maintains the tradition. Acquisitions Edi-
tor Sladjana Repic is wonderful to work with and an advocate for making the book you
see before you great. It is great to work with you. Lois Berlowitz is one of the few people
at Brady who has been there longer than I have been writing. She is the backbone of the
editorial process. I am grateful for everything Lois does. Long ago she said, “Dan, that is
an interesting idea … but it doesn’t make good book sense.” I always listen to Lois’s book
sense. Thanks also go to Kelly Clark, Editorial Assistant.
Julie Alexander is the publisher at Brady. Even though she has responsibilities
throughout a large company, Julie is always there, involved, and passionate about projects
such as this one.
The production department puts the book together and does a wonderful job. Julie
Boddorf and Cindy Zonneveld are truly dedicated and professional.
Michal Heron is responsible for the photo program you see in the book. When you
notice a photo that really draws you in, this is because of Michal’s tireless efforts and
attention to even the most minute detail—as any EMS provider/model who has spent
a day on the set can attest to! Michal’s influence is on every page of this book. Michal’s
mentoring an aspiring photographer is also greatly appreciated.
The developmental editor for this book is Jo Cepeda. Jo and I go back a long
way and have worked on many books together. I was thrilled she was available to do
this—and she stepped up to the plate for this project and its breakneck pace. I told
her more than once during this process that her attention to detail is nothing short
of amazing. It is directly responsible for the quality you will find within these pages.
Thank you, Jo.
Our sales force does more than sell books. They are the way your instructor is
most likely to hear from Brady. Our reps are talented and dedicated but most impor-
tantly they are passionate about their products and the people they serve. Tom Ken-
nally, their fearless leader, is always at the helm. To this wonderful group of people,
my thanks.
Finally, I would like to offer my most sincere thanks to you, the future Emergency
Medical Responder, for the adventure you are embarking on and to your instructor for
xxxi
choosing my book for your education. Creating this book is a responsibility I take with
the utmost seriousness. Be safe. Care for people. And have fun while you’re doing it. It is
an amazing journey.
Dan Limmer
danlimmer@mac.com
Thank You
CONTENT CONTRIBUTORS
Thank you to the following people for their contributions to the updated second edition
of EMR Complete: A Worktext:
Medical Editor
Edward T. Dickinson, MD, FACEP
We also wish to thank the following people for their contributions to the first edition of
EMR Complete: A Worktext:
Medical Editor
Edward T. Dickinson, MD, FACEP
REVIEWERS
The following reviewers of the updated second edition of EMR Complete: A Worktext
provided invaluable feedback and suggestions:
xxxii www.bradybooks.com
Tony Crystal, Sc.D., EMT-P Rebecca P. Smith, NREMT, B.S., MEd Andrew W. Stern, NREMT-P, MPA, MA
EMS Program Coordinator EMS Program Director/Instructor CME Coordinator
Richland Community College LEARN Commission, LAREMT, NAEMT Colonie Emergency Medical Services
Decatur, IL Folsom, LA Colonie, NY
We also wish to thank the following EMS professionals who reviewed the first edition of
EMR Complete: A Worktext:
Evelyn D. Barnum, EMS-P/IC, PhD Mike Grill Cheryl Pittman, EMT1, PhD
Lansing Community College EMS Program Coordinator Assistant Professor, EMT and First
Lansing, MI Cochise Community College Responder Program Director
Sierra Vista, AZ East Los Angeles College
John L. Beckman, FF/EMT-P, AA, BS Monterey Park, CA
Affiliated with Addison Fire Protection Gregory LaMay
District TEEX-ESTI Capt. Robert W. Rosier, NREMT-P
Fire Science Instructor, Technology Center College Station, TX Martinez-Columbia Fire Rescue
of DuPage EMS Director
Addison, IL Lawrence Linder PhD (c), NREMT-P Level II EMS Instructor
Educator Martinez, GA
Cheryl Blazek, EMT-P, EMS Training Hillsborough Community College
Program Coordinator Tampa, FL Kristie Skala
Southwestern Community College AIMS Community College
Creston, IA Eric T. Mayhew, AAS, NREMT-P, CICP Greeley, CO
Training Coordinator
Leo M. Brown Pender EMS Advanced Education Wade Skinner, EMT-B
Administrative Deputy Chief (retired) Institution West Jordan, UT
Longboat Key Fire Rescue Rocky Point, NC
Sarasota, FL Andrew W. Stern, MPA, MA, NREMT-P
Joseph McConomy Jr., MICP, EMT-B (I) Senior Paramedic
David J. Casella, NREMT-B Senior EMT Instructor Town of Colonie Emergency Medical
Opportunities in Emergency Health Care Burlington County Emergency Services Services
Program Training Center Colonie, NY
Osseo, MN Westampton, NJ
David L. Sullivan, PhD(c), NREMT-P
Tony Crystal, ScD, EMT-P Jack H. Meersman, NREMT-P EMS/CME Program Director
St. Mary’s Hospital Director of Training Pinellas County EMS
Decatur, IL Gold Cross Ambulance St. Petersburg College
Salt Lake City, UT Pinellas Park, FL
Lyndal M. Curry, M.A., NREMT-P
EMS Degree Program Director Edward Mello Jr., MSN., RN APN Robert G. West, Med., EMT-I, I/C
College of Allied Health Professions Director of Basic EMT Program Educator
University of South Alabama Westfield State College North Shore Community College
Mobile, AL Danvers, MA
Jeff Och, NREMT-B, RN
Doyle Dennis, AAS, NREMT-P Carver, MN
Medical Program Coordinator
Safety Management Systems Training Guy Peifer
Academy Paramedic Program Coordinator
Lafayette, LA Borough of Manhattan Community College
City University of New York
New York, NY
ACKNOWLEDGMENTS xxxiii
PHOTO ACKNOWLEDGMENTS
All photographs not credited adjacent to the photograph were photographed on
assignment for Brady/Pearson Education.
ORGANIZATIONS
We wish to thank the following organizations for their assistance in creating the photo
program for this book:
Alfred Fire Department, Alfred, ME David Kennebunk Fire and Rescue, Kennebunk, United Ambulance Service, Lewiston, ME.
Lord, Fire Chief ME. Deputy Chief David Cluff Paul Gosselin, Chief Executive Officer;
Elizabeth Delano, MS/IC/EMT-P, Education
Delta Ambulance, Waterville, ME. Paul NorthStar Ambulance, Farmington, ME. Manager; Stephanie Cordwell, AA/IC/EMT-
Thompson, EMT-P, Fleet Coordinator Michael Senecal, EMT-P, Director P, Education Coordinator
Oakland Fire Rescue, Oakland, ME. Chief Waterville Fire Department, Waterville, ME.
Fairfield Fire Rescue, Fairfield, ME. Chief
David Coughlin Chief David Lafountain
Duane Bickford
Sanford Fire Department, Sanford, Winslow Fire Department, Winslow, ME.
Falmouth Fire-EMS, Falmouth, ME. Asst. ME. Chief Raymond Parent, Regional Chief David Lafountain
Chief Doug Patey, EMT-P, I/C Coordinator
Kennebec Valley Emergency Medical
Services Council, Winslow, ME. Rick Petrie, Sanford Police Department, Sanford, ME.
EMT-P Thomas P. Connolly, Jr., Chief of Police
TECHNICAL ADVISORS
Thanks to the following people for providing technical support during the photo shoots
for this book:
Brian Chamberlin, EMT-P, KVEMSC/Augusta Rescue
Steven Diaz, MD, Maine General Medical Center & Maine EMS Medical Director
Carl French, CCEMTP/FF EMT-T, Sanford Fire Department, Sanford, ME
Judy French, EMT-I, Alfred Rescue, Alfred, ME
Lt. Paul Goldstein, FF/EMT, Falmouth, ME
Mark King, EMT-P, KVEMSC/Winthrop Ambulance, Winthrop, ME
Marc Minkler, EMT-P, Portland Fire Department, Portland, ME
Asst. Chief Doug Patey, EMT-P, I/C, Falmouth Fire-EMS, Falmouth, ME
Rick Petrie, EMT-P, KVEMSC/United Ambulance, Winslow, ME
Carol Pillsbury, EMT-P, NorthStar Ambulance
Tiffany Stebbins, EMT-P, KVEMSC
LOCATIONS
Thank you to the following people for providing locations for the updated second edition
of EMR Complete: A Worktext:
Matt and Melissa Bors, Sanford, ME
Kristin and Benjamin DalPra, Sanford, ME
Missy and Sear McCarthy, Sanford, ME
Sanford Police Department, Sanford, ME
Sgt. Craig Andersen, Team Commander, Southern Maine SRT
United Ambulance Service, Lewiston, ME
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DANCE ON STILTS AT THE GIRLS’ UNYAGO, NIUCHI
I see increasing reason to believe that the view formed some time
back as to the origin of the Makonde bush is the correct one. I have
no doubt that it is not a natural product, but the result of human
occupation. Those parts of the high country where man—as a very
slight amount of practice enables the eye to perceive at once—has not
yet penetrated with axe and hoe, are still occupied by a splendid
timber forest quite able to sustain a comparison with our mixed
forests in Germany. But wherever man has once built his hut or tilled
his field, this horrible bush springs up. Every phase of this process
may be seen in the course of a couple of hours’ walk along the main
road. From the bush to right or left, one hears the sound of the axe—
not from one spot only, but from several directions at once. A few
steps further on, we can see what is taking place. The brush has been
cut down and piled up in heaps to the height of a yard or more,
between which the trunks of the large trees stand up like the last
pillars of a magnificent ruined building. These, too, present a
melancholy spectacle: the destructive Makonde have ringed them—
cut a broad strip of bark all round to ensure their dying off—and also
piled up pyramids of brush round them. Father and son, mother and
son-in-law, are chopping away perseveringly in the background—too
busy, almost, to look round at the white stranger, who usually excites
so much interest. If you pass by the same place a week later, the piles
of brushwood have disappeared and a thick layer of ashes has taken
the place of the green forest. The large trees stretch their
smouldering trunks and branches in dumb accusation to heaven—if
they have not already fallen and been more or less reduced to ashes,
perhaps only showing as a white stripe on the dark ground.
This work of destruction is carried out by the Makonde alike on the
virgin forest and on the bush which has sprung up on sites already
cultivated and deserted. In the second case they are saved the trouble
of burning the large trees, these being entirely absent in the
secondary bush.
After burning this piece of forest ground and loosening it with the
hoe, the native sows his corn and plants his vegetables. All over the
country, he goes in for bed-culture, which requires, and, in fact,
receives, the most careful attention. Weeds are nowhere tolerated in
the south of German East Africa. The crops may fail on the plains,
where droughts are frequent, but never on the plateau with its
abundant rains and heavy dews. Its fortunate inhabitants even have
the satisfaction of seeing the proud Wayao and Wamakua working
for them as labourers, driven by hunger to serve where they were
accustomed to rule.
But the light, sandy soil is soon exhausted, and would yield no
harvest the second year if cultivated twice running. This fact has
been familiar to the native for ages; consequently he provides in
time, and, while his crop is growing, prepares the next plot with axe
and firebrand. Next year he plants this with his various crops and
lets the first piece lie fallow. For a short time it remains waste and
desolate; then nature steps in to repair the destruction wrought by
man; a thousand new growths spring out of the exhausted soil, and
even the old stumps put forth fresh shoots. Next year the new growth
is up to one’s knees, and in a few years more it is that terrible,
impenetrable bush, which maintains its position till the black
occupier of the land has made the round of all the available sites and
come back to his starting point.
The Makonde are, body and soul, so to speak, one with this bush.
According to my Yao informants, indeed, their name means nothing
else but “bush people.” Their own tradition says that they have been
settled up here for a very long time, but to my surprise they laid great
stress on an original immigration. Their old homes were in the
south-east, near Mikindani and the mouth of the Rovuma, whence
their peaceful forefathers were driven by the continual raids of the
Sakalavas from Madagascar and the warlike Shirazis[47] of the coast,
to take refuge on the almost inaccessible plateau. I have studied
African ethnology for twenty years, but the fact that changes of
population in this apparently quiet and peaceable corner of the earth
could have been occasioned by outside enterprises taking place on
the high seas, was completely new to me. It is, no doubt, however,
correct.
The charming tribal legend of the Makonde—besides informing us
of other interesting matters—explains why they have to live in the
thickest of the bush and a long way from the edge of the plateau,
instead of making their permanent homes beside the purling brooks
and springs of the low country.
“The place where the tribe originated is Mahuta, on the southern
side of the plateau towards the Rovuma, where of old time there was
nothing but thick bush. Out of this bush came a man who never
washed himself or shaved his head, and who ate and drank but little.
He went out and made a human figure from the wood of a tree
growing in the open country, which he took home to his abode in the
bush and there set it upright. In the night this image came to life and
was a woman. The man and woman went down together to the
Rovuma to wash themselves. Here the woman gave birth to a still-
born child. They left that place and passed over the high land into the
valley of the Mbemkuru, where the woman had another child, which
was also born dead. Then they returned to the high bush country of
Mahuta, where the third child was born, which lived and grew up. In
course of time, the couple had many more children, and called
themselves Wamatanda. These were the ancestral stock of the
Makonde, also called Wamakonde,[48] i.e., aborigines. Their
forefather, the man from the bush, gave his children the command to
bury their dead upright, in memory of the mother of their race who
was cut out of wood and awoke to life when standing upright. He also
warned them against settling in the valleys and near large streams,
for sickness and death dwelt there. They were to make it a rule to
have their huts at least an hour’s walk from the nearest watering-
place; then their children would thrive and escape illness.”
The explanation of the name Makonde given by my informants is
somewhat different from that contained in the above legend, which I
extract from a little book (small, but packed with information), by
Pater Adams, entitled Lindi und sein Hinterland. Otherwise, my
results agree exactly with the statements of the legend. Washing?
Hapana—there is no such thing. Why should they do so? As it is, the
supply of water scarcely suffices for cooking and drinking; other
people do not wash, so why should the Makonde distinguish himself
by such needless eccentricity? As for shaving the head, the short,
woolly crop scarcely needs it,[49] so the second ancestral precept is
likewise easy enough to follow. Beyond this, however, there is
nothing ridiculous in the ancestor’s advice. I have obtained from
various local artists a fairly large number of figures carved in wood,
ranging from fifteen to twenty-three inches in height, and
representing women belonging to the great group of the Mavia,
Makonde, and Matambwe tribes. The carving is remarkably well
done and renders the female type with great accuracy, especially the
keloid ornamentation, to be described later on. As to the object and
meaning of their works the sculptors either could or (more probably)
would tell me nothing, and I was forced to content myself with the
scanty information vouchsafed by one man, who said that the figures
were merely intended to represent the nembo—the artificial
deformations of pelele, ear-discs, and keloids. The legend recorded
by Pater Adams places these figures in a new light. They must surely
be more than mere dolls; and we may even venture to assume that
they are—though the majority of present-day Makonde are probably
unaware of the fact—representations of the tribal ancestress.
The references in the legend to the descent from Mahuta to the
Rovuma, and to a journey across the highlands into the Mbekuru
valley, undoubtedly indicate the previous history of the tribe, the
travels of the ancestral pair typifying the migrations of their
descendants. The descent to the neighbouring Rovuma valley, with
its extraordinary fertility and great abundance of game, is intelligible
at a glance—but the crossing of the Lukuledi depression, the ascent
to the Rondo Plateau and the descent to the Mbemkuru, also lie
within the bounds of probability, for all these districts have exactly
the same character as the extreme south. Now, however, comes a
point of especial interest for our bacteriological age. The primitive
Makonde did not enjoy their lives in the marshy river-valleys.
Disease raged among them, and many died. It was only after they
had returned to their original home near Mahuta, that the health
conditions of these people improved. We are very apt to think of the
African as a stupid person whose ignorance of nature is only equalled
by his fear of it, and who looks on all mishaps as caused by evil
spirits and malignant natural powers. It is much more correct to
assume in this case that the people very early learnt to distinguish
districts infested with malaria from those where it is absent.
This knowledge is crystallized in the
ancestral warning against settling in the
valleys and near the great waters, the
dwelling-places of disease and death. At the
same time, for security against the hostile
Mavia south of the Rovuma, it was enacted
that every settlement must be not less than a
certain distance from the southern edge of the
plateau. Such in fact is their mode of life at the
present day. It is not such a bad one, and
certainly they are both safer and more
comfortable than the Makua, the recent
intruders from the south, who have made USUAL METHOD OF
good their footing on the western edge of the CLOSING HUT-DOOR
plateau, extending over a fairly wide belt of
country. Neither Makua nor Makonde show in their dwellings
anything of the size and comeliness of the Yao houses in the plain,
especially at Masasi, Chingulungulu and Zuza’s. Jumbe Chauro, a
Makonde hamlet not far from Newala, on the road to Mahuta, is the
most important settlement of the tribe I have yet seen, and has fairly
spacious huts. But how slovenly is their construction compared with
the palatial residences of the elephant-hunters living in the plain.
The roofs are still more untidy than in the general run of huts during
the dry season, the walls show here and there the scanty beginnings
or the lamentable remains of the mud plastering, and the interior is a
veritable dog-kennel; dirt, dust and disorder everywhere. A few huts
only show any attempt at division into rooms, and this consists
merely of very roughly-made bamboo partitions. In one point alone
have I noticed any indication of progress—in the method of fastening
the door. Houses all over the south are secured in a simple but
ingenious manner. The door consists of a set of stout pieces of wood
or bamboo, tied with bark-string to two cross-pieces, and moving in
two grooves round one of the door-posts, so as to open inwards. If
the owner wishes to leave home, he takes two logs as thick as a man’s
upper arm and about a yard long. One of these is placed obliquely
against the middle of the door from the inside, so as to form an angle
of from 60° to 75° with the ground. He then places the second piece
horizontally across the first, pressing it downward with all his might.
It is kept in place by two strong posts planted in the ground a few
inches inside the door. This fastening is absolutely safe, but of course
cannot be applied to both doors at once, otherwise how could the
owner leave or enter his house? I have not yet succeeded in finding
out how the back door is fastened.