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(Ebook PDF) Cardiorespiratory Physiotherapy: Adults and Paediatrics: Formerly Physiotherapy For Respiratory and Cardiac Problems 5Th Edition
(Ebook PDF) Cardiorespiratory Physiotherapy: Adults and Paediatrics: Formerly Physiotherapy For Respiratory and Cardiac Problems 5Th Edition
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1
Dysfunctional Breathing
References
References
7 Physiotherapy Interventions
Traditional and Manual Airway Clearance Techniques
Adjunctive Techniques
Non-Invasive Ventilation
Incentive Spirometry
Glossopharyngeal Breathing
Oxygen Therapy
Hypertonic Saline
8
Mannitol
Dornase Alpha
Bronchodilators
Assessment of Dyspnoea
Breathing Control
References
Impact of Diagnosis
Conclusion
References
9
Problem Identification and Physiotherapeutic Interventions in ICU
Conclusion
References
Mechanical Ventilation
Pulmonary Conditions
References
10
11 Upper Abdominal and Cardiothoracic Surgery for Adults
Introduction
Types of Surgery
Acknowledgements
Appendix
References
Introduction
Exercise Prescription
Timing of Rehabilitation
Non-COPD Populations
Conclusions
11
Introduction
Exercise Prescription
Programme Implementation
Conclusion
References
Introduction
Introduction
Introduction
Respiratory Assessment
Physiotherapy Treatment
Conclusion
Introduction
History
Selection of Candidates
Contraindications to Transplantation
Assessment
12
Surgical Procedures
Key Concepts
Preoperative Rehabilitation
Postoperative Management
Outpatient Rehabilitation
Long-Term Management
Conclusion
Acknowledgement
Introduction
Conclusion
Introduction
Cystic Fibrosis
Asthma
Obesity
Heart Disease
Exercise Prescription
13
Introduction
Neurocognitive Interventions
Resources
Summary
References
Conversion Table
Abbreviations
Index
14
Copyright
Previous editions:
© 1993 Longman Group (UK) Limited.
© 1998, 2002, 2008 Elsevier Ltd. All rights reserved.
ISBN 978-0-7020-4731-2
Notices
Knowledge and best practice in this field are constantly changing.
As new research and experience broaden our understanding,
changes in research methods, professional practices, or medical
treatment may become necessary.
15
Practitioners and researchers must always rely on their own
experience and knowledge in evaluating and using any
information, methods, compounds, or experiments described
herein. In using such information or methods they should be
mindful of their own safety and the safety of others, including
parties for whom they have a professional responsibility.
To the fullest extent of the law, neither the Publisher nor the
authors, contributors, or editors, assume any liability for any injury
and/or damage to persons or property as a matter of products
liability, negligence or otherwise, or from any use or operation of
any methods, products, instructions, or ideas contained in the
material herein.
For Elsevier
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16
Printed in Italy
17
Dedication
18
Foreword
As previous editors of this textbook we feel very fortunate to have
two remarkably busy professors of physiotherapy who have carried
forward the editorship of this book. They are both actively involved
in leading cardiorespiratory physiotherapy research and in teaching
under- and postgraduate physiotherapists – Eleanor Main in
London and Linda Denehy in Melbourne.
The editors have brought together a wealth of knowledge and
evidence-based practice in respiratory and cardiac medicine,
physiotherapy and assessment techniques. Expert clinicians have
contributed important new material in cardiorespiratory care. This
international collaboration will facilitate further progress for the
benefit of both physiotherapists and patients.
Despite improvements in the design, quality and rigour of allied
healthcare research, there remains a paucity of evidence and a lack
of clarity for best practice in some clinical areas. In physiotherapy
research the ‘gold-standard’ randomized controlled trial is often
fraught with difficulty because of the inability to conceal treatment
allocation from participants. This can create uncontrollable bias
resulting from patient preference, particularly in studies which
involve a long-term burdensome intervention. Therefore clinical
expertise currently remains an important element of evidence-
based practice.
There have been many changes in healthcare provision and we
have come a long way since the early days of ‘chest physiotherapy’
and ‘postural drainage’ prescribed by medical practitioners. This
edition recognizes physiotherapists as highly skilled independent
practitioners who are integral members of the multidisciplinary
19
team. Their considerable depth of knowledge and ability to
interpret the many and ever-increasing investigative tests enable
them to identify appropriate treatments, exercise or education
programmes which meet the needs of individual patients.
This comprehensive new edition will be a great asset to both
undergraduate and postgraduate physiotherapists and other health
professionals interested in respiratory and cardiac problems. The
increase in research and improvements in clinical practice,
undertaken during the 23-year lifetime of this textbook, are in part
due to imaginative methods, advances in technology and education
by enthusiastic clinicians and academics such as our two new
editors. We believe that this edition will inspire another generation
of physiotherapists to advance our profession.
Barbara A Webber
Jennifer A Pryor
S Ammani Prasad
2016
20
About the Editors
Eleanor Main
21
Research at UCL in 2001, promoted to Senior Lecturer in 2007 and
to Professor of Physiotherapy in 2015. She has been programme
director for the UCL postgraduate Certificate, Diploma and MSc in
physiotherapy at UCL since 2005 and has supervised five PhD
students and 79 MSc project dissertations to date. In 2011 she was
awarded a Fellowship of the Chartered Society of Physiotherapy in
London for her ‘significant contribution to education, teaching and
learning in the field of cardiorespiratory and paediatric
physiotherapy’. Eleanor's primary research interests relate to
outcome measurement and clinical efficacy studies in
physiotherapy. This research, resulting in more than 80 peer-
reviewed publications, and attracting over £2.8 million in project
grant funding so far, has resulted in substantive advances in the
understanding of assessment and treatment of children who require
physiotherapy.
Linda Denehy
22
Linda developed curricula in cardiorespiratory physiotherapy both
for undergraduate and for postgraduate students and led the
implementation of the new three-year doctor of physiotherapy
entry to practice course at the University of Melbourne. She has
supervised 30 higher degree research students to completion and
has extensive research expertise in the area of cardiorespiratory
physiotherapy, particularly in patient populations who are acutely
unwell, including patients after major surgery and critically ill
patients. She has published more than 100 research publications in
peer-reviewed journals and 15 invited editorials or book chapters
and has been invited to more than 25 national and international
meetings as a keynote speaker. These include the European
Respiratory Society in 2014 and the American Thoracic Society in
2014 and 2016. She is currently involved in developing international
guidelines for ICU mobility and outcome measures in ICU. Linda
has been successful in obtaining funding from more than 30
applications of over $6 million Australian dollars for research into
physiotherapy and rehabilitation, including as a chief investigator
on five nationally competitive grants in rehabilitation after critical
illness, lung cancer and breathlessness in COPD. She reviews for
national and international competitive granting bodies and for
several international scientific journals including Lung Cancer,
Intensive Care Medicine, Critical Care Medicine and Thorax. Her
research has contributed to evidence-led practice, clinical guidelines
and improved patient-centred outcomes.
23
Preface
It has been a real privilege to be invited to co-edit the fifth edition of
this core international cardiorespiratory textbook. It has always
been an important text for undergraduate students around the
world but is also an enduringly valuable reference text for both
experienced and novice practitioners involved with
cardiorespiratory care.
There have been some interesting and important advances in
cardiorespiratory physiotherapy in the nine years since the first
printing of the fourth edition, and we have tried hard to include as
many of the new ideas and new pieces of evidence as possible.
Having said that, we acknowledge without reserve that we ‘stand
on the shoulders of giants’, and many of the essential timeless
features of the earlier editions remain intact.
Before we started, we asked clinical and university staff and
students what they most wanted to see in this new edition and, as a
result, we have made changes that we think will enhance the book.
Some of the changes involved updating information or
reorganizing where it is found in the text, and some are entirely
new chapters. For example, the new first chapter is an overview of
cardiorespiratory anatomy and physiology essentials, with
wonderful new illustrations, which we hope will be an outstanding
clinical reference. Similarly, the assessment chapter, now doubled
in length, provides an expanded and structured systematic
approach to clinical cardiorespiratory assessment. Other new
chapters include two dedicated to cardiac and respiratory problems
or pathology, an outcome measures chapter, a chapter on the
principles of exercise and physical activity in cardiorespiratory
24
populations and a chapter on cardiorespiratory rehabilitation of
special populations, for example, children or those with obesity,
cancer, liver disease or burns. Also new is the structure of the
Physiotherapy Interventions chapter (previously Techniques),
which is now problem-based rather than alphabetical, and which
hopefully will facilitate a clearer clinical reasoning pathway for
students or novice practitioners.
In general, topics related to the care of children with
cardiorespiratory problems have now been incorporated into
appropriate sections of text throughout the book, either because
there is significant overlap in approach or care between adults and
children, or because understanding children with cardiorespiratory
problems facilitates better care of individuals through the lifespan:
problems in childhood frequently continue into adulthood. An
exception is the division between the adult and paediatric ICU
chapters, because differences in the reasons for hospital admission
and clinical and physiotherapy management of these populations
remain substantial.
We are excited about and proud of the new edition and hope that
it continues to serve physiotherapy professionals in
cardiorespiratory care around the world for many years to come.
EM
LD
London and Melbourne 2016
25
Another random document with
no related content on Scribd:
We now come to Ebn Batúta; and we again find the same
surprising harmony between the fact regarding Bórnu, as mentioned
by him, and the dates of the chronicle. The famous and enterprising
traveller of Tangiers, on his return-journey from his visit to Western
Sudán, left the capital of Mélle or Máli (that is, Mungo Park’s Jára)
the 22nd of Moharrem, 754, and, proceeding by way of Timbúktu or
Túmbutu, and thence down the Ísa or Niger to Gágho or Gógo, and
thence to Tekádda,[44] in speaking about the copper found in the
mines near this town, relates that the bars made of it were exported
to Góber and Rágha (or rather Ragháy), and also to Bórnu, and then
adds the interesting fact that the name of the ruling king of the latter
country was Edrís.
Now if we follow implicitly the dates of the chronicle, Edrís ben
Ibrahím (Nikále) ascended the throne in that very year (753) when,
according to this precious and unimpeachable testimony of the
illustrious and intelligent traveller, he actually occupied the throne.
The very remarkable and really surprising harmony here shown to
exist between the chronicle and the dates which have come to our
knowledge from other sources, will, I hope, give to any unprejudiced
mind some degree of confidence in the authenticity of that
document, and will make him aware of its superiority over the
information of a man like Leo Africanus, or rather Hasen Ebn
Mohammed el Wasas, who, though he undoubtedly has, and will
always have, the merit of having given to Europe a clear general
view of the political and linguistic groups of Central Africa, yet, on
account of the manner in which his report was drawn up (merely
from memory, after the lapse of many years), cannot be a decisive
authority on any special circumstance. Hence, when he states that
the name of the king of Bórnu, at the time when he visited the
country, was Abraham (Ibrahím), we may confidently assume that he
is wrong, and that he speaks of the illustrious conqueror ʿAlí ben
Dúnama, who restored peace and glory to that distracted country,
and, on account of his warlike character and his various expeditions,
obtained the surname el Gházi. I shall return to this subject in the
chronological table, in speaking of the reign of ʿAlí ben Dúnama.
As for the document mentioned above as No. 5, it contains a few
valuable dates with regard to those Bórnu kings who reigned near
the time when the author obtained his information in Tripoli, while for
the older times, about which the people could only inform him “par
tradition des leurs pères,” his information is of little value. The most
important dates which it contains are those which have reference to
the time of the accession to the throne of the three Bórnu kings,
ʿAbdallah ben Dúnama, Háj ʿOmár, and Háj ʿAlí; and these vary but
little from the dates computed from the chronicle, and serve
therefore to confirm its accuracy.
However, it is not my design to vindicate this chronicle from all
possibility of error; but my object is to show that its general
character, dry and meagre as it is, has the strongest claim to
authenticity. Indeed I am sure that it can be fully relied upon, all
uncertainty being reduced to a space of one or two years; I may
therefore be allowed to assert that the chronological table, which I
shall give in the Appendix, is something more than a mere fairy tale.
But in this place, I think it well to offer a few general remarks on the
characteristic features of the history of Bórnu.
I have first to speak of the origin of the Séfuwa or Dúguwa. We
have already seen that the chronology of the Bórnu people, if
palpable absurdities be left out of consideration, does not carry their
history further down than the latter half of the ninth century of our
era. Accordingly there can be no further question as to whether Séf
was really the son of the celebrated Dhu Yazan, and identical with
Séf Dhu Yazan, the last native ruler of the Himyaritic kingdom, who
celebrated his accession to the throne in the famous castle of
Gumdán, and with the assistance of Khosru Parvis liberated Yeman
from the dominion of the Abyssinians. I frankly confess that, while
Ibrahím the son of Séf, as “father of the king” (as he appears to have
been entitled occasionally), seems to me to have a really historical
character, I entertain sincere doubts whether Séf be not a mere
imaginary personage, introduced into the pedigree expressly in order
to connect it with Yeman. Indeed, in one short list of Bórnu kings
which I possess, several princes are mentioned before Séf, whose
names, such as Futírmi, Hálar Sukayámi, Halármi, Bunúmi, Rizálmi,
Mairími, have quite a Kanúri character. As the reader will see, I do
not at all doubt of some connection existing between the ruling family
of Bórnu and the Himyaritic or Kushitic stock; but I doubt its
immediate descent from the royal Himyaritic family.
But be this as it may, I think that Leo Africanus, who is a very good
authority for general relations, is right in stating that the kings of
Bórnu originated from the Libyan tribe of the Bardoa, a tribe also
mentioned by Makrízí as Berdʿoa. That there is an ethnological
connection between the names Bérnu or Bórnu, Bórgu, Berdʿoa,
Berdáma, Berauni, Berber, can scarcely be doubted; but to many the
Berdʿoa might seem to have nearer relation with the Tedá or Tébu
than with the real Berber or Mazígh. Sultan Béllo certainly, in the
introduction to his history of the conquests of the Fúlbe, expressly
says that the Bórnu dynasty was of Berber origin; and it is on this
account that the Háusa people call every Bórnu man “ba-Bérberche,”
and the Bórnu nation “Bérbere.” This view of the subject is confirmed
by the distinct statement of Makrízí, who says that that was the
common tradition of the people at his time—“it is said that they are
descended from the Berbers,”—and moreover in another passage
informs us that the king of Kánem was a nomade, or wanderer;
although it seems that this statement refers properly to the Bulála
dynasty.
Before the time of Sélma, or Sélmama, the son of Bíkoru, whose
reign began about a.h. 581, the kings are stated by the chronicle to
have been of a red complexion, like the Arabs; and to such an origin
from the red race, the Syrian-Berber stock, is certainly to be referred
their custom of covering the face and never showing the mouth, to
which custom Ebn Batúta adverts in speaking of King Edrís, who
ruled in his time. To this origin is also to be referred the custom, till
recently practised, of putting the new king upon a shield, and raising
him up over the heads of the people, as well as the polity of the
empire, which originally was entirely aristocratical, based upon a
council of twelve chiefs, without whose assent nothing of importance
could be undertaken by the king.
We have a very curious statement concerning the Bórnu empire,
emanating from Lucas, the traveller employed by the African
Association, and based on the authority of his Arab informants,
principally Ben ʿAlí, who no doubt was a very clever and intelligent
man. He describes the Bórnu kingdom as an elective monarchy, the
privilege of choosing a successor among the sons of a deceased
king, without regard to priority of birth, being conferred by the nation
on three of the most distinguished men of the country. He does not
say whether these belonged to the courtiers, or whether every
private individual might be called upon promiscuously to fulfil this
important duty; but the strict etiquette of the court of Bórnu makes it
probable that the former was the case. Be this as it may, the choice
being made, the three electors proceeded to the apartment of the
sovereign elect, and conducted him in silence to the gloomy place in
which the unburied corpse of his deceased father was deposited; for
till this whole ceremony was gone through the deceased could not
be interred. There, over the corpse of his deceased father, the newly
elected king seems to have entered into some sort of compromise
sanctioned by oath, binding himself that he would respect the
ancient institutions, and employ himself for the glory of the country.
I shall have to mention a similar custom still prevailing at the
present day in the province of Múniyó, which belonged to that part of
the empire called Yerí, while the dynasty of the Múniyóma probably
descended from the Berber race. Every newly elected Múniyóma,
still at the present day, is in duty bound to remain for seven days in a
cave hollowed out by nature, or by the hand of man, in the rock
behind the place of sepulchre of the former Múniyóma, in the ancient
town of Gámmasak, although it is quite deserted at present, and
does not contain a living soul.
But that not only the royal family, but even a great part of the
whole nation, or rather one of the nations which were incorporated
into the Bórnu empire, was of Berber origin, is still clear so late as
the time of Edrís Alawóma, that is to say, only two centuries and a
half ago; for in the report of his expeditions, constant mention is
made of the Berber tribes (“kabáíl el Beráber”) as a large component
part of his army, and constantly two parts of this army are
distinguished as the Reds, “el Áhhmar,” and the Blacks, “eʾ Súd.”
This part of the population of Bórnu has separated from the rest, I
suspect in consequence of the policy of ʿAlí, the son and successor
of Háj ʿOmár, a very warlike prince, who, in the second half of the
seventeenth century, waged a long war with Ágades.
Viewed in the light thus shed by past history, the continual and
uninterrupted warlike expeditions made by the Tuarek at the present
time against the northern regions of Bórnu and against Kánem
assume quite a new and far more interesting character. Now if it be
objected that the Kanúri or Bórnu language does not appear to
contain any Berber elements (which indeed it does not), I have only
to adduce the exactly parallel example of the Bulála, a brother
dynasty of the Bórnu royal family, descended from the same stock,
who, having settled and founded a dynasty among the tribe of the
Kúka, in the territory of Fíttri, still continue to speak their native
language, that is the Kanúri, in the time of Leo,[45] but have now
entirely forgotten it, adopting the language of the people over whom
they ruled; and similar examples are numerous.
A second point which deserves notice is, that the Kanúri even at
the present day call people in general, but principally their kings,
always after the name of their mother, and that the name of the
mother’s tribe is almost continually added in the chronicle as a
circumstance of the greatest importance. Thus the famous king
Dúnama ben Selmʿaa is known in Bórnu generally only under the
name of Díbalámi, from the name of his mother Díbala; and the full
form of his royal title is Díbalámi Dúnama Selmámi, his mother’s
name, as the most noble and important, preceding his individual
name, which is followed by the name derived from his father. It is
also evident, even from the dry and jejune report of the chronicle,
what powerful influence the Walíde or “Mágira”—this is her native
title—exercised in the affairs of the kingdom; I need only mention the
examples of Gúmsu (“gúmsu” means the chief wife) Fasámi, who
imprisoned her son Bíri, when already king, for a whole year, and of
Áʿaishad or ʿAisa, the mother of Edrís, who for a number of years
exercised such paramount authority, that in some lists, and even by
many ʿulama at the present time, her name is inserted in the list of
the sovereigns of the country.
These circumstances may be best explained by supposing that a
kind of compromise took place between the strangers—Berbers, or
rather Imóshagh (Mazígh) from the tribe of the Berdʿoa—and the
tribe or tribes among whom they settled, just in the same manner as
we have seen that a stipulation of the same kind was probably made
between the conquering Kél-owí and the ancient inhabitants of Aír of
the Góber race; and the same circumstances, with similar results,
are observable in ancient times, in the relations subsisting between
the Grecian colonists and the original inhabitants of Lycia.
The most important among the indigenous tribes of Kánem are the
Kíye or Beni Kíya, also mentioned in the time of Edrís Alawóma, the
Meghármah, who may possibly be identical with the Ghemármah,
the Temághera (evidently a Berber name), the Débiri, the Kúnkuna,
at present established in Kárgá, and finally the Tébu or Tubu, or
rather Tedá. Of all these the last-named constituted by far the most
important and most numerous tribe. To them belonged the mother of
Dúnama ben Humé, the most powerful of the older kings of Bórnu,
who appears to have thrice performed the pilgrimage to Mekka.
Indeed it would seem that the real talisman which Díbalámi Dúnama
Selmámi spoiled consisted in the friendly relation between the
Berauni or Kanúri and the Tébu, which was so intimate that the
name of Berauni, which originally belonged to the inhabitants of
Bórnu, is still at present the common name given by the Tuarek to
the Tébu; or rather, the latter are a race intimately related to the
original stock of the Kanúri, as must become evident to every
unprejudiced mind that investigates their language.
How powerful a tribe the Tedá were, is sufficiently shown by the
length of the war which they carried on with that very king Dúnama
Selmámi, and which is said to have lasted more than seven years.
Indeed, it would seem as if it had been only by the assistance of this
powerful tribe that the successors of Jíl Shikomémi were able to
found the powerful dynasty of the Bulála, and to lay the foundation of
the great empire called by Leo Gaoga, comprehending all the
eastern and north-eastern parts of the old empire of Kánem, and
extending at times as far as Dóngola, so that in the beginning of the
sixteenth century it was larger than Bórnu. Even in the latter half of
the sixteenth century, the Tedá appears to have constituted a large
proportion of the military force of the Bulála in Kánem; and great
numbers of them are said, by the historian of the powerful king Edrís
Alawóma, to have emigrated from Kánem into Bórnu, in
consequence of the victories obtained by that prince over the Bulála.
At that time they seem to have settled principally in the territories of
the Koyám, a tribe very often mentioned in the book of Imám Ahmed
as forming part of the Bórnu army, and with whom at present they
are completely intermixed. It is very remarkable, that neither by the
chronicle, nor by the historian of Edrís Alawóma, the large tribe of
the Mánga, which evidently formed a very considerable element in
the formation of the Bórnu nation, is ever once mentioned.
While the tribes above enumerated were more or less absorbed by
the empire of Kánem, and, in the course of time, adopted the
Mohammedan religion professed by its rulers, there was on the other
hand a very numerous indigenous tribe which did not become
amalgamated with the conquering element, but, on the contrary,
continued to repel it in a hostile manner, and for a long time
threatened its very existence. These were the “Soy” or “Só,” a tribe
settled originally in the vast territory enclosed towards the north and
north-west by the komádugu Wáube, erroneously called the Yeou,
and towards the east by the Shári, and divided, as it would seem,
into several small kingdoms.
This powerful tribe was not completely subjugated before the time
of Edrís Alawóma, or the latter part of the sixteenth century; and it
might be matter of surprise that they are not mentioned at all by the
chronicle before the middle of the fourteenth century, if it were not
that even circumstances and facts of the very greatest importance
are passed over in silence by this arid piece of nomenclature. It
would therefore be very inconsistent to conclude from this silence,
that before the period mentioned the princes of Kánem had never
come into contact with the tribe of the Soy; the reason why the
chronicle, sparing as it is of information, could not any longer pass
them over in silence, was that in the space of three years they had
vanquished and killed four successive kings. The places mentioned
in the list, where the first three of these princes were slain, cannot be
identified with absolute certainty; but as for Nánighám, where
Mohammed ben ʿAbdallah was killed, it certainly lay close to, and
probably in, the territory of the Soy. After this period we learn
nothing, with regard to this tribe until the time of Edrís Alawóma,
although it seems probable that Edrís Nikálemi, the successor of
Mohammed ben ʿAbdallah, and the contemporary of Ebn Batúta,
had first to gain a victory over the Soy, before he was able to sit
down quietly upon his throne.
Altogether, in the history of Bórnu we can distinguish the following
epochs. First, the rise of power in Kánem, Njímiye being the capital
of the empire, silent and imperceptible till we see on a sudden, in the
beginning of the twelfth century, the powerful prince Dúnama ben
Humé start forth under the impulse of Islám, wielding the strength of
a young and vigorous empire, and extending his influence as far as
Egypt. The acme, or highest degree of prosperity, of this period
coincides with the reign of Díbalámi Dúnama Selmámi, in the middle
of the thirteenth century, during the prime of the dynasty of the Beni
Háfis in Tunis. But this reign already engendered the germs of
decay; for during it the two cognate elements of which the empire
consisted, namely the Tedá and the Kanúri, were disunited, and it
yielded too much influence to the aristocratical element, which was
represented by the twelve great offices, an institution which seems to
deserve particular attention.
The consequence was, that a series of civil wars and regicides
ensued, interrupted only by the more tranquil reign of Ibrahím
Nikálemi in the first half of the fourteenth century, which was
followed, however, by the most unfortunate period of the empire,
when the great native tribe of the Soy burst forth and killed four kings
in succession. Then followed another respite from turmoil, just at the
time when Ebn Batúta visited Negroland; but the son of the very king
who in the time of that distinguished traveller ruled over Bórnu fell
the first victim in the struggle that ensued with a power which had
arisen from the same root, had gained strength during the civil wars
of Bórnu, and which now threatened to swallow it up altogether. This
was the dynasty of the Bulála, which, originating with the fugitive
Bórnu prince Jíl Shikomémi, had established itself in the district of
Fíttri over the tribe of the Kúka, and from thence spread its dominion
in every direction till, after a sanguinary struggle, it conquered
Kánem, and forced the Kanúri dynasty to seek refuge in the western
provinces of its empire, about the year 1400 of our era.
The Bórnu empire (if we may give the name of empire to the
shattered host of a belligerent tribe driven from their home and
reduced to a few military encampments) for the next seventy years
seemed likely to go to pieces altogether, till the great king ʿAli
Dúnamámi opened another glorious period; for having at length
mastered the aristocratical element, which had almost overwhelmed
the monarchy, he founded as a central point of government a new
capital or “bírni,” Ghasréggomo, the empire having been without a
fixed centre since the abandonment of Njímiye. It was in his time that
Leo Africanus visited Negroland, where he found the Bulála empire
(Gaoga) still in the ascendant: but this was changed in the beginning
of the sixteenth century, even before the publication of his account;
for in the hundred and twenty-second (lunar) year from the time
when ʿOmár was compelled to abandon his royal seat in Njímiye,
ceding the rich country of Kánem, the very nucleus of the empire, to
his rivals, the energetic king Edrís Katakarmábi entered that capital
again with his victorious army, and from that time down to the
beginning of the present century Kánem has remained a province of
Bórnu, although it was not again made the seat of government.
Altogether the sixteenth century is one of the most glorious
periods of the Bórnu empire, adorned as it is by such able princes as
the two Edrís and Mohammed, while in Western Negroland the great
Sónghay empire went to pieces, and was finally subjugated by Mulay
Hámed el Mansúr, the Emperor of Morocco. Then followed a quieter
period, and old age seemed gradually to gain on the kingdom, while
pious and peaceful kings occupied the throne, till in the middle of the
last century the energetic and enterprising king ʿAli ʿOmármi began a
violent struggle against that very nation from which the Bórnu
dynasty had sprung, but which had now become its most fearful
enemy—the Imóshagh or Tuarek. He made great exertions in every
direction; but his efforts seem to have resembled the convulsions of
death, and being succeeded by an indolent king, for such was
Ahmed, the fatal hour, which was to accomplish the extinction of the
dynasty of the Séfuwa, rapidly approached. At last, when the very
centre of the empire had already fallen a prey to a new nation which
had started forth on a career of glory, the Fúlbe or Felláta, there
arose a stranger, a nationalized Arab, who, in saving the last
remains of the kingdom, founded a new dynasty, that of the
Kánemíyín, which, after having shone forth very brightly under its
founder, was recently reduced by civil discord, and seems now
destined to a premature old age.
CHAPTER XXX.
THE CAPITAL OF BÓRNU.