Agriculture Reference
In-Depth Information
4. Male circumcision
5. Piercing of earlobes
6. Extraction of carious teeth
7. Trephination
8. Cesarean section
Traditional surgeons are also capable of performing cataract operations; Thompson recorded this
observation:
8
Witch doctors of many tribes perform operations for cataracts. They squeeze the juice from the leaves
of an alkaloid-containing plant directly into the eye to desensitize it, then push the cataract aside with
a sharp stick. A surprising number of these cases turn out successfully'.
trEPhINatION Or CraNIOtOMY
It is perhaps necessary to discuss further the practice of trephination or craniotomy in traditional
African medicine. Trephination, in which a hole is drilled through the skull without penetrating
the brain membrane, is one of the oldest therapeutic procedures for which archaeological evidence
exists. Trephination was recommended by Hippocrates, the father of modern medicine, for the treat-
ment of skull fractures, epilepsy, and headache.
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In Africa, the practice of craniotomy dates as far
back as the time of the Egyptian pharaohs, and various forms of this surgery are known in parts of
North, East, and South Africa.
Two excellent accounts on the practice of trephination are the work of Margetts
10
and that of
Furnas et al.
9
on the craniotomy operations in East Africa. According to Furnas et al.
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a craniotomist
is known as
ornobari omotwe
, meaning “surgeon of skull” (plural
ababari ernetwe
), among the
Kisii tribe of Kenya. The authors observed that:
The ababari were neatly dressed, often with a necktie and jacket; they were punctual, clean, and precise
in their work, and they conducted their examinations, operations, and postoperative visits in a dignified
manner, showing genuine concern for their patients. When a serious postoperative complication was
recognized, the Ornobari would not delay in sending the patient to the hospital for treatment.
The ornobari employs various herbs and drugs to aid his surgical operation. Freshly prepared
leaves are used as hemostatic agents. Special medicines in the form of powders are also used to keep
out evil spirits during the surgery. The watery sap from the banana tree is used as an irrigation solu-
tion. Although the ornobari claim that the sap cools the wound, the real utility of the banana sap is
to provide astringency to the cut tissues. Oily preparations, including animal fats, petroleum jelly,
and butter (ghee), are used to cover the wound at the end of the operation. Effects of modernization
are beginning to show in the traditional practice as some ababari use antibiotics as part of their
postoperative care.
The wounds are usually left open but covered with herbal packs. Furnas et al. observed the
use of boiled hair from a cow's tail placed with an eyed needle as a form of suture.
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The authors
quoted an ornobari as saying that, “I leave the head wound open; otherwise, it will rot underneath.”
A detailed account of a case study of “a Kisii craniotomy” has been provided by Furnas et al. The
report contained details of preparations, instrument setup, anesthetics, scalp incisions, craniotomy,
and postoperative care.
The art of craniotomy is used for the treatment of acute head injury, post-traumatic symptoms,
and certain types of persistent headaches. The ababari advise against craniotomy during pregnancy,
while bleeding from both nose and ears, and for patients in coma.
