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A History of Modern Africa 3rd Edition

Richard J. Reid
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Praise for the first edition

“This book stands as a remarkable achievement and will be the choice volume
on modern African history for some time to come.”
—International Affairs

“A number of introductions to African history aimed at the undergraduate and


general reader have appeared in recent years. Reid’s text stands out among
these as an invaluable teaching‐tool due to its concise but appealing tone, its
clear style, and its sensitive treatment of Africa’s often tumultuous past and
contested present‐day experiences. This is an excellent introduction to Africa
for the student reader.”
—History

“This is a comprehensive, appealing and highly‐accessible history of modern


Africa which portrays the continent’s turbulent past and contested present in
all its variety and complexity. Its combination of sound scholarship, clear writ-
ing and humane understanding make it an important contribution to under-
standing of recent African history.”
—Bill Nasson, University of Cape Town

“This is the book for which I have been waiting. The author has done all of us a
great service in providing such an effective teaching tool.”
—Richard Waller, Bucknell University
A History of Modern Africa
Concise History of the Modern World

Covering the major regions of the world, each history in this series provides a v ­ igorous
interpretation of its region’s past in the modern age. Informed by the latest scholarship,
but assuming no prior knowledge, each author presents developments within a clear
analytic framework. Unusually, the histories acknowledge the limitations of their own
generalizations. Authors are encouraged to balance perspectives from the broad historical
landscape with discussion of particular features of the past that may or may not conform
to the larger impression. The aim is to provide a lively explanation of the transformations
of the modern period and the interplay between long‐term change and “defining
moments” of history.

Published

A History of Modern Latin America


Teresa A. Meade

Forthcoming

A History of Modern East Asia


Charles Armstrong

Chosen Nation: A History of the American People since 1886


Maurice Isserman

Europe since 1815


Albert Lindemann

A History of Russia since 1700


Rex Wade
A History of Modern Africa
1800 to the Present
THIRD EDITION

Richard J. Reid
This edition first published 2020
© 2020 John Wiley & Sons, Inc.

Edition History
John Wiley & Sons Ltd (2e, 2012); Blackwell Publishing Ltd (1e, 2009)

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Library of Congress Cataloging‐in‐Publication Data


Names: Reid, Richard J. (Richard James), author.
Title: A history of modern Africa : 1800 to the present / Richard J. Reid.
Description: Third edition. | Hoboken : Wiley, 2019. | Series: Concise
history of the modern world | Includes index. |
Identifiers: LCCN 2019014831 (print) | LCCN 2019015533 (ebook) | ISBN
9781119381952 (Adobe PDF) | ISBN 9781119381778 (ePub) |
ISBN 9781119381921 (pbk.)
Subjects: LCSH: Africa–History. | Africa–Historiography. |
Africa–Colonization–History. | Decolonization–Africa–History. | Slave
trade–History–Colonies.
Classification: LCC DT20 (ebook) | LCC DT20 .R45 2019 (print) | DDC
960.3–dc23
LC record available at https://lccn.loc.gov/2019014831

Cover image: © Robert Muckley / Getty Images


Cover design by Wiley

Set in 10/13pt Photina by SPi Global, Pondicherry, India

10 9 8 7 6 5 4 3 2 1
Still for Anna and May, and now also for Thea.
Contents

List of Maps xiii


List of Plates xv
Acknowledgments xviii
Acknowledgments for the Second Edition xix
Acknowledgments for the First Edition xx

1 Introduction: Understanding the Contours of Africa’s Past 1


A Brief History of the Study of Africa 5
Land 8
People 12

Part I Polity, Society, and Economy: Ingenuity and Violence


in the Nineteenth Century 19

2 Western Transitions: Slave Trade and “Legitimate”


Commerce in Atlantic Africa 25
States and Societies during the Atlantic Slave Trade 26
“Illegal” Traffic: The Nineteenth‐Century Slave Trade 30
Mineral and Vegetable: “Legitimate” Commerce 34
Change and Continuity in Forest and Savannah 37

3 Eastern Intrusions: Slaves and Ivory in Eastern Africa 47


Commercial Horizons: Slaves and Ivory 48
Maritime Empire: Zanzibar 53
Statehood, Conflict, and Trade (1): The Lacustrine Zone 57
Statehood, Conflict, and Trade (2): Northeastern Africa 64
x C o ntents

4 Southern Frontiers: Colony and Revolution in


Southern Africa 71
African State and Society to around 1800 71
War, Revolution, and the Zulu Impact 73
Cape Colonialism: White Settlement and the “Native Question” 78
Balances of Power to around 1870 81

Part II Africa and Islam: Revival and Reform in the


Nineteenth Century 85

5 Revival and Reaction: North African Islam 89


Old and New Identities: Brotherhoods of the Desert 89
Trade and Conflict in the Mediterranean World: Ottoman and
European Frontiers 90
Changing Society (1): The Maghreb 94
Changing Society (2): Egypt 97

6 Jihad: Revolutions in Western Africa 103


Islam in Western Africa to the Eighteenth Century 103
The Wandering Fulani 105
Prophets and Warriors 106

7 The Eastern Crescent: The Islamic Frontier in


Eastern Africa 112
Swahili Islam: Coastal Frontiers in the Nineteenth Century 112
Islam in the Central East African Interior 114
Cross and Crescent in Northeast Africa 115
Islam on the Nile 117

Part III Africa and Europe: Commerce, Conflict and


Co-option, to c.1920 121

8 The Compass and the Cross 127


Interested Gentlemen and Learned Bodies: Explorers
and Exploration 128
Creeping Hegemony and the Invention of Africa 131
European Missionary Activity in Africa to around 1800 133
Evangelical Humanitarians: Missionary Revival 135
The Christian Impact on Culture, State, and Society 137
Mission and Empire 142
C o ntents xi

9 “Whatever Happens …”: Towards the Scramble 148


Africa and Theories of Imperialism 149
Race and Culture 152
Disorder and Civilizing Violence: Political and Economic
Justifications 154

10 Africans Adapting: Conquest and Partition 159


Explaining the “Conquest” 159
Spears and Water: Violent Resistance 164
Histories Old and New: Colonialism and
Historical “Knowledge” 174
Realities Old and New: Colonialism and
Political “Knowledge” 177
Bush Wars and Distant Shadows: Africa in
Global War 184

Part IV Colonialisms 193

11 “Pax Colonia”?: Empires of Soil and Service 199


Monopolies on Violence 200
Slaves and Labor 203
Cash Crops 204
White Settlement 209
Industry 211
Social Change and Emergent Crisis 214
Hearts and Minds 217
Environment and Medicine 220

12 Hard Times: Protest, Identity, and Depression 230


Making Tribes 230
Emergent Protest in the Islamic World 233
Salvation and Resistance: The African Church 235
Class and Tribe: The Industrial Complex 236
Cash Crops, Rural Crises, and Peasant Protest 239
Other Voices 242

13 Battles Home and Away: Africa in


Global War (Again) 248
The War in the Continent 248
Shifts in Politics and Society 253
xii C o ntents

Part V The Dissolution of Empire 259

14 The Beached Whale: Colonial Strategies in the Postwar World 265


Postwar Africa and the International Climate 266
Economic Policies and Visions, c. 1945–50 267
Political Plans, c. 1945–50 270

15 Conceiving and Producing Nations 273


The Widening Horizons of Belonging 274
Tensions and Transitions: From Political Consciousness to Political Parties 275
Irresistible Force and Immovable Object: Nationalists and Settlers 282
A Time of Contrasts 287

16 Compromising Conflict: Routes to Independence 290


Debate and Debacle: “Constitutional” Transfers of Power 290
Violence: Growth, Form, and Impact 299
From Suez to Sharpeville, and Beyond: The End of High Imperialism 305

Part VI Legacies, New Beginnings, and Unfinished Business 311

17 Unsafe Foundations: Challenges of Independence 317


Building the Nation (1): Economy and Society 317
Building the Nation (2): Polity 324
Political Stability and Islam 330
Crowded House: Africa and the Cold War 335

18 Violence and the Militarization of Political Culture 343


The Military in African Politics 343
The Politics and Cultures of Insurgency 347
New Wars, Old Problems, and Expanding Military Horizons 354

19 Rectification, Redemption, and Reality: Issues and Trends


in Contemporary Africa 359
Africa and the Contemporary World 359
Democracy and Authoritarianism: Trends in Governance 363
Body and Mind 369
Contemporary Economics: Assessing “Development” and “Growth” 372

Further Reading 381


Index384
List of Maps

Main vegetation zones of Africa. Source: From M. Crowder (ed.),


Cambridge History of Africa. Vol. 8: c.1940–c.1975 (Cambridge, 1984),
p. 194, Map 5; © 1984 by Cambridge University Press. Reprinted with
permission from Cambridge University Press. 9
Physical Africa. Source: From J. Iliffe, Africans: The History of a Continent
(Cambridge, 1995), p. 2, Map 1. © 1995 by Cambridge University Press.
Reprinted with permission from Cambridge University Press. 10
Atlantic Africa in the nineteenth century. 27
Central Africa in the nineteenth century. Source: From J. E. Flint (ed.),
Cambridge History of Africa. Vol. 5 c.1790–c.1870 (Cambridge, 1976),
© 1976 by Cambridge University Press. Reprinted with permission
from Cambridge University Press. 29
West Africa c.1865. Source: From J. E. Flint (ed.), Cambridge History of
Africa. Vol. 5: c.1790–c.1870 (Cambridge, 1976), Map 7; © 1976 by
Cambridge University Press. Reprinted with permission from
Cambridge University Press. 31
Eastern and southern Africa in the nineteenth century. 49
East Africa c.1870. Source: From J.E. Flint (ed.), Cambridge History
of Africa. Vol. 5: c.1790–c.1870 (Cambridge, 1976), p. 281, Map 10;
© 1976 by Cambridge University Press. Reprinted with permission
from Cambridge University Press. 52
The Horn of Africa in the nineteenth century. Source: From J. E. Flint (ed.),
Cambridge History of Africa. Vol. 5: c.1790–c.1870 (Cambridge, 1976),
© 1976 by Cambridge University Press. Reprinted with permission
from Cambridge University Press. 65
Southern Africa in the nineteenth century. Source: From J. E. Flint (ed.),
Cambridge History of Africa. Vol. 5: c.1790–c.1870 (Cambridge,
1976), p. 354; © 1976 by Cambridge University Press. Reprinted
with permission from Cambridge University Press. 74
x iv L ist o f M aps

North Africa in the nineteenth century. Source: From J. E. Flint (ed.),


Cambridge History of Africa. Vol. 5: c.1790–c.1870 (Cambridge,
1976), p. 100, Map 6; © 1976 by Cambridge University Press.
Reprinted with permission from Cambridge University Press. 93
Egypt and the Nile Valley c.1800. Source: From J. E. Flint (ed.),
Cambridge History of Africa. Vol. 5: c.1790–c.1870 (Cambridge,
1976), p. 12, Map 1; © 1976 by Cambridge University Press.
Reprinted with permission from Cambridge University Press. 98
The early phase in the partition of Africa, to c.1887. Source: From R.
Oliver and G.N. Sanderson (eds.), Cambridge History of Africa. Vol. 6:
1870–1905 (Cambridge, 1985), p. 140, © 1985 by
Cambridge University Press. Reprinted with permission from
Cambridge University Press. 163
The partition continued: Africa c.1895. Source: From R. Oliver and
G.N. Sanderson (eds.), Cambridge History of Africa. Vol. 6: 1870–1905
(Cambridge, 1985), p. 146, © 1985 by Cambridge University Press.
Reprinted with permission from Cambridge University Press. 168
Partition complete: Africa c.1902. Source: From R. Oliver and
G.N. Sanderson (eds.), Cambridge History of Africa. Vol. 6: 1870–1905
(Cambridge, 1985), p. 152, © 1985 by Cambridge University Press.
Reprinted with permission from Cambridge University Press. 173
Colonial economics (1): areas of European farming. Source:
From B. Davidson, Modern Africa: A Social and Political History,
3rd ed. (London and New York: Longman, 1994), p. 15, Map 2. © 1994 by
Basil Davidson. Reproduced with permission of Taylor and Francis. 205
Colonial economics (2): mineral exploitation and railways.
Source: From B. Davidson, Modern Africa: A Social and Political
History, 3rd ed. (London and New York: Longman, 1994),
p. 49, Map 5. © 1994 by Basil Davidson. Reproduced with permission
of Taylor and Francis. 213
Decolonization. Source: From G. Arnold, Africa: A Modern History
(London: Atlantic Books, 2005), p. xxii. © 2005 by Guy Arnold.
Reprinted with permission from Atlantic Books Ltd and the author. 293
Postcolonial cash‐crop economies. Source: From B. Davidson,
Modern Africa: A Social and Political History, 3rd ed. (London and
New York: Longman, 1994), p. 222, Map 10. © 1994 by Basil Davidson.
Reproduced with permission of Taylor and Francis. 319
Postcolonial mineral exploitation. Source: From B. Davidson,
Modern Africa: A Social and Political History, 3rd ed. (London and
New York: Longman, 1994), p. 235, Map 11. © 1994 by Basil Davidson.
Reproduced with permission of Taylor and Francis. 320
Modern African nation‐states. 321
List of Plates

Ruler of a kingdom in transition: King Gezo of Dahomey, with


Prince Badahun, in 1856. Source: BLM Collection/Alamy Stock Photo. 40
An aspect of Kumasi, capital of Asante, in the 1820s. Private Collection/
The Bridgeman Art Library. Source: The New York Public Library/https://
digitalcollections.nypl.org/items/510d47da‐71ff‐a3d9‐e040‐
e00a18064a99/Public Domain. 42
An East African ivory porter in the mid‐nineteenth century.
Private Collection/The Stapleton Collection/The Bridgeman
Art Library. Source: The New York Public Library/ https://
digitalcollections.nypl.org/items/510d47da‐6e21‐a3d9‐e040‐
e00a18064a99/Public Domain. 54
Commercial pioneers: Seyyid Barghash, Sultan of Zanzibar (1870–88),
with his advisors. Source: Photograph courtesy of the Peabody Essex
Museum. Neg 13462. 55
Slaving violence in East Africa: the massacre of Manyema women at
Nyangwe, c.1870. Source: The British Library Board, The British
Library, B 224 DSC. 56
The state‐builder: Mirambo of the Nyamwezi, in the early 1880s.
Source: Reproduced from London Missionary Society/Council for
World Mission Archives. 62
Mutesa, kabaka of Buganda (c.1857–84), with his court, late 1870s.
Source: Universal History Archive/UIG via Getty Images. 64
Vision of African genius: Shaka, king of the Zulu, c.1816–28. British
Library/HIP/Topfoto. Source: Reproduced with permission of
The Trustees of the British Museum. 76
Romanticized Africa: Napoleon’s invasion of Egypt portrayed in
The Battle of Heliopolis, by Leon Cogniet (c.1850). Source: Photograph
courtesy Mathaf Gallery, London. 91
xvi L ist o f P lates

Cairo in the mid‐nineteenth century. Syndics of Cambridge University


Library, Tab. b.13. Source: Reproduced with permission of
University of Cambridge. 100
Ethiopian depiction of the battle of Adwa, 1896. © The Trustees of
the British Museum. Source: PvE/Alamy Stock Photo. 161
“The aftermath at Omdurman,” from the Illustrated London
News, 1898. Source: Reproduced with permission of Mary
Evans/ILN Pictures. 170
New order in Uganda: the young Kabaka Daudi Chwa at
Namirembe Cathedral, Kampala, 1902. Source: ©The British
Library Board, British Library, W24/2136 DSC. 182
Lord Lugard and Northern Nigerian chiefs, London Zoo, c.1925.
Hulton Archive/Getty Images. Source: Reproduced from Fox
Photos/Stringer. 183
African view of the colonial order: Congolese wood carving from
the 1920s. Source: Reproduced with permission of Werner
Forman Archive/Musée Royal de l’Afrique Centrale, Tervuren. 241
Urban idyll: Freetown, Sierra Leone, c.1960. Source: Interfoto/
Alamy Stock Photo. 244
For the empire? West African troops in action in Burma, c.1943.
Imperial War Museum Q 53630. Source: Reproduced with
permission of AP Images. 252
Military tradition: officer and men of the Kings African Rifles,
Uganda. Source: Courtesy of the Council of the National
Army Museum, London. 253
Kwame Nkrumah, first leader of independent Ghana. Source:
akg‐images/ullstein bild. 279
Hastings Banda, first leader of independent Malawi. Source:
Central Press/Getty Images. 280
The cost of violence: funeral of the victims of the Philippeville
massacres in Algeria, 1955. Source: © Charles Courriere/Paris
Match/Scoop. 291
Response to insurgency in Kenya. Source: Popperfoto/Getty Images. 297
Nelson Mandela and associates at the Treason Trial, South Africa,
1956. Source: Drum Social Histories/Baileys African History Archive/
africanpictures.net. 303
Anarchy in the Congo, 1960: Patrice Lumumba is arrested by
Mobutu’s soldiers. Source: © Bettmann/CORBIS. 306
Power in the postcolonial state: President Mobutu of Zaire (Congo),
1984. Source: © AFP/Getty Images. 331
New alliances: Kwame Nkrumah of Ghana and Gamal Abdul
Nasser of Egypt. Source: Stan Wayman/Time and Life Pictures/
Getty Images. 337
L ist o f P lates xvii

Victims: famine in northern Ethiopia, mid‐1980s. Source: Finn


Frandsen/AFP/Getty Images. 338
Victims: a father brings his wounded daughter to an EPLF hospital,
Eritrea, early 1980s. Source: Photo by Mike Goldwater. 351
Humanitarianism or neo‐imperialism? A US soldier in Mogadishu,
Somalia, 1992. Source: © Peter Turnley/CORBIS. 353
Protesters gather at Tahrir Square in Cairo April 1, 2011. Thousands of
demonstrators gathered in Tahrir Square calling for the demands of
the revolution that toppled Egypt’s former president Hosni Mubarak
from power to be met. Source: Reuters/Mohamed Abd El Ghany. 360
Irresistible momentum: Nelson Mandela and F. W. de Klerk of South
Africa. Source: RASHID LOMBARD/AFP/Getty Images. 367
Acknowledgments

Events can be relied upon to leave the historian looking either prescient or foolish. Either
way, the best that can be done is what has been attempted here: to bring the narrative
up to date, and to highlight, by expanding the references, the key scholarly trends, and
at least some of the key literature. Once again, my thanks go to those fellow travelers
who, responding to Wiley’s request, anonymously provided feedback on the previous
edition; to my own friends and colleagues who offered constructive comments, includ-
ing on behalf of their own students; and to the editorial team at Wiley for proposing a
new edition and supporting its completion. I have become even more painfully aware of
the inherent weaknesses of a general history, but I am even more convinced, in an ever‐
changing world, of the need to attempt one. And the failings in this text remain, of
course, my own.
Acknowledgments for the
Second Edition

I am now more keenly aware than ever before what a vulnerable creation is a general
history, especially one that runs to the present. Thanks go to Wiley‐Blackwell for the
opportunity to perform some reconstructive surgery. I am also grateful to both p ­ ublished
reviewers and providers of less formal feedback on the first edition for their suggestions
and comments. As ever, the flaws are mine.
Acknowledgments for the
First Edition

Whatever merits this book has are in large part thanks to the many people who have
educated, inspired, and assisted the author in a myriad of ways over a number of years.
These are too many to list in full here. But I should like to record my gratitude to just a
few of them. Christopher Wheeler, now at Oxford University Press, suggested the book
while he was still at Blackwell, and I am very grateful to him for the opportunity; Tessa
Harvey and Gillian Kane at Wiley‐Blackwell have been a pleasure to work with. Heartfelt
thanks go to Richard Waller and an anonymous reviewer for their comments on an
earlier draft. Murray Last, Robin Law, John McCracken, and Andrew Roberts have
taught me more than they realize. Friends and colleagues at the University of Asmara
in Eritrea and at Durham University and the School of Oriental and African Studies in
the UK provided environments conducive to conceptualization and writing. Friends in
eastern Africa have been both inspirational and questioning. Any remaining inadequa-
cies are my responsibility.
1 Introduction
Understanding the Contours
of Africa’s Past

The stories of entire continents cannot adequately be told in single‐volume histories. It


is a matter of debate, indeed, why individual (or groups of) historians actually do what
they do, and even more so, what it is that they aim to achieve. But in a volume such as
this, the aim is – indeed, can only be – to grasp key ideas and apply them broadly; to
appreciate thematic coherence while equally recognizing discord in this regard; to iden-
tify overall processes while paying due attention to the individuals and whirlpools that
make up the great flow of human history. It is a sad but inevitable truth that in writing
wide‐ranging survey histories of peoples – even where, as in this one, the timeframe is
carefully capped – the number of individual lives which are mentioned is infinitesimal,
vis‐à‐vis the millions of lives which are actually lived. Yet above all the aim in a book like
this is to do justice to Africa and Africans. If this is even approached, then the author
can be, if not content, then at least somewhat relieved.
This book is concerned with the past two centuries, a timeframe that is not simply a
matter of organizational convenience: rather, the central idea is that Africa’s twentieth
century cannot be understood in isolation from its nineteenth century and that
­transformative processes – political, social, and economic – span the entire period under
examination and are distinctive to it.1 We return to this later. More broadly, it is
­important, at the outset, to elucidate some of the core themes which run through the
narrative, whether explicitly or implicitly. The continent remained underpopulated
until the second half of the twentieth century, and thus, a host of states and societies
were concerned first and foremost with the maximization of numbers.2 As a result,
African ideologies were frequently centered around the celebration of fertility, and
myths of creation around the carving of civilization out of wilderness, and its subse-
quent defence against Nature. Fertility and reproductive capacity were sought through

A History of Modern Africa: 1800 to the Present, Third Edition. Richard J. Reid.
© 2020 John Wiley & Sons, Inc. Published 2020 by John Wiley & Sons, Inc.
2 I nt ro d ucti o n

polygamy; control of people – frequently through the practice of slavery, for


­example – was more significant as a feature of social organization than control of land,
which was plentiful, with a handful of important exceptions, as we shall see. Thus, for
example, West African history is characterized by frequently violent competition for
women because women underpinned male status, worked land, and produced children
who would do likewise. Across the continent more generally, intergenerational conflict
among men over women was common. Marriage was very much a public rather than a
private affair, involving alliances between lineages; the distribution of women repre-
sented sociopolitical arrangements. Of course the status of women themselves varied
greatly across the continent, ranging from low and exploited, to respected, influential,
and economically independent.3
One of the major challenges for ruling elites across the continent – in the nineteenth
century as in more recent decades – was the construction of permanent systems of
governance by which large numbers of people might be controlled. Underpopulated
regions in particular were often characterized by the instability of the polity and by the
failure of would‐be state‐builders to extend their control beyond the “natural” limits
imposed by demography and geography. In underpopulated areas, discontented people
might rebel against the existing order – forming an “armed frontier” which might
march on the center, or otherwise consume it – but they might just as easily migrate
beyond the reach of that order, in so doing often causing its very downfall.4 This con-
stant cycle of violent fission and fusion drove much political and social change in Africa,
and it was an increasingly violent process in the nineteenth century with the emer-
gence of new polities and social systems. Territorial states with ambitions beyond the
immediate community had to overcome the problem of how to ensure loyalty across a
wider area and how to create supra‐provincial identities. The problem is exemplified by
the situation in the West African savannah, where states and empires have historically
been confronted with localism and segmentation. The savannah was characterized by
countless local communities, groups of villages which formed miniature states, known
as kafu; the kafu symbolized the localism of African politics, and empire‐builders had
both to construct their polities around them, and to dominate them through military
force and control of wealth.5 Again, this was as true in the colonial and post‐colonial
eras as it was in the nineteenth century. Throughout the book, then, we are concerned
with the emergence of identities, local, regional, even continental, over time, and the
dynamics involved in the shaping of those identities.
In understanding the continent’s history over the past two centuries, moreover, due
emphasis needs to be placed on the longue durée as well as on dramatic change; there has
been much continuity as well as upheaval between the eighteenth and the twenty‐first
centuries, and in many respects colonialism – the focus of the bulk of Africanist schol-
arship in recent decades6 – constituted a mere “moment” in time, with a variable impact
across the continent. Firstly, Africa’s nineteenth century was a period of violent refor-
mation, of political destruction and reconstruction, and the effects of this prolonged
transformation continued to be felt deep into the twentieth century and beyond, espe-
cially during, and in the wake of, decolonization. Secondly, these internal processes of
change need to be understood at least partly against the backdrop of emerging patterns
I nt ro d ucti o n 3

of external economic relations – in essence, between Africa and the northern Atlantic
economies – in the course of the nineteenth century. In many respects, colonial rule
was only the latest manifestation of a Westernized commercial system – fundamentally
disadvantageous, in terms of modern ideas about development, to African producers,
though not necessarily to the elites who governed them – which long pre‐dated it.
Colonialism, then, was clearly significant in its own terms, as will be demonstrated in
the course of the story which follows. Arguably, it had the greatest impact through the
manner of its departure, in the sense that it left much of the continent ill‐equipped to
deal with the challenges of independence. But colonial rule must be contextualized:
with regard to internal political development, it was in many respects co‐opted into
ongoing African processes of change, while in terms of external economy it represented
only the latest stage of a system which had been a long time in the making. What came
after it – the era of the “post‐colony” and the “new” international order – must be
understood in terms of what preceded it. What is certainly clear is that colonial rule was
in many ways as African as it was European, and cannot be understood as some great
unilateral imposition: Africans shaped their own societies in the age of foreign rule
much more effectively than any colonial official or European government could, even in
the face of – and to a large extent in response to – an aggressively extractive external
economic system.
Social, political, and economic change, moreover – as with every other human com-
munity – was represented in African art and material culture. This is not a subject to
which this volume has been able to devote much space, unfortunately; nonetheless,
suffice to observe here that aesthetic endeavors often provide vital clues to African polit-
ical as well as culture life. Art was a mediation between the living and the dead, and
thus often underpinned political power, as well as attempting to ensure agricultural
prosperity; sculptures represented – as with story‐telling – social and political commen-
tary and critique. Belief in the supernatural and the afterlife shaped Egyptian art and
architecture, as it did along much of the Nile valley, notably in Nubia; Christianity
spurred artistic achievement in the Ethiopian highlands, and Islam did the same along
the east African coast and across the western African savannah.7 African crafts-
men – working in terracotta, gold, copper, brass, bronze, wood, and stone – told stories
of the formation of kingship, the struggle against Nature, and the quest for fecundity;
they produced material cultures which were both aesthetically pleasing and had socio-
political utility, as they projected ideas about group cohesion or reinforced hierarchy.
The spread of artistic styles, moreover, was the result both of political upheaval – population
movement on the back of the slave trade, for example, or of widespread conflict – and
commercial interaction. Traders brought culture as well as commodities, and networks
of artistic exchange opened up in the precolonial era just as trading systems did.
Africans borrowed from one another and adapted styles accordingly; and so too did
external influence come to have an important impact on local art forms? Islamic input,
again, is evident in Swahili architecture, notably,8 and later European colonialism influ-
enced the form which African artistic expression took in certain areas.9
Indeed, another of the core issues that arises in a study of Africa in the nineteenth
and twentieth centuries is the continent’s relationship with the rest of the world in
4 I nt ro d ucti o n

general, and of course Europe in particular. It is important that we appreciate, from the
outset, the degree to which Africa has been judged, or measured, by the “outside world”;
this has happened to a remarkable degree and continues to happen in much the same
way, both subliminally and more consciously, down to the present day.10 Clearly, impor-
tant external influences have been brought to bear on African cultural, economic, and
political development. Islam was the most important such influence before the nine-
teenth century, first coming to the continent through Egypt and the Red Sea, from
whence it spread across the Maghreb, as well as traveling up the Nile valley into north-
ern and central Sudan; it would become established in the Horn, too, in the Somali
plains and the Ogaden. From northern Africa, it would move via trade routes into the
Sudanic belt and across West Africa, where it remains the dominant faith today. In sub‐
Saharan East Africa, too, Islam was a critical component of Swahili civilization. Overall,
Islam would shape African culture and society, linking swathes of the continent to a
dynamic and expanding Muslim world. The coming of Islam also involved the emer-
gence of a long‐distance slave trade, across the Sahara and linking the continent to the
Middle East, the Arabian peninsula, and the Indian Ocean.11 European influence, argu-
ably, was much less than that of Islam before the nineteenth century, certainly in terms
of direct cultural and political change: missionary activity, for example, beginning with
the Portuguese in the fifteenth and sixteenth centuries, had limited success, and white
settlement was negligible outside the Dutch colony at the southern Cape. Europe was
largely restricted to trading posts and forts on the coast. Europeans did, however, intro-
duce new crops to Africa from the Americas, and cassava, maize, groundnuts, and
tobacco became central to many African agricultural economies.12 Europe’s greatest
impact on the continent prior to about 1800 came through the Atlantic slave trade,
which began in the early sixteenth century and reached its height in the seventeenth
and eighteenth. Initially, it was dominated by the Portuguese, but later, they were edged
out by the Dutch, the Danes, the French, and the British, who transported millions of
Africans – the precise figure is a matter of contention – to the Americas.
Yet these were no unilateral impositions; they were, rather, complex, and multifac-
eted interactions, involving mutual borrowing and adaptation. The influence of ancient
(pre‐Christian) Egyptian – and, by extension, upper Nile valley – culture and civilization
on the Hellenistic world is undeniable, for example, despite European attempts to sever
Egypt from the rest of Africa through much of the nineteenth and twentieth centu-
ries.13 Later, the Islam that came to Africa was adapted to local needs and conditions,
and the global faith would be greatly enriched through its Africanization; and Europe
itself – in ways which we perhaps do not yet fully appreciate – would be fundamentally
changed by its relationship with Africa, in economic, cultural, and perhaps political
terms, during the era of the Atlantic slave trade. At the same time, moreover, by placing
too much emphasis on the supposed “external,” we not only run the risk of oversimpli-
fying processes of historical interaction but we also risk losing sight of the key notion of
internal dynamics. And these internal dynamics include the force of “people power”;
processes of social formation; economic ingenuity and innovation; cultural and politi-
cal creativity; the playing out of revolution – and, indeed, the reverse of the same coin,
the establishment and broader acceptance of a given status quo. Kings are “bad,”
I nt ro d ucti o n 5

sometimes, and sometimes internal structures do not work; at other times “external”
things are “good” and are adopted. This is true throughout history, and of all peoples
and cultures; above all, of course, change is ongoing and experiential. It is also impor-
tant to remember, even as we seek to identify the ways in which Africa has been objecti-
fied by the outside world, that history itself objectifies: the very discipline of the study of
the past is an exercise in objectification. We need to keep this in mind when at times we
rely on historical studies which have themselves been dependent upon “objectifying”
European sources, especially for the nineteenth century.
Above all, emphasis should be placed on the importance of the nineteenth and twen-
tieth centuries as a cogent timeframe for close examination, and one which encom-
passed clear lines of continuity as well as dramatic change. In many respects, the
nineteenth century constituted something of a “golden age” of African political, eco-
nomic, and cultural creativity; but it was also an extremely violent era, as “golden ages”
often are, and the violence itself was routinely misunderstood at the time and has con-
tinued to be since. Colonialism, again – enormously significant though its impact was in
certain key respects – was in many ways absorbed into African patterns of change, while
the postcolonial era has borne witness to the resurgence of unfinished business, much
of it dating to the pre‐1900 age. All this, meanwhile, must be understood against the
backdrop of a global economy several centuries in the making and increasingly inimical
to Africa’s own development. It is critical to stress the importance of Africa’s longue
durée, as otherwise particular patches of the continent’s history – not least the most
recent past, often viewed in curiously ahistorical isolation – simply will not make sense,
and are certainly vulnerable to misapprehension.

A Brief History of the Study of Africa

African history as an academic discipline is relatively young. As recently as the early


1960s, an Oxford scholar could famously dismiss the continent’s past as “the unre-
warding gyrations of barbarous tribes”14; but even as he did so, new approaches to the
study of African history were being developed. What we mean here, of course, is the
application of an intellectual “modernity” to Africa; needless to say, Africans have long
understood the histories of their own societies on their own terms. Since the middle of
the twentieth century, however, European historical methodology in the Greco‐Roman
tradition has been utilized, for better or for worse, in the attempt to reconstruct the
African past. In the 1950s and 1960s, professional historians and social scientists in a
range of other disciplines, many of them based at African universities – Ibadan in
Nigeria, the University of Ghana, Dar es Salaam in Tanzania – began to treat African
history as a field for serious study; and it is no coincidence that this took place when
most of Africa itself was gaining independence from European colonial rule.15 With
newly rediscovered sovereignty came new interest in Africa’s deeper past: history,
indeed, was seen as an essential part of the nation‐building process. The past, of course,
has long been used – or, more commonly, abused – by politicians, guerrillas, statesmen,
and would‐be builders of nations of every hue, and in Africa, as elsewhere, these would
6 I nt ro d ucti o n

become less enthusiastic and more cynical about history as time went on. But the
“nationalist history” of the 1960s launched a vigorous new academic discipline which
continues to challenge racist, Eurocentric assumptions about the world and to recon-
struct and interpret the historical journeys of the myriad of peoples and communities
that make up the vast region we know today as “Africa.”
Historians of Africa have made use of a range of sources.16 The identification of usa-
ble sources was particularly important for the precolonial past, as few societies – with
the exception of the Arabic north and the Ethiopian highlands – left behind written
records. Archeology was used to chart material and cultural change over the longer
term, while linguistic change and spread could also be employed in discerning social,
economic, and political metamorphosis. Historians have also had to make use of the
written sources of foreigners, beginning with those of the Arabic‐speaking travelers
and traders from the Middle Ages onward, and after the sixteenth century those of
European missionaries, traders, and explorers; in the twentieth century, extensive use
of a vast array of colonial records has supported new avenues of historical research. Yet
scholars have also been able to utilize the recorded indigenous oral histories and tradi-
tions which are the heart of all communities17 and the testimonies which have been
recorded in the course of the twentieth century. Clearly, each of these types of source
has its limitations as well as its contribution to make. Studies of archeology and lan-
guage generally permit the historian to glimpse only very approximate timescales and
only very broad patterns of change; the written words of foreigners are riddled with the
cultural and social prejudices and misunderstanding characteristics of outsiders,
though some are more problematic and insensitive than others. Indigenous oral histo-
ries themselves were prone to change and distortion over time, and as a general rule
favored the authors’ particular lineage as well as reflecting current political circum-
stances. Nonetheless, used with caution, these sources have proved invaluable, and
their utilization in the 1950s and 1960s reflected a new respect for (and indeed empa-
thy with) Africa’s past.
Why had there been no attempt to reconstruct Africa’s past systematically before this
time? The answer, hopefully, can be found at various junctures in the course of this
book. But suffice to say here that by the beginning of the twentieth century, by which
time most of the continent had been brought under European colonial rule, there
existed a firm belief that Africa did not have a history. This “truth” persisted through
much of the colonial period: Africans were perceived as “primitive,” “savage,” and lack-
ing in political, cultural, and technological sophistication. Europeans in this period pos-
sessed a deeply rooted belief in the superiority of their own civilization, and vast swathes
of the non‐European world, Africa included, were regarded as “inferior” on numerous
levels. Concepts of inferiority were vital in that they justified colonial rule itself; and
thus Africans were depicted as lacking history, a benighted people without a past, and
with no future either, unless “rescued” by Europe from the fate assigned them by biol-
ogy. Moreover, most African societies, outside the Islamic zone and the Ethiopian high-
lands, were nonliterate, and Europeans argued that a people without writing, without
documentation, could not possibly have a history. Africa’s “history,” according to this
view, began only when Europe introduced literacy to African elites – for most, only after
I nt ro d ucti o n 7

the 1880s and 1890s. As for literate Muslims and Abyssinians (Ethiopians), these were
slightly higher up the scale of civilization, but not much: their barbarity was inherent,
and their written languages are merely expressions of semi‐civilization.18
Not only were these ideas worked into the narratives of colonial power but they also
shaped Europe’s perceptions of Africa’s precolonial past. Where evidence did exist of
“civilization” – the state of Great Zimbabwe north of the Limpopo, for example, or the
monarchical states of eastern and northeastern Africa – Europeans decided either that
Africans were not ultimately responsible for it or that the particular peoples involved
were not actually African in any case. External, usually lighter‐skinned, influences must
have created such cultures: thus were the marvellous stone buildings of Great Zimbabwe
the handiwork of a mysterious, vanishing white race, and “Ethiopians” possessed of
Caucasian ancestry.19 In South Africa, racist presumptions of this kind had profound
political consequences: twentieth‐century apartheid, notably, rested in part on the con-
viction that white settlers had discovered an “empty land” in the seventeenth century, a
land given to them by God, and inhabited by a few “blacks” who were in any case not too
far above animals in the grand scheme of things.20 These ideas were influential through
much of the twentieth century, and during that time, Africa was represented largely
through European cultural prisms. One of the key challenges for students of modern
African history is to consider in what ways – if at all – this has changed in our own era.
It is not easy to ascertain exactly where these perceptions originated – their roots lie
deep in Europe’s own historical development – but there can be little doubt that the
growth of the Atlantic slave trade was accompanied by the rise of European racism
toward Africa. Between the fifteenth and the nineteenth centuries, Africans came to be
seen as “natural” slaves, the products of undeveloped societies and cultures, and “black-
ness” thus became associated in the “Western” mind with servitude and savagery.21 We
will deal with some of these issues in greater detail in the early part of the book, but it is
worth noting here that in the course of the eighteenth century, there emerged in Europe
a public debate around the slave trade, a debate which would have a profound influence
on perceptions of Africa and which in some ways continues to resonate today. One
group was opposed to the slave trade, the abolitionists, and another defended it, the
apologists, but they shared certain basic assumptions about African society itself. The
apologists argued that because Africa was a savage and backward place, a kind of “liv-
ing hell,” the slave trade was a form of blessed release, taking Africans from their cursed
environments and landing them in the Americas, a new beginning. Moreover, they
argued, Africa produced slaves in any case, through endemic warfare; there was noth-
ing to be done to stop this.22 The abolitionist position was that because Africa was a
savage and backward place, it was in need of European intervention which would intro-
duce to it what became known as the “three Cs” – Christianity, Commerce, and
Civilization.23 The slave trade caused violence and suffering; Africans must be saved,
from slave traders as well as from themselves. The two groups had in common a belief
in African backwardness, their differences a matter of emphasis. It was the abolitionist
position which prevailed, in terms of both tangible outcome – the slave trade was indeed
“abolished,” Denmark and Britain leading the way – and ethos, in that their view of
Africa prevailed through the nineteenth century. By the end of the century, the
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number of cases; the only authority of weight who opposes this view
is Charcot, and his opposition is abundantly neutralized by a number
of carefully-studied American and European cases.
145 The coincidences among these three cases were remarkable. All three were
Germans, all three musicians, two had lost an only son. In all, the emotional
manifestations were pronounced from the initial to the advanced period of the
disease.

146 A Bohemian cigar-maker was startled by the sudden firing of a pistol-shot in a


dark hallway, and on arriving at the factory, and not fully recovered from the first fright,
he was again startled by the sudden descent of an elevator and the fall of a heavy
case from it close to where he stood. From the latter moment he trembled, and his
tremor continued increasing till the last stage of his illness was reached. This was my
shortest duration, four years, and of nuclear oblongata paralysis type.

Hysterical and other obscure neuroses have been claimed to act as


predisposing causes. But, inasmuch as it is well established that
sclerosis is not a legitimate sequel of even the most aggravated
forms of true hysteria,147 and, on the other hand, that disseminated
sclerosis, particularly in the early stages, may progress under the
mask of spinal irritative or other neuroses, it is reasonable to
suppose that cause and effect have been confounded by those who
advanced this view. According to Charcot, the female sex shows a
greater disposition to the disease than the male. Erb, who bases his
remarks on the surprisingly small number of nine cases, is inclined to
account for Charcot's statement on the ground that it was at a
hospital for females that Charcot made his observations. On
comparing the figures of numerous observers, it will be found that in
the experience of one the females, and of the other the males,
preponderate. In my own experience the males far exceed the
females both in private and in dispensary practice. Of 22 cases with
accessible records, only 7 were females.
147 Charcot's observation of lateral sclerosis in hysterical contracture, although made
so long ago, has not been confirmed, and the most careful examinations in equally
severe and protracted cases have proven altogether negative.
Syphilis has also been assigned as a cause. The connection is not
as clear as in tabes. In the few cases where there appears to be a
direct causal relation the lesion is not typical. There are sclerotic foci,
but in addition there is a general lesion, particularly of the posterior
columns of the cord, such as is found with paretic dementia. And it
has been noted that periendymal and subendymal sclerosis is more
frequent with the cases of alleged syphilitic origin than with those of
the typical form.

DIFFERENTIAL DIAGNOSIS.—In view of what has been already stated


regarding the numerous clinical types found in disseminated
sclerosis, it is easily understood why the diagnosis of this disease is
becoming more and more uncertain: every new set of researches
removes some one or several of the old and cherished landmarks;
and it may be safely asserted that only a minority of the cases show
that symptom-group which was formerly claimed as characteristic of
all. The discovery of a series of cases by Westphal,148 in which the
typical symptom-group of Charcot was present, but no sclerosis
deserving the name found after death, as well as the interesting
experience of Seguin, who found well-marked disseminated
sclerosis in a case regarded as hysterical intra vitam, illustrates the
increasing uncertainly of our advancing knowledge. It was believed
within a few years that the presence of cranial nerve-symptoms was
a positive factor in determining a given case to be one of
disseminated sclerosis, but in the very cases described by Westphal
such symptoms were present notwithstanding the lesion was absent.
Up to this time, however, no case has been discovered in which,
optic-nerve atrophy being present in addition to the so-called
characteristic symptoms of intention tremor, nystagmus, and
scanning in speech, disseminated foci of sclerosis were not found at
the autopsy. This sign may be therefore regarded as of the highest
determining value when present; but as it is absent in the majority of
cases, its absence cannot be regarded as decisive. The presence of
pupillary symptoms also increases the certainty of the diagnosis
when added to the ordinary and general symptoms of the disorder
related above.
148 Archiv für Psychiatrie, xiv. p. 128.

Although the difference between the tremor of typical disseminated


sclerosis and that of paralysis agitans is pathognomonic, yet the
existence of a group of cases of disseminated sclerosis, as well as of
one of cases of paralysis agitans without tremor, renders an exact
discrimination in all cases impossible. It is a question, as yet,
whether the form of paralysis agitans without tremor described by
Charcot, and which is marked by pains in the extremities, rigidity,
clumsiness, and slowness of movement, general motor weakness, a
frozen countenance, impeded speech, and mental enfeeblement, is
not in reality a diffuse or disseminated sclerosis.

The diagnosis of this disease, while readily made in a large number


of cases on the strength of the characteristic symptoms detailed,
may be regarded as impossible in a minority which some good
authorities incline to regard as a large one.

Diffuse Sclerosis.

SYNONYMS.—Chronic myelitis, Diffuse myelitis, Simple or Diffuse


spinal sclerosis, Chronic transverse myelitis, Sclerosis stricte sic
dicta (Leyden, in part), Gray degeneration.

The various forms of sclerosis thus far considered were at one time
considered as varieties of chronic myelitis, and under different
names, founded on leading symptoms, were considered to be
merely local, and perhaps accidental, variations of one and the same
morbid process. More accurate clinical and pathological analysis has
separated from the general family of the scleroses one clearly
demarcated form after another. Tabes dorsalis, disseminated
sclerosis, amyotrophic lateral sclerosis, and the combined forms of
sclerosis have been successively isolated. Still, a large number of
cases are left which cannot be classified either with the regular
affections of the cord, limited to special systems of fibres, or with the
disseminated form last considered. They agree with the latter in that
they are not uniform; they differ from it in that they are not
multilocular. Not a few modern authors have neglected making any
provisions for these cases, while others treat of them in conjunction
with acute myelitis, of which disease it is sometimes regarded as a
sequel. The term diffuse sclerosis is here applied to those forms of
chronic myelitis which follow no special rule in their location, and to
such as are atypical and do not correspond in their symptomatology
or anatomy to the more regular forms of sclerosis. In regional
distribution the foci of diffuse sclerosis imitate those of acute myelitis:
they may be transverse, fascicular, or irregular.

MORBID ANATOMY.—In typical cases the lesion of diffuse sclerosis


constitutes a connecting-link between that of the disseminated form
and posterior sclerosis. Its naked-eye characters are the same.
There is usually more rapid destruction of the axis-cylinders, more
inflammatory vascularization, proliferation of the neuroglia-nuclei,
and pigmentary and hyaline degeneration of the nerve-cells, than in
the disseminated form.

Syphilitic inflammation of the cord extends along the lymphatic


channels, including the adventitial spaces, and leads to a diffuse
fibrous interstitial sclerosis. In one case in which I suspected syphilis,
though a fellow-observer failed to detect it after a rigid search, I
found a peculiar form of what would probably be best designated as
vesicular degeneration, according to Leyden, though associated with
a veritable sclerosis. The lymph-space in the posterior septum
showed ectasis; the blood-vessels were sclerotic, and each was the
centre of the mingled sclerotic and rarefying change. It appears that
while the interstitial tissue hypertrophied, the myelin of adjoining
nerve-tubes was pressed together till the intervening tissue
underwent pressure atrophy. The result was, the myelin-tubes
consolidated, some axis-cylinders perished, others atrophied, a few
remained, and, the myelin undergoing liquefaction, long tubular
cavities resulted, running parallel with the axis of the cord, and
exposed as round cavities on cross-section (Fig. 32). The changes in
the cells of the anterior horn in the same cord (Fig. 33) illustrate one
of the common forms of disease to which they are subjected in the
course of sclerotic disease.
FIG. 32.

FIG. 33.
The so-called myelitis without softening, or hyperplastic myelitis of
Dujardin-Beaumetz, which is ranked by Leyden and Erb among the
acute processes, properly belongs here. It is characterized by a
proliferation of the interstitial substance, both of its cellular and
fibrillar elements. The nerve-elements proper play no part, or at best
a very slight or secondary one. In the sense that this affection occurs
after acute diseases and develops in a brief period it may be called
an acute myelitis, but both in its histological products and its clinical
features it approximates the sclerotic or chronic inflammatory
affections of the cord. As far as the clinical features are concerned,
this is particularly well shown in the disseminated myelitis found by
Westphal after acute diseases, such as the exanthematous and
continued fevers.

CLINICAL HISTORY.—Impairment of motion is the most constant early


feature of chronic myelitis; in the transverse form it may be as
absolute as in the severest forms of acute myelitis; as a rule,
however, it is rather a paresis than a paralysis. The patient is usually
able to walk, manifesting the paraparetic gait: he moves along
slowly, does not lift his feet, drags them along, makes short steps; in
short, acts as if his limbs were heavily weighted. This difficulty of
locomotion is preceded and accompanied by a tired feeling before
other sensory symptoms are developed. Rigidity of the muscles, like
that found in disseminated sclerosis, is a common accompaniment,
and may even preponderate over the paresis to such an extent as to
modify the patient's walk, rendering it spastic in character. In such
cases the muscles feel hard to the touch, and the same exaggerated
reflex excitability may be present as was described to be
characteristic of spastic paralysis.

If, while the leg is slightly flexed on the thigh, the foot be extended,149
so as to render the Achilles tendon and the muscles connected with
it tense, and the hand while grasping the foot suddenly presses the
latter to still further extension, a quick contraction occurs, which, if
the pressure be renewed and kept up, recurs again and again, the
succession of the involuntary movements resembling a clonic
spasm. This action is termed the ankle-clonus or foot-phenomenon.
Gowers has amplified this test of exaggerated reflex excitability by
adding what he calls the front-tap contraction. The foot being held in
the same way as stated above, the examiner strikes the muscles on
the front of the leg; the calf-muscles contract and cause a brief
extension movement of the foot. It is believed that the foot-clonus
and the front-tap contraction are always pathological, but a few
observers, notably Gnauck, leave it an open question whether it may
not occur in neurotic subjects who have no organic disease. Gowers
considers the foot-clonus found in hysterical women as spurious,
and states that it differs from the true form in that it is not constant,
being broken by voluntary contractions, and does not begin as soon
as the observer applies pressure. But I have seen the form of clonus
which Gowers regards as hysterical in cases of diffuse sclerosis.
With regard to the front-tap contraction, its discoverer150 admits that
it may be obtained in persons in whom there is no reason to suspect
organic disease. It is significant only when unequal on the two sides.
149 By extension the approximation of the dorsal surface to the tibial aspect of the leg
—what some German writers call dorsal flexion—is meant.
150 Gowers, The Diagnosis of the Diseases of the Spinal Cord, 3d ed., p. 33.

In severe cases contractures are developed in the affected muscular


groups, being, as a rule, preceded by the rigidity, increased reflex
excitability, and the thereon dependent phenomena above detailed.
These contractures may be like those of spastic paralysis, but
usually the adductors show the chief involvement, and sometimes
the leg becomes flexed on the thigh and the thigh on the abdomen in
such firm contraction that the patient, albeit his gross motor power is
not sufficiently impaired, is unable to move about, and is confined to
his bed, his heel firmly drawn up against his buttock. It is stated by
Leyden that the contracted muscles occasionally become
hypertrophied—an occurrence I have not been able to verify. As a
rule, some muscular groups are atrophied, though the limbs as a
whole, particularly in those patients who are able to walk about, are
fairly well nourished.

Pain in the back is a frequent accompaniment of diffuse sclerosis. It


is not pronounced, but constant.

The drift of opinion to-day is to regard pain in the spinal region as not
pathognomonic of organic spinal affections. It is true that pain is a
frequent concomitant of neuroses, and that it is more intense and
characteristic in vertebral and meningeal disease; but in denying a
significance to pain in the back as an evidence of diffuse disease of
the cord itself, I think many modern observers have gone to an
extreme. It is particularly in diffuse sclerosis that a dull heavy
sensation is experienced in the lumbo-sacral region; and in a
number of my cases of slowly ascending myelitis and of tabes
dorsalis the involvement of the arms was accompanied by an
extension of the same pain, in one case associated with intolerable
itching, to the interscapular region. It cannot be maintained that the
pain corresponds in situation to the sclerotic area. It is probably, like
the pain in the extremities, a symptom of irradiation, and
corresponds in distribution to that of the spinal rami of the nerves
arising in the affected level.
As the posterior columns are usually involved in transverse myelitis,
the same lancinating and terebrating pains may occur as in tabes
dorsalis. As a rule, they are not as severe, and a dull, heavy feeling,
comparable to a tired or a burning sensation, is more common. A
belt sensation, like that of tabes, and as in tabes corresponding to
the altitude of the lesion, is a much more constant symptom than
acute pains.

Cutaneous sensibility is not usually impaired to anything like the


extent found in advanced tabes. It is marked in proportion to the
severity of the motor paralysis; where mobility is greatly impaired,
profound anæsthesia and paræsthesia will be found; where it is not
much disturbed, subjective numbness, slight hyperæsthesia, or
tingling and formication may be the only symptoms indicating
sensory disturbance; and there are cases where even these may be
wanting.

The visceral functions are not usually disturbed. In intense


transverse sclerosis of the upper dorsal region I observed gastric
crises, and in a second, whose lesion is of slight intensity, but
probably diffused over a considerable length of the cerebro-spinal
axis, there is at present pathological glycosuria. The bladder
commonly shows slight impairment of expulsive as well as retaining
power, the patients micturating frequently and passing the last drops
of urine with difficulty. Constipation is the rule. The sexual powers
are usually diminished, though rarely abolished. As with sclerotic
processes generally, the sexual functions of the female, both
menstrual and reproductive, are rarely disturbed.

It is not necessary to recapitulate here the symptoms which mark


diffuse sclerosis at different altitudes of the cord. With this
modification, that they are less intense, not apt to be associated with
much atrophic degeneration, nor, as a rule, quite as abruptly
demarcated in regional distribution, what was said for acute myelitis
may be transferred to this form of chronic myelitis. The progress of
diffuse sclerosis is slow, its development insidious, and the history of
the case may extend over as long a period as that of diffuse
sclerosis. Sooner or later, higher levels of the cord are involved in
those cases where the primary focus was low down. In this way the
course of the disease may appear very rapid at one time, to become
almost stationary at others. Of three deaths which occurred from the
disease in my experience, one, in which there were distinct signs of
involvement of the oblongata,151 occurred from sudden paralysis of
respiration; a second from a cardiac complication, which, in view of
some recent revelations concerning the influence of the tabic
process on the organic condition of the valves of the heart, I should
be inclined to regard as not unconnected with the sclerosis; and in a
third, from bed-sores of the ordinary surgical variety. The malignant
bed-sore is not of frequent occurrence in this disease.
151 On one occasion the patient had momentary anarthria, followed a day later by two
successive periods of anarthria, lasting respectively about twenty seconds and one
minute, one of which was accompanied by diplopia of equally brief duration.

PROGNOSIS.—The disease may, as in the instances cited, lead to a


fatal termination, directly or indirectly, in from three to twenty years.
The average duration of life is from six to fifteen years, being greater
in cases where the sclerotic process is of slight intensity, even
though it be of considerable extent, than where it is of maximum or
destructive severity in one area, albeit limited. I am able to say, as in
the case of tabes dorsalis, that a fair number of patients suffering
from this disease whom I have observed for from two to six years
have not made any material progress in an unfavorable sense in that
time. One cure152 occurred in this series, of a patient manifesting
extreme contractures, atrophies, bladder trouble, and ataxiform
paresis, where the cause was plainly syphilis, and the histological
character of the lesion is somewhat a matter of conjecture in
consequence. Diffuse sclerosis of non-syphilitic origin—and this may
apply also to established sclerosis in syphilitic subjects—is probably
as unamenable to remedial treatment as any other sclerotic
affection.
152 The patient went, under direction of Leonard Weber and R. H. Saunders, to Aix-
la-Chapelle, where this happy result was obtained after mixed treatment had
practically failed.

The same rules of DIAGNOSIS applicable to transverse myelitis of


acute onset apply, level for level, to the diagnosis of transverse
myelitis of insidious development, the history of the case often
furnishing the only distinguishing point between the acute and the
chronic form.

The main difference between the diffuse sclerosis and acute myelitis,
clinically considered, consists in the gradual development of
symptoms in the former as contrasted with their rapid development
in the latter disease. Acute myelitis is established within a few hours,
days, or at most, in the subacute forms, a few weeks; chronic
myelitis requires months and years to become a clearly-manifested
disorder. It is the essential correspondence of the symptoms of both
conditions, intrinsically considered, which renders it impossible to
distinguish clinically and in the absence of a history of the case
between some cases of acute myelitis in the secondary period and
the processes which are primarily of a sclerotic character.

It is unusual to find the degeneration reaction in myelitis of slow and


gradual development. Sometimes there is diminished reaction to
both the faradic and galvanic currents, or the so-called middle form
of degeneration reaction is obtained from atrophied muscles, the
nerve presenting normal or nearly normal irritability, and the muscle
increased galvanic irritability and inversion of the formula.

Among the less reliable or accessible points of differentiation


between the residua of acute myelitis and the chronic form is the
history of the onset and the age of the patient at the time of the
onset. Myelitis in young subjects is more likely to be of the acute
kind; in older persons it is more apt to be chronic.

In the diagnosis of diffuse sclerosis the question of differentiation


from neuroses not based on ascertainable structural disease, such
as are called functional, will be most frequently raised. In
differentiating between organic and functional spinal disorders all
known exact signs of organic disease must be excluded before the
case can be considered as appertaining to the latter group.
Symptoms of hysteria, nervous exhaustion, and spinal irritation
frequently coexist with diffuse sclerosis as well as with the
disseminated form; and this is not surprising, for, instead, as seemed
at one time to be believed, of the neurotic taint granting comparative
immunity against organic disease, it is the reverse, and it is not at all
uncommon to find a strongly-marked neurotic diathesis in the family
history of sufferers from diffuse sclerosis. That ordinary hysteria,
epilepsy, and what is vaguely called nervousness are common
features in the ancestral record of the hereditary forms of spinal
disease has already been stated in considering those affections.

One of the commoner forms of the grave phase of hysteria is


paraplegia.153 Often muscular atrophy—which ensues from disuse—
exaggeration of the deep reflexes, and retention of urine are added
to the paraplegia and heighten the resemblance to an organic
affection. Its development, though sometimes sudden, often
occupies weeks or months, and may be preceded, exactly as in
chronic myelitis, by weakness in the legs, and not infrequently by
combined ataxia and weakness. It is much more difficult to
discriminate here than is generally held or than is enunciated in
textbooks. The sufferer from hysterical paraplegia does not always
give other indications of the hysterical neurosis, and even if she did
show a globus and tenderness at certain points, it is a question
whether it could be called a scientific diagnosis which determined the
case to be one of functional trouble on these signs alone. More than
one error has been committed in this respect. In chronic myelitis
retention of urine is less common than incontinence, which is the
reverse of hysterical paraplegia. Pupillary symptoms do not occur
with the latter affection. If there be sensory anæsthesias, they are
bizarre in character or distribution, and do not usually harmonize with
the distribution of the paralysis. In most cases moral influences can
be exerted so as to increase the power of movement far beyond
what would be possible in an organic disease; and while an electrical
examination will not always yield positive results in chronic myelitis,
yet no case of chronic myelitis with complete or nearly complete
paraplegia but will show at least quantitative changes of such extent
as to prove beyond doubt that the case is of an organic character.
153 I have observed for two years a stationary brachial diplegia, of undoubted
hysterical origin, although the patient had never shown any ordinary hysterical
manifestations, and had had no other hysterical symptom than chromatopsia, and that
only for a short period. From its long duration, constancy, and the resulting atrophy of
disuse it had been regarded as a case of peculiarly limited chronic myelitis.

There is one point in which spinal and cerebral disease involving the
motor tract differs in the majority of cases, which may be utilized in
distinguishing obscure affections of the former from those of the
latter kind. In cerebral paralysis of any standing the superficial
reflexes, such as the cremaster and abdominal reflexes, are usually
diminished or abolished, while the deep or tendon reflexes are
exaggerated. In spastic conditions due to spinal disease—say
sclerosis of any kind affecting the lateral column and leaving the
motor nuclei of the anterior cornua unaffected—the deep reflexes
are similarly increased, but the cremaster reflex is increased also.154
This feature of the superficial reflexes is significant in the case of
cerebral disease only when unilateral.
154 Attention has been called, I believe, by Westphal, to the fact that the cremaster
reflex may not be demonstrable when reflex excitability is at its highest, because the
cremaster muscle is already in extreme spastic contraction.

The initial period of diffuse sclerosis is sometimes confounded with


rheumatism—an error less pardonable than in the case of tabes,
inasmuch as in diffuse sclerosis the pains are not usually
premonitory, but associated with motor paresis. It is erroneous to
regard a pain as rheumatic because it is aggravated or relieved by
changes in the weather. There are many subjects of myelitis who
regard themselves as veritable barometers, and with more justice
than most rheumatic patients.

In some cases of chronic alcoholism there are motor weakness and


a gait much like that of diffuse sclerosis.155 It is to be remembered
that the solar tickling reflex is very often abolished in alcoholic
subjects, and profound diminution of the normal cutaneous
sensibility of the leg and feet usually coexist. But unless there is
peripheral neuritis—which is an exceptional and, when present, well-
marked affection—the absence of profound nutritive changes of the
muscle, the presence of the alcoholic tremor, the absence of
sphincter and bladder trouble, and the great variation of the
symptoms from week to week, and even from day to day, serve to
distinguish the alcoholic spinal neurosis from myelitis.
155 Wilks' alcoholic paraplegia.

The Secondary Scleroses.

In studying the lesions underlying the symptoms of organic spinal


disease, the occurrence of fascicular scleroses, secondary to such
disease and due to the destructive involvement of nerve-tracts, was
repeatedly noted. Türck may be regarded as the discoverer of these
degenerations, and the reliability of this old observer may be inferred
from the fact that one bundle of fibres liable to individual
degeneration still goes by his name, and that, as far as he was able
to discriminate between the various paths which secondary
degenerations follow through the cerebro-spinal fibre-labyrinth, his
statements have not been materially modified by more recent
investigators, such as Bouchard, Vulpian, and Westphal.

The discovery by Meynert that the great cerebro-spinal tracts attain


the white color which they owe to the development of myelin around
their component axis-cylinders with advancing maturity, and that the
tracts of noblest, and therefore most intelligent, function were the last
to show this sign of maturity, was greatly extended by Flechsig, who
found that each tract receives its myelin at a definite period of intra-
uterine life, the lowest or the nerve-roots first; then the short or
intersegmental or—as the physiologist may call them—the automatic
tracts; then the long or controlling tracts; and last, the associating
tracts of the cerebral hemispheres which mediate the complex
relations underlying mental action. It was this discovery which gave a
new impulse to the study of the secondary affections of the cord and
brain. The accuracy with which secondary degeneration follows the
lines marked out by the normal course of the tract is as great,
diminishing when the tract diminishes, changing its position or
direction and decussating where the latter changes its direction or
position or decussates, that it constitutes not alone an interesting
subject for pathological study, but has become one of the most
reliable guides of the cerebral anatomist. It is of great importance to
the pathologist to be able to differentiate between the primary
disease and its secondary results, and, as the controversy
concerning the so-called system diseases shows, even the most
studious observers are uncertain in this direction in many cases.

MORBID ANATOMY.—Secondary degeneration manifests itself by a


discoloration of the affected nerve-tract, which accurately
corresponds in area to the normal area of that tract. The more recent
the degeneration the less pronounced is this change. In advanced
cases the color may be a dark gray, in moderately old ones a reddish
or yellowish gray, and in those of very recent origin no change may
be visible to the naked eye. It is claimed, however, that even here a
loss of translucency of the white substance, giving it a sort of
cheese-like opacity, may be detected. On hardening the specimen
containing the degenerated tract in Müller's fluid or a simple
bichromate salt solution, the affected area, instead of appearing dark
on section in contrast with the gray substance—which in such
preparations appears yellowish or a light brown—contrasts with the
former by its lighter tinge. This contrast is observable even in cases
where the naked eye was unable to detect the change in the fresh
specimen. It can be sometimes found as early as the tenth day after
the primary lesion, and is apparently simultaneously developed in
the whole length of the nerve-tract affected.

The minute changes characterizing secondary degeneration begin in


the essential conducting elements, the axis-cylinder, which exhibits a
finely granular or molecular disintegration, and disappear. According
to Homén, it shows an initial swelling and a failure to stain properly
before this. The myelin then follows suit: it becomes fragile, forms
variously-shaped globules, and also disappears, and together with
this a nuclear proliferation is noticed in the interstitial substance; fatty
granule-cells are observed in large numbers, and manifest a
tendency to accumulate in the perivascular districts. These cells are
not permanent; their gradual diminution is accompanied by a
proliferation of the interstitial tissue, which ultimately appears as a
pure connective substance composed of fine fibrillæ arranged in
undulating bundles. The entire process may be not inaptly compared
to an hypertrophy of the interstitial substance resulting from
overfeeding of its cellular elements by the morbid pabulum furnished
through the disintegration of the nervous substance proper.

The disappearance of the nerve-tubes, and the formation of a new


tissue in their place, which, like all tissues of the same character,
undergoes shrinkage, leads to considerable deformity in the shape
of the part which is the site of secondary degeneration. This is seen
in the accompanying figure, where in an old-standing secondary
degeneration of one interolivary layer the corresponding half of the
medulla is greatly reduced in diameter as compared with the other
side (Fig. 34), and the entire raphé is distorted. When one side of the
cord is the site of such a change a similar asymmetry results.

FIG. 34.
Secondary Degeneration of Interolivary Layer: D Ds D, degenerated
area; r, the distorted raphé.

According as the original lesion is incompletely or completely


destructive, a larger or fewer number of axis-cylinders may be found
preserved in the sclerotic tissue. It is not yet determined whether in
some instances these fibres may not represent an admixture from
another source than are comprised in the mainly affected tract.

Secondary degenerations are classified as ascending and


descending. An ascending degeneration is one which is found
situated brainward of the primary lesion; a descending one is found
caudad of the lesion. It was once maintained that the direction of the
secondary degeneration was constant for each individual tract. This
seems to be true for a few. Some tracts, particularly in the brain,
degenerate on both sides of the lesion, as I showed with regard to
the interolivary layer.

The best studied form of secondary degeneration is that of the


voluntary motor conduit known as the pyramid tract. Beginning in the
so-called motor area of each cerebral hemisphere, the Rolandic loop
passes into the anterior part of the posterior half of the internal
capsule, to be thence continued through the crus, pons, and the
pyramids of the oblongata to the decussation or crossing-point of the
pyramids. Here the greater part of the tract crosses into the opposite
lateral column, occupying the position described in the section on
Spastic Paralysis. A smaller part remains on the same side of the
continuous interpyramidal and ventro-spinal fissure, constituting the
direct fasciculus of Türck.

The crossed-pyramid tract diminishes as it passes caudad in the


cord, giving off its fibres to the lateral reticular processes of the cord,
whence—whether interrupted by cells (Von Monakow) or not—they
probably reach the great cells in the gray substance from which the
anterior rootlets spring. The direct fasciculus probably terminates in
a similar way, and perhaps makes good, as it were, its failure to
participate in the gross decussation at the level of the foramen
magnum by decussating in detail along its entire length. It is usually
exhausted before the lumbar cord is reached, whereas the crossed
tract in the lateral column continues down as low as the origin of the
sacral nerves. A destructive lesion anywhere in the course of the
pyramid tract, whether it be in the motor area of the cortex, in the
loop of Rolando, in the internal capsule, the pons, or the cord itself,
will provoke descending degeneration; that is, sclerosis of so much
of the tract as lies below the lesion. Thus such degeneration is found
with porencephalic defect of the motor area. I found it in a paretic
dement who had extensive cortical destruction following a
submeningeal hemorrhage. It has been observed after focal lesion of
the pons (Homén, Schrader), and after transverse lesions of the
cord, either myelitic, traumatic, or as the result of compression by
vertebral disease. As a rule, the cells in the anterior horn are not
involved, and some observers question whether this ever occurs. I
have never found such involvement, although in its gross dimensions
the anterior horn as a whole appears atrophied. This atrophy I have
been able to account for satisfactorily by the disappearance of many
of the fibres which run into the gray substance from the reticular
processes.
While the distribution of degeneration in the cord is rather uniform,
varying only in harmony with the ascertained individual variations in
the relative preponderance of the crossed and uncrossed parts of
the pyramid tract, there is much more variation in the cerebral
distribution of the degeneration according to the extent of the original
lesion. Thus, if the entire capsule be destroyed, the greater part of
the crus is involved. If only the posterior division in its anterior part
be destroyed, the degeneration is in the crus, limited to that part
which runs a subpial course on the crural demi-cylinder, occupying
from a fifth to a third of its surface-area. Still more limited
degenerations are described, but as yet are too few in number to
base other than tentative conclusions on them. Among these is one
occupying a thin strip on the inner side of the crus, which
degenerates after lesions near the genu of the capsule, and probably
represents the tract which governs the cranial nerve-nuclei. An
excellent observation by Von Mannkopf shows that the course of the
motor fasciculus is subject to some individual variation even within
the capsule.

A number of forms of secondary degeneration are described,


involving intracerebral tracts, such as those connecting the cerebrum
and cerebellum. The degeneration of the visual tract, from the optic
nerve to the occipital lobe, observed by Richter and Von Monakow,
with some conflict of opinion between these observers, is often as
perfectly demonstrative of the course of the optic fasciculi as
degeneration of the pyramid tract is demonstrative of the course of
the voluntary innervation of the muscles moving the limbs.

The secondary degenerations following lesion of the pons varolii are


acquiring special interest in view of their relation to special nerve-
tracts of the spinal cord of hitherto unknown function. The purest
instance of an isolated degeneration of other than the pyramid tract
is the case illustrated in the accompanying diagrams. It involved the
interolivary layer, was both ascending and descending, being traced
above into the subthalamic region, and below decussating into the
opposite side of the oblongata, to terminate in the nuclei of the

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