There is, as is in all things West African, a great deal of fetish ceremonial mixed up with West African medical methods. Underlying them throughout there is the fetish form of thought; but it is erroneous to believe that all West African native doctors are witch doctors, because they are not. One of my Efik friends, for example, would no more think of calling in a witch doctor for a simple case of rheumatism than you would think of calling in a curate or a barrister; he would just call in the equivalent to our general practitioner, the abiabok. If he grew worse instead of better, he would then call in his equivalent to our consulting physician, the witch doctor, the abiadiong. But if he started being ill with something exhibiting cerebral symptoms he would have in the witch doctor at once.

This arises from the ground principle of all West African physic. Everything works by spirit on spirit, therefore the spirit of the medicine works on the spirit of the disease. Certain diseases are combatable by certain spirits in certain herbs. Other diseases are caused by spirits not amenable to herb-dwelling spirits; they must be tackled by spirits of a more powerful grade.