Sanity and Madness: The accountant is so impeccably dressed that when Marlow first meets him he thinks he is a vision. This man, who has been in−country three years and witnessed all its attendant horrors, manages to keep his clothes and books in excellent order. He even speaks with confidence of a Council of Europe, which intended Kurtz to go far in “the administration,” as if there is some overall rational principle guiding their lives. Sanity and Insanity Closely linked to the themes of order and disorder are those of sanity and insanity. Madness, given prolonged exposure to the isolation of the wilderness, seems an inevitable extension of chaos. The atmospheric influences at the heart of the African continent—the stifling heat, the incessant drums, the whispering bush, the mysterious light—play havoc with the un-adapted European mind and reduce it either to the insanity of thinking anything is allowable in such an atmosphere or, as in Kurtz’s case, to literal madness. Kurtz, after many years in the jungle, is presented as a man who has gone mad with power and greed. Marlow conversation with the doctor and what does it reveal? Marlow visits the Company doctor. The doctor's purpose is to declare Marlow fit to travel, but it is what he says outside of this that works as foreshadowing. He measures Marlow's head, saying 'I always ask leave, in the interests of science, to measure the crania of those going out there' but comments that really, 'the changes take place inside, you know.' He then asks Marlow, 'Ever any madness in your family?' Marlow dismisses this and never mentions it again, but it serves to foreshadow the effect that the Congo has on people. Both Marlow and (especially) Kurtz feel the maddening effects of the Congo, and do things that they would not do in other places, such as Kurtz killing the natives and putting their heads on spikes.