“In the year 1868 Dr Rion Kérangel found Anchylostomes in the bodies of hypoæmics in Cayenne. Thus, the occurrence of Anchylostomes in hypoæmics has been authenticated by Pruner, Bilharz, and Griesinger, in Egypt; by myself, Dr Moura, Dr Tourinho, and other physicians, in Brazil; by Monestier and Grenet, in the Comoros; and by Rion Kérangel in Cayenne. It thus also appears, from the wide separation of these several localities, that the Anchylostomes, if duly sought for, will be found in many other countries.”
These details given by Wucherer are so precise and instructive that I could not have further abridged them without injustice to his record. The bearing of the foregoing facts in relation to the question as to how we may hope to arrest the fatal action of many of these nematodes is sufficiently obvious. That strongyles and their allies prove highly destructive to man and beast is as well established as any other recognised conclusion in medical science; nevertheless, there are those who still doubt the power of these nematodes in relation to the production of fatal epidemics. I shall deal with the sanitary bearings of the subject hereafter. In conclusion, I may mention that Dr da Silva Lima has forwarded specimens of Anchylostomum to the Hunterian Museum, where they may be seen.
Bibliography (No. 29).—Bilharz, ‘Zeitschr. f. wiss. Zool.,’ Bd. iv, s. 55.—Cobbold, ‘Entozoa,’ p. 361.—Idem “Remarks on Recent Contributions to our Knowledge of the Parasitic Nematoids, especially in reference to the Wasting Diseases they produce in Man and Animals,” the ‘Veterinarian,’ Jan., 1876, p. 1.—Davaine, l. c., pp. 118 and 931.—Diesing “Revis. der Nematoden,” ‘Sitzb. d. m.-naturw. cl. d. k. Akad.,’ 1860, s. 716.—Dubini, ‘Entozoografia,’ &c., 1849.—Griesinger (quoted above), see also ‘Arch. f. Phys. Heilk.,’ 1854.—Küchenmeister, l. c., Eng. edit., p. 383.—Leuckart, l. c., ss. 410–455.—Molin, ‘Il sottordine degli Acroffali,’ p. 61 (quoted by Leuckart).—Siebold, ‘Zeitsch. f. wiss. Zool.,’ 1852, s. 55.—Sonsino, P., L’Anchilostoma duodenale in ‘relazione coll’ Anemia progressiva perniciosa,’ Egitto, 1877.—Idem, ‘Sull.’ Anch. duod., 1878 (see also Bibliog. No. 27, both reprinted from ‘Imparziale.’)—Weber, H., l. c., 1867.—Wucherer (quoted above), 1872.
Fig. 42.—Outline of a female Dracunculus medinensis. Nat. size. Original.
Dracunculus medinensis, Cobbold.—This parasite is popularly known as the guinea-worm, or Medina-worm. Probably Lister was the first writer who distinctly spoke of it as the Dracunculus, 1690, the same title being applied to it by Kaempfer, 1694. Be that as it may, Gmelin, long afterwards, placed the parasite in the genus Filaria, at the same time adopting the specific title medinensis. This had been previously employed by Linneus, who, however, regarded the worm as belonging to the genus Gordius. It being clear from the distinctive characters of the entozoon that it was desirable to separate it from the Filariæ, and that no better generic name could be devised than Dracunculus, I thought it right to combine Lister’s and Gmelin’s nomenclature as above, 1864. Leuckart pursued a similar course, crediting Linneus with the titles.
The guinea-worm having been known from the earliest times, it is not surprising that its true nature long remained a mystery. Any one who has read Küchenmeister’s elaborate narrative of the historical significance of the Dracunculus will hardly have failed to arrive at the conclusion that Moses was probably the earliest writer on the endemic disorder which is occasioned by this parasite. There can be no doubt that the “fiery serpents” which afflicted the children of Israel during their stay in the neighbourhood of the Red Sea were neither more nor less than examples of our Dracunculus. It is further evident that Plutarch spoke of Dracunculi, when in the eighth book of his ‘Symposiacon,’ he quotes Agatharchidas as stating that the people taken ill on the Red Sea suffered from many strange and unheard-of attacks, amongst other worms, from “little snakes, which came out upon them, gnawed away their legs and arms, and when touched retracted, coiled themselves up in the muscles, and there gave rise to the most insupportable pains.” In order to render the passage more readable, it will be seen that I have slightly altered the original version (‘Parasites,’ s. 305).
The guinea-worm may be described as a nematode measuring from one to six feet in length, having a thickness of 1/10th of an inch. The body is uniformly cylindrical, terminating below in a more or less curved and mucronately pointed tail. The head is flatly convex or truncate, having a central, simple mouth, which is surrounded by four equi-distantly and cruciately disposed papillæ. The mode of reproduction is viviparous, the body enclosing a prodigious number of hatched embryos, which, by distension of the uterine ducts, almost entirely obliterate the somatic cavity. Notwithstanding the statements of Owen to the contrary, the male Dracunculus is at present altogether unknown.
The guinea-worm possesses a comparatively limited geographical range, for not only is it proper to the tropical regions, but within intertropical limits it is almost exclusively confined to certain districts in Asia and Africa. Thus, according to Künsenmuller, as quoted by Busk, it occurs endemically in Arabia Petræa, on the borders of the Persian Gulf and Caspian Sea, on the banks of the Ganges, in Upper Egypt, Abyssinia, and the coast of Guinea. “In America the guinea-worm is unknown, except in persons who have had communication with Africa or other parts where it is indigenous. The island of Curaçoa is the only locality in the New World which offers an apparent exception to this fact, and it would be highly desirable to ascertain the real state of the case in this instance.” The observations of Chisholm showed that the Dracunculus is really prevalent in several of the West Indian islands, especially in Grenada, and the still later investigations of Dr Da Silva Lima point to its former prevalence in Brazil. Now, the worm is rarely seen at Bahia. Mr Busk said:—“Though endemic only in the above-mentioned parts of the world, it would yet appear that all races of mankind are obnoxious to the attacks of the Filaria when exposed to what may be called the contagion; that is, when placed in circumstances under which it might be supposed a contagious seminium could be conveyed to them.” Mr Busk also added:—“I have known many instances tending to prove that, in order that a European should become infected with the guinea-worm on the coast of Africa, it is not necessary that he should have been on shore at all. It has been quite sufficient for him to have exposed the bare surface of some parts of his person to the water in the native canoes alongside, or, it may be, to the discharge from the sores of those laboring under the disease. This mode of its introduction accounts for the frequency with which the legs and feet are attacked by the parasite, in preference to other parts of the body, as it will always, I believe, be found that the men who have become so affected have been in the habit of going about with bare feet, as is common among sailors in warm latitudes. That the contagious material is conveyed in water is also further indicated by the well-known fact that in India, where it is the custom of the natives to carry water in skins on their backs, the worm makes its appearance on the back and shoulders and upper part of the body.” These views were published by Busk in 1846, and I am free to confess that—confirmed as they appeared to be by subsequent and independent testimony—they completely dominated my conceptions as to the mode of ingress of the young parasites within the human bearer. Thus, those of our Indian troops which were most exposed during the rainy season, subsequently exhibited evidence of having been invaded by the Dracunculus. As, moreover, the period of incubation of the entozoon commonly extends from twelve to fifteen months, it necessarily happened that the disease often showed itself in localities far distant from the spot where the troops originally contracted the disorder. The statement that the period of incubation of the worm is not less than a year, is probably incorrect, since Carter mentions that in a school of fifty boys bathing in a certain pond at Bombay—the sediment of which swarmed with microscopic tank-worms (Urobales palustris, Carter)—twenty-one were attacked with Dracunculus during the year, whilst the boys of other schools, bathing elsewhere, remained, with few exceptions, uninfected. This is a remarkable occurrence, and it points to the possibility of the young Dracunculi being confined to particular pools. That they should, whether occupying the bodies of intermediary bearers or not, be more abundant in some waters than others, is just what might be expected, since such a distribution is in harmony with a recognised law affecting the abundance or limitation of species in particular localities. Much, indeed, has been written respecting the nature of the soil and geological formations occurring in the Indian worm-districts, but the speculative views enunciated on this point are little worthy of credit. Those who desire information on this head should at all events consult the valuable writings of Smyttan, Greenhow, Bird, Forbes, Chisholm, and Aitken, who, apart from the question at issue, supply abundance of practical information.
