386 ENTOZOA. 



this subject, and many of the ancient works have been illustrated 

 with elaborate figures showing the worms in situ. Amongst the 

 most remarkable of these is that of Gr. H. Yelschius, in the 

 perusal of which we are amused, if not edified, by the numerous 

 plates representing the old Persian surgeons extracting the Dracun- 

 culus.* The plan followed of old is essentially the same as the 

 one most successfully employed at the present day. In all cases 

 it has been found that the most satisfactory treatment consists in 

 extracting the worm slowly by gentle traction. This is done by 

 winding the exposed or protruding end of the parasite round a 

 small stick of ivory, bone, or wood, or even round a portion of 

 adhesive plaster, cardboard, or stout paper. The great thing to 

 be avoided is the rupture of the worm, which, if it only once takes 

 place, is extremely liable to produce serious inflammatory action 

 in the infected parts. From this condition there usually follows a 

 considerable amount of irritative fever, which is subsequently 

 aggravated by the formation of abscesses, fistulous sinuses, and 

 more or less extensive gangrene. Under these circumstances, 

 therefore, even death itself may sometimes supervene. In certain 

 cases, it has been observed that the worm exhibits a tendency to 

 migrate fi:'om one part of the body to the other. Aitken quotes 

 one or two remarkable instances of this kind from the " Indian 

 Annals.^' Their direction of movement in the body is usually, if 

 not invariably, from above downwards. Dr. Stewart gives the 

 case of an officer who suffered for a period of three months from 

 a Dracunculus, originally occupying the thigh, but which, in the 

 space of a few days, passed down to the deep muscles of the foot, 

 giving rise to violent inflammation and many abscesses. It is also 

 stated that Dr. Ewert had seen a worm " change its position from 

 the upper part of the lateral aspect of the thorax to the groin in 

 the course of twenty- four hours." In similar cases, therefore, 

 whenever the worm appears to be superficially situated, it would 



* " Georgius Hieronymus Velschiiis. — Exercitationes de Vena Medinensi, et de 

 Vermiculis Capillaribus Infantium." Ang.sburgli, 1674. 



