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NOTE ON DRACUNCULUS MEDINENSIS 
(GUINEA-WORM) 
By MAJOR W. G. RICHARDS, M.B., I.M.S., Retired. 
When the 26th Madras Light Cavalry were reconstituted at Bangalore in 
1903 the regiment was joined by a couple of squadrons of men from an 
Imperial Service Regiment in the north, and, after these men had been at 
Bangalore some months, many developed guinea-worms, our wards becoming 
filled with cases showing the worms in all stages of delivery. It took many 
days or weeks to wind out the worms and so many were broken in the operation 
that the number of men rendered unfit for duty became a serious matter. 
I consequently made enquiries as to methods employed for hastening the 
exit of the worm, since its rupture during extraction always led to severe 
suppuration. 
An Indian Hospital Assistant advised me to feed the men with raw Indian 
sugar while starving and to allow them only sufficient water to keep them on 
a sugar diet. Some determined men partook of a pound or more of sugar 
a day. If possible this treatment was continued for a second day, and, in 
such cases the worm was usually out by the third day, it being found easy 
to wind out the worm which came away unruptured in all cases wherein the 
sugar diet was rigidly maintained. In short there were no failures, the worm 
being extracted in a few days instead of taking weeks to come out. The only 
cases of dracontiasis we had at Bangalore were among the northern men 
previously mentioned, and in practically all patients the worms occurred in 
the legs and feet. The men told me, however, that in the case of water carriers, 
who carry water in goat skins, the worm sometimes comes out on the back 
of the shoulder. That the worm occurs in this situation in water carriers is 
well known. 
Dracontiasis, as far as I know, only occurs regularly in step well districts, 
the worm discharging its embryos into the well water where the larvae 
penetrate into and develop in Cyclops , which, when swallowed by man are 
digested, thereby liberating the worm which then attacks the vertebrate host. 
In the Salem District in 1913-14, during the cold weather, we had numerous 
cases of dracontiasis, some men harbouring up to five worms at a time. The 
worms occurred most commonly in the legs but they also were found in the 
scrotum and subcutaneous tissue of the abdomen. Whereas the usual native 
practice of pouring water over the part was tried, the employment of sugar 
diet proved far better in hastening the elimination of the worm. Cases were 
