An extraordinary worm
A Glasgow surgeon related the case of a gruesome parasite in 1734.
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The reasons for the duel have not been handed down; whether it resulted from betrayal, insulted honour or property disputes, we cannot tell. Surgeon John Paisley (d. 1740) of Glasgow did not concern himself with the backstory – he simply sought to get his wounded patient back in action. But a case that began with a sword fight unexpectedly turned into something quite different.
A young man had been punctured by a smallsword on the right side of his chest. The wound was about four inches deep and slanted at a downwards angle, his opponent having been taller than him. He left the conflict, presumably after conceding, and somehow ended up alone and unconscious for an hour on a cold staircase with blood trickling from his side. Paisley and a physician, Dr Brisbane, patched him up and within a couple of weeks the wound was healing well. The duel is only really significant for the fact that it brought the man – and his subsequent troubles – to Paisley’s attention.
For it transpired that the gentleman’s tall opponent was not the only antagonist in play. As Paisley related in a case history for Medical Essays and Observations vol 2 in 1734, a more horrifying enemy lurked within. Although his wound improved, the man developed stomach pain, convulsions, profuse sweating and jaundice, and Paisley worried that the sword had pierced his liver. Then ‘he passed a huge quantity of faeces, which looked like boiled blood’.
Two days later he voided a large worm, 18 inches long and 1 1/2 inches in diameter. It got stuck on the way out and, in an act of heroism far beyond the call of duty for even the closest of friends: ‘one in whose house he staid, pulled it from him’.
The Worm was dead when he passed it, and made up of a great many Rings like the Earth-worm; the Interstices between each Joint was rather larger than as they appear in the Figure, and were of a dark Chocolate Colour; the Joints themselves more pale, or of a livid Flesh-colour; The Head was considerably smaller than the Body, though made up of Joints, and very much resembled a Duck’s Bill.
The young man was ‘much surprised at it, and afraid that it had been one of his intestines,’ but rather than screaming and setting fire to his own backside, he investigated the worm by cutting a chunk off it and slashing it with a knife, whereupon blood gushed out. A drawing of the specimen was made by G Robertson, medical artist at the University of Glasgow, where John Paisley was a lecturer. Over the next couple of weeks, the patient passed a lot of blood, but gradually improved enough to make a trip to Ayr. He wrote to Paisley that he had passed another worm, larger than the first but broken in pieces.
This was no run-of-the-mill tapeworm or ascarid. The picture appears to be an Armillifer species of tongueworm (technically a crustacean) – a creature that parasitises snakes and is endemic in parts of West and Central Africa. Human infection is rare, but can occur if someone accidentally ingests the eggs from contaminated food or water, or eats snake meat. The eggs hatch into nymphs that can become encysted in various organs – including the liver, lungs or eyes – but they die and calcify without developing into adults.
It is possible that the chap was a well-travelled adventurer and had at some point swallowed a python’s gall bladder for the heck of it, but this still doesn’t explain a monster adult worm in his intestines. I do not have the answer as to what this thing was, but I’m sure the young man – and the person he was staying with – appreciated getting rid of it.