The Doctor's Bag
The blog about Medicine and Surgery in the Old West
By Keith Souter aka CLAY MORE
OK, I appreciate that this blog about the medicine of yesteryear is not for everyone's taste. I take into account that some people are squeamish about blood and body fluids, but the reality of life in the 19th century is that sanitation and hygiene were not as well developed as they are now. People fell ill, they contracted all manner of infections and infestations and the treatments were not always pleasant to take.
So, if you are squeamish please do not read further. I'm going to talk about worms. Specifically, tapeworms. These are a potential problem
A word about parasites
Humans are hosts to around 300 types of parasitic worms, and to around 70 types of protozoa. Doctors have known about several of them since antiquity. Canopic jars containing the intestines of mummies have been found to contain tapeworms.
The Ebers papyrus
Indeed, the Ebers papyrus, a medical papyrus written around 1550 BC contains a chapter on stomach disorders and describes the treatment for tapeworm infestation. They used the roots of the pomegranate tree. Interestingly, this is an anthelminthic (a drug used to expel worms), so they had discovered a treatment over three millennia ago.
The medical name for tapeworm infestation is Cestodiasis. There are about 40 species of tapeworms and 15 larval forms.
The main ones that cause illness are:
Taenia sodium - the pork tapeworm
Taenia saginata- the beef tapeworm
Diphillobothrium latum- the fish tapeworm
Tapeworms can reach a length of several meters, live in the intestine of the host attached by a scolex (head). The long body is called the strobila and is formed of multiple segments. Each of these segments is called a proglottis. Once mature, many of these proglottids containing numerous eggs, pass out in the excreta into soil or water, where the eggs are released.
Taenia solium - the pork tapeworm
When an intermediate host consumes the eggs, they hatch in the intestine, releasing larval stages called oncospheres, that burrow through the gut wall to reach various tissues of the host, where they develop into cysts in muscle.
Life cycle of the pig tapeworm
The life cycle is completed whenundercooked or raw meat is eaten and the cysticerci are released and attach to the gut wall of the final host and develop into adult tapeworms.
Remarkably, there may be none. More often though, there will be vague abdominal symptoms. A voracious appetite is common and is accompanied by weight loss.
Diagnosis is made by examination of the stools for segments of the worms. Eggs may also be found on the peri-anal skin.
Trust your butcher and make sure you cook it properly
The Victorian worm diet
It is often quoted that in Victorian times people could buy pills containing tapeworm eggs in order to grow your own tapeworm inside your intestine. People were persuaded that the tapeworm absorbed all of the nutrients and that the person lost weight.
I have not been able to track this down and think it is probably a myth. However, I have read of one case in recent times where someone tried this and became quite ill. It is definitely not something that anyone should ever attempt.
Doctrine of Signatures
In ancient times the dominant theory in medicine was that plants and minerals had special markings, nature's clues about their medicinal value.
As mentioned above, the Ebers papyrus from ancient Egypt describes a treatment derived from pomegranate roots. The pomegranate is full of little seeds which resemble the segments of the tapeworm.
Another often used remedy came from pumpkin seeds.
Both actually have antihelminth properties, which is interesting.
Pumkin seeds were used in the 19th century. The outer husks were peeled off, then the seeds were ground in a pestle and mortar. Then sugar was added to make into a paste and finally water was added to make it into a drink.
Sometimes a dose of castor oil would be taken to produce a laxative effect.
From The Cincinnati Lancet and Observer, June 1862, republished in The American Journal of Medical Sciences, July 1862:
Seeds of the Cucurbita Pepo, or Pumpkin in Taenia, by Dr G R Patton;
Fourteen cases of taenia successfully treated by an emulsion of pumpkin seeds. One patient was troubled by the Bothrocaphalus latus (fish tapeworm) , the others with the solum (pork tapeworm)
Dr P says that "of all the antihelminhics proposed for the extermination of taenia, the seed of the ordinary pumpkin claims our first attention. It is innocuous, inexpensive, readily procured and by far the least disagreeable of all the vermifuge medicines. Its power to dislodge large fragments of these worms has never been questioned; but it has not succeeded in every instance in destroying them. This results evidently from discontinuing the remedy too soon. By maintaining the treatment from four to six days (unless the head is discovered with the fragments first passed) success would, doubtless, result in all cases.
The administration of castor oil during its use is not to be recommended. The emulsion itself is sufficiently laxative in large doses, if a light diet be strictly enforced. By purgation we may defeat our end, by interfering with the action of the pumpkin to produce its full toxicological effect upon the head of the parasite.
Other treatments used by doctors included making a liquid extract of Lady Fern, which had the added effect of making the patient nauseous!
Turpentine in tiny doses was advocated by some physicians, as were chloral hydrate, naphthalene and chloroform. The aim in all of these was to paralyse the worm so that it would relinquish its hold on the intestinal wall and be passed out of the body.
None of these would be recommended today, as we have more effective drugs. It has to be said that in parts of the world these parasites are all still a major problem.
If you are intrigued by medical Latin, then you might like to dip into this book, which you can pick up for a cent or two!
If you are interested in reading more about medicine and surgery in the frontier days, then you may find The Doctor's bag useful. It is a collection of my past blog posts, published by Sundown Press.
The novel about Dr George Goodfellow, the Tombstone surgeon to the gunfighters
The novel about Ned Buntline, the King of the Dime Novelists