In the other negro he observed the worm moving about under the
conjunctiva when he depressed the lower lid. The patient was affected
with slight conjunctivitis. Dr. Thompstone wished to undertake the
extraction of the parasite, but the patient declined operative
interference. While at Opobo he neither saw nor heard of other cases of
the affection. The water-supply for the native population there was very
polluted.
The literature on this subject is very scanty. As far as I have been
able to ascertain there have hitherto not been more than twenty cases
recorded, and in most of them the accounts given have been bald and short
in the extreme. I may, therefore, be permitted to give a short _résumé_
of what has been written regarding this filaria.
The first case recorded appears to be that observed by M. Bajon,[1] a
French surgeon, who for twelve years practised his profession in the
island of Cayenne and in Guiana. He reports that in July, 1768, the
captain of a ship from Guadalupe brought to him a young negress about
six or seven years of age, and asked him to examine one of her eyes, in
which a small worm, about the thickness of a fine sewing thread, could
be distinctly seen. It was about two inches in length. It cruised round
about the eyeball in the cellular tissue between the conjunctiva and
sclerotic. It moved in a tortuous oblique manner. The colour of the eye
was not changed, and the young negress said she felt no pain with the
movements of the worm, but she had an almost continual watering of the
eye.
On reflecting on the means he should employ to draw it out, he concluded
that if he made a minute aperture in the conjunctiva close to the head of
the small animal, and then stimulated it to move, it would emerge through
the opening. In carrying out this manœuvre, however, he found that in
place of escaping through the incision he had made, it passed by the side
of it, and went to the opposite surface of the eye. As this proceeding
did not succeed with him, he had recourse to the device of seizing the
worm by the middle with small forceps, along with the conjunctiva, then
making a small deep opening with a lancet by the side of its body, and
then introducing an ordinary needle, whereby he succeeded in drawing it
out doubled in two.
Again, in 1771, another young negress, a little older than the last,
was brought to M. Bajon suffering from painful inflammation of the
conjunctiva. On examination he observed a worm a little longer than in
the previous case, and which, like it, moved round about the eye between
the conjunctiva and sclerotic. He proposed to employ the same procedure
that succeeded in the other case, but the patient would not consent.
He considered that the worm was a dracunculus (dragonneau) similar to
those removed from other parts of the body in negroes, only finer and
shorter.
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