In India and the upper parts of Egypt a class of worms called dracunculi, resembling the intestinal, are formed in the muscular parts of the body, such as the anus, thighs, legs, and in the sides of children, under the skin; and they move in a perceptible manner. Then in process of time at the extremity of the dracunculus matter is formed in the part, and the skin being opened the head of the dracunculus comes forth. But if the worm be dragged it occasions pains, and particularly when it breaks. Wherefore some say that it is proper to fix a piece of lead to the worm in order that its discharge may not take place at once, but gradually with the weight of the lead. Some disapproving of this practice, inasmuch as the worm is apt to break with the weight of the lead and occasion violent pains, direct the part to be put into hot water, in order that the dracunculus being warmed may come forward, when it is to be seized with the fingers and dragged forth by degrees. But Soranus is of opinion that the dracunculus is not an animal originally, but a nervous concretion, which has only the appearance of moving. Whether this or the former be the true account of the matter, it appears to Soranus, Leonides, and others, that they are to be treated with the affusion of warm water, and digestive cataplasms made of honied water and the flour of wheat or barley; and they approve of sometimes using a plaster possessed of similar properties. Wherefore that from bay-berries, and the one from honey are proper. For by the use of these the dracunculus or concretion dies and falls out. But when suppuration takes place, if it does not fall out, the skin is to be divided, and the part being laid open, that which is contained in it is to be taken out, when a tent is to be put into the skin, and then the treatment for suppurations is to be applied. * * * * * COMMENTARY. The following authors treat of the vena medinensis, or dracunculus, now generally called the Guinea worm: Galen (De Loc. Affect. vi, 3; Isagoge;) Aëtius (xiv, 85); Pollux (Onomast. iv); Plutarch (Symp. viii, 9); Theophrastus (H. P. ix); Actuarius (Meth. Med. vi, 8; iv, 16); Avicenna (iv, 3, 2, 21); Avenzoar (ii, 3, 20); Haly Abbas (Theor. viii, 18); Alsaharavius (Pr. xxviii, 12); Rhases (ad Mansor. vii, 24; Cont. xxvi.) Galen admits that he had never seen the dracunculus, and that therefore he could not be positive respecting its origin and nature. He had known many persons, however, who had seen it, and was inclined to believe that it is of a nervous nature, and resembles lumbrici only in colour and thickness. The author of the Isagoge states that dracunculi resemble varices, and that when they project or move about they occasion great pain, and are to be removed by making an incision of the skin as for varices. Plutarch briefly mentions the dracunculus as being a disease which had newly attacked the inhabitants of the country adjoining the Red Sea.