Transmission of Guinea worm in Bukhara in the 16th century
By Robert Killick-Kendrick
Guinea worm was known in antiquity, with records dating back many centuries. It was named by Linnaeus in 1759 and formally described by Bastian in 1863. By 1914, its life cycle through copepods was known, and the danger of drinking contaminated water was fully recognised. All the information needed to attack the worm was available and, with the programme to eradicate the worm spearheaded by the Carter Foundation in full swing, it looks as if the world will soon be free from this infection for ever.
Buried in the old literature is a clear reference to contaminated water as a source of infection. Interestingly, it also records how restrictions on the use of alcohol could have favoured transmission. The reference is in Anthony Jenkinson’s account of his explorations on the land route to China, 1558–60, given in full in The Principal Navigations, Voyages, Traffiques and Discoveries of the English Nation by Richard Hakluyt (1903–05), vol. II, pp. 449–79. An edited version of Jenkinson’s account of his stay in Bukhara, in modern-day Uzbekistan, is given below with the kind permission of Lance Jenott (see depts.washington.edu/silkroad/texts/jenkinson/bukhara.html):
So upon the 23rd day of December we arrived at the city of Boghar [Bukhara] in the land of Bactria. This Boghar is situated in the lowest part of all the land, walled about with a high wall of earth, with divers gates into the same: it is divided into 3 partitions, whereof two parts are the king’s, and the 3rd part is for the merchants and markets, and every science hath their dwelling and market by themselves. The city is very great, and the houses for the most part of earth, but there are also many houses, temples and monuments of stone sumptuously built, and gilt, and specially bathstoves so artificially built, that the like thereof is not in the world: the manner where of is too long to rehearse. There is a little river running through the midst of the said city, but the water thereof is most unwholesome, for it breedeth sometimes in men that drink thereof, and especially in them that be not there born, a worm of an ell long, which lieth commonly in the leg betwixt the flesh and the skin, and is plucked out about the ankle with great art and cunning, the surgeons being much practiced there, and if she break in plucking out, the party dieth, and every day she commeth out about an inch, which is rolled up, and so worketh till she be all out. And yet it is there forbidden to drink any other thing than water, & mares milk, and whosoever is found to break that law is whipped and beaten most cruelly through the open markets, and there are officers appointed for the same, who have authority to go into any man’s house, to search if he have either aquavitae, wine, or brage, and finding the same, do break the vessels, spoil the drink, and punish the masters of the house most cruelly, yea, and many times if they perceive but by the breath of a man that he hath drunk, without further examination he shall not escape their hands.
Professor Robert Killick-Kendrick is an Honorary Research Fellow at Imperial College London, UK.