xamined had formerly resided in
Liberia, where, doubtless, the disease commenced, but for the last three
years previously had resided at Ijaye, in the capacity of cook, for the
American Baptist Missionaries, Revs. A. D. Phillips and J. R. Stone and
lady, and then resided at Abbeokuta. This is a peculiar ulceration of
the leg, immediately above the ankle-bone, where they say it usually
commences; the edges of the ulcer, and the cuticle quite up to the edge,
and all the surrounding parts, having a healthy appearance, as though a
portion of the flesh had been recently torn out, leaving the cavity as
it then was. The most peculiar feature of this singular disease is a
_white fiber_, which, coming out from the integuments of the muscles of
the leg above, hangs suspended in the cavity (ulcer) the lower end
loose, and somewhat inclined to coil (and when _straightened_ out,
resuming again the serpentine curves, of course from the _elasticity_
with _motion_), is supposed to be a _worm_; hence its name--_Guinea
worm_. The fibre seems in color and texture to be in a normal condition;
indeed, there appear to be little or no pathological symptoms about the
parts at all, except a slight appearance of _vermillion_ inflammation
over the surface of the ulcer, which is more apparent sometimes than
others.

What Is Guinea Worm?

I have examined closely this fibre, and from its appearance, color,
size, and texture, especially as it is sensibly felt high up in the leg
near the tuberosity of the tibia, when pulled by the dangling end, my
own impression is that the so-called "Guinea worm" is nothing more than
the _external saphenus_ or _communis tibiae_ (nerve) exposed in a
peculiar manner, probably by a disease, which, by a curious pathological
process, absorbs away the muscular parts, leaving the bare nerve
detached at its lower extremity, suspended loose in this unnatural
space. I have never seen but this one case of Guinea worm, but had
frequent opportunities of examining it; indeed, the patient consulted me
concerning it, and by the advice and consent of the very clever native
gentleman, Samuel Crowther, Esq., who received his professional
education at the Royal College of Surgeons, Lincoln's Inn Fields,
London, insisted on my taking the case, which I declined, partly for the
want of time to do justice to the patient, and aside from courtesy and
equity to the surgeon who had the case in hand, mainly because I _knew
nothing about it_-