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Caelius Aurelianus (5Th Century AD) Study on Worms Le Infezioni in Medicina, n. 4, 391-395, 2018 INFECTIONS IN THE HISTORY OF MEDICINE 391 Caelius Aurelianus (5th century AD) study on Worms Konstantinos Laios Medical School, National and Kapodistrian University of Athens, Greece SUMMARY Caelius Aurelianus (5th century AD) translated in Latin an infection. In addition, there are saved the views of the work of Soranus of Ephesus (2nd half of 1st century many other ancient Greek physicians whose original - 1st quarter of 2nd century AD) On Acute and on Chronic text now are lost. Although the study of Caelius Aure- Diseases. In this Latin translation, the 8th chapter of the lianus was based on the original Greek text of Soranus fourth book of chronic diseases is devoted in worm’s of Ephesus it should not be denied that Caelius Aureli- infection in children and in adults. This study is the anus made his own additions and arranged the text in most complete and comprehensive analysis of this a more accurate and organized manner. special infection of the Greek and Roman antiquity. In this chapter, the physician examined in great detail the Keywords: Caelius Aurelianus, Soranus of Ephesus, semiology, differential diagnosis and treatment of such Hippocrates, Worms, Olive Oil. n INTRODUCTION al can be presented with severe or mild symptoms affecting or not the strength of the patient, with or aelius Aurelianus (5th century AD) in the 8th without fever. Regarding the corporal symptoms Cchapter of the fourth book of chronic diseases of in these conditions, the physician wrote about his study On Acute and on Chronic Diseases (De mor- the looseness of the bowels as a major symptom bis acutis et chronicis), which is a Latin translation of without the expulsion of worms and the intestinal Soranus of Ephesus (2nd half of 1st century - 1st quar- cramps, twisting pains and tenderness in the in- ter of 2nd century AD) lost study written in Greek testines or the stomach which are always present. entitled On Acute and on Chronic Diseases, gave us He noticed that many times the patients lost their a thorough study on worms infection [1-3]. In this appetite, felt weak, had a pallor in their faces and study, one can find a detailed analysis considering were emaciated. The physician also focused on the the semiology, differential diagnosis and treatment loss of logic which could be seen in this disease and of such an infection. In addition, this study is of the seizures presented by the patients in severe cas- great value because there are saved the views on es, in which also convulsion, arrhythmia, aphonia, the theme of many other ancient Greek physicians, fever and death can occur. Special symptoms were many of them are lost in their original texts. described when this type of infection appeared in children. The physician noticed sometimes in chil- Semiology dren infected a restless movement of parts of the Caelius Aurelianus described the symptoms in body when the child is sleeping, accompanied by adults and in children in a case of worms’ infec- sighing, tossing and gnashing the teeth. The child tion. He underlined that worms’ infection in gener- could lie in an unusual position and could cry without reason. In case of a massive discharge of worms in children, the physician was able to pal- Corresponding author pate a mass. (Caelius Aurelianus On Acute Diseas- Konstantinos Laios es and on Chronic Diseases pp.884-885, 106.1-108.3). E-mail: [email protected] Caelius Aurelianus wrote also about the character- 392 K. Laios istics of the discharge of worms. The expulsion of sicians, which did not happen in worms’ infec- worms mainly was seen through the bowels, but tion, while hysterical suffocation was diagnosed also could happen through the mouth and esoph- only in adult women [7]. He also distinguished agus or nostrils. Worms could be expelled dead or worms’ infection from catalepsy, underlining that alive, in a sphere mass or one by one. They could in catalepsy the presence of fever and the large be covered with blood or bile and when expelled and strong pulse of the patient help for its diag- by the bowels they could be covered with feces nosis, which did not appear in the examined in- or with a yellowish fluid. The color of the worms fection (Caelius Aurelianus On Acute Diseases and could be white or yellow (Caelius Aurelianus On on Chronic Diseases pp.109.6-110.8). Acute Diseases and on Chronic Diseases. pp.885-887, Apart from mental diseases, the writer tried also 108.4-109.5). to give directions in order to distinguish this infec- Furthermore, the physician believed that the pres- tion from other corporal diseases by the other phy- ence of worms as a special disease or their ap- sicians. He advised that this infection is different pearance during another pathology was a sign of from cases of ileus because in the second disease decomposition and each physician should be alert there is suppression of the function of the bow- except in case of lientery (in ancient medicine the els. The presence of intestinal cramps in worms’ pathological condition in which the food passed infection was used by Caelius Aurelianus as di- through the bowels undigested, was described as agnostic criterion in order to separate this disease lientery), where the presence of worms was inter- from a wasting disease or a disease of esophagus preted as a good sign probably because there was because, according to the physician, in these latter the conviction that worms helped the patient to diseases this symptom was missing. Finally, the manage the undigested food [2]. Nevertheless, writer pointed out that the withhold of food could Caelius Aurelianus had the impression that worms deteriorate the condition of the patient in worms’ full of blood were a sign of weakness, while he infection, fact which was used in order to distin- thought that whitish worms were nourished by the guish the symptoms of the contraction of the lips food eaten by the patient and worms foul of blood or the sucking or also the jumping up without by blood that was drained from the bowels of the reason during sleep of patients suffering of this patient. In addition, he had the idea that the expul- infection from persons expressing the same symp- sion of worms during high fever was a sign of a dis- toms naturally or due to excessive consumption of turbance of the inner organs even more if worms food (Caelius Aurelianus On Acute Diseases and on were full of blood, while their expulsion during low Chronic Diseases pp.886-889, 110.9-111.11). fever was considered as a sign of relaxation of the body (Caelius Aurelianus On Acute Diseases and on Treatment of worm’s infection Chronic Diseases pp.890-891, 115.8-117.2). Caelius Aurelianus was also interested in the treatment of worms; therefore, he devoted a great Differential diagnosis part of his study on the drugs used to fight this Caelius Aurelianus was also interested in the dif- condition. He mainly listed almost all the ancient ferential diagnosis of the symptoms in a case of an drugs made by plants and also all the other ther- infection of worms. He focused a lot on the lack of apeutic methods introduced in the antiquity in logic presented in this condition, which was com- order to treat this pathological condition. mon in the various mental diseases as they were Before examining the ancient drugs, we should considered in antiquity such as mania, phrenitis, discuss the other therapeutic methods, which were lethargy, hysterical suffocation, apoplexy, epilep- not only applied against worms but they were sy, and catalepsy [4-9]. used as a general treatment almost in all corporal Although he did not examine all the mental dis- or mental diseases. Venesection, fomentation, cup- eases in his text as it is saved today - there is the ping with scarification, a relaxing poultice and plas- possibility that a portion of the text is lost - he ters were these methods [11]. Now due to the fact pointed that worm infection should be differen- that Soranus of Ephesus and Caelius Aurelianus tiated from epilepsy because the patients did not were members of the methodic school of medical foam [10]. In a case of hysterical suffocation an as- thought they advised that these measures should cent of the uterus was diagnosed by ancient phy- be introduced when a state of stricture was pres- Caelius Aurelianus study on Worms 393 ent in patient’s body, except of the plasters which man physician listed the views of Hippocrates were used in a state of looseness [12]. Plasters were (ca. 460-375/351 BC) as they were saved in Cor- made by ground lupines, vinegar and honey with pus Hippocraticum [13], Diocles of Karystos (375- an admixture of sprinkle of spoonful of the savings 295 BC) [14], Chrysippus (280-205 BC) [15], Hero- of stag’s horn or ground lupines soaked in a de- philus (ca. 330-250 BC) [16], Apollonius of Glau- coction of wormwood proper or Santonian worm- cus (1st or 2nd c. AD) [14], Apollonius of Memphis wood, when worms appear during the interval or (3rd c. BC) [2] and Antiphanes of Delos (2nd c. AD) remission of another disease (Caelius Aurelianus [17] (Caelius Aurelianus On Acute Diseases and on On Acute Diseases and on Chronic Diseases pp.892- Chronic Diseases pp.888-891, 112.1-115.7). 895, 119.2-120.10). He wrote that, according to Hippocrates in his The main drugs used against worms were olive books Prognostic, the expulsion of dead worms oil, sharp foods as onion, garlic, mustard juice, was a sign for the oncoming death of the patient, silphium juice, Pontic wormwood, wormwood of while it was believed that the presence of dead the sea, Santonian wormwood, while there were worms in the human body indicated the aggrava- also used aloes, cardamom, mulberries, nettle and tion of the conditions and that the body was in a chamelaea.
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