PART III

EXOTIC LEECHES

(_Limnatis nilotica_ and _Haemadipsa zeylanica_).

Rulers that neither see nor feel nor know, But leech-like to their fainting country cling, Till they drop, blind in blood, without a blow. (SHELLEY, _England in 1819_.)

THE extension of war into the Near and Far East has brought into action two genera of leeches which were and still are the cause of extreme inconvenience and even of real danger to troops operating in these areas. The enemies of our Allies will still insist on fighting on richly stocked leech-grounds. For in the new war area, in southern Europe, Asia Minor, Syria, Palestine, Egypt, and parts of India and the real East, two genera of leeches—which are indeed not the friend but the enemy of man, especially of the soldier—abound.

The first of these two is _Limnatis nilotica_ (Sav.), and it is from Savigny that I have stolen the picture of this species.

It is a leech of considerable size, attaining a length of 8 cm. to 10 cm., and its outline rather slopes inward at the anterior end. The dorsal surface is brownish-green with six longitudinal stripes, and the ventral surface is dark. It is a fresh-water leech, and it occurs from the Atlantic Islands, the Azores, and the Canaries—its western limit—all along the northern edge of Africa until it reaches Egypt, Palestine, Syria, Armenia, and Turkestan, where it achieves its uttermost eastern boundary. This leech lives in stagnant water; especially does it congregate in drinking-wells—the wells so often mentioned in the New Testament. In the Talmud (Abōdāh Zārāh, 17_b_) an especial warning is given against drinking water from the rivers or wells or pools for fear of swallowing leeches. Doubtless the New Testament Jew knew in his day almost as much as we know now about these leeches. They were the cause of endless trouble to Napoleon’s soldiers in his Egyptian campaign, and are still a real pest in the Near East.

I cannot recall that Napoleon talked much about spreading ‘Kultur,’[18] but he certainly did it. He took with his army into Egypt a score of the ablest men of science he could gather together in France. He established in Cairo an ‘Institut’ modelled on that of Paris; and his scientific ‘corps’ produced a series of monographs on Egyptian antiquities and on the natural history of Egypt that has not yet been equalled by any other invading force. Napoleon freed the serfs in Germany, he codified the laws of France, and these laws were adopted by large parts of Europe; he extended the use of the decimal system. Napoleon had a constructive policy, and was never a consistent apostle of wanton destruction. If he destroyed it was to build up again, and in many instances he ‘builded better than he knew.’ He seldom so mistook his enemies as to destroy, to terrify; the ‘frightfulness,’ though bad enough in his times, had limits. Napoleon had at least in him the elements of a sane and common-sense psychology. He knew that what was ‘frightful’ to the French was not necessarily ‘frightful’ to the Russian.

Amongst the wonderful series of books and monographs on Egypt which described the varying activities of the savants he took in his train, and who, at the confines of the eighteenth and nineteenth centuries invaded the country of the Pharaohs, none is more remarkable than Savigny’s monograph on the ‘Natural History’ of that country. And in this folio the leech (_Limnatis nilotica_) was for the first time fully described and depicted.

This particular leech is swallowed by man, by domestic cattle, and doubtlessly by wild animals, with their drinking-water. Amongst the medical writers of the Eastern world in classical times who mention leeches there was always, as there was amongst the authors of the Talmud, a great and haunting fear of leeches being swallowed, and these writers mostly wrote from the area where _Limnatis nilotica_ still abounds.

According to Masterman, who has had, as a medical officer in Palestine, a first-hand opportunity of studying this leech, the pest attaches itself to the mouth or throat or larynx during the process of swallowing, and he is convinced that if it be once really swallowed and reaches the stomach it is killed and digested.

_Limnatis nilotica_, unlike _Hirudo medicinalis_ the medicinal leech, is unable to bite through the outer integument of man and is only able to feed when it has access to the softer mucous membrane of the mouth or of the pharynx or of the larynx, and of the other thinner and more vascular internal mucous linings.

In Palestine these pests are particularly common in the region of Galilee and in the district of Lebanon. They are, in these and other districts, so plentiful in the autumn that almost every mule and almost every horse the tourist comes across is bleeding from its mouth or from its nose, for this species of leech is by no means only a human parasite. The natives, who know quite a lot about these pests, generally strain them out of their drinking-water by running the water through a piece of muslin or some such sieve when they fill their pitchers at the common well. In certain districts these leeches in the local pools or reservoirs are kept in check by a fish—a species of carp (_Capöeta fratercula_).

In the cases which recently came under Mr. Masterman’s observation, the leeches were attached to the epiglottis, the nasal cavities, and perhaps most commonly of all to the larynx of their host. When they have been attached to the anterior part of the mouth, or any other easily accessible position, their host or their host’s friends naturally remove them, and such cases do not come to the hospital for treatment.

The effect of the presence of this leech (_L. nilotica_) on the human being is to produce constant small haemorrhages from the mouth or nose. This haemorrhage, when the leech is ensconced far within the buccal, the nasal, or the pharyngeal passages of the host, may be prolonged, serious, and even fatal. Masterman records two cases under his own observation which ended in death: one of a man and the other of a young girl, both of whom died of anaemia produced by these leeches.

The average patients certainly suffer. They show marked distress, usually accompanied by a complete or partial loss of voice; but all the symptoms disappear, and at once, on the removal of the semi-parasite. Sometimes the leeches are attached so closely to the vocal cords that their bodies flop in and out of the vocal aperture with each act of expiration and inspiration. The hosts of leeches so situated usually suffer from dyspnoea, and at times were hardly able to breathe.

The native treatment is to remove the leech, when accessible, by transfixing it with a sharp thorn; or they dislodge it by touching it with the so-called ‘nicotine’ which accumulates in tobacco-pipes. But nicotine is destroyed at the temperature of a lighted pipe, so whatever the really efficient juice is, it is not nicotine. Still, as long as the fluid proves efficient, the native is hardly likely to worry about its chemical composition.

Masterman says that the two means he has found most effective were: (1) Seizing the leech, when accessible, with suitable forceps; or (2) paralysing the leech with cocaine. In the former case the surgeon is materially assisted by spraying the leech with cocaine, which partially paralyses it and puts it out of action. In the latter case, if the spraying of cocaine is not sufficient, Masterman recommends the application of a small piece of cotton-wool dipped in 30 per cent. cocaine solution, which must be brought into actual contact with the leech’s body. The effect of the cocaine in contact with the skin of the leech is to paralyse it and to cause it at once to relax its hold. In such a case the leech is occasionally swallowed, but it is more often coughed up and out. Headaches and a tendency to vomit are symptoms associated with the presence of this creature in the human body; the removal of the leech or leeches coincides with the cessation of these symptoms.

In the East, where many of our Territorial regiments are now stationed, we come across another species of leech even more injurious to mankind than _Limnatis nilotica_. This Asiatic leech is known as _Haemadipsa zeylanica_, and is one of a considerable number of leeches which have left the water, their natural habitat, and have taken to live on land.

From India and Ceylon, throughout Burma, Cochin China, Formosa to Japan, the Philippines, and the Sunda Island, this terrible, and at certain elevations ubiquitous, pest is spread. It lives upon damp and moist earth. The family to which it belongs is essentially a family which dwells in the uplands and shuns the hot, low-lying plains. Its members do not occur on the hot, dry, sandy flats. Tennant has described the intolerable nuisance they are in Ceylon. In fact of the many visible plagues of tropical Asia and its eastern islands they are perhaps the worst. Yet few have recorded their dread doings, and those few have escaped credence.

Each specimen of _Haemadipsa zeylanica_ is of a clear brown colour with a yellow stripe on each side and with a greenish dorsal stripe. There are five pairs of eyes, of which the first four occupy contiguous rings; but between the fifth and seventh ring there are two eyeless rings interposed. As in the medicinal leech there are three teeth, each serrated like a saw.

In dry weather they miraculously disappear, and nobody seems to know quite what becomes of them; but with returning showers they are found again on the soil and on the lower vegetation in enormous profusion. Each leech is about one inch in length and is about as thick as a knitting-needle. But they contract until they attain the diameter of a quill pen, or extend their bodies until they have doubled their normal length. They are the most insinuating of creatures, and can force their way through the interstices of the tightest laced boot, or between the folds of the most closely wound puttee. Making their tortuous way towards the human skin, they wriggle about under the under-clothing until they attain almost any position on the body they wish to take up. Their bite is absolutely painless, and it is usual for the human sufferer to become aware that he has been bitten by these silent and tireless leeches when he notices sundry streams of blood running down his body when he at last has the opportunity of undressing.

Sometimes, as Tennant’s figure shows, these land-leeches (_H. zeylanica_) rest upon the ground. At other times they ascend the leaves of herbs and grasses, and especially the twigs of the forest undergrowth. Perched upon the ends of growing shoots, leaves, and twigs, stretching their quivering bodies into the void, they eagerly watch and wait the approach of some travelling mammal. They easily ‘scent’ their prey, and on its approach advance upon it with surprising rapidity in semicircular loops. A whole and vast colony of land-leeches is set in motion without a moment’s delay, and thus it comes about that the last of a travelling or prospecting party in a land-leech area invariably fares the worst, as these land-leeches mobilise and congregate with extraordinary rapidity when once they are warned of the approach of a possible host, but not always in time to engage in numbers the advanced guard.

Horses are driven wild by them, and have poor means of reprisal. They stamp their hooves violently on the ground in the hope of ridding their fetlocks of these tangled masses of bloody tassels. The bare legs of the natives, who carry palanquins, are particularly subject to the bites of these bloodthirsty brutes, as the palanquin-bearer has no free hand to pick them off. Tennant writes that he has actually seen the blood welling over the boots of a European from the innumerable bites of these land-leeches; and it is on record that during the march of the troops in Ceylon, when the Kandyans were in rebellion, many of the Madras sepoys, and their coolies, perished from their innumerable and united attacks. It is also certain that men falling asleep over-night in a Cingalese forest have, so to speak, ‘woke up dead’ next morning. These sleepers have succumbed during the night to the repeated attacks of these intolerable and insatiable pests.

Dr. Charles Hose, for many years Resident at Sarawak, has told me that on approaching the edges of woods in Borneo you can hear every leaf rustling, and this is due to the fact that the eager leech, perched on its posterior sucker on the edge of each leaf in the undergrowth, is swaying its body up and down, yearning with an ‘unutterable yearning,’ to get at the integument of man or some other mammal.

Landor, who wrote, I think, the best book about our adventure into Thibet some ten years ago, entitled ‘Lhassa’ (London, 1905), says of Sikkim:—

The game here is very scanty: the reason is not uninteresting. For dormant or active, visible or invisible, the curse of Sikkim waits for its warm-blooded visitor. The leeches of these lovely valleys have been described again and again by travellers. Unfortunately the description, however true in every particular, has, as a rule, but wrecked the reputation of the chronicler. Englishmen cannot understand these pests of the mountain-side, which appear in March, and exist, like black threads fringing every leaf, till September kills them in myriad millions.

To remove them a bowl of warm milk at the cow’s nose, a little slip-knot, and a quick hand are all that is required. Fourteen or fifteen successively have been thus taken from the nostrils of one unfortunate heifer.

When fully fed, a process which takes some time with _Haemadipsa zeylanica_, the individual leeches drop off; and they can be made to loosen their hold by the application of a solution of salt or of weak acid. Attempts to pull them off should be avoided, as parts of the biting apparatus are then often left in the wound, and these may cause inflammation and suppuration. Dr. R. J. Drummond, who has had experience of these land-leeches in Ceylon, has told me that the bite is often septic and that it often leads to a serious abscess which is long in healing. He recommends pushing a match, which has been dipped into carbolic acid, well home into the sinus made by the leech’s head.

When winter approaches the leeches die down with extraordinary rapidity, and the species ‘carry on’ over the cold-weather period in the form of eggs laid in cocoons on the ground, under leaves, or other débris. Hence no land-leech ever sees its offspring, and no land-leech has ever known a mother’s care.

FOOTNOTES

[1] p. 18.

[2] _B.M.J._ No. 2824, Feb. 13, 1915.

[3] Only the larger print, such as the leading articles and letters from Admirals.

[4] September 1914.

[5] Pope’s _Epistle to Dr. Arbuthnot_.

[6] _Journ. Roy. Army Med. Corps_, vol. xx. No. 6, 1913. The figures in this chapter are taken from this article.

[7] _With Napoleon at Waterloo._ By Edward Bruce Low; edited by Mackenzie MacBride; p. 21. London: Francis Griffiths, 32 Maiden Lane, Strand, W.C. 1911.

[8] New Series, No. 102.

[9] _Reports on Public Health and Medical Subjects_ (New Series), No. 85, pp. 15 and 16.

[10] One of the first to fall a victim in defending the South African Federation against De Wet’s rebellion.

[11] _T. holosericeum_.

[12] A µ = 1000th of a millimetre.

[13] _Sarcoptes scabiei._

[14] November 1914.

[15] Campbell’s _Lives of the Chancellors_, vol. vi.

[16] Proverbs xxx. 15.

[17] _Materia Medica and Therapeutics._ By Charles D. F. Phillips, p. 1015.

[18] I wonder if it is _any_ use pointing out that the German word _Kultur_ is not the equivalent—as our daily Press takes it to be—of the English word ‘Culture,’ brought into fashion forty years ago by Matthew Arnold and sadly overworked. Put shortly _Kultur_ = ‘civilisation.’ The German word which we associate with ‘Culture’ is _Bildung_.

INDEX

_Acanthia_, 23 _Acarina_, 89 Acarus (_Sarcoptes scabiei_), 99 Acne, 99 African tick-fever, 116, 121 Agronom, M., 16, 17 Allcock, Colonel, 109 Analgesinae, 111 Annandale, Dr., 129 _Anoplura_, 1, 11 Antelopes, 36 Antennae, of lice, 3; of bed-bug, 25 Anthomyidae, 74 Anthrax, 72 Ants, 27 Arachnids, 88 _Argas persicus_, characteristics of, 114; breeding habits, 115 Argasidae, 113 _Arhynchobdellae_, 125. See _Rhynchobdellae_ _Arthropoda_, 88 _Auchmeromyia luteola_, 82, 83 _Aulostoma_, 144; _A. gulo_, 147 Austen, Mr. E. E., 65

_Babesia bovis_, 120 _Bacillus pestis_, 45 Bed-bug (_Cimex lectularius_), 23; antennae of, 25; characteristics, 25–26 Benzine, 13, 33 Beveridge, Lieut.-Colonel, 48, 50 Biscuits, infestation of Army, 50 Biscuit-moth, 48 Black Death, 38, 45 Blake, 45 Blow-flies, 83 Blue-bottle (_Calliphora erythrocephala_), 74, 76 Boars, 36 Body-louse, 3, 10, 20 Boer prison-ship, 20 Brightwell, 131 British Expeditionary Force, 46 _British Medical Journal_, 21 British Museum, 50 Bubonic plague, 35, 38 Bug. _See_ Bed-bug Burns, 4 Butler, Mr., 40

_Calliphora erythrocephala_ (blue-bottle), 76; _C. vomitoria_, 76 Carp, 153 Centipedes, 88 _Ceratophyllus fasciatus_, 45 Chigo (burrowing-flea), 37 _Chrysomyia macellaria_, 83 Ciliata, 138 _Cimex_, 23, 25, 26, 27; _C. lectularius_ (bed-bug), 23; _C. rotundatus_, 23 Cockroach, 21, 24, 26, 27, 39 Cocoons, 161 Congo-floor-maggot, 82 Copeman, Dr. S. Monckton, 21, 65 _Corcyra_, 49; _C. cephalonica_, 49 Cow-dung, 42 Cresol-soap solution, 21, 22 Crustacea, 88 _Ctenocephalus canis_, 37; _Ct. felis_, 37 _Cyclops_, 138 _Cytoleichus sarcoptioides_, 111

Deer, 36 De Geer, 30 _Demodex_, 97 ff _Demodex folliculorum_, 97 _Dermacentor vernustus_, 120 Diarrhoea, 70 Dizziness, 85 Dog-flea, 40 Dog-tick, 120 Drummond, Dr. R. J., 15, 42 Durrant, Mr., 48, 50 _Dytiscus_, 144

Ébrard, 131 _Empusa_, 65 Enteric, 69 Entomologist, 18 _Ephestia kühniella_, 48 Erskine, Lord, 139 Erythema, 94 _Erythema autumnale_, 94 _Esox lucius_, 15

Faichne, 69 _Fannia_, 76, 84; _F. canicularis_, 74, 75; _F. scalaris_, 74, 76 Flea (_Pulex irritans_), 35; extermination of, 42 Flies (_Musca domestica_), 57; breeding habits, 59; powers of travel, 67 Flour-moth, the (_Ephestia kühniella_), in soldiers’ biscuits, 46 Flowers of sulphur, 16 Folklore, 15 French, Field-Marshal, 135 Frogs, 144 Fumigation, method of, 33

Gascoigne, 40 Goats, 36 Graham-Smith, Dr., 68, 81 Grimbert, 97 Guiart, 97

_Haemadipsa zeylanica_, 156, 157 Harding, Mr. W. A., 123, 129, 137 Hair-follicles, 94 Hair-louse, 3 Harman, Dr. N. Bishop, 19 Harvest-mite (_Trombidium_), 87, 91, 92, 97 Head-louse, 4, 9 Hemipterous insects, 27 Henna, 16 Herod Agrippa, 84 Hewitt, Dr. C. Gordon, 58 _Hirudinea_, 124 _Hirudo medicinalis_, 123, 127, 129, 136, 140, 153 _Horse_-leech, 147 Hose, Dr. Charles, 160 Huxley, 87 Hydrocyanic-acid gas, 33 _Hydrophylus_, 144

Itch-mite, 99 _Ixodes_, 119; _I. ricinus_, 120 _Ixodiphagus caucurtei_, 120

Jeyes’ fluid, 22 Jigger (chigo), 95 Joffre, General, 135

Khiva, 17 Kerosene, 33

_Laminosioptes gallinarum_, 111 _Lancet_, 21 Landor, 160 Larva, 8; of flea, 41 Latter, Mr. H. O., 140 Leech, 123; the medicinal (_Hirudo medicinalis_), 123; breeding habits, 142, 143; coloration of, 137; enemies of, 144; exotic (_Limnatis nilotica_ and _Haemadipsa zeylanica_), 149; farming of, 145; fear of swallowing, 152; modes of conveying, 133; movements of, 137; suffering caused by, 154; Asiatic, 156; characteristics of, 157, 161; disappearance of, 157; method of attack, 158; size of, 157 to remove, 142; traffic in, 131; uses of, 130 Leech-ponds, 128 Lefroy, Professor, 22 Leishman, Sir William, 70 _Leptus autumnalis_, 91 Lice (_Pediculus_), 1; rules for avoidance of, 12 _Limnatis granulosa_, 129; _L. nilotica_, 149, 152, 153, 154, 156 Linnaeus, 87 Lounsbury, Mr. C. P., 18 _Lucius_, 15

Maggot, 82 Mallophaga, 18 Martin, Professor C. J., 31 Masterman, Dr., 154, 155 Mercury, 17 Mites, 87; bites of, symptoms and treatment, 107–9; breeding habits of, 103; characteristics, 103, 104; _Demodex, Sarcoptes_, 97; epidemics caused by, 105; endo-parasitic, 109; nourishment of, 91 Montagu, Lord, 59 Murinae, 45 Murray, Andrew, 3 _Musca_, 84; _M. domestica_ (house-fly), 57, 70, 74, 75 Myiasis, 81

Napoleon, 151 Necrosis, 83 _Nepa_, 144 _Nephrophages sanguinarius_, 109, 111 Newsholme, Dr., 65 Nicholas, Grand Duke, 135 Nicol, Sergeant Daniel, 55 Nicol, W., 85 Nicotine, 155 Nightingale, Dr. P. A., 43 Nits, 12 Nymph, 117

_Oligochaeta_, 124 Ophthalmia, 72 Ormerod, Miss, 48 _Ornithodorus megnini_, 117; _O. moubata_ (‘tampan’), 116, 121; _O. turicata_, 117

Panama Canal, 86 Paraffin, 13, 14 _Pediculoides ventricosus_, 95 _Pediculus_ (lice), 2; _P. capitis_, 2, 4, 10, 12, 13; _P. vestimenti_, 2, 4, 8, 10, 12, 14 Pernet, Dr. G., 107 Petrol, 13, 14 Petroleum, 17 Pharynx, 140; sucking, 141 Phillips, Dr., 147 _Phthirius_, 2 Pike, 15 Plague, 31; Pepys’s, 45 Proboscis, 25 Protoplasm, 87 Protozoal diseases transmitted by ticks, 117 _Pulex irritans_ (flea), 37, 40, 45 Purkinje, 87

Quick Laboratory, 9; Quick Professor of Biology, 11

Radcliffe, Dr. H., 107 Rat-fleas, 38 Redi, 80 Relapsing fever, 14 _Rhynchobdellae_, 125. See _Arhynchobdellae_ Rice, 49 Riley, Professor, 48 Rocky Mountain Fever, 120 Romilly, Sir Samuel, 139 Rothschild, Hon. Charles, 38 Rubies, 94 Ruskin, 57 Russell, Mr., 39

_Sarcophaga carnaria_, 80 _Sarcoptes_, 104 _Sarcoptes scabiei_, 106 Sarts, 16, 17 Savigny, 149, 152 Scabies, 107 Sharp, Dr. David, 88 South African War, 11, 19 Spirochaete, 31; _S. obermeieri_, 31 Spirochaetosis, conveyed by _A. persicus_, 114 Stable-yards, 59 Stag-beetle, 39 Sulphur, 33; bags, 18; flowers of, 18 Sweat-glands, 94

Talmud, 150 ‘Tampan,’ 114, 116 Tennant, Mr., 159 Ticks, characteristics of, 112, 113, 117; breeding habits, 119; habits, 114, 115 Tomkins, Dr. H. H., 18 _Trichinella_, 53 _Trombidium_ (harvest-mite), 95; _T. holosericeum_, 91 Tuberculosis, 31 Tunnels, burrowed by mite, 106 Turpentine, 13; oil of, 34 Typhoid, 69; bacilli, 68 Typhus, 10, 14, 31

‘Vermijelli,’ 22 Von Hindenburg, General, 135 Von Kluck, General, 135 Voles, 143

Warburton, Mr. C., 4, 5, 8, 9 Water-rats, 143 Wordsworth, 127

_Xenopsylla cheopis_, 45 _Xylol_, 13

Yeomanry, D.C.O., 19

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Transcriber’s Note (continued)

Minor typographical errors have been corrected in this transcription.

Other errors and unusual or variable spelling and hyphenation have been left unchanged except as noted below.

Page xvi — “Sargophaga” changed to “Sarcophaga” (Sarcophaga carnaria)

Page 27 — “features” changed to “feature” (Perhaps the most disagreeable feature)

Page 38 — “bubonic-plague” changed to “bubonic plague” (bubonic plague was associated first with rats)

Page 38 — “subtropical” changed to “sub-tropical” (in all tropical and sub-tropical countries)

Page 49 — “inself” changed to “itself” (The moth itself is a rather insignificant)

Page 65 — “Austin” changed to “Austen” (Dr. Monckton Copeman and Mr. E. E. Austen)

Page 75 — “housefly” changed to “house-fly” (F. canicularis, the ‘lesser house-fly,’)

Page 93 — “proboscis” changed to “hypo-pharynx” (presence of their hypo-pharynx in the skin)

Page 123 — “gentlemen” changed to “gentleman” (when an old gentleman had upset)

Page 126 — “has removed been” changed to “has been removed” (the right half of this organ has been removed to show)

Page 135 — “von Hinderberg” changed to “von Hindenburg” (General von Hindenburg)

Page 150 — “freshwater” changed to “fresh-water” (It is a fresh-water leech)

Page 152 — “preceeding” changed to “preceding” (See preceding figure.)

Page 158 — “underclothing” changed to “under-clothing” (they wriggle about under the under-clothing)

Page 163 — “Austin” changed to “Austen” (Austen, Mr. E. E.)

Page 163 — “lectularis” changed to “lectularius” (Bed-bug (Cimex lectularius))

Page 164 — “Ctenophalus” changed to “Ctenocephalus” (Ctenocephalus canis)

Page 164 — “Ebrard” changed to “Ébrard” (Ébrard, 131)

Page 164 — “Hirudi” changed to “Hirudo” (Hirudo medicinalis)

Page 164 — “Lemna” changed to “Henna” (Henna, 16)

Page 164 — “Limnalis” changed to “Limnatis” (Limnatis nilotica)

Page 164 — “vernustus” changed to “venustus” (Dermacentor venustus)

Page 166 — “Trombidum” changed to “Trombidium” (Trombidium (harvest-mite))

Page 166 — “Von Hinderberg” changed to “Von Hindenburg” (Von Hindenburg, General)

Footnotes have been re-indexed using numbers and placed before the Index.