Reading the Guinea Worm: Medical Encounters and Protestant Hermeneutics

In 1628, Reformed minister John Paget delivered a sermon to his congregation in Amsterdam, which included an apocalyptic description of West Africa, its peoples, and their purported afflictions. After describing the searing heat of the sun which was supposed to have scorched African skin black, he informed his flock that, 

As the state of those in Hell is described by a worme that torments them & never dyeth: so those that live in this Torrid Zone in Guinea have often & ordinarily a worme of strange & incredible length that breedeth in their flesh, as those that travel thither have both seene and felt, and in their flesh have brought home from thence unto their owne countries, & have had the same drawne out from under their skin after their returne. In this regard it carryeth some shadow & resemblance of Hell, where the worme of conscience shall gnaw the wicked for ever.[1]

In this passage, Paget provided a Biblical gloss for an increasingly well-known phenomenon: a parasite which came to be known as the Guinea worm, alias dracunculiasis medinensis, which had been known since antiquity but was particularly prevalent in the coastal region of West Africa after which it was named.

Title page of John Paget’s Meditations of Death (Dordrecht: 1639). Photo by author.  

Given the detail and accuracy of the passage, it is clear that Paget was drawing here on contemporary accounts of the region written by European travellers and traders. He identifies the parasite specifically with Guinea, notes the unusual length which was its distinguishing feature, and accurately describes its treatment.[2] The fullest account of the Guinea worm which would have been available as he was preparing his sermon was written by Pieter de Marees, a Dutch trader and explorer whose narrative describing travels around the Gold Coast remained popular throughout the seventeenth century.[3] A significant portion of this narrative is devoted to describing the ailments most prevalent in the region and reporting the local methods of treatment—including an entire chapter devoted to the Guinea worm.

Portrait of Saint Roch by an anonymous painter, thought to show an emerging Guinea worm. Pinacoteca di Bari, Italy (15th century).

In appropriating secular reports of global encounter for spiritual purposes, Paget was not unique. As D. L. Noorlander explains, Amsterdam’s Reformed ministers were convinced of the theological relevance and spiritual benefits of global travel, trade, and settlement, and carefully monitored and interpreted contemporary accounts for evidence of God’s will.[4] The well-known cosmographer and astrologer Petrus Plancius, for example, started his career as a minister in the Dutch Reformed Church and frequently drew on such accounts in his sermons.[5] The cited passage from Paget’s sermon allows us to reflect on the dynamics of such appropriations in more detail, showing how a secular account of—in this case, medical—encounter could be transformed into a charged site of eschatological examination.

In one sense, Paget’s sermon takes the material fact of the Guinea worm as its object, with this affliction providing the stimulus for the contemplation of spiritual precepts. Paraphrasing the glosses in the Geneva Bible, Paget interprets the worm in relation to the Biblical worm of conscience described in the Old Testament and thrice described by Christ in the New Testament.[6] However, from another—and I would argue more important—perspective, Paget’s sermon takes the world of scripture as its primary object, with this context providing the framework within which the ‘real world’ can be apprehended and understood. In keeping with this perspective, the “as…so…” syntax which frames the passage, establishes Hell and the worm of conscience as the ontological priors for which the Torrid Zone and its worms are only a secondary referent. Rather than Guinea providing the occasion for reflecting on Hell, it is Hell which provides the lens through which Guinea and its people can be understood.

In order to make this claim, Paget must work hard to compress the region and its inhabitants into admonitory signs—a fact which can be brought out more clearly through comparison with Pieter de Marees’ account. Whilst de Marees points to regional distinctions in the prevalence of the Guinea worm, noting that ‘the Negroes that dwel but 25 miles lower Eastward [than Mina] are not troubled with wormes as their neighbors are’[7], Paget identifies it as endemic to the Torrid Zone in general. Additionally, whilst de Marees explains that the worms are likely to ‘proceed and breed of the water’ collected and drunk in the affected regions[8], Paget instead claims that they breed directly the flesh of the afflicted. In both cases, environmental causes and variations in prevalence are deemphasised in favour of a universalising, apocalyptic narrative which casts the Torrid Zone in general as the site of earthly judgement. The prospect of both medical treatment and spiritual conversion are far from his mind as he articulates the hellish torment of the Guinea worm for the benefit of his European flock.

Paget’s hermeneutic manoeuvrings are important for a number of reasons. Firstly, sermons of this kind provided an important point of mediation between global accounts of travel and encounter and godly audiences in Amsterdam. By reframing de Marees’ account of medical encounter in a loaded narrative of affliction and admonition, Paget dictated the terms on which Guinea’s inhabitants could and should be understood by his congregation. Notably, Paget and his wife became investors in the Dutch West India Company after its founding in 1621, making them direct beneficiaries of its endeavours, which included the trade of enslaved peoples destined for plantations in the New World.[9] Whilst his identification of the region’s inhabitants with the perpetually and irreversibly damned stands at odds with the practical realities of encounter, it perfectly accords with the economic necessity of legitimating the capture and trade of West African people. Thus, Paget’s sermon both offers a case study for the reception of Dutch accounts of medical encounter, and points towards the biographical contexts and material investments which might inform and contextualise such reception.

Eli Cumings is a literary scholar whose work explores the interpretation of bodily and human difference in the textual culture of Reformation England. She is a research associate on the historical project Medicine and the Making of Race, based at King's College London, where she is thinking about the relationship between medical and theological race-making. In July 2024, she will join the Society of Fellows at Columbia University and begin work on her book project.

[1] John Paget, Meditations of death wherein a Christian is taught how to remember and prepare for his latter end (Dordrecht: 1639), pp.209-210.

[2] On treatment, see Jonathan Roberts, ‘Medical Exchange on the Gold Coast during the Seventeenth and Eighteenth Centuries’, Canadian Journal of African Studies (2011), pp.487-488.

[3] Pieter de Marees, Beschryvinge ende historische verhael van het gout koninckrijck (Amsterdam: 1602); Samuel Purchas, Purchas his pilgrimes in five books (London: 1625).

[4] D. L. Noorlander, Heaven’s Wrath: The Protestant Reformation and the Dutch West India Company in the Atlantic World (Cornell University Press, 2019), p.14.

[5] Noorlander, p.12.

[6] Geneva Bible, Isaiah 66:24; Mark 9: 44, 46, 48.

[7] Purchas, p.964.

[8] Purchas, p.964.

[9] Keith L. Sprunger, ‘John Paget, d.1628’, in Oxford Dictionary of National Biography; for more on the WIC, see Johannes Postma and Victor Enthoven (eds), Riches from Atlantic Commerce: Dutch Transatlantic Trade and Shipping, 1585-1817 (Brill, 2003).