Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Pinworms

Episode Date: April 7, 2019

We recorded this episode of Sawbones live on the Joco Cruise 2019. (Book your cabin for 2020 now, they're filling up fast!) When confronted with the beauty of the ocean and cool island breezes, Dr. Sydnee's mind turns to the only rational place: Pinworms. Music: "Medicines" by The Taxpayers

Saubones is a show about medical history and nothing the hosts say should be taken as medical advice or opinion It's for fun Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it just sit back relax and enjoy a moment of distraction from that weird growth Your worth it All right, Tommy is about to books. One, two, one, two, a day for all. Hello, Jonathan Colton Cruz 2019, and welcome to Saul Bones, a Merrill Turf, Miss Guy, Admedicine, I'm your co-host Justin Macaroy. And I'm Sydney Macaroy.

It's fine. It's fine. That's actually, those where I actually exactly theAroy. That's fine. It's fine. That's actually, those were exactly the same, but there's an aquatic echo that made the second one. Hey, if this boat's a rockin', I was hoping you knew, because I am at a loss. It's really moving. It's truckin' A. Kappin opened her up.

I went in and he asked me, he's like, Justin, do you think she could take a few more knots? And I was like, let's turn this Easter damn into a booster damn. I'm like, open it up. And he asked me, he was like, would you feel more comfortable if I, would you like to come to the bridge and open her up for me, because I'm a little hesitant.

And I was like, no, Kappin, you do it. You can do this. I believe in you. The magic was within you the entire time. I've taught you all that I know about the sea. That whole story was just so you could use the term booster dam, wasn't it? I'm really into booster dam. He's been practicing it for a couple of days.

I'm really into it. I'm glad you found a whole anecdote. So the problem, we can sometimes cover some challenging topics on solbones. And the problem with doing that in a podcast setting is if people get skived out, totally wigged out and grossed out, they can turn the podcast off. You're on a boat. You're trapped here with us. Last time we did a show on the cruise, we did Norovirus, which made everyone uncomfortable.

And I think maybe even alerted like the crew, like, what are those two up to? Yeah, what's their angle? So we maybe took it too far. So I was trying to come up with something else that would be, you know, especially relevant to all of us living in close quarters. And something that maybe is, I find very interesting,

but I think Justin would say is a little challenging. So I wanted to talk about pin worms. So that's the one you get. Because after this, you know, flee now if you need to, because after this, we're barring the doors. We're not. Actually, that'd be a fire after that.

There's nothing to be squeamish about because the thing is pinworms affect people everywhere, all over the world. No matter it is truly like a parasite of equality. It does not discriminate. We can all celebrate that here on the Jococruz, right? In fact, 20% of people in the United States will be infected with pinworms at some point in their life. Hey y'all, there's more than five people in here.

Isn't there? Run the numbers real quick. Look to your left. Look to your right. If those four people don't have pinworms. So it's no big deal. No big deal. And specifically, some people in high-risk environments are more likely to get pin warms, and that's usually places with like close quarters.

One of those is actually schools. So school kids are at higher risk for pin warms. I don't know any other populations that are living in close quarters. Well, I just wanted to make sure you knew we brought one on board a school kid. Yeah, we do have a school kid on board. Just in case. Yeah.

Don't worry, we have one. I don't think she has pinworms. We only have two kids, so the odds are good. I don't think so. So usually on sobhones, I start with all the history because we're talking about a disease that everybody knows a lot about. When it comes to parasites, I feel

like they're not as well-known. Like, what do they do? What are they? How do they happen? It's weird. It's like, almost people don't like to talk about it. So I wanted to take just a little bit of time to kind of explain what pinworms are and how they happen,

how you can get them, and why you shouldn't stress out about it, even though I know that I'm going to keep saying that. Nobody's going to care, right? Yeah. OK. They're going to get to you to stress. The name that you can use, if you don't like pinworms, is interrobius vermicularis.

If you like that better, I think it's a little more clinical. I mean, it's still worms, but a little more clinical. And they live their whole little lives, their wormy little lives inside humans. And the way that happens. Hey, I'm a human. Wait. So what happens is you got to swallow the eggs first, but don't worry, you won't know.

They're very little. They're very tiny, you wouldn't know. So it's no big deal, they're not like, you know, they don't taste bad or anything. So you're gonna swallow them. They're gonna get down to your small intestine and then hatch and become little larva. And then they're gonna keep migrating down

and on their way in the ilium, they're going to stop. What's the ilium? The ilium is the last part of the small intestine. OK, thanks. So when they get there, they're going to mate, to make more pinworms. Oh, I heard some allas out there. How sweet.

Now, at that point, usually the male pinworms die. Sorry. What a cool boat. The gravid pinworms continue on. The pregnant pinworms continue on on their journey throughout the rest of the intestine. And as they migrate down, they get larger and larger until they're essentially just filled with eggs. Somewhere between 11,000 and 16,000 eggs

in a pregnant penworm. So many, really. It's like a lot, huh? It's a lot. It's a lot. Like their whole body. It's filled with eggs. So, and they migrate in case anybody is curious at a rate of 12 to 14 centimeters per hour.

So I don't know who needs to know that, but hey, trivia. Yeah, okay, so that comes up. So anyway, they keep moving on down the colon, but the thing is they need some oxygen for the maturation of the eggs. So they're not gonna lay, they're not gonna open up and lay all those eggs inside your intestine, they need to get out.

And now they're closest to, well, the other end. Like, right, they came in through your mouth, but they've migrated down down down down So there there's a light at the end of the tunnel Not usually but I I guess maybe And they're going to follow it doing some fractions Yes, it's possible To oxygen for the egg.

So what happens is eventually they will migrate out of your anus and lay their eggs there. Interstellar pinworms migrate out of interplanetary. Oh, okay. We have some leftover space nerds from the last row. Here to correct that, thank you. It was fair.

I didn't know the difference. So they migrate out and they lay their eggs in the like the perianal folds. So they just, just kind of all around the area. Just, good. You can't see that on the podcast. I was just kind of a circular motion around the area. Yeah, yeah, yeah, yeah.

Cool, cool, cool. Cool, cool, cool. This is happening at night, by the way. They do this at night. Oh, so wait. Stop in the body? In the human body. They do it at night?

Yeah. How do they know? It's a good question. They do it at night, though. That do I know? It's a good question. They do it at night though. That's when they come out and lay their head. Okay, just looking for the light at the end of the anus. And they're like, well, it looks like... Well, I know, look at the light.

They're looking for the ox, but I don't know. It looks like new to everybody back to bed. I think that generally speaking, they lay their eggs at night. I mean, I guess they could in the day. Like if you're somewhere where they're like, if you're, let's say you're up at the North Pole. I'm not gonna, let's move on.

Okay. Anyway, so they lay their eggs and then they hide back inside, or at that point what can happen is as they're laying their eggs and the worm is moving around, well you could, you might feel this now. And it's not painful, it's more itchy would be the word, it's itchy. And so, what can happen at this point

is either they lay all their eggs or... I don't like that one, so let's see what the other one is. Or you scratch. And if you scratch right at that moment when the worm's there, you're gonna break the worm open. Oh! Ha! Ha! Ha! And lay all the eggs for it. You're welcome.

Oh! Ha! And this, to continue with the life cycle... Oh! There's more! I thought they'd all be for them. Interomias vormicularis. No, the eggs don't.

No, no, no. The pinworm that has led the eggs is no longer with us. It has departed. Its job is done. But the eggs are just getting started. The eggs are very sticky, and they're very hearty eggs. They can live for like three weeks in a moist environment. So they can hang around for a while.

And what tends to happen since the eggs are irritating and then the worm itself is also irritating is people scratch and then touch things. And that's how the eggs spread. So, sorry about that one. Just that. That was the only one that was bad, right? That's the only one that's been bad.

So, you touch things, surfaces, and like I said, they're pretty hearty, so they can live there for a while. So you touch surfaces that other people touch, or maybe you touch, I don't know, somebody's face. I don't know why you just scratch your butt and you're touching somebody's face, but maybe you do. Or you could touch your own mouth and reinfect yourself. That can happen too.

Everybody, back to that. You got the fast pass. You all were taking the ride again. Come on. Come on, kids, that was a hoot. Let's get back in line. But one way or another, they get into another mouth. And then the whole-

Some other mouth, any mouth doesn't matter to them. The whole life cycle repeats itself again. You can also, by the way, I thought this was an interesting note. Well, this is the most common path. This isn't going to be interesting. You can spread them by inhaling the eggs, because they're very small. And I was like, well, how does that happen? And the example that they gave was like shaking out a bed sheet. Like, you know, you just kind was like, well, how does that happen? And the example that they gave was like, shaking out a bed sheet.

Like, you know, you just kind of like, before you spread it on the bed, and just shh, eggs everywhere. Her. Hoooo. So here's the good news. If you get pinnacle. This is all been a dream,

and I'm about to wake up and these don't exist. No, they do exist. But if you get your symptoms really aren't that bad. The number one symptom of pinworms, and again, not everybody gets any symptoms. Like some people just have them and have no idea. Perfect. You feel fine, you have no idea, you just got eggs down there. Just an egg down there and a big.

You might be spreading them or maybe you're a very excellent hand washer and you never scratch your butt because it's not itchy. Just a giant one. Just a giant one. Just a giant one. Just a giant one. Just a giant one. Just a giant one. Just a giant one. Just a giant one. Just a giant one. Just a giant one. Just a giant one. Just a giant one.

Just a giant one. Just a giant one. Just a giant one. Just a giant one. Just a giant one. Just a giant one. Just a giant one. Just a giant one.

Just a giant one. Just a giant one. Just a giant one. Just a giant one. Just a giant one. Just a giant one. Just a giant one. Just a giant one. Just a giant one. This symptom though is paritis ani, which just means you're anus itches, you're butt itches. Itchie butt. Yes, you have an itchy butt. That's number one is you'll complain about like,

man, my butt itches. Meanwhile, everyone in the audience is like, wait, my butt itched. Yeah. My butt itched three months ago. Hey, Doug, remember how I was telling you my butt itched? So bad for days and days. And like I said, it can be worse at night.

So specifically like an itchy butt that at night, you're like, you can't sleep. So like insomnia can be another symptom, but it's really just that your butt itches so much. You have trouble sleeping. See you wake up, just scratch your butt a lot. Or the area around your butt can be itchy. Everything down there can get itchy.

Everything down there. More severe cases, you can just have general below the waist. Perfect. Itchiness. Perfect, cool. But most of the time that doesn't happen. Most of the time, the only symptom is that your butt

might ditch a little bit, and that's it. Which is why in kids, this stuff can spread a lot and like daycares and schools and things, because like kids scratch their butt all the time. I don't know if you know that. Kids are constantly scratching their butts. And so if every time they scratch their butts, you thought they had pinworms, you'd be taking them to the doctor all the time.

So you just assume like, well, it's a kid. Their butt itches. The way you diagnose pinworms, so let's say you do have an itchy butt and you're starting to think, oh, it does, it's a lot at night. And it keeps me up at night, it just so much. Maybe I should get this checked out. Well, the test that is best for penworms is something called the Scotch tape test. I hate it.

I hate it. I hate the test. I hate it. I love this stuff. It sounds like you make it up, but I didn't. It's just the thing. It's just the test. Justin hate it. I love this stuff. It sounds like you make it up, but I didn't. It's just the thing. It's just the test. Justin, do you think you could guess

what the Scotch tape test is? I mean, Scotch tape over your mouth and your nose and your weight, and eventually you die, and you don't have to think about this anymore. And you pass the test. Everyone passes. This one? Well, no. Do you put it on your butt and then you take it off

and see if there's worms there on the table. Hey, yeah. Now, you usually are going to have to do like a microscopic evaluation. Like, well, I have prescribed this in the office. Here's what you're going to do. You're going to get some clear tape. Any clear tape will do.

It doesn't have to be Scotch tape. That's just, oh, we tend to. That's what we're taught do. You're gonna get some clear tape. Any clear tape will do. It doesn't have to be Scotch tape. That's just, oh, we tend to. That's what we're taught in medical school, the Scotch tape test. So a clear piece of tape. Packing tape would really be ideal. Put it. Because Scotch tape is not.

The really Scotch tape is not as perfectly clear as the packing tape. Like a good sturdy packing tape. Because what you're looking for is what's gonna be a good slide for your microscope later. So you're gonna put the tape there, leave it overnight, and then the next morning you can bring it in, and we can look at it under my microscope.

Here's my butt tape. Excuse me? Can you direct me to the counter where I should give my butt tape? And we look for worms or eggs or whatever we might find. And usually this will identify them. If they're there, we usually can find them using this test. Now, I found it, when I was reading all this,

I had the question, well, why don't we do a stool test because for most worms, in case you're not familiar, for most worms, we just ask you to poop in a cup. That's, hey, I need to know if you have a worm. I need a stool sample, you give me a stool sample, we go look at that, well, we have to prepare it, we have like mix it, a certain way, like liquefie it, like get it like watery, I mean, like not liquefie it,

but like get a watery, and then like, prepare a slide and look at that, and look for eggs or worms or whatever we're looking for. But in this case, that doesn't work very well. And I wanted to know why, am I getting to, is this too? Go ahead. OK. I have this noted, like, this is.

Sit bolder to it and said, when I get to this part, I need you to make a judgment call as to whether or not I should read this part. So now I'm saying, read this part, because you can only get so wet and we're all here together. So let's go. Well, and I think I blew it by describing how you prepare a stool sample. So I think I may be already made it too bad.

But so the reason checking the stool doesn't help, it's diagnostic like 5% of the time. So almost never do you actually find anything because they actually would have to cling to the sample on its way out if you're following me. And in order for enough worms or eggs or whatever to cling to the sample, you'd have to have a lot there. So like a super infection, lots of eggs, and then you'd have to choose just that right piece. So it's really hard to do it in a stool sample. Okay. The medicines, the medicines that ask you lift my cards before the mouth. Now humans have been infected with worms of all kinds for a very long time.

Parasites kind of live with us. Sometimes, like I said, sometimes you don't have any symptoms of pinworms. They're just kind of hanging out with you and they're just, you're like, you're a little, just like, you don't know. Humans and parasites, we just evolve together. Sometimes they're problematic, not always. But a lot of what we have learned about them has come from studying copper lights.

I love when we get to talk about copper lights. Justin, what's a copper light? I don't know. I've told you on the show before. You told me a lot of things on the show before. I don't know. I'm sorry. I don't have a degree.

It's what, what, what, what game was Super Mario Bros. 2 based on? Ha, ha, ha, ha. Doki Doki Panic? OK. Ah! Ah! Ah! All right.

Fine. Fine, you win. You win this round, Smirl. A coprolite is fossilized poop. So we can get fossilized stool samples. Thank you, one person that uploaded. From humans. And I love reading about this because I

was reading all these articles specifically about finding parasites and finding larvae in fossilized poop samples and how difficult it can be, depending on which castle, like they were looking at all these different castles and finding the bathroom in the castle, and then analyzing stool samples found on the soil in that area, which is a pretty cool way to deduce it. Okay, this is who lived here.

But the problem is, in some castles, they were only used for a short period of time, and so you can really pinpoint, this is when this stool sample is from, and who may have made it, and so you can really pinpoint like this is when this still samples from and who may have made it and what larva are in it. And then other castles were used for centuries. And so you have no idea, you just find these coprolites and they got worms in them and they don't help.

But this is where we've learned most of what we know about how old parasites are and how long they've been with us. The earliest known instance of pinworms is actually from Utah, and it was from 78, 37 BCE. Wow. So we've had pinworms in us for a very long time. And like I said, not causing us problems,

most of the time. They knew as we're going through ancient history, they knew specifically that embalmers had a risk of contracting various worms. And as you look through ancient texts and their diagnosis and treatment of different parasitic infections, and specifically worms, it all kinds of overlaps.

We didn't know exactly the difference between a tapeworm and a roundworm, and the pinworm versus an ascarus and all these different kinds of worms. So you'll see treatments for how to get rid of intestinal worms in general. So some of these treatments probably were aimed a little more at an ascarus worm over a pinworm,

but nobody really knew the difference. So they were just used for any kind of wormy thing that might be coming out of you at the bottom. Um, ha ha ha ha. In the Ebers Papyrus, we find like an incantation that it was used to try to protect embalmers. It was specifically like the incantation

to prevent worm infections and embalmer. It's a very specific incantation. It's a specific incantation. Which suggests that there was some belief that like, we don't know why this happens. We think it's some sort of like maleficent. Malevolent, maleficent. We think maleficent from Disney.

I think maleficent too. That's a lot of maleficent too. It's her infecting embalmers with pinworms. It's very niche. Yeah. We think so much. I mean, almost as niche as a movie about Maleficent and a sequel to that movie about Maleficent. So this reflects the belief that it was some sort of malevolent force. Like you were cursed with worms. We don't know why you got them, but something to do, you think we would have put this together.

Like, you're an embalmer. You work with dead bodies. I got nothing there. You were cursed. But what's interesting is in that same papyrus, they talk about a treatment for worm infections of any kind, any kind of worm intestinal problem, and they suggest

pomegranate roots. And what's kind of cool about this is that this is actually something that they've done studies on in the modern day, there is some worm killing property to certain parts of the pomegranate. So this isn't totally off base, now depending on which kind, and where you're eating the root, or the flower flower or the leaf or whatever It can kill some worms and certain concentrations. So this was like a really good idea I don't think the incantation necessarily worked, but the the pomegranate actually was a really good idea

Hypocrites talked about worm infections specifically a lot about roundworms Some of this was probably ascras, but he was probably also referring to pinworms because all these symptoms can kind of overlap. Like, in really severe infections, people will complain of like loss of appetite or maybe some stomach cramping. And then some of the other parasitic infections, those can get really severe, those symptoms. With pinworms, you probably wouldn't have that, but the itchy butt you usually think of is probably penworms.

Hippocrates, Galen, are old pal Pliny the Elder. Whoo! They all had one number one treatment that kind of persisted for a while was garlic. Everybody just said, well, eat garlic. I don't have any evidence that that necessarily worked, but garlic. And then a lot of their other advice was based on the idea of humor.

So at the time, the prevailing medical theory is that you have four humors in your body, and you got to keep them in balance, either by getting red of some or adding more in in order to maintain health. And so a lot of how to get rid of worms was just eat some, what we're called like cold foods and drinks, because cold foods and drinks, because those foods and drinks were thought to balance out like too much warm humor, and then you got more cold humor, and then the worms went away.

So that was a lot of their advice. Galen was big on modifying your diet. Also blood-letting, there was a big treatment of the time. Like, I don't know, you got worms. Let's open a vein. We don't know. But they also, like Galen specifically said,

in part of this was the problem. They thought that worms formed through spontaneous generation. So like, if you've got something decaying and some heat and leave it there long enough, a worm will crop up. And it'll just appear. And so without an understanding that worms were a communicable thing and we were passing them around and they were living inside of us,

they were just like happening in humans. So you can see where like, then you would balance your humors to treat that as opposed to like, well, let's stop pooping into our drinking water. It's another thing we could try, it's all sort're just trying stuff. I mentioned Plenty the Elder, and you know I had to do a deep dive there to see, you can't just have garlic, Plenty, come on.

Come on, bring the heat. A lot of people had worms. You had to have more than just garlic. And oh, he did. So we had lots of different treatments. One was mixing water and barley and worm wood, which I guess that sounds like it would make sense. You may be familiar, it's an ingredient in absent.

There was also, there was some nettle mixed with salt and hydromel, which was like mead sort of like a fermented honey kind of thing. So, yeah, okay, sure. There was some other like wine with some roots or wine with some oregano or just wine. Yeah, I don't know. Stop worrying about the worms.

So you butt it, just fine. By the end of it, I don't even care if I've worms or not. It's fine, I don't care. He's hanging out, it's fine. He specifically mentioned if you've got helium trope flowers, you can mix it with wine, and that'll get red of worms, or gravel.

Why? You've got some gravel? So one thing I could do is wine with flowers. The other thing is gravel? No, it'll get red of gravel that you've got in you. Okay. Which I thought like, well gravel that you've got in you. OK. Which I thought, well, that's got maybe kidney stones. How big of a problem was this? But specifically, if you want to get red of kidney stones,

you have to also add cumin. So it wasn't kidney stones. What's happening? There was gravel in there. He also mentioned pomegranate. Again, this was a good idea. He was just copying. But what he said was, you've got to take a pomegranate,

boil it down until it's the third of its size, and then just fill in all that you just lost with wine. Again. Perfect. And drink it. That sounds pretty good. Sure, yeah. Sure. Yeah, I like that. And then his last recommendation, this was my favorite. That sounds pretty good. Sure, yeah. Sure.

Yeah, I like that. And then his last recommendation, this was my favorite. This is a quote, a considerable number of walnuts. Ha-ha-ha-ha-ha-ha. Is that enough plenty? You'll know when it's enough. Just keep munching. A considerable number.

A considerable number of walnuts. Would you say you've ever. A considerable number of walnuts. Would you say you've ever eaten a considerable number of walnuts? I don't like walnuts at all. So no. So no. So you might have walnuts? Consider a number of walnuts for me is like four. If you see me four to five walnuts, assume I have pin worms.

Assume that I am trying to get rid of my pin worms, because that is a lot of walnuts for a cat that does not enjoy them particularly. I'd rather do the pomegranate fruit challenge or whatever. That look like, you know, you remind me of all those things that you'd see on allrestopies.com,

but they're like, I'm gonna do that, and then you don't. I'm like, I should do this. This would be that hard. We just gotta get the pomegranate and get the one and then take photos of pomegranate seeds and then you pull it out. I'll just do hard. We just kind of get the mom and grandma to get the one and then take photos of mom and grandma to get that. And you pull it out. I'll just do it.

We'll do it next time we have a party. But we don't have a party because we have two kids. Anyway, you were saying about gravel. Uh-huh. I found so many articles as I was trying to research like ancient treatments for penworms and all this kind of stuff. What did we use to use? I have found that, and I don't know if this is common knowledge,

archaeologists seem to really love to dunk on the Romans for not being as smart as we all think they were. I found all these articles which were like, Romans not as clean as they seemed. Roman baths ineffective. Romans, all that water, still as clean as they seemed. Roman baths ineffective. Romans, all that water, still not clean. And I was like, what is the deal? Like, why are we hating on the ancient Romans?

I don't know. But apparently, the ancient Romans were crawling with worms of all kinds all the time. The great thing about the Joker cruise is there's probably like eight people in here like, typical Romans. Well, that's what I was hoping. I thought somebody would be like, I know, right, the ancient romance, because it was really

like just endless articles that were like, you had your bath houses and you thought you were clean, but guess what? You weren't. And they did, like, sanitation improved. I mean, at least I remember learning that like in grade school, like you learned about aqueducts and you're like, aha, we have a sanitation system. And it did improve at that point in history,

but the worm thing didn't. It actually got worse. Nice. Paracetic infections actually got worse in ancient Rome. And that was, I think a lot of the question was why because everybody was like trying to use toilets and trying to drink clean water. So what was going on? And so part of that was probably the bath houses,

because they didn't necessarily clean them all the time, or drain them and refill the water. So I read that there were like layers of like... Like human... Human... End of sentence, human. Layers of human, end of sentence. Layers of human. Like on the water.

Just like layers of people, person on the water. And I also didn't know that people ate a lot in the bath houses. It didn't seem like a playthrough you want to eat. You have to eat a big, rowdy chicken leg. There's like chunks falling. Like, it's local. There you go, yeah, my goodsus. I'm gongam.

Well, I'm not, because I keep thinking of like a hot tub. And I've never been in like a hot tub. It's a luke tub. It's a luke warm tub. I want to big ol' plate of food. But I don't know. Maybe, maybe people are doing that. Like, there's the taco bar.

There's the hot tub here. It's right there. It's begging for it. Anyway, so apparently, it was not, the bathhouses were there's the hot tub here. It's right there, it's begging for it. Anyway, so apparently the bathhouses were not necessarily the most sanitary of places. So this could have been a way that even though you were taking a bath, which was great, that we were actually spreading a lot of these parasitic infections.

They also, on a side note, there was also a lot written about how much lice there was. Like they invented all all of these fine Lice Combs to remove Lice. Like they found these. I don't know why that was important. Again, I feel like Archeologists just really hate the Romans. They're like they even had their own Lice Combs. Well, I mean, that's good. They were getting the Lice out. So anyway, aside from all that, there were probably two other reasons that parasitic infections spread in ancient Rome.

One was, there was a sauce called garum, garum, garum, I believe, that was very popular, and it was made from pieces of fish, herbs, salt, and other like, flavorings and stuff, spices and seasonings. And it was like fermented and old and like fish sauce, basically. And it may have had like, things like tapeworm eggs

in there very easily. And it was used all over Rome. And it was like taken like people would, when they would travel outside of the empire, would take it with them to put on their foods other places and give everyone else their intestinal worms as well. So this spread a lot of, like you can follow the path of this sauce and follow the path of worms throughout the ancient world where humans were just like here, have our tapeworms.

I didn't touch condiments when I was five years old and it turns out I had it right. I knew what I was five years old and it turns out I had it right. I knew what I was doing. I found, I found one archaeologist that I read a lot of his work on this and it was very interesting. Dr. Pears Mitchell and he said he summed up all of Rome's sanitation by saying that this, it seems likely that while Roman sanitation may not have made people any healthier, they would probably have smelled better.

That's it. All right. All those, I mean, don't you remember all the aqueducts? I feel like we weren't able to, anyway. They also, a practice that started then and would continue throughout the medieval period was fertilizing crops with human waste. And this was probably also a big reason

that any kind of pinworms, any roundworms, any tape, all these different worms would continue to be spread is because it was like a time period where like, let's get the poop out of the streets. Let's keep our streets clean. Let's put the poop on our plants. Let's put it in the fields. Let's get it all out to the fields.

And so this was probably another big reason that this stuff spread. And then this was, again, very popular in medieval times. So you would just, you know, don't you call it like night soil? It's a lot of people who know that. So anyway, this was probably another big reason, because then like it's all over the fruits and vegetables and then you're eating it.

And this was another reason like everybody, again, that didn't discriminate. Like royalty was documented as having intestinal worms, just like the peasants who worked the fields. Like everybody got infected with worms. I like that, great unifier. That's something we can, that can, this age of division can bring us all together.

Our intestinal worms. So in the medieval period, they didn't have a lot of better ideas than the ancient Greeks or the Romans did as far as how to treat this stuff. We were still using a lot of humoral system of medicine, so a lot of leeches, a lot of bloodliding, a lot of things that might make you puke or pee or poop. And then the only thing was tanzy. For whatever reason, tanzy was like an herbal remedy that would be cooked into fritters and given to people.

I just love the idea that was like, oh, you got some worms? Let me make you a fritter. I hear fritter. You won't be any better, but like fritters are delicious. So take your mind off of it a bit. In the, as we move move into the 1800s, you find that this, that various worm infections

become a big deal in the American South. And so you can find a lot of like folk remedies and herbal remedies, like traditional medicine that came out of the American South to try to treat all of these different worm infections. A lot of them, you'll see the term vermouthuge. Vermifuge? Vermifuge, which was something to like clean out the worms, vermouth referring to worms. infections. A lot of them, you'll see the term verma fuge. Verma fuge?

Verma fuge, which was something to like clean out the worms, verma referring to worms, and you just clean them verma fuge. Anyway, if you see that, that means it'll get the worms out of you. And while, again, these were not specifically always aimed at pin worms, a lot of worm infections were hard to tell. Like, you didn't know what worm you were treating. And it didn't work anyway, so what's the Y-quipple? So, molasses candy was a very popular. I'm into this. Yeah.

To me, that just seems like we think our kids might have worms. What will they eat? That must be a vermouthute. So, molasses candy was a popular. And sometimes they would add certain herbal things to the candy that were thought to be good specifically for worms, something called worm seed, or also called goose root.

It was Jerusalem oak, whatever you know, or worm seed, American worm seed. It's not in some way sometimes when things are named stuff like worm seed, it's kind of nature's way of telling you, like, this can help with worms, you know? It's kind of nature's way of telling you, like, this can help with worms, you know? It's nice. All makes sense. And all that's of the circle of life. You know we call it that, right?

Yeah, yeah, no. Like, plants aren't like labeled. It was more of a thinker. Plants aren't like labeled in nature. It's more of a grower. You'll be walking back to the Rotterdam deck here in a few minutes. You're like, wait a minute,

that's hilarious. He knew the difference. What a kidder. Tobacco tea was a popular treat for- Now we're talking. That probably didn't work. Things like sage or sienna or horse mint, just all different kinds of herbal things. Now pumpkin seeds were made into a tea and this was often used for worms.

And again, sort of like pomegranate, we've actually done some studies now that have shown this may work a little bit. This may actually kill some worms in some conditions. It's harder to predict how the dosing, so who knows how strong was their pumpkin seed tea, I don't know. So was it actually doing anything, I can't speak to that, but may it have been and could it actually work? Yeah, and there have been what's really cool is I was looking specifically at these studies

like now are these in a lab, or did they do these in humans? They've actually done with pomegranate and pumpkin seeds in vivo, in body, in living human-been studies, and they've killed worms that way. So it's kind of neat. I am not suggesting that if you have, if you think you have a parasitic infection

that you make yourself a pumpkin seed tea, you have no idea if it will be strong enough. But it is kind of interesting that there was, there was truth to some of these, these little trees. The little pastries hope, because I've eaten a lot of those this week. Do they have pumpkin seeds or pomegranate?

I don't know. Okay, well, red. Why don't you know? What? Why don't I know? I don't really look at them. I just kind of, I don't know. I'm worried people will try to take them.

I know that's not how it works. I'm on vacation, sort of. You're dressed for it. We matched. You can't tell this if you listen to it later, but we're wearing the same patterns. Our formal. When we found out it was formal wear day,

we were like, what does formal wear mean to us? Well, we bought these at Disney and we matched. There you go. Is that formal? Is that formal? Is that formal? Oh, thank you. Oh, thank you.

Thank you. If you're listening to this later, someone just said, you guys look amazing. Like Greek gods. No. So one interesting note I found was that there was a belief that turpentine was very good for like anything that made you sick. Let's go back to the pumpkin seed.

Well, I thought this was interesting because I have seen this as like a folk remedy in where we're from West Virginia, which isn't really the south, like, we left the South. Specifically, not the South. Specifically, we said no South, we're the North. But then still, turpentine was still used. Still we drink turpentine. Still we drink turpentine sometime in the city.

We can't let it stay up on a high horse about it. But even though this was, like, people recommended against this. Like doctors would be like, please don't have your children drink turpentine. That was a very popular thing to do was to give your kid like a sugar cube with turpentine on it. Because they thought it was a cure for anything intestinal like near stomach, stomach, stomach, come here. At least they've got the great taste of molasses candy.

They get the taste out. There were a lot of patent medicines at this time, some of which we've talked about before, but there were a lot of medicines advertised to get rid of worms that probably didn't do anything, but they were very popular and were advertised well and some people would buy them. A lot of them were relaxatives,

so you would think you were ridding yourself of worms because you would poop a lot afterwards. And like parents specifically were targeted because it was like, your kids will go to the bathroom a ton, and you got to think, well, the worms got to be gone. Everything else is gone. And so they were all like called vermouth huge. So there was like white-screen vermouth huge, Jains vermouth huge, young kinds, tape-worm specific vermouth huge, and then my favorite, which was kick-a-poo worm killer. Great, great, great.

Again, all of which probably... Nothing worked. ...didn't do anything. What do we do today, said? So, the nice thing today is we have lots of treatments for all varieties of intestinal worms. Pinworms are pretty easy to treat with like two doses, usually one, and then like a week later,

another dose of a medication, and it's that simple. And you can be rid of them. And it's almost, I found lots of notes and it's almost easier to just treat them if they happen than it is to like worry yourself too much about preventing them, because they are hard to prevent. They are fairly contagious. So like if one member of a household comes in and we diagnose them with penworms, we're

going to treat everybody. We're just going to assume like, we're... Everybody's got the worms. Yeah, we've got penworms. But again, it's not something, it is the most common parasite in the developed world. We all are going to encounter it in a family member or a friend, a loved one, or maybe an enemy. I don't know. Somebody you know is gonna get pinworms.

So, that's true. And maybe you. It's probably you. Hasn't that been the way it's gone so far for you? It has for me. That's been the situation for me so far. So, it probably is me. And I know statistically it doesn't

because for all of us have pinworms, but it feels that way, doesn't it? It feels like probably the way things have been going. We've probably got pinworms also. It just seems like that's where our love's been going. But again, don't stress about it. Just wash your hands. Don't scratch your butt. And when you do start to get rid of it. Folks, thank you so much for listening to us talk about pinworms. You've all been very courageous and I'm very proud of you. Thank you to the taxpayers for the use of their song,

Medicines, as the intro and outro of our program. Thank you to Paul, support, and Jonathan Colton, all of the Jokeho family for having us here aboard their just massive boat. And thank you to you for braving the rocking of these waves to listen to us. That is gonna do it for us this week. So thank you so much for listening.

Until next time, I'm him, Justin McElroy. I'm Sydney McElroy. As always, don't, do the whole in your head! Yeah. I'm the one who comes to try and turn it in. And it's time to stay. Stay with fun. The fun thing grows. Alright!