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Psyche 4:27-30, 1883.

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March-April 1883.J PSYCHE. 2 7
moving the air, in the brown scales. In
gitudinal striae toward the middle of the the white scales the bands usually start scale (see fig. 7, b and c) ; exception- out from or beneath the marginal longi-
ally, however, they begin beneath one
tudinal stria of the upper side of the
of the other longitudinal striae.
scale, and extend beneath the other lon- (To be continued.)
HOMINIVOROUS HABITS OF L UCILIA MA CELLARIA, " THE SCREW-WORM."
BY FRANCIS HUNTINGTON SNOW, LAWRENCE, KANSAS. I have from time to time had occa-
sion to note the depredations of the
screw-worm upon horses and cattle in
this "state, but until recently have not received positive evidence of its attacks upon human subjects in any locality so
far north as Kansas. But early in Sep-
tember, 1882, I received from Mr. S.
D. Osborn, the postmaster at Varck,
in Southeastern Kansas, specimens "of
the worms which came from the nos-
trils of Milton Carter." These proved
to be the larvae of Lucilia macellaria
Fab., the so-called " screw-worm."
Upon further inquiry I learned that
upwards of one hundred full-grown
maggots escaped from the nose of this
patient, who finally recovered from the
serious illness consequent upon their
ravages. I also ascertained that Mr.
Carter had long been afflicted with an
offensive nasal catarrh, which made
his nostrils an attractive place for the oviposition of the fly, and that he had
fallen asleep in the woods in the day-
time only a few days before the first
appearance of the symptoms produced
by the presence of the larvae.
Several other instances of the attacks
of Lucilia upon man soon came to
my knowledge, most of which led
to fatal results. Among these I will
select the case attended by Dr. J. B.
Britton, of Mapleton, in southeastern
Kansas, who reported it in full at the
session of the Southeast Kansas District Medical Society, in January, 1883.
From this report I condense the follow-
ing account: " On the evening of Au-
gust 22d, 1882, Mr. M. E. Hudson
complained of a peculiar sensation at
the base of the nose and along the
orbital processes, which was first fol-
lowed by inordinate sneezing, and later
by a most excruciating pain over the
os frontis, also involving the left supe- rior maxillary. This patient also had
suffered, and was still suffering, from
an aggravated form of nasal catarrh.
The discharge was quite purulent, of
a yellowish color frequently tinged with blood, with a disagreeable odor and
at times intolerably offensive. On the
24th there was a profuse discharge of
much purulent matter from the nostril
and mouth, when all pain instantly
Pu&e 4 027-10 (pre. 1903). hfp //psyche aitclub orgM4-0027.htd



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subsided. This discharge continued
for three days, during which time as
much as sixteen ounces escaped, in-
creasing in consistency until it was pure n
pus. 1 he odor becoming much more
offensive, his cough was more ti-ouble-
some and fever increased to such an
extent as to produce slight delirium for twelve hours. What was thrown off
was with much difficulty expectorated,
and was sanious, containing micro-
scopic particles of osseous matter, to-
gether with flakes of plastic exudation. The os hyoides was evidently destroyed.
The patient had spoken with difficulty
for thirty-six hours and there was much
trouble in swallowing'. The soft palate
had evidently given way and there was
an entire inability to protrude the tongue or use it in speech.
"About this time a worm similar to
a maggot dropped from his nose. That
was the first indication or suspicion that there was anything of the kind present.
There was not, as in some other cases
reported, any swelling, or movements
traceable under the skin, nor was there
at any time any complaint of the patient, calculated to lead to a knowledge of
their presence. After the appearance
of the first, I expected more, and was
surprised to see them drop from the
nostrils and wiggle from the month
without any discomfort to the patient
until they came in contact with the
Sclmeiderian membrane, when they
annoyed 11im greatly, and every effort
was made on his part to expel them ;
but so soon as expelled, 110 further
trouble was manifested until another
would get into the nostril. Every effort was made on my part to discover them
under the tissue, but the soft palate being destroyed to a great extent, and the
palatine arch apparently lowered, it was with m~1c11 difficulty that. an examination could be made. The worms were
evidently burrowing under the palatine
fascia, as it presented a honey-combed
appearance and in places patches were
totally destroyed as large as a dime
[18 inin.]. They continued to drop
from the mouth and nose, forced from
the nostrils by the efforts of the patient. for the following forty-eight hours,
during which time 227 were counted
and the estimated number exceeded 300.
At this time the whole of the soft
palate was destroyed. The patient
lived four days after the last worm came away.
"I put five of the worms in dry earth
and in fourteen days from the time they
dropped from the nostril there hatched
out three flies.
"Upon a very minute and careful ex-
amination after death I was astonished
to find that all the tissue covering the cervical vertebrae, as far clown as I could see by throwing the head back and
compressing the tongue, was wholly
destroyed and the vertebrae exposed.
The palatine bones broke with the
slightest pressure of the finger. The
os hyoides was destroyed and the nasal
bones loose, only held in position by the superficial fascia.
"My own theory is that the fly depos-
ited the eggs while the patient was
asleep, probably the clay previous to




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enough to annoy him
few days after the accident and shortly
hey gave no further laboring under a severe cold. Had slight congestion of the lungs, and
mens of the fly, bred as above stated,
seemed greatly swollen and he com-
which I identified as Luciliamucellaria
plained of a smarting, uneasy feeling
Fab. In order, however, that there in it, and general misery through the Republic annoyance in his nose and head. A few its v;wia- hours after, I was sent for in haste with iril. Milking a 20 per cent solution of
a! Monthly
chloroform ill sweet milk I made a few
shua Rich-
injections up both nostrils, which im-




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salycilate of soda, bicarbonate of soda
and carbolic acid we hoped to drown
out the remaining larvae.
But they
had by this time cut their way into so
many recesses of the nose and were so
firmly attached that we were unable to
;iccomplisl~ much. Finally we resorted
to the chloroform injections, which im-
mediately brought away a considerable
number. Friday I was able to open
tip two or three canals that they
had cut, extracting several more
that
had literally packed themselves one
iifter another in these fistnloiis channels. His speech becoming suddenly much
worse, I examined the interior of his
mouth and fouitci that a clear-cut open- ing had been made entirely through
the soft palate into 1Cs mouth and large enough to insert the end of a common
lead pencil. Saturday the few remain-
ing larvae began changing color and
one by one dropped away. On Sunday
for the first time hernorrltagc from both nostrils took place, which continued
;it intervals for three days but was not :it any time severe. On this day the
patient began to improve, the delirium
;md erysipelas having subsided, leaving
but little or no annoyance in his head.
In a few days he became able to go
about home, and even to walk a dis-
timce of half a mile to visit a friend and return. But while there he began coin-
plaining of a pain in the neighborhood
of his left ear, apparently where the
ei!,<tachian tube connects with the i'nkl- (lie ear. It proved to be an abscess.
Being already so reduced by the first
attack, he
was unabie to withstand the
second, and died after an illness of
nearly three weeks, corppletely ex-
hausted hy his prolonged sufferings.
Three days before his death the abscess
discharged its contents by the left nos- tril. The quantity of pus formed was
about 2& ounces (78 grains].
"In all about 350 larvae vere taken
away from him during the first attack,
and, as the visible results, not only hid they cut the hole through the soft pal-
ate, but had also eaten the cartilage of the septum of the nose so nearly
through as to give hiin the appearance
of having a broken nose. The case
occupied, from the first invasion of the fly to its final result, ne;n'ly two months. lie doubtless would have recovered but
for the formation of the abscess, which, from all the symptoms, was caused by
one or more of the larvae having found
their way up the left eustachian tube."
Dr. Richardson also quotes the Rev.
Williniii Dixon, of Green. Clay Co.,
Kansas, as giving the foliowing account
of his own experience ;
While riding in his buggy a few
years ago in Te:::is, a screw-fly attacked him flying up one nostril.
He blew it
out, when it dashed up the other and .
deposited its eggs before he was able
to expel it. Not realizing the danger
he did nothing for about three days,
when the pain beciiine so great that he
hastened to Austin to consult a phj si-
cian. His soft palate was almost de-
stroyed before the Iarvne. over 200 in
number, were expelled." This was
the only one of twelve cases known to
Dr. Richdson in which the patient
recovered.




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