As we prepare for interesting times, we come across ideas that make us shudder and say, "I'm not going there." There varies from person to person. Today's article focuses on a place I have no desire to visit, either. Because we prepare, we will have other options. However, I think it's important to understand that even practices we find undesirable or distasteful can serve legitimate, medically accepted purposes.
Maggot therapy is one of those practices. It's a place I don't want to go, ever, and you probably don't either. The idea of having little maggots, cute as they are, clean out an infected wound just grosses me out. I'll use sugar or honey. You probably will, too. However, we may come across a physician who uses this method for treating a patient. And what would you think of that doctor if you didn't know maggot therapy was a legitimate treatment option? In all likelihood, you'd steer clear of the guy. And that might be a mistake. Maggot therapy is what people who didn't store enough sugar or honey or antibiotics will get to use to have their infected wounds cleaned.
So let's check out what maggot therapy really is.
Maggot therapy has actually been around since antiquity, though when Job lamented that "My flesh is clothed with worms and clods of dust; my skin is broken, and become loathsome (Job 7:5)," he might not have understood that the maggots were doing him a great service.[1] Records show that cultures the world over have used maggot therapy for the last thousand years. During the American Civil War, doctors on both sides credited the use of maggots with saving countless lives. However, with advances in the study of germs came the belief that maggots were introducing infection, rather than cleaning it up. And such is actually sometimes the case, particularly when non-sterile maggots are used. So the baby (maggots) got thrown out with the bathwater.[2]
Until another war blasted onto the scene. As often happens during wars with so many casualties to be treated, doctors resort to what actually works to save lives, rather than the newfangled treatments and theories that sound great on paper but don't really work in reality. As a military surgeon in World War I, Dr. William Baer noticed that patients whose wounds were infested with maggots recovered better than those whose wounds were clean. And he subsequently used maggots to treat patients in war-torn Europe as well as in his practice at Johns-Hopkins in Boston. In the course of treating patients with maggots, it was found that some patients developed tetanus. That led doctors to begin using sterile flies that they raised themselves.[3]
The practice of using maggots continued into World War II, especially by Americans. However, with the advent of antibiotics, maggot therapy fell out of favor. After all, what would you want? Some little pills or a bunch of maggots?
In the 1980s, however, with increasing cases of antibiotic resistance, maggot therapy was again turned to as a treatment of last resort. Wounds for which maggot therapy is most effective include:
- burns, partial- and full-thickness;
- pressure ulcers;
- chronic wounds that are not healing.
Maggot therapy will not permanently resolve ulcerating skin cancers, but the maggots may remove some tissue. A physician will need to remove the entire cancer and close the wound with sutures.
How would one use maggot therapy in a survival situation? First, you really want sterile maggots (yeah, raising sterile maggots is a topic for another article) if at all possible. The green blow fly (Phaenicia sericata) and the black blow fly (Phaenicia regina) are the most studied and most commonly used. The larvae are placed in the wound, with more used for tissues that are clearly infected and for larger wounds, usually about eight per square centimeter of wound. The wound is then covered with gauze and taped in place, to prevent any escapees. Every one to three days the maggots are washed out with water or sterile saline and replaced with new maggots.[4] Not only do the maggots clean away the dead tissue, but they also excrete antimicrobial substances.[5]
However, these professional wound cleaners don't get a lot of respect. Many physicians don't acknowledge or understand the work they do. And why would they? The physicians have no financial incentive to prescribe them (and yes, medical maggots are only available by prescription) because they are so cheap. The maggots are like the lowest castes of society: they're doing a job people don't want to do, doing it much better, and doing it for free. And when they're done, they'll be treated like garbage and thrown away. They really do deserve more respect. But instead, we worship Big Pharma and pay them big bucks.
However, in the interest of full disclosure, and being honest, and all that, I have to admit that if I've got a wound that won't heal, I'm turning to sugar or honey first. No offense, guys.
Links to related posts:
Medicinal Uses of Sugar
Medicinal Uses of Honey
Acquiring Antibiotics
For further reading:
[1] Iain S. Whitaker, et al., "Larval therapy from antiquity to the present day: mechanisms of action, clinical applications and future potential," Postgraduate Medical Journal, June 2007, 83(980), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600045/ (accessed 7 March 2020).
[2] "Wound Series Part 2: Approaches to Treating Chronic Wounds," CEUfast, https://ceufast.com/course/wound-series-part-2-approaches-to-treating-chronic-wounds (accessed 7 March 2020).
[3] "Medical Maggots™ (maggot therapy, maggot debridement therapy, MDT, biotherapy, biosurgery, biodebridement, larval therapy)," http://www.monarchlabs.com/mdt (accessed 7 March 2020).
[4] R. A Sherman, "Maggot Therapy Takes Us Back to the Future of Wound Care: New and Improved Maggot Therapy for the 21st Century," Journal of Diabetes Science and Technology, March 2009, 3(2), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2771513/ (accessed 7 March 2020).
[5] Iain S. Whitaker, et al., "Larval therapy from antiquity to the present day: mechanisms of action, clinical applications and future potential," Postgraduate Medical Journal, June 2007, 83(980), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2600045/ (accessed 7 March 2020).
13 march 2022
Hey! I do want to respond with my experiences. I'm no dr or guru but as a kid late'60s early '70s we had an occasional cat or dog show up with an infected wound... Sometimes within a day or 2 it would have maggots in it. An usually in another 3-7 days they would be gone and the wound would be clean... My now life is an equine vet tech. Maggot therapy getting more an more popular in non healing hoof injury, abscess an infected distal limb wounds in horses. The little smaller than a grain of rice maggots placed in a juicy wound grow to big fat 3/4-1" maggots fairly quick....an now days I work weekend nights an have no idea of the cost but 6 years ago a 'dose' of maggots was $60...... An often replenished 2x a week.
ReplyDeleteThank you, Annie, for sharing your experiences.
DeleteI've been involved with maggot therapy studies at Johns Hopkins. Aside from the ewww factor it was outstanding in debriding infected wounds of necrotic tissues.
ReplyDeleteIn fact with bed sores on diabetics (Often Fatal after several trips to Surgery to try to get all of it) the success rate was so high there was some talk about making it a "Gold Standard". But if you know your medical history "Learned Opinions" of senior Dr.'s often trumps good studies.
It took Years of Shame and Abuse before Dr. Semmelweis's (and others) research on how Midwives who routinely washed their hands had 20% of the "Child Birth Fever deaths as Male Doctors who normally did not between patients before hand washing before delivering babies came into "Vogue".
Post SHTF where a gut shot is going to be fatal in 90+% maggot therapy could give a much higher (30-40%) survival rate. As proven in Bosnia recently.
Might be worth while to get past the ewww as breeding surgically clean maggots wasn't that hard.
These "learned opinions" have been proven wrong so often. I think its important to be humble and willing to learn truth wherever it comes from. If an herb can work to promote healing, and it's better than a pharmaceutical, so be it. If sugar can do the job for healing chronic ulcers, yeah! I hadn't read about maggots being used in Bosnia.
DeleteThanks so much for your comments.