Subject: Re: Maggot Debridement Therapy

From: [email-masked] (Robert Allen)
Date: 18 Jan 1995 17:45:40 GMT

In article <[email-masked]> [email-masked] (Andrew T Piskorski) writes:
+
+In today's Wall Street Journal, on the front page center column, there's 
+an article on "Maggot Debridement Therapy [or Treatment, I forget]".
+
+The concept is that maggotts eat only rotten flesh and secret an ammonia
+based disinfectant, so therefore they are good for gangrenous wounds. 
+Says that Dr. Ronald Sherman became interested in this old therapy (was
+used, or at least noted, by Baron D.J. Larrey, Napolean's battlefield
+surgeon) when he noticed that patients with untreated wounds containing
+(gasp!) maggots were much healthier and healed with less scarring than
+might be expected. 
+
+The process Dr. Sherman uses is a little more complex, but this obviously
+has promise for survival medicine type situations where hospital care is
+not available. 
+
+For those of you in sci.med, I wonder how accepted this procedure is.

    I've been taught about this procedure in a Survival Medicine
    3 day course sponsored  by Earthbound  Wilderness Medicine
    in  San Jose  CA. The teacher  was an ex-Special Forces
    medical officer who has reportedly published  a paper
    on the theory.  Apparently the treatment works quite well,
    but it does need  to be managed.  For one thing,  maggots
    will eat healthy flesh once all the diseased flesh is
    eaten.  Management consists of counting  the  maggots and
    watching the wound to  ensure  that you  get  all the
    maggots  out at the right  time.  This treatment is  also
    documented in the Special Forces  Medical Handbook, published
    by Palladine Press, which  I sell.  I don't recall if it's
    mentiond in Ditch Medicine, which also discusses advanced 
    primitive medicine.

    For  those interested Earthbound is reportedly planning another
    Surivival  Medicine  Course  June 16-18, 1995.  They also
    periodically teach a  2 day Wilderness Medicine  Course.

---

From: [email-masked] ()
Date: Wed, 18 Jan 1995 17:55:45 GMT

In article <[email-masked]> [email-masked] (Andrew T Piskorski) writes:
>
>In today's Wall Street Journal, on the front page center column, there's
>an article on "Maggot Debridement Therapy [or Treatment, I forget]".
>
>The concept is that maggotts eat only rotten flesh and secret an ammonia
>based disinfectant, so therefore they are good for gangrenous wounds.
>Says that Dr. Ronald Sherman became interested in this old therapy (was
>used, or at least noted, by Baron D.J. Larrey, Napolean's battlefield
>surgeon) when he noticed that patients with untreated wounds containing
>(gasp!) maggots were much healthier and healed with less scarring than
>might be expected.
>
>The process Dr. Sherman uses is a little more complex, but this obviously
>has promise for survival medicine type situations where hospital care is
>not available.
>
>For those of you in sci.med, I wonder how accepted this procedure is.
>--
>
>--
>Andrew Piskorski
>[email-masked]

Maggot therapy has a history that goes back further than Larrey - Pare'
noted the beneficial effects of maggots back in 1557. "Modern" maggot
therapy dates to the late 1920's - early 1930's, with William Baer's
study of its utility for treating chronic osteomyelitis. Baer also
came up with a simple method of producing sterile maggots (not in the
reproductive sense) which prevented the problems associated with the
previous use of this therapy (patients had a tendency to come down
with tetanus when treated with unsterilized maggots). The use of
maggots for debridement of wounds fell into disuse with the advent of
antibiotics, but was quite popular for a while. It has been reported
on frequently since, usually in situations where the wounds were
accidentally infested with maggots before the doctor saw the patient,
with the physician reporting on the apparent beneficial effects of the
infestation, but occasionally by intention, as in Horn, et al's use
of maggots in the treatment of a patient with intractable subacute
mastoiditis in 1976. Some military manuals recommend a very risky
form of maggot therapy, involving exposure of a wound to flies followed
by reduction of the maggot population manually by a care giver, as
a survival medical technique - the potential for infection is obvious
and this is clearly a desperation measure.

A very nice summary of maggot therapy's history can be found in the
paper "Maggot Therapy: The Surgical Metamorphosis" by Edmund A.
Pechter and Ronald A. Sherman on pages 567-570 of the October, 1983
	    ^^^^^^^^^^^^^^^^^
issue of "Plastic and Reconstructive Surgery" (Vol 72(4)). The
references section of this paper will point you to Baer's work as
well as that building on him, if you are interested in more than
an overview.
******************************************************************************
Renegade academician. They're a dangerous breed when they go feral,
academics are...a chemist, too.
		    -(James P. Blaylock in "Lord Kelvin's Machine")

My organization hasn't agreed with any of my opinions so far, and
I doubt they'll start now.

Stanley Roberts