extracted gave rise to much bleeding. Tlie throat was well washed with the nmriated tincture of irpn; the nose to be a gargle of syringed frequently with Conor's fluid, and strong salt and water to be used (id libitum. One ounce of the following mixture every third hour: Pot. lodid. ?
?
Bromidi
Ghloratia Tr. Ferri, Mur. Amn^onise Carb. ,,
...
...
aa
...
???
...
S1'-
5^ 5"_
Aquam J? 3lu he ; Vespere.?The discharge from the mouth is offensivefound is complains of pain in the throat, which on examination to be covered with a black slough, which, on removal, showed the further existence of maggots. With the kind co-operation of Surgeon-Major Whylock ten were extracted, and the throat was again well washed with tincture of iron. To have a morphia draught at bed hour. 26th.?Slept at short intervals ; is said to have been violent, and insisted on having pledgets of lint saturated with the tincture of iron applied to the nose; he complains of pain in the throat, the back of which is covered with a black slough : when this membrane is detached, it shews in places a white surface. No change in applications. Vespere.?Slept a little during the day ; ho spat up seven maggots, and I extracted eight more. To have a calomel purge and camphor inhalation every third hour. 21 tli.?Slept about three hours. The oedema of face and eyelids is less, and his condition generally is somewhat improved. Beneath the velum there is a large white slough, and the parts lowor down the throat, as far as can be seen, are covered with a black slough. There are no maggots visible, ...
CASE OF ERYSIPELOID INFLAMMATION OF NOSE, THE RESULT OF IRRITATION SET UP BY MAGGOTS
// A.B., M.D., Surgeon-Major, A.M.D.
IN THE POSTERIOR NARE3.
By ^
T. B. ilontiUTr,
The subject Of tins disease was fpirate w. A., ot cue '/ucn a strong and healthy-looking young soldier. He to hospital on the evening of the 24th of M-ireh for fever and bleeding from the nose. When seen, his eyelids were puffy, the eyes closed up, and the nose was in an erysipelatous condition ; beside him there was a bowl full of sanious discharge, which he said came from the nose drop by dtop. He states that he has not felt quite well for the last three days, but was well enough to perform his duties up to the hour of admission. His tongue is of a dirty brown colour, bowels confined, and his entire appearance looked as if he had been "on the spree." The swollen condition of the face was supposed to be dependent on ulceration of the bones of the nose, the result of secondary syphilis?a disease for which he had been ten times under treatment, first in April 1870, when he was An examination of the nose by the 45 days in hospital. speculum shewed a chronic thickening of the mucous membrane only, in consequence of which the posterior nares could not be seen. He made no complaint of the existence of disease in the throat. To have a calomel purge ; the nose was plugged -with lint saturated with the muriated tincture of iron, and simple ointment used as an external application. March 2oth.?Had a restless and disturbed night; has passed a large quantity of sanious discharge from the nose; has also spat up for the first time a few maggots. Oil looking into the throat I observed a nest of maggots situated beneath the folds of the isthmus faucium. With a bullet forceps and subsequently with a long dressing forceps, I extracted at one sitting 40 maggots. The tails were blackish, while the head was white and pointed, and the body was encircled with rings. Each maggot was half an inch in length. From those parts from which they were extracted, a thick bloody-like discharge oozed forth, and to such a degree as to prevent the work of extraction The mucous membrane in patches from being completed. appeared whitish, as if it constituted the base of a cyst, but certain it is that each maggot had a distinct nidus. When the first lot was extracted another appeared like bees in a hive, embedded as it were on oue another, and each separately
Regiment, came
...
???
.
but it is stated that he spat up four ; the throat has been washed every fourth hour with a strong solution of carbolic acid ; a weaker solution has been frequently injected into tho nose. Continue morphia draught. 2Wu?The throat, though much cleaner and less swollen, is still covered in the centre with a white, thick and tenacious slough ; three maggots have come through the nose, and he spat as many more. The lining membrane of the nose is covered with thick yellow mucus. 3Oth.?Condition of the throat is much improved ; no maggots visible. April 6th.?Progressing steadily ; there is no extension of the ulceration in the throat, and the ulcer is about the size of a shilling and with ulcerated edges ; no change in the applications. 13th.? Ulcer in throat is smaller, and separated into two parts by a strong and well raised band of flesh. 21th.?Discharged. General health is pretty good. Over the right side of the throiit there is tho mark of a cicatrix in the site of the ulcer, the separating band has become thicker. Remarks.?Amongst the recordsof tho Army Medical Department for 1870, page 529, I find the report of a fatal case by Surgeon W. IL Stewart in connection with a malarial cachexy. I have been informed of the occurrence of another case at this station, the subject of which attempted suicide. Beyond the existence of a filthy form of disease the case does not present any peculiarities: the impression I received while extracting tiiese maggots from the living body, the extraordinary expressions of surprise of the orderlies, and the anxiety of tho man himself to see what, these were like, as well as the great patience he exhibited, will never be forgotten. There is no source of wonder in finding that the subjects of such a disease would become violent. I believed this man's life was saved by not delaying the extraction of the maggots. When the first lot. was extracted, I had them collected and placed in a bottle which admitted air through a cork perforated with a quill. On the 26th March, two days after extraction, all seemed dead, and of a blackish colour. On the 8th April three dead flies appeared in the bottom of the bottle, the body and wings had a bright, metallic lustre, while the head is of a dirty brown colour ; they are a quarter of an inch in length. No more flies appeared, although small pieces of beef were thrown into the bottle for the purpose of developing living flies. Dr. Whylock saw a mild form of this disease at Sealkote, which was quickly cured by the application of turpentine vapour. The maggots which were dislodged were placed in a box covered with a piece of linen gauze. After the lapse of a few days, they became blue bottle flies. Since his discharge this man has enjoyed good health.
Mooltax, August 1877.
?
Bromidi
Ghloratia Tr. Ferri, Mur. Amn^onise Carb. ,,
...
...
aa
...
???
...
S1'-
5^ 5"_
Aquam J? 3lu he ; Vespere.?The discharge from the mouth is offensivefound is complains of pain in the throat, which on examination to be covered with a black slough, which, on removal, showed the further existence of maggots. With the kind co-operation of Surgeon-Major Whylock ten were extracted, and the throat was again well washed with tincture of iron. To have a morphia draught at bed hour. 26th.?Slept at short intervals ; is said to have been violent, and insisted on having pledgets of lint saturated with the tincture of iron applied to the nose; he complains of pain in the throat, the back of which is covered with a black slough : when this membrane is detached, it shews in places a white surface. No change in applications. Vespere.?Slept a little during the day ; ho spat up seven maggots, and I extracted eight more. To have a calomel purge and camphor inhalation every third hour. 21 tli.?Slept about three hours. The oedema of face and eyelids is less, and his condition generally is somewhat improved. Beneath the velum there is a large white slough, and the parts lowor down the throat, as far as can be seen, are covered with a black slough. There are no maggots visible, ...
CASE OF ERYSIPELOID INFLAMMATION OF NOSE, THE RESULT OF IRRITATION SET UP BY MAGGOTS
// A.B., M.D., Surgeon-Major, A.M.D.
IN THE POSTERIOR NARE3.
By ^
T. B. ilontiUTr,
The subject Of tins disease was fpirate w. A., ot cue '/ucn a strong and healthy-looking young soldier. He to hospital on the evening of the 24th of M-ireh for fever and bleeding from the nose. When seen, his eyelids were puffy, the eyes closed up, and the nose was in an erysipelatous condition ; beside him there was a bowl full of sanious discharge, which he said came from the nose drop by dtop. He states that he has not felt quite well for the last three days, but was well enough to perform his duties up to the hour of admission. His tongue is of a dirty brown colour, bowels confined, and his entire appearance looked as if he had been "on the spree." The swollen condition of the face was supposed to be dependent on ulceration of the bones of the nose, the result of secondary syphilis?a disease for which he had been ten times under treatment, first in April 1870, when he was An examination of the nose by the 45 days in hospital. speculum shewed a chronic thickening of the mucous membrane only, in consequence of which the posterior nares could not be seen. He made no complaint of the existence of disease in the throat. To have a calomel purge ; the nose was plugged -with lint saturated with the muriated tincture of iron, and simple ointment used as an external application. March 2oth.?Had a restless and disturbed night; has passed a large quantity of sanious discharge from the nose; has also spat up for the first time a few maggots. Oil looking into the throat I observed a nest of maggots situated beneath the folds of the isthmus faucium. With a bullet forceps and subsequently with a long dressing forceps, I extracted at one sitting 40 maggots. The tails were blackish, while the head was white and pointed, and the body was encircled with rings. Each maggot was half an inch in length. From those parts from which they were extracted, a thick bloody-like discharge oozed forth, and to such a degree as to prevent the work of extraction The mucous membrane in patches from being completed. appeared whitish, as if it constituted the base of a cyst, but certain it is that each maggot had a distinct nidus. When the first lot was extracted another appeared like bees in a hive, embedded as it were on oue another, and each separately
Regiment, came
...
???
.
but it is stated that he spat up four ; the throat has been washed every fourth hour with a strong solution of carbolic acid ; a weaker solution has been frequently injected into tho nose. Continue morphia draught. 2Wu?The throat, though much cleaner and less swollen, is still covered in the centre with a white, thick and tenacious slough ; three maggots have come through the nose, and he spat as many more. The lining membrane of the nose is covered with thick yellow mucus. 3Oth.?Condition of the throat is much improved ; no maggots visible. April 6th.?Progressing steadily ; there is no extension of the ulceration in the throat, and the ulcer is about the size of a shilling and with ulcerated edges ; no change in the applications. 13th.? Ulcer in throat is smaller, and separated into two parts by a strong and well raised band of flesh. 21th.?Discharged. General health is pretty good. Over the right side of the throiit there is tho mark of a cicatrix in the site of the ulcer, the separating band has become thicker. Remarks.?Amongst the recordsof tho Army Medical Department for 1870, page 529, I find the report of a fatal case by Surgeon W. IL Stewart in connection with a malarial cachexy. I have been informed of the occurrence of another case at this station, the subject of which attempted suicide. Beyond the existence of a filthy form of disease the case does not present any peculiarities: the impression I received while extracting tiiese maggots from the living body, the extraordinary expressions of surprise of the orderlies, and the anxiety of tho man himself to see what, these were like, as well as the great patience he exhibited, will never be forgotten. There is no source of wonder in finding that the subjects of such a disease would become violent. I believed this man's life was saved by not delaying the extraction of the maggots. When the first lot. was extracted, I had them collected and placed in a bottle which admitted air through a cork perforated with a quill. On the 26th March, two days after extraction, all seemed dead, and of a blackish colour. On the 8th April three dead flies appeared in the bottom of the bottle, the body and wings had a bright, metallic lustre, while the head is of a dirty brown colour ; they are a quarter of an inch in length. No more flies appeared, although small pieces of beef were thrown into the bottle for the purpose of developing living flies. Dr. Whylock saw a mild form of this disease at Sealkote, which was quickly cured by the application of turpentine vapour. The maggots which were dislodged were placed in a box covered with a piece of linen gauze. After the lapse of a few days, they became blue bottle flies. Since his discharge this man has enjoyed good health.
Mooltax, August 1877.
