SRINAGAK
\
DISPENSARY, GURHWAL.
I A CASE OF PINASH.
By Mohendua Nath Ohdedak, L.M.S.
i\
Hindu female, aged 25, came to hospital on 28th. She complained of epistaxis. There was a foul smell about her, but an examination of the nose showed nothing but thickeniug of the mucous membrane. On looking into the mouth, an opening?the size of a^ four-anna piece? was seen in the hard palate, and through this opening a jgest of maggots was seen. Eight were removed, each had evf-" dently 'a' distinct nidus. The removal of these caused some bleeding. The throat and nose were syringed with a weak lotion of Tincture Ferri Muriat. and a gargle of carbolic lotion was given to be used ad libitum, and the following was
Madori, May 1880.
a
prescribed:? R.
Tinctur Ferri Muriat.
Mag. Sulph. Aquas
opium
M. at bed time.
???
???
???
T. D.
29th.?Face and lids puffy.
HJ.X. 3ss.
3j-
To have
a
grain
of
Removed nine maggots ; the to be frequently syringed with Condy's lotion and the gargle to be continued. 30th.?No maggots can be seen : slight epistaxis. Though no maggots are perceptible yet the very appearance of the patient shows that there is some mischief in the nasal cavity. Continue mixture, injection and gargle. June 4th.?Erysipeloid inflammation of the eyelids and upper part of the nose. No maggots are visible through the opening in the hard palate. A new opening is seen at the inner angle of the left eye. Many small maggots, of the thickncss of ordinary silk ligature, are seen in it. This opening probably communicates with that in the hard palate. Inject Oil of Turpentine through the opening in the hard palate-and nose
if arch 1,
A MIRROR OP HOSPITAL PRACTICE.
1881.]
apply a few drops following :?
of the same to the new
the
R.
Amnion. Carb. Spt. Chloroformi Inf. CliirettiB M. T. D.
...
opening,
and
give
grs. v.
...
Il\
...
5i.
xx.
6th.?Maggots making their way ont at the inner canthus of the right eye. Suffers from great pain : cannot open her eyes : scarcely takes any food. Continue treatment and increase spirit chloroform to 3SS7th.?Coma supervened and she died. Remarks.?In this case there was no history of syphilis to account for the perforation in the hard palate, but the patient might have given a wrong history. The maggots worked their way out through the groove of the nasal duct on either side, and some might have also entered the frontal sinus along the infundibulum. It should be remarked that when she came to hospital no maggots were visible inside the nostrils, but any number of these were seen through the opening in the hard palate. Now the question is, how were these maggots produced in this case ? It is said that these voracious worms are only produced by the deposition of larvae. In this case the mucous membrane of the nose was only thickened, but was this a sufficient nidus ? SurgeonMajor W. J. Moore, in his " Native Practice in Rajpootana," latter the And the in I believe that larvae of says,?" deposit (nostrils) may take place, aud the maggots arrive at maturity without, as is generally supposed, the previous existence of ulcer or sore, or at least some specific or syphilitic discharge"?Yide The Indian Annals of Medical Science, July 1873, No. XXXI., page 103. Granting this, I do not understand how any sane person can allow flies to enter into the nostrils and deposit eggs, or the maggots to creep up into the nasal cavity. The very act of a fly enteriug into the nostrils and that of a maggot creeping up into the nasal cavity, would caused titillation resulting in sneezing, and this reflex action is sure to throw them out.
\
DISPENSARY, GURHWAL.
I A CASE OF PINASH.
By Mohendua Nath Ohdedak, L.M.S.
i\
Hindu female, aged 25, came to hospital on 28th. She complained of epistaxis. There was a foul smell about her, but an examination of the nose showed nothing but thickeniug of the mucous membrane. On looking into the mouth, an opening?the size of a^ four-anna piece? was seen in the hard palate, and through this opening a jgest of maggots was seen. Eight were removed, each had evf-" dently 'a' distinct nidus. The removal of these caused some bleeding. The throat and nose were syringed with a weak lotion of Tincture Ferri Muriat. and a gargle of carbolic lotion was given to be used ad libitum, and the following was
Madori, May 1880.
a
prescribed:? R.
Tinctur Ferri Muriat.
Mag. Sulph. Aquas
opium
M. at bed time.
???
???
???
T. D.
29th.?Face and lids puffy.
HJ.X. 3ss.
3j-
To have
a
grain
of
Removed nine maggots ; the to be frequently syringed with Condy's lotion and the gargle to be continued. 30th.?No maggots can be seen : slight epistaxis. Though no maggots are perceptible yet the very appearance of the patient shows that there is some mischief in the nasal cavity. Continue mixture, injection and gargle. June 4th.?Erysipeloid inflammation of the eyelids and upper part of the nose. No maggots are visible through the opening in the hard palate. A new opening is seen at the inner angle of the left eye. Many small maggots, of the thickncss of ordinary silk ligature, are seen in it. This opening probably communicates with that in the hard palate. Inject Oil of Turpentine through the opening in the hard palate-and nose
if arch 1,
A MIRROR OP HOSPITAL PRACTICE.
1881.]
apply a few drops following :?
of the same to the new
the
R.
Amnion. Carb. Spt. Chloroformi Inf. CliirettiB M. T. D.
...
opening,
and
give
grs. v.
...
Il\
...
5i.
xx.
6th.?Maggots making their way ont at the inner canthus of the right eye. Suffers from great pain : cannot open her eyes : scarcely takes any food. Continue treatment and increase spirit chloroform to 3SS7th.?Coma supervened and she died. Remarks.?In this case there was no history of syphilis to account for the perforation in the hard palate, but the patient might have given a wrong history. The maggots worked their way out through the groove of the nasal duct on either side, and some might have also entered the frontal sinus along the infundibulum. It should be remarked that when she came to hospital no maggots were visible inside the nostrils, but any number of these were seen through the opening in the hard palate. Now the question is, how were these maggots produced in this case ? It is said that these voracious worms are only produced by the deposition of larvae. In this case the mucous membrane of the nose was only thickened, but was this a sufficient nidus ? SurgeonMajor W. J. Moore, in his " Native Practice in Rajpootana," latter the And the in I believe that larvae of says,?" deposit (nostrils) may take place, aud the maggots arrive at maturity without, as is generally supposed, the previous existence of ulcer or sore, or at least some specific or syphilitic discharge"?Yide The Indian Annals of Medical Science, July 1873, No. XXXI., page 103. Granting this, I do not understand how any sane person can allow flies to enter into the nostrils and deposit eggs, or the maggots to creep up into the nasal cavity. The very act of a fly enteriug into the nostrils and that of a maggot creeping up into the nasal cavity, would caused titillation resulting in sneezing, and this reflex action is sure to throw them out.
