REVIEW — TEOPICAL MEDICINE, ETC. 139 



Commenting on those notes, Younge' recommends the following method for getting Myiasis— 

 rid of subcutaneous larvte : — continued 



Thii tip of au ordiu:iry probe is liglitly smeared witli vaseline and jircssed on to a little calomel so as to take 

 up about 1 grain of the drug. It is then passed into the cavity containing the larvje and gently moved round it. 

 The calomel kills the larvte in a few minutes. They can then be removed by gentle pressure, or, better still, by 

 syringing the cavity which contains them with a little warm boraoio lotion. 



The other drugs, such as turpentine, which have been recommended for destroying maggots, are uncertain, 

 irritating and very painful. On the other hand, calomel acts r.apidly, with certainty, and without causing the 

 slightest pain or discomfort. It also seems to destroy or neutralise the excretory products of the larvse, which are 

 often suiEoiently irritating to excite considerable local inflammation and high fever. 



Calomel is also fatal to most of the lower forms of life, and I have used it successfully to get rid of a leech 

 which had accidently entered the nasal fossa. 



Blankmeyer-* has described a case of infection with the larvag of Anthomyia 

 caualimdaris . The symptoms consisted of abdominal pain and distension, with bloody 

 diarrhcea, followed by constipation. Treatment of many kinds was tried, but after the 

 patient had eaten raw pumpkin seeds on an empty stomach for three days, a saline purge 

 was given, when from 1000 to 1500 larvae were expelled in a bulky stool. A few continued 

 to come away for several weeks. 



It used to be believed that Hi/podertna hovis was able to pierce the skin with its 

 ovipositor and deposit its eggs directly in the subcutaneous tissue where they underwent 

 development. Jost,'* however, has recently proved that — 



The egg is fixed by the fiy on the hair of the host, and is introduced into the mouth by licking, probably still 

 unhatched. The young larvse are only to be found in the lower part of the cesojihagus and commencement of the 

 stomach. Thence they make their way into the submucosa of the (Esophagus and travel under the pleura or 

 peritoneum to the sides of the verteliral column, generally by way of the mediastinum and pillars of the 

 diaphragm, and the capsule of the kidneys, and follow the vessels and nerves through the inter-vertebral notches, 

 where they may be found from December to March. From thence they pass out into the inter-muscular planes of 

 the dorsal region, and so reach the skin, from which situation they escape after about a month, being in the 

 meantime enclosed in a capsule formed by the host. The larva undergoes two ecdyses, becomes a pupa, and this 

 finally gives exit to the imago. 



The Sergents-* have brought to light a form of human myiasis occurring in Algeria 

 amongst Kabyl shepherds. It is due to (Estrus avis, a sheep parasite, called locally 

 Thim'ni, as is also the disease it produces. It deposits its ova while in flight without 

 settling, upon the eyes, the nostrils or the lips of shepherds, especially those who have 

 eaten of the fresh sheep or goats' cheese. The condition is also found in dogs fed on 

 cheese. 



Irritation and inflammation is produced at the site of deposition, great pain if the 

 nose be attacked, together with frontal headache and nasal discharge. In the case of the 

 lips, the inflammation may spread to the throat. Tobacco is the best cure, used as snuff 

 or smoke for the nasal condition, or as an infusion in the form of a gargle for the throat. 



Shattock^ records a case of intestinal myiasis due to the larvae of Eristalis tenax. 

 This is a dipterous fly which produces larvae as large as tadpoles and furnished 

 with a respiratory proboscis, hence the name "rat-tailed larvae." A similar kind of fly, 

 EelopMlus trivittatus, is described in our Second Report, but there is no record of its 

 producing myiasis. 



Onyalai. This is a disease of Portuguese West Africa, which has been described in 

 two papers by Massey" ' and one by Wellman." As it is quite possible that it exists in the 



1 Younge, Gt. H. (February 13th, 1904), "The Treatment of Myiasis." British Medical Journal, Vol. I. 



' Blankmeyer, H. C. (May 4th, 1907). Journal American Medical Associatio^i. 



^ Jost, H. (1907), "The Development of the larvse of Hypoderma bovis," de Geer. Zeit. filr Wiss. Zool. 

 Bd. LXXXVI. Quoted in Journal of Tropical Medicine and Hygiene, November loth, 1907, Vol. X. 



•* Sergent, B., and Sergent, E. (May 25th, 1907), " La Thim' ni, myiase humaine d'Algerie, causee par 

 (Estrus ovis," L. Ann. de I'lnstitut. Pasteur, Vol. XXI., No. 5. 



° Shattock, Q. S. (March •28th, 1908), Larvje of Eristalis Tenax passed by the Bowel. Report of Meeting of 

 Roy. Soc. of Med. Path. Sec. Lancet, Vol. I. 



" Massey, A. Y. (September 1st, 1904), " Onyalai, a Disease of Central Africa." Journal of Tropical Medicine 

 and Hygiene, Vol. VII. 



' Massey, A. Y. (April 1st, 1907), "Onyalai, a Disease of Central Afi'ica." Journal of Tropical Medicine 

 and Hygiene, Vol. X. 



» Wellman, F. C. (April 1.5th, 1908), "A Fatal Case of Onyalai, with Remarks on the History, etc." Journal 

 of Trojncal Medicine and Hygiene, Vol. XI. 



• Article not consulted in the original. 



