2S 



rsrciiii. 



|M;ircli— April iSS.l. 



subsided. This discharge continued 

 for three daj's, during which time as 

 much as sixteen ounces escaped, in- 

 creasing in consistenc}- until it was pure 

 pus. Tiie odor becoming much more 

 oHensive, his cough was more trouble- 

 some and fever increased to such an 

 extent as to produce slight delirium for 

 twelve hours. What was thrown off 

 was with much difiiculty expectorated, 

 and was sanious, containing micro- 

 scopic particles of osseous matter, to- 

 getlier with flakes of plastic exudation. 

 The OS hyoidcs was evidently destroyed. 

 The patient had spoken with diilicultv 

 for thirty-six hours and there was much 

 trouble in swallowing. Tlie soft palate 

 had evidently given way and there was 

 an entire inability to protrude the tongue 

 or use it in speech. 



•'About this time a worm similar to 

 a maggot dropped from his nose. That 

 was the first indication or suspicion that 

 there was anything of the kind present. 

 There was not, as in some other cases 

 reported, any swelling, or movements 

 traceable under the skin, nor was there 

 at any time any complaint of the patient, 

 calculated to lead to a knowledge of 

 their presence. After the appearance 

 of the first, I expected more, and was 

 surprised to see them drop from the 

 nostrils and wiggle from the mouth 

 without any discomfort to the ]5atient 

 until they came in contact with the 

 Schneidcrian membrane, when the}' 

 ainioyed him greatly, and every efibrt 

 was made on his part to expel them ; 

 but so soon as expelled, no further 

 trouble was manifested until another 



would get into the nostril. Every effort 

 was made on my part to discover them 

 under tiie tissue, but the soft palate being 

 destroyed to a great extent, and the 

 palatine arch apparently lowered, it was 

 with much difficulty that an examination 

 could be made. The worms were 

 evidently burrowing under the palatine 

 fascia, as it presented a honey-combeil 

 appearance and in places patches were 

 totally destroyed as large as a dime 

 [iS mm.]. They continued to drop 

 from the mouth and nose, forced from 

 the nostrils by the efforts of the patient, 

 for the following fort^-eight hours, 

 during which time 327 \vere counted 

 and the estimated number exceeded 300. 

 At this time the whole of the soft 

 palate was destroyed. The patient 

 lived four days after the last worm came 

 awa}'. 



"I put five of the worms in dry earth 

 and in fourteen dajs from the time they 

 dropped from the nostril there iiatciicd 

 out three flies. 



"Upon a very minute and careful ex- 

 amination after death I was astonished 

 to find that all the tissue covering the 

 cervical vertebrae, as far down as I could 

 see by throwing the head back and 

 compressing the tongue, was wholly 

 destroyed and the vertebrae exposed. 

 The palatine bones broke with the 

 slightest pressure of the finger. The 

 OS hyoidcs \\ as destro\ed and the nasal 

 bones loose, only held in position b\' the 

 superficial f;iscia. 



"Mv own theory is that the fly depos- 

 ited the eggs while the patient was 

 asleep, probably the day previous to 



