:^^) 



psrciiE. 



I Miirch — April iSS.v 



salycilate of soda, bicarbonate of soda 

 and carbolic acid we hoped to drown 

 out the remaining hirvac. Hut they 

 iiad by this time cut their way into so 

 many recesses of the nose and were so 

 lhini\ attached that we were unable to 

 accomplish much. Finally we resorted 

 to the chloroform injections, which im- 

 mediately brought away a considerable 

 number. Friday I was able to open 

 up two or three canals that they 

 had cut, extracting several more that 

 hail literally packed themselves one 

 after another in these fistulous channels. 

 His speech becoming suddenlv much 

 worse, I examined the interior of his 

 mouth and found that a clear-cut open- 

 ing had been made entirely through 

 the soft palate into his mouth and large 

 enough to insert the end of a common 

 lead pencil. Saturday the few remain- 

 ing larvae jjegan changing color and 

 one bv one dropped away. On Sunday 

 for tlie first time hemorrhage from both 

 nostrils took place, which continued 

 at iuteixals for three da\s but was not 

 at anv time severe. On this day the 

 patient began to improve, the delirium 

 and erysipelas having subsided, leaving 

 but little or no annoyance in his head. 

 In a few days he became able to go 

 about home, and even to walk a dis- 

 trmcc of half a mile to visit a friend and 

 return. I>ut while there he began com- 

 plaining of a pain in the neighborhood 

 of his left ear, apparently where the 

 eustachian tube connects with tiie mid- 

 dle ear. It proved to be an abscess. 

 Heing already so reduced by the first 

 attack, he was unable to withstand the 



second, and died after an illness of 

 nearly three w-eeks, com])letely ex- 

 hausted b\ his prolonged suHerings. 

 Three da\s before his death the abscess 

 discharged its contents by the left nos- 

 tril. The quantity of pus formed was 

 about 2.J ounces [78 grams]. 



"In all about 250 larvae nere taken 

 away from him during the first attack, 

 and, as the visible results, not only had 

 they cut the hole through the soft jial- 

 ate, but liad also eaten the cartilage of 

 the septum of the nose so nearly 

 through as to give him the appearance 

 of having a broken nose. The case 

 occupied, from the first invasion of the 

 fly to its final residt, nearly two months. 

 He doubtless would have recovered but 

 for the formation of the abscess, which, 

 from all the symptoms, was caused by 

 one or more of the larvae having foimd 

 their way up the left eustachian tube." 



Dr. Richardson also quotes the Rev. 

 William Dixon, of Green. Clay C"o.. 

 Kansi'.s. as giving the following account 

 of liis o\\ n experience : 



'• While riding in his buggy a tew 

 years ago in Texas, a screw-fly attacked 

 him fl', ing up one nostril. He blew it 

 out, when it dashed up the other and 

 deposited its eggs l)eforc he was able 

 to ex]iel it. Not re:di/.ing the danger 

 he did nothing for about three days, 

 when the pain became so great that he 

 hastened to .\ustin to consult aplnsi- 

 cian. His sol't palate was almost de- 

 stroyed before the larvae, over 200 in 

 number, were expelled." This was 

 the only one of twelve cases known to 

 Dr. Richardson in which the patient 

 recovere<l. 



