2l8 MYIASIS 



common, but cases are occasionally met with in temperate 

 climates, 



Chrysoiiiyia viaccllaria is responsible for many cases in 

 tropical America, where " the disease is rather common in 

 persons who sleep in the open and in the sores of uncleanly 

 individuals." In Paraguay, for instance, Lindsay (1902) says, 

 " cases of myiasis are very common. The screw-worms are 

 found in all conceivable situations." Harrison (1908) in Honduras, 

 illustrates and describes two typical cases of the disease. In one 

 case a chronic ulcer of the right cheek became infected. 



"On admission a huge open foul ulcer was seen exposing the bones of the face 

 and forehead and destroying the tissues of the cheek and face of the right side, and 

 implicating also the right eye and orbit ; any number of worms were seen wriggling 

 about in this cavity, which was over 4 inches in diameter. Altogether upwards 

 of about 300 worms were removed." In the other case extensive destruction of the 

 nasal cavity had been produced. 



In India the larvae of SarcopJiaga carnaria, S. magnifica, 

 S. riificornis, and of SarcopJiila have been known to cause 

 extensive destruction of tissue in wounds. The larvae of several 

 species of Lucilia have been detected in wounds in different 

 parts of the world. 



In England ver}' few cases have been recorded. Andrewes 

 records a case which "occurred in the summer of 1889 or 1890." 



"The patient was a destitute person suffering from chronic Bright's disease and 

 .dropsy, who also had a chronic ulcer over the lower part of his leg. He slept out in 

 Hyde Park, and the ulcer became fly-blown. When I saw him in the Surgery 

 of St Bartholomew's Hospital, the larvre had made a pretty clean dissection of the 

 tibialis anticus and other muscles over the floor of the ulcer, which was some three or 

 four inches in diameter. They had devoured the connective tissues, but spared the 

 muscles and tendons. The ulcer was very foul and there were hundreds, perhaps 

 thousands of maggots. The maggots were unfortunately not preserved but were 

 probably those of Calliphora or Lucilia.'' 



Lawrence (1909) records another case in which the species of 

 the larva was not determined. 



"An elderly lady had an epithelial tumour of the size of a small hen's egg growing 

 in front of the left ear. It had begun to bleed. On examining its base, which was 

 about li inches by \ inch, I saw a few maggots. Evidently the bleeding was due to 

 the destruction of the tissue where the vessels entered. In spite of strong applications 

 for their destruction the maggots, which proved far more numerous than I thought, 

 succeeded in riddling the tumour in 24 hours, causing pretty severe loss of blood. 

 By the next day the tumour was fetid, the bleeding continuous and the face as far as 



