142 



Accidental or Facultative Parasites 



of the larvae. Left untreated, the patient rapidly becomes worse, 

 and pus and blood are discharged from the nose, from which an 

 offensive odor issues. Cough appears as well as fever, and often 

 some delirium. If the patient lives long enough, the septum of the 

 nose may fall in, the soft and hard palates may be pierced, the wall 

 of the pharynx may be destroyed. By this time, however, the course 

 of the disease will have become quite evident by the larvae dropping 

 out of the nose, and if the patient continues to live all the larvae 

 may come away naturally." 



For treatment of rhinal myasis these writers recommend douch- 

 ing the nose with chloroform water or a solution of chloroform in 

 sweet milk (10-20 per cent), followed by douches of mild antiseptics. 

 Surgical treatment may be necessary. 



105. Larva of a flesh fly (Sarcophaga) .1 Caudal aspect. Anterior stigmata. Pharyngeal skeleton. 



Sarcophagidae The larvae (fig. 105) of flies of this family usually 

 feed upon meats, but have been found in cheese, oleomargerine, 

 pickled herring, dead and living insects, cow dung and human feces. 

 Certain species are parasitic in insects. Higgins (1890) reported 

 an instance of ''hundreds" of larvae of Sarcophaga being vomited by a 

 child eighteen months of age. There was no doubt as to their origin 

 for they were voided while the physician was in the room. There 

 are many other reports of their occurrence in the alimentary canal. 

 We have recorded elsewhere (Riley, 1906) a case in which some ten 

 or twelve larvae of Sarcophaga were found feeding on the diseased 

 tissues of a malignant tumor. The tumor, a melanotic sarcoma, 

 was about the size of a small walnut, and located in the small of the 

 back of an elderly lady. Although they had irritated and caused a 

 slight hemorrhage, neither the patient nor others of the family knew 



