SUPPLEMENT 717 



neighbourhood, six ended fatally ; in all these cases Kimball 1 dia- 

 gnosed ozaena ; attracted by the strong odour the flies forced their 

 way into the noses of the patients when asleep and there deposited 

 their ova. In a case reported by Carriere 2 an abscess of the nasal 

 septum was produced by the larvae of flies ; Chiodi 3 reports seven 

 cases of myiasis due to Lncilia niacellaria ; among these was a case 

 of rhinitis myiatica, in which a cerebral abscess leading to a fatal 

 termination developed, being produced by the migration of a larva 

 into the brain. Among the three cases of Lesbini 4 was that of a girl, 

 aged 1 6, with 250 larvae in the diseased nasal cavity. Quintano 5 

 observed larvae beneath the eyelids in one case. It is possible that 

 the cases of Cesare 6 and Calamida 7 were those of myiasis nasi due to 

 Lncilia niacellaria. The larvae are also found in the nasal accessory 

 sinuses, as is seen from the cases reported by De Saulle 8 (frontal 

 sinus), Delasiauve 9 (frontal sinus), MacGregor 10 (antrum of Highmore), 

 and Bordenave 11 (antrum of Highmore). 



If a survey is made of the literature of the cases described of 

 myiasis nasi produced by Lncilia niacellaria 12 the following information 

 is forthcoming : In Europe this form of the disease is of very rare 

 occurrence, whilst in America and India 13 it is frequent. Persons 

 suffering from ozaena are rendered the most liable to danger as the 

 penetrating odour entices the flies in tropical countries with intense 

 frequency, so much so that v. Frantzius does not consider this 

 myiasis as an independent disease, but as a complication of ozaena of 

 frequent occurrence in warm countries. The infection is so far 

 of interest in its nature, in that it only takes place during the day. 

 The fly is on the wing only by day when the sun is shining, and 

 consequently only deposits its eggs at this time. Therefore persons 

 suffering from ozaena are principally exposed to the danger of being 

 pursued by the flies when they succumb to sleep during the mid-day 

 hours in the open or in dwellings that are not closed up. 



Headache is the symptom which most troubles the patients. 

 It extends over the whole cranium and persists uninterruptedly, with 



1 Kimball, New York Med. Journ., 1893. 



2 Carriere, Gas. hebd. de Med. et de Chir., 1898, xciv. 



3 Chiodi, La Argent. Med., March I, 1905. 4 Lesbini, ibid. 



5 Quintano, " Cronic oftalm. de Cadiz," 1878. 



6 Cesare, Arch. ital. di OtoL, April, 1903. 



7 Calamida, Giorn. d. R. Accad. de Med. di Torino, September, 1903. 



8 De Saulle, Gaz. des Hdp., Paris, 1857. 



9 Delasiauve, Gaz. hebd. de Med., Paris, 1885. 



10 MacGregor, Arch. gen. de Med., No. 1,031. 



11 Bordenave, " Deuxieme Mem. presente a 1'Acad. de Chir.," v, p. 387. 

 " [And the other species, of course, must be included here. F. V. T.] 



13 [Concerning Europe and India, macellaria does not occur. F. V. T.] 



