SUPPLEMENT 723 



aged 71, suffering from czaena, were recognized by the well-known 

 dipterologist Braun as belonging to S. wohlfahrti. Among the cases 

 reported by Joseph, one only affected the nose; it was that of a 

 peasant girl, aged u, who had suffered from ozaena; she had 

 travelled on the open road and had there gone to sleep. Severe 

 symptoms set in and death followed under delirium. In making the 

 post-mortem it was found that the interior of the nose was extensively 

 destroyed by larvae of S. wohlfahrti. Powell found Sarcophaga 

 larvae in two persons who had slept in the open air ; the larvae were 

 killed by injections of chloroform and sublimate. Destruction of the 

 eyes by S. wohlfahrti has only been observed in a few cases ; it is 

 reported by Cloquet 1 that, in the case of a ragman who had lain 

 some time in the fields, both eyes were pierced by larvae. On the outer 

 skin the larvae of S. wohlfahrti have been found more than once in 

 inflammatory or festering areas. Freund 2 demonstrated that from 

 a live year old child, which had suffered for some time from an 

 impetiginous eczema of the skin of the head, from two suppurating 

 abscess cavities which extended to the periosteum, which was already 

 affected, twenty-one living larvae were taken ; rapid healing took place 

 under antiseptic bandaging. 



The small treatise by Balzer and Schimpff 3 contains two new 

 observations on myiasis externa ; in the one case an ulcer on a man's 

 foot was full of larvae, in the other case the head of a woman showed 

 numerous larvae without the skin of the head being destroyed. 

 Brandt's 4 observation is interesting, for he found such larvae in the 

 gums of a sick person. 



The impression which one obtains of the active movement of 

 larvae on wounds is a strange and at the same time uncanny one. 

 One finds that the larvae to obtain protection against the drying of 

 the surface of the abscess almost incessantly burrow with their heads, 

 first contracting and then expanding the body, which rises and falls, 

 and keeping the tail upwards. Owing to these movements producing 

 irritation, increase of inflammation may ultimately arise, causing 

 erysipelas and cellulitis. 



The treatment of myiasis nasalis caused by Sarcophaga is the same 

 as in myiasis caused by Lucilia, and in the other places where found it is 

 merely a question of the removal of the larvae and the subsequent 

 proper treatment of the surface of the abscess. In Northern Nigeria 



1 Cloquet, see Schultz-Zehden, loc. cit. 



2 Freund, Ges. f. innere Med. in Wien, December 5, 1901 ; and Wien. mtd. Wochenschr., 

 1910, li. 



3 Balzer and Schimpff, Annal. de Derm, et de Syph., 1902. 



4 Brandt, Wratsch, 1888. 



