DISCUSSION. 



DISCUSSION OF THE PAPER "UNIDENTIFIED LARViE OF SOME DIPTEROUS 



INSECT DEVELOPING IN THE DEEP URETHRA AND BLADDER OF MAN 



PRODUCING SEVERE ABDOMINAL SYMPTOMS," BY DR. G. P. 



TRIBLE, ASSISTANT SURGEON, UNITED STATES NAVY. 



Dr. E. R. Stitt, surgeon, United States Navy, associate professor of 

 medical zoology, department of tropical medicine, Philippine Medical 

 School, Manila, P. I. — A very interesting point in connection with the 

 case reported by Doctor Trible is that of the identity of the larva;. Those 

 sent to me by Doctor Trible were not full-grown and there was some 

 distortion. However, they resembled the larva? of Miisca domestica. 

 I took some bottles containing horse manure and placed several females of 

 M. domestica in them. The larvae which developed agreed in all im- 

 portant details with those sent by Doctor Trible, an opinion with which 

 Mr. Banks coincided, so that I think they were undoubetedly larvae 

 of Musca domestica, but the question is: How did they get into the 

 urethra ? 



Mr. Charles S. Banks, Biological Laboratory, Bureau of Science, lec- 

 turer on medical entomology, department of tropical medicine, Philippine 

 Medical School, Manila, P. I. — The question of how these larva; got into 

 the bladder is a very obscure and interesting one. They have no mouths 

 -in the sense that chewing larva; have, namely coleopterous and lepidop- 

 terous larva;. They get their food by means of two hooks which they use 

 as scraping instruments, and by moistening with saliva the substances 

 on which they live, they obtain a liquid diet, as it were. If this man had 

 swallowed the ova or larva; of the house fly, it is almost inconceivable that 

 they could have traveled from the alimentary canal into the bladder. I 

 have thought of this question considerably since Doctor Stitt mentioned it 

 to me, and the only possible way I can see for this man to have become in- 

 fected with these larva; is by his having used some infected fluid for mak- 

 ing a surreptitious injection. Larva; of this class penetrate readily into 

 any available cavity where they find suitable conditions for development, 

 and thus they might have entered the external ureter and fixed themselves 

 on the mucosa of the urethra. 



Doctor Stitt. — I would like to say that the catheter used in this case 

 was sterilized. It was taken directly out of the sterilizer and used at 



517 



