126 _ INSECTS AFFECTING DOMESTIC ANIMALS. 
The attacks upon man are usually due to deposition of eggs in the 
nostrils or mouths of sleeping or unguarded individuals, though no 
doubt exposed sores or bruises having a bloody surface would be equally 
attractive. 
Professor Snow! has given a very careful description of the attacks 
and results in a number of cases, and it will be useful here to extract 
from his paper some of the especially typical cases as showing the 
mode of attack, the effects of the presence of the larv, and the treat- 
ment resorted to: 
Ihave from time to time had occasion to note the depredations of the screw-worm 
upon horses and cattle in this State, but until recently have not received positive 
evidence of its attacks upon human subjects in any locality so far north as Kansas. 
But early in September, 1882, I received from Mr. 8. D. Osborn, the postmaster at 
Varck, in southeastern Kansas, specimens ‘‘of the worms which came from the nos- 
trils of Milton Carter.” ‘These proved to be the larve of Lucilia macellaria Fab., the 
so-called ‘‘screw-worm.” Upon further inquiry, I learned that upward of one hun- 
dred full-grown maggots escaped from the nose of this patient, who finally recovered 
from the serious illness consequent upon their ravages. I also ascertained that Mr. 
Carter had long been afflicted with an offensive nasal catarrh, which made his nos- 
trils an attractive place for the oviposition of the fly, and that he had fallen asleep 
in the woods in the daytime only a few days before the first appearance of the symp- 
toms produced by the presence of the larve. 
Several other instances of the attacks of Lucilia upon man soon came to my knowl- 
edge, most of which led to fatal results. Among these I will select the case attended 
by Dr. J. B. Britton, of Mapleton, in southeastern Kansas, who reported it in full at 
the session of the Southeast Kansas District Medical Society, in January, 1883. 
From this report I condense the following account: 
“On the evening of August 22, 1882, Mr. M. E. Hudson complained of a eeu 
sensation at the base of the nose and along the orbital processes, which was first fol- 
lowed by inordinate sneezing, and later by a most excruciating pain over the os 
frontis, also involving the left superior maxillary. This patient also had suffered, 
and was still suffering, from an aggravated form of nasal catarrh. The discharge 
was quite purulent, of a yellowish color, frequently tinged with blood, with a disa- 
greeable odor and at times intolerably offensive. On the 24th there was a profuse 
discharge of much purulent matter from the nostril and month, when all pain 
instantly subsided. ‘This discharge continued for three days, during which time as 
much as 16 ounces escaped, increasing in consistency until it was pure pus. The 
odor becoming much more offensive, his cough was more troublesome, and fever 
increased to such an extent as to produce slight delirium for twelve hours. What 
was thrown off was with much difficulty expectorated, and was sanious, containing 
microscopic particles of osseous matter, together with flakes of plastic exudation. 
The os hyoides was evidently destroyed. The patient had spoken with difficulty for 
thirty-six hours and there was much trouble in swallowing. The soft palate had 
evidently given way, and there was an entire inability to protrude the tongue or use 
it in speech. 
“‘About this time a worm similar toa maggot dropped from his nose. That was 
the first indication or suspicion that there was anything of the kind present. There 
was not, as in some other cases reported, any swelling, or movements traceable under 
the skin, nor was there at any time any complaint of the patient calculated to lead 
to a knowledge of their presence. After the appearance of the first I expected 
more, and was surprised to see them drop from the nostrils and wiggle from the 
mouth without any discomfort to the patient until they came in contact with the 
1 Psyche, Vol. IV, p. 27 (1883). 
