Maggots (India)

As with leeches, the use of maggots is not exactly the treatment one expects when visiting the doctor but maggots are well known for their ability to clean wounds and thereby help them heal more rapidly. Their healing uses have been known since the 16th century when first noted by Ambroise Pare. Maggots have since been used throughout history, especially for treating wounds sustained during battles. William Baer, an American doctor, noticed during World War I that soldiers with maggot infestation in wounds recovered better than soldiers treated by conventional methods in hospital. After the war, further work was done, and during the 1930s maggot therapy was widespread, in over 300 hospitals in the US alone. However, with the advent of antibiotic therapy in the 1940s, the use of maggot therapy decreased.

The life cycle of a maggot begins with the parent housefly (or similar species) laying eggs. After about a day the eggs hatch and the larval stage of the fly is born, otherwise known as the maggot. The maggots feed quickly, moult twice and, after about five to six days, turn into pupae. Development takes place within the pulpae for about ten days after which they emerge as flies. It is during the feeding stage that the maggots are most useful for therapy.

In 1982, however, interest in maggot therapy surged when an orthopaedic surgeon, John Church, observed that, in a car crash victim, wounds infested with maggots healed quicker than those not infested. Maggot infestation of humans is known as myiasis, which may or may not be beneficial. In controlled medical situations it can obviously be beneficial and may also be known as maggot debridement therapy. The healing properties of maggots are thought to exist for two reasons. Firstly, they eat dead flesh and not live healthy flesh. Secondly, they are thought to excrete substances that are inhibitory or even kill infecting bacteria. Maggot therapy is particularly useful when used for areas receiving a poor blood flow supply. In these areas antibiotic penetration is poor but maggots can help the healing process. Care must be taken, however, as not all maggots eat dead flesh; some, such as the maggot of the Screw-worm fly, eat live healthy flesh.
Obviously, a number of ethical considerations arise with maggot therapy. The first question is whether or not maggots can be classed as a medicine. If they were, they would come under the control of the Medicines Control Agency. But would they ever be available on prescription? I suspect not. It is hard to imagine seeing a parent visiting the local chemist to pick up a pot of maggots and following the instructions to treat the cut on their child's leg! One ethical problem that has been solved is that of sterility. As living organisms they are not naturally sterile but scientists have managed to farm sterile maggots for medical use. The cost of maggot therapy provides support for their use. A study indicated that typical maggot therapy costs half as much as conventional therapy.