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No. 996:
Medicine and Maggots

Today, reflections on fear, loathing, and maggots. The University of Houston's College of Engineering presents this series about the machines that make our civilization run, and the people whose ingenuity created them.

Ask yourself what it takes to make a thing loathsome. That question took shape for me when I read a recent article in the Wall Street Journal on the use of maggots to eat away infection in a wound. Can anything be as loathsome as the idea of dumping maggots into the festering wound of a patient!

Yet turning a loathsome idea into a friendly one is where creativity begins. Fear and loathing are interwoven. So it is with any creative enterprise. We must make friends with the many-tentacled alien idea. We must breach our terror. That's why this new therapy attracts me. I really do loathe maggots.

Dawn Blalock, writing for the Wall Street Journal, tells about Harold Taylor, a diabetic suffering from gangrene -- beyond antibiotics. Taylor was about to lose his leg.

But Taylor is one of hundreds of people whom Dr. Ronald Sherman has been treating with maggots. Sherman breeds blowflies in putrid liver. He sterilizes the eggs so the maggots won't grow into flies. He planted those newborn bugs, about a millimeter long, in Taylor's wound and wrapped it in gauze.

Gauze let the maggots breathe. Taylor could watch them at work. They fed on the infection, growing to a full centimeter. He said he could feel them gnawing and scratching. But it didn't bother him -- after he'd passed the first psychological hurdle.

There's more. Maggots leave behind a kind of ammonia-like excretion that disinfects the wound. The healing is cleaner and more complete than it would be after surgery. In the end, those maggots have saved Taylor's leg.

Last night I went to a computer index of current medical articles and found a set on maggots -- their biochemistry and their role in healing. That role has been known for a long time. Napoleon's battle surgeon pioneered their use. A few doctors were still using maggots just before WW-II. But we dropped the whole business like a stone when we discovered the new wonder drugs -- sulfa and penicillin. We dropped it until just now.

It all reminds me of my time in graduate school. I liked to work out on a diving board. The hardest thing I did was my first back flip, heaving myself backward into space I couldn't see. That terrifying -- and loathsome -- offense to my own body was the price I had to pay for the exhilaration I so craved to have.

It takes creative fearlessness to return to this remarkable technology of healing. This particular back-flip off the high board is one we'd really rather not even contemplate. And those friendly little worms make a powerful parable about our natural fear of undertaking creative change.

I'm John Lienhard, at the University of Houston, where we're interested in the way inventive minds work.

(Theme music)

Blalock, D., Grubby Little Secret: Maggots Are Neat At Fighting Infection. Wall Street Journal, January, 1995. (incomplete citation.)

I am grateful to Roger Eichhorn, Dean of Engineering at UH, for suggesting the idea and providing the article.

A maggot must be born i' the
rotten cheese to like it.
Geroge Eliot
(Mary Ann Cross)


Larvae of Cyclorrhapha are maggots or grubs,
with no distinct head; mouth-hoods working
vertically, and usually two spiracles post-
eriorly; ...
Larvae of flies have adapted themselves to
an extraordinary range of food-materials,
perhaps greater than those of any other
order of insects. A great many feed in
decaying vegetable materials, leaf-mold,
rotting wood or fungi. Some attack healthy
plants ... others feed in dung, carrion,
or wounds and fetid discharges. ...
Encylopaedia Britannica, 1970


Augurs and understood relations have
By maggot-pies and choughs and rooks brought forth
The secret'st man of blood.
Shakespeare, Macbeth


Have you not maggots in your brains?
Beaumont and Fletcher