Maggots and Leeches
A column devoted to maggots and leeches?
But hold on, readers, let’s dig a little deeper.
Last month, this column offered a piece on the overuse and misuse of certain weighty words such as awesome and disgust. These words have their place in our language; however, they are limited in scope.
You could be forgiven for using both “disgust” and “awesome” in describing these critters we generally consider, at the very least, repugnant. They have played a crucial role as biological medical devices for centuries. And for a good reason, they are often effective when nothing else works.
The Second Battle of Somme in WW I – 1918
The young and wounded American soldier was quickly removed from the back of an ambulance and laid directly on the ground outside a surgical tent. Several more injured men were taken from the converted milk truck and placed beside him.
The ambulance then hurried away to pick up more injured from the front line.
Machine guns and heavy artillery were taking a toll on Allied troops. Among the injured, most deaths resulted not from the gunshots but from the difficulty in controlling infections. Remember, this was before the era of antibiotics; even penicillin wasn’t discovered until 1928.
Our wounded American and his comrades will have to wait their turn at treatment despite their many open wounds. Infection would not take long to set in.
As unappetizing as it sounds, flies are attracted to open wounds, specifically the non-viable flesh. The young soldier glanced down at his bloody leg and noticed maggots in the largest of his injuries. He was too weak and in too much pain to brush the maggots away. For that, he was fortunate.
By the early 20th century, biotherapy, such as maggots and leeches, had fallen out of favor. They were not considered a part of modern medicine.
However, an observant doctor noticed that those soldiers treated on the battlefield who were infected with maggots had much higher survival rates. So, once again, our creepy friends were back in vogue.
Today, maggots from certain species of flies are obtained sterile from laboratories. They are of particular importance because these little guys only eat dead flesh. And damaged flesh can interfere with the treatment of infections.
Maggots have enzymes in their saliva that liquefy damaged skin. The tradeoff is that the maggot slurps up a meal, and the patient gets their wound debrided. This has the overall effect of allowing the wound to heal properly.
According to several resources on biotherapies, the area around the wound is cleaned and a thick ring of zinc-oxide (imagine toothpaste) is applied around the insects. This prevents the maggots from wandering off to other parts of the patient’s body.
Maggots and leeches enjoyed a short-lived comeback until antibiotics became all the rage. Once antibiotics were available, we could again openly revile leeches and maggots with impunity.
And we did so – in spades.
But then, Oh, my!
We didn’t give antibiotics the respect they deserved and misused them. Doctors would prescribe a suitable antibiotic for an infection, but patients would take the pills until they started feeling better, and then, well, you could finish this sentence, I’m sure. Yep, we quit taking them.
The delighted bacteria now have a reprieve from certain death. And, being resourceful, they use that time to create resistance to their would-be executioner.
Long story short, some doctors in the early 1980s made it their business to open dusty old books from the medical library and take another look at maggots and leeches.
Voila! The creepy crawlers were back in fashion again.
All because we didn’t follow our doctor’s orders; shame on us.
See any leeches hanging around?
Anytime someone waded through a swamp in the movies, they always exited with a multitude of squiggling leeches hanging from their bodies. Leeches were as ubiquitous in Hollywood productions as quicksand was in the old westerns.
(As far as I know, quicksand has never been a medical therapy. Although we all know someone we would like to try it on, Yes?)
Having experienced dive recovery work in murky freshwater lakes and ponds, I have had my brush (no pun intended) with leeches. I know that when you first see one hanging from an appendage, there is an overwhelming desire to get it off and fling it as far as possible.
Leeches are parasitic worms that feed on blood, nothing else, just blood. They are exceptionally well equipped to be a squirmy little vampire, having a triangular mouth with three rows of sharp teeth.
You may not notice you have a leech attached to you after exiting leech-infested water because their saliva has both an anticoagulant and a powerful anesthetic.
Both of these features have been a boon to medical practitioners for millennia.
One of the big problems doctors face in attempting to reattach limbs and digits is getting and maintaining blood flow to the reattached body part. Leeches have proven to be indispensable when small veins in the reattached body part collapse.
The leech can ingest a considerable amount of pooled blood and assist in getting the blood flowing to areas where it is vitally needed. It can make a difference between a successful reattachment and losing a limb.
A single attached leech becomes engorged in blood in approximately 45 minutes. Most regimens require applying a single leech every eight hours or three times daily. To ensure a successful reattachment leeches continue to be applied from three to seven days.
Given the facts, most of us would welcome a leech when faced with the alternative.
Another benefit of maggots involves helping law enforcement determine an accurate time of death in a suspected murder. Forensic Etymologists can predict the time of death based on the size of immature maggots and other insects found in corpses.
Rather than being disgusted by the thought of leeches and maggots, we may want to remember the many benefits they offer to humanity.
Until next week,