The ear maggots

Westminster medical societyOn Saturday, May 19th 1849 the Westminster Medical Society held one of its regular meetings. Here is an extract from the minutes, as reported in The Lancet:

larvae in the meatus auditoriusDr. Routh exhibited to the Society two small maggots, which had come out of the ear of a gentleman.

Well, that would certainly grab my attention.

This gentleman held the office of Superintendent in some gold mines in Brazil. Being engaged on a Thursday in October, 1846, in reading, he was tormented by a fly, at which he struck with the palm of his hand, and accidentally pushed it within the meatus auditorius.

The opening of the ear canal.

He was not able to extract it till four or five minutes after, when his daughter succeeded in doing so by means of a small forceps. The fly came out entire, excepting one leg, and alive, and was seen by every member of the family, and recognised to be a musca carnaria, or flesh-fly.

Sarcophaga carnaria
Sarcophaga carnaria

Originally named Musca carnaria by Linnaeus, but now known as Sarcophaga carnaria. These flesh flies commonly feed on rotting meat or excrement, so it’s fair to say that you don’t want one inside your ear.

On the same evening be began to feel an uneasy sensation in his ear, which went on from bad to worse, until the internal ear became exceedingly painful. The sensation was as if there was something like a gnawing or rasping of the drum. The natives around him stated that maggots had been found in the ear. An English medical gentleman was sent for, who ordered a few drops of a solution of opium in dilute nitric acid, to be instilled in the ear. The pain and gnawing, however, were in no way relieved.

It sounds most unpleasant. And somewhat reminiscent of a famous scene from Star Trek II: The Wrath of Khan.

On the Saturday, at 4 PM, he was seized with a convulsion: he moaned terribly, plunged his head in his pillow, bending forcibly the joints, and rolling the eyes; the general character, however, of the spasmodic movements was clonic…

Clonic seizures are those in which the muscles contract and relax repeatedly. They are rare, so a notable and potentially worrying symptom.

The convulsion lasted from seven to ten minutes. The medical gentleman called the same evening with a forceps, extracted a living maggot, and ordered a weak solution of bichloride of mercury to be applied within the ear.

Bichloride of mercury (today known as mercury (II) chloride) is a particularly unpleasant compound. It is highly poisonous and corrosive. This did not prevent its widespread use as a treatment for syphilis and as an antiseptic, though thankfully its use was discontinued early in the 20th century.

The rasping, gnawing, and pain continued. At 11 PM the same evening, another convulsion occurring, further medical aid was called in, and, on consultation, it was agreed to apply white precipitate suspended in milk to the ear.

‘White precipitate’ is an irritatingly vague description for mercuric amidochloride, a chemical obtained by adding ammonia to bichloride of mercury. Widely used as an antiseptic at this date – again, despite being highly toxic.

This was done, and somewhat relieved the pain; soon after, two other maggots came out alive. On the Sunday morning another convulsion occurred, but much less violent; the same day a fourth maggot dropped out, also alive. From this time all the acute pain subsided, but slowly at first, as a purulent discharge continued to flow from the ear, but which at last yielded to injections and counter-irritants. The patient finally recovered in about six weeks, but has remained deaf in that ear ever since.

I strongly suspect that the deafness was caused not by the maggots, but by the ‘cure’. Highly corrosive chemicals poured into the ear cannot have been good for the eardrum or the delicate mechanisms of the inner ear. As ever, and particularly if you know more about these things than I do, please feel free to leave a comment.

One thought on “The ear maggots”

Leave a Reply

Your email address will not be published. Required fields are marked *