Innovative. Groundbreaking. Revolutionary. When used in the medical field, these words usually describe technological breakthroughs or scientific developments that help renovate medical treatment and save lives. However, these words are once again being connected with ancient natural remedies that many people would not expect. These "folk" remedies were accepted as standard medical procedure for centuries until advances in science replaced them. Therapeutic treatment using maggots, leeches, and worms has been recently found to an extremely efficient means of treating many medical problems. However, despite their effectiveness in treating certain ailments, deep-rooted cultural feelings of repulsion towards insect detract from its potential success.
The use of leeches in medical practice dates back to the Ancient Egyptians and their belief in bloodletting to alleviate pain from headaches, hemorrhoids, nephritis, laryngitis, eye disorders and help treat mental illness and obesity. The Ancient Greeks also exercised bloodletting in order to maintain the humoral theory. The humoral theory in essence maintains that the human body is composed of blood, phlegm, black bile, and yellow bile, and when completely healthy, these elements are in balance with each other in a person's body. In cases of excessive imbalance (sickness), doctors would apply leeches in order to drain the body of the excess element and restore the body to equilibrium and thus full health (El Awaday). Michele Root-Bernstein, an author of Honey, Mud, Maggots, and Other Medical Marvels, believes that although broad in its application and often referred to as "the aspirin of that age," leech therapy was an efficient remedy for relevant ailments.
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There is evidence that suggests that the use of maggots as a remedy was first conducted by the ancient Mayans. Observations made after intense warfare concluded that severely infected wounds healed at a much faster pace when maggots entered the wounds than with other forms of ointment at that time. It was accepted by the Mayans that a special secretion which maggots produced when feeding on wounds helped eliminate dead tissue and promote the growth of new, healthy tissue, which was in fact true (Root-Bernstein). This observation was reaffirmed during the Civil War by Confederate medical officer Joseph Jones in the statement, "I have frequently seen neglected wounds... filled with maggots...as far as my experience extends, these worms only destroy dead tissues, and do not injure specifically the well parts. I have heard surgeons affirm that a gangrenous wound which has been thoroughly cleansed by maggots heals more rapidly than if it had been left to itself" (Sherman). At the time, the thought of using maggots as a form of treatment must have astounded physicians and had to have been seen as a medical miracle because there wasn't any research in support of its benefits. Even today, with all the statistical research in its defense, many doctors refuse to accept its medical aptitude.
Due to medical advancement in the form of antibiotics and medical devices, the use of leeches and maggots diminished drastically during the 20th century; however, there has been a recent movement towards their increased implementation in modern medicine as evidenced by the following sentiment, " we're relearning that nature's medicines often called 'gross" are sometimes the best" (Weinstock). Maggots are primarily used to treat various types of leg ulcers, post operative wounds, and various traumatic wounds (Jones). The special types of maggots used in patient treatment, which are bred exclusively to eat dead tissue only, are derived from sterile greenbottle blowfly larvae. They have three distinct functions: debridement, disinfection, and recovery (Picollo). Essentially, maggots are placed in the infected area where they produce a chemical enzyme which turns the dead cells into a digestible liquid and promotes tissue decomposition. The maggots are specifically bred to only eat until the dead cells no longer remain, and then they are removed from the wound once the procedure is over and discarded by the physician (Gross Medicine). Recent results reveal that healthy tissue growth is seen within three weeks after the procedure and it is estimated that maggots salvage 40%- 50% of limbs that would have been otherwise amputated (Collier). After three months, 65% of the patient wounds had healed completely; 19% of the patients required amputation after the surgery, but the level of amputation required was reduced significantly from expectations before the therapy (Steenvorde).
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Leeches, as Anna Baldwin, technician at the Biopharm Leech Center in South Carolina, describes are a "mini-drugstore" (Picollo). Presently leeches are used most commonly on patients who have had reconstructive surgery as well as skin flaps in order to remove pools of congested blood that interfere with circulation and can cause lack of oxygen to tissues post surgery. The effectiveness of the leech is due to the small bleeding incision it makes that allows blood to circulate throughout the congested area. When a leech bites the host, it releases a local anesthetic as well as an anti-clotting emission (hirudin) and vasodilator (antibiotic) which help promote recovery. The leech aids in the recirculation of the blood until it consumes roughly five times its weight and then detaches itself in order to digest the contents of its stomach. The increased circulation of the blood continues for an additional twelve to fifteen hours after the initial leach concludes its duty due to the anti-clotting agent that is released in the patient's blood stream (Gross Medicine).
The use of patristic worms in medicine has risen due to the increased amount of gastrointestinal related diseases. Patients experiencing these problems are prescribed microscopic pig worm eggs, which must be taken in conjunction with liquid treatments. These worms are relatively safe because they only survive in the intestine for eight weeks and do not cause sickness. The eggs are undetectable to the naked eye since they are smaller than a grain of sand and grow in the intestine to the half an inch long and thinner than a human hair (Rubin). As reported by the American Journal of Gastroenterology, results pertaining to the treatment's effectiveness revealed that out of the seven patients suffering from Crohn's disease and ulcerative colitis, six achieved remission and one improved dramatically (Picollo).
In spite of the astounding information supporting the wonders of these natural remedies, people often resort to these treatments as a last resort and often times it may be too late to make a profound impact on the ailment. It is quite disheartening to think that some patients are too afraid or stubborn to consider the treatment and would rather risk losing limbs than to be a part of this remedy.
The delay in the accepting this form of therapy is attributed to the way in which these means of healing are portrayed in society. In movies and television, maggots are depicted feeding off organisms that are dead as evidenced by programs such as CSI. One particular experience was deeply ingrained into my memory concerning this type of imagery. When seeing the movie Gladiator at Chicago Ridge Theater, I remember the crowd collectively falling back in the reclining seats and violently jerking their heads in disgust away from the movie screen when Russell Crowe's battle wound was treated with maggots (MacDonald). Certain television shows such Survivor and Fear Factor capitalize on the "yuck factor" by offering prizes for contestants who eat bugs. An episode that made me particularly nauseous involved the eating of live spiders for the chance of advancing in the contest in hope of winning $50,000. After a woman's first attempt at munching on the arachnid failed, she was enticed by her contestants and the show's host to try once again. On the second try, the spider wriggled in her hands in an attempt to escape. She brought it closer to her mouth and reluctantly willed her jaw to close on the helpless spider. Although already mostly chewed in the contestant's mouth, the spider continued to frantically shake its legs in its final seconds of life prompting me to change the channel (Youtube). Knowing that the spider in addition to maggots, worms, and leeches dwells among grass, mud, creeks, and other filthy elements, is probably the foremost influence on the repugnance.
In everyday life, interaction between human and maggots usually occurs in disease breeding situations involving garbage cans or rotten food. In some extreme cases, even doctors and nurses sometime refuse to offer these types of treatment because of their personal feelings of disgust towards the application of the treatment (Collier). Furthermore, doctors had worried that implementing what is considered by the public a "primitive" medicine would bring about the view that the hospital is out-dated and insanitary (Rubin). Therefore, it is not difficult to understand why people would be weary of this type of treatment if doctors and nurses do not even believe in the effectiveness of this form of treatment. In order to reverse this type of negative thinking, an emphasis must be put on the benefits as compared to the detriments so that they become more comfortable in offering these types of therapy.
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On the other hand, certain assumptions are not accurate regarding these therapies. For example, it is accepted that maggot, leech, and worm treatment inflict pain on the patient; however, that is not true because each is shown to inflict minimal pain as evidenced by a study conducted by Professor Sherman in which a survey was conducted among twenty-one patients who had had maggot therapy and it was determined that pain did not cause any patient to end treatment (Sherman). In fact, many patients report that the most discomforting feeling of the procedure is the unpleasant reactions of family, friends, co-workers, etc (Steenvorde). In a similar manner, when telling classmate the topic of my paper, many often winced at the simple mention of the words maggots, worms, and leeches. They zeroed in on those particular words and failed to hear what the thesis of my paper when I tried to explain it. It became a little frustrated to continually repeat myself; however, it definitely showed that subconscious repugnance towards these bugs can often muddle thought processes. Therefore, it is not surprising that many patients refuse to initially entertain the thought of these treatments when assessing treatment options.
The cultural image of maggots, leeches, and worms as the completely opposite image of sanitation hinders the recognition of these bugs as a superior medical treatment. Although accepted approved by the FDA, the concept that maggot, leech and worm therapy are obsolete modalities, and the anxiety of having live insects roaming within the body, have prevented some healthcare providers and patients from benefitting from these types of medical procedures. Acceptance of these therapies will only become reality with the publication of well-designed clinical trial, the educations of medical practitioners, and most importantly the education of the public. Hopefully through these actions, the therapeutic benefits of these critters will be acknowledged and remain applied rather than be abandoned as readily as they were at the beginning of the twenty-first century.
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