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Gross medicine.

Hundreds of years ago, maggots, leeches, and dirt were "medicine cabinet" staples. Now old is new again: Ready to try them?

You're lying in the emergency room, in agonizing pain from open gash on your leg. You crashed your bike weeks ago, the wound has gotten worse--black, festering, and foul-smelling. Now you have acute gangrene--"flesh-eating" microscopic bacteria are feeding on your live tissue. What would it take to destroy the bacteria causing your leg to rot?

Well, how do maggots sound? That's doctor's recommendation: unleash of tiny worm-like fly larvae to feast your leg. Is this a putrid nightmare? Have become the star of yet another sequel--Holloween: When the Bugs Bite ???

It may curdle your blood, but science is re-examining a host of "folk" remedies to heal all kinds of wounds and diseases. They include maggots, leeches (a type of segmented worm), and even geophagy or dirt-eating (see sidebar, p. 17).

Alternative folk cures were standard medical fare for centuries. But late-19th-century advances like the theory--keeping and instruments from germs promotes healing--and 20th-century drugs called antibiotics, helped banish folk remedies from modern hospitals.

Now, recent studies suggest some old remedies may do the trick as well as, or better than, some techniques that replaced them. "We no longer think of antibiotics as the cure-all for every infection," says Dr. Ronald Sherman, at the University of California at Irvine.

"Almost by chance we're relearning that nature's medicines--often called `gross'--are sometimes the best," adds Michele Root-Bernstein, author of Honey, Mud, Maggots and Other Medical Marvels (Houghton Mifflin, 1997). Maggot and leech therapies are a growing trend, says Root Bernstein, though you probably won't find them in your local doctor's office. "Doctors are likely to turn to maggots and leeches only when nothing else works," she says.

Today, as in the past, maggots are used to eat dead tissue, thereby cleaning open wounds. During the Civil War and again in World War I, battlefield physicians saw that soldiers' wounds infested with maggots tended to heal better than non-infested wounds. Soon maggot therapy was born.

On the other hand, leeches were put to the test in a practice called phlebotomy, or bloodletting, a remedy once as popular as aspirin. A leech's bite was only one tactic used to drain human blood--knives, sharp stones, teeth, and thorns also proved popular. Though they didn't know why at the time, doctors found bloodletting reduced severe fever. A doctor might use leeches to drain ounces or pints of blood--in extreme cases, up to 1/5 of a person's total blood supply! Today, leaches are making a comeback in reconstructive surgery when, for example, surgeons reattach a severed finger.

For more news on some of the world's oldest and grossest medical remedies, turn the page.

Maggot therapy

Today, more than 200 hospitals in the U.S. and Europe have prescribed maggots to treat patients with infections from injuries like pressure ulcers ("bed sores"), leg and foot ulcers, stab wounds, and post-surgical wounds that won't heal. In fact, about 5,000 laboratory grown and disinfected (microorganism-free) maggots are delivered to hospitals across the U.S. every week!

"It's faster than any non-surgical method for wound-healing and not as likely to injure healthy tissue," says Dr. Sherman. He grows the larvae in his Irvine laboratory and ships batches to hospitals around the world. The flies that lay maggot eggs are force-fed on Gainers Fuel 100, a body-building supplement. Sherman puts up to 20,000 maggot eggs in a single vial, and after hatching, feeds them sterilized meat. The larvae are then placed in special bandages which hold the maggots in after they are applied to a human wound.

Here's an example of when and how maggot therapy works: Open, untreated wounds can become infected and gangrenous if left untreated. Gangrene is the death of human cells or tissues caused by a blockage of blood supply to a wound. If gangrenous tissue isn't removed, the affected limb eventually begins to rot. And if bloodless tissue should become infected by poisonous bacteria such as clostridium, results can be fatal.

Maggots are immature blowflies (a type of fly) in their second or larval stage of life. Young blowfly maggots are implanted directly onto a wound, where they eat dead flesh, clean out dead skin, and kill harmful bacteria that need injured tissue to survive. Once maggots reach their fill of dead and dying flesh, they're removed from the wound and new maggots are applied. Blood can then flow throughout the tissue, promoting the growth of new flesh (see below).

Are patients totally grossed out by maggot therapy? "I've never had anyone freak out--not even those who are initially extremely reluctant," says Dr. Jane Petro, a plastic surgeon at Westchester County Medical Center in Valhalla, New York. Maybe someone should conduct a study on how her patients got such strong stomachs!

Leeches: out on a limb

Maggots may not be the only healing creepy critters to have earned a foul rap. For 2,500 years, doctors have used blood-sucking leeches for bloodletting. A leech can gorge itself with up to five times its body weight in blood!

In 1994, a woman's scalp was ripped off when her hair was yanked into moving machinery. Doctors performing microsurgery at the University of Southern California reattached the scalp, but one area swelled with congested blood. They applied leeches, one at a time for eight days, to suck up stagnant blood. Eventually new capillaries, or tiny blood vessels, formed in the scalp wound, leading to healing circulation.

Is something repulsive going on? All leeches have two suckers--one on each end of its body--and the mouth end has hundreds of teeth (see diagram, above right). When applied to an injury or reattached limb, leeches dig their teeth right into the flesh and start sucking. Surprisingly, the bite doesn't seem to hurt. That's because leech saliva contains a natural anesthetic, or pain-killer.


Leech saliva is also full of other important curative chemicals. One is called hirudin, which keeps blood from clotting. Scientists have devised a method to genetically engineer hirudin, which they hope to prescribe as an alternative treatment for unclogging blood vessels during heart surgery.

Another leech benefit is an agent that prevents bacteria from infecting the wound area. And a third is a vasodilator, which causes human blood vessels to open. "Leeches are like a mini-drugstore, because of the 'cocktail' of chemicals within their systems," says Anna Baldwin at the Biopharm Leech Center in Charleston, South Carolina. The potent leech cocktail seems to promote the circulation of blood critical to healing a wound. By the way, when a leech has finished sucking your blood, it simply falls off. How comforting!

Will such creepy folk remedies become part of the future's mainstream medicine? Would you let a doctor apply slimy maggots or leeches to your body? If you love gross-outs, your prayers have been answered.


Could eating dirt really be good for you? Believe it or not, the practice of geophagy, or dirt-ingestion, is practiced by many cultures in Africa, Indonesia, the Caribbean, even the southern U.S. The reasons vary from eating mineral-rich matter to soaking up food and bacterial poisons, and combatting hunger in times of famine.

Native Americans in the Southwest, for example, once mixed ground acorns with clay, then baked the mixture as a bread, to make the toxic nuts more edible. The Chinese and Europeans used muds and clays to combat infections, malnutrition, and diarrhea.

Today, some pregnant women in Africa eat clay--rich in minerals such as iron, potassium, and zinc--to satisfy their nutritional needs. "It may be that the world's oldest medicine is the earth itself," says anthropologist Timothy Johns.
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Title Annotation:use of leeches and maggots in health care
Author:Bregman, Mark
Publication:Science World
Article Type:Cover Story
Date:Oct 19, 1998
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