Page 17 - Pharmacy History 32 July 2007

Wandering the web
WWW = world wide wounds
From Greg Haines.
Topical words: Larval therapy
T his is not a subject for the squeamish, but the term
is currently appearing on news pages as well as in research
publications. Larval therapy involves introducing larvae or maggots of the bluebottle or greenbottle to wounds to clean them and encourage healing. There’s nothing new about either
the idea or the name. Experience
on battlefields in the American
Civil War and the First World War showed that wounds healed quicker among casualties who had been left untreated long enough to be infected by maggots hatched from fly eggs. The maggots of these flies remove dead tissue and secrete chemicals
that inhibit bacteria, but avoid live flesh, so giving healthy tissue the chance to regrow. The technique was used during the 1930s and 1940s to treat burns, abscesses, leg ulcers and gangrene. It went out of fashion when antibiotics came in after World War Two, though I’ve read it is still taught to army surgeons in some countries. It’s coming back into use, not least because it can successfully treat wounds infected with bacteria resistant to antibiotics. It has been reported this month that a team at Manchester University has found maggots can heal foot ulcers infected with the superbug
MRSA (methicillin-resistant Staphylococcus aureus). The team has been awarded a grant to carry out a controlled trial.
Early doctors called it ‘maggot therapy’, employing a medieval word that might be a variation on the old Germanic ‘maddock’ or ‘mathe’, now
volume 3 ■ no 32 ■ JULY 2007
Pharmacy History Australia ■ 17
Maggot therapy (courtesy of the US National Institutes of Health
known only in dialect, or which the Oxford English Dictionary thinks might have been influenced by Magot or Maggot, pet-names of Margery
or Margaret. But there’s nothing in the least affectionate about ‘maggot’ itself and doctors came to realise
that calling it ‘maggot therapy’ was
a public-relations no-no, though
the term is still around in the literature. In the early 1930s ‘larval therapy’ began to appear instead, based on a rather more recent and specific scientific term that had
been borrowed from Latin ‘larva’, a ghost, spectre, or hobgoblin, which figuratively took a grub to be a
ghost of the final adult form of an insect. However, ‘larval therapy’ was not so much better that it entirely extinguished shudders from fastidious potential patients.
Around a decade ago, ‘biosurgery’ became popular as a euphemistic alternative. But this has come
much more common in surgery
to mean the employment of biological replacement materials (‘biomaterials’) to reconstruct or seal tissues within the body. So the unambiguous term ‘larval therapy’ continues in use. It’s also sometimes called maggot debridement therapy or biodebridement, in which debridement is the cleansing of a wound, a 19th-century borrowing from French, literally meaning ‘unbridling’, though the link with saddlery is obscure.