As regards the mode in which the maggot gained access to the child in Horne’s case, it was not easy to decide; but in the case of the girl Riordan the mode of ingress was sufficiently explained. The Blapsidæ, as a family, are closely allied to the meal-worms, and, like most of the Tenebrionidæ, are black and foul-smelling beetles, frequenting dark and damp situations, from which they escape only at night. The family comprises numerous species, of which probably not more than three are found in this country. They are abundant in Africa, especially in Egypt, where (according to Fabricius, as quoted by Westwood, Figuer, and others) the women eat Blaps sulcata cooked with butter in order to make themselves grow fat. The insects are also employed as specifics against ear-ache and the bite of the scorpion. The superstitious notion of a “charm” is generally at the bottom of these domestic remedies. In the girl Riordan’s case, as Westwood observes (when epitomising Pickell’s account), the parasites, as such, “probably originated in an absurd and superstitious practice, which she had for some time followed, of drinking daily for a certain time a quantity of water mixed with clay, taken from the graves of two Catholic priests, and eating large pieces of chalk. One of these beetles was immersed repeatedly in spirits of wine, but revived after remaining therein all night, and afterwards lived three years.” The intolerance of light shown by the perfect insect seems to be equally shared by the larva. Of this fact I had repeated evidence by observing the behaviour of the living specimen sent to me by Dr Horne. Thus, when, on February 5th, 1877, I placed the maggot on the surface of some moist mould, scarcely half a minute elapsed before it commenced to bore its way downwards, and in less than a minute all but the tip of the tail had disappeared. In like manner, when, on the 7th, I raised the lid of the box, and found the maggot on the surface of the soil, it almost instantly proceeded to bury itself. Hope’s list records no less than nine instances of parasitism in man from the larvæ of Tenebrio molitor, and he gives a score of other Coleopterous insects which he regarded as human “intestinal worms.” Undoubtedly a large number of insect larvæ do get introduced into, and actually live within the human intestines.
Numerous cases of this sort have come under my observation, but it often requires a profound knowledge of entomology to determine the species. Several examples of œstridean larvæ occur amongst them. For one example of Œstrus hominis I am indebted to Mr Higginson, of Liverpool, who obligingly supplied me with notes of the case. Dr Kirk presented me with a small bot which he removed from Livingstone’s leg. I afterwards deposited the African bot, in his name, in the Hunterian collection. Bates speaks of an Œstrus in Brazil producing boils in human flesh. Westwood quotes similar instances. Of these, one was extracted from the thigh by Dr Brick. Mr Doubleday, the entomologist, extracted one from his own leg, and M. Goudot, another entomologist, was also victimised in the same way. Both of these savans were travelling in America at the time. Two cases from South America were also recorded by Howship. In one the larva lodged in the back; in the other in the scrotum. Humboldt noticed that the Indians were much infested by Œstridæ. Three cases are severally recorded by Roulin, Guérin, and Audouin. Mr Stroop also mentions a case in which an Œstrus was removed from an ulcer on the shoulder of a boy in Texas. Another kind of bot known as the Macaco worm (Cuterebra noxialis) occasionally attacks man, but more frequently cattle and dogs. For one example, taken from the leg of a negro, at Belize, British Honduras, I am indebted to Dr Dobson (A. M. D., Netley). Hope’s list records five cases of bots of Œstrus hominus, one of Œ. Guildingii, one of Œ. bovis, and thirteen others (belonging to the same genus) as having been noticed in man. Since his time many additional cases have been recorded by J. M. Duncan and others. In like manner a legion of cases in which the maggots of various Muscidæ have been noticed, either in, upon, or from the human body. At a meeting of the American Academy in April, 1859, Dr Leidy showed some larvæ of the bluebottle fly vomited by a child; five larvæ of the flower-fly (Anthomyia) from a physician’s own person (which had produced choleraic symptoms); and nine examples of Cuterebra noxialis. I have myself encountered numerous insect larvæ in medical practice. Amongst others I have obtained the larvæ of Anthomyia canalicularis in six or eight separate instances. One set of specimens, identified by Wunderlich, was sent to me by Dr Brandt, of Oporto. Drs Duffin, W. Fox, and Leared have supplied me with others. The larvæ described in Farre’s case, not being setose, must be referred to one or other of the Muscidæ proper. Mr Hope gave nearly forty cases of this kind, referable to eight different species of fly, and, as already implied, I have myself collected a great variety of the maggots of Muscidæ passed by the bowel, besides others obtained either from beneath the skin or from open ulcerations.
The flies hitherto noticed as supplying parasitic maggots in man are Musca domestica, M. carnaria, M. larvarum, M. nigra, and perhaps M. Cibaria, M. stabulans, and M. Cæsar. This last, a handsome fly, is the species which proves so troublesome to sheep. The habit which flies have of depositing their eggs in open wounds, when the victims are asleep, is a fertile source of this kind of parasitism. Some of the instances recorded by Kirby and Spence are revolting in the extreme. They quote the cases which came under Mr Sell’s notice in Jamaica. In one instance the flies were hatched in a neglected blister on the chest; in another from the gums and inside of the cheek; and in a third, from the nostrils of a negro, from whom 235 larvæ were expelled. The case of the Lincolnshire pauper, Page, who was literally eaten up by maggots, is almost incredible. An equally horrible instance, however, is recorded by Cloquet. It is said that the Jamaica cases were all due to the larvæ of the bluebottle fly (M. vomitoria). An instance of the same kind has been recorded by Mr Knox (A. M. D.). Sufficiently revolting as these cases are, the horrors attending them are eclipsed by the habits of the larvæ of Lucilia hominivora. The best accounts of its habits are those by M. Coquerel, M. Saint-Pair, and M. Vercammer. The insects lay their eggs in the mouth and nostrils, and when the larvæ escape they devour the tissues surrounding the buccal cavity, the pharynx, glottis, frontal and nasal sinuses, even reaching the sockets of the eye. Several Cayenne convicts have perished from the maggots of this fly, which is also prevalent in Mexico. These are not, however, the only instances of maggots gaining access to the nasal chambers. In a case recorded by Dr Astros, of Aix, 113 were discharged from the nose of a woman; and M. Legrand du Saulle records an instance where a number of larvæ occupied the frontal sinuses of a girl, nine years of age. The larvæ produced persistent headache and convulsions. In the case recorded by Wohlfart, 18 larvæ were discharged from the nose of an old man, and in the example given by Latham several larvæ were obtained from the frontal sinuses of a woman. Bracey Clark also gives an instance in which a bot was taken from a woman’s jaw. Not improbably the well-known Indian disease, termed peenash, or worm in the nose, is due to the presence of Œstridean larvæ. Cases by Rustomjee and Lahory are quoted below. Possibly Stockett’s is another of the same order. The case by Kilgour (Bibliog. No. 34) may be another. I may add that Moquin-Tandon gives an instance of the discharge of seventy-two bots, resembling those of the sheep, from a woman’s nose (‘Journ. de Vandermonde’). The rat-tail maggots or larvæ of Helophilus are parasitic. Two or three instances have been recorded from the horse. I possess one from the human intestine. Kirby also quotes an instance in which Heloph. pendulus was obtained from the stomach of a woman (‘Philos. Mag.,’ vol. ix, p. 366).
A vast number of non-parasitic insects are injurious to man and beast. Inasmuch as they subsist at the expense of their victims and also adhere to his person during their attacks for a shorter or longer time, they, like the leeches, may be spoken of as free parasites. The leg-sticker (Stomoxys calcitrans) penetrates through thick stockings, causing blood to flow freely. The clegg of the West Highlands (Hæmatopota pluvialis) also violently attacks man and beast, especially horses. The mosquito (Culex anxifer), the gnats (C. pipiens, C. annulatus, and C. pulicaris), and the midge (Chironomus plumosus) need only be mentioned. The creeping gnat (Simulium reptans) is also very annoying in Sweden. The rôle of the mosquito, as itself constituting a parasite-bearer, will be again referred to in the closing pages of this work (Book II, Section V). The bites of the tsetse (Glossina morsitans), though so destructive to the horse, ox, sheep, and dog, are not dangerous to man himself. According to Sir S. Baker, the seroot-fly, or zimb of Bruce, which is a species of Pangonia, is excessively annoying to travellers in Abyssinia. Amongst the hemipterous insects the common bug (Acanthia lectularia) is sufficiently blood-thirsty; but there is a far more sanguinary species of this kind in South America. This is the pampas benchucha (Conorhinus nigrovarius). Our distinguished countryman, Darwin, in his ‘Voyage,’ speaking of these wingless insects, says:—“Before sucking they are quite thin, but afterwards become round and bloated with blood. In less than ten minutes the insect is changed from being as flat as a wafer to a globular form.” This insect somewhat resembles our water-scorpion (Nepa cinerea), a non-parasitic species whose bite causes severe pain, as does also the wound inflicted by the water-boatman (Notonecta glauca). There are other species of bug, such as the Acanthia rotundata of Réunion Island and A. ciliata of Kasan, the bites of which are worse than that of the common species. The fly-bugs also, such as the Reduvius personatus, so common in France, and the R. amænus of Borneo and Java, attack man, although their especial habit is to attack and destroy other insects, including bugs themselves. Other species or varieties of Reduvius (R. cruentus, and R. serratus) attack man. The last named is an Indian form, capable, it is said, of producing an electric shock.
Passing to the fleas, the most important and truly parasitic form is the chigoe or gigger (Pulex penetrans). This abounds in tropical America and the West Indies. The female insects only attack man, and this they do for the purpose of securing a lodgment for their offspring. They attack especially the soles of the feet, between the toes and near the nails. In bad cases the whole of the foot becomes affected. After the insect has penetrated the skin its body swells enormously and becomes a mere bag of eggs. This swelling causes active inflammation, which terminates in suppuration and the formation of open ulcers. The chigoe also attacks various animals. In addition to the common flea (P. irritans) other species infesting animals are said to attack man occasionally. As regards those degraded types of insects known as lice I can only afford space to remark that five species have been recognised as human. These are the head-louse (Pediculus capitis); the louse of the eyelids (P. palpebrarum); the clothes-louse (P. vestimenti); the distemper louse (P. tabescentium); and the pubic louse (P. inguinalis). The distress these creatures occasion is only fully known to physicians who deal with the obstinate cutaneous affections caused by their presence (Phthiriasis). Some of the lice found on negroes and Greenlanders are regarded as distinct varieties. Lice are abundant on animals, and some of the species are apt to transfer themselves from one host to another. Thus the Ornithomyia avicularis of cage birds has been found on man, whilst one or more of the numerous species infesting the common fowl are, by transfer, apt to produce a severe phthiriasis in the horse. The lice of the fowl belong to the genera Leipurus, Liotheum, Menopon, Philopterus, Goniodes, and Goniocotes. The unsuitableness of man’s person as a habitation for bird-lice should, however, check the fear which many persons have of handling fresh-killed poultry and game birds. Poultry lousiness in man is probably impossible from this source.
Bibliography (No. 40).—Arture, “Obs. sur le ver nommé Macaque,” in ‘Mém. Acad. des Sci.,’ Paris, 1753.—Bates, “Œstrus in Man,” ‘The Naturalist on the Amazons.’—Beneden, Van, ‘Animal Parasites and Messmates,’ 1876.—Idem (with Gervais), ‘Traité de Zool. Méd.’—Blood, M., “Case of Larvæ (Musca sarcophaga) expelled alive in the Fæces,” ‘Beale’s Arch. of Med.,’ vol. iii, p. 134, 1862.—Brinton (similar case), ‘Arch. of Med.,’ vol. iii, p. 133, 1862.—Bouyer (quoted by Figuer), ‘Tour du Monde,’ p. 318, 1866.—Clark, Bracey, in ‘Linn. Trans.,’ vol. iii, 1797 (the jaw-case at p. 323), and vol. xv, 1827.—Idem, ‘Essay on Bots,’ 1815.—Cloquet, J., “Case of Blindness from Worms (larvæ of Musca) in the Eyes,” from ‘Arch. Gén. de Méd.,’ in ‘Lancet,’ 1828.—Cobbold, “On Blaps mortisaga as a Human Parasite,” ‘Brit. Med. Journ.,’ 1877, p. 420.—Idem, “Entoz.” (‘Hope’s List.’), p. 416.—Idem, in ‘Worms’ (“Leptus,” &c.), p. 140, 1872.—Coquerel (quoted by Figuer).—Cormack, J. R., “Exhibition of a Larva (B. mortisaga) passed by a Child,” ‘Month. Journ. Med. Sci.,’ vol. i, 1841.—Crumpe, S., “History of a Case in which Worms (larvæ of a beetle) were discharged from the Stomach,” from ‘Trans. of the Roy. Irish Acad.,’ vol. vi, in ‘Med. Facts and Observ.,’ vol. viii, p. 229, 1800.—Denny, ‘Monog. Anoplurorum Brittaniæ,’ 1842.—Duncan, J. M., “On the Occurrence of Bots in the Human Subject,” ‘Edin. Vet. Rev.,’ vol. i, p. 275, 1858–59.—Idem, “The Larva of Œstrus bovis in the Human Subject,” ‘Rep. of Edin. Med.-Chir. Soc.,’ in ‘Month. Journ. of Med. Sci.,’ July, 1854.—Farre, A., “On the Larva of Anthomyia canalicularis,” ‘Micr. Journ. and Struct. Rec.,’ 1841, p. 129, and in ‘Trans. of Micr. Soc. of Lond.,’ orig. ser., p. 51, 1844.—Figuer, in ‘The Insect World’ (good figs.), Janson’s edit., 1869.—Furlonge, “Anat. of Pulex,” in the ‘Journ. of the Queckett Club,’ vol. iii.—Geer, De, ‘Mémoires pour servir à l’Histoire des Insectes,’ 1773.—Gervais (see Van Beneden).—Hill, “Account of the Larva of a supposed Œstrus hominis, or Gad-fly, which deposits its Eggs in the bodies of the human species, with particulars of a Case,” ‘Edin. New. Phil. Journ.,’ vol. xxii, p. 284, 1830.—Hilaire (see St Hilaire).—Hope, “Tables of Cases of (spurious) Intestinal Worms,” ‘Lond. Med. Gaz.,’ 1837–38.—Hoppe, “Case of Larvæ of Insects (Musca stabulans) passed by Stool,” from ‘Bibl. für Läger,’ in ‘Med.-Chir. Rev.,’ 1842.—Hopper, R. S., “Insects (Stratiomis) voided with Urine,” edit. note in ‘Micr. Journ. and Struct. Rev.,’ p. 160, 1841.—Joly, ‘Recherches sur les Œstrides en général,’ &c., Lyons, 1846.—Keferstein, ‘Sur l’Oistros,’ Isis, 1827.—Kirby (and Spence), ‘Introd. to Entomology,’ 7th edit., 1856.—Knox, M., “Maggots, the larvæ of the Bluebottle Fly, in Syphilitic Ulceration of the Throat,” ‘Lancet,’ Oct. 6, 1877, p. 514.—Lahory, B. T. C., “On Peenash, or Worms in the Nose,” ‘Ind. Ann. of Med. Sci.,’ 1855, and ‘Edin. Med. Journ.,’ 1857.—Leach, “Œstridæ,” in ‘Wernerian Trans.,’ 1817.—Leidy, in ‘Proc. Phil. Acad. Nat. Sci.,’ 1859, p. 7.—Maclean, “On the Oistros,” ‘Linn. Trans.,’ vol. xiv, 1824, and in ‘Zool. Journ.,’ vol. i and iv.—Metaxa, “Vom Œstrus (u. s. w.),” in ‘Neuen Nord. Beitr.,’ Bd. i, and in ‘Mém. de Zool. Med.,’ Rome, 1835 (quoted by Westwood).—Moquin-Tandon, ‘Med. Zool.’ (l. c., Bibl. No. 38).—Newport, art. “Insecta,” ‘Todd’s Cyclop.,’ 1839.—Rustomjee, B., “Case of Worms in the Nose, or ‘Peenash,’” in ‘App. to Bomb. Med. and Phys. Soc. Trans.,’ No. vii, new ser., p. 21, 1861; see also Lahory, on ‘Peenash.’—Saint-Hilaire, “Sur l’Œstre chez l’homme,” in ‘Ann. Soc. Ent. de France,’ 1833.—Say, “Brick’s Case,” in ‘Trans. Acad. Nat. Sci. Phil.,’ vol. ii.—Sells, in ‘Trans. Entom. Soc. Lond.;’ see also Lemprière’s ‘Diseases of the Army in Jamaica,’ vol. ii.—Stockett, T. H., “An account of a Headache cured by the discharge of a Worm (?) from the Nose,” ‘Med. Com.,’ vol. xix, p. 157, 1794, and in ‘Trans. Coll. of Phys. Phil.,’ vol. i, part i, p. 181, 1793.—Stroop, St J., “Œstrus,” in ‘Amer. Naturalist,’ vol. vii, p. 437.—Tanner, “On Lice,” in his ‘Pract. of Med.,’ vol. ii, p. 429, 6th edit., 1869.—Westwood, in his ‘Classification of Insects,’ vol. ii, 1840.—Wohlfart (quoted by Moquin-Tandon).—Yule, “Case of Larvæ of Insects in the Human Stomach,” ‘Edin. Phil. Journ.,’ and ‘Lond. Med. Repos.,’ 1825.
SECTION IV.—Part VI.—Protozoa (Psorospermiæ, Gregarinidæ, &c.).
The scope of this work does not demand that I should comprise within its limits any vegetable parasites; nevertheless, I must needs refer, however briefly, to certain confervoid and sarcodic organisms, which, for the most part, lie on the borderland of the animal and vegetable kingdoms. Professor Cohn regards the bacteria as allied to the Oscillitoriaceæ. He puts them in his order Schizosporeæ. It is of little moment, practically, where these protista forms are placed. Unquestionably many of them are parasitic, as they live in the tissues, fluids, and secretions of animal bodies, including man. Their presence in cattle is associated with an anthracoid disease (charbon), whilst in the human body they have been detected in connection with zymotic affections. They have been found by Cohn, Sanderson, Klebs, Chauveau, and others, either in the lymph of vaccine pustules, or in the miliary eruptions of typhus fever. Professor Beale, who was one of the first to observe these special organic particles in vaccine lymph, denies that they are true Bacteria; and, indeed, he warmly disputes the inferences that have generally been drawn from the fact of the presence of such particles in lymph, blood, and other nutrient fluids. The best known and defined forms are Bacterium termo and Bact. lineola, which are concerned in the production of putrefaction, Bacillus anthracis, found in the blood of animals suffering from carbuncular disease, Micrococcus septicus, found in typhus and pyæmia, M. vaccinæ of cow pox lymph, and M. diphthericus, in diphtheria. As regards their prevalence in certain forms of relapsing fever, Sanderson states that Dr H. V. Carter, of Bombay, examined the blood of 250 fever patients and found spirilla in nearly every instance. From the independent observations of Pasteur, Sanderson, Lister, Tyndall, Bastian, Eberth, Roberts, Davaine, and many others, it seems clear that the Bacteria and their allies play an important part in association with certain morbid states. However, as regards the etiology of the maladies in which these organisms are found, it is perhaps too early to speak with absolute confidence. The subject cannot be dealt with here; moreover, it is outside the range of my personal investigations.
Passing to those protozoa which, although retaining some vegetable affinities, are more or less distinctively animal, I notice the obscure organisms termed psorosperms. In dealing with these I shall treat of the forms that infest both man and animals, confining my remarks to such as happen to have come under my own observation.