Age-Old Cures, Like the Maggot, Get U.S. Hearing

New York Times ^ | August 25, 2005 | Gardiner Harris

[infocats]

Flesh-eating maggots and bloodsucking leeches, long thought of as the tools of bygone medicine, have experienced a quiet renaissance among high-tech surgeons, and for two days beginning Thursday a federal board of medical advisers will discuss how to regulate them.

Leeches, it turns out, are particularly good at draining excess blood from surgically reattached or transplanted appendages. As microsurgeons tackle feats like reattaching hands, scalps and even faces, leeches have become indispensable.

And maggots clean festering wounds that fail to heal, as among diabetics, better than almost anything else, although their use in the United States has been slight, in part because of squeamishness.

But neither leeches nor maggots have ever been subject to thorough regulation by the Food and Drug Administration. So the medical advisers are being asked to create general guidelines about how they should be safely grown, transported and sold.

Since 1976, the F.D.A. has required that makers of medical devices prove that their products are safe and effective. Those already on the market as of that year had to prove their worth; those invented later had to get approval before marketing.

There are unexplored corners of the nation's medical market, however - no one knows how many, but they are certainly a vanishing few - in which doctors and manufacturers have been doing business since well before 1976 without much notice from the agency. The sale of maggots and leeches is one of those corners.

[looney tune]

Can you imagine waking up from surgery and seeing maggots all over the wound? That is too creepy!

[Pharmboy]

Back in medical school in the '70s, I worked at this state mental hospital. Because it was large, it had its own medical/surgical hospital on site. One night the nurses called me (practically screaming) because a patient's foot wound had "bugs crawling in it." It was infested with maggots.

I called the surgical resident on call at the medical center, and he said that they could be good for the wound. The nurses would not hear of it, so I asked him how to get rid of them. I was impressed when he knew the answer: place a 4x4 gauze pad over the wound and pour acetone on it. They curled up and died for easy removal.

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[SC DOC]

Not for the squeamish

YOU HAVE BEEN WARNED!

[aardvark1]

Take two maggots and call me in the morning.

[infocats]

Thanks for the Great Link. The V.A. and their sister organizations are often at the forefront of cutting edge therapies.

[stayathomemom]

My mother in law had maggot therapy after surgery on her toes about 10 years ago at U of M Hospital in Ann Arbor. It probably helped to save a couple of them. (Toes, that is.) She had a regular stream of hospital personnel coming in to her room to get a look. The creepiest part for her was when they became fully engorged, (about 4" long and 1" in diameter) they would fall of her foot and onto her bed. In the middle of the night, this was not fun!

[snowsislander]

For what it is worth, there is a company Biopharm (http://www.biopharm-leeches.com/) that has been in the leech business for a good while. Here is their FAQ about leeches:

Biopharm's Leech Facts Did You Know...?
1. There are 650 known species of leeches.
2. The largest leech discovered measured 18 inches.
3. About one fifth of leech species live in the sea where they feed on fish.
4. The leech has 32 brains - 31 more than a human.
5. The Hirudo leech lays its babies within a cocoon; whereas the Amazon leech carries its babies on its stomach - sometimes as many as 300.
Leech cocoons on moss	6. Not all leeches are bloodsuckers. Many are predators, which eat earthworms, etc.
	7. At Biopharm we mainly deal with three species:- HIRUDO MEDICINALIS European Medicinal Leech HIRUDINARIA MANILLENSIS Asian Medicinal Leech HAEMENTERIA GHILIANII Amazon Leech
	8. The Hirudo leech has three jaws with 100 teeth on each jaw - making 300 teeth in all.
9. The Amazon leech uses a different method of sucking blood. They insert a long proboscis into the victim as opposed to biting.
10. The bite of a leech is painless due to its own anaesthetic.
11. The Hirudo injects an anti-coagulant serum into the victim to prevent the blood clotting.
12. The leech will gorge itself until it has had its fill and then just fall off.
13. The leech will gorge itself up to five times its body weight.
	14. After the Hirudo leech drops off the wound it leaves will bleed, on average, for ten hours.
	15. The first leech was used in medicine about 1000 B.C., probably in ancient India.
	16. Wales was once one of the major leech collecting areas of Europe.
	17. People would stand in the lakes and pools dotted around the country and when the leech attached to their legs they would put them in baskets and sell them. Today the Hirudo leech is an endangered species.
	18. The original surgeons were barbers and they used leeches to cure anything from headaches to gout!
20. The barber pole is coloured now but originally barber - surgeons used to hang their bandages on a pole in front of the shop. Hence the red and white stripe of the pole.
21. HIRUDO MEDICINALIS is the leech mostly used in plastic and reconstructive surgery.
22. In plastic and reconstructive surgery BIOPHARM® LEECHES have helped to save the limbs of patients in 29 different countries.
	23. By extracting the anti-clotting serum from the leech researchers are isolating new pharmaceutical compounds for eventual treatment of heart diseases.
	24. The nervous system of the leech is very similar to the human nervous system and is of enormous benefit to researchers in their quest for the answers to human problems.
	25. The nearest relatives of leeches are earthworms.

Biopharm Copyright © 1996 - 2005

Most recent revision January 2005

[wolfcreek]

"The leech has 32 brains - 31 more than a human."

AND THEY STILL SUCK!

[SlowBoat407]

I CAN'T HEAR YOU, MAGGOTS!!!!!

[TomGuy]

But neither leeches nor maggots have ever been subject to thorough regulation by the Food and Drug Administration. So the medical advisers are being asked to create general guidelines about how they should be safely grown, transported and sold.

If something works, tax it and regulate it!!!!! [Gotta give the bureaucrats something to do with their time.]

It is amazing how many of the 'old remedies' and methods seem to return -- with renewed appreciation, because they work better than some of the 'modern remedies' and methods.

[American Vet Repairman]

"Can you imagine waking up from surgery and seeing maggots all over the wound?"

In a fresh surgical wound there most likely would be no need for maggots. On the other hand, many elderly patients that are diabetic and have hard to heal wounds would benefit greatly from this regimen.

[Drammach]

This same practice works well on the farm, too..

One of my sisters was raising vietnamese pot-belly pigs for a while, and they would occassionally get into "arguments"..

She was compaining about the maggots on the ears of one pig that had been bitten, and wondering how to get rid of them..
I had read about maggots somewhere eating only dead flesh, and how it was being used in Human medicine, so I suggested to her that she simply leave them alone..
She (and I) were amazed at how quickly the pig's wounds healed up..
They ate the dead flesh, but left the living tissue alone..
An additional "benefit" was that the pigs ate the maggots as they filled up and fell off the injured pig..

From then on, we left the maggots alone, and let them do their job..
( Just make sure it's an External wound they're working on..)

[Desdemona]

It is amazing how many of the 'old remedies' and methods seem to return -- with renewed appreciation, because they work better than some of the 'modern remedies' and methods.

My grandfather had horrible arthritis in his hands. They tried every drug on the market and the only thing that worked was daily parafin wax dipping and letting the heat seep to the hands for a half an hour.

[lastchance]

From what I have read leeches are very valuable in microsurgery. Also maggots that are used to clean out gangrene and/or other infected flesh are specially bred. We might remember that " all creatures great and small... the Lord God made them all" and put what He has made to the best use.

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"Biopharm"

Great resource. Thanks for posting.

[infocats]

"It is amazing how many of the 'old remedies' and methods seem to return -- with renewed appreciation, because they work better than some of the 'modern remedies' and methods."

I guess the more things change, the more they stay the same.