Latest / Stuff You Should Know / Maggots: Good For Healing Wounds, Turns Out
Transcript
- 0:01Speaker 1: Welcome to Stuff you should know from house stuff Works
- 0:05Speaker 1: dot com. Hey, and welcome to the podcast. I'm Josh Clark,
- 0:14Speaker 1: There's Charles w Chuck Bryant, and uh no one, no
- 0:18Speaker 1: one else is in here with us yet again, because
- 0:21Speaker 1: we've graduated to the point where we don't even need
- 0:23Speaker 1: a producer. We need somebody who presses record and leaves.
- 0:27Speaker 1: That's it. Because we're pros. Yep, not p R O
- 0:32Speaker 1: s E. P r O S that's right, we're not.
- 0:35Speaker 1: But we are prosaic, yes, but definitely not p r
- 0:38Speaker 1: O apostrophe es. Very few things drive me crazier than that,
- 0:41Speaker 1: And I know it's stupid and pedantic, but to see,
- 0:44Speaker 1: like somebody take out a huge billboard or something and
- 0:48Speaker 1: so a word has an apostrophe. That shouldn't pros. People say, like,
- 0:53Speaker 1: leave it to the pros and they'll put an apostrophe. Yes,
- 0:56Speaker 1: and it's it's that graphic designer should be, you know,
- 1:00Speaker 1: doctor half a day's paying maybe bucks. Something we want
- 1:05Speaker 1: to issue and you probably would get this from the
- 1:08Speaker 1: title of the episode, but we want to issue a
- 1:10Speaker 1: meal warning. Oh good thinking, because we've gotten complaints in
- 1:14Speaker 1: the past when people are eating and get sick listening
- 1:16Speaker 1: to some of these. Yeah, this would do it possibly
- 1:19Speaker 1: for some people. I was fine. I ate a running
- 1:23Speaker 1: yolk egg sandwich while I was right. It didn't bother me,
- 1:28Speaker 1: but I could totally see how it could be any people.
- 1:30Speaker 1: I also want to say, um, if it comes up,
- 1:33Speaker 1: do not go Google image search wound sloth. Well, I
- 1:38Speaker 1: just put do not Google image search maggot therapy at all. Okay, sure,
- 1:42Speaker 1: but definitely stay away from wound sloth s l o
- 1:46Speaker 1: U g h. Yeah wow, and definitely don't look at
- 1:52Speaker 1: wound slough while you're eating. Yeah. Okay, so that's all
- 1:56Speaker 1: out of the way. Yes, I predict we're going to
- 1:58Speaker 1: be kind of excited about this one. I'm feeling a
- 2:00Speaker 1: little pumped about it. Well, we did cover in uh
- 2:03Speaker 1: tin Bizarre medical Treatments uh leech therapy, which is still
- 2:08Speaker 1: being used, and I'm surprised this wasn't in that article.
- 2:10Speaker 1: To be honest, I am as well. But this gets
- 2:13Speaker 1: its own special deal, and well it should actually because
- 2:16Speaker 1: it's a pretty amazing thing. Um, we're talking about maggot therapy.
- 2:22Speaker 1: Yes it is so, or they really or is that
- 2:25Speaker 1: a name? Well, it's a band name. To end all
- 2:28Speaker 1: band names. There probably wasn a band name that. So
- 2:30Speaker 1: there's it's called maggot therapy, maggot dibridement therapy, larval therapy,
- 2:35Speaker 1: or bio. There's another one called I think like bio
- 2:41Speaker 1: biodebridements or therapeutic wound miasses. Yeah, and that's basically all
- 2:50Speaker 1: the all of them, no matter what you call it,
- 2:52Speaker 1: no matter how you church it up. It is the
- 2:55Speaker 1: application of live maggots fly larva to purposefully to an
- 3:01Speaker 1: open wound in order to help that wound heal faster. Yeah,
- 3:06Speaker 1: and better and cleaner and all that good stuff everything.
- 3:10Speaker 1: Daft Punk said, Oh yeah, you know, should we talk
- 3:15Speaker 1: about some of the history of this stuff. Let's just
- 3:18Speaker 1: say that one more time. Okay. Maggot de bridemant therapy
- 3:22Speaker 1: is taking live maggots and putting them in an open
- 3:26Speaker 1: wound on a human being or an animal. It's used
- 3:28Speaker 1: in veterinary medicine as well, wrapping it up tight and
- 3:32Speaker 1: letting them just eat the dead and dying flesh of
- 3:34Speaker 1: that wound while you get your foot tickled. Okay, I
- 3:39Speaker 1: would be so skiped out by this. I just wanted
- 3:41Speaker 1: to make sure that everybody knows exactly what we're talking about, right,
- 3:44Speaker 1: and goodbye to everyone everyone who fainted. Okay, yeah, let's
- 3:49Speaker 1: talk about the history, chuck, because this is um, this
- 3:51Speaker 1: is in use today, but it's actually pretty old. Yeah,
- 3:55Speaker 1: I mean it's it's some say it's an even an
- 3:57Speaker 1: ancient tradition like in place is like Burma in Central
- 4:01Speaker 1: America with the Mayans. Um, they were smart enough to
- 4:05Speaker 1: know that maggots do a pretty good job of consuming
- 4:08Speaker 1: human flesh. Uh, And it can be used for good
- 4:12Speaker 1: in that regard. Yeah, at some point, I guess healer's noticed,
- 4:15Speaker 1: like y, people who had maggots in their wounds tended
- 4:18Speaker 1: to have wounds heal Uh. And actually, as far as
- 4:21Speaker 1: the Western literature goes, that's exactly how UM maggot therapy
- 4:25Speaker 1: first finds its way, first crawls into the medical literature
- 4:31Speaker 1: is from a French surgeon named Ambro Ambras Pore. Yeah,
- 4:38Speaker 1: but how would you say, I don't know, I don't
- 4:40Speaker 1: speak French Ambras even though it doesn't have the little
- 4:45Speaker 1: what is that an accent? Yeah, it's just the e.
- 4:49Speaker 1: But he was a sixteenth century surgeon and he noticed that, um,
- 4:54Speaker 1: that people didn't necessarily fall over dead if there was
- 4:58Speaker 1: a maggot in the wound. Yeah. He was a first
- 5:00Speaker 1: doctor to actually come out and say, you know, I
- 5:03Speaker 1: had this patient got a big skull wound, and unbeknownst
- 5:07Speaker 1: to me, there were maggots in there. I saw them
- 5:09Speaker 1: crawling out one day and even though they had a
- 5:11Speaker 1: lot of bone. Um, the guy was great. He healed
- 5:15Speaker 1: like he lost a hand sized slab of skull and
- 5:19Speaker 1: he lived. And I think it might have something to
- 5:22Speaker 1: do with the maggots. Yeah, and he presumably wore a
- 5:24Speaker 1: helmet for the rest of his life. Probably he had
- 5:26Speaker 1: a probably big soft skull there. Uh. That was followed
- 5:31Speaker 1: in uh with the mid seventeen hundreds by another Frenchy baron,
- 5:37Speaker 1: Dominique Jean Laoie Uh, and he said, you know what,
- 5:43Speaker 1: on this Egyptian expedition, Uh, these blue fly maggots are
- 5:47Speaker 1: actually doing the right thing and helping us out. So
- 5:51Speaker 1: it's almost like these doctors just noticed this exactly and
- 5:55Speaker 1: it meant enough to him that they were like, I
- 5:57Speaker 1: should probably write this down. This is gonna be my
- 6:00Speaker 1: contribution to medical history of the history of science right there. Um.
- 6:05Speaker 1: So it wasn't until the uh, I guess the Civil
- 6:09Speaker 1: War that a doctor actually said I'm going to purposefully
- 6:12Speaker 1: put maggots in a wound and see what happens. And
- 6:16Speaker 1: that doctor was John Forney Zacharias. He probably didn't tell
- 6:19Speaker 1: his patient that. I think probably that he was just like,
- 6:22Speaker 1: just bite down on this brooms and look the other way.
- 6:25Speaker 1: Do you want to lose your foot or do you
- 6:26Speaker 1: want to try something really weird? Well, supposedly in studies
- 6:31Speaker 1: of people, modern patients who are offered this therapy say
- 6:34Speaker 1: yes to it. Well, yeah, because I think that's what
- 6:36Speaker 1: it comes down to you. It's a last resort. Basically,
- 6:39Speaker 1: it's not the first thing they offer, not necessarily. Um So, anyway,
- 6:43Speaker 1: doctor Zacharias um Hey had a great quote. He said,
- 6:47Speaker 1: during my service in the hospital at Danville, Virginia, I
- 6:50Speaker 1: first used maggots to remove the decayed tissue in Hospital
- 6:54Speaker 1: Gang Green, and with my eminent satisfaction, in a single day,
- 6:58Speaker 1: they would clean a wound much better than any agents
- 7:00Speaker 1: we had at our command. I used them afterwards at
- 7:03Speaker 1: various places. I am sure I saved many lives by
- 7:05Speaker 1: their use escape septicemia and had rapid recoveries period. End quote.
- 7:11Speaker 1: Pretty great. Yeah, So he was a huge believer and
- 7:14Speaker 1: not just a passive observer like people who came before him.
- 7:17Speaker 1: He said, yeah, I put maggots on wounds and it helps,
- 7:20Speaker 1: that's right. And uh, people experimented with it for a
- 7:23Speaker 1: little while until um, a guy named Louis Pasteur and
- 7:27Speaker 1: Robert Coke came along, Uh, microbiologists and germ theorists that
- 7:32Speaker 1: basically said, you know this, this is disgusting. We might
- 7:37Speaker 1: want to not do this. Yeah, because they're dirty. Yeah, yeah,
- 7:40Speaker 1: And it's true maggots naturally in the wild carry lots
- 7:44Speaker 1: of pathogens with them that um can infect us in
- 7:47Speaker 1: other ways, can make a wound worse, can actually kill you.
- 7:50Speaker 1: So this the idea behind germ theory as far as
- 7:52Speaker 1: maggots goes right. But um, it seems like there's this
- 7:58Speaker 1: long history of necessity and discussed with maggot therapy that
- 8:03Speaker 1: kind of wayne ebbs and flows right, and necessity rears
- 8:07Speaker 1: its head on the battlefield. It did in the Civil War,
- 8:09Speaker 1: and it also did in World War One. There was
- 8:12Speaker 1: a surgeon um named William S. Baer, and he was
- 8:16Speaker 1: working on the front lines in France, and he used
- 8:19Speaker 1: maggots on stomach wounds and open fractures and he found,
- 8:24Speaker 1: to his great satisfaction, just like Dr Zacharias and the
- 8:27Speaker 1: other before him, that this stuff actually worked. Yeah, and
- 8:30Speaker 1: he actually said, you know what, I have some further advancements. UM,
- 8:34Speaker 1: maybe we should put a bandage over this thing so
- 8:37Speaker 1: it doesn't completely discussed the patient. Uh, and let me
- 8:41Speaker 1: UM put bandages around the wound so they don't start
- 8:46Speaker 1: creeping onto the healthy flesh and doing damage or just
- 8:49Speaker 1: itching you or creeping you out further right exactly, UM,
- 8:52Speaker 1: which are still in use today. These techniques. He also
- 8:55Speaker 1: pioneered another huge technique, and this is after the war
- 8:58Speaker 1: was over. Ten years later, when he was back at
- 9:01Speaker 1: Johns Hopkins UM. He he pioneered another really important technique,
- 9:05Speaker 1: and that was using sterilized UM maggots. Like germ free maggots,
- 9:10Speaker 1: they were raised as eggs in a sterile environment, and
- 9:14Speaker 1: so when they were introduced to the wounds, they weren't
- 9:16Speaker 1: carrying these pathogens anymore. And he found this is the jackpot.
- 9:21Speaker 1: Now you can use maggots from now on. That's right.
- 9:24Speaker 1: And there was a big boom uh in the thirties
- 9:26Speaker 1: up until the mid nineteen forties. Uh, three hundred more
- 9:30Speaker 1: than three hundred American hospitals. Uh, we're using maggot treatment,
- 9:34Speaker 1: maggot therapy. And then in uh, antiseptics came along, or
- 9:40Speaker 1: you know, new antiseptics, and they said, you know what,
- 9:42Speaker 1: maybe there was another lull in the use of maggot.
- 9:44Speaker 1: They right, necessity didn't didn't spur this stuff, and it
- 9:48Speaker 1: was they went back to just being gross again. There
- 9:50Speaker 1: was a guy UM who by the eighties wrote what
- 9:53Speaker 1: what this one article calls the majority opinion. Fortunately, maggot
- 9:57Speaker 1: therapy is now relegated to a historical backwater of interest,
- 10:01Speaker 1: more for its bizarre nature than its effect on the
- 10:03Speaker 1: course of medical science. A therapy the demise of which
- 10:06Speaker 1: no one is likely to mourn. That's just that kind
- 10:10Speaker 1: of Western medicine hubris, where like we can do anything
- 10:14Speaker 1: except everything, you know, that's right. And in the nineteen nineties,
- 10:21Speaker 1: UM a dude named Ronald Sherman and Edward Pector basically
- 10:26Speaker 1: champion the technique again and kind of brought it into
- 10:31Speaker 1: the modern age. Yeah, and still very much is UM.
- 10:34Speaker 1: Ronald Sherman is one of the first, i think, to
- 10:38Speaker 1: receive a license to produce sterile maggots for use as
- 10:43Speaker 1: medical devices. Um. And there's another guy over in uh
- 10:48Speaker 1: the UK named John Church um who uh who brought
- 10:53Speaker 1: the maggot their maggot therapy into the four So it
- 10:58Speaker 1: was an ancient thing, it was. It's found to be disgusting,
- 11:02Speaker 1: it's found to be useful, it's found to be disgusting.
- 11:04Speaker 1: It's it's found ways you can make it better. It's
- 11:08Speaker 1: found to be disgusting. And then now that this idea
- 11:11Speaker 1: of complimentary medicine is is kind of regaining some traction again. Um,
- 11:16Speaker 1: I think it's here to stay, though I think so too,
- 11:19Speaker 1: unless someone comes along in ten years is you know
- 11:21Speaker 1: what it's disgusting, well, you know the chuck. I mean
- 11:24Speaker 1: probably what we're seeing is the next thing that will
- 11:26Speaker 1: happen is there will be some huge leap, some huge
- 11:28Speaker 1: development in science, and science will get its tackles up
- 11:31Speaker 1: again and great about itself and we don't need any
- 11:34Speaker 1: of that stupid nastiness. And then we'll find that Nope,
- 11:38Speaker 1: you still can't beat good old fashioned maggots. And that's
- 11:41Speaker 1: that should be the title of this thing. You can't
- 11:43Speaker 1: beat good old fashioned maggots for healing a wound that
- 11:46Speaker 1: won't heal otherwise it's a great title. So you want
- 11:49Speaker 1: to take a break. Uh, yeah, let's do it, and
- 11:51Speaker 1: we'll go um treat our own wounds and we'll be
- 11:54Speaker 1: back shortly. All right, Let's talk about diabetes for a second. Yeah,
- 12:29Speaker 1: more than twenty three million Americans are affected with diabetes.
- 12:34Speaker 1: And one thing that can happen, uh is nerve damage,
- 12:38Speaker 1: especially in the extremities the hands and feet and the
- 12:41Speaker 1: toes and the and the fingers. Your blood vessels become
- 12:45Speaker 1: hard and they don't circulate the blood like you need.
- 12:48Speaker 1: That can lead to open sores called ulcers, which can
- 12:52Speaker 1: become infections, which can spread to nearby bone, which can
- 12:55Speaker 1: lead to amputation. Yeah. It all this is just from
- 12:59Speaker 1: a long exposure to high levels of blood sugar and
- 13:02Speaker 1: they're not sure how it can do it. But yeah,
- 13:04Speaker 1: the blood, the blood vessels not helping pump blood very well,
- 13:08Speaker 1: get nutrients, or your tissue can die. But also that neuropathy,
- 13:11Speaker 1: that dead and nerve cell um that actually makes it
- 13:15Speaker 1: hard for you to notice. If you have like a
- 13:18Speaker 1: really bad ulcer on the bottom of your foot, you
- 13:21Speaker 1: can't feel it and so you don't get treatment early enough,
- 13:23Speaker 1: so it can get an infection can get out of
- 13:25Speaker 1: hand and when it spreads to bone that's called osteomyelitis.
- 13:30Speaker 1: That's problematic because that very quickly will lead to an amputation.
- 13:34Speaker 1: And there's some pretty shocking stats here from this article
- 13:38Speaker 1: that Tom wrote. Um about this sheave jam Yeah nice,
- 13:42Speaker 1: it's yeah for sure, Um. But about amputations from diabetes. Yes,
- 13:47Speaker 1: seventy thousand to foot and leg amputations each year in
- 13:51Speaker 1: the United States alone, and uh they say around the world,
- 13:55Speaker 1: they estimate every thirty seconds someone gets a limb cut
- 13:58Speaker 1: off because of diabetes. Yeah, that's sad, Yeah, it really is,
- 14:02Speaker 1: and we should We will do one on diabetes for sure.
- 14:05Speaker 1: Oh yeah, I'm surprised we haven't already. Um. But the
- 14:09Speaker 1: so amputation is used to halt the progress of an infection,
- 14:17Speaker 1: and that's usually the last resort. But what's what Tom
- 14:20Speaker 1: points out is that there are plenty of doctors around
- 14:23Speaker 1: the world I imagine that aren't aware that you can
- 14:27Speaker 1: use maggots or have never done it before. And if
- 14:30Speaker 1: you are facing an amputation from say like a wound,
- 14:34Speaker 1: a persistent wound, a chronic wound that won't heal, um,
- 14:37Speaker 1: you may want to suggest maggots to your doctor. You
- 14:40Speaker 1: may have to actually take this the the initiative on
- 14:43Speaker 1: this one, and say, let's make sure the amputation is
- 14:47Speaker 1: the absolute last resort. Let's see if we can put
- 14:49Speaker 1: one more resort in there before then. I'm willing to
- 14:51Speaker 1: let maggots crawl inside my body in this wound is
- 14:54Speaker 1: open wound if you're willing to apply them. And they like.
- 15:00Speaker 1: Doctors love hearing when patients suggest treatments. Oh, they do.
- 15:04Speaker 1: They love feedback. They love to be guided in their
- 15:07Speaker 1: diagnoses and prognoses. Yeah, I love it. That's a tough jam.
- 15:11Speaker 1: I get it. Doctors are frustrated a lot of these
- 15:13Speaker 1: days with self diagnosis and online doctoring. Sure, but you
- 15:17Speaker 1: should also be your own advocate. We can't be in
- 15:19Speaker 1: that before. Yeah, it's your leg. Yeah, if you want
- 15:22Speaker 1: to keep your leg, you tell that doctor to go
- 15:24Speaker 1: get some maggots. You're going to replace them with the
- 15:26Speaker 1: doctor who will. How can I can find a guy? Yeah,
- 15:29Speaker 1: I can get a guy by noon that'll put maggots
- 15:31Speaker 1: on that wound. And actually there's a there's a group.
- 15:33Speaker 1: I think Ronald Sherman, the guy we mentioned earlier, who's
- 15:36Speaker 1: like the the US champion of maggot therapy. Um, it's
- 15:41Speaker 1: there's this group called the b Turf Foundation b t
- 15:44Speaker 1: e Er Foundation, UM, and they have all sorts of
- 15:48Speaker 1: resources for people in that very situation, like how to
- 15:52Speaker 1: talk to your doctor, UM that if your insurance won't
- 15:56Speaker 1: cover it, let them know, because they say insurance actually
- 15:59Speaker 1: most insurance covers maggot therapy, but most insurance claims people
- 16:04Speaker 1: are not aware of that, so you may get denied
- 16:06Speaker 1: at first. And here's how to talk to your insurance
- 16:09Speaker 1: company that it really is. That beats going to your
- 16:12Speaker 1: doctor and saying, well, you know what Josh and Chuck said.
- 16:15Speaker 1: He you're not gonna like hearing this, right because you think, doctor,
- 16:19Speaker 1: please take a sleep and be put maggots on my feet, right.
- 16:23Speaker 1: And and that's the other thing too. I mean, like
- 16:25Speaker 1: we wouldn't be suggesting this and the betur Foundation probably
- 16:29Speaker 1: wouldn't be such advocates for it if it didn't work
- 16:32Speaker 1: so amazingly well. It study after study, and we'll talk
- 16:38Speaker 1: about the details of it, but there's so many studies
- 16:40Speaker 1: out there. UM. Again. Sherman, who agreed, is an advocate,
- 16:45Speaker 1: but in a pure reviewed journal published a survey of
- 16:47Speaker 1: studies that he could find on maggot therapy and it's
- 16:51Speaker 1: very clear that it works really, really well, and not
- 16:55Speaker 1: only necessarily um as a means of last resort, but
- 16:59Speaker 1: even just compare to the standard of care using like
- 17:03Speaker 1: hydrogell or other things that you might use to treat
- 17:05Speaker 1: a chronic wound. Maggots destroy it. They leave it in
- 17:08Speaker 1: the dust. Yeah. And if it doesn't work, it's not
- 17:11Speaker 1: gonna hurt anything, I can tell. Yeah, it just puts
- 17:14Speaker 1: off how much longer before they amputate your foot? Pretty much?
- 17:18Speaker 1: Uh So what will happen is they will Well, let's
- 17:21Speaker 1: get into this a little bit. Um. There are four
- 17:24Speaker 1: different and you where did you find this? Was this
- 17:26Speaker 1: a a research paper? Yeah? This is by Ronald Sherman
- 17:31Speaker 1: Mechanisms of Maggot Induced Wound Healing colin What do we
- 17:34Speaker 1: know and where do we go from here? It was
- 17:36Speaker 1: in the journal Evidence Based, Complimentary and Alternative Medicine in
- 17:40Speaker 1: two thousand fourteen, that's right. And he describes for different
- 17:44Speaker 1: phases of basically healing a wound um homeostasis, inflammation, ploriferate. Man,
- 17:51Speaker 1: I'm so bad at that one. Oh yeah, keep it coming,
- 17:55Speaker 1: proliferation and uh, remodeling and maturing, and what happens is
- 18:01Speaker 1: the cells get to work, they recruit other cells, they
- 18:04Speaker 1: alter their activities and basically say, let's get to work
- 18:07Speaker 1: cleaning and uh, well on all four of these stages
- 18:14Speaker 1: to help heal the wound. Yeah, and at any any
- 18:16Speaker 1: one of those stages, um, the the next process can
- 18:20Speaker 1: stall out. Um. Normally it stalls out at inflammation because
- 18:25Speaker 1: the infection gets out of hand in the body can't
- 18:28Speaker 1: fight off the infection faster than it's laying the extra
- 18:32Speaker 1: cellular matrix for the new cells to be rebuilt, the
- 18:36Speaker 1: new tissue to recro um. And that's that's it's a
- 18:39Speaker 1: common thing that leads to chronic wounds that just won't heal.
- 18:43Speaker 1: And that's where maggots are really really useful to basically
- 18:46Speaker 1: interrupt that stall and get the car moving again in
- 18:50Speaker 1: the right direction. It's exactly right, they kick started. Uh
- 18:53Speaker 1: So de Bradmant is removing dead tissue. And that is
- 18:57Speaker 1: really where maggots excel um. They said, Uh, in here,
- 19:01Speaker 1: each maggot can chew, well, they don't exactly chew, which
- 19:04Speaker 1: we'll get to. Uh. They remove twenty five milligrams of
- 19:08Speaker 1: necrotic material dead flesh, uh in just twenty four hours.
- 19:12Speaker 1: That's pretty good. Yeah, and uh, there's there's actually three
- 19:16Speaker 1: ways that maggots clean a wound. But the bridemant, which
- 19:19Speaker 1: is getting in there and like just cleaning out, removing
- 19:22Speaker 1: physically removing um that dead material. That's like the key
- 19:27Speaker 1: that seems to be the key. And then there's also
- 19:30Speaker 1: um anti microbial activity like actually killing the bacteria that's
- 19:34Speaker 1: killing the flesh, leaving it cleaner than when they came in, yeah,
- 19:37Speaker 1: which is amazing. And then even more astounding, stimulating new growth,
- 19:44Speaker 1: like the act the presence of maggots in your wound
- 19:48Speaker 1: stimulates new tissue growth around your skin. It's the most
- 19:52Speaker 1: they're just like wonder creatures who knew. One of the
- 19:57Speaker 1: ways that they remove this dead tissue is just by
- 20:01Speaker 1: the nature of what their body is like. And they
- 20:05Speaker 1: have these little prickly spines all over their body that
- 20:09Speaker 1: act as a surgeon's rasp rasper or file what It
- 20:13Speaker 1: basically just the fact that they're moving around on the
- 20:15Speaker 1: wound is going to like file the stuff down and
- 20:19Speaker 1: scrape the wound, which helps loosens it up. It's like
- 20:22Speaker 1: a plow. It burrows through this dying and dead tissue
- 20:26Speaker 1: and it just yeah, it loosens up. That's part one
- 20:28Speaker 1: of deprived Part one. There's another part of it, which
- 20:32Speaker 1: is the digestive enzymes that they excrete and secrete. It's
- 20:36Speaker 1: called alimentary secretions and excretions a s. It's basically they're
- 20:40Speaker 1: digestive juices, right, and they puke these up as they're
- 20:44Speaker 1: moving around, and they just they just puke them everywhere
- 20:48Speaker 1: and it dissolves this flesh. Yeah, I remember in the
- 20:51Speaker 1: Body Farms episode we we talked about this one one
- 20:54Speaker 1: of the old classics. And that's why I said earlier.
- 20:57Speaker 1: They don't bite or choose something, they just lickquify it.
- 21:00Speaker 1: And then and this this A s. C. Stuff is
- 21:03Speaker 1: so greedy that it liquefies more dead flesh than the
- 21:07Speaker 1: maggots can even consume, and they consume quite a bit,
- 21:11Speaker 1: like you said, twenty five milligrams. That's a lot for
- 21:14Speaker 1: a little tiny maggot in one day. But even more
- 21:17Speaker 1: than that, they're liquefying even more of this dead tissue.
- 21:20Speaker 1: So that part of the process of maggot debridemant therapy
- 21:24Speaker 1: is draining out this liquefied necrotic tissue that's become liquefied
- 21:30Speaker 1: from the alimentary or the the A S C stuff,
- 21:34Speaker 1: the digest events ons, right, So you've got them burrowing around,
- 21:38Speaker 1: you've got them puking into your wound, liquefying the dead tissue,
- 21:43Speaker 1: leaving pretty much entirely the living tissue alone, and then
- 21:48Speaker 1: you just kind of drain out the stuff that's that's
- 21:52Speaker 1: in there. And the reason um that maggots are considered
- 21:55Speaker 1: by the FDA a medical device rather than a drug
- 21:59Speaker 1: is because the whole process of debridement isn't just a
- 22:03Speaker 1: reaction to the chemicals. It is part of that mechanical
- 22:06Speaker 1: movement of the maggots through the wound. So it's a drug,
- 22:10Speaker 1: it's a device. I mean it's a device. Look at them, yea.
- 22:15Speaker 1: And those that the secretions are so potent. They have
- 22:20Speaker 1: basically DNA destroying qualities, Like they not only just break
- 22:25Speaker 1: down tissue, they destroy the DNA. It's pretty amazing stuff
- 22:30Speaker 1: it is. Should we take another break? Yeah, I'm a
- 22:33Speaker 1: little excited. We probably should. I'm gonna go to the vomitorium.
- 22:37Speaker 1: Are you grossed out slightly? I am not in the least.
- 22:41Speaker 1: What does that say about me? I don't know. You
- 22:45Speaker 1: have a stronger stomach, but I don't necessarily. I'm I'm
- 22:48Speaker 1: just excited. All right, we'll go watch me vomited. At
- 22:50Speaker 1: least that will gross me out, all right, Well that
- 23:13Speaker 1: was disgusting, it was. It made me throw up in turn. Uh.
- 23:17Speaker 1: So here's a couple of questions. Um, does it hurt
- 23:24Speaker 1: Maybe a little bit at first. Yeah, I don't get
- 23:26Speaker 1: the feeling that it's extremely painful. It probably depends on
- 23:29Speaker 1: the wound. Um, But it can the first few treatments
- 23:33Speaker 1: can apparently be a little bit painful. Right, And there's
- 23:35Speaker 1: there's actually two mechanisms for the pain. One is that
- 23:39Speaker 1: of an open wound, right, and you have maggots crawling
- 23:42Speaker 1: over the exposed nerves in your open wound. That's not
- 23:44Speaker 1: gonna feel good, No, it won't. Uh. And then number two,
- 23:48Speaker 1: pressure in the wound can increase as the maggots get
- 23:50Speaker 1: bigger from eating so much dead flesh. So, yes, the
- 23:55Speaker 1: the the cura to that is pain killers, which, frankly,
- 23:58Speaker 1: if you have an open wound with exposed is nerves,
- 24:00Speaker 1: you should probably be on those anyway. Sure you will be,
- 24:03Speaker 1: so it probably won't hurt because there'll be some sort
- 24:06Speaker 1: of pain management going on, but you will still feel
- 24:10Speaker 1: most likely unless the doctor completely numbs the area. Maggots
- 24:14Speaker 1: crawling around inside you see, That's what That's the part
- 24:17Speaker 1: that gets me is actually thinking about undergoing this therapy
- 24:21Speaker 1: myself is what gets me, not like seeing it or
- 24:24Speaker 1: reading about it, but thinking about having an open wound
- 24:27Speaker 1: on the bottom of my foot and having maggots creeping
- 24:29Speaker 1: around in there. See. The thing is is I think
- 24:32Speaker 1: anybody would feel that way. There's very few, included myself.
- 24:35Speaker 1: I'm not grossed up by this, but I wouldn't want
- 24:37Speaker 1: maggots talking wound. But I think if your backs against
- 24:40Speaker 1: the wall, uh that, or you lose your foot, I try.
- 24:44Speaker 1: I would definitely try. I think people would apparently man
- 24:48Speaker 1: and I would demand some high quality drugs. And they
- 24:52Speaker 1: also have um, what is it called amnesiotics to make
- 24:57Speaker 1: you forget about it so you can't form memor while
- 25:00Speaker 1: it's happening. So maybe that would be a nice thing
- 25:02Speaker 1: to do too. So the other question is can you
- 25:04Speaker 1: just use any kind of maggot And the answer is no.
- 25:08Speaker 1: What they found is the most useful is the larva
- 25:11Speaker 1: of the green blowfly. And like we said earlier, these
- 25:14Speaker 1: things are now grown just sort of like the medical
- 25:17Speaker 1: leeches there shipped and sterile containers. Uh, as if it
- 25:21Speaker 1: were medicine, even though it's a device and the B
- 25:24Speaker 1: T E R. Foundation. They go into a lot about this,
- 25:28Speaker 1: like could anybody do this? And they say, well, no,
- 25:31Speaker 1: because you need a prescription. It's an FDA control yourself.
- 25:35Speaker 1: But they say, anybody who can read can basically follow
- 25:40Speaker 1: the instructions on the package. Yeah, I wouldn't. I mean,
- 25:44Speaker 1: I wouldn't advise that as your nondoctor. Sure, I'm not
- 25:47Speaker 1: saying that either, but I mean this may be your
- 25:49Speaker 1: doctor's first time too. There. Their point was, it's not
- 25:53Speaker 1: it's not difficult, just follow the instructions on the packet.
- 25:56Speaker 1: What if you went into your doctor though he got
- 25:58Speaker 1: the maggots out and he put on his bifocals, was like,
- 26:01Speaker 1: all right, let's see how to do this right, or
- 26:03Speaker 1: like he tears the package open. They go everywhere you
- 26:06Speaker 1: have like Jerry Lewis as a doctor. Uh oh. But
- 26:10Speaker 1: although they do say, um, you can't just load it
- 26:13Speaker 1: up with maggots. There should be no more than eight
- 26:15Speaker 1: maggots per square centimeter. Yeah, I saw five to eight.
- 26:18Speaker 1: And so when you have the maggots applied to your
- 26:22Speaker 1: UM wound. They're going to make sure that the healthy
- 26:26Speaker 1: area around the wound is covered up so the maggots
- 26:29Speaker 1: can't get to it, which goes back to World War Two.
- 26:32Speaker 1: They're going to cover it, cover up the wound after
- 26:34Speaker 1: they apply the maggots five to eight per square centimeter,
- 26:37Speaker 1: like you say, they're gonna cover it up so they
- 26:39Speaker 1: can't wander off because maggots like to leave before their
- 26:42Speaker 1: work is done. Um TV. They're full pretty much, UM,
- 26:47Speaker 1: but they can still eat more if you'll keep them
- 26:50Speaker 1: in there, so they will cover up. They will put
- 26:53Speaker 1: the maggots in five to eight, cover it up with
- 26:55Speaker 1: this bandage and basically they will just sit there and
- 26:58Speaker 1: eat for between forty eight and seventy two hours, and
- 27:03Speaker 1: then the bandage will be removed. The maggots will then
- 27:06Speaker 1: sadly be incinerated or put into an autoclave or put
- 27:12Speaker 1: into a plasma gas of fire, or bronzed and hung
- 27:16Speaker 1: on your wall for real, like an ant farm. Yeah,
- 27:19Speaker 1: because it's like, thank you for this great contribution to
- 27:22Speaker 1: saving my foot, Now go be autoclave today. I would
- 27:26Speaker 1: name them and save them and preserve them. Um, you'd
- 27:31Speaker 1: be violating, I'm sure all sorts of medical waste laws,
- 27:34Speaker 1: but who cares and so and then that's that's what's
- 27:37Speaker 1: called the treatment cycle, and most patients UH supposedly go
- 27:41Speaker 1: between two and four treatment cycles. And again, while this
- 27:46Speaker 1: is happening, what's going on is the maggots are debriding
- 27:49Speaker 1: the dead flesh, they're liquefying it, they're eating it, and
- 27:53Speaker 1: they're also disinfecting it and stimulating growth. Right, pretty amazing.
- 27:57Speaker 1: So with the with this, with the disinfecting, figured that
- 28:01Speaker 1: there was some sort of gut flora that the maggots
- 28:05Speaker 1: have that prevents them from being infected by microbial That
- 28:09Speaker 1: would make sense because they're in that rotting flesh as well,
- 28:11Speaker 1: and they're right, So what gives Well, it turns out
- 28:15Speaker 1: that there are a couple of um types of I'm
- 28:19Speaker 1: not quite sure what what kind of um bacteria they are,
- 28:23Speaker 1: but they are. That's not true. The proteus mirabilious is
- 28:28Speaker 1: a type of symbiotic microbe that you find in the
- 28:31Speaker 1: gut of a maggot, right, And this thing just destroys
- 28:35Speaker 1: microbial life. So it's killing the bacteria that's causing this
- 28:39Speaker 1: infection in your wound. But there's something that that maggots.
- 28:43Speaker 1: This is yet another thing. So think about it, Chuck,
- 28:45Speaker 1: Like you said, maggots, the very structure of a maggot
- 28:48Speaker 1: body dibrides the wound. That's pretty amazing. This maggot anti
- 28:53Speaker 1: microbial stuff not only does it kill microbes, it destroys
- 28:57Speaker 1: the thing that naturally protects microbes, which called biofilm. Yeah,
- 29:01Speaker 1: we've talked about biofilm a lot on this show, and um,
- 29:04Speaker 1: it's basically it's basically a film, like a literal film,
- 29:09Speaker 1: like a They call it a polymeric matrix. But the
- 29:12Speaker 1: easiest way to say in Leyman's Terman is it's a film, right,
- 29:15Speaker 1: It's like a protective coding. Yeah, and the little spiny bodies,
- 29:18Speaker 1: like one way they get rid of the thing is
- 29:20Speaker 1: by roughing it up, And that's exactly what the little
- 29:22Speaker 1: bodies do, right, And that's part of surgical derived mint
- 29:25Speaker 1: with like um, like going in there and scrubbing a wound,
- 29:29Speaker 1: um with I don't know, steel wool or something like
- 29:32Speaker 1: that that will break up the biofilm. It's also must
- 29:35Speaker 1: be awfully painful, right. Maggots naturally can destroy not just
- 29:40Speaker 1: the bacteria, but also the biofilm that protects it too.
- 29:43Speaker 1: Which makes them extremely handy with things like MERSA and
- 29:47Speaker 1: other antibiotic resistant um bacteria and all kinds of ulcers, right,
- 29:54Speaker 1: not like internal ulcers, but the open wound kind right
- 29:56Speaker 1: exactly from diabetes, from bed sore um. And there's been
- 30:01Speaker 1: a lot of studies of people with bedstors that have
- 30:03Speaker 1: found that maggots helped those kind of ulcers tremendously. So, uh,
- 30:07Speaker 1: let's talk about this one study or a couple of studies. Actually, UM,
- 30:11Speaker 1: there was one study of spinal cord injury patients that
- 30:14Speaker 1: had non healing ulcers, which is the problem. They monitored
- 30:19Speaker 1: them over three to four weeks UM, and they were
- 30:22Speaker 1: getting regular wound care at the same time, like sometimes
- 30:24Speaker 1: it's used in conjunction, I think usually is used in
- 30:27Speaker 1: conjunction with like standard care. Uh. And they found that, uh,
- 30:33Speaker 1: after three or four weeks of maggot therapy, tissue quality
- 30:35Speaker 1: and wound size were ressessed weekly, and they found that
- 30:39Speaker 1: debridement was achieved in less than fourteen days an average
- 30:42Speaker 1: of ten days, and none of the control group wounds
- 30:45Speaker 1: were more than fifty dibrided after a month. A month
- 30:49Speaker 1: not even half dibrided. None of the wounds not half
- 30:52Speaker 1: the wounds were divided. None of the wounds were even
- 30:55Speaker 1: half dibrided after a month, chuck of the control group, Yes,
- 30:58Speaker 1: amazing where they didn't use the mag gets that. Yes,
- 31:01Speaker 1: that's that's objectively amazing it is. And then they did
- 31:05Speaker 1: a larger clinical trial and found UH. This time they
- 31:09Speaker 1: got two hundred and sixty three subjects, which is pretty
- 31:11Speaker 1: good for this kind of rare treatment for UH. And
- 31:14Speaker 1: they found that um using the hydrogel which you mentioned earlier,
- 31:18Speaker 1: compression dressings, just the standard care. That was the control. Yeah,
- 31:24Speaker 1: that's obviously the control they um. It differed significantly between
- 31:27Speaker 1: the three groups. Um, what was the third group? The
- 31:30Speaker 1: third group used bio bags, which are like it's like
- 31:33Speaker 1: a little pouch. You said, it was like a rav
- 31:35Speaker 1: healthy Yeah, and it's filled with live maggots, but it
- 31:38Speaker 1: prevents them from burrowing. All it is is using their
- 31:41Speaker 1: chemical secretions. Yeah, I don't That to me is just
- 31:44Speaker 1: like why go halfway? Right? Exactly? Well, people, I don't
- 31:48Speaker 1: want a maggot crawling in my wound, but a bag
- 31:51Speaker 1: of them is fine doing the shake shake near my wound. Right. So, um,
- 31:55Speaker 1: it actually has been shown to be not nearly as
- 31:58Speaker 1: effective as just letting what's called free range maggots burrow
- 32:02Speaker 1: through the wound. So they found the media time for
- 32:04Speaker 1: debryment was fourteen days with free range, twenty eight days
- 32:08Speaker 1: with the bag ravioli, and seventy two days for the control. Yeah,
- 32:13Speaker 1: that's pretty amazing. Yeah, Like I I don't know, I
- 32:16Speaker 1: don't think it should be a last resort. You know,
- 32:20Speaker 1: I agree, and I think that increasingly it's becoming less
- 32:23Speaker 1: and less of the last resort, because I mean, you
- 32:25Speaker 1: can compare it to the control, Like the standard of
- 32:28Speaker 1: care took seventy two days for the wound to be divided,
- 32:32Speaker 1: free range maggots fourteen days. That to me says that
- 32:35Speaker 1: free range maggots top the standard of care as it
- 32:38Speaker 1: stands right now. But like you say, there's a lot
- 32:41Speaker 1: of people who are saying, this is just a last resort.
- 32:44Speaker 1: The next thing we're gonna do is amputate your foot.
- 32:46Speaker 1: But let's try this one last time. Or in the
- 32:48Speaker 1: case of persistent infections from like MERSA, where just antibiotics
- 32:53Speaker 1: just don't work, let's let's try maggots and see if
- 32:57Speaker 1: we can fix it. And maggots do work. There was
- 32:59Speaker 1: a study that found that of thirteen people treated who
- 33:03Speaker 1: had Merca treated with maggots alone. Twelve of the thirteen
- 33:08Speaker 1: had complete recovery and wound healing um from a mercer infection.
- 33:14Speaker 1: Mercy's nasty stuff too. Yeah, I think did we do
- 33:16Speaker 1: what I'm merca? I feel like we did. I know
- 33:20Speaker 1: we've talked about it. I don't know if it got
- 33:21Speaker 1: its own show, though it may have been in the
- 33:23Speaker 1: should we outlaw anti bacterial Soap episode? Well there's been
- 33:28Speaker 1: a lot of them, almost eight hundred. Uh you got
- 33:32Speaker 1: anything else? Surely I do, but I guess not. Um.
- 33:42Speaker 1: Oh yeah, Well, there's one other thing we kept kind
- 33:44Speaker 1: of teasing it. It actually stimulates growth. A couple of
- 33:49Speaker 1: studies have found that the presence of maggots um produce
- 33:54Speaker 1: more blood vessel redevelopment and tissue redevelopment than it's not
- 34:00Speaker 1: being present. So something about them actually stimulates tissue growth
- 34:05Speaker 1: and blood vessel growth, which promotes wound healing even more.
- 34:09Speaker 1: Up with maggots. Up with maggots indeed, Man, I love them.
- 34:12Speaker 1: I'm so psyched about maggots right now. Well, it definitely
- 34:15Speaker 1: changes the way you think about them, Like next time
- 34:17Speaker 1: you see a the dead squirrel that you've killed. They're
- 34:22Speaker 1: clearly trying to bring it back to life. Yeah, and
- 34:24Speaker 1: you see the maggots you can. You don't think that's disgusting.
- 34:26Speaker 1: You just think those are little things doing their thing,
- 34:30Speaker 1: doing their thing. Little things doing their thing. Now I'm
- 34:32Speaker 1: going to auto clay them. That's right. If you want
- 34:35Speaker 1: to know more about maggot therapy, you can type those
- 34:38Speaker 1: words in the search bar at how stuff forks dot com.
- 34:41Speaker 1: And since i said search parts, time forward listener, I'm
- 34:47Speaker 1: gonna call this taking the task somewhat over a term. Guys,
- 34:52Speaker 1: I want to say you are my favorite podcast by far.
- 34:55Speaker 1: I've been listening since you were just a little five
- 34:58Speaker 1: minute blurbs. Oh man, you sure have grown up. I've
- 35:01Speaker 1: never written in before, but felt I had to comment
- 35:03Speaker 1: on Josh's statement that climate change was for global warming
- 35:06Speaker 1: was settled science. No, I'm not disputing the data that
- 35:10Speaker 1: shows an increase in global temperatures. While you can certainly
- 35:13Speaker 1: argue it's accuracy, especially for older data, it's still just data.
- 35:16Speaker 1: It's not science. The part that gets me upset about
- 35:19Speaker 1: the term settled science that by definition, science is never settled,
- 35:24Speaker 1: and that's in all caps. I think we talked a
- 35:27Speaker 1: lot about this as a scientific method up this stuff.
- 35:29Speaker 1: You guys actually did a podcast on the scientific method,
- 35:32Speaker 1: So you should know that at best you can show
- 35:35Speaker 1: a particular theory is supported by existing data and not
- 35:38Speaker 1: contradicted by anything we know of at the time. But
- 35:41Speaker 1: there's a reason that ultra successful theories like Muton's theory
- 35:43Speaker 1: of gravity hind science theory of relativity are still theories.
- 35:47Speaker 1: They could be completely discredited by a single piece of
- 35:50Speaker 1: data contradicting them. So the whole idea of taking a
- 35:53Speaker 1: body of fact saying it's settled is far more political
- 35:55Speaker 1: concept than scientific. When while people with various viewpoints in
- 35:59Speaker 1: the subject would like to have uh someplace to plant
- 36:01Speaker 1: their ideological flag, saying something is indisputedly true as opposed
- 36:06Speaker 1: to probably false is simply not something science and the
- 36:09Speaker 1: scientific method is equipped to do. In short, science is
- 36:13Speaker 1: never settled. You cannot simply say this is true. Move on,
- 36:16Speaker 1: it's not how it works. And that is from Spencer
- 36:19Speaker 1: Carpenter right here in our own Smyrna, Georgia. We're not
- 36:22Speaker 1: in well, I mean it's it's nearby. What I just
- 36:28Speaker 1: did is what Spencer just did. Spencer, I was using
- 36:32Speaker 1: a literary device. I was actually using the same type
- 36:35Speaker 1: of argument that science that non science climate deniers use
- 36:39Speaker 1: against scientists. I was basically saying, like, it's done, drop it.
- 36:44Speaker 1: There's enough science there to say you're you're you're wrong.
- 36:50Speaker 1: Let's move on and just all except that climate science
- 36:52Speaker 1: is going. It's a layoff. So that was a clever ruse.
- 36:56Speaker 1: It wasn't a ruse at all. It was it was
- 36:58Speaker 1: just I was not be literal like apparently, which is
- 37:02Speaker 1: what Spencer deals in literal terms. Uh, if you want
- 37:06Speaker 1: to take us to test because you are overly literal,
- 37:09Speaker 1: we want to hear from you. You can tweet to
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- 37:20Speaker 1: how stuff Works dot com and has always joined us
- 37:23Speaker 1: at our home on the web, Stuff you Should Know
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- 37:33Speaker 1: is it how Stuff Works dot com