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