Observations on Myiasis in Bihar

This interesting disease which is not altogether uncommon in the province of Beliar appears to be clinically identical with that described by Manson as occurring in certain parts of America. The malady is the result of a Blue Bottle Fly (Pycnosoma) depositing its larvae in a slight abrasion of, or in the unbroken mucous membrane of, the nasal fossa of the patient. The larvae burrow into the delicate membrane, and feed on I the underlying structures causing considerable destruction of tissues with Occasionally severe constitutional symptoms. The patient on coming to hospital presents a characteristic appearance of having a diffused oedeinatous swelling about the upper portion of the face, more or less localised to the nose, eyes, lower part of the forehead and upper lip. The swelling about the eyes often being sufficient to reduce the palpebral fissures to mere slits, and thus impairs vision temporarily. The voice is nasal and breathing is mainly carried out through the mouth. The patient complains of an intense burning and gnawing pain in the affected parts, associated frequently with the feeling of maggots being present in them. Also of a severe frontal