Inflammation …

Rubor, dolor, calor, tumor and loss of function. That’s the way we all remembered it, four latin words and a short English phrase.

The Latin translates as redness, pain, heat and swelling . They are the signs of inflammation described by Aulus Cornelius Celsus in the first century AD. Loss of function was added by Rudolf Virchow in the 19th century, it can be rendered in Latin but it doesn’t rhyme and he was German.

There were four abscesses now on my arm, the loss of function was an inability to wear my wrist watch. The rubor was only a problem when you looked at it, the dolor however was becoming rather inescapable.The surrounding area was as hard as a rock, indurated is the technical term.

The first line of treatment for an abscess hasn’t changed since the time of Galen – remove the cause, drain the pus, rest the part. I carefully sterilised a needle by wiping it on my sleeve, passed it quickly through the top of each abscess and squeezed. A bead of pus began to emerge but then took the form of a maggot. The first one was actually quite easy to deliver. The subsequent ones were harder work but believe me there was no way they were staying in!

Cordylobia anthropophaga

The second of the offenders, shown here adjacent to its recent living quarters is variously known as the Putzi, Tumbu or Mango Fly Cordylobia anthropophaga. The species name translates as man-eater. They are restricted to tropical Africa.

The commonest way to fall foul of them is to hang your damp washing out to dry. The fly lays its eggs in damp places (if not your socks often sandy soil contaminated with faeces), the eggs hatch out and the resulting maggots have a few days to meet with a mammalian host. They burrow into the skin keeping a tiny hole open to the surface for their oxygen needs. When they’ve eaten their fill (8 to 12 days) they emerge, turn into a fly and go looking for some more damp socks.

The answer is to dry your clothes indoors or make sure they are well ironed. In any case no great harm befalls the host.

In my case I had not worn a long-sleeved shirt in the relevant period, I must have contacted the maggots on the ground or in damp vegetation. The relief was almost instantaneous once the maggots were evicted. Pain gave way to itchiness, the induration and redness faded quickly. Three weeks later the sites are still a little red and raised but soon there will be no sign of my heroic endurance, my cutaneous myiasis, my brush with a man-eater.

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