It may be a difficult pill to swallow, but the use of maggots and leeches in medicine is making a comeback. These practices, which are often thought to be consigned to the medical methods of yesteryear, are now being used in the fight against antibiotic-resistant infections and in the treatment of various other conditions. 

The history of creepy cures

The use of maggots in medicine has a long history. The earliest recorded use of these wriggling larvae dates back to the ancient Egyptians who used them to treat abscesses. There is also evidence that various ancient cultures relied on them during the last 1,000 years, such as the aboriginal Ngemba tribe of New South Wales, the Hill tribes of Myanmar, and the Maya people of Central America. Anthropologists have found that the Maya would soak dressings in cattle blood and expose them to the Sun before applying them to certain wounds. They would then wait to see if the dressings wriggled with maggots. 

This method of treatment became more widespread during the 18th and 19th centuries when war surgeons observed that wounds contaminated with maggots appeared to recover faster. Then, during the First World War, the orthopedic surgeon William Baer was the first to apply them systematically to non-healing wounds. This led to a sudden fashion of relying on maggots in wound treatment, but the practice more or less disappeared after the 1940s, presumably because of the arrival of effective antibiotics. 

The use of leeches in medicine has an equally ancient lineage. In the Egyptian medical text known as the Ebers Papyrus (c. 1550 BCE), leeches are mentioned in the treatment of various conditions. During the medieval period, these parasites were often used in conjunction with bloodletting practices, as the purging of blood was believed to remove harmful fluids from the body, according to Hippocratic medicine.

An old practice made new

With the growth of new superbugs – bacteria, viruses, parasites, and fungi that are resistant to most antibiotics and other medications – some doctors have turned to these old treatments for their efficacy, safety, and simplicity. It may be a bit disgusting to think about, but once you get around that fact, it appears these methods may be as brilliant as they are gross. 

Maggot therapy, sometimes referred to as debridement therapy or biosurgery, is an increasingly popular method for treating necrotic wounds. As maggots only eat dead tissue, they are a cost-effective and non-invasive method that not only cleans wounds quickly but also seems to speed up the healing process. In fact, it has been estimated that between 2007 and 2019, the number of NHS patients in the UK treated with maggots increased by 47 percent.

There is even a company dedicated to producing these crawling cleaners. BioMonde has a sterile maggot-production factory in Wales, UK, and is currently the only provider of medical maggots to the NHS. The factory houses about 24,000 flies, which produce maggots that are shipped in aseptic polyester nets known as BioBags, which are designed with the individual patient’s needs in mind. At present, BioMonde ships about 9,000 bags to UK healthcare providers each year.

Equally, leech therapy, also known as hirudotherapy, has continued to be practiced into the present day. Leeches are used in fields including microsurgery, plastic and reconstructive surgery, dermatology, and in the treatment of cardiovascular disease. 

Once a leech latches onto a host, its blood-sucking action helps increase blood circulation and flow, which can speed up the healing process. They also produce a series of helpful chemical compounds that serve as a local anesthetic, anticoagulant, and antibiotic that kills harmful bacteria. 

As with the maggots, there is a farm another farm in Wales that produces leeches for the NHS and other healthcare providers. BioPharm is a 211-year-old company that has seen the demand for its medical leeches grow over the last 20 years. During the 1990s, they may have produced a few hundred leeches a year, but now they supply 60,000 of the critters each year. 

Leech therapy can last anywhere between 10 minutes to an hour. Once the leech has gorged on blood, they naturally drop off their host. They are then disposed of in BioPharm’s purpose-made disposal kit, called Nos Da, “goodnight” in Welsh.  

Patients who have been treated with maggots and leeches have shown a range of reactions to them, but it seems that, once you’re over the more grim aspects of this treatment, the benefits outweigh the discomfort. So while it may be unpleasant to think about, it seems our brave medical future will likely continue to benefit from the presence of these old friends.