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To the Editor:
—Regarding the article by Drs. S. K. Livingston and L. H. Prince on "The Treatment of Chronic Osteomyelitis" (The Journal, April 2), it may be helpful to the authors to know that what they term "maggot active principle" was identified by H. Fabre in his Souvenirs entomologiques long before the therapeutic use of maggots in osteomyelitis. He avers that the maggot has no mandible. Its mouth is not articulated. It has no lower jaw to permit it of biting or mastication. It feeds by suction. It has to liquefy its food to be able to ingest it. This it accomplishes by secreting an enzyme which converts the decayed proteinic matter into a broth. Under the circumstances, perhaps pepsin U. S. P. or 1: 10,000 may be equally effective.[The letter was referred to Dr. S. K. Livingston, who replies:]
Elia S. MAGGOT TREATMENT OF OSTEOMYELITIS. JAMA. 1932;98(18):1585. doi:10.1001/jama.1932.02730440065025