Transcribe your podcast
[00:00:00]

You already know his big brain checking in and, you know, is the voice of the one and only D.J. Scream and the number one podcast industry's big fix is now on the black affect and heart radio. Now, bank, if somebody ain't never listen to Big Fast before, let them know what time it is. They're going to get the truth. They're going to get our facts, our facts, big facts.

[00:00:17]

No, I'm saying the biggest names in the culture, the realest conversations, it gets no better than big, fat, big fat. So get an audio experience like no other big facts on our heart radio app, on Apple podcast or wherever you get your podcast.

[00:00:34]

My name is Rita. I am Ellen Bernstein Brodsky. This is your grandmother. What's the matter with you?

[00:00:41]

Well, and it is a podcast about the relationship between grandmothers and grandchildren, as my mother would have said, TACA, who wouldn't have wanted a Jewish grandmother?

[00:00:52]

Sometimes she accidentally live streams. We're like, who's going to tell her?

[00:00:56]

I'm just hearing about this now. Listen to your grandmother on the IHOP radio app, Apple podcast, almost where ever you get the podcast. Hello there, it's Josh, and for this week's Aspies Kids Selex, I've chosen Magots Colen good for healing wounds.

[00:01:14]

Turns out, and that is absolutely true. I listen to all of our Selex episodes and I listen to this one and I'm clearly excited in the episode, but I was just as excited listening to it all these years later, what, five years after we released it. So I hope it excites you. It is grody, but it's also pretty awesome. So enjoy slash prepare to be grossed out.

[00:01:43]

Welcome to Stuff You Should Know. A production of pilot radios HowStuffWorks. Hey, and welcome to the podcast, I'm Josh Clark. There is Charles Doublecheck Bryant and no one, no one else is in here with us yet again because we've graduated to the point where we don't even need a producer. We need somebody who presses record and leaves. Yep, that's it. Because we're pros. Yep. Not pro se. Pro. Yes, that's right.

[00:02:16]

We're not. But we are prosaic. Yes.

[00:02:19]

But definitely not pro apostrophe. S very few things drive me crazier than that.

[00:02:24]

And I know it's stupid and pedantic, but to see like somebody take out a huge billboard or something and so a word has an apostrophe that shouldn't uprose people say like like leave it to the pros and they'll put an apostrophe.

[00:02:37]

Yes.

[00:02:38]

And it's it's that graphic designer should be, you know, doctor, half a day's pay, maybe 80 bucks, something we want to issue.

[00:02:48]

And he probably would get this from the title of the episode.

[00:02:51]

But we want to issue a meal warning. Oh, good thinking. Because we've gotten complaints in the past when people are eating and get sick listening to some of these.

[00:02:59]

Yeah, this would do it possibly for some people. I was fine. I ate a runny yolk egg sandwich while I was white.

[00:03:08]

Yeah, right. It didn't bother me, but I could totally see how it could be many people.

[00:03:13]

I also want to say, if it comes up, do not go Google image search wound.

[00:03:18]

Soloff Well, I just do not Google image search maggot therapy at all. OK, sure.

[00:03:24]

But definitely stay away from wound sluff slow you G.H.. Yeah. Wow.

[00:03:32]

It definitely don't look at wounds while you're eating. Yeah. OK, so that's all out of the way.

[00:03:39]

Yes. I predict we're going to be kind of excited about this one. I'm feeling a little pumped about it.

[00:03:44]

Well we did cover in ten bizarre medical treatments, leech therapy, which is still being used. And I'm surprised this wasn't in that article, to be honest. I am as well. But this gets its own special deal and.

[00:03:57]

Well, it should actually, because it's a pretty amazing thing. Agreed. We're talking about maggot therapy also banned, by the way.

[00:04:04]

Yes, it is. And they were awesome. So are they really or is that getting, well, a bad name to end all bad names? There probably was a bad name. So it's called maggot therapy, maggot debridement therapy, lavall therapy or bio. There's another one called, I think like bio bio debridement or therapeutic wound.

[00:04:26]

Mieses. Yeah, and that's basically all the all of them, no matter what you call it, no matter how you church it up, it is the application of live maggots fly larva. Yeah. To purposefully to an open wound. Yep. In order to help that would heal faster.

[00:04:48]

Yeah. And better and cleaner and all that good stuff. Everything Daft Punk said.

[00:04:54]

Oh yeah.

[00:04:55]

You know, so we talk about some of the history, this stuff. Let's just say that one more time. OK, Maggert.

[00:05:02]

Debridement therapy is taking live maggots and putting them in an open wound on a human being or an animal.

[00:05:10]

It's used in veterinary medicine, is wrapping it up tight and letting them just eat the dead and dying flesh in that wound.

[00:05:17]

Yeah, while you get your foot tickled. I would be so squeezed out by this, I just wanted to make sure that everybody knows exactly what we're talking about. Right. And goodbye to everyone, everyone who fainted. OK, yeah. Let's talk about the history, Chuck, because this is this is in USA Today, but it's actually pretty old. Yeah.

[00:05:37]

I mean, it's some say it's an even an ancient tradition, like in places like Burma and Central America with the Mayans, they were smart enough to know that Magots do a pretty good job of consuming human flesh. Right. And can be used for good in that regard. Yeah.

[00:05:55]

At some point, I guess Healer's noticed, like people who had maggots in their wounds tended to have wounds heal. And actually, as far as the Western literature goes, that's exactly how maggot therapy first finds its way. First crawls into the medical literature. Yeah. Is from a French surgeon named Ambros Ambrose Power.

[00:06:20]

Yeah. How would you say? I don't know. I don't speak French, embroils para Cipora, even though it doesn't have the little. What does that actually tell you?

[00:06:29]

Yeah, it's just the way he was a 16th century surgeon and he noticed that, that people didn't necessarily fall over dead if there is a maggot in the wound.

[00:06:41]

Yeah. He was the first doctor to actually come out and say, you know, I had this patient who had a big skull wound. Right. And unbeknownst to me, there were maggots in there. I saw them crawling out one day. And even though they had a lot of bone, the guy was great. He healed.

[00:06:57]

Yeah. Like he lost a hand sized slab of skull and he lived. And I think it might have something to do with the maggots.

[00:07:05]

Yeah. And he presumably wore helmet for the rest of his life. Probably he had a probably soft skull there.

[00:07:10]

Yeah, I guess so. That was followed in with the mid seventeen hundreds by another Frenchy baron, Dominique Jean Louis. And he said, you know what, on this Egyptian expedition, these Bluefly maggots are actually doing the right thing and helping us out. So it's almost like these doctors just noticed this. Exactly. And it meant enough to him that they were like, I should probably write this down. This is going to be my great contribution to medical history, the history of science I therapy.

[00:07:47]

So it wasn't until the I guess, the civil war that a doctor actually said, I'm going to purposely put maggots in a wound.

[00:07:56]

Yes. And see what happens. And that doctor was John Forni Zacharias.

[00:08:00]

He probably didn't tell this patient that. I think probably he was just like this bite down on this barrooms. Right.

[00:08:06]

And look, the other way you want to lose your foot or do you want to try something really weird? Well, supposedly in studies, 95 percent of people, modern patients who are offered this therapy say yes to it.

[00:08:17]

Well, yeah, because I think that's what it comes down to. Yeah, it's a last resort. Basically, it's not the first thing they offer. Not necessarily.

[00:08:24]

Right. So anyway, Dr. Zacharias, he had a great quote. He said, During my service in the hospital at Danville, Virginia, I first used maggots to remove the decayed tissue in hospital gangrene.

[00:08:37]

And with my imminent satisfaction in a single day, they would clean a wound much better than any agents we had at our command.

[00:08:44]

I used them afterwards at various places. I am sure I saved many lives by their use escape septicemia and had rapid recoveries, period and quote, pretty great. Yeah. So he was a huge believer in not just a passive observer like people who came before him. He said, yeah, I put maggots on wounds and it helps. That's right.

[00:09:03]

And people experimented with it for a little while until a guy named Louis Pasteur and Robert Koch came along. Microbiologist and germ theorists basically said, you know, this this is disgusting. We might want to not do this. Yeah, because they're dirty. Yeah. Yeah. And it's true.

[00:09:23]

Maggots naturally in the wild carry lots of pathogens with them that can infect us in other ways, can make a wound worse, can actually kill you. So the idea behind germ theory as far as maggots go is right.

[00:09:36]

Yeah, but it seems like there's this long history of necessity and disgust with maggot therapy that kind of wane ebbs and flows.

[00:09:47]

Right. And necessity rears its head on the battlefield. It did in the civil war. And it also did in World War One. There was a surgeon named William S. Bayer and he was working on the front lines in France and he used maggots on stomach wounds and open fractures. Good. Yes. And he found to his great satisfaction, just like Dr. Zacharias and the others before him, that this stuff actually worked.

[00:10:12]

Yeah. And he actually said, you know what, I have some further advancements. Maybe we should put a bandage over this thing so it doesn't complete. We discussed the patient, right? And let me put bandages around the wound so they don't start creeping on to the healthy flesh and doing damage or just itching you or creeping you out further.

[00:10:33]

Right, exactly. Which are still in use today. These techniques.

[00:10:36]

He also pioneered another huge technique, and this is after the war was over 10 years later when he was back at Johns Hopkins, he pioneered another really important technique and that was using sterilized maggots like germ free maggots.

[00:10:52]

They were raised as eggs in a sterile environment. And so when they were introduced to the wounds, they weren't carrying these pathogens anymore.

[00:11:00]

And he found this is the jackpot. Now you can use maggots from now on. That's right.

[00:11:06]

And there was a big boom in the 30s up until the mid 1990s, 300 more than 300 American hospitals were using maggot treatment, maggot therapy. And then in 1944, antiseptics came along or, you know, new antiseptics. And they said, you know, maybe there was another lull in the use of maggots. Right. Right. Necessity, right. Didn't spur this stuff. And it was they went back to just being gross again. And there was a guy who by the 80s wrote with this one article calls the majority opinion.

[00:11:38]

Fortunately, maggot therapy is now relegated to a historical backwater of interest, more for its bizarre nature than its effect on the course of medical science, a therapy, the demise of which no one is likely to mourn. That's just that kind of Western medicine. Hubris, sure. Where like we can do anything except everything, you know.

[00:12:01]

That's right. And in the 1990s, a dude named Ronald Sherman and Edward Pectore basically championed the technique again and kind of brought it into the modern age. Yeah. And still very much as Ronald Sherman is one of the first, I think, to receive a license to produce sterile maggots for use as medical devices. And there's another guy over in the UK named John Church who who brought the maggot their maggot therapy.

[00:12:37]

And therefore, so it was an ancient thing. It was found to be disgusting and to be useful. It's found to be disgusting, is found ways you can make it better. Yeah, it's found to be disgusting. And now that this idea of complementary medicine is kind of regaining some traction, again, I think it's here to stay, though.

[00:13:00]

I think so, too. Unless someone comes along in 10 years is you know what? It's disgusting. Well, you know, the Chuck I mean, probably what we're seeing is the next thing that'll happen is there'll be some huge leap, some huge development in science and science will get its hackles up again and write right. Great about itself. And we don't need any of that stupid nastiness. And then we'll find that, no, you still can't be good old fashioned maggots.

[00:13:22]

And that's that should be the title is like you can't be good old fashioned maggots for healing a wound that won't heal. Otherwise, it's a great title.

[00:13:30]

So you want to take a break? Yeah, let's do it. And we'll go treat our own wounds and we'll be back shortly.

[00:13:55]

My name is Rita Kay. I am Ellen Bernstein Brodsky. This is your grandmother. What's the matter with you?

[00:14:02]

Well, and it is a podcast about the relationship between grandmothers and grandchildren, as my mother would have said, TACA, who wouldn't have wanted a Jewish grandmother?

[00:14:13]

Sometimes she accidentally live streams. We're like, who's going to tell her?

[00:14:17]

I'm just hearing about this now. Let's you to call your grandmother on the I Heart radio app, Apple podcast or wherever you get your podcasts.

[00:14:28]

It's safe to say 20 was one of the most difficult years ever for so many, and these remain very challenging times. That's why I'm here to ask you, how can I help?

[00:14:40]

My name is Dr. Gail Saltz, host of the new weekly podcast, How Can I Help with Dr. Gail Saltz, brought to you by the Seneca Women Podcast Network and I Heart Radio. I'm a clinical associate professor of psychiatry at the New York Presbyterian Hospital, a psychoanalyst, bestselling author. And I'm here to help. Join me every Friday where you can ask your most pressing questions and get helpful guidance on topics ranging from coping with anxiety and mood relationships to family and parenting issues, to workplace dynamics, to dealing with covid fatigue and everything in between.

[00:15:17]

While it has been a tough time, you don't have to navigate it alone. So how can I help? You can send your questions anonymously to me at how can I help at Seneca Women Dotcom and I will answer with specific advice and understanding. Listen to how can I help with Dr. Gail Saltz on the I Heart radio app, on Apple podcasts or wherever you get your podcast.

[00:15:44]

Josh. All right. OK, let's talk about diabetes for a second. Yeah, more than 23 million Americans are affected with diabetes. And one thing that can happen is nerve damage, especially in the extremities, the hands and feet and the toes and the fingers. Your blood vessels become hard and they don't circulate the blood like you need. That can lead to open source ulcers, which can become infections, which can spread to nearby bone, which can lead to amputation.

[00:16:26]

Yeah, and all of these a lot of this is just from a prolonged exposure to high levels of blood sugar and they're not sure how it can do it. But yeah, the blood, the blood vessels not helping pump blood very well. You get nutrients so your tissue can die.

[00:16:39]

But also that neuropathy, that deadly nerve cell, that actually makes it hard for you to notice if you have like a really bad ulcer on the bottom of your foot, you can't feel it.

[00:16:51]

Yeah. And so you don't get treatment early enough so it can get an infection, can get out of hand. And when it spreads to bone, that's called osteomyelitis, that's problematic because that very quickly will lead to an amputation.

[00:17:04]

And there's some pretty shocking stats here from this article that Tom wrote about this sheave, Jim.

[00:17:11]

Yeah, nice. Yeah, for sure. But about amputations from diabetes.

[00:17:17]

Yes, 70000 toe foot and leg amputations each year in the United States alone. So crazy. And they say around the world, they estimate every 30 seconds someone gets a limb cut off because of diabetes. Yeah, that's sad. Yeah, it really is. And we should all do it on diabetes for sure. Oh yeah.

[00:17:36]

I'm not surprised we haven't already. Yeah, me too. But the so amputation is used to halt the progress of an infection. Yes. And that's usually the last resort. But it's what Tom points out is that there are plenty of doctors around the world, I imagine, that aren't aware that you can use maggots or have done it before. And if you are facing an amputation from, say, like a wound, a persistent wound or chronic wound that won't heal.

[00:18:06]

Yeah, you may want to suggest maggots to your doctor. You may have to actually take this the initiative on this one. Yeah. And say let's make sure the amputation is the absolute last resort. Let's see if we can put one more resort in there before then. I'm willing to let maggots crawl inside my body in this wound open wound if you're willing to apply them.

[00:18:28]

And they, like most doctors, love hearing when patients suggest treatments. Oh, they do.

[00:18:33]

They love feedback. They love to be guided in their diagnoses and prognoses. Yeah, love it. That's a tough jam. I get it. Doctors are frustrated a lot these days with self diagnosis and online doctoring. Sure. But you should also be your own advocate.

[00:18:48]

We've seen that before. Yeah, it's your leg. Yeah.

[00:18:51]

You want to keep your leg, you tell that doctor to go get some maggots. You're going to replace them with the doctor who will.

[00:18:57]

I can find a guy. Yeah, I can get a guy by noon that'll put maggots on that wound.

[00:19:01]

And actually there's a there's a group I think Ronald Sherman, the guy we mentioned earlier, who's like the the U.S. champion of maggot therapy, it's there's a group called the Beta Foundation, BTR Foundation. And they have all sorts of resources for people in that very situation, like how to talk to your doctor.

[00:19:23]

Right. If your insurance won't cover it, let them know because they say insurance, actually, most insurance covers may get therapy, but most insurance claims people are not aware of that. So you may get denied at first. And here's how to talk to your insurance company.

[00:19:39]

That's a great resource. It really is. That beats going to your doctor and saying, well, you know what Josh and Chuck said, eh? You're not going to like hearing this, right? Because you think you know it all. Doctor, please take a seat and be put maggots on my feet. Right.

[00:19:52]

And that's the other thing, too.

[00:19:54]

I mean, like, we wouldn't be suggesting this and the Beta Foundation probably wouldn't be such advocates for it if it didn't work so amazingly well.

[00:20:05]

Yes. Study after study and we'll talk about the details of it. But there's so many studies out there. Again, Sherman, who agreed is an advocate, but in a peer reviewed journal, published a survey of studies that he could find on maggot therapy. And it's very clear that it works really, really well.

[00:20:23]

Yeah, and not only necessarily as a means of last resort, but even just compared to the standard of care using like hydrogel or other things that you might use to treat a chronic wound.

[00:20:36]

Maggots destroy it.

[00:20:37]

They leave it in the dust. Yeah.

[00:20:39]

And if it doesn't work, it's not going to hurt anything. Yeah, but I can tell. Yeah.

[00:20:43]

It just puts off how much longer before they amputate your foot. Pretty much, yeah.

[00:20:48]

So what will happen is they will. Well let's get into this a little bit OK. There are four different and you where did you find this? Was this a research paper? Yeah, this is by Ronald Sherman. Mechanisms of maggot induced wound healing. Cohen, what do we know and where do we go from here? It was in the journal Evidence Based, Complementary and Alternative Medicine in 2014.

[00:21:10]

That's right. And he describes four different phases of basically healing a wound, homeostasis, inflammation, periphery. Man, I'm so bad at that one.

[00:21:23]

Oh, yeah. Keep it coming. Proliferation, nice going and remodeling and maturing. And what happens is the cells get to work. They recruit other cells. They alter their activities and basically say, let's get to work cleaning. And well on all four of these stages. Right. To help heal the wound.

[00:21:44]

Yeah. And any any one of those stages, the next process can stall out. Sure. Normally it stalls out at inflammation because the infection gets out of hand and the body can't fight off the infection rate faster than it's laying the extracellular matrix for the new cells to be rebuilt, the new tissue to regrow. And that's that's a common thing that leads to chronic wounds. Yes. They just won't heal.

[00:22:13]

And that's where maggots are really, really useful to basically interrupt that stall. Right. And get the car moving again in the right direction. That's exactly right. They kick started. So debridement is removing dead tissue and that is really where maggots excel. They said in here, each maggot can chew. Well, they don't exactly chew, which will get you right. They remove 25 milligrams of necrotic material, dead flesh and just 24 hours. Yeah, that's pretty good.

[00:22:43]

Yeah. And there's there's actually three ways that maggots clean a wound, but debridement, which is getting in there and like just cleaning out, removing physically removing that dead material, that's like the key. Yeah, that seems to be the key. And then there's also antimicrobial activity, like actually killing the bacteria that's killing the flesh, leaving it cleaner than when they came in. Yeah. Which is amazing. And then even more astounding, stimulating new growth like the the presence of maggots in your wound stimulates new tissue growth around your skin.

[00:23:21]

It's the most they're just like wunder creatures who knew one of the ways that they remove this dead tissue is just by the nature of what their body is like. And they have these little prickly spines all over their body that act as a surgeon's rasp, rasp or firewood. It basically just the fact that they're moving around on the wound is going to like file this stuff down and scrape the wound. Yeah. Which helps loosens it up.

[00:23:52]

It's like a plow. It burrows through this dying and dead tissue and it just. Yeah, it loosens up. That's part one of debridement, part one. There's another part of it, which is the digestive enzymes that they excrete and secrete. It's called alimentary secretions and excretions. AFSC. Yeah, it's basically their digestive juices. Right. And they pick these up as they're moving around and they just they just puke them everywhere and it dissolves this flesh.

[00:24:20]

Yeah. I remember in the Body Farms episode, we talked about this one of the old classics. Sure. And that's why I said earlier, they don't bite or choose something. They just liquefy it right and then suck it in.

[00:24:31]

And this AFSC stuff is so greedy that it liquefies more dead flesh than the maggots can even consume.

[00:24:39]

And they consume quite a bit, like you said, 25 milligrams.

[00:24:43]

That's a lot for a little tiny maggot in one day.

[00:24:46]

But even more than that, they're liquefying even more of this dead tissue.

[00:24:50]

So that part of the process of maggot debridement therapy is draining out this liquified necrotic tissue that's become liquefied from the alimentary or the the AC stuff, the digestive enzymes. Right.

[00:25:06]

So you've got them burrowing around. You've got them puking into your wound. Yeah. Yeah. Liquefying the dead tissue. Yeah. Leaving pretty much entirely the living tissue alone. And then you just kind of drain out the stuff that's that's in there. And the reason that maggots are considered by the FDA, a medical device rather than a drug is because the whole process of debridement isn't just a reaction to the chemicals. It is part of that mechanical movement of the maggots through the wound.

[00:25:38]

Yeah. So it's a drug. It's a device.

[00:25:41]

I mean, it's a device. Well, they are device. Look at them. Yeah. And those that the secretions are so potent they have basically DNA destroying. Qualities like they not only just break down tissue, they destroy the DNA, it's pretty amazing stuff. It is. Shall we take another break? I'm a little excited. We probably should.

[00:26:04]

All right. I'm going to go to the atrium. Are you grossed out?

[00:26:09]

Slightly. I am not in the least. What does that say about me? I don't know. You're a I know you have a stronger stomach, but I don't necessarily. I'm just excited.

[00:26:19]

All right. Well, go watch me vomit. At least that will gross me out. Once you know who it is, D.J., scream, Big Bang Cecchini and Big Facts has officially touched down on the black Ofek and I heart radio now bang, you know, big fix it a foot a week hard at midday for the sensitive big, big fix, which I put it up about real topics, real situations. And of course, you know, we have no conversations with the biggest names in the culture.

[00:26:57]

Twenty one Savage is on big fast giving up. What's up, Sam? What's been going on with you when you get to a certain level?

[00:27:06]

Like I got out of college, you got everything. How can I help my community and I live my people out of money and we're staring at me like I feel like you complete. I like you did your job. I then being a big fat nothing is bigger than big facts. Make sure you listen to big facts on our radio app, on Apple podcast or whatever. You get your podcasts. You know how we come. All right, well, that was disgusting.

[00:27:43]

It was it made me throw up in turn. So here's a couple of questions. Does it hurt? Maybe a little bit at first? Yeah, I don't get the feeling that it's extremely painful. It probably depends on the wound, but it can the first few treatments can apparently be a little bit painful. Right.

[00:28:05]

And there's actually two mechanisms for the pain. One is that you have an open wound, right? Yes. And you have maggots crawling over the exposed nerves in your open. That's not going to feel good. No, it won't. And the number two pressure in the wound can increase as the maggots get bigger from eating so much dead flesh.

[00:28:22]

That's right.

[00:28:23]

So, yes, the cure to that is pain killers, which frankly, if you have an open wound with exposed nerve, you should probably be on those anyway.

[00:28:32]

Sure, you will be. So it probably won't hurt because there'll be some sort of pain management going on.

[00:28:38]

But you will still feel most likely unless the doctor completely numbs the area. Maggots crawling around inside.

[00:28:45]

See, that's what that's the part that gets me is actually. Thinking about undergoing this therapy myself is what gets me. Yeah, not like seeing it or reading about it, but thinking about having an open wound on the bottom of my foot and having maggots creeping around in there.

[00:29:00]

See, the thing is, is I think anybody would feel that way. I sure is very few, including myself. I'm not grossed out by this, but I wouldn't want maggots, in my opinion. But I think if your back's against the wall and.

[00:29:12]

Oh, sure. That or you lose your foot. I try. I would definitely try.

[00:29:15]

I think absolutely 95 percent of people would appear a man and I would demand some high quality drugs. Yeah. And they also have, what is it called, amnesiac addicts that make you forget about this.

[00:29:28]

So you can't form memories while it's happening. So maybe that would be a nice thing to do, too.

[00:29:33]

So the other question is, can you just use any kind of maggot in? The answer is no. What they found is the most useful is the larva of the green blowfly. And like we said earlier, these things are now grown just sort of like the medical leeches.

[00:29:47]

They're shipped in sterile containers as if it were medicine, even though it's a device and the BTR Foundation, they go into a lot about this, like, could anybody do this? And they say, well, no, because you need a prescription.

[00:30:02]

It's an FDA controlling community. Do it yourself.

[00:30:05]

But basically, anybody who can read can basically follow the instructions on the packet.

[00:30:11]

Yeah, I wouldn't I mean, I wouldn't advise that as your non doctor. Sure.

[00:30:16]

I'm not saying that either. But I mean, this may be your doctor's first time to their point was is it's not it's not difficult.

[00:30:24]

Just follow the instructions on the packet.

[00:30:26]

What if you and your doctor, though, you got the maggots out and he put on his bifocals? It was like, all right, let's see how to do this right. Or like he here's the package open.

[00:30:34]

They go everywhere you have like Jerry Lewis as a doctor.

[00:30:40]

Oh. Although they do say you can't just load it up with maggots. There should be no more than eight maggots per square centimeter. Yeah, I saw five to eight.

[00:30:48]

And so when you have the maggots applied to your wound, they're going to make sure that the the healthy area around the wound is covered up so the maggots can't get to it.

[00:30:59]

Which goes back to World War Two. Yeah, they're going to cover it, cover up the wound after they apply the maggots five to eight per square centimeter. Like you say, they're going to cover it up so they can't wander off because maggots like to leave before their work is done.

[00:31:13]

Sure, they watch TV.

[00:31:14]

They're full pretty much, but they can still eat more if you'll keep them in there. Yeah. So they they will cover up. They'll put the maggots in five to eight, cover it up with this bandage and basically they will just sit there and eat for between 48 and 72 hours and then the bandage will be removed.

[00:31:35]

The maggots will then sadly be incinerated or put into an autoclave that's said or put into a plasma gasifier or bronze and hung on your wall for real, like an ant farm.

[00:31:48]

Yeah, because it's like, thank you for this great contribution to saving my foot. Yeah. Now go the autoclaves.

[00:31:56]

I would name them and save them and preserve this year you'd be violating, I'm sure, all sorts of medical waste laws, but who cares. So and then that's, that's what's called the treatment cycle. And most patients supposedly go between two and four treatment cycles. And again, while this is happening, what's going on is the maggots are debriding the dead flesh. They're liquefying it, they're eating it, and they're also disinfecting it and stimulating growth. Right.

[00:32:26]

Pretty amazing.

[00:32:27]

So with the with the with the disinfecting, they figured that there was some sort of gut flora that the maggots have that prevents them from being infected by microbes.

[00:32:38]

Yeah, that would make sense because they're in that rotting flesh as well and they're thriving. Right. So what gives? Well, it turns out that there are a couple of types of I'm not quite sure what kind of bacteria they are, but they are. Oh, that's not true. The Proteus mirabilis is a type of symbiotic microbe that you find in the gut of a maggot, right? Yeah. And this thing just destroys microbial life. So it's killing the bacteria that's causing this infection in your wound.

[00:33:10]

But there's something that maggots this is yet another thing. So think about it, Chuck. Like you said, maggots, the very structure of a maggot body debride the wound. That's really amazing. This maggot antimicrobial stuff. Not only does it kill microbes, it destroys the thing that naturally protects microbes, which is called biofilm.

[00:33:30]

Yeah, we've talked about biofilm a lot on this show. And it's basically it's basically a film like a literal film like they call it a polymeric matrix. But the easiest way to say it in layman's terms, and it's a film, it's like a protective coating. Yeah. And the little spiny body's like one way the. Get rid of this thing is by roughing it up, right, and that's exactly what the little bodies do, right. And that's part of surgical debridement with like like going in there and scrubbing a wound with, I don't know, steel wool or something like that that will break up.

[00:34:03]

The biofilm also must be awfully painful, right. Maggots naturally can destroy not just the bacteria, but also the biofilm that protects it too, which makes them extremely handy with things like MRSA and other antibiotic resistant bacteria and all kinds of ulcers.

[00:34:23]

Right. Not like internal ulcers, but the open wound kind.

[00:34:26]

Right, exactly. From diabetes, from bedsores. And there's been a lot of studies of people with bedsores that have found that maggots help those kind of ulcers tremendously.

[00:34:36]

So let's talk about this one study or a couple of studies. Actually, there was one study of spinal cord injury patients that had non healing ulcers, which is the problem, and they monitored them over three to four weeks and they were getting regular wound care at the same time. Like sometimes it's used in conjunction, think usually is used in conjunction with, like, standard care. Sure. And they found that after three to four weeks of maggot therapy, tissue quality and wound size recessed weekly.

[00:35:07]

And they found that debridement was achieved in less than 14 days, an average of 10 days, and none of the control group wounds were more than 50 percent debrided after a month or a month, not even half debrided.

[00:35:21]

None of the wounds, not half the wounds were debrided. None of the wounds were even half debrided after a month. Chuck of the control group. Yes. Amazing where they didn't use the maggots. Yeah. Yes. That's that's objectively amazing. It is.

[00:35:35]

And then they did a larger clinical trial and found this time they got two hundred and sixty three subjects, which is pretty good for this kind of rare treatment for sure. And they found that using the hydrogel, which you mentioned earlier, compression dressings, just the standard care. Right.

[00:35:52]

That was the control. Yeah, that's obviously the control. They differed significantly between the three groups. What was the third group?

[00:36:00]

The third group use bio bags, which are like, oh, yes, like a little pouch. You said it was like a rather healthy. Yeah.

[00:36:06]

And it's filled with live maggots, but it prevents them from burrowing. All it is is using their chemical secretions.

[00:36:12]

Yeah, I don't use that to me. It's just like I go halfway.

[00:36:15]

Right, exactly. Well people really open.

[00:36:17]

I don't want a maggot crawling in my wound, but a bag of them is fine doing the shake shake near my wound.

[00:36:24]

Right. So it actually has been shown to be not nearly as effective as just letting what's called free range maggots burrow through the wound.

[00:36:33]

So they found the median time for debridement was fourteen days with free range. Twenty eight days with the bagged ravioli and seventy two days for the control. Yeah, that's pretty amazing. Yeah. Like I said. I don't know. I don't think it should be a last resort. You know, I agree, and I think that increasingly it's becoming less and less of a last resort because I mean, you can compare it to the control, like the standard of care took 72 days for the wound to be debrided, free range magots, 14 days.

[00:37:04]

That, to me, says that free range magots top the standard of care as it stands right now.

[00:37:09]

Yeah, but like you say, there's a lot of people who are saying this is just a last resort. The next thing we're going to do is amputate your foot. But let's try this one last time. Right. Or in the case of persistent infections from like Mersa, where just antibiotics just don't work. Let's let's try Magots and see if we can fix it and make it steelwork. There is a study that found that of 13 people treated who had mersa treated with maggots alone, 12 of the 13 had complete recovery and wound healing from a mersa infection.

[00:37:43]

Merce's nasty stuff, too. Yeah, I think. Did we do a mersa feel like we did?

[00:37:48]

I know we've talked about it. I don't know if it got its own show, though.

[00:37:52]

It may have been in the should we outlaw antibacterial soap episode. Boy, there's been a lot of them. Almost 300. You got anything else?

[00:38:07]

Shirley, I do. But I guess not. Oh, yeah, there is one other thing we kept kind of teasing and it actually stimulates growth. A couple of studies have found that the presence of magnets produce more blood vessel redevelopment and tissue redevelopment than maggots not being present.

[00:38:31]

So something about them actually stimulates tissue growth and blood vessel growth, which promotes wound healing even more up with magnets. Up with maggots. Indeed. Man, I love them. I'm so psyched about maggots right now.

[00:38:44]

Well, it definitely changes the way you think about it. Like next time you see a dead squirrel that you've killed right off your porch.

[00:38:51]

Oh, they're clearly trying to bring it back to life. Yeah. And you see the maggots. You think that's disgusting? You just think those are little things doing their thing, doing their thing, little things, doing their thing.

[00:39:01]

Now I'm going to autoclave them. That's right. If you want to know more about maggot therapy, you can take those words in the search bar, howstuffworks dot com.

[00:39:10]

And since I said search part time for listener, I'm going to call this taking the task somewhat of a return.

[00:39:21]

Guys, I want to say you're my favorite podcast by far. Been listening since you were just little five minute blurbs. Oh, man. You sure have grown up.

[00:39:31]

I've never written it before, but felt I had to comment on Josh's statement that climate change was or global warming was settled. Science. No, I'm not disputing the data that shows an increase in global temperatures. While you can certainly argue its accuracy, especially for older data, it's still just data. It's not science. The part that gets me upset about the term settled science that by definition, science is never settled and that's in all caps.

[00:39:55]

I think we talked a lot about this in the scientific method.

[00:39:59]

You guys actually did a podcast on the scientific method. So you should know that at best you can show a particular theory supported by existing data and not contradicted by anything we know of at the time. But there's a reason that ultra successful theories like Newton's theory of gravity, Einstein's theory of relativity, are still theories. They could be completely discredited by a single piece of data contradicting them. So the whole idea of taking a body effect, saying it's settled is far more a political concept than scientific one.

[00:40:27]

While people with various viewpoints on the subject would like to have some place to plant their ideological flag, saying something is indisputably true as opposed to probably false is simply not something science and the scientific method is equipped to do. In short, the science is never settled. You cannot simply say this is true, move on. It's not how it works.

[00:40:48]

And that is from Spencer Carpenter right here in our own Smyrna, Georgia.

[00:40:52]

Renouncement. Well, I mean, it's it's nearby.

[00:40:57]

It's over. But that what I just did is what Spencer just did. Spencer, I was using a literary device. I was actually using the same type of argument that saying that non science climate deniers used against scientists. I was basically saying, like, it's done, drop it enough science fair to say you're you're wrong.

[00:41:19]

Let's move on and just all accept that climate science is going to lay off. So that was a clever ruse. It wasn't a ruse at all. It was it was just I was not being literal, like apparently, which is what Spencer deals in literal terms. If you want to take us to task because you are overly literal, we want to hear from you. You can tweet to us as far as podcast. You can join us on Facebook, dotcom stuff.

[00:41:47]

You should know you can send us an email to Stuff podcast, that HowStuffWorks dot com. And as always, join us at our home on the web stuff you should know dot com. Stuff you should know is a production of I Heart Radio for more podcasts, my heart radio is the radio app, Apple podcasts or wherever you listen to your favorite shows. Oh, do you ever wish you could get more from your podcasts?

[00:42:19]

Well, you can with BuzzFeed Daily hosted by me, Casey Rock'em and me Zaphod on our show, we've got more good news and more pop culture, more Meems and more celebrity to more of everything that's blowing up your timeline and trending on the Internet every weekday evening, we're giving you more of what you need to enjoy your day, because what's life, if it is it to be enjoyed?

[00:42:39]

What's more enjoyable than everything fun and exciting from across the world of BuzzFeed?

[00:42:43]

Yes. If you've ever loved a video from tasty cocoa butter parro like Nifty Goodwell or BuzzFeed celeb, we'll have something for you on BuzzFeed Daily.

[00:42:52]

And don't forget about great interviews that break down all the wait, what from the Internet and beyond, whether it's the world's preeminent astrologists, the star of your favorite streaming show or maybe even the person behind that tick tock, you know, the one if they're making you smile or talking to them.

[00:43:07]

Listen to BuzzFeed Daily on the radio app, Apple podcast, or wherever you get your podcast. Ever wonder what kind of job you would have if you were born in a different time? You're in luck because Jobs Elite is a new podcast that just may have an answer for you. I'm Helen Hunt.

[00:43:28]

And I'm Matt Beat. Take a spin through workplaces of the past as we scout history's most interesting jobs in every episode from the forgotten jobs of history to obscure occupations that still survive.

[00:43:42]

We'll talk with an expert to answer the burning questions, and you'll discover some of the most fascinating and unusual ways people have made a living through the centuries.

[00:43:53]

And who knows, maybe you'll find a job you love as a town crier or switchboard operator, a food taster or an MTV veejay you can listen to obsolete on the I Heart radio app, Apple podcast or wherever you get your podcasts.