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902 creature a screw-like appearance; hence the vulgar name. They burrow in the tissues, devouring the mucous membrane, muscles, cartilages, periosteum, and even the bones, thereby causing terrible sores, and not infrequently—particularly when they attack the ear or nasal fossæ, by penetrating to the brain



—death. Of 13 cases collected by Laboulbène 9 proved fatal; of 31 collected by Maillard 21 died.

If treated properly and in time by injections of chloroform, carbolic acid, turpentine, infusion of pyrethrum, and similar substances, the patient may be saved; neglected, he will most

probably die. If necessary the frontal sinuses, the antrum, and other bony cavities must be opened to secure the expulsion of the larvæ.

In countries where this pest occurs bloody and offensive discharges from the nostrils should be carefully investigated, and, if found to be caused by the screwworm, vigorously treated.