Lunchtime Seminar – 27th September 2016 – Mathew Andrews (CHSTM)

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Scavengers in wound care: figured maggots in the work of W.S. Baer, 1928-1931

Responding to the challenges of the First World War, surgeons experimented with methods that were often incongruous with pre-war civilian practice. Their results had a far reaching impact on wound care, not least the revival of ‘debridement’. Originally used in the Napoleonic wars, debridement was a two-part treatment for gunshot injuries which involved opening a wound and surgically removing necrotic tissue and contaminants. The success of this procedure was understood to depend on a delicacy of hand and the surgeon’s technical ability. At the same time, its apparent violence led to comically grotesque comparisons with butchery and dissection, and the suggestion that the cardinal principles of war surgery were ‘brute force and bloody ignorance.’

In 1928 William Stevenson Baer (1872-1931), head of orthopaedics at John Hopkins Hospital, began applying maggots to the postoperative wounds of adults and children. Basing his work on an observation he made during the war, Baer hypothesised that feeding maggots may act as a ‘viable antiseptic’ and help prevent the recurrence of osteomyelitis (bone infection). Baer’s therapeutic interpretation of the maggots’ action on wounds stood in stark contrast to a longstanding and dominant view where fly larvae (or ‘worms’) were understood as not only detrimental to wound healing but at times symptomatic of a caregivers’ negligence or a patient’s underlying moral or medical corruption.

Drawing on discussion in contemporary publications this paper develops a historical literary analysis informed by theoretical insights from animal studies. I argue that by figuring maggots as ‘scavengers’ Baer established parallels between their action on wounds and debridement. Through this figuration the ambivalent tension at the heart of debridement, the entanglement of destruction and regeneration, was inscribed upon the maggots. By adopting a resonant comically grotesque discourse, I contend that Baer was able to respond to, and mitigate, the prevailing pathology of maggots in wounds, by representing them in a way that was playfully, and powerfully, ambivalent. In turn, this paper contributes to the history of how surgery has represented and understood itself through a distinctive analysis of the role of maggots in wound healing.

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