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In House of the Dragon, S01E02, the maester is giving King Viserys I a very unique treatment for his pinky finger.

  • By burying it into a swamp of maggots.

enter image description here

The purpose is to allow maggots to eat away the dead flesh off from his pinky finger.

How realistic is it?

But what happens to all the bacteria/parasites one can contract from maggots? How practical is it?

I remember in the movie, Gladiator, starring Russel Crowe, when he travels in a slave cage, a fellow slave puts some maggots onto his open wound as well for the same purpose.

Ankit Sharma
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Yu Zhang
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    If you raise the maggots yourself there shouldn't be bacteria or parasites. I don't think they just pick maggots out of the trash. – DKNguyen Aug 29 '22 at 23:22
  • @DKNguyen, true, somehow I was thinking the Maester found the maggots from somewhere instead of farming them. – Yu Zhang Aug 30 '22 at 01:01
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    If cities and royalty exist such as ancient China or Rome, I would expect them to be farmed. I am not sure where Native Americans would get them from. – DKNguyen Aug 30 '22 at 01:29
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    Apparently you can sterilize maggots without killing them: https://biology.stackexchange.com/questions/17629/how-are-maggots-sterilized-disinfected Also, consider that their use may have outweighed the disadvantages even if they weren't sterile. – DKNguyen Aug 30 '22 at 01:33
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    I wonder why do the maggots only consume the dead flesh and don't touch the living parts. Yes, I know they couldn't pierce the skin if they were placed on a healthy body, but if placed into a wound, there is no physical barrier. – vsz Aug 30 '22 at 04:35
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    And ornithologists use maggots to strip flesh from the delicate skeletons of their bird specimens. – Basil Bourque Aug 30 '22 at 06:00
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    @vsz It's really no different from "why do we eat bread instead of raw wheat corn?" The rotten flesh is completely different from living flesh - it's much easier to digest (and even chew up), the nutrient composition is changed... Some animals prefer fresh fruit, others prefer rotten fruit - these things are all over nature. Omnivores are the rare thing - most animals have very specific dietary needs (for a variety of reasons). – Luaan Aug 30 '22 at 08:12
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    @Luaan And then you have opportunistic species that will not hesitate to help themselves to extra food. Oxpeckers are known to drink blood, and will even open new wounds to do so. Some cleaning station species will do the same. – KC Wong Aug 30 '22 at 08:31
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    @BasilBourque - cleaning flesh from delicate skeletons doesn't have the same "leave live healthy flesh at least mostly unharmed" requirement though. – armb Aug 30 '22 at 14:14
  • @vsz The article is very informative (and I found although the wound being treated was bad, you can see worse on any A&E reality show -- the maggots are not even obvious). Maggots use different enzyme regimes, so you choose carefully. Blow-flies (e.g. Green Bottle Fly) do not affect live tissue, and their secretions actively destroy pathogenic bacteria. The only issue with the film scenario is the "swamp of maggots": they need oxygen, so one layer deep is optimal. And apparently, they tickle. You might not like them at first, but they grow on you. – Paul_Pedant Aug 31 '22 at 08:28
  • I remember Dr House also doing this in an episode of House MD. I guess this is a common trope? – GuilleOjeda Aug 31 '22 at 15:14
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    @Blueriver It's not quite a trope but rather a real medical treatment we use to this day. The thing that surprised me from these answers and comments is to learn how old this treatment is. I've thought this is a fairly modern treatment that started some time in the mid 1990s (which was when I first heard about it) – slebetman Sep 01 '22 at 07:07
  • @slebetman you're right! I do wonder if it's used in TV just to show something cool, when other treatments would be more effective and readily available. This is clearly not the case with OP's question, as that show is set in a world with pseudo-medieval tech level. Meh, I guess this happens with everything in TV and movies, right? I'm just rambling. – GuilleOjeda Sep 01 '22 at 13:30

2 Answers2

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It is realistic and has historical and recent usage proof/

From the Wikipedia page of Maggot therapy (Warning: This page contains graphic images):

Written records have documented that maggots have been used since antiquity as a wound treatment. There are reports of the use of maggots for wound healing by Maya, Native Americans, and Aboriginal tribes in Australia. Maggot treatment was reported in Renaissance times. Military physicians observed that soldiers whose wounds had become colonized with maggots experienced significantly less morbidity and mortality than soldiers whose wounds had not become colonized. These physicians included Napoleon’s general surgeon, Baron Dominique Larrey. Larrey reported during France's Egyptian campaign in Syria (1798–1801) that certain species of fly consumed only dead tissue and helped wounds to heal.

Even from the same page:

There were reports that American prisoners of war of the Japanese in World War II resorted to maggot therapy to treat severe wounds.

A survey of US Army doctors published in 2013 found that 10% of them had used maggot therapy.

Some other useful links are provided by justanothercoder and mgarey in the comments respectively:

From NHS

Larval debridement therapy (biosurgery)

Certain types of fly larvae are ideal for this because they feed on dead and infected tissue but leave healthy tissue alone. They also help fight infection by releasing substances that kill bacteria and stimulate the healing process.

Maggots used for larval therapy are specially bred in a laboratory using eggs that have been treated to remove bacteria. The maggots are placed on the wound and covered with gauze, under a firm dressing, which keeps them on the wound (and out of sight). After a few days, the dressing is cut away and the maggots are removed.

Medical studies have shown larval debridement therapy can achieve more effective results than surgical debridement. However, because of the nature of this type of treatment, many people are reluctant to try it.

Also, KSL artilce provides as latest as 2006 for the case of such treatment.

Ankit Sharma
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    there is a wikipage for everything, :-D – Yu Zhang Aug 29 '22 at 11:48
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    The first image in that wikipedia page is nightmare fuel – Cave Johnson Aug 29 '22 at 20:15
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    @CaveJohnson I read your comment but for some reason still clicked the link – dbmag9 Aug 29 '22 at 20:49
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    @dbmag9 Same here. I thought : it can't be that bad. It is that bad. – Eric Duminil Aug 30 '22 at 06:30
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    @EricDuminil Wait, wait... wait... oh, uh... yeah, can confirm. – Corey Aug 30 '22 at 08:48
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    In the same wikipedia article, there is an image of a modern day packet of medical maggots. You obviously want to make sure the maggots are clean so you do not get sick from it, but it's definitely real and an actual thing. – Nelson Aug 30 '22 at 09:35
  • "Count 'em in, count 'em out." – StuperUser Aug 30 '22 at 13:13
  • This process is also shown in TV medical shows such as Grey's Anatomy. Not that they are an authority, but I'd think they wouldn't make up such an odd procedure if it weren't real. – JTP - Apologise to Monica Aug 31 '22 at 02:29
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    I want to thank CaveJohnson, @dbmag9, EricDuminil and Corey for their brave sacrifice. I did not click the link after reading your comments. I will forever be curious but will sleep peacefully :D – Canuk Aug 31 '22 at 06:56
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    @CaveJohnson You definitely should not read Iain Banks' Wasp Factory. – Peter - Reinstate Monica Aug 31 '22 at 11:28
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    Just to add to the list, the UK NHS website mentions use of maggots as a gangrene treatment currently in real world use: https://www.nhs.uk/conditions/gangrene/treatment/ with a note that "Certain types of fly larvae are ideal for this because they feed on dead and infected tissue but leave healthy tissue alone." – JustAnotherCoder Aug 31 '22 at 12:35
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    My dad used medical maggots as a wound care doctor (this is in the 2000s). He was not an army doctor (or a doctor for any military branch).

    I found the news article about it (quoting my dad in the article): https://www.ksl.com/article/728784

    I recommend adding this to your answer, since it is a recent (2006) and specific source.

    – mgarey Aug 31 '22 at 22:03
  • Pubmed: 1931: https://pubmed.ncbi.nlm.nih.gov/20532712/ First modern article!; 1985: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1306099/ ; 2020: https://pubmed.ncbi.nlm.nih.gov/32825736/ – Trish Sep 01 '22 at 11:55
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Maggot Therapy is explored in modern medicine since at least WW1

The first modern article about maggot therapy by William S. Baer was published in 1931. In his introduction, he starts with an anecdote about how he came in contact with maggot therapy during the first world war (1914 to 1918):

At a certain battle during 1917, two soldiers with Compound fractures of the femur and large flesh wounds of the abdomen and scrotum were brought into the hospital. These men had been wounded during an engagement and in such a part of the country, hidden by brush, that when the wounded of that battle were picked up they were overlooked. For seven days they lay on the battlefield without water, without food, and exposed to the weather and all the insects which were about that region. On their arrival at the hospital I found that they had no fever and that there was no evidence of septicaemia or blood poisoning. Indeed, their condition was remarkably good, and if it had not been for their starvation and thirst, we would have said they were in excellent condition. When I noticed the extent of the wounds, of the thigh particularly, I could not but marvel at the good constitutional condition of the patients. At that time the mortality of Compound fractures of the femur was about seventy-five to eighty per cent.—even when the wounded had the best of medical and surgical care that the Army and Navy could provide. [...]

Here, however, were two men in the earlier part of our engagement in the War, when the mortality of Compound fractures of the femur was high, who, to all intents and purposes, were constitutionally well. This unusual fact quickly attracted my attention. I could not understand how a man who had lain on the ground for seven days with a Compound fracture of the femur, without food and water, should be free of fever and of evidences of sepsis. On removing the clothing from the wounded part, much was my surprise to see the wound filled with thousands and thousands of maggots, apparently those of the blow fly. These maggots simply swarmed and filled the entire wounded area. The sight was very disgusting and measures were taken hurriedly to wash out these abominable looking creatures. Then the wounds were irrigated with normal salt Solution and the most remarkable picture was presented in the character of the wound which was exposed. Instead of having a wound filled with pus, as one would have expected, due to the degeneration of devitalized tissue and to the presence of the numerous types of bacteria, these wounds were filled with the most beautiful pink granulation tissue that one could imagine. There was practically no bare bone to be seen and the internal structure of the wounded bone, as well as the surrounding parts, was entirely covered with the pink, rosy granulation tissue which filled the wound. Bacterial cultures were made and, while one found a few staphylococci and Streptococci still remaining, they were very few in number and not sufficient at that time to cause a pus formation. These patients went on to healing, notwithstanding the fact that we removed their friends which had been doing such noble work.

This is the first description in modern medicine history, after following research and evaluation of developing an aseptic method. But it is by far the first description of maggot therapy itself. In fact, the very article points out that the idea is far from novel:

Note: It is evident that even in ancient times many surgeons had observed the effect of maggots on wounds, but it has remained for Dr. Baer to develop this idea in accordance with scientific medicine and surgery. The following article by Dr. Goldstein gives an interesting historical review of the subject of these observations referred to by Dr. Baer.—Editor.

Older Maggot Therapy

In 2011, Ron Sherman wrote this article, giving an abridged version of the history of maggot therapy:

For centuries, military surgeons observed the benefits of maggots in the wounds of fallen soldiers. Maggot-infested wounds were cleaner, and healed faster than non-infested wounds. Soldiers whose wounds where infested with maggots were more likely to survive their wounds than soldiers not so infested.

But that is by far not the most conclusive one. For that, we can look at an article by Iain S Whitaker, Christopher Twine et al. from 2007:

Larval association with infected wounds has been reported since ancient times, with the Old Testament being the oldest written piece to cite the infestation of an infected wound of a man by fly larvae (myiasis).6

Evidence exists that larvae have been used for the last thousand years by various ancient cultures, such as the aboriginal Ngemba tribe of New South Wales,7 the Hill people of Northern Myanma (Burma)8 and the Mayan healers of Central America.9 Anthropological research suggests that the Maya soaked dressings in the blood of cattle and exposed them to the sun before applying them to certain lesions, expecting the dressings to squirm with maggots.7


  1. Zumpt F.Myiasis in man and animals in the Old World. London: Butterworths, 1965
  2. Dunbar G. Notes on the Ngemba tribe of the Central Darling River of Western New South Wales. Mankind 19443140–148. [Google Scholar]
  3. Greenberg B. Flies through history. In: Greenberg B, ed. Flies and disease. Princeton, NJ: Princeton University Press, 1973
  4. Sherman R A, Pechter E A. Maggot therapy: a review of the therapeutic applications of fly larvae in human medicine, especially for treating osteomyelitis. Med Vet Entomol 19882225–230. [PubMed] [Google Scholar]
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