The agent, Penicillin, is discussed with a view
to possible local application in the nose and throat,
suitable vehicles chosen, and administration decided.
Bacteriological and clinical methods are detailed.
A series of experiments prove that the Penicillin
lozenge will sterilize the surface of the fauces within
eight hours, and that this means can be used for
pre-operative preparation and post-operative control in
in tonsillectomy. It will not sterilize the tonsillar
crypts even after prolonged administration.
The normal process of healing after tonsillectomy
is described, and a scheme for the investigation of
possible improvement by the use of Penicillin is put
to trial. Results show that the improvement is
greatest in the immediate post -operative phase, best
results being obtained with administration of lozenges
every two hours for sixteen hours before and eight
days after tonsillectomy. A series of 77 cases is
The aetiology of Vincent's infection is reviewed,
and the various forms of treatment discussed. A new
method of therapy is suggested, using only Penicillin
lozenges every two hours for 4-5 days followed by
eradication of predisposing factors. Details of ten
cases illustrate the efficacy of this method.
Various treatments of acute tonsillitis are discussed
and the place of local Penicillin therapy defined,
by conclusions derived from eight cases treated,
as effective prophylaxis and treatment of early cases,
but only as an adjunct to general treatment in later
The use of local Penicillin in Peritonsillar
abscess permits safe tonsillectomy very soon after
incision: in streptococcal carriers renders them clear
during use of the lozenge: in streptococcal gingivitis
is the treatment of choice.
Local nasal administration of Penicillin is best
by means of a snuff inhaled from specially designed
applicators, given every 2 hours over at most four
days: it is effective bacteriologically and clinically
in eliminating susceptible pathogens from the nose
and so in preventing or curing the secondary infective
stage of the common cold, although aids to decongestion
may also be required: 38 cases are cited.
Sinus infection and its treatment is revi6wea,
and modern treatment with local and general Penicillin
described. Six cases are described in detail with
the conclusion that in the acute suppurative form the
ideal treatment is conservative control of the
critical and dangerous early stage, by Penicillin
and minimal surgical drainage, leaving any further
interference till a later and safer date: in the
chronic condition local Penicillin therapy has no
advantage over surgery.