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dc.contributor.authorMitchell, James F. O.en
dc.date.accessioned2019-02-15T14:37:23Z
dc.date.available2019-02-15T14:37:23Z
dc.date.issued1945en
dc.identifier.urihttp://hdl.handle.net/1842/35360
dc.description.abstracten
dc.description.abstractThe 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 detailed. 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 cases. 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.en
dc.publisherThe University of Edinburghen
dc.relation.ispartofAnnexe Thesis Digitisation Project 2019 Block 22en
dc.relation.isreferencedbyen
dc.titleUse of penicillin in the nose and throaten
dc.typeThesis or Dissertationen
dc.type.qualificationlevelDoctoralen
dc.type.qualificationnameMD Doctor of Medicineen


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