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Since adenocarcinoma of the ethmoid sinuses was first described as an occupational disease in the woodworkers of High Wycombe, over the 50 subsequent years there has been a gradual decrease in the numbers to none over the last 12 years. Although this mirrored the decline in local industry, it seems the causative factor was first seen and then disappears over a 50-year period.
Methods
A total of 146 cases have been traced historically over this time as well as personal experience of 33 cases; these cases are reviewed and success with a new modality of treatment is discussed.
Conclusion
This paper outlines how the disease was initially recognised, both its diagnosis and treatment development. It also describes how both the appearance and disappearance were seemingly caused by changes in manufacturing practice.
Sir Morell Mackenzie (1837–1892), the pre-eminent early laryngologist in the UK, is nowadays perhaps better remembered for his role in the management of the Crown Prince of Germany in 1887, than for his major contribution to the development of laryngology as a specialty. In this article we focus upon his text The Pharmacopoeia of the Hospital for Diseases of the Throat (fourth edition), and attempt a comparison of Victorian ENT treatments with today's management of ENT diseases.
Treatments:
Some of these Victorian treatments bear a resemblance to modern day practices. Others have not withstood the test of time, in particular: silver nitrate sticks for syphilitic ulcers of the larynx (not epistaxis); nebulised sulphuric acid, which was used as a stimulant; nasal bougies, including scotch pine and lead acetate; chloroform vapour for the treatment of hay fever; ‘London paste’, a non-surgical treatment for the reduction of the tonsils, (which was perhaps the Victorian equivalent of coblation); and zinc chloride darts, which were plunged into intractable goitres.
Conclusion:
Some of these remedies bear no resemblance to today's evidence-based practices, while other treatments (such as silver nitrate) are still in common use. In Victorian times, however, Mackenzie's books were widely read throughout Europe and were the standard references for a specialty in its infancy. The Pharmacopoeia was published in 1872, and major advances in medicine have been made since then. We have no way of knowing which treatments in today's British National Formulary will still be in use in 140 years.
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