- Email: [email protected]
GANGRENE OF THE TONSIL.
1270 sufficient to destroy the ordinary bacterial flora of running water if allowed to act upon it for 24 hours. Again, 1 part of the copper sulphate in 75,000 parts of water-i.e., about a grain per gallon-is sufficient according to his observations to destroy the vitality of the typhoid bacillus in an infected water with an exposure of three hours. Copper vessels if presenting a sufficiently large polished surface exercise, he adds, a distinctly controlling influence upon the bacterial life present. He sums up by stating that in sulphate of copper used in water in the proportion indicated " we possess an agent which promises to be both valuable and safe," and practical
the left tonsil was covered with a dirty greyish-looking patch and the temperature was 99 - 6°. Bacteriological examination failed to reveal the diphtheria bacillus. On the 17th the patient complained greatly of dyspnoea, pain in the throat, and dysphagia. The temperature was 100.2°. The right tonsil was covered with a blackish exudation, with an exceedingly offensive odour. The tonsil was vigorously On curetted but healthy tissue could not be reached. the 18th the slough had re-formed and was extending to the pillars of the fauces. Curetting was again performed. A smear from the tonsil showed an organism resembling the diplococcus lanceolatus in trials he suggests should be made in view of the incidence greater abundance than any other microbe and staphyloof water-borne diseases upon the South African communities. cocci. There were no spirilla or fusiform bacilli of It is an important observation that the water treated by Vincent. The gangrene extended in depth and extent and the copper sulphate method becomes freed from the sulphate death from exhaustion occurred on June lst. The following in proportion to the germicidal effect exerted by it, for this is an outline of the other recorded cases. A negro. aged 45 bears obviously on the question of the effects that minute years, was admitted into hospital on August 13th suffering traces of soluble copper might have upon health. If from sore throat. He was intolerant of examination of the copper salts are shown to have such powerful effects upon throat in which little was noticed. He died on the 20th pathogenic organisms it seems hardly possible that they from haemorrhage from the mouth and nose. The necropsy would in the long run be entirely without disturbance upon showed a large ulcer in the site of the right tonsil and the tissues of the human organism. There seems to be, extending to the posterior wall of the pharynx. To this as Mr. Watkins-Pitchford points out, however, a general a very offensive slough was attached.’ In the second case agreement of scientific opinion that small quantities of the patient, a man, aged 26 years, had suffered from sore copper can be ingested even regularly without producing throat for a week. There were a peculiar pallor and partial any deleterious effects upon the system. Before any attempt stupor. The stench of the room was most offensive, sugis made to purify water in this manner and on a large scale, gesting some necrotic process. The gums, the inner surface of the lips, and the under surface of the tongue were covered as when a community is affected by typhoid fever, this statement of the innocuousness of traces of copper salts should be with deep ulcers. The tonsils were deep red and swollen. On the left tonsil were greenish necrosed spots from which very carefully examined. brownish grumous discharge was issuing. The gangrenous was removed and nitric acid was applied. tissue Recovery GANGRENE OF THE TONSIL. took place, but three months later the patient succumbed to IN the American Journal of the Medical Sciences for another attack.2 The third case is described as "gangrenous October Dr. C. W. Richardson has published an important eschar of the tonsils." It occurred in a ten years, aged girl, paper on a condition which, though apparently not very who succumbed at the end of a week.3 Dr. Richardson uncommon, is not well recognised-gangrenous tonsillitis. describes the stench in his cases as being like the odour of Within 14 months he has observed two cases but has been atrophic rhinitis, characteristic and never to be forgotten. able to find on record only three other cases. In his first It is noteworthy that in his second case the patient was in case the patient was a robust man, aged 45 years, addicted health at the time of the attack. perfect to alcohol. He came under medical observation with dysphagia and infiltration of the right side of the neck. His PROPOSALS TO STRENGTHEN THE ADMINISTRAmedical attendant observed white spots on the right tonsil, TION OF THE SALE OF FOOD AND DRUGS ACTS. diagnosed diphtheria, and administered antitoxin. But THE importance of the efforts made, amongst others, by the patient grew worse and became delirious on the Cuthbert Quilter, M.P., during the last two sessions of Sir ninth day. On the tenth day Dr. Richardson saw him in to secure the more effectual administration of Parliament consultation. The temperature was 102° F., the pulse was Food and Drugs Acts has scarcely been realised, the Sale of and 120, soft compressible, and there was muttering delirium. The peculiar odour due to sloughing tissue, different from probably because the matter has only come before the the foetor of diphtheria, was present. The right tonsil and public in the form of occasional questions in the House of by the Minister concerned. pillars of the fauces and the visible pharynx presented a Commons and answers thereto that The fact remains, however, step by step the Governcontinuous greyish, brownish, putty-like slough. The left tonsil and the soft palate were normal. A complete line of ment has been urged to carry out certain recommendations demarcation had formed between the healthy and the of the Royal Commission on Arsenical Poisoning and necrotic tissue. Death occurred two hours later. In the previous departmental committees and that ultimately the second case Dr. Richardson was asked to see in consultation President of the Local Government Board agreed in principle to the establishment of a new branch of his department. A on May 17th, 1904, an unusual case of ulceration of the tonsil. The patient was a man, aged 36 years, who preliminary grant was included in this year’s Civil Service estimates and just before the close of the session, in denied exposure to the risk of contracting syphilis. to a further inquiry, Mr. Gerald Balfour stated that a reply On May 4th he was seen by his medical attendant and said special inspector had been appointed and that arrangefor several throat a mouth and sore that he had had days. ments were being proceeded with as to the appointment of The temperature was 99 8°, the breath was extremely an assistant ; that the duty of the inspector fcetid, the tongue was coated, the gums were congested would be to inspectorthe advise Board as to the administration and swollen and separated from the teeth, and there were of the Sale of Food and Drugs Acts and other some greyish patches along their lower borders. The tonsils, to deal with matters to the purity and measures ; relating Two the were much days especially right one, enlarged. later there were ulcerative tonsil. On adulteration of food brought to the Board’s notice by public on the -
right patches improved : the patches on the gums and tonsils had disappeared and the tonsils were much reduced in size. On the 15th there was a great change :
the 12th the patient
was
much
1
2
E. B. Cragen : New York Medical Journal, Sept. 1st, 1888, p. 233. A C. Howe: Philadelphia Medical Journal, March 7th, 1900, p. 643. 3 J. F. McVeigh : Dublin Quarterly Journal of Medical Sciences,
1867, p. 78.
the left tonsil was covered with a dirty greyish-looking patch and the temperature was 99 - 6°. Bacteriological examination failed to reveal the diphtheria bacillus. On the 17th the patient complained greatly of dyspnoea, pain in the throat, and dysphagia. The temperature was 100.2°. The right tonsil was covered with a blackish exudation, with an exceedingly offensive odour. The tonsil was vigorously On curetted but healthy tissue could not be reached. the 18th the slough had re-formed and was extending to the pillars of the fauces. Curetting was again performed. A smear from the tonsil showed an organism resembling the diplococcus lanceolatus in trials he suggests should be made in view of the incidence greater abundance than any other microbe and staphyloof water-borne diseases upon the South African communities. cocci. There were no spirilla or fusiform bacilli of It is an important observation that the water treated by Vincent. The gangrene extended in depth and extent and the copper sulphate method becomes freed from the sulphate death from exhaustion occurred on June lst. The following in proportion to the germicidal effect exerted by it, for this is an outline of the other recorded cases. A negro. aged 45 bears obviously on the question of the effects that minute years, was admitted into hospital on August 13th suffering traces of soluble copper might have upon health. If from sore throat. He was intolerant of examination of the copper salts are shown to have such powerful effects upon throat in which little was noticed. He died on the 20th pathogenic organisms it seems hardly possible that they from haemorrhage from the mouth and nose. The necropsy would in the long run be entirely without disturbance upon showed a large ulcer in the site of the right tonsil and the tissues of the human organism. There seems to be, extending to the posterior wall of the pharynx. To this as Mr. Watkins-Pitchford points out, however, a general a very offensive slough was attached.’ In the second case agreement of scientific opinion that small quantities of the patient, a man, aged 26 years, had suffered from sore copper can be ingested even regularly without producing throat for a week. There were a peculiar pallor and partial any deleterious effects upon the system. Before any attempt stupor. The stench of the room was most offensive, sugis made to purify water in this manner and on a large scale, gesting some necrotic process. The gums, the inner surface of the lips, and the under surface of the tongue were covered as when a community is affected by typhoid fever, this statement of the innocuousness of traces of copper salts should be with deep ulcers. The tonsils were deep red and swollen. On the left tonsil were greenish necrosed spots from which very carefully examined. brownish grumous discharge was issuing. The gangrenous was removed and nitric acid was applied. tissue Recovery GANGRENE OF THE TONSIL. took place, but three months later the patient succumbed to IN the American Journal of the Medical Sciences for another attack.2 The third case is described as "gangrenous October Dr. C. W. Richardson has published an important eschar of the tonsils." It occurred in a ten years, aged girl, paper on a condition which, though apparently not very who succumbed at the end of a week.3 Dr. Richardson uncommon, is not well recognised-gangrenous tonsillitis. describes the stench in his cases as being like the odour of Within 14 months he has observed two cases but has been atrophic rhinitis, characteristic and never to be forgotten. able to find on record only three other cases. In his first It is noteworthy that in his second case the patient was in case the patient was a robust man, aged 45 years, addicted health at the time of the attack. perfect to alcohol. He came under medical observation with dysphagia and infiltration of the right side of the neck. His PROPOSALS TO STRENGTHEN THE ADMINISTRAmedical attendant observed white spots on the right tonsil, TION OF THE SALE OF FOOD AND DRUGS ACTS. diagnosed diphtheria, and administered antitoxin. But THE importance of the efforts made, amongst others, by the patient grew worse and became delirious on the Cuthbert Quilter, M.P., during the last two sessions of Sir ninth day. On the tenth day Dr. Richardson saw him in to secure the more effectual administration of Parliament consultation. The temperature was 102° F., the pulse was Food and Drugs Acts has scarcely been realised, the Sale of and 120, soft compressible, and there was muttering delirium. The peculiar odour due to sloughing tissue, different from probably because the matter has only come before the the foetor of diphtheria, was present. The right tonsil and public in the form of occasional questions in the House of by the Minister concerned. pillars of the fauces and the visible pharynx presented a Commons and answers thereto that The fact remains, however, step by step the Governcontinuous greyish, brownish, putty-like slough. The left tonsil and the soft palate were normal. A complete line of ment has been urged to carry out certain recommendations demarcation had formed between the healthy and the of the Royal Commission on Arsenical Poisoning and necrotic tissue. Death occurred two hours later. In the previous departmental committees and that ultimately the second case Dr. Richardson was asked to see in consultation President of the Local Government Board agreed in principle to the establishment of a new branch of his department. A on May 17th, 1904, an unusual case of ulceration of the tonsil. The patient was a man, aged 36 years, who preliminary grant was included in this year’s Civil Service estimates and just before the close of the session, in denied exposure to the risk of contracting syphilis. to a further inquiry, Mr. Gerald Balfour stated that a reply On May 4th he was seen by his medical attendant and said special inspector had been appointed and that arrangefor several throat a mouth and sore that he had had days. ments were being proceeded with as to the appointment of The temperature was 99 8°, the breath was extremely an assistant ; that the duty of the inspector fcetid, the tongue was coated, the gums were congested would be to inspectorthe advise Board as to the administration and swollen and separated from the teeth, and there were of the Sale of Food and Drugs Acts and other some greyish patches along their lower borders. The tonsils, to deal with matters to the purity and measures ; relating Two the were much days especially right one, enlarged. later there were ulcerative tonsil. On adulteration of food brought to the Board’s notice by public on the -
right patches improved : the patches on the gums and tonsils had disappeared and the tonsils were much reduced in size. On the 15th there was a great change :
the 12th the patient
was
much
1
2
E. B. Cragen : New York Medical Journal, Sept. 1st, 1888, p. 233. A C. Howe: Philadelphia Medical Journal, March 7th, 1900, p. 643. 3 J. F. McVeigh : Dublin Quarterly Journal of Medical Sciences,
1867, p. 78.