DESTRUCTION OF TONSILS BY DIATHERMY
Authors: W. Collins
Journal: BMJ (1930)

T MEDICALJO3RNTLfor forty-eight hours.Improvement was rapid, and in four days after the onset of the rash the patienit was feeling quite well and able to get out of bed.The cough was almost gone and inidleed was less iintense than it had been before her attack of measies.In view of this resuilt, wllicll confirmied Loewesnthnl's finding.q,I decided to make fuirther investigations, and adImiinistered amllidopylrini in twenty-six cases.The dintig wa.'s given in the formiii of pyr-ami-iidoni cr-ystals, tlhe alpl)ro- priiate dose being aidministered in a teaspoon with a little water.In all cases twelve powders were given at fouir- hourtly initervals (luriing the day and night.Eveii itifants took tlie diug easily.Comparatively large doses were iused accordinig to the formulal: Age Dose.(to nearest graini) = 4-2 x maximuim dose of drug (gr.15). Age+1The dosrs given wvere 2 to 5 gri.ains.Resutlts.It miiust be stated at the outset that it was impossible to obtain accurate statistics in geneial lpractice, especially in the pooIrerldistricts of London, wher'e this work was cairied ouit.In some eases a doctor is called in only to make a diagnosis and in other cases only when the patient (locs not seem to be progressing well.In view of the special treatinent patients were visited more often than is ususlal in suelh cases, though a number of parents had to be persuaded to allow this to be done.In the series of cases reporte(d six were seen twice a day duri ng the course of thc illness, fifteen were seen once' daily, and five onily twice withl an interval of a few days.It follows that th.e results cani onily be recordedi in general telrmls, but, evreil so, the results are remarkable.It may be taken that ani average case of measles as, seen in gen'eral practice is quite well and able to get out of bed in ten to twelve days, a slight cough usually persisting even for a week or two longer.This will be takeni as a standard witlh which to compaire these cases treated with aniidopyrini.These are divided into three groups, accord- inig to the time of administratioln of the drug in relation to the onset of the disease.Gr oup 1 consists of five cases, contacts from anotlier member of the family, who were specially watched for the onset of the disease, and were treated during the invasion stage on the appearanice of Koplik's spots.The measles did not develop in these cases; in only two was there a suspicion of a rash.The clhildr:en were put to bed as a precaution, but were quite well in two days.Grotup 2 consists of sixteen cases seen at the onset of the rash.This is the largest group, the stage at which most cases are first seeni in geineral practice: The administration of amidopyrini caused inuiniiediate reduction of temperature, and all symptonms cleared rapidly.The patienits were quite well in thlree or four days.6'roup 3 consists of five cases seen at various late stages of the disease in which the drug had a beneficial but less striking effect.A malked feature of tlle drug treatment was the fall in temll)erature withlini the first day and the complete clearing up of the cough.No complications were observed.The impression conveyed by these results was that the drug mllust be giveni ear'ly in the disease, and if given early enouigh in the " Koplik's spot " stage the disease is even a-bortedl.Criticism,.