Montgomery J, Robertson A
Department of ENT, Royal Alexandra Hospital, Paisley, Scotland, UK.
J Laryngol Otol. 2012 Nov;126(11):1159-63. doi: 10.1017/S0022215112001612. Epub 2012 Jul 18.
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.
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.
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.
莫雷尔·麦肯齐爵士（1837 - 1892）是英国早期杰出的喉科医生，如今人们对他的记忆或许更多地来自于1887年他对德国王储的治疗，而非他对喉科学作为一门专科发展的重大贡献。在本文中，我们聚焦于他的著作《喉科医院药典》（第四版），并尝试将维多利亚时代耳鼻喉科的治疗方法与当今耳鼻喉疾病的治疗进行比较。
这些维多利亚时代的治疗方法有些与现代做法相似。其他一些则未能经受住时间的考验，特别是：用于喉部梅毒溃疡（而非鼻出血）的硝酸银棒；用作兴奋剂的雾化硫酸；包括苏格兰松木和醋酸铅的鼻探条；用于治疗花粉热的氯仿蒸汽；“伦敦糊剂”，一种用于缩小扁桃体的非手术治疗方法（这可能相当于维多利亚时代的低温等离子消融术）；以及刺入难治性甲状腺肿的氯化锌镖。
这些疗法中有些与当今基于证据的做法毫无相似之处，而其他一些治疗方法（如硝酸银）仍在普遍使用。然而，在维多利亚时代，麦肯齐的著作在欧洲广泛流传，是一门尚处起步阶段的专科的标准参考文献。《药典》于1872年出版，自那时起医学取得了重大进展。我们无法知道当今英国国家处方集里的哪些治疗方法在140年后仍会被使用。
