During the last fifteen years of my practice as an otorhinologist I have tried to avoid as much as possible the use of snuffs or nose drops in the treatment of acute and chronic rhinitis. The theoretic argument for the use of these medicaments has been only a little convincing, and in general the therapeutic results have not been encouraging. As a rule, I have endeavored to combat nasal infections by entirely different methods and have made use of snuffs, nose drops and penciling of the nasal mucous membrane only on rare occasions. It was therefore after much hesitation that I persuaded myself to begin the insufflation of sulfathiazole into the nasal cavities in treatment of inflammatory conditions. However, since good results had been announced from so many quarters in the local treatment of infection with this agency, from which toxic effects were rarely observed, I at last overcame my doubts.Before I began the treatment of my patients with sulfathiazole, I tried the medicament on myself. I insufflated sulfathiazole powder into my nose once a day for four consecutive days. I did not have the least indication of irritation, such as sneezing, or feel the slightest discomfort immediately after insufflation, or later. I have even treated inflammatory conditions of the nose other than acute rhinitis with sulfathiazole. However, as yet the results in cases of such disorders have not been better than those which I have obtained with earlier methods. On the other hand, the results of local treatment of acute rhinitis with sulfathiazole have been so good that I consider them well worth reporting.When, in February 1942, I began to treat acute rhinitis with insufflations of sulfathiazole, this method was not new in principle. Only one report, how¬ ever, had been published on the treatment of the nasal mucous membrane with sulfathiazole powder x (an investigation in which I later had an opportunity of taking part). In this study Delafield and his associates used snuffs containing 10 per cent sulfathiazole with magnesium carbonate as a base and expressed the belief that with this treatment acute rhinitis cleared more rapidly and with less discomfort than usual.The next year Richtnér2 published 30 cases of acute rhinitis in which he treated the condition by spraying sulfathiazole into the nose. At the same time, he treated the disease in another 30 cases by instilling a solution of azosulfamide and ephedrine (3 per cent solution of azosulfamide and 1.5 per cent ephedrine sulfate) into the nose. He concluded:Since altogether not more than about 30 cases are available in each group, it is as yet too early to make any definite statement regarding the result, but the general impression is that the effect of sulphathiazole is superior to that of nasal drops as far as the length of time of healing is concerned, and probably also with regard to the bacteriostasis.
