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Patrick Watson-Williams and the concept of focal sepsis in the sinuses: An historical caveat for functional endoscopic sinus surgery

Published online by Cambridge University Press:  29 June 2007

James W. Fairley
James W. Fairley*
Affiliation:
Sheffield
*
Mr J. W. Fairley, ENT Department, Royal Hallamshire Hospital, Sheffield SlO 2JF.
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Abstract

From 1900 to 1940 the theory of focal sepsis was invoked to justify a number of dubious surgical procedures. Surgeons believed they were acting rationally. Patrick Watson-Williams advocated suction exploration of the paranasal sinuses for mental patients, claiming to cure criminal insanity by sphenoidotomy. Favourable contemporary reviews showed international approval. The rational basis of treatment was emphasised, but there was little systematic evaluation of outcome. Current enthusiasm for functional endoscopic sinus surgery is also based on a rational approach, logical deductions from pathophysiological ‘facts’. Outcome has still not been evaluated scientifically. We should learn from history. Treatment should not be based too readily on what seems to be rational now. Ideas of physiology and pathology change. What seems logical today may appear ridiculous tomorrow. Careful analysis of outcome, preferably by controlled clinical trials, is needed as a rational treatment requires empirical validation just as much as any other.

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 105 , Issue 1 , January 1991 , pp. 1 - 6
Copyright
Copyright © JLO (1984) Limited 1991

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References

Anonymous (1988) Guidelines for writing papers. British Medical Journal, 296: 48–50.Google Scholar
Ames, E., Anke, I. M., Mair, I. W. S. (1985) A comparison between middle and inferior meatal antrostomy in the treatment of chronic maxillary sinus infection. Rhinology, 23: 65–69.Google Scholar
Billings, F. (1914) Focal infection: its broader application in the etiology of general disease. Journal of the American Medical Association, 63: 899–903.Google Scholar
Buiter, C. T. (1988) Nasal antrostomy. Rhinology, 26: 5–18.Google Scholar
Cotton, H. (1923) The relations of chronic sepsis to the functional psychoses. Journal of Mental Science, 69: 434–465.CrossRefGoogle Scholar
Davis, D. J. (1912) Bacteriological and experimental observations on focal infections. Archives of Internal Medicine, 9: 505–514.Google Scholar
Domagk, G. (1935) Ein Beitrag zür Chemotherapie der bakteriellen Infektionen. Deutsche medizinische Wochenschrift, 61: 250–253.Google Scholar
French, J. G. (1927) Infection of the nasal sinuses in relation to insanity. Lancet, 2: 13.CrossRefGoogle Scholar
Goodwin, C. S., Armstrong, J. A., Marshall, B. J. (1986) Campylobacter pyloridis, gastritis and peptic ulceration. Journal of Clinical Pathology, 39: 353–365.Google Scholar
Graves, T. C. (1923) The relation of chronic sepsis to mental disorder. Journal of Mental Science, 69: 465–471.CrossRefGoogle Scholar
Hunter, W. (1900 a) Further observations on pernicious anaemia (7 cases): A chronic infectious disease; its relation to infection from the mouth and stomach; suggested serum treatment. Lancet, 1: 221–224 and 371–377.Google Scholar
Hunter, W. (1900 b) Oral sepsis as a cause of septic gastritis, toxic neuritis and other septic conditions. Practitioner, 65: 611–638.Google Scholar
Huxley, A. (1960) Collected Essays. Chatto and Windus, London.Google Scholar
Kennedy, D. W. (1985) Functional endoscopic sinus surgery technique. Archives of Otolaryngology, 111: 643–649.Google Scholar
Miller, W. D. (1891) The human mouth as a focus of infection. Dental Cosmos, 33: 689–713.Google Scholar
Popper, K. R. (1959) The logic of scientific discovery. Hutchinson, London.Google Scholar
Rosenow, E. C. (1914) The newer bacteriology of various infections as determined by special methods. Journal of the Amen can Medical Association, 63: 903–912.Google Scholar
Semon, F., Watson-Williams, P. (1908) In: A System of Medicine by Many Writers (Allbutt, C. and Rolleston, H. D., Eds.) Vol. 4. part 2: Diseases of Nose, Pharynx and Ear, 2nd edn., Macmillan, London.Google Scholar
Stammberger, H. (1986) Endoscopic nasal surgery–concepts in teatment of recurring sinusitis. Part 1. Anatomic and pathophysiologic considerations. Otolaryngology Head and Neck Surgery, 94(2): 143–156.CrossRefGoogle Scholar
Stell, P. M. (1987) Epithelial tumours of the external auditory meatus and middle ear. In: Scott-Brown's Otalaryngology 5th edition, vol3 (Booth, J. B., Ed. ) Otology. Butterworths, London, p 534.Google Scholar
Wakley, T. (1842) Editorial reply to a letter ‘Old Medical Books’ from Branson, F. Lancet, 2: 197.Google Scholar
Watson-Williams, P. (1901) Diseases of the Upper Respiratory Tract, the Nose, Pharynx and Larynx. 4th Edn. John Wright, Bristol.Google Scholar
Watson-Williams, P. (1910) Rhinology: A text-book of diseases of the nose and the nasal accessory sinuses. Longmans, London.Google Scholar
Watson-Williams, P. (1925) The toll of chronic nasal focal sepsis on body and mind. The Semon Lecture. Journal of Laryngology and Otology, 40: 765–780.CrossRefGoogle Scholar
Watson-Williams, P. (1930) Chronic nasal sinusitis and its relation to general medicine. John Wright, Bristol.Google Scholar
Watson-Williams, P. (1933) Chronic nasal sinusitis and its relation to general medicine. 2nd Edition. John Wright, Bristol.Google Scholar