鼓膜裂創の治療法に就て

　緒言

　鼓膜裂創就中介達性鼓膜裂創の療法は，鼓膜の再生能力が旺盛である爲に，鼓室の二次的感染を防止して自然治癒を俟つ姑息的療法が從来行われ，現在も尚本法を踏襲している人もある．即ち外耳道を清拭後外耳孔に綿栓を施すか，或いは室の感染予防の爲に硼酸末を吹粉して擤鼻を禁じた．

　然るに第一次世界大戰後には，鼓室の感染を恐れるあまり損傷部に触れる事を避けたのに反し，直接創縁に薬物を作用させち其の刺戟によつて鼓膜の再生を促進する所謂刺戟療法が提唱されて來た．本療法に用いられた藥物では1918年Vulpiusによつて推奬された5％プロタルゴルが最も著名であるが，其の他Lehmannの1％食塩水，Imhoferの猩紅軟膏，Okuneff，Wassermannの三塩化醋酸溶液，Uffenordeの硝酸銀小桿等が挙げられる．

　Nosaka says that, for treatment of traumatic rupture of the tympanic membrane a 2 per cent pellidol (diacetyl-aminoazo-toluol) in ointment base appeared to be most effective in that it tends to stimulate epithelial regeneration at the edge of the lesion which would be, at the same time, afforded a mechanical protection by adsorption of blood and epithelial debris to the agent. A five per cent protagol solution is an agent that might be the next in preference but its action at times proved to be detrimantal. One per cent saline solution has some healing effects; but, none is seen by use of liver oil in ointment base. Rivanol in 0.5 per cent, 1 per cent solution of trichioracetic acid and 2 per cent mercurochrome showed tendency to deter healing. Boric acid used as dustin powder in the canal seemed to be effective in preventing of middle ear infections.