Medicine: Tonsils

The late great Dr. Frank Billings of Chicago persuaded the doctors of the world that focal infections were often the cause of systemic diseases like rheumatism, arthritis, heart disease, kidney disease. Immediately there followed a great wave of tooth-pulling, tonsil-snaring, adenoid-raking, sinus-reaming. The tide, however, had turned before Dr. Billings died two years ago, and last week was in full retreat as the American Academy of Ophthalmology & Otolaryngology met in Chicago.

Dr. Albert David Kaiser, professor of pediatrics at the University of Rochester, went so far as to state, with the censoring approval of his fellow academicians: “Too much was promised by physicians. Nowthe mother whose first child had his tonsils removed when it was perhaps unnecessary, is disappointed because the child continued to have colds, and she doesn’t want her second child’s tonsils removed, although the tonsils are diseased.

“Having his tonsils out will make little difference in his susceptibility to colds, and bronchitis occurs more frequently in tonsillectomized children and the same is true of pneumonia. On the other hand an infected tonsil may develop local trouble, may be a factor in systemic disease and may be a cause in less easily classified but threatening diseases such as excessive fatigue. It also may be a factor in scarlet fever and diphtheria.”

In such cases, said Dr. Kaiser, frankly infective tonsils should come out. Nonetheless, the fact remains “that the function of the tonsils is not understood,” and practice gives the lie to theory.

Tonsillectomy used to be a “kitchen chair” operation. Now in the hands of a throat specialist it entails all the pomp and ceremony of a major operation. At the Manhattan Eye, Ear & Throat Hospital, Surgeon David H. Jones related, an interne makes a preoperative examination of the patient’s skin, nose, throat, ears, heart, lungs and kidneys. Continued Dr. Jones, “All patients with any suspected involvement, including rise in temperature over 100.4° F., are held for final examination by the Tonsil Supervisor. No patients are operated upon following a recent illness and no female patient is operated upon five days prior to or during menstruation.”