THE TONSURE OF THE TONSILS.
Though not strictly within the scope of my intention in the present booklet, I feel that no treatise, however brief, which purports to be a free and candid expression of the ills that child-life is heir to, could afford to ignore the burning and much debated question of the tonsils and their significance, present and future, to the well-being of the child, or could deem the task accomplished without raising a warning and protesting voice on behalf of the helpless victims, whose recurrent name is legion, against the callous and persistent violation and destruction of the functions of vital organs, the only shadow of justification of which is, on the one hand, a fashionable popular delusion on the part of parents and, on the other, interested complacency on the part of their medical advisers, accentuated by a strong and dangerous tendency towards operation and empiric surgery generally.
This is a strong and sweeping indictment, perhaps. Let us therefore pause for a moment whilst we consult other sources of opinion for confirmation or refutal.
And, in the wide range of American and English criteria, what corroboration do we find? We find, as regards America, the venerable Professor Alexander H. Stevens, M.D., a member of the New York College of Physicians, writing as follows:
"The reason medicine has advanced so slowly is because physicians have studied the writings of their predecessors instead of nature."
From England the verdict comes to this effect:
Professor Evans, Fellow of the Royal College of Physicians and Surgeons, of London, says, in part:
"The Medical Practice of our day is, at the best, a most uncertain and unsatisfactory system: it has neither philosophy nor common sense to recommend it to confidence."
If such opinions prevail within the sacred, State-protected precincts of the profession, how long, revolted confidence exclaims—how long before a credulous, deluded public awakens from its deep hypnotic trance.
Against Tonsil destruction three arguments stand:
(1) That the primal intention of Universal Mind—(sometimes termed the Soul of Being; the Spirit of All Good or, in simple reverence, "God")—was obviously no malign intention, but an intention for good, is an axiom which will be rationally accepted, I presume, as logically and conclusively assured.
(2) That the functions of the tonsils are, in the present state of medical knowledge, practically still unknown is the deliberate and final statement made within the past few years by one of the greatest reputed authorities on the subject.
(3) That the tonsil has some important mission to fulfill is clearly demonstrated by the fact of its frequent recrudescence, or rather, the natural renewal of the organ after surgical removal—a spontaneous physiological organic mutiny, as it were, supported by its lymphatic glandular dependents, against the reckless ignorance of medical practitioners and the perversity of the medico-cum-parental fashion of the day.
For the fact that it is a fashion, and nothing more, is unhappily fully established on ample and high authority within the medical prescriptive pale. And, in fact, even as "The Tonsure" or shaving of the crown, became by fashion and mendicity a feature of priesthood and monastic piety, so has the slaughter of the Tonsils come to be regarded by fashion and mendacity as a feature of childhood and medical expediency and ineptitude.
Professor John D. Mackenzie, M.D., of Baltimore, a distinguished leader of the advanced school of medical science, in the course of a brilliant and exhaustive treatise on the subject written as he says, reluctantly, in the interest of the public health and safety, quotes the deliberate opinion of an equally eminent medical friend to the effect that:
"Of all the surgical insanities within his recollection this onslaught on the tonsils was the worst—not excepting the operation on the appendix."
Dr. Mackenzie then proceeds to show how abysmal has been the ignorance of the functions of these organs from the earliest times, (including a distinguished English medical luminary who went to far as to say: "were I attempting the artificial construction of a man I would leave out the tonsils,") adding that the tonsil was regarded as a useless appendage and "like its little neighbour, the uvula, was sacrificed on every possible pretext or when the surgeon did not know what else to do."
"Never," he says, "in the history of medicine has the lust for operation on the tonsils been as passionate as it is at the present time. It is not simply a surgical thirst, it is a mania, a madness, an obsession. It has infected not only the general profession, but also the laity." In proof of this he adds: "A leading laryngologist in one of the largest cities came to me with the humiliating confession that although holding views hostile to such operations he had been forced to perform tonsillectomy in every case in order to satisfy the popular craze and to save his practice from destruction." He cites an instance in which a mother brought her little six-year-old daughter to him, "to know whether her tonsils ought to come out;"—and in answer to the assurance: "your baby is perfectly well, why do you want her tonsils out?" the fond mother's reply was: "Because she sometimes wets the bed!"
Recent universal inspection of the throats of school children has revealed the fact that nearly all children at some time of life have more or less enlarged tonsils. And the reports maintain that this, for the most part, is harmless if not actually physiologic—natural—and that their removal in these cases is not only unnecessary but injurious to the proper development of the child.
Nevertheless, the reports of the special hospitals for diseases of the nose and throat show to what an appalling extent this destructive operation is perpetrated throughout the land.
"Much wild and incontinent talk," Dr. Mackenzie continues, "for which their teachers are sometimes largely to blame, has poisoned the minds of the younger generation of operators and thrown the public into hysteria. They are told that with the disappearance of the tonsils in man, certain diseases will cease to exist and parents nowadays bring their perfectly sound children for tonsil removal in order to head off these affections. Summing up the writer demonstrates that the functions of the tonsils are, at present unknown and that until known nothing authoritative can be said definitely on the subject, whether they be portals for the entrance of disease or the exit for the very purpose of germs of infection; common sense must decide;—whether they protect the organism from danger or invite the presence of disease."
I, for my own part, am of Dr. Mackenzie's opinion: that there is an endless flow of lymph from their interior to the free surface, which unchecked, prevents the entrance of germs from the surface and washes out impurities from within. That in any case, one of the functions undoubtedly is the production of leucocytes or protective white blood corpuscles and that the tonsil is not, as generally understood, a lymphatic gland; that the general ignorance of this fact has led to the useless sacrifice of thousands of tonsils, on the fallacious assumption that their functional activities may be vicariously undertaken by other lymphatic glands; and finally, that the physiologic integrity of the tonsil is of the utmost importance in infant and child life.
The consensus of advanced scientific opinion is now to the effect that the activity of the tonsils as possible accessories of disease has been vastly exaggerated, that like the thousand and one successive misleading theories which in turn, from time to time, have seized upon the imagination and obsessed the minds of the medical fraternity for brief and passing periods, this pernicious craze too, has about run its course. The causes from which this peculiar lust for operation emanates would be perhaps a difficult psychological puzzle to determine; the malign impulse, as regards some special function, seems to spring, as it were, by intuition, unbidden into being from the illusive depths of some perverted intellect, to rage for a while through the medical world with a death roll deadly as the plague and as suddenly to pass into desuetude and disappear behind the impregnable ramparts of "prescriptive right" and "privilege"—terms which in plain parlance mean to the masses in cold actual fact, the absolute negation of all right—the domination of arbitrary, irresponsible and State protected wrong.
Between facts and fables, the evidence with regard to the tonsils and their functions seems to establish the conclusion that they have been wrongfully and foolishly held responsible for "an iliad of ills." The region of the nose and mouth is obviously the happy hunting-ground of myriads of pathogenic bacteria. It is likewise continually the scene of innumerable surgical operations, performed necessarily without antiseptic precautions, thus extending the area of possible infection indefinitely to the entire upper air tract which medical incompetence so often fails to explore. And indeed, as Dr. Mackenzie freely remarks: "Of far graver, far-reaching and deeper significance are cases of infection in which life has doubtless been sacrificed by clinging to the lazy and stupefying delusion that the tonsil is the sole portal of poisoning."
The mere size of the tonsil, it is shown, is no indication for removal except it be large enough or diseased enough to interfere with respiration, speech or deglutition—that is, swallowing; in which case only a sufficient portion should be taken away, and that without delay. The tonsil may be greatly enlarged or buried deeply in the palatine arcade and yet not interfere with the well-being of the individual. Such tonsils are the special prey of the tonsillectomist. If they are not interrupting function they are best left alone. Moreover, it occasionally happens that the resurrection of a "buried" tonsil is followed shortly by the burial of the patient.
The practical illuminating lesson to be gleamed is this: That if in infancy and childhood, we pay more attention to the neglected nasal cavities and to the hygiene of the mouth and teeth, we will have less tonsil disease and fewer tonsil operations.
"The partial enucleation of the tonsil," the writer asserts, "with even the removal of its capsule if desired, is complete enough for all necessary purposes and practically free from danger; moreover, it produces equal or better results than complete enucleation with its many accidents and complications, to say nothing of its long roll of unrecorded death."
Another point: From the professional vocalist's point of view. The tonsils are phonatory or vocal organs and play an important part in the mechanism of speech and song. They influence the surrounding muscles and modify the resonance of the mouth. Enlarged by disease, they may cripple these functions and if so, their removal may increase the compass of the voice by one or more octaves; but it is a capital operation and a dangerous one in which a fatal result is by no means a remote possibility.
The object of this interesting paper, it is pointed out, is not to assail operation for definite and legitimate cause, but to warn against the "busy internist"—the hospital surgeon—too busy for careful differential diagnosis—and his "accommodating tonsillectomist" who is "in the business for revenue only." But the onus for the existing deplorable state of affairs he lays frankly upon the shoulders of the teachers and insists that the cure of the evil is largely educational. "When," says he, "pre-eminent authority proclaims in lecture and text book as indisputable truth the relationship between a host of diseases and the tonsils of the child and advises the removal of the glands as a routine method of procedure, what can we expect of the student whose mind is thus poisoned at the very fountainhead of his medical education by ephemeral theory that masquerades so cheerily in the garb of indestructible fact?" "How," he exclaims, "are we to offset the irresponsibility of the responsible?" But we hear on all sides—"Look at the results." Results? Here is a partial list from the practice—not of the ignorant, but of the most experienced and skilled: Death from hemorrhage and shock, development of latent tuberculosis, laceration and other serious injuries of the palate and pharyngeal muscles, great contraction of the parts, removal of one barrier of infection, severe infection of wound, septicemia, or bacterial infection, troublesome cicatrices, suppurative otitis media and other ear affections, troubles of voice and vision, ruin of singing voice, emphysemia, or destruction of the tissues, septic infarct,—infected arterial obstruction, pneumonia, increased susceptibility to throat disease, pharyngeal quinsy and last, but not least tonsillitis!
The trenchant and tragic article concludes with the expression of the hope that the day is not far distant when not only the profession but the public shall demand that this senseless slaughter be stopped. "Is not this day of medical and moral preaching and uplifting," it is asked, "a fitting one in which to lift the public out of the atmosphere into which it has been drugged, and as to the reckless tonsillectomist, a proper time to apply the remedy of the referendum and recall. It has come to a point when it is not only a burning question to the profession, but also to the public. This senseless, ruthless destruction of the tonsil is often so far reaching and enduring in its evil results that it is becoming each day a greater menace to the public good."
Such is the wisdom of these world-wide sages,
They wildly yearn to learn its innermost
And break the organ's wondrous works with sledges—
Though music, its sweet soul, for aye is lost;
That they have reached the goal, such is their dreaming,
When tissues, nerves, and veins reveal their knife—
When in the very core their steel is gleaming—
But, one thing they forget—and that is life!
This matter of the functions of the tonsils is fully dealt with in my greater work "Regeneration or Dare to be Healthy"—Chapters VII. and VIII., in which I show on the best authority that the tonsils have a great mission to fulfill—so great indeed that their treatment according to the present methods of the medical faculty can, in my estimation, only be stigmatized as the equivalent of a crime.
It is the conclusion arrived at scientifically by the greatest authorities that the Tonsils secrete a very potent anti-toxic fluid which is excreted whenever dangerous pathogenic bacilli attempt to enter the pharynx or larynx, constituting in fact the ever watchful sentinels of the oral and nasal portals through which an entrance into the human organism might be surprised by its ever active surreptitious enemies—the bacteria of infection and disease.