Valere Aude: Dare to Be Healthy, Or, The Light of Physical Regeneration

by Louis Dechmann

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.