"It is a well-known fact that hypertrophy of the tonsils and presence of adenoids may produce more or less dullness of the intellect in normal children. This is a result of the imperfect aeration of the blood which supplies the brain, on account of obstruction to respiration. In the Feeble-minded, conditions are more or less similar."
One hundred and twelve cases in the Sonoma State Home, Eldridge, California, were operated on. Of these 6 are recorded as borderline, 39 as morons, 50 as imbeciles, and 17 as idiots. Adenoids were always removed when they were present. The results of the operation are as follows:
| Number before Operation | Number after Operation | ||
| Mouth breathing | 43 | 31 | |
| Eneuresis | 33 | 32 | |
| Sore throats | 70 | 2 | |
| Ear trouble | 19 | 2 | |
| Change in voice | 38 | improved | |
| Tonsillar tissue recurred in | 5 | ||
| General physical health | 90 | improved | |
| 6 | borderlines | ||
| 33 | morons | ||
| 42 | imbeciles | ||
| 9 | idiots | ||
| Mental improvement from observation | 27 | improved | |
| 4 | borderlines | ||
| 15 | morons | ||
| 7 | imbeciles | ||
| 1 | idiot | ||
The inaccuracy of this investigation is evident. The mental improvement was measured by "observation," which is at best inexact, and susceptible to the influence of any expectation of improvement on the part of the observer. The degree of improvement is not mentioned, nor is the time interval allowed for the appearance of such improvement. There is no control group, and consequently, no way of knowing whether the improvement was due to the removal of the defect.
A similar, though rather more careful study is reported by Dr. Charles James Bloom in the New Orleans Medical and Surgical Journal for April, 1917. Dr. Bloom's experiment consisted of eighteen months' observation on the mental and physical state following the removal of adenoids and tonsils from one hundred and fourteen children. This number was later reduced to fifty-seven, because of the fact that a number failed to return. There was no selection, all the patients being taken as admitted.
The patient's physical and mental state was recorded at the time of admission. School reports were used as an index of intelligence. From this time on the patients were examined, weighed and measured at monthly intervals.
The ages of the children ranged from four to fourteen years, inclusive. Thirty-five per cent were under six years, and sixty-five per cent, therefore, over six. Twenty-nine were boys, twenty-eight girls.
Omitting a part of the study which though interesting has no bearing upon our problem, we turn to results in the way of mental status. There were fifty-seven cases, ten of whom were under the school limit. Of the remaining forty-seven, seven sent in no report. In four, or ten percent of the forty remaining, there was no progress. In thirty-six, or ninety per cent, appreciable progress was reported. One of the four unimproved cases was syphilitic, the other, the author says was a moron.
Quotation of the teachers' reports will be of interest.
"'Some improvement.' 'Better work than previous year.' 'More effort displayed.' 'Improved wonderfully.' 'Improvement first term, not so much second.' 'Before removal, not transferred; after removal transferred.' 'Very much improved, both mentally and physically.' 'Has made progress.' 'Remarkable improvement.' 'Not transferred before removal, but after.' 'More attentive.' 'A very small but gradual improvement.' 'Am happy to tell you that he is studying more since tonsils and adenoids were removed.' 'Greatly improved.' 'Attention better.' 'More concentration.'"