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.