12 November 2007

Tonsils - in or out?

So, this post is a more personal one.

I have my tonsils. I've often wondered why others have theirs removed, since I've always considered them a part of my immune system. I came across this article: "The rise and decline of tonsillectomy in twentieth-century America" by Gerald N. Grob, which as its title describes, explains the history of tonsillectomy in America.

I'm amazed that so many physicians in the early 20th century really believed in the "focal infection theory," or the idea that the tonsils, as diseased organs contributed to systemic disease / infection, such as rheumatism or endocarditis...especially with no evidence! Wow. Fortunately, through numerous epidemiologic studies, and continued scrutiny, tonsillectomy has been on the decline...especially now with the success of antibiotics for various bacterial infections.

I had fun with this article, as it satisfied my curiosity, and wanted to share it with you.


J Hist Med Allied Sci. 2007 Oct;62(4):383-421. Epub 2007 Apr 10.
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2 comments:

Lauren7630 said...

On a personal note, I am having my tonsils removed at the end of this class. My doctors were hesitant on removing them but decided it would be the best to do so. In April, I was hospitalized with a severe and aggressive tonsillitis. I felt a soar throat in the morning and 2 hours later I was in the ER with an obstructed air way and necroses of the tonsils. After several months of observation, it was evident that I have chronic tonsillitis possible do to the deep fishers that were created during the first infection. These fishers are thought to harbor infectious agents. And do to that all my doctors decided it would be best to have my tonsils removed. Plus, I could have a recurrence of the first infection, if I don’t have them removed. So I believe in some cases tonsils may be best if they are removed.

21 November, 2007 11:51
JJ Cohen said...

I think that the reason tonsillectomy works when it does is in line with Lauren7630's story: that the lymphoid tissue is not the problem, it is the deep wrinkles in the pharyngeal epithelium that can trap bacteria in a strange situation that is neither in or out of the body; a great place for them to set up chronic infection. In my view, the operation smooths out the mucosa and leaves no place for the bacteria to hide. Good luck with the operation, Lauren! When I had mine out, I was allowed to eat only ice cream for a week! Yum!

21 November, 2007 17:08

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