Better Leave Them In

Doctors used to snip out tonsils right & left. They thought that the tonsils did no good, that large tonsils were always infected, that infected tonsils could cause all manner of serious diseases, so they were "better out." The operation was supposed to be so trivial that any physician could do it in his office. The result, for a generation or so, was "the massacre of the tonsil."*

Doctors know better nowadays, says Dr. Francis L. Lederer of the University of Illinois, but too many tonsils are still being snipped. The first thing to remember, he writes in Postgraduate Medicine, is that all sorts of germs nestle in the tonsils from infancy; the body destroys many of them on the spot. Thus, the tonsils are a natural battlefield where a child can develop useful immunities.

Tonsils should never be removed just because they are large (no harm in that, and small, embedded ones may be worse), or because of frequent sore throats, says Dr. Lederer. The operation should be performed only if the tonsils have been "acutely and repeatedly" infected. Then it should be done in a hospital by a specialist. But nowadays, with the new antibiotics, serious infections starting in the tonsils should be few & far between. Says Dr. Lederer: "We certainly should expect the number of tonsillectomies to drop off dramatically and almost . . . completely."

As one fad dies out, another often takes its place. The latest, Dr. Lederer believes, is the indiscriminate use of radium treatments for adenoids. These oldtime medical villains (once blamed for everything from bad teeth to snoring) should be left alone, he says, unless they are damaging the patient's hearing. If so, out with them.

* Thirty-odd years ago tonsils were often clipped instead of cut out, which made them tougher and sometimes bushier, like pollarded poplars.

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