Diseases Of The Eye, Ear, Nose And Throat

EFFECT OF ACUTE TONSILLITIS; SOME OF ITS CONSEQUENCES

ALTHOUGH it may occur during any season of the year, like all infections of the respiratory tract, acute tonsillitis is more likely to occur in the winter time and during inclement weather.

Anyone who ever has had it will tell you that it is quite a disease. There is not much to be seen in the throat except that the tonsils are swollen and red, and that there are little pockets of pus scattered through them. But this apparently slight invasion is calculated to make a person feel about as miserable as anything known.

I am sure that most people with tonsillitis feel worse than those with a severe case of diphtheria. In fact, one of the dangers of diphtheria is that the patient does not feel very bad constitutionally; there is a little sore throat and a mild amount of malaise the first few days, and all too frequently these are allowed to pass on as being of no consequence, and the precious time is lost when antitoxin treatment could do the most good.

But bad as acute tonsillitis is, some of its consequences may be even more serious. One immediate sequel is quinsy. Quinsy is known as “retropharyngeal abscesses,” and is the extension of the tonsillar infection into the tissues of the soft palate at the back of the throat. An abscess is formed. The discomfort from this mass in the back of the throat, which usually interferes quite considerably with breathing, is almost the limit of human endurance.

There is no way to predict whether or not acute tonsillitis will develop into quinsy and no way for the attending physician to prevent it. Many families blame the doctor when this accident occurs, but this is entirely unjust, as it happens with the best care. The only way to prevent it is, after an acute attack of tonsillitis, to have the tonsils out.

Following one of the fundamental surgical rules not to operate in the presence of acute infection, or not to handle acutely infected tissues, removal of tonsils during the acute stages of tonsillitis is universally condemned, but after the infection has calmed down, they certainly should be removed. An attack of acute tonsillitis is a certain indication for removal of the tonsils. After the attack the tonsils may harbor germs which send out their toxins through the body, producing infection of the joints, of the bones, infection in the eye, the kidneys and heart muscle, and skin rashes. Such being the case, it seems only sensible to remove such a potential source of danger.

WHY AND WHEN THE TONSILS HAD BETTER BE REMOVED

“I have a theory,” writes a reader, “that everything in the body is of some value, and I wonder whether the tonsils can be taken out without doing harm. What are the functions of the tonsils?”

The theory is a pleasant one, but does not always hold water. We have many scraps and relics of anatomical structures in our bodies that might once have been useful, but are no longer. And it certainly is abundantly demonstrated that the tonsils can be removed without any change in the individual’s health.

Like most questions of this kind, however, an exception should be made, for when disease attacks a structure it changes it from a useful to a dangerous part of the body, and we are even able to remove diseased structures, which in a normal state are very useful, and the body has great powers of compensation to make things run smoothly even without these highly necessary structures.

The function of the tonsil is probably the same as the function of any lymph gland. Its structure is the same as a lymph gland, the only difference being that it is exposed on the surface of the body, at the very portal of entry of food and air, without any capsule on the exposed surface. It may be assumed, therefore, that it has the same functions as any other lymph gland, that is, to provide a barrier against the advance of infection from one tissue to another.

The tonsil destroys bacterial infections, or enmeshes and holds them and this, to some extent at least, prevents their entrance into the general system. This function is most active in early life, and it is in early life that the tonsils are largest. The function is impaired with the infective process that the tonsil sustains, and it is probably finally abated entirely as the tonsils are more or less changed by their constant warfare against invading infection.

A normal tonsil, at any age, has some useful function. Its function is most active in the first two years of childhood. A seriously diseased tonsil has no useful function and, in fact, is a serious menace to health. When repeated infections have occurred, the tonsil is likely to be a resting place for germs of all kinds, which may spread to different parts of the body and produce serious alterations in the bones, joints, eyes, heart muscle, kidneys, etc.

For that reason, when infection occurs after the first two or three years of life, it is a beneficial thing to remove such a cesspool of filth.