Trolls and proxy posts against Harvey and Lee.

[Jim Hargrove]

So, I don't want to put myself in the middle of this multi-dimensional debate, but I feel compelled to point out, as a father whose kid has had tonsillitis, and a partial tonsillectomy/adenoidectomy (sp?), that a.) partial removal of the tonsils is common (at least now it is), and b.) "normal" in a diagnostic sense means "not inflamed," not that the tonsils have regrown from a post-operative culling.

The doctor calls my kid's partially removed tonsils/adenoids "normal" at our yearly visits. However, she has cautioned us that tonsillitis may recur.

That must be relatively new. As the following excerpt from a peer-reviewed medical monograph shows, complete removal of the tonsils became standard starting around 1910.

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A HISTORY OF TONSILLECTOMY:
TWO MILLENIA OF TRAUMA, HAEMORRHAGE
AND CONTROVERSY
By RONALD ALASTAIR McNENLL, M.B., B.Ch.
Senior House Officer in Surgery, Royal Victoria Hospital, Belfast
....


The first sign of a permanent change from partial to complete removal of the
tonsils came in 1897. Ballenger in the U.S.A. realised that partial removal failed
to alleviate symptoms completely in a large majority of cases. He began to
remove the tonsil with its capsule, using a scalpel and forceps. His results, using
this new technique, were so much better than partial removal, for a time the
guillotine fell into disrepute in America.




Some ten years later, dissection tonsillectomy was pioneered in this country
by George Waugh of Children's Hospital, Great Ormond Street. In 1909 he
published, in the Lancet, his account of nine hundred cases of dissecting out
the tonsils complete with capsule, using fine dissecting forceps and curved
scissors. The operation was performed with the patient lying on his back with
the head extended. The tongue was held out of the way with a stitch, and the
mouth held open with a gag between the last molar teeth. Waugh became a
great opponent of guillotine tonsillectomy, giving his reasons in these words:
"Even in highly skilled and experienced hands, the complete removal of
tonsils by means of a guillotine is a task of such technical difficulty as to be,
except in a few rare cases, quite impossible."




In the following year Whillis and Pybus in Britain and Sluder in America
pointed out that a guillotine with a fairly blunt blade instead of a sharp one
could be used in such a way as to enucleate the tonsil complete in its capsule.
Whillis and Pvbus gave the following figures for their series:




Tonsil completely enucleated in its capsule - - - 74%
,,,, capsule incomplete - - 13.5%
in two pieces - - 9%
in three pieces - - 0.5%
Incompletely enucleated - - - - - 3%




From this time onwards the value of complete removal of the tonsil has been
accepted.

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