Recent Views on the Tonsil and Adenoid Problem

BE1FORE comiimencing my paper on recent views on the tonsil and adenioid problem, I xvill take you back to ancient timnes and verv briefly tell you somiiething about the tonsil problem of those days. In the reign of the Roman Emperor Tiberius there lived a imian, Cornelius (ialsus, who wrote an encVclopaxdia, in which, although not himilself a medical imian, lc emboilhocics a treatise on mle(dicinc. In li's I)' Medicimi lic writes of ''idurate(l tonsils," that they result fromii inflammation, and that as they are only covered by a very thin miiembrane, to reimiove them it is only necessary to separate thenm all round with the fingers and lift theimi out-in other Nords, enucleate themii with the finger. Calsus goes on to say that " if this is not possible, the tonsils shotuld be grasped with a hook and excised with a bistuory." There is a great smiiack of modernity in this brief imonograph on the tonsils by this Ancient. A writer in the seventh century gives a detailed descriptioin of how to stop post-operative hfi1enorrhage. For slight hemorrhage he used a tepid decoction of brambles, roses, and mvrtle leaves, but for excessive hTemorrhage somne special type of eairtlh as plastered on the area. He goes oIn to sax that if onI the following (lay the hzemorrhage has not stopped, the area shouild be anoiilte(l with the flow.ers of roses, saffron ancl starch, with milk, or wsith the wh-lite of ail egg. If thle area looked septic, honey poultices wvere used. Albucasis, anl Arabiain surgeon of the elev enth century, wxas probably the first to recomnmniieiid the actual cautery as a means for the removal of the tonsils. Needless to say, it was ilot the electric c.autery. Another imetho(d for renmoval tried muclh later was the application of a ligature rounid the tonsil, which wvas gradually tightened until the tonsil sloughed off. The rotting tonsil in the m11outh1 is said to have infected the breath m11ost horr ibl. A Lonidon surgeon xx rote a book on surgery in 1768; after describilng the crude miiethods used at that time when operatinTg on tonsils, lie winds up with the following: "This operation is not onlv too severe and cruel, but also too difficult in the performnance, to comiie into the practice of the modlerins, because of the obscure situation of the tonsils." WVlhen one consi(lers the mletho(ds adopted and the fact that …