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Old 02-26-2008, 08:19 AM
Zsofia Zsofia is offline
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Why did they used to take everybody's tonsils out?

I'm a little concerned about mine, and it got me to wondering - why on earth did every kid in America in days of yore have their tonsils out? Why was that standard practice? Isn't it usual now to just give antibiotics for infection?

Also, was this the case in other places as well? Is there not a tonsil to be found among Japanese people my mom's age? Australians? South Africans?
Old 02-26-2008, 08:46 AM
CalMeacham CalMeacham is offline
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They didn't used to take everyone's tonsils out. Pepper Mill is my age, and still has hers.

My sister and I, however, don't have ours. Back in our day it was common to excise the tonsils rather than trying to save them -- I don't know why. Maybe antibiotics weren't as reliable and selective then.
Old 02-26-2008, 09:14 AM
Alive At Both Ends Alive At Both Ends is offline
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It was routine in the UK in the 1950s as well. Tonsils were whipped out at the first sign of infection. I think it was standard medical practice worldwide. I have no idea why.
Old 02-26-2008, 09:28 AM
Athena Athena is offline
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After have strep throat once or twice a year for most of my childhood, they finally removed my tonsils and I haven't had it since. That was somewhere around 1981 or so.

I'm glad they did it. Strep throat wasn't fun.
Old 02-26-2008, 10:48 AM
Bayard Bayard is offline
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I can't answer your question. But, if it is of any interest, there was at least some skepticism about the routine removal of tonsils in 1925, when Sinclair Lewis wrote Arrowsmith:

Originally Posted by Sinclair Lewis
Roscoe Geake was a peddler. He would have done well with oil stock. As an otolaryngologist he believed that tonsils had been placed in the human organism for the purpose of providing specialists with closed motors. A physician who left the tonsils in any patient was, he felt, foully and ignorantly overlooking his future health and comfort--the physician's future health and comfort.
I know this is fiction, but Lewis probably wasn't the only person in 1925 thinking, "You know, maybe this is kind of a scam." Whether that sketicism was reasonable or not, I have no idea. According to Wikipedia, Lewis wrote the novel with the assistance of science writer Dr. Paul de Kruif (who received 25% of the royalties on sales). So, my guess is that de Kruif probably shared some of Lewis' cynicism as well.

Last edited by Bayard; 02-26-2008 at 10:49 AM.
Old 02-26-2008, 11:08 AM
TWDuke TWDuke is offline
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A cynical guess would be that it's related to the shift from traditional health insurance, which rewarded physicians for expensive treatments, to HMOs, which reward physicians for withholding expensive treatments.

I have nothing to back this up but cynicism and guesswork.
Old 02-26-2008, 11:22 AM
CalMeacham CalMeacham is offline
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Quick, lazy search, using Wikipedia yields:

Most tonsillectomies are performed on children, although many are also performed on teenagers and adults. The number of tonsillectomies in the United States has dropped significantly from several million in the 1970s to approximately 600,000 in the late 1990s[citation needed]. This has been due in part to more stringent guidelines for tonsillectomy and adenoidectomy (see tonsillitis and adenoid). Still, debate about the usefulness of tonsillectomies continues. Not surprisingly, the otolaryngology literature is usually pro-tonsillectomy, whereas the pediatric literature has the opposing view[citation needed].

And this choice result:

Paradise, JL. and et al. "Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and non randomized clinical trials." The New England Journal of Medicine 310 (1984): 674-83 - Paradise studied 187 children with tonsillectomy or tonsillectomy and adenoidectomy. 91 children were randomly put in surgical and non-surgical groups. The other 96 were place by parentís choice. The results favored the surgical group on reoccurrence of throat infections during their initial and second year follow-up where the data was collected. While non-surgical groups did better in the long run. 13 out of the 95 surgical group encountered surgical complications after their second year follow up
Old 02-26-2008, 11:27 AM
ZipperJJ ZipperJJ is offline
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Originally Posted by Athena
After have strep throat once or twice a year for most of my childhood, they finally removed my tonsils and I haven't had it since. That was somewhere around 1981 or so.

I'm glad they did it. Strep throat wasn't fun.
Boo! I had the same problem in the LATE 80s and they left mine in!
Old 02-26-2008, 11:44 AM
RealityChuck RealityChuck is offline
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In general, people began to think that, just perhaps, a part of the body people came equipped with from birth actually had a purpose. The tonsils and adenoids were considered vestigial and useless in the 50s and 60s, so no one saw any reason not to remove them. There were enough cases of it working -- reducing the severity of colds afterwards -- that doctors and parents were happy.

In some cases, tonsillitis could affect breathing so that an operation wasn't a bad idea.

Later, it was discovered that the tonsils were part of the lymphatic system and getting infected was just part of their doing their job.

I was at the age where tonsils were removed routinely, and I had tonsillitis enough so that they were considering a tonsillectomy, but eventually we decided not to bother, and I didn't have much problem with it after that point. If they had been removed, that would have "confirmed" the operation had an effect.

I was disappointed at the time. Most kids were: they liked the idea of getting all the free ice cream they could eat (the standard menu item post op).
"If a person saying he was something was all there was to it, this country'd be full of rich men and good-looking women. Too bad it isn't that easy.... In short, when someone else says you're a writer, that's when you're a writer... not before."
Purveyor of fine science fiction since 1982.
Old 02-26-2008, 11:47 AM
ivylass ivylass is offline
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I had mine out when I was about 8. Something about recurring sore throats. I don't remember much of it, and I seem to have suffered no ill effects.

Now, my appendix bursting two weeks after Ivyboy was born...that was an event.
Old 02-26-2008, 11:48 AM
CalMeacham CalMeacham is offline
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For both children and adults, tonsillectomies are performed less often than in the past. Tonsils used to be blamed for many different conditions, including skin problems, arthritis and other health problems. Tonsil removal was often the treatment. Today we know that tonsils are beneficial because they filter harmful bacteria and viruses that could cause serious health problems.

Procedure now is apparently only to do tonsillectomies for chronic tonsillitis -- you have to get it at least 4 or at least seven times a year (depending upon the authority you consult). Or if it's indicated by some other condition, such as sleep apnea.

I don't recall my case being chronic -- I got tonsillitis once, and had them out. At least, that's what I recall. I was pretty young when I had them iout.

Last edited by CalMeacham; 02-26-2008 at 11:49 AM.
Old 02-26-2008, 11:53 AM
MLS MLS is offline
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My recollection is that back in the old days it was observed that kids of a certain age got a lot of sore throats, but that after they had their tonsils out this stopped happening, ergo the tonsillectomy cured them. However, nobody had actually done the clinical trial to prove it. Turned out that most of the time after a certain age kids stopped getting as many sore throats anyway. WE know correlation does not equal causation, but apparently lots of folks back in the day didn't.

These days it's not done unless there's a clear need for it, as in swollen tonsils blocking airways or some other condition mandates it. I don't think it has anything to do with HMOs or other insurance. Neither of my children had the operation and they were of the appropriate age before we had an HMO.
Old 02-26-2008, 12:17 PM
kiz kiz is offline
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I had my tonsils out back in 1965. I was in the hospital for almost a week because there were complications of some sort, I don't remember exactly what. But yeah, I ate all the ice cream I could!

It was routine. The part somebody upthread mentioned that tonsils are now thought to help fight harmful bacteria/viruses was unknown back then. There were guidelines, though -- you had to have chronic sore throats/ear infections/whatever else x times within x period of time to be considered for a tonsillectomy. Since I had the first two with alarming regularity as a little kid, I was a shoo-in.

I remember they saved my tonsils in a glass jar for me to take home. They were the size of tennis balls
Old 02-26-2008, 12:18 PM
UltraVires UltraVires is offline
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I just had surgery for obstructive sleep apnea, and my ENT told me that it was "too bad" that I came through a few years after tonsil removal was popular because it most likely would have saved me years of sleep apnea.

Through the years of infections, my tonsils were enlarged and almost useless, serving only to obstruct my airway during sleep...
Old 02-26-2008, 12:27 PM
BwanaBob BwanaBob is offline
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My son fell into the chronic category. He had 5 or 6 strep throats in a 12 month period. Out went the tonsils - no strep throat since then (18 months).
Old 02-26-2008, 02:48 PM
Harmonious Discord Harmonious Discord is offline
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I was having severe infections and eventually the tonsils were removed. My four siblings never had them out. We all had the measles though, which was good for a week and a half off school with all the nasty sores.
Old 02-26-2008, 03:27 PM
Voyager Voyager is offline
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When I was growing up in the '50s, it was pretty standard whenever a kid had too many colds. My brother had his out, and I was scheduled. But I got sick just before I was supposed to be operated on, and my mother decided that was a sign that I shouldn't have them out. I rarely got sick again (I was far from chronic then) and I still have them.

My wife has hers. The first operation her aunt, who was a nurse, assisted in was a tonsilectomy for an adult who died on the table.

When my kids were growing up tubes in the ears were the hot thing. My oldest daughter got lots of earaches, which cleared right up after the tubes got inserted. Her friends had a lot more tubes than tonsilectomys.


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