^i IMMUNITY IN HEALTH 



of the two groups to infectious diseases during the 

 remaining years of childhood. The statistical and 

 scientific difficulties would be immense, but until some 

 such investigation has been made, one must conclude 

 that the question of disabilities following removal is 

 quite unproven either way. Isolated cases of infective 

 diseases following tonsilectomy have been recorded. 

 Their occurrence may well have been accidental, but 

 it must not be assumed too readily that removal of 

 the tonsils and adenoids lessens the incidence of infec- 

 tious disease. Indeed, the converse may be the case. 

 A very careful investigation of the after histories of 

 cases submitted to this operation at the Johns Hopkins 

 Hospital has been recorded by Crowe, Watkins and 

 Rotholtz. "During the past four years," they say, 

 ''we have seen eight cases with a history of frequent 

 attacks of tonsilitis preceding, but never with anything 

 but local symptoms." After partial removal of the 

 tonsils "all went well until the next coryza, following 

 which the joint symptoms appeared for the first time." 

 The authors attribute this to cicatricial tissue from the 

 first operation narrowing the crypts as "the joint 

 symptoms gradually disappeared and the temperature 

 returned to normal" after complete removal of the 

 tonsils. But in another part of their paper they write : 

 "Organisms probably pas< through the mucous mem- 

 brane of the nose, nasopharynx and pharynx more 

 frequently than is generally supposed. We have on 

 several occasions seen, in patients whose tonsils and 

 adenoids had been thoroughly removed, an enlarge- 

 ment of the glands of the neck, a return of arthritic 

 symptoms, repeated attacks of rheumatic fever, and 

 especially frequently a recurrence of chorea after a 

 mild coryza or pharyngitis." 



Quite recently Zahorsky published a valuable paper 

 on the late result's of the removal of the tonsils and 



