06 IMMUNITY IN HEALTH 



X^ensation that local losses cah usually be made good. 

 It is probable that adjacent subepithelial lymphatic 

 glands hypertrophy and largely replace the organs 

 removed. 



Another consideration which may serve to stay the 

 surgeon's hand in absence of definite call for operation 

 is the fact that the subepithelial lymphatic glands lie 

 close to an alimentary canal swarming with pathogenic 

 organisms. 



Any removal involves cutting into this region as well 

 as dividing healthy tissues'. With the vermiform ap- 

 pendix technical skill has so well met the difficulty 

 that the risk in removing a normal or quiescent appen- 

 dix should be little, if any, greater than the risk of 

 exploratory laparotomy. But removal of tonsils and 

 adenoids can make no pretence to being an aseptic 

 operation, and septic complications are far commoner 

 than is generally admitted. The following is a list of 

 complications directly the result of the operation for 

 removing these structures ; — 



Sapraemia with pyrexia for a week or more. 



Suppurating cervical glands. 



Retropharyhgeal abscess. 



Suppurative otitis media. 



Septicoemic abscess (e.g., abscess of rib). 



Endocarditis. 



Primary, reactionary, and secondary haemorrhage. 



Syncope, sometimes fatal, during anaesthesia. 



Bronchitis and pneumonia. 



Some cases "of scarlatina, of diphtheria and of rheu- 

 matic fever have been recorded. 



In view of the bacteriology of the fauces, the wonder 

 is that septic complications are not more serious than 

 they are. Perhaps the explanation is that the resulting 

 wounds are freely open ones. 



Dr. Mackenzie (1912) has written eloquently against 



