Adenoid

“ I found the front door open. I might have walked in without ceremony; but, inspired by a very proper fear of Miss Ada Weeks, I tapped respectfully and waited. There was no response. Presently I became aware of voices proceeding from the front parlour, the door of which stood wide open just inside the passage. This is what I heard.
"Adenitis, and Adenoid Growths—that's the nearest I can find. Which do you want?"
"I think Adenoid Growths, my dear. Read it through once, as usual; then again line by line." ”

“ It is not uncommon to find adenoid growths in the pharynx of the very young infant. There is a superficial inflammation of the mucous membrane producing a local calorific plus. This is the result of interference with transmission of mental impulses to these tissues and when this interference is removed Innate Intelligence will function normally and the growths will disappear. ”

“ Similar adenoid hyperplasia has been found in the lungs, the bronchial mucous membrane, the pleura, the mediastinal and bronchial glands, and the pericardium. In man this has invaded the nerve centres, and it seems that at any point where there is a lymph gland or a lymph plexus this adenoid hyperplasia may localize itself.
Symptoms. The general symptoms of failing health are as described in leukæmia. The particular symptoms of this disease consist in the recognition of the adenoid hyperplasia in the absence of a marked leucocytosis. ”

“ For adenoid disease is fraught with many evils, among them mental hebetude, blocking of the Eustachian tubes, and manifold other auditory troubles, gastro-intestinal disturbances from the passage into the stomach of unhealthy discharges, and, most serious of all, nasal obstruction and consequent mouth-breathing. ”

“ Pronounced adenoid disease is always associated with mouth-breathing, and there can be no doubt that in the majority of these cases, the nasal obstruction is not in the nasal passages primarily, but is due to a blockage of the posterior nares by the adenoid growths, for it generally happens that nasal breathing is rapidly re-established after their removal, though in a certain proportion of cases the obstruction still persists, and has to be dealt with by treatment directed to the nasal passages themselves. ”

“ Children who suffer from adenoids are usually pale, often narrow-chested, and altogether are not as strong and robust as are normal children.
But this is by no means all of the harm done by adenoids. They affect [5] the voice, disfigure the facial expression, interfere with hearing, give rise to night terrors, open the way for serious invasions by disease germs, and, through the development of chronic nasal catarrh, may lead to loss of the sense of smell. ”

“ More oxygen finds its way to the tissues, his face takes on better color, he gains in weight, in fact, there appears to be a complete rejuvenation mentally and physically.
The signs or symptoms of adenoids are mouth breathing, restlessness at night, snoring, recurring colds, nasal discharge, swelling of the glands of the neck, poor nutrition, loss of appetite, bed wetting, impaired hearing, lack of attention, and mental dullness. The removal of adenoids is neither a serious or difficult procedure, and they may safely be removed at any age. ”

“ Children with adenoids are very liable to colds in the head, which aggravate all the symptoms, and in the slighter forms of the disease the symptoms may hardly be noticeable, except when the child is suffering from a cold.
[10 MOTHERS' REMEDIES] Chronic catarrh is often caused by adenoids. A chronic pus discharge often develops, especially in children. There is often a half-pus discharge trickling over the posterior wall of the pharynx from the nose-pharynx. And yet some children with adenoids never have any discharge from the nose. ”

“ Adenoids always interfere with respiration, thereby depriving the child of a normal quantity of oxygen, thus rendering the blood less pure, and, as a consequence, seriously interfering with the nourishment and general health. The impaired nourishment and poor health thus produced, as a direct result of adenoids, renders the child more liable to disease; he may thus acquire ailments that may affect his whole subsequent life. ”

“ How to Tell When a Child Has Adenoids.—Children with well-developed adenoids are "mouth-breathers." Instead of breathing through the nose they breathe with the mouth open, especially when sound asleep. If a child has a discharge from its nose and a chronic cough, both of which resist treatment, and if in addition it is a mouth-breather, it is safe to investigate the naso-pharynx for adenoids. ”

“ Relief is immediate and the health and strength of the child usually improves rapidly afterwards. It is wrong to delay having the operation done, for the presence of adenoids not only endangers the child's health, but a few months' delay may cause considerable malformation of the jaws, palate, nose, and face. ”

“ Often a surprising development of both mental and physical power follows the removal of adenoids. In one case reported by Professor Swift, a girl of fourteen grew three inches within six months after an operation for adenoids, and at the same time showed an improvement in her school work that contrasted strikingly with the dullness that preceded it. Another, three years younger, grew six inches in about five months, and from being a sad idler was transformed into an unexpectedly attractive and bright pupil. ”

“ The influence in setting up adenoids of toxic saturation with its resulting catarrhal tendency is shown by the frequency with which this affection follows upon the rhinitis and naso-pharyngitis of measles and diphtheria, and in order to realise how greatly the circulation of blood and lymph in the walls of the naso-pharynx must be influenced by mastication, one has but to remember how very closely the pterygoids are related to this region; in exploring it for adenoids they can, indeed, often be felt to stand out prominently. ”

“ The presence of adenoids should be suspected if the child habitually sleeps with open mouth, snores a great deal, or has frequent strangling coughing spells. Sleeping with open mouth is one of the first signs and should therefore lead at once to a careful examination by a physician. Sometimes difficulty in hearing is one of the early symptoms. Therefore, in all cases of ear trouble an examination should be made for adenoids. ”

“ The tale of troubles due to adenoids is not even yet exhausted; a considerable amount of discharge collects about them which it is not easy to clear away, it undergoes very undesirable changes, and is then swallowed to the great detriment of the stomach and the digestion. The removal of septic tonsils and of adenoids is most urgently necessary, and usually involves little distress or danger. The change in the child's health and appearance that can thus be secured is truly wonderful, especially if it be taught, as it should be, to keep its mouth shut and to breathe through the nose. ”

“ The aim of this study is, rather, to determine experimentally whether or not there exists any causal relation between defect in this respect and lowering of intelligence level. One hears statements made both pro and con by physicians and laymen but there has been little experimental proof. It would seem to be rather useful for a physician to know in advance with how much probability of correctness he is speaking, when he advises a mother that the removal of adenoids and tonsils from the throat of her backward child will make him "bright." ”

“ If a child with these symptoms is not in good health, is listless and depressed, looks stupid, snores at night, has difficulty in breathing and cannot blow its nose satisfactorily, is troubled occasionally with "nose bleeds" and headaches, we may be satisfied that the child has adenoids, as no other condition could produce such a picture. ”

“ A great many suffer from adenoids, and some are dull and backward because they are ill, or in a chronic state of discomfort, strain, or depression because of bad feeding, bad air, want of sleep, and the burden of a life passed under difficult conditions. ”

“ Adenoids form a soft, velvety mass, which projects from the vault of the naso-pharynx and extends down its posterior and lateral walls, in some cases filling up the fossæ of Rosenmüller behind the Eustachian cushions. They do not grow from the margins of the posterior nares. Adenoids are frequently associated with hypertrophy of the faucial tonsils, and the patient often suffers from granular pharyngitis and chronic nasal catarrh. ”

“ This disease is, in fact, scarcely less prevalent in the country than in the towns, scarcely less common among the rich than among the poor. Yet in primitive communities it is practically unknown. And what, I would ask, is the one condition in the material environment of my supposititious child differing from that of the primitive child? What but the factor of diet? Therefore, I say, the prevalence of adenoids among moderns must be the result of the modern system of feeding children, and the defective mastication which goes along with it. ”

“ A Study of Improvement After Treatment
The method employed here is based on the hypothesis that if a physical defect is the cause of retardation in mental or physical development, removal of the cause will tend to lessen [Pg 25] the retardation. In other words, if a child's working efficiency is lowered by the effects of adenoids and bad tonsils, their removal should, unless such lowering be permanent, be followed after a reasonable time by an improvement. ”

“ Clyde.
“From her remotest imaginable ancestor, probably.”
“Why, aren’t they a disease?”
“No. An inheritance. The race has always had them. Probably they’re vestigial salivary glands, the use of which we’ve outgrown. Unfortunately they may overdevelop and block up the air-passages. Then they have to come out.”
For the first time in the conference Grandma Sharpless gathered force and speech.
“Young man,” she said solemnly—rather accusingly, in fact—“if the Lord put adenoids in the human nose he put ‘em there for some purpose.” ”

“ When this goes on for some time the nose and throat should be examined by a physician for adenoids, or growths of soft masses of tissue which fill up the nose cavity, thus causing a shortage of the air supply for the body. Many a child, backward at school, thin and irritable, has been changed to a healthy, normal, bright scholar by the removal of adenoids. Sometimes the tonsils at the back of the mouth cavity may become enlarged, thus shutting off the air supply and causing the same trouble as we see in a case of adenoids. ”

“ In the unenlightened days many children must have got well of adenoids without operation, and even at the present time it by no means follows that because a child has these postnasal vegetations he must forthwith be operated on. The condition is very similar to that of enlarged tonsils, where with time, patience and attention to general measures, operation is often rendered unnecessary. ”

“ Allowing the child to "outgrow" adenoids may mean not only that he is being subjected to infection chronically but that his body is allowed to be permanently deformed and his health endangered. Beginning at the age of the second dentition, the bones of jaw, nose, throat, and chest are undergoing important changes—nasal occlusion. Adenoids left to atrophy—if large enough to cause mouth breathing—may mean atrophy of this developing process, permanent disfiguration of face, and permanent deformity of chest and lungs. ”

“ The diet may be at fault; adenoids are supposed by some physicians to be the cause. No matter what the actual cause may be, it must be found and remedied before we can hope for a permanent cure. A very large majority of these cases are due to nervousness. These children are of a nervous temperament. They are not necessarily sickly children; they are simply of a nervous type. They are well-nourished, active, and lively. Incontinence of urine during the day and long-continued bed-wetting does not at all affect the health of the child. ”

“ The mental side of a child's development is also affected by the presence of adenoids, so much so that actual statistics prove that these children cannot keep up with their classes in the public school. ”

“ It was expected that improvement in general health would probably follow the removal of the defects. This physical gain should come to light in increased height and weight. In every case, therefore, height and weight were measured.
It is conceivable that adenoids and tonsils might have no effect upon general intelligence, and yet might cause a noticeable pedagogical retardation, simply as a result of the child's physical handicap, tendency to fatigue and consequent defect in attention or sustained effort. ”

“ The point of greatest interest in the present study is, as has been said, improvement in intelligence. Does operation for adenoids and tonsils result in improvement in intelligence, as measured by I.Q.? If such improvement does not manifest itself after six months, can it be found after a second period of the same length? The latter question is answered by observation of Table XXI and attention to the following facts, gathered from the 21 pairs of cases who were given intelligence tests after the twelve months' interval. ”

“ Since we were unable to secure a large test group from Public School 64, the experiment was continued at the Manhattan Eye, Ear and Throat Hospital where opportunity was given for testing the children after they had been admitted for operation. In order to be sure that in each case the defect was sufficiently pronounced to render decisive the results of the experiment, each child's card was examined. Only those [Pg 26] children were included who were undergoing operation for both adenoids and tonsils. ”

“ Adenoids sometimes become so enlarged that they interfere with the passage of air through the nose, thus predisposing to catarrh, colds, and other respiratory diseases, to high palate with irregular teeth, to inflammation of the middle ear leading to deafness, to diminished mental activity, and to general poor health.
If a child breathes through his mouth, if he snores at night, keeps his mouth open and has a dull, apathetic expression, his nose and throat should be examined, and if advisable his tonsils and adenoids should be removed. ”