Tonsillectomy like circumcision has been subject to much debate. Both have been practiced for more that 2,000 years, the latter often associated with religious practice, while the former was performed because of infection and airway obstruction. Both procedures have become less common today and their use is often questioned.
Tonsillectomy was reported from India in 400 BC. Before anaesthesia it was usually performed with a specially designed guillotine or even by finger enucleation. With the advent of Ethyl Chloride and Ether as anaesthetic agents in the late 19th century its frequency increased remarkably.
The benefit of the procedure became doubtful in the 1950s when it was noted that children who had been on the waiting list for long periods of time lost their symptoms. However in the mid 20th century it was the most common surgical procedure in children.
The anaesthetics used were Ethyl Chloride and Ether. There was a special mouth gag to provide access and the tonsil was freed by blunt and occasionally sharp dissection. Its pedicle was then severed by a snare. Haemorrhage was the most common complication. The anaesthesia was very basic. After mild sedation plus an atropine injection, a gauze mask was placed over the patient’s mouth and nose and Ethyl Chloride was squirted onto the mask. Once the second stage of anaesthesia was reached Ether was used for maintenance. The procedure was simple and commonly performed by general practitioners.