Welcome to our new regular feature, “Adventures in the Archives!”
In this reoccurring series, Nursing Clio bloggers will share interesting finds in the archives and ask our readers for feedback, ideas, and analysis. It’s just like you’re sitting in the dusty archives with us!
Earlier this summer I was enjoying a productive day in the archives of the Dittrick Medical History Center in Cleveland, Ohio. After lunch, I decided to take a break from the materials I was focusing on (the institutional records of Women’s General Hospital, 1878-1984) and spend a little time skimming through an interesting journal titled “Record of Operations, Woman’s Hospital, September 1, 1920.” The volume looked like an old-fashioned hotel registration book. But the lines of each page were not filled with sloppy signatures and addresses. Instead, someone with very neat handwriting had been tasked with keeping a detailed accounting of every surgical procedure performed by the hospital’s staff. The first entry in the volume was dated September 1, 1920, and the last entry was made on January 15, 1924. The vast majority of the procedures were D&C’s and tonsillectomies, with a handful of Caesarean sections, circumcisions, and other operations. But then I read an entry that nearly made me fall out of my chair: On September 20, 1920, a Mr. Jennings had a tonsillectomy AND a circumcision at the same time. He was not an infant (those were noted as “Baby” rather than “Mr.”, and I’ve never heard of an infant getting a tonsillectomy). His age was not noted. As I pondered what it would be like to be the caretaker of a male of any age who had had a tonsillectomy-circumcision combo (remember, there were no bags of frozen peas, popsicles, or home ice packs in 1920!!!), I came across a second entry for this procedure, this time for a Mr. Shipley. By the time I reached the entries for late August 1921, there were numerous incidences of this surgical double-whammy. At that point, I went back to reviewing the institution’s annual reports. Had to get back to business.
But I haven’t been able to stop thinking about Mr. Jennings and Mr. Shipley. Why were they having these two procedures performed at the same time? Were they both therapeutic, or was one preventive? How old were they? Did they consent themselves, or did someone consent for them? My imagination has been piqued. Unfortunately, my research efforts (read: attempts to avoid working on more pressing matters) have not proven fruitful. A Google© search for “tonsillectomy and circumcision” turned up many articles on both procedures, but only one reference to their simultaneous performance in Maine. This is from an unattributed compilation of anecdotes, so it’s not a reliable source. I also found this reference to a soldier being circumcised (without his prior knowledge or consent) during a tonsillectomy. Taking the search over to Google Books© and Google Scholar© was not any more helpful (although I did read some interesting tidbits!). So I’m putting it out here in the hope that one of you can shed some light on the matter. Anybody have an idea?
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Just a guess, but at the time they were both considered preventative surgeries, so they likely were doing both at the same time just like we have our infants get multiple vaccines at the same time.
See, “The Rise and Decline of Tonsillectomy in Twentieth-Century America” by Gerald Grob, for the idea that tonsillectomy was preventative in particular. And there is a long history of thinking of circumcision as preventative. See: http://www.cirp.org/library/history/gollaher/.
So, I don’t have this particular medical journal available online, but here’s a a Google snippet where it seems a joint tonsillectomy-circumcision was performed in Texas in 1926.
http://books.google.com/books?id=G6lEAAAAYAAJ&q=%22circumcision+and+tonsillectomy%22&dq=%22circumcision+and+tonsillectomy%22&source=bl&ots=fC4UCOYE1x&sig=_K5lpNxm5-fzOxiHYW7iCor7PnI&hl=en&sa=X&ei=OHMiUPf0OKOxywHuiYGgDA&ved=0CEAQ6AEwAQ
Interesting! I know another grad student who has written about the “adenoid riots” in New York City and given fantastic conference papers on the removal of adenoids in public schools as a way to improve student behavior and performance. I think tonsillectomy was also lumped into this kind of thinking . . . might be connected. Not sure.
My ninja Google skills found some interesting psychology case studies. They are generally from the 50s and study men who had been traumatized by undergoing both procedures at the same time. I didn’t have any luck finding the full text versions online, but they should be easy to get via interlibrary loan. Here are the snippets I found:
Social treatment in probation and delinquency: treatise and … Pauline V. Young – 1952
“At this time the father stated the boy practiced masturbation and that probably this was the cause for his trouble, and the mother added that Milton was a bed-wetter and … It was further ordered that arrangements be made for an operation fortonsillectomy and circumcision. ”
Encyclopedia of aberrations: a psychiatric handbook, Edward Podolsky – 1953
“He recalled that, at the age of six, he had a tonsillectomy and circumcision at the same time his sister had her tonsillectomy.”
Marriage counseling: a casebook; the theory and practice of … American Association of Marriage Counselors, 1958
“Fourth Interview: Patient talked of a tonsillectomy which had been performed sometime between the ages of 6 and 9. He felt he had been prepared for thetonsillectomy but not the circumcision which was done at the same time.”
American handbook of psychiatry: Volume 1 -1959
“Peter, aged seven, for example, blinked, gasped, and threw his arm in front of his face, at the same time flexing his … the anesthetic applied before a tonsillectomy at age three during which a circumcision, which he had not been told about,”
Wow, that’s fascinating. I am just wondering, at what age (if there was anyway to find out through medical records) did these men have the procedure. At what age was “Mr.” an appropriate title? It would mean something different if the “Mr.” in question had this procedure at 13 vs. 35. For a teen, would that have been a parental choice? Peer pressure to conform their body to a certain aesthetic (as is sometimes the case with contemporary circumcision). For an older gentlemen would it have been elective? Related to venereal disease? What I am curious to know is are there records of non infant males having only a circumcision procedure? If not is the double whammy tonsillectomy and circumcision a way to cover up what was happening? If you have the tonsillectomy you literally can’t talk about the other procedure. Just some musings over coffee in the morning. I know these are more questions than suggestions. Good luck with this, it would make such an interesting article. And I’ve been really enjoying the site!
I updated the post so that it has the hyperlinks I intended to be there. Thanks for the ideas, everyone! I’m glad to see that I am not the only one who thought this was fascinating.
Tiffany, your ninja Google skills rock! Those sound like very traumatic cases. I’m especially interested in the boy who had both surgeries as a preventive measure when his sister needed the tonsillectomy. It reminded me of the original “Cheaper by the Dozen” (I’ve never seen the remake, so I don’t know if it’s the same) when the whole family had their tonsils out.
Christina, I totally dig the conspiracy theory of performing the tonsillectomy so that they can’t talk about the circumcision! There were records for other males identified as “Mr.” for circumcision. No birthdates or ages were given, though, so there isn’t an easy answer on the age range.
It’s anecdotal but I knew a man in Cumberland, Maryland who had this double surgery performed without his consent when he was about 12, in the late 1950’s. It was traumatic and he felt it was linked to his bipolarity. I suspect that this double procedure was pretty common practice for quite a while. And I suspect that somewhere there’s some med school texts or professional articles advocating it.
Rich Meckel at Brown has presented papers at various conferences on tonsillectomies and adenoidectomies that were regularly performed on public school children. You could see if he’s come across combined tonsillectomy/circumcision
Here’s my guess — according to Meckel, tonsillectomy and/or appendectomies were believed to be treatments for children who were not doing well in school — either because of frequent illness or because of a theoretical link between infected tonsils and intelligence. The examples cited above indicated the circumcision was used to treat various behavioral and mental “aberrations ( e.g. masturbation).
Anyway, it’s worth looking at the literature on pediatrics and child and adolescent psychology to see what’s going on here.
My guess is that taking out tonsils was seen as having a purpose similar to non-religious circumcision. Not prophylaxis but the diminution of male sexual desire.
John Harvey Kellogg, Plain Facts for Old and Young (1888), is a well known example, but it’s everywhere on both sides of the Atlantic.
Try looking for tonsils + desire or sexual. Perhaps not to be found, but a possibility.
The ascription of health purposes to Levitical law arose from the (sometimes) secularizing tendency to read (selected) taboos as wholesome dietary restrictions; e.g. pork and shellfish without refrigeration.
My impression is that the direction has changed. Many of those who promoted circumcision as prophylactic, before large-scale trials were launched in Africa (by whom? evangelicals had a huge influence on US policy), appeared to have the understandable aim of defending religious circumcision against accusations of needless cruelty.