10 Fascinating Facts About the Tonsils

iStock
iStock

The human body is an amazing thing. For each one of us, it's the most intimate object we know. And yet most of us don't know enough about it: its features, functions, quirks, and mysteries. Our series The Body explores human anatomy, part by part. Think of it as a mini digital encyclopedia with a dose of wow.

Most of us only become aware of our tonsils if they become swollen or infected, as in the condition tonsillitis. But these masses of lymphatic tissue in the mouth and throat are considered "immunological guardians of the upper aerodigestive tract," according to a 2016 study in the Encyclopedia of Immunobiology. To learn more about the tonsils, Mental Floss spoke to Raja Seethala, the director of head and neck pathology at the University of Pittsburgh Medical Center and a member of the College of American Pathologists Cancer Committee, and Donald Levine, an ear, nose, and throat specialist in Nyack, New York.

1. YOU ACTUALLY HAVE FOUR KINDS OF TONSILS.

When used in the general sense, the term tonsils usually refers to your palatine tonsils, the ones that can be seen at the back of your throat. But tonsillar tissue also includes the lingual tonsil (located in the base of the tongue), tubal tonsils, and the adenoid tonsil (often referred to in the plural). "Collectively, these are referred to as Waldeyer's ring," Seethala explains to Mental Floss.

2. THEY ARE ONE OF YOUR BODY'S FIRST RESPONDERS TO PATHOGENS.

The tonsils are key first responders to inhaled or ingested pathogens that can cause infection or other harm, Seethala says. "These pathogens bind to specialized immune cells in the lining—epithelium—to elicit an immune response in the lymphoid T and B cells of the tonsil." Essentially, they help begin your immune response.

3. ADENOIDS CAN OBSTRUCT BREATHING AND CAUSE FACIAL DEFORMITIES.

If the adenoids become enlarged, they can block breathing and clog up your sinus drainage, which can cause sinus and ear infections. If adenoids are too big, it forces a person to breathe through their mouth. In children, frequent mouth breathing has the potential to cause facial deformities by stressing developing facial bones. "If the tonsils are too large and cause airway obstruction, snoring, or obstructive sleep apnea, then removal is important," says Levine. Fortunately, the adenoids tend to get smaller naturally in adulthood.

4. AS MANY OF US KNOW, SOMETIMES THE TONSILS NEED TO GO.

Even though your tonsils are part of your immune system, Levine says, "when they become obstructive or chronically infected, then they need to be removed." The rest of your immune system steps in to "handle further infectious assaults." Another reason to remove tonsils besides size, Levine says, is "chronic tonsillitis due to the failure of the immune system to remove residual bacteria from the tonsils despite multiple antibiotic therapies."

5. TONSILLECTOMIES HAVE BEEN PERFORMED FOR MILLENNIA.

The idea of removing a tonsil is believed to have been in existence for three millennia. The procedure is found in ancient Ayurvedic texts, says Seethala, "making it one of the older documented surgical procedures." But though the scientific understanding of the surgery has changed dramatically since then, "the benefits versus harm of tonsillectomy have been continually debated over the centuries."

6. EARLY TONSILLECTOMIES WERE PROBABLY QUITE PAINFUL.

The first known reported case of tonsillectomy surgery, according to a 2006 paper in Otorhinolaryngology, is by one Cornélio Celsus, a Roman "encylopaediest" and dabbler in medicine, who authored a medical encyclopedia titled Of Medicine in the 1st century BCE. Thanks to his work, we can surmise that a tonsillectomy probably was an agonizing procedure for the patient: "Celsus applied a mixture of vinegar and milk in the surgical specimen to hemostasis [staunch bleeding] and also described his difficulty doing that due to lack of proper anesthesia."

7. THE SURGERY WAS PERFORMED FOR HIGHLY UNLIKELY REASONS.

The same paper reveals that among some of the more outlandish reasons for removing tonsils were such distinctly un-tonsil-related conditions as "night enuresis (bed-wetting), convulsions, laryngeal stridor, hoarseness, chronic bronchitis, and asthma."

8. EARLY TREATMENTS INCLUDED FROG FAT AND OILS.

As early practitioners struggled to perfect techniques for removing tonsils effectively, another early physician, Aetius de Amidarecommended such treatments as "ointment, oils, and corrosive formulas with frog fat to treat infections."

9. MODERN TONSILLECTOMY IS, THANKFULLY, MUCH MORE SOPHISTICATED.

A common technique today for removing the tonsils, according to Levine, is a far cry from the painful early attempts. Under brief general anesthesia, Levine uses a process called coblation. "[It's] a kind of cold cautery, so there is almost no bleeding, less post operative pain, and quicker healing. You can return to normal activities 10 days later," Levine says. 

10. ONE KIND OF TONSIL CANCER IS A SEXUALLY TRANSMITTED DISEASE.

In contrast to other head and neck sites, the incidence of tonsillar cancers is increasing, according to Seethala. "Unlike other head and neck cancers, which are commonly associated with smoking and alcohol, tonsillar cancers are driven by high-risk human papillomavirus (HPV)," he says. He notes, "HPV-related tonsillar cancer can be considered sexually transmitted."

Why Is Pee Yellow?

Chloe Effron
Chloe Effron

WHY? is our attempt to answer all the questions every little kid asks. Do you have a question? Send it to why@mentalfloss.com.

Your body is kind of like a house. You bring things into your body by eating, drinking, and breathing. But just like the things we bring home to real houses, we don’t need every part of what we take in. So there are leftovers, or garbage. And if you let garbage sit around in your house or your body for too long, it gets gross and can make you sick. Your body takes out the garbage by peeing and pooping. These two things are part of your body’s excretory system (ECKS-krih-tore-eee SISS-tem), which is just a fancy way of saying “trash removal.” If your body is healthy, when you look in the toilet you should see brown poop and yellow pee.

Clear, light yellow pee is a sign that your excretory system and the rest of your body are working right. If your pee, or urine (YER-inn), is not see-through, that might mean you are sick. Dark yellow urine usually means that you aren’t drinking enough water. On the other hand, really pale or colorless pee can mean you might be drinking too much water! 

Your blood is filtered through two small organs called kidneys (KID-knees). Remember the garbage we talked about earlier? The chemicals called toxins (TOCK-sins) are like garbage in your blood. Your kidneys act like a net, catching the toxins and other leftovers and turning them into pee.

One part of your blood is called hemoglobin (HEE-moh-gloh-bin). This is what makes your blood red. Hemoglobin goes through a lot of changes as it passes through your body. When it reaches your kidneys, it turns yellow thanks to a chemical called urobilin (yer-ah-BY-lin). Urobilin is kind of like food coloring. The more water you add, the lighter it will be. That's why, if you see dark yellow pee in the toilet, it's time to ask your mom or dad for a cup of water. 

To learn more about pee, check out this article from Kids Health. 

12 Facts About Kidney Stones

Illustration by Mental Floss. Images: iStock
Illustration by Mental Floss. Images: iStock

Kidney stones are more common than ever. According to Harvard Medical School, every year more than 3 million people see a doctor for relief from these hard mineral and salt deposits, which form in your kidney when urine becomes too concentrated. Here's what we know about the condition formally called nephrolithiasis.

1. KIDNEY STONES TYPICALLY CAUSE REALLY PAINFUL SYMPTOMS.

At first you may notice your urine is cloudy, bloody, and foul smelling. Your back may begin to ache, and nausea may come over you. Then, as the stone moves from your kidney into your urinary tract or bladder, sometimes becoming trapped, there’s often an intense, stabbing pain that many people say they wouldn’t wish on their worst enemy.

2. MOST PEOPLE DEVELOP ONE TYPE OF STONE …

What kind of kidney stone you get depends on your diet, fluid intake, genetics, hereditary disorders, and even whether you take certain medications, but the vast majority of people get calcium oxalate stones. They're formed from a mix of calcium in urine and the compound oxalate, which is found naturally in food like nuts, chocolate, and some vegetables, including beets and spinach; oxalate is also produced by your liver. There's some evidence that people who take the seizure medicine topiramate can develop these stones in the form of calcium phosphate.

3. … BUT THERE ARE THREE OTHER KINDS TOO.

Struvite stones are fast-growing mineral deposits that typically develop in response to a urinary tract infection, and can grow large enough to block the kidney, ureter, or bladder before you notice any symptoms; they affect women more than men. Uric acid stones turn up in people who eat a lot of red meat, shellfish, and organ meats, which contain hefty doses of an organic compound called purine that can lead to more uric acid than the kidneys can excrete. Cystine stones are caused by a rare hereditary disorder called cistinuria in which your kidneys excrete excessive amounts of the amino acid cystine.

4. THEY'RE EXTREMELY COMMON—ESPECIALLY IN MEN.

There's a solid chance you could end up with a kidney stone. The National Kidney Foundation notes that one in 10 people will develop one during the course of their life. And if you’re male, take note: Your gender alone is considered a kidney stone risk factor. Men are twice as likely as women to develop them. Another factor is age: Although stones are most common from ages 20 through 50, they tend to peak around age 30.

5. IF YOU’VE HAD A KIDNEY STONE, YOU’LL PROBABLY DEVELOP ANOTHER ONE …

Sorry to say, but simply having a kidney stone puts you at risk for a recurrence. If you’ve had one, the U.S. National Library of Medicine notes that there’s a 30 to 50 percent chance more stones will form within five years.

6. … BUT YOU CAN TAKE STEPS TO PREVENT THEM.

Cutting back on sodium (i.e. deli meats, packaged soups, and processed foods) can help, because a stone can form from excessive salt consumption. You should also avoid too much animal protein—it produces urine containing more acid, which is known to increase your risk for kidney stones—and increase your intake of fruits, vegetables, whole grains, and low-fat dairy. And be sure to drink plenty of fluids, especially water—at least 12 glasses a day. (That's good advice for everyone, not just those prone to kidney stones.)

Don't drink much apple or cranberry juice as both contain oxalates and are linked to an increased risk of developing calcium oxalate stones. High doses of Vitamin C may boost the concentration of oxalate in urine; the Cleveland Clinic recommends a daily maximum of 500 milligrams.

7. IT'S A MYTH THAT CALCIUM CREATES SOME KIDNEY STONES.

Despite the fact that the word calcium is part of the most common kind of kidney stone, you don’t need to treat calcium as the enemy. In fact, having too little calcium can actually increase the odds you’ll get these types of stones. According to the Cleveland Clinic, eating about two or three servings of calcium-rich foods daily reduces oxalate absorption, helping to keep calcium oxalate stones away. So get out the cheese.

8. IF YOU PASS A STONE, CONGRATULATIONS! NOW TAKE IT TO A DOCTOR.

Ninety percent of kidney stones are passed through urination. Getting one out this way may hurt a lot, but once the stone has finished causing you agony, it could provide clues that could help you avoid developing another one. If you’re able to retrieve the stone, bring it to your doctor, who can order an analysis. Identifying its components can reveal the kind of stone it is and potentially point to a treatment or prevention plan.

9. IF YOU CAN’T PASS A STONE, TREATMENTS ARE AVAILABLE …

In an attempt to exit the body, a stone travels from the kidney to the bladder through a narrow tube called the ureter. If the stone is larger than a quarter-inch, it's simply too big to pass through the ureter, and will get trapped there. (If it can make it through to your bladder, it's small enough to pass out out of your body through the urethra.) This causes intense pain, blocked urine flow, and possible bleeding from urinary tract walls. That's when it's time for treatment.

There are several methods for getting rid of a kidney stone, all of which aim to break the stone into smaller pieces so they can leave the body. In an extracorporeal shock wave lithotripsy (from the Greek for "crushed stone"), high-frequency sound waves are applied externally to break stones up, allowing them to pass when you pee. Laser lithotripsy takes a similar approach: Stones in the ureter are broken up with a laser and also leave the body naturally. More invasive is percutaneous ultrasonic lithotripsy, which involves passing narrow instruments (including a fiberoptic camera) through your back to your kidney; ultrasound breaks the stones up, and then fragments are removed by an instrument. Finally, a ureteroscopy is a treatment option in which a small scope is inserted in the ureter towards the bladder to determine the stone's location. Then it's broken up for natural passage or removed altogether. Luckily, you're unconscious under general anesthesia during the last procedure.

10. … AND THEY'RE FAR SUPERIOR TO THOSE USED IN THE PAST.

Kidney stones are nothing new—mentions of the painful formations go back more than 5000 years, to Mesopotamian medical texts—and medical interventions have occurred for just as long. Stones made it into the Hippocratic Oath, in which physicians swore they would "not use the knife, not even on sufferers from stone," leaving the procedure to "such men as are engaged in this work" [PDF]. Surgeons in ancient Greece and India were attempting stone removal as far back as the 7th century BCE.

The 16th to 18th centuries were a heyday for stone surgeons, who were largely self-taught. The most notorious of them was Frere Jacques Beaulieu. He pioneered the lateral perineal lithotomy—which involved making an incision in the perineum, inserting a terrifying cutting instrument into the bladder, cutting up the stone, and then extracting the pieces with the instrument or his fingers—in the late 17th century. Unfortunately for his patients, he had no technical training, and his method was often deadly; in 1698, after 25 of his 60 patients died, he was banned from doing the procedure—but he didn't stop. He's thought to have performed more than 5000 lithotomies. (And no, the song doesn't seem to be about him.)

11. IF ALL ELSE FAILS, TRY RIDING A ROLLER COASTER.

If you’re a thrill seeker who happens to have kidney stones (and some vacation time), you may be in luck. After a "notable number" of patients reported that riding the Big Thunder Mountain roller coaster at Walt Disney World in Orlando helped them to pass their kidney stones, Michigan State University urologist David Wartinger decided to investigate. He created a kidney replica—complete with kidney stones—put it in a backpack, and let it ride the roller coaster 60 times. It worked—but passing the stones depended on where the backpack was placed in the coaster. Rides in the last car were the most effective, with the stones passing 64 percent of the time, while the front few cars yielded only a 16 percent success rate.

Big Thunder Mountain was the only ride in the theme park that was effective. Neither Space Mountain nor Aerosmith's Rock 'n' Roller Coaster did the trick, likely because they were too fast, with a G-force that pinned the stones in place. Of course, while this is an interesting finding, if you suspect you have kidney stones, speak to your doctor before you high-tail it to Walt Disney World.

12. A KIDNEY STONE THE SIZE OF A MOUSE WAS REMOVED FROM A MAN IN 2004.

The stone measured 5.11 inches at its widest point—a world record. Five years later, a whopping 2.5-pound stone was surgically removed from a man in Hungary in 2009. Perhaps seeing a bunch of kidney stones in one place other than originating from your own body will put you at ease. If that’s the case, check out the International Museum of Surgical Science in Chicago, where a collection of stones is on display in glass jars.

SECTIONS

arrow
LIVE SMARTER
More from mental floss studios