In 1932 I1 described a reaction, specific in nature, which occurs with each electrosurgical treatment of an infected focus. Subsequent observations have brought to light a rational explanation for the "immunity reaction" which follows electrocoagulation. In order that a scientific appraisal of this so-called "autogenous vaccine reaction" may be made, an analysis of the reaction in 100 patients on whom electrosurgical tonsillectomy was performed has been undertaken.The throat of each patient was swabbed and the predominant organism isolated by smear and culture at the initial treatment. A measured dose of electrocoagulation, desiccation and fulguration was given each patient at each weekly sitting. The time at which the reaction occurred, its duration, type and severity, whether local or general in scope, were noted and recorded in each case.It has been apparent for some time that patients responded with a marked degree of variation in the intensity of their reaction, both local and general, to the standardized electrosurgical treatment of each tonsil. At first, it appeared cursorily that an idiosyncrasy of each patient was sufficient to account for this variation. Empirical observation, followed by systematic analysis, revealed a definite causative factor for the immunologic response to surgical diathermy.Many investigators have noted the end-results of tonsillectomy in childhood and adolescence. The work of Kaiser,2 lately corroborated by Cunningham 3 and by Glover and Wilson,4 stands out as a beacon to a more scientific interpretation of the effects of tonsillectomy and adenoidectomy. Their observations show that the condition of the tonsils is of minor importance in the history of the health of the patient and in the determination of physical measurements; that the contention 1. Silvers, Lewis J.
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