Howard Fischer
Uppsala, Sweden

 

Sagittal section of nose mouth, pharynx, and larynx showing the adenoids, or pharyngeal tonsils (in green). Not to be confused with the tonsils in the back of the throat. From Grays Anatomy, 20th edition. Bartleby via Wikimedia. Public domain.

On June 28, 1906, thousands of Eastern European Jewish women surrounded and attacked twelve public schools in the Lower East Side of Manhattan.¹ The community where they lived was an “unbearably crowded, unhealthy, and impoverished urban neighborhood.”² The Danish-American photographer, journalist, and social reformer Jacob Riis wrote that “nowhere in the world are so many people crowded together on a square mile as here.”³

The rioters believed that their children were going to be harmed or murdered by physicians employed by the school system. One week earlier, a group of students in Public School 110 had on-site surgery for the removal of enlarged adenoids. The adenoids, or nasopharyngeal tonsils, are collections of “lymphatic tissue located behind the nasal cavity, in the roof of the nasopharynx, where the nose blends into the throat.” This tissue enlarges from birth until five to seven years of age, and usually regresses by adolescence.⁴ Physicians and school systems during this time period were concerned about nasal obstruction and mouth breathing caused by adenoid enlargement. Mouth breathing, they thought, would lead to less brain oxygenation and “feeblemindedness.”⁵

In 1905, New York City became one of the first cities to inspect school children for adenoid hypertrophy. The chief medical inspector for the New York City Department of Health found that at Public School 110 in a group of 150 children in classes for “backward, incorrigible or truant” children, 137 (91%) had adenoidal hypertrophy. After adenoidectomy, “all but four had remarkable academic improvement.” This enthusiasm started to wane towards 1910, as it became recognized that the diagnosis was often subjective and over-used.⁶

Before the 1906 riot, some local doctors went door-to-door telling parents that their children were “in danger in the hands of Christian physicians.”⁷ They saw the free surgical service in school as a “threat to their business,”⁸ as they would have charged fifty cents per adenoidectomy.⁹ The rioting parents believed that their children would “have their throats slit.”¹⁰ School windows were broken, school personnel assaulted, and police reserves called out. School authorities let the children out of school so their parents could see that they were unharmed. Two rioters were arrested for disorderly conduct, and another for pointing a pistol at a physician. The New-York Tribune called the riot a “tempest in a teapot,”¹¹ and claimed that the Lower East Side was a “volcano of superstitious ignorance.”¹²

These parents were not aware that adenoidectomy was considered to be standard medical practice at that time. They appreciated their children’s education but did not believe that health “was the business of school teachers.” However, it was established policy that public schools “served a public health function.”¹³ Consent forms in English for earlier public school adenoidectomies had been sent home to parents. However, 98% of these parents spoke only Yiddish. Wanting to be “good parents,” they may have signed the consent form without understanding it, or children may have signed parents’ names without telling them.¹⁴

“A child with the typical face of a mouth-breather from adenoids.” From The hygiene of the schoolroom by William Francis Barry, 1911, p. 107. Internet Archive Book Images on Flickr. Public domain.

Eastern European Jews had an understandable distrust of authority as well as of Christians. In 1906, these fears were reinforced by the knowledge of a pogrom in Bialystok in the Russian Empire just two weeks before the adenoid riots.¹⁵ Some of the parents who yelled “Remember Kishinev” during the riots had been witnesses of the 1903 Kishinev pogrom, also in Russia.¹⁶ The day after the riots on the Lower East Side, there were riots in Manhattan’s “Little Italy” and in Williamsburg and Brownsville in Brooklyn, two areas with substantial Jewish populations.¹⁷

At least one physician with the New York City Department of Health was horrified by the classroom adenoidectomies. Dr. S. Josephine Baker observed that there had been no attempt to explain the procedure to the children, nor to psychologically prepare them. Although school-based adenoidectomies may have been the “standard of care” at the time, Baker described them as “cruel and stupid.”¹⁸ She was ignored.

Today we recognize that adenoidal hypertrophy can produce mouth breathing, a denasalized voice, snoring, and an “adenoid facies” with an open mouth, elongated face, hypoplastic maxilla, and a high-arched palate. However, the adenoids, like the palatine tonsils, also serve an immune function and there are defined criteria for adenoidectomy,¹⁹ which is performed in a sterile environment under general anesthesia.²⁰

 

References

1. Eddy Portnoy. “Sore,” Tablet, 2010. https://tabletmag.com/sections/community/articles/sore
2. Alan Kraut. Silent Travelers: Germs, Genes, and the “Immigrant Menace,” Baltimore: Johns Hopkins University Press, 1994.
3. Jacob Riis. How the Other Half Lives, New York: Dover Publications, 1971. This is a reprint of the 1891 publication.
4. “Adenoid.” Wikipedia. https://en.wikipedia.org/wiki/Adenoid.
5. Kraut, Silent Travelers.
6. Kate Mazza. “Adenoids and American school hygiene in the early 20th century,” New York Academy of Medicine. History of Medicine and Public Health, March 10, 2015. https://nyamcenterforhistory.org/2015/03/10/adenoids-and-american-school-hygiene-in-the-early-20th-century/.
7. Gil Ribak. “‘They are slitting the throats of Jewish children,’ the 1906 New York School riots and contending images of Gentiles,” American Jewish History, 94(3), 2008.
8. Mazza, “School hygiene.”
9. Portnoy, “Sore.”
10. Ribak, “Slitting.”
11. “East Side women riot. Stone schoolhouses.,” New-York Tribune, June 28, 1906. Found at Museum of Family History, Lower East Side of New York.
12. Portnoy, “Sore.”
13. Kraut, Silent Travelers.
14. Kraut, Silent Travelers.
15. “This day in Jewish history/New York Jews riot over rumor of school pogrom,” Itongadol, 2014. https://itongadol.com/noticias/79694-this-day-in-jewish-history-n-y-jews-riot-over-rumor-of-school-pogrom.
16. Ribak, “Slitting.”
17. Ribak, “Slitting.”
18. Didier Cohen-Salmon. “‘A call for Doctor Baker!’ Tribute to a resistance fighter,” April 4, 2019. https://didiercohensalmon.org/2019/04/04/a-call-for-doctor-baker/.
19. “Clinical indicators: Adenoidectomy,” American Academy of Otolaryngology – Head and Neck Surgery, 2021.
20. “Adenoid hypertrophy.” Wikipedia. https://en.wikipedia.org/wiki/Adenoid_hypertrophy.

 

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HOWARD FISCHER, M.D., was a professor of pediatrics at Wayne State University School of Medicine, Detroit, Michigan. His father grew up on the Lower East Side of Manhattan.

 

Fall 2022 | Sections | History Essays