拉马克在《动物的哲学》中阐述了“用进废退”学说，认为生物在新环境的直接影响下习性改变，某些经常使用的器官变得更加发达、功能更加强大，不经常使用的器官结构萎缩、功能逐渐退化。

达尔文1859年发表《物种起源》，借鉴了法国生物学家拉马克提出的“用进废退”学说。进化假说把“用进废退”作为进化的驱动力之一，认为没有用的东西就没有了竞争力，都会退化或者被淘汰掉。

然而，用处的大小不一定直接对应着功能的强弱。人所认为的退化的功能，不一定是没有用的。

比如，人如果真的是从猴子变来的，那么猴子皮肤上的毛还能保暖，为什么一定要淘汰掉？人为什么需要长出头发来呢？从如何更加有利于生存的角度来看，似乎看不出头发比身体体毛的更大的用处在哪里，那为什么人的体毛会“退化”，却非要长出更多的头发来呢？

3.1 扁桃体被切除的后果

扁桃体是淋巴组织，由四部分组成：腭扁桃体、舌扁桃体、咽扁桃体（腺样体）和咽鼓管扁桃体，一起形成了一个坚固的防御环，称为Waldeyer环¹³²，是喉头的第一道防线，日夜守护在咽喉要塞，抵抗细菌和病毒，以保护我们免受空气和食物带入的病毒和细菌的侵害。

因为腺样体在人的童年后期往往会缩小，到青少年时期几乎完全消失，所以，现代医学常常认为扁桃体是退化了的器官，认为它没有用了，一旦反复发炎、肿大，就建议做手术切除。

事实并非如此，扁桃体是免疫器官，尽管看似有些部分萎缩掉了，但是不等于它没有功能了。现代科学研究发现，如果扁桃体被割掉了，可能会引发一系列长期疾病，增加身体发生感染等疾病的概率。

2018年《美国医学会杂志—耳鼻喉科学》（JAMA Otolaryngology）发表了对近120万儿童进行的一项10到30年的长期跟踪随访研究结果。报告指出，儿童时期切除扁桃体或腺样体，与日后患呼吸道疾病、过敏性疾病和传染病的相对风险显着增加有关。具体而言，已进行了扁桃体切除手术的人，感染上呼吸道疾病的风险增加近3倍；腺样体被切除的人，罹患慢性阻塞性肺疾病的风险会增加1倍多，上呼吸道疾病和结膜炎的相对患病风险也增加近1倍。¹³³

一项台湾研究分析了1,300名接受扁桃体切除术的患者和2,600个（未接受扁桃体切除术的）人组成的匹配对照组的数据，发现接受扁桃体切除术的患者罹患肠易激综合症的风险几乎是未接受扁桃体切除术的人的两倍。¹³⁴

一项瑞典研究追踪了80,000余名在20岁之前切除了扁桃体或阑尾的人，发现他们在以后的生活中患心脏病的风险更高，而这两种手术都做过的人的患病风险最高。¹³⁵

3.2 松果体的奇特功能

松果体（corpus pineale）位于丘脑后上方，以柄状联于第Ⅲ脑室顶的后部。幼儿期发育很快，20岁后机能开始减弱，而后便钙化并且萎缩。

但松果体形体的萎缩，并不代表功能的萎缩或退化。人们发现松果体在人的一生中，对人的内分泌、神经、视觉、生殖和免疫系统都持续发挥着重要作用。

1）分泌褪黑素¹³⁶：松果体分泌褪黑素，调节生物钟和睡眠。松果体的功能与光感知和季节性节律有关。松果体中的神经元可感受到环境中的光照强度，因此它们能够帮助调节人体对光的敏感度。

2）与光感效应有关¹³⁷：光感信息通过从视网膜开始的复杂多神经通路到达松果体。松果体、缰核和视网膜—视交叉上通路之间存在联系。

3）影响性腺：松果体通过调节性激素的分泌，进而影响人体的生殖能力。

4）影响免疫系统：松果体可能会影响T淋巴细胞的功能。

松果体肿瘤患者往往出现的是向上凝视麻痹。对这样的患者实施松果体肿瘤切除术，尽管患者手术后向上凝视症状趋于改善，但存在显着的长期视力障碍，特别是在复杂的会聚和调节功能障碍方面。¹³⁸

3.3 胸腺真的萎缩了吗

胸腺位于胸腔上纵隔前部、胸骨柄后方，分左、右两叶，呈长扁条状，两叶经由结缔组织相连在一起。胸腺作为中枢免疫器官，在人体免疫系统中居于中枢地位，有着至关重要的作用。¹³⁹它是T淋巴细胞发育、分化的大本营。

然而，因为在儿童时期胸腺机能很活跃，青春期达最高峰，以后逐渐萎缩，胸腺也曾被进化论者认为是人类从动物进化来之后的与人体无关的退化器官，切除无妨。

现代科学研究发现，胸腺兼有内分泌机能。胸腺不仅仅是免疫器官、内分泌腺体且与神经内分泌系统间有双向联系，而且，胸腺是人的“寿命时钟”（the life clock），胸腺与寿命长短有着密切的关系。¹⁴⁰

有时西医会对患有重症肌无力（一种神经肌肉疾病）的患者实施胸腺切除术。一项研究发现，胸腺切除术可能会增加重症肌无力患者患自身免疫性疾病的风险。¹⁴¹

总而言之，这些器官形体上的退化，其实只是它们在器官发育过程中的规律，并不代表其功能的退化。拉马克的“用进废退”是错误的，被达尔文用来发展出“进化假说”，更是错上加错。

人是五脏俱全的，人体的每一个器官都是有用的。既然存在，必然有它的合理性，不能单纯说某个器官有用、某个器官没有用。人体是各个器官系统协调、统一的有机体，所以，打算切除器官的人应当慎行。（待续）

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