Oh, I knew.

I think I've coughed / spat these things up before? Without tools?

Tie a string around them, then around a doorknob on the other end.

Relevant fact that deserves repeating:

https://www.youtube.com/watch?v=SFr3DSpgmx4

That time that "Ted Cruz ate a booger during a debate".

That was no booger. It was a tonsil stone. And he ate it.

Working in the medical world, I hear they are one of the most rancid things that can happen in your mouth. They are utterly rancid nuggets of puke-inducement, and Cruz just swallowed his up on live TV like he'd been to that dance before.

After becoming way too good at digging these suckers out, I bought a tongue scraper (U-shaped piece of stainless steel) and use it every night, and haven't had tonsilloliths since.