I, for my own part, am of Dr. Mackenzie’s opinion:  that there is an endless flow of lymph from their interior to the free surface, which unchecked, prevents the entrance of germs from the surface and washes out impurities from within.  That in any case, one of the functions undoubtedly is the production of leucocytes or protective white blood corpuscles and that the tonsil is not, as generally understood, a lymphatic gland; that the general ignorance of this fact has led to the useless sacrifice of thousands of tonsils, on the fallacious assumption that their functional activities may be vicariously undertaken by other lymphatic glands; and finally, that the physiologic integrity of the tonsil is of the utmost importance in infant and child life.

The consensus of advanced scientific opinion is now to the effect that the activity of the tonsils as possible accessories of disease has been vastly exaggerated, that like the thousand and one successive misleading theories which in turn, from time to time, have seized upon the imagination and obsessed the minds of the medical fraternity for brief and passing periods, this pernicious craze too, has about run its course.  The causes from which this peculiar lust for operation emanates would be perhaps a difficult psychological puzzle to determine; the malign impulse, as regards some special function, seems to spring, as it were, by intuition, unbidden into being from the illusive depths of some perverted intellect, to rage for a while through the medical world with a death roll deadly as the plague and as suddenly to pass into desuetude and disappear behind the impregnable ramparts of “prescriptive right” and “privilege”—­terms which in plain parlance mean to the masses in cold actual fact, the absolute negation of all right—­the domination of arbitrary, irresponsible and State protected wrong.

Between facts and fables, the evidence with regard to the tonsils and their functions seems to establish the conclusion that they have been wrongfully and foolishly held responsible for “an iliad of ills.”  The region of the nose and mouth is obviously the happy hunting-ground of myriads of pathogenic bacteria.  It is likewise continually the scene of innumerable surgical operations, performed necessarily without antiseptic precautions, thus extending the area of possible infection indefinitely to the entire upper air tract which medical incompetence so often fails to explore.  And indeed, as Dr. Mackenzie freely remarks:  “Of far graver, far-reaching and deeper significance are cases of infection in which life has doubtless been sacrificed by clinging to the lazy and stupefying delusion that the tonsil is the sole portal of poisoning.”

The mere size of the tonsil, it is shown, is no indication for removal except it be large enough or diseased enough to interfere with respiration, speech or deglutition—­that is, swallowing; in which case only a sufficient portion should be taken away, and that without delay.  The tonsil may be greatly enlarged or buried deeply in the palatine arcade and yet not interfere with the well-being of the individual.  Such tonsils are the special prey of the tonsillectomist.  If they are not interrupting function they are best left alone.  Moreover, it occasionally happens that the resurrection of a “buried” tonsil is followed shortly by the burial of the patient.