DISEASED TONSILS
Tonsils which remain permanently enlarged and show signs of disease and debilitation—filled crypts—may be removed as early as the fourth or fifth year, if necessary. If proper treatment does not improve the tonsils as the child grows older, their removal should seriously be considered. The tonsils may serve some special secretory or defensive function during the first few years of life and we think best, therefore, not to advise their removal—except in extreme cases—until the child is at least four or five years old.
When it is necessary to attack the tonsils, they should be thoroughly dissected out—not merely burned or clipped off. If they are properly removed, the danger of heart trouble, rheumatism, and many other infections may be considered as greatly lessened.
After five years of age the normal tonsils should begin to shrink, and at about the beginning of adolescence they should be no larger than a small lima bean, hidden almost completely out of sight behind the pillars of the throat. While healthy tonsils may serve some useful purpose even in the adult, it is almost universally conceded that the thoroughly bad and diseased tonsil is utterly useless to the body—only an open gateway for the entrance of infection.