An enlarged tonsil may project beyond the pillars of the fauces without giving rise to any special subjective symptoms, or it may provoke serious disturbance and yet be invisible except during the act of retching. It may interfere with hearing, impede breathing, or obstruct swallowing, or it may simply be the cause of pharyngeal irritability or of various reflex disorders. The amount of functional derangement excited by an enlarged tonsil depends in part upon the relative dimensions of the faucial space and upon the temperament of the individual. Moderate hypertrophy in a contracted pharynx or in a neurotic subject may be the source of excessive annoyance, whereas an extreme degree of enlargement may be easily tolerated in a capacious pharynx or by a phlegmatic subject.
At the present day but few will be found to object to the statement that hypertrophied tonsils require to be reduced or removed, even in