d catches cold.

A greater degree of enlargement of the tonsils occasions deafness from
pressure on the passage leading to the internal ear, and is also apt to
give rise to a troublesome hacking cough which sometimes excites
apprehension lest the child's lungs should be diseased. When still more
considerable the enlarged tonsils block up the passage through the
nostrils, and air consequently enters the lungs but very imperfectly.
The nostrils thus disused become extremely small, narrow, and
compressed, the upper jaw does not undergo its proper development, the
teeth are crowded and overlap each other, the palate remains narrow and
unusually high-arched, and the face assumes something of a bird-like
character. Besides this the child grows pigeon-breasted, owing to the
lungs not being filled sufficiently at each inspiration to overcome the
pressure of the external air on the yielding sides of the chest.

When any considerable enlargement of the tonsils exists, each cold that
the child may catch aggravates it, and if diphtheria, scarlatina, or
severe sore-throat should occur, the temporary increase of the swelling
may become the occasion of serious danger. The question arises, what are
the chances that a child whose tonsils are enlarged will outgrow the
condition, or when is it necessary to have the enlarged tonsils removed?

It scarcely ever happens that any such enlargement of the tonsils exists
in children under six years of age as to call for their removal. There
is almost always ground for the hope that after the irritation caused by
cutting the first four permanent grinding teeth has completely ceased,
the tonsils may return by degrees to their former size. A similar
shrinking of the enlarged tonsil sometimes takes place, especially in
the boy, at the time of approach to manhood, when the vocal organs
undergo full development. This can be counted on, however, only in cases
where the tonsils are not of extreme size, and have not undergone
frequent attacks of inflammation. Whenever the hearing is habitually
dull, and the voice always thick, when cough is frequent, the nostrils
narrow, the chest pigeon-breasted, and the child feeble and ill-thriven,
removal of the tonsils is absolutely necessary. In cases where the
question is doubtful, its decision must turn on whether the tonsils have
often been inflamed. So long as their surface is smooth, and their
substance soft and elastic, delay is permissible. When their substa