The hematopoietic theory or the theory of blood formation has a rather definite basis because such a function would be possible from the histologic structure. The formation of small lymphocytes has been attributed to tonsil tissue (Flemming) and this view has been generally accepted. Some of the lymphocytes however, find their way through the epithelial walls into the crypts and are discharged as “mucous plugs”, while others are carried by the efferent lymphatics into the circulatory system. In this respect, the tonsils, like other lymphoid tissue, produce lymphocytes which are essential constituents of the blood. This function is particularly marked during the growing period, but this function is also highly developed in all lymph nodules during this period, and in the growing child there is an abundance of such tissue and thus it seems that the tonsils, while important to the growing child, would not be at all indispensable structures. Some physicians claim to have observed deficiencies in growth and development of children whose tonsils had been removed during the first ten or fifteen years of life, but this is not commonly accepted. The tonsils have their greatest cellular activity during the growing period and unless chronically hypertrophied they atrophy during adult life. Tonsillectomy We may safely conclude from this evidence, that in the growing child, it may be well to retain the tonsils providing they are not directly affected in such a way as to endanger the general health of the child, but that there is little, if any, danger in their early removal. In adults, there seems to be no reason why they should not be removed in cases in which there is evidence of involvement beyond restoration by treatment or those cases in which there is evidence of toxic absorption. When surgical removal of the tonsils is indicated, the complete removal or tonsillectomy should always be done. A careful and complete enucleation of the tonsils when properly done will never be followed by any untoward results other than the temporary surgical sore throat. There is never any excuse, much less a reason, for partial removal of the tonsils or tonsillotomy, because such operations never accomplish the desired result and they nearly always require tonsillectomy later. In association with a reputable vocal teacher I have studied the results of tonsillectomy on the voice. In none of the twenty cases studied was there any impairment following the operation, but on the other hand sixty per cent were improved either in range of pitch, quality or endurance, in addition to their being more free from laryngitis, pharyngitis, etc. for which the operation was done. Doctors Ruddy, Edwards and Reid of our profession have told me of similar experiences, so I am certain that tonsillectomy properly done will in selected cases, improve the voice. Acute Tonsillitis