2. Positive evidence of arthritis of any form with microscopic evidence of some virulent organism, such as staphylococcus, streptococcus or long-chain pneumococcus, present deep in the tonsillar tissue. 3. Any persistent discharge of pus from the tonsil in which the microscope shows the presence of virulent bacteria and which will not be relieved by treatment. 4. Markedly hypertrophied tonsils which directly interfere with the voice, deglutition or respiration and which do not respond to treatment. 5. Persistent focal infections of the middle ears, or sinuses or root abscesses which do not respond to treatment and in which case there is a virulent infection of the deep parts of the tonsil, shown by microscopic examination. The above are only general conditions and there are probably many other indications or groups of symptoms that would indicate tonsillectomy. In most cases, unless the findings show positively that tonsillectomy should not be delayed, we advise treatment. If treatment does not restore to normal, it will probably reduce the time of the surgical sore throat following the operation. =Non-surgical treatment.=—The local direct treatment, as we practice it, consists of: 1. Direct aspiration by means of the tonsil cup, applying from fifteen to twenty inches of vacuum. 2. Application of phenol-glycerine by means of cotton applicator to the full depth of each crypt. 3. Irrigation of the crypts by means of a catheter and hot salt mixture solution. 4. Syringing of the crypts by means of the catheter and phenol 10%, alcohol 20% and glycerine 70%. The digital treatment of the tonsil consists of: 1. Applying pressure against the anterior pillar thus forcing the contents out of the tonsil, the Ruddy method. 2. By the bidigital technic, the front finger of one hand inside, posterior and inferior to the tonsil and the fingers of the other hand outside exerting deep pressure and opposing the finger inside. In this way the tonsil can be lifted forward and upward and its contents expressed. The digital treatment is not as effective as that described above. The osteopathic corrective treatment consists of adjustment of the atlas and axis and the mandibular articulation and the obtaining of free movement of the hyoid and the relaxation of the submaxillary musculature and other deep structures. This treatment, if followed persistently, will relieve the local symptoms of a very high percentage of cases of chronic tonsillitis, and in many cases even the systemic complications will be relieved. Whether in cases of systemic absorption this is the preferable treatment I am not sure, because, once the local condition is improved the patient will usually refuse operation and even if the physician finds definite evidence of toxic absorption he cannot convince the patient that his tonsils require surgery. MENTAL DISEASES BY L. VAN H. GERDINE AND A. G. HILDRETH. INTRODUCTION