The general practitioner first comes in contact with the child, and on him must largely rest the responsibility of recognizing the symptoms of these conditions as they appear in extreme cases. He should, moreover, appreciate the fact that there are remote and often less-pronounced symptoms connected with the adenoid and tonsil question that are as much a menace to the health as the others. It is not difficult to decidethat a child who presents very large tonsils and adenoids and who breathes with open mouth, vacant expression, etc., should have an operation that removes the mechanical obstruction to a normal breath-way. But there are many cases in which the mere mechanical obstruction is the least important of the considerations involved, and the decision must often be based on symptoms not directly connected with the nose and throat, and which we are coming to recognize more and more fully as proper
RHODES JE. THE ADENOID AND TONSIL OPERATION. JAMA. 1911;LVI(12):878–881. doi:10.1001/jama.1911.02560120018009
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