IT is impossible to think of any operation or procedure which is as 1commonly resorted to for the correction of any and all defects or complaints as is a tonsillectomy. Our search through available literature on the subject reveals an abundance of material and an almost universal opinion that good results, both curative and preventive, are to be expected.Kaiser, of Rochester, N. Y., has done a very thorough and gratifying piece of work with convincing conclusions.Besides verifying the figures and results obtained by Kaiser, Barrett, Robey, Mann and others, we have drawn some conclusions as to:1. The age group which shows the greatest improvements and the complaints, if any, which can be relieved to the greatest degree in the respective age groups.2. The length of time after operation before improvement is evidenced and the symptoms showing the earliest tendency toward improvement.3. The effect on the school progress of those being physically handicapped. 4. The effect on children with subnormal mentality or those who are mentally retarded and lack application and alertness.5. The effect of tonsillectomies on .the progress of children having coexisting conditions related and not related to diseased tonsils.It has been suggested by Brokay and others that the parents should be consulted as to the child's condition following the operation. In our study the parents' opinions were obtained in each case. We believe that information secured through the parents' daily observation is likely to be more dependable than that which might be secured from any other single source; however, the teachers' observations were not overlooked. We were also mindful of the fact that this information should be supplemented by physical examinations before and after operation.This study was based on cases operated on by private physicians

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In organizing the Oakland County Department of Health in 1926 many factors led us to believe that a coniplete village and rural school health service would be indispensable in our plan of organization.W e definitely decided that health education should consunie the greater part of our efforts and these efforts would be necessarily of slight importance if not applied to all of our County schools. W e were also of the opinion that in the control of communicable diseases, our efforts would be practically lost if we did not have complete control over all school children.However, we were not unmindful of the fact that in organizing the Oakland County Department of Health an addition was being made to our existing form of county government. To many, the needs were apparent but to the greater number, the idea of rural or suburban health service had to be sold. l y e realized that the whole plan had to be sold step by step, and that the complete organization to eventually have the efficiency we desired, would take years of patient campaigning. In favor of such an organization, were the physicians and welfare workers, and most important the school principals and teachers who had been taught health in its various phases during their college years. Ll7e could not attempt to ask in the beginning for an adequate budget, but as the various phases of our county program were organized and sold to the people. our budget was more easily increased.That our county budget for complete operation would not seem too large. we decided upon a cost to the village schools of $1.10 for each school child to defray the cost of employment of a nurse. Contracts were made out between the Ychool boards and our department and the total amount was paid to us at the end of each semester At the time the contracts were signed. a definite agreement was made as to the number of days of service each school was to receive. In allotting the number of days of service, no definite system was used. The number of pupils. the type of cooperation w c could expect to receive or had received in the past, and the fact that the greater proportion of the population in sonie of our districts rated above the average, financially, were considered in deciding on the distribution of the nurses' time. Of course. should a school be large enough and the finances of the village or city in such condition that a nurse could be used most of the time, we offered no objection.The strictly rural schools were not placed upon this cost basis because many of them were small and the financing would have been very com-