The tonsils protrude from the two palatal arches and are second or third degree in size, chronically congested, with an uneven or scarred surface, or with vascularity, and are hard to the touch; if seen in children, the tonsils are second or third degree large, smooth, non-congested, and soft to the touch, they are mostly physiological tonsillar hypertrophy. 2, fiber type or atrophy type: mainly is the fibrosis of the tonsil interstitial tissue, resulting in contraction, making the tonsil volume smaller and the follicular tissue atrophy. As seen clinically, the tonsils are smaller and often do not protrude from the plane of the two palatal arches (once large), and their surfaces have chronic congestive changes. 3. Crypt type: The main problem is that there is a large amount of rotten material in the crypt of the tonsils forming chronic inflammation, even cysts and abscesses, which can also lead to scarring changes of the tonsil follicular tissue. When the palatoglossal arch is squeezed, a large amount of putrefactive material or bean residue-like material spills out of the crypt mouth. Such patients have more pronounced halitosis. According to the above types of pathological changes, the size of the tonsils cannot be the main basis for clinical diagnosis of chronic tonsils. Because the physiological tonsillar hypertrophy in children does not have chronic inflammation although the tonsils are large (second or third degree size); while the tonsils in adults may have chronic inflammation even though they are small (one degree size). The diagnosis of chronic tonsillitis can be confirmed by general examination, without special examination. 1, medical history: a history of acute tonsillitis, or a history of recurrent acute tonsillitis, easy to catch a cold. 2, conscious symptoms: similar to chronic pharyngitis, mainly a slight pain or stinging sensation in the throat, dry discomfort, foreign body sensation, or cough, or bad breath, sometimes can cough up or spit out smelly heavy yellow-white granular material (tonsillar fossa out, chronic pharyngitis will not have this symptom). Systemic symptoms are not specific and not obvious, there may be constipation, or long-term low fever, fatigue, easy fatigue, hand and foot fever, etc. 3, examination: tonsils chronic congestion, or enlargement, or tonsil surface unevenness, scarring, vascular dilatation; palatoglossal arch and palatopharyngeal arch congestion; tonsil surface or pus spots, or squeeze the palatoglossal arch when the tonsils overflow putrescence; submaxillary lymph nodes or swelling painful to the touch. 4, chronic pharyngitis is sometimes accompanied by chronic tonsils, the two symptoms are very similar. Therefore, mild chronic tonsillitis (tonsils are not significantly enlarged, no secretion adhering to the surface, no obvious scar-like changes) is easily missed and only diagnosed as chronic pharyngitis. The diagnosis of chronic tonsillitis may also be missed by clinically experienced physicians. The main reason why chronic tonsillitis can cause complications is because it causes systemic complications as a focal point, the mechanism of which may be related to metabolic reactions; if an acute attack occurs, it can also cause many complications as in acute tonsillitis. Therefore, chronic tonsils cause more complications than acute tonsillitis. Common complications are: 1. Local and adjacent organ complications: e.g. pharyngeal abscess (especially peri-tonsillar abscess), acute pharyngeal inflammation, acute tracheitis, pneumonia, acute sinusitis, acute otitis media (purulent and non-purulent otitis media). 2. Systemic complications: the more common ones are acute arthritis, rheumatic fever, multiple heart diseases, acute nephritis, acute urethritis, acute orchitis, acute cryptorchitis, subacute thyroiditis, acute peritonitis, acute appendicitis, acute cholecystitis, etc.