Nowadays, we have a number of opportunities of operating on the laryngeal carcinoma; that is to say, the writers have been gradually meeting many tragedies of lost cases in voice function. Among a great many people suffering from laryngeetomies in Japan, an artificial larynx is in everyday use. Bearing in mind that the esophageal (speech) voice is superior in several respects, the author provided guidance of the esophageal voice method and it study, by gathering many laryngeetomies, for the purpose of taking proper measures to relieve these people. During 1955, and in August, 1960, we came into contact with 253 cases, 96 of which have been able to carry on smoothly conversation with normal people, 47 cases had undergone an operation of neck dissection.
By the dermal cicatrice of operation, the writer grouped these cases into four classes: a surgical operation in which a lengthwise cut is made; a Utype cut; andothers. This order arranged according to the number of cases. The first three types account for the greatest nuumber of cases, with the exception of a few. However, they are not related to the esophageal speech. In years of ago, the order is 60's, 50's, 70's, and 40's.
The patient was ordered to swallow air, and then the author tried to classify the esophageal speech into three groups of deglutition, injection, and suction methods. Deglutition is a methods that sends air to the gullet (esophagus) by swallowing normally. In the injection method, as soon as a light swallowing movement comes about at the root of the tongue and in the throat redius (pharyngis medium), the pharyngis inferior and the upper part of esophagus open largely. In the suction method the swallowing as well as injection method does not occur; it is possible to open the pharyngis inferior freely, and the esohagus at the upper part. Then, according to suck-action of thorax (pectus), the air lets in the esophagus at a stretch without pause. So the deglution method has greater possibilities than the injection method. Although in a great number of cases the injection method in the esophageal speech has been practiced, some of them, however, gradually turn into the suction method. Of course, there are some people who are able to try the suction method from the beginnig.
The esophagus being filled with air is distended in the middle of gullet, both ends become a little narrow, and two hollows are formed at the place where the left bronchus and the aortic arch cross. In consequence of these changes, one distension is there all the time as a fixed form between the two hollows.
The esophageal speech in substitute phonations is most excellent. When they attempt to utter a cry (word) strongly, they could speak as well as anyone.
The air quantity breathing out of the esophagus was about 45cc - 140ee. In the esophageal phonation, we are nearly able to raise a voice within the limits of the C.D.E.F.G.A.H.C. (bass) clef in piano. And it was also possible with the esophageal phonation, in cases which had undergone an plastic neck operation of esophagus.
Pseudoglottis of the esophageal phonation is the situation within the range that is suited to the height of about V cervical vertebra and VI cervical vertebra. In studying esophageal speech, we found that there are conspicuously individual differences among them, which are sure to succeed it constant efforts and appropriate guidance of the esophageal speech are given them.

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The treatment of four cases of chronic or subacute severe shoulder strain was reported. In each case, there was found severe inflamation at the corresponded side of the upper part of esophagitis was always followed by the complete removal of shoulder strain. The auther said that almost all cases of shoulder strain of uncertified origine could be connected with the oesophagitis of this type.

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Many original device were casted about the extracting method of bronchial foreign body, removal of small iron object in a deep portion of bronchus is not always easy in some times by the use of forceps, particularly in case of young children.
Author easily succeeded to extract in such two cases of bronchial foreign body by the use of new invited instrument-parmanent bar magnet.

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A case report concerns the man of 41 years old who had been suffering from the obstinate hemoptoe with uncertain in cause for years, which gradually developed continuous, copious hemoptoe and in spite of hemostatic treatment i. e., hemostatics, blood transfusion and operation, he died of an unhappy death, leaving diagnosis obscure.
However, it has been proved by autopsy that the main and serious cause of his death was bleeding of lung parenchyma, tracheal mucus and larynx by allergic angiitis. Such a case seems to be very rare.

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We made the esophagoscopic observations on 142 cases of “Disturbance of deglutition” in past 5 years.
These were:
esophageal tumors 23,
esophageal foreign bodies 37,
esophagitis, 47,
esophageal neurosis 22,
esophagospasmus 4,
esophagostenosis 3,
diaphragmatocel, esophageal bleeding
periesophageal abscess, esophageal injury, and radiation injury of esophagus (Co⁶⁰-burns) each 1.
We added a few interesting case which we recently experienced.

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