Erroneous diagnosis had been made of a boy, aged one year and three months, who had aspirated a pin, that the foreign body had been in the stomach by X-ray examination. The facts that the pin had been shown to be seated verticaly in front of the vertebra by the following X-ray photography at transverse and oblique presentation and that no coughing and no moving by respiration resulted, had led to the misdiagnosis that the pin was in the esophagus.
The authors demonstrated clearly that it was at the bifurcation by the entro-dorsal X-ray and extracted it safely. The authors had the ground to distrust that the neelde was in the stomach. They explained that the boy did not cough because the needle was fixed instantly as it was aspirated and the foreign body in the bronchus was not moved by respiration but was moved by swallowing action.

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Recently there is a growing tendency that tonsillectomy and adenotomy are performed on considerably small children. However, the author is of the opinion that the removal should not be made so hastily in view of the function of the tonsils. In the otorhinolaryngological circles the hypertrophy of tonsils is classified into three degrees, I, II and III, but it does not seem fit to apply this classification to infants, because the tonsils of the infant keep changing with age. Pediatrists use the classification U, O, A, E, I by Pirquet-Schoenberger. Types U and O, or smaller tonsils, are mostly with babies and older children, and types A, E and over, or larger tonsils, are found mostly in infancy to school ages. Since the tonsils are physiologically large with children in infancy and school ages, tonsillectomy should not be performed on them because their tonsils are large. The conditions of tonsils are an indication of the constitution and the large tonsils, leanness and slight fever found with the so-called abnormal constitution are in many cases not due to the tonsils but are indications of the constitution. If the symptoms are alleviated by tonsillectomy, it is sometimes only a mental effect.
Thus the author considers the indications for tonsillectomy are (1) mechanical troubles in the respirating organ,(2) tonsillitis of frequent occurrence,(3) peripheral diseases,(4) when there is focal infection and (5) when it is the focus of general disorder. As regards the opinion that the polio season, especially summer time, is not suitable for tonsillectomy, the author believes that poliomyelitis is not the direct influence of tonsillectomy but is related with non-specific causes. It is the author's opinion that consultation between otorhinolaryngologists and pediatrists is necessary regarding tonsillectomy in the future.

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The author has used “Trichlorethylene”(Trilene) as analgesic with the “Cyprane Inhaler” in minor otological operations and painful treatments (puncture of maxillary sinus, paracentesis, scraping of tympanic cavity in radical operations of middle ear, change of tampon after radical operations of middle ear), and obtained the following results: 1. Patients fall into analgesic state easily without sick feeling, 2. Patients fall into analgesic state without loss of consciousness and reflex, 3. This treatment is safe and easy to be performed without ill effect, 4. This treatment is inexpensive.
Consequently, analgesia by “Trichlorethylene”(Trilene) is simple, safe and readily applicable without need of assistants in minor otological operatidns and painful treatments.

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An operation which may be named “subhyoidal incision of the pharynx (or incision of the piriform sinus)” is reported as an easy method causing less injury on tissues for malignant tumors of the epiglottis for which removal of the epiglottis seems the only fit method, by an example of a case of a 61-year-old female.
Five to seven cm of skin-incision was performed at the front edge of the Musculus sternocleidomastoideus with the height of the thyroid cartilage as the center, of a patient of pedunculated cancer at the lingual surface of the epiglottis, the free edge of the thyroid cartilage was reached between the M. sternocleidomastoideus and the M. sternohyoideus, the attached M. constrictor pharyngis was partly cut, the piriform sinus was opened, the epiglottis was cut under direct sight, the mucous membrane of the base of tongue and the membrane of the cut-edge of the epiglottis were sutured together, the incision wound of the mucous membrane on the side of the neck was sutured with cat-gut and the rest part of the wound was sutured by the ordinary method.
The wound took the healing by first intention in 5 days after the operation while the nourishment was fed through the tube.

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There have been described various causes regarding the neurosis of the pharynx, larynx and the upper esophagus. While the authors were investigating the relation between this disease and disharmony of the autonomic nerve, they thought from their former studies that Curare might be effective in some degree. They gave injections of Amerizol, which allegedly has similar effect to Curare, to 26 patients of this disease, and some effect was achieved by the use of Amerizol within the safe dosage.
The effect of this medicine was in most cases of a schort duration, but in some cases it was effetive for a rather long time. From these results, the authors are of the opinion that the abnormal strain in pharyngo-laryngeal and esophageal muscles should be added to the causes of this neurosis which have been described so far.

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The Difference Limen Test has been employed recently to determine the location of impairment causing difficulty of hearing due to defective auditory system. The results of this test given to the patients who were hospitalized in the author's clinic to undergo the operation to improve hearing show a tendency that the discrimination index for the otitis media chronica perforativa is somewhat smaller than that for the normal ear.
The relation between the differences of discrimination indexes for 250 cycles, 1000 cycles and 4000 cycles before and after the operation and the hearing after the operation, and the case of the small discrimination index at 250 cycles before the operation, are discussed. Also a comparative study was made of the discrimination index before the operation and a great improvement of hearing after the operation.

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The grade of eosinophilic infiltration in the water for irrigation of the punctured maxillary sinus was measured after the O. Stroemme Method with 50 sides of 38 patients of chronic paranasal sinusitis and 15 sides of 13 patients were found positive, and the majority showed the mixed type as regards the type of the mucous membrane.
In short, a considerably close correlation is supposed between the mixed type and the allergy reaction. However, the allergic reaction in this case was a light allergic inflammation accompanied by Hensel's so-called secondary infection.

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A clinically rare case of bilateral maxillary cancer is reported. A female' patient, aged 41 years, contracted right maxillary cancer three years after she had had left maxillary cancer. Examination of the pathologic-histologic image and clinical observations led to the diagnosis that it was a duplicate cancer.

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Der Verfasser hat neuerdings zwei Fälk von Lymphom im Nasopharynx erfahren. Der erste Fall war eine 33 jährige Frau, die klagte über die Nasenverstopfung und Schwerhörigkeit, und der zweite war ein 40 jähriger Mann mit Nasenverstopfung und Ohrverstopfungsgefühl.
Die Tumoren in beiden Fällen bestanden aus lockerem Bindegewebsnetz und dichter Lymphocytenanordnung. Klinisch nahmen die beiden Fälk ganz guten Verlauf ohne Infiltration ins umgebende Gewebe und Metastasenbildung.

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The author emphasises the great effect of tonsillectomy on tonsillar focal infections from his long clinical experiences (since 1912), and explains with examples of various diseases.
1. Tonsillectomy for nephritis.
2. Tonsillectomy for peritonsillar abscess (with peritonsillar abscess following tonsillectomy)
3. Seasickness
4. Tonsillectomy for singers
5. Tonsillectomy for tonsillitis acuta
6. Bed-wetting
7. Tonsil hypertrophy and intellect
8. Tonsil and physical conditions
9. Reminiscences of appendicitis
10. Other symptoms
11. Tonsillotomy
12. Night-terrors and sleep-walking
Finally, the author stresses that the operation should be performed boldly and carefully, and although he had experiences of tonsillotomy for children, he would rather not employ it.

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先天性に喉頭に高度の崎型が成立した場合には其の機能障碍も顕著で死産となるか, 出産後間もなく死亡するのが普通で臨床的に意義が少ない. 幸い生を得ても呼吸障碍の為に早晩不幸の転帰をとるものが少くなく橋本, 網徳,(1) 難波,(2) 斎藤 (3)等の報告を見る通りである.
之に反し崎型が軽度で機能障碍も僅微なものでは発見せられずに終るか, 臨床的に意義が少ない儘に看過せられてしまうことが少くないと瓜われる. 本邦に於ける先天性喉頭崎型に関する文献は少く, 朶, 久保 (猪), 松田 (豪), 甕, 腫村, 難波, 橋本・河原, 天野, 斎藤等の報告が見られるのみである.
喉頭に崎型が成立し機能障碍が随伴すれば呼吸困難, 嗄声, 喘鳴等が単独に或は合併して現われるものであるが, 私の経験した症例は斯る症状は何れもなく, 唯吸気に際して鼾様の音響を発する珍しい先天性喉頭崎型であるので之を録音すると共に従来の文献に追加報告する.

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The authors report four cases of laryngeal granuloma, with two additional cases of laryngeal stenosis in early occurrence, which occurred as a result of the late complication of endotracheal intubation.
Case 1: I. M., a man aged 27. Case 2: K. T., a man aged 41.
Case 3: A. N., a woman aged 31. Case 4: S. O., a woman aged 16.
These patients underwent intrathoracal operations of the heart and the lung under endotracheal intubation about three months ago, and appeared at the authors' clinic complaining of hoarseness.
Granulomas from soya bean size to pea size were observed on both the vocal cords in two cases and on the left vocal cord at its posterior portion in two cases. Two cases were recovered by removal, and one by spontaneous exhalation. Histologically the tumors were nonspecific granulation tissues. The remainder is now under observation of process. Case 5: R. I., a woman gaed 27. Case 6: Y. M., a man aged 7.
In these cases, dyspnea and stridor appeared immediately after the operations which were performed under endotracheal intubation, and they consulted the authors on the first postoperative day. Thick pseudomembrane was found at the glottic and subglottic space.
Case 6 was recovered by performing repeated suction, but tracheotomy was required for case 5.

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Twenty-four patients, composed of six patients each of esophageal atony+esophagitis+hypertrophy of lingual tonsil, esophageal atony+esophagitis, esophageal atony + hypertrophy of lingual tonsil, and esophageal atony, out of twenty-eight male and four female patients with abnormal sensation in the larynx and the esophagus were treated with Vagostigmin injections and the radiothermie. Fifteen patients (62.5%) were cured of the subjective symptoms and eight patients (33.3%) took favorable turns. Seven patients (29.1%) were cured and sixteen (66.7%) took favorable turns with esophageal atony; one (8.3%) was cured and three (25.0%) took favorable turns with esophagtis.
It was induced that the esophageal atony is an important factor in this group of symptoms and some part of esophagitis can ensue from the esophageal atony.

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The Tokyo Municipal Elementary School for Water-faring Families has an unusually great number of children with definitely husky voices. The authors carried out otorhinolaryngological examinations, especially laryngeal examinations, on 125 children of the school of ages from 6 to 12 years and got some findings usually considered as prodromes of the so-called mutation, but many children had stronger changes in color and shape than usual in the larynx, especially in the vocal cords. There were found many that had lost the normal of the vocal cords and been clouded in various ways.
As for the cause of these husky voices, it was experimentally proved in some degree that there is less reverberation and the communication is disturbed by the wind and they are compelled to resort to excessive vocalization on the barges on which they live. It is considered also that the effect of the sea wind cannot be neglected.

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A case of hysteric aphonia complicated with hysteric bilateral deafness is reported. The patient, aged 18, male, complained of aphonia and left deafness after psychological trauma. It was proved by laryngeal examination that the vocal cords came in contact with each other momentarily at the beginning of phonation, but directly after that instantaneous adduction, the glottal opening became spindle-shaped, as a result of paralysis of the internal muscles. The audiogram showed the hearing loss on both sides varying from 40 to 50 db in either air or bone conduction.
By means of the isomital interview, it was found that the patient could whisper, and the power of hearing was improved temporarily on both sides to the hearing loss of 10-30 db in air or bone conduction.
The patient was treated with electroshock and suggestion, and was completely cured.

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The Otorhinolaryngological Clinic of the Chiba University has had a total of 219 cases of foreign bodies, composed of 112 cases of foreign bodies in the esophagus, 47 cases of foreign bodies in the inferior air passages and 60 cases of foreign bodies in the pharynx. The number of cases declined for a while after the war, but it has shown a growing tendency again recently. The male cases were 1.5 times more than the female cases. Six cases that ended in death were mostly cases of foreign bodies in the inferior air passages of small children. From the view point of age, both esophageal and laryngo-tracheo-bronchial foreign bodies with children, pharyngeal foreign bodies with youth and esophageal foreign bodies with adults and older people are salient. As for the nature of forein bodies, pea-nuts are ranked first in the inferior air passages, and so are the coins in the esophagus and fish-bones in the pharynx.
Symptoms and operational findings of 8 cases where cervical incision was required are repor- ted. The incisions were repuired (1) to drain the abscess caused by the foreign body,(2) because the foreign bodies were outside the lumens or (3) because the foreign bodies were perpendicular to the lumens.
Attention is directed to the danger of pointed foreign bodies in the esophagus, especially that of unexpected foreign bodies that stray into foods and the importance is stressed of the effort to try to detect any foreign body in the food even when there is no foreign body in direct vision.

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