To make short of the above mentioned results, c⁵ dip appears with distinguished individuality. At first its characteristics seem to be related to a certain factor connected directly with the mode of the auditory middle ear muscle reflex. The bulging type of the tympanic membrane response, in which the stapedius muscle plays the principal role has some resistance to acoustic trauma.
On the other hand, the reaction form to soundstimulation of the native tonus of the sympathetic nervous function co-relates to c⁵dip.
The tendency corresponding to the V₄ type of Dresel's adrenalin test (labile type) after noise exposure, produces resistance to acoustic trauma.
Furthermore, the latent deficiency of thiamine seems to make a disposition to easily cause c⁵dip. For prevention of acoustic trauma, it is desirable to relieve the violent angioneurotic disorder and promote the inner ear anaerobic metabolism.
For this purpose it is very appropriate to use thiamine. Concerning the occurrence of c⁵dip, a certain factor other than acoustic trauma for instance, angiovascular phenomenon will be surely participated in the ground and it should have a correlation with bearing noise-susceptibility.

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Stimulation deafness is characterized by a h earing loss limited to high frequencies. The maximum threshold shift of hearing due to intense tone stim ulation has been considered to occur at a higher frequency than the stimulating tone. In 1934, RAWDON-SMITH found that temporary deafness due to intense tones often involved tones an octave above the fatiguing tone. 1) PERLMAN also reported that, when acoustic trauma was produced, the maximum dip was usually an octave above the frequency of the fatiguing tone2). RUEDI and FURRER described that the exposure of the human ear to a very intense pure tone produced an increase of the auditory threshold at frequencies above this tone3). DAVIS and others reported that the greatest loss of auditory sensitivity regularly occurred at a frequency about half an octave above the exposure tone, and often occurred throughout a range of one to two octaves above the exposure tone. 41
KAWATA studied the auditory fatigue caused by 1000 cps, 2000 cps, 3000 cps and 4000 cps pure tones of 110 dB in young subjects with normal hearing. He found that the maximum threshold shift for 1000 cps tone stimulation occurred at 1500 cps, for 2000 cps tone at 3000-4000 cps, for 3000 cps tone at 4000 cps and for 4000 cps tone at 6000 cps. In the combined chart of these curves, he pointed out that the intersection of each auditory fatigue curve (audiogram after stimulation) was found on the ordinate of 4000 cps. And, he indicated that only the auditory fatigue curve for the 3000 cps tone crossed this ordinate below that intersection point. He also found the same phenomenon in bone conduction test. From these results, he deduced that any intense pure tone, regardless of frequency, would cause hearing loss of approximately the same degree at the c5 area of the cochlea. 5) 6) HOOD7) and NAKAMURA8) reported that the maximum threshold shift occurred at approximately the same frequency with a stimulating tone of relatively low intensity and that the frequency of the maximum threshold shift moved upward with an increase of intensity of the stimulating tone.
BÉKÉSY studied the vibration pattern of the cochlear partition in the human cadaver using a stroboscope. He reported that high frequency vibration of the cochlear partition caused the greatest movement of the basilar membrane at the lower turn and the maximum movement moved to the upper turn as the frequency was decreased. 9) Utilizing a model experiment of the cochlea, NAKAMURA reported that as the intensity of vibration increased the movement of the basilar membrane toward the basal portion of the cochlea was more affected than that of the apical portion. But, the maximum movement of the basilar membrane due to vibration at a fixed frequency stayed at the same point regardless of the intensity of stimulation. 8) HILDING pursued the auditory physiology on the basis of anatomical studies with measurement of the human cochlear section. He reported that the directional conversion of hydrodynamic force produced the maximum impact point in the area around 6 - 8 mm from the basal end of the cochlea. 10) Using electrophysiological methods, TASAKI reported that low fr equency tones produced a significant cochlear potential at all regions of the cochlea while high frequency tones produced the potential at only the lower turn. 11)
Despite these many studies, the reason why the maximum threshold shift in hearing occurs at a higher frequency than the stimulating tone is not satisfactorily explained. The authors will discuss this problem from the standpoint of electrophysiological methods and findings in the cochlea

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necessary to hold a certain pressure of air behind the articulation point. The authors had decided to call the air pressure “the pressure effect of articulation”, and had reported about the measuring method and its usefulness in the diagnosis of articulation defects in nasal speech. 9)
In this series of experiments, the characteristics of Japanese consonants plosives, fricatives and affricates, were investigated from the viewpoint of the intraoral pressure change produced by the articulation.

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The aerodynamic measurements were performed to examine the intensity and pitch regulation mechanism in voice production. The intensity of voice was proportional to 3.5±1.6 power of the subglottic pressure with males and 3.9±2.9 power of it with the females. The volume velocity of exhaled air generally increased as the intensity increased, and the intensity of voice was proportional to 3.6 power of the volume velocity with the males and 7.0 power of it with the females. But in some cases, especially in the phonation at lower pitches, the volume velocity was costant or slightly decreased as the intensity increased. The glottal resistance did not exhibit a close correlation with the intensity and the pitch of voice. In general, the change of resistance in the regulation of intensity was less with the males than with the females. The subglottic power in a given intensity was less with the males than with the females. The glottal efficiency was not constant but changed as the intensity varied. The intensity of voice was proportional to 1.7-9.3 power of the glottal efficiency with the males and 1.2-6.0 power of it with the females.
The glottal efficiency of the patients with voice disorder was not so different from the normal as it has been expected. To discuss this result another experiment was intended, and the influences of the mode of phonation upon the aerodynamic parameters were investigated. The change of the mode of phonation brought about considerable changes of glottal efficiency, phonation length and others.
The glottal efficiency changed along with the subglottic pressure in pressed phonation, and it changed along with the glottal resistance in breathy phonation. From this fact, the author concluded that the exertions play a principal part in the regulation of the intensity and pitch of voice. In some cases the glottal exertion (glottal resistance) will dominate and in other cases the expiratory exertion (subglottic pressure) will do.
The subglottic pressure was minimum at natural pitch and it increased as the pitch became higher. The volume velocity slightly increased according as the pitch became higher with the males, while it slightly decreased with the females. It was proved that the natural phonation (in normal intensity and at natural pitch) is the most rationalistic way for speech from a viewpoint of the aerodynamic aspect of voice regulation.
The compensation of the glottal function in voice disorder may be attributed to the change of the mode of phonation. It followed that in the clinical examination of voice disorder we must pay attention to the change of the mode of phonation, that is, the change of exertions.
The author wishes to express his gratitude to Professor S. Kawata for the valuable guidance and encouragement.

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Electronystagmography not just enables a qualitative and quantitative analysis of nystagmus possible, but furthermore gives nystagmus findings of open eyes in the dark and closed eyes which cannot be observed by the unaided eyes.
This results is a marked increase in the detection ratio of pathological nystagmus, and this tendency can be strengthened further by taking ENG recordings when posture test are made.
At such times, it is very necessary that recordings not only of closed eyes but open eyes in the dark should be taken so as to increase the positive ratio of detecting pathological symptoms and to obtain nystagmus tracings that are less distorted than when the eyes are closed.
On the other hand, ENG from its principle does not record rotatory components, nor from the characteristic of the equipment is it adapted to record slow ocular movements, and it has also the fault that other types of bio-electric potential cause interference.
To compensate for these shortcomings a method was devised by employing an infrared television so as to observe the findings when the eyes are open in the dark in the same way as when the eyes are open in the light.
By combining this apparatus and ENG, all pathological findings that show up as ocular movements can be completely caught, and this is expected to open the way for future studies.

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In the summer of 1963, utilizing the mechanism of Grahe's apparatus, KAWATA and his collaborators devised an equiangular-accelerating positional table. This rotary apparatus of a new design for the functional examinations of the semicircular canals and otolithorgans is reported here.

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Using the rotary apparatus of the positional table system, the author gave centrifugal force to labyrinths and observed with ENG how the nystagmus response caused by caloric stimulus goes on.
In a supine position there rises a difference in intensity of caloric nystagmus between the two opposite directions of the rotation, while in a lateral position caloric nystagmus is not affected even when under centrifugal force.
Consequently the author proposes the possibility of the influence of centrifugal force on the otolithorgans. These observations indicate that the intensity of caloric nystagmus directed to the side where pressure is given to saccular macula decreases.

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Delayed cases of CO poisoning which happened in the coal mine were examined. All of the 14 patients showed neither severe disturbance of hearing nor equilibruim, although spontaneous nystagmus in 7 and positional nystagmus in 3 cases were found. Calorigrams were made in all of the patients and were classified as follows: DP in 7, DP+CP in 3, CP in 1 and Normal in 2. One patient had congenital nystagmus and could not be classified to any group. Attention was paid to the dysrhythmia of nystagmus patterns which appeared in 8 cases during caloric testing.
Diffuse brain lesions were suspected from neurological and electroencephalographical findings and it is considered that they were probably the causes of vestibular findings, such as spontaneous and positional nystagmus, DP and dysrhythmia.

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We conducted an experimental study of the acoustic trauma in the guinea pigs and histochemically proved the reduction of activity of succinic dehydrogenase and phosphorylase participating in energy production process, in the sensory cells of the cochlea exposed to an intense noise.
We are thus convinced that the breakdown of metabolism of the inner ear is one of the most important factor contributing to the occurrence of an acoustic trauma.

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The author have been studied the nucleic acids and vitamin Bi in the organ of Corti following the sound stimulation. The intense sound stimulation damaged the hair cells, especially the outer hair cells, and nucleic acids decreased remarkably. The distribution of vitamin B₁ in the organ of Corti exists in stria vascularis, basilar membrane and hair cells. Vitamin Bt in the same places was decreased by the intense sound stimulation. By the administration of vitamin B₁, the damages of hair cells, nucleic acids and Preyer reflex was a little.

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When the MES was operated, various degrees of temporal and permanent hearing losses occurred. The effects upon hearing of the total ablation of the MES on one side were not equal to those on the other side and either of them was dominant. It seems that the unilateral dominance rested on which side the shock had been given during the training and the dominant part was the MES contralateral to the charged limb. The total ablation of the non-dominant MES caused in same cases no loss of hearing at all, or if it did the loss was temporary and very small, while that of the dominant MES caused slight but permanent hearing loss. The hearing loss caused, however, by the total ablation of both MES did not exceed the loss caused by the total ablation of the dominant MES.
These results should be interpreted as a guidepost for further reserch rather than a fully documented conclusion.
I am greatly indebted to Prof. S. Kawata for his advice and help in carrying out this work.

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Experiments were carried out with anesthetized rabbits to attempt to clarify the relationship between the ballistocardiogram (BCG) and microvibration (MV).
Pilocarpine enhanced MV and inhibited BCG.
Succinylcholine markedly inhibited MV.
The body surface of the animals showed a vibration similar to MV after the cessation of the heart beat.
MV response differed from that of BCG, but the latter had an influence on the former.
It is suggested that MV consists of a neuromuscular vibrating element and a cardiac one.

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This description is made about foreign body cases treated in the ENT Clinic, Faculty of Medicine, Kyushu University, from 1956 to 1965.
1.15% of 48, 902 patients who visited the Clinic during these 10 years had some foreign bodies in their food or air passage or some other canal. 48.7% of all foreign body cases, or 0.56% of all the patients who visited the Clinic during this period were related to the esophgus, 12.9% of foreign body cases or 0.15% of all the patients were concerned with the lower respiratory tract. The others were composed of 102 cases related to the pharynx, the larynx and the stomach, 36 cases related to the nasal cavities or the auditory meatuses and 77 patients in whom was not found any foreign body through attentive examinations such as endoscopy or X-ray searching (Table1).

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Two cases with different audiogram of presbycusis out of 105 temporal bone series were demonstrated and discussed.
The atrophy of the spiral ganglion seemed to coincide well with the audiometric results. The changes in the organ of Corti and the stria vascularis were slight.
The changes in the central auditory pathway seemed to cause the hearing threshold elevation in low frequency range as well as in high.
The arteriosclerosis, together with senile atrophy, might influence the degeneration of the, cochlea and central auditory pathway.
A comment of this study was presented at the 68th Annual Congress of the Oto-Rhino-Laryngological Society of Japan, March 30-31, 1967.

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As a means to indirectly grasp the state of circulation in the inner ear, observations were made on the sludge phenomenon in the bulbar conjunctival vessels.
After obtaining exact data on the bulbar conjunctival vessels of the healthy as well as of the patients of inner ear diseases, stellate block and intense tonal stimuli were administered with a view to examining the changes in the bulbar conjunctiva. In addition, the state of the bulbar conjunctival vessels of the workers in noisy workshop as well as the relationship between the sludged blood and microvibration was also investigated. From these experiments, the following findings were obtained:
1) As a rule, normal subjects seldom have sludged blood, but it was conjectured that the aged do to a considerable degree.
2) Of the inner ear diseases, the incidence of sludged blood in Ménière's disease and sudden deafness was higher than in the case of sensory neural deafness.
3) The right-left imbalance of hearing in Ménière's disease often corresponded to that of the sludged blood in the bulbar conjunctiva.
4) No close relationship was found between the erythrocyte sedimentation rate and sludged blood as far as the inner ear diseases were concerned.
5) The parallelism between the in vivo sludged blood and the in vitro results of sludge test was not so significant as had been expected.
6) As far as the inner ear diseases were concerned, the vasomotor nerves appeared to play an important part as the origin of sludged blood.
7) An antagonistic relation to a certain extent was found to exist between the effect of stellate block and that of intense tonal stimulus, the former tending to inhibit the sludged blood and the latter doing the reverse.
8) A high incidence of sludged blood was ascertained with the workers in noisy workshop.
9) The parallelism observed between the changes in sludged blood and those in microvibration suggested that the two phenomena shared a common basis originating in the autonomic nervous system.

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