As a new method of the masking in the measurement of bone conduction, the author verified the use of the gradually increasing masking noise theoretically and proved experimentally, using artificial shadow-hearing.
Fur thermore, the comparison with the commonly used masking method, in which the constant intensity of the masking noise is used. The method with gradually increasing masking noise was more preferable on the view-point of masking effect of the noise, individual difference, psycholo- gical influence of masking noise, plug effect with masking receiver applie- to the contralateral ear etc. The author mentioned that this method was valuable for the differential diagnasis of various cases in which the masking was ineffective.

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It has already been known that the blood sludge phenomenon often found in Meniere's disease can be observed by dipping the hand into cold water or by putting a lump of ice to the neck, but the research on the living organs under the direct vision has not been made.
Various changes of blood flow and the blood sludge phenomenon were observed in the small vessels of the hypothermic rat mesenteries.
The intravenous injection of 7% sodium bicarbonate solution very effective in Meniere's disease, was also effective. The intravenous injection of 7% sodium bicarbonate solution and the extravas_cular administration of the same soluoion were done and it was found that the latter was less effective than the former.

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The author observed variation of skin impedance depending on labyrinthine stimulation in the human bodies and following results were obtained.
By the stimulation of labyrinth, skin impedance was decreased 1/3_??_1/8 of the average level before the stimulation. It seemed that the decrease of skin impedance was mainly depends on the decrease of the reactance which is one factor of impedance.
In the next experiment, the variation of skin impedance was observed with stimulation of laby fiinfh in the !human body after adrenalin, pilocarpin, atropine, tebron and immidarin injection.
It seemed that the variation of skin impedance by stimulation of labyrinth was closely related with the excitement of sympathetic cholinergic nerves which control sweat glands.

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The author measured articulation scores for various bands of frequency range by various combination of high and low pass filters in 25 persons with normal hearing and the following conclusions were obtained.
1) The more narrow the widthth og pass band, the more reducek the articulation. However, the, rate of reduction is unproportional to the width of pass band. i.e. articulation of words has anincreasing resitance for dividing the words sounds into narrower bands.
2) A pass band of 1.5-0.25kc is most important for articulation of Japanese words and holds 30%ol articulation. This fact will be available to design of hearing aids.
3) Reduced articulation due to interband masking by 0.25-0.15kc band for the other higher bands can be found in composing the diveded bands.
4) Articulatians for the remaining range by elimination of varions width of band are measured and show rklatively better scores than those of the corresponding pass bands.
5) The aconstic spectrums of varions words are mehsured through varigns pass bands and arefound comprementary in form as compared with the sensitivity curve of the ear.

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Tests for bleeding tendency were studied in the cases with spontaneous and operative naso pharyngeal bleeding. General skin method and my original mucous membrane method were com- pared clinically, and hemostatic effect of systemic hemostatics was studied. Also, an experimental investigation of petechiae in the vascular fragility test was made. 1) Bleeding from the mucous membrane, encountered in the field of oto-rhino-laryngology, is more closely related to the results obtained by the mucous membrane method than that of the- skin method of tests for bleeding tendency. 2) In spontaneous nasopbaryngeal bleeding, vascular fragility plays a most important role. In the operative (traumatic) bleeding, coagulability of the blood is also important as well as vascular- fragility. 3) Among the systemic hemostatics, those who act on the blood vessels are most effective. For blood coagulation is the thromboplastin most effective. 4) Petechiae of the mucous membrane developed by the application of negative pressure are seen in the cases with hemorrhage per rhexin (big one), as well as reversible change of the blood vessels like aneurysmal dilatation (small one). Those developed by the application of positive pressure are seen in the cases with hemorrage per rhexin.

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The author designed an apparatus for acoustical douche of the Eustachian tube basing the idea of Perlman's pneumophone and fount it was more preferable clinically than the catheterization commonly used. It consists of an audiometer, an amplifier, a horn speaker unit, a manometer aglass bottle for stability of air pressure and a rubber balloon as an air compresser. Acoustical douche by the author's apparatus requires air pressure of 0_??_30mmH2O for the normal patent Eustachian tube while the catheterization requires air pressure of 20 to 60mmHg. Such a large difference in air pressure between the two methods is considered to be due to the opening function of the tube during swallowing because the former method is performed during the swallowing. The author's method will be further studied by the application to many patients with oto-rhinological diseases.

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Comparative studies were made on the reliability and certainty of the threshold and amplitude obtained by the fixed and continuous method. The fixed method showed superior results in both the threshold and amplitude (the threshold was compared with the threshold obtained by the ordinary manual audiometry). However, the continuous method has many advantages which failed to be found in the fixed method.Acordingly it was believed that more reliable results could be obtained by the combined use of the both methods.

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This is a case report of a.53 year old male with primary carcinoma of the frontal sinus in a 53, years-old male.The tumor was localized in the frontal sinus. The preoperative diagnosis was possible mucacele. A radical extranasal operation was cerried out successfully. The patient has shown no signs of recurrence for orte year.

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en-abstract=The experimental study was done on the medical treatment of suppurative meningitis using sulfa drugs such as domian, thiazine and supronal, and antibiotics such as penicillin (P), streptomycin (SM), chlortetracyclin (CTC), oxytetracyclin (OTC), tetracyclin (TC), chloramphenicol (CM) and erythromycin (EM). The drugs were given to normal and diseased rabbits by oral route, intravenous or intramuscular injection.
I. The dispersion into the cerebrospinal fluid.
In the sulfa-drugs, the best dispersion was seen with domian, next with supronal and then with thiazine. When the drugs were given intravenously, the dispersion into the spinal fluid and also the elimination from the spinal fluid were remarkably faster than that of oral administration. However, the concentration in the spinal fluid did not show remarkable difference when the drugs were given intravenously or orally, suggesting that the initial dose to be given intravenously in urgent cases, and followed by oral maintenauce doses.
In the antibiotics, the best dispersion was shown by CM and TC and then OTC, CTC, SM, EM and P in order. In the rabbits with meningitis, the effective concentration of CM and TC in the cerebrospinal fluid was maintained for 6 hours after the injection but the effective concentration of the other antibiotics was maintained for 3 hours after the injection in most of the cases. Though 'CM, TC and OTC were effective in the treatment of meningitis other antibiotics were less effective in the treatment because of lower concentration, short duration of effective concentration and uncertain dispersion.
II. Meningeal irritation
Sulfa drugs were strongly irritative and inappropriate for the intrathecal use. Among the antibiotics, P, TC and OTC were slightly irritative, CTC and SM were moderately irritative and CM and EM were most irritative. Among these antibiotics, OTCwas least irritative. P, TC and OTC were thought to be most appropriate for the intrathecal use.
III. Elimination of drugs from the cerebrospinal cavity.
In the normal rabbits, P, OTC, TC and CM in the cerebrospinal fluid were eliminated quickly and disappeared in 6_??_7 hours from the spinal cavity. SM, CTC and EM were eliminated slowly and considerable amount of the antibiotics remained in the fluid even 24 hours after the injection.
In the rabbits with meningitis, the elimination of the drugs from the cerebrospinal cavity was retarded, effective concentration being kept for 18_??_24 hours.
IV. Drugs to promote the dispersion of the antibiotics into the cerebrospinal fluid.
Hyaluronidase, methobromine, amid of nicotinic acid and immidarin were given togather with CM, EM and P, and the change in dispersion of these drugs in the cerebrospinal fluid was studied using the normal rabbits. These drugs except immidarin increased the dispersion of the antibiotics into the cerebrospinal fluid, particularly that of EM and P.

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Aging and changes inaudiogram of normal persons were studied in large number.Attention was given to the following two facts:1.Existence of special audiogram(C5dip)in persons not exposed to noise, 2.Acceleration ofchanges with age by severe hypertension.

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For the diagnosis of the chronic paranasal sinusitis, the author devised the Relief examination method of mucous membrane of antral floor by the injection of 40% Moljodol into the maxillary sinus and intraoral roentgenogram.
Fourty-nine patients with sinusitis and four normal persons were examined and the following results were obtained.
The Relief of mucous membrane of maxillary sinus could be classified into four types;line, . rolled cloud, clot and intermittend line (Fig. 1_??_12).
The line Relief were observed in many normal and doubtfull cases. However, this Reliefcould be considered as normal picture by excreting function test.
With the advance of pathological condition of sinusitis, the rolled cloud Relief turned into the clot and then into the intermittend line. These findings of relief were all found to be pathological.Seventeen raeical operation of sinusitis were carried out and the results of histological examination of the mucous membrane of maxillary sinus revealed the value Relief examination method in the diagnosis of sinusits.
The Relief method was found to be valuable for the diagnosis of chronic paranasal sinusitis:.andfor the determenation of the indication of operation.

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In order to study the condition of maxillary sinus in relation to the etiology of chronic paranasal sinusitis, the author carried out an intraoral roentgenographic study of the bony floor of the maxillary sinus of 298 cases with chronic sinusitis, and 302 normal cases, and a histological study on 32 materials of facial wall. Result are as follow.
Bony cortex of maxillary sinus develops until 18_??_19 year of age in normal group, the comoletion is retanded, however, in afflicted group and the development toward antral floor is arrested at the age of 10_??_11, accompassied by the hypertrophy of the bony floor of the maxillary antrum.
There is no significant difference in the condition of the bony floor of the maxillary antrumc between young adult (20_??_35year) and aged (36_??_59year).
The relationship between the chronic paranasal sinusitis and the maldevelopment of sinus was seen in a little less than 30%, which is signicantly defferent from normal control group.
Histopathological study showed inflammatory change of facial wall in 4 cases (12.5%), bony change due to reconstruction in 30 cases (93.8%).
Bone absorption appered to be common in those cases with well developed maxillay sinus, and osteoblastic activity was marked in cases with maldeveloped maxillary sinus.

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Firstly the observation was made on morphological changes of pharyngeal orifice of the Eustachian tube in Japanese adult cadavers in 12 cases or 24 ears. It was noted that in most cases the pharyngeal orifice was long ellipse in shape, next in the order of oval, pear, adnate, small groove and fissure. Nearly half of them showed morphological difference in right and left. Torus musculi levatoris showed also various types which proved to have a close relation with the morphological variety of pharyngeal orifice. Individual difference was remarkable in distance between each part of pharyngeal orifice of the Eustachian tube and also between the each part of the orifice and surrounding portion. The difference in the measurement on right side and the left side was seen even in the same person.
The second observation was made on pharyngeal orifice of the Eustachian tube of living body by transnasal salpingoscopy and photography whereby 'comnarative study with that in cadavers.Further study was carried out on several cases with no defects on face and palate and with no oto-laryngological diseases, in which photographs and films were taken to investigate the movement of pharyngeal orifice of the Eustachian tube during the speech and swallowing.By transnasal salpingoscopy, the orifices were classified into 8 types viz. "normal", "catarrhal"" swollen " " nodular " granular " " atrophic " " mixed " and " others ". Tubal floor in livingsubject was almost flat, or showed slightly raised torus musculi levatoris. Premarkable elevation of the torus was seen on the centre of dorsal side of soft palate when vowel "I" was pronounced.During swallowing, unlike during the speech, anterior tubal lip and membraneous region moved forward, downward and particularly outward because the tubal lips enlarged conjointly with torus musculi levatoris and back, up and inward movements of posterior tubal lip (likewise seen in speaking). However the movement of torus musculi levatoris and posterior tubal lip proved to be more remarkable than that of anterior tubal lip and membraneous region.
The third observation of pharyngeal orifice of the Eustachian tube was made by the use of nasal salpingoscopy on patients with otosalpingitis, adenoids and nasopharyngitis.
In 48 cases or 66 ears with otosalpingitis, swollen type was found in the greatest number, then followed by in the order of normal, granular, mixed, catarrhal, nodular and atrophic type. Catarrhal and swollen types were noticed in many cases with acute otosalpingitis while normal, nodular, atropic and granular types in chronic cases. When there were marked morphological changes of pharyngeal orifice of the Eustachian tube and pharyngeal orifice was narrow and small, in most of the cases, the movement at the time of swallowing or air-douche was disturbed. The symptoms of tuba, obstruction were serious. Granular type was found mostly in the cases with recurrent otosalpingitis accompanied by acute inflammation and swelling of the granules was observed

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The systematic hereditary studies of congenital atresia of the ears of 98 families among 144 patients were observed. These patients consisted of the outpatients of the Depertment of Otorhinol-aryngology, Keio University Hospital, patients examined in Shizuoka-Prefecture, students in Primary and Junior High Schools in Tokyo and Deaf-mute Schools in Japan.
The results were as follows:
1) The possibility of heredity could be considered. The reasons are as below mentioned.
(a) The familiar appearances were found among 98 families.
(b) The morbidity was 2.02% among probands'fathers and 0.61% among their aunts. These mor-bidities were higher compared with 0.0016%, the mean of the morbidities of the general population.
(c) The same disease was found in twin brothers (monozygotic twin supplied by Dr. Fujita)
2) It was pointed out by many authors that the sex ratios in hereditary malformations and diseases were higher in the male than in the female. The ratio observed by the author was 78.49/ in the male and 21.51% in the female patients. Affected-side ratios were 30.63% on the left, 63.96% on the right and 5.41% on both sides. These ratios were almost similar to those reported by American, European and other Japanese authors.
3) Several associated malformations and congenital diseases are often found in probands, their sibships and other relatives when one congenital malformation is investigated. The observation of these associations were also very important in view of the embryology and heredity. In my studies, the associated ratio was 18.18% in probands and 29.90, %, in their families. The kinds of associationswere Atresia auris congenita, congenital paralysis of facial nerves, congenital lameless, congenital scoliosis, microphthalmus congenita, polydactylia, several kinds of psyco'sis, congenital deaf-mutism, etc.
4) The familiar appearances were not frequent enough to investigate the families of the 98 pro-bands by means of statistical and hiometry examination. But by observing their pedigrees directly, the auther obtained the results as follows:
(a) In most pedigrees, the charactor appeared in the father's or mother's side only.
(b) There were pedigrees that the charactor was handed down from one of the parents to theirchildren.
(c) The intermarriage ratio, as observed by the author, was 8.08±2.72%, which had no significantdifference compared with 4.69±0.33%, the ratio of the general population reported by Dr. Kawa-kami, and 7.1% reported by Dr. Tachikawa.
(d) The morbidity of their sibships was very low, in spite of the fact that the morbidity perce-ntage would be higher in their sibships if this disease had a very low percentage and followedthe recessive hereditary system.
(e) The penetrance of this disease was 1.02±10.09% among 98 pedigrees.From the above stated results, the author concludes that Atresia auris congenita follows the dominant hereditary system with very low penetrance.

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The author measured the diameter, the length and the capacity of external auditory meatusand middle ear cavity in 34 different species of vertebrates including 2 amphibians, 4 reptiles, 6birds, and 22 mammals, to study the mutual relationship of each measurement and also studied the morphology of the middle ear cavities.The conclusions were as follows:-
1). The length of the external auditory meatus was always in proportion to the size of theskulls, but not to the breadth. The larger animals had longer meatus. The ratio of the length tobreadth of meatus was 11.4 in ox, 13.7 in pig, but in small animals like bat or rat, was nearly 1.0.
In animals which behave in water, for example, otter, sea-lion and fur-seal, the ratios wereremarkably large. The partially closed meatus observed in whale was an extreme case.
2). The external auditory meatus is essential for fine perception of air conduction sound.Moreover, the resonance effect of the meatus which is determined by the length of it may profitthe hearing acuity of the animal, when awared of the close relationship between tbe resonanceeffect and animal's cry.
3). The capacity of tympanic cavity was always larger than those of external meatus, and theratio dividing the former by the latter was very much constant in each mammal, for example, 3.0_??_3.4 in dogs. and 3.7_??_4.1 in cats.
4). In general, the capacity of the tympanic cavity was proportional to the size of the head, mainly due to the capacity of the tympanic bulla. On the other hand, the mesotympanum contain-ing the tympanic membrane, ossicles and windows showed a little variation.I have observed also this tendency among the different mammals. The ratio of tympanic cavityper 1mm2 of ear drum was 4 in rat, 6 in mole and 435 in ox.
5). The tympanic cavity of bird was uniform in shape as well as external meatus, exceptsome variation in shape and size of air cells fully developed in the skull.
6). The form of accessory air spaces of vertebrates were classified into several types accordingto the"order"or "family", such as single bulla with or without bony septum (rodentia, chiro-ptera, some uugulates and cetacea), and cellular structure developed in the bulla (ox, pig andhorse), in the mastoid process (some primates), or in the basis of the skull (insectivora).
7). But certain irregularities of the structures of the auditory organs were noted, because ofthe adaptation to the circumstances. For example, Barary sheep, classified in bovidae, had a singlebulla and large epitympanum with large Schrapnell's membrane as seen in cervidae.
8). Accessory air spaces are thought to have significance in four points, that is, making the tympanic membrane easily vibrate by the low frequency sound waves, reducing the weight of theskull, and the effect of reservoir action and acoustic dissipation. The resonance or insullation effect are doubtful.
9). The size of the air sinuses in the skull has a tendency to change according to the size of the skull. Therefore we must consider the relation of the both when the air sinuses are discussed.

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In order to establish a preventive method for the occupational deafness, the author made hearing tests of 522 workers in various industrial noise and obtaind acoustical spectrum of the noise -by means of a frequency analyzer. It was confirmed that the noise over 80 db in the frequ-ency range higher than 2000 cps (re 0.0002 dyne/cm2) was harmful to the ear.
The maximal safety level of industrial noise was decided in detail in wide range of frequencyfrom the relation between hearing loss and acoustical spectrum. Such a safety level was again confirmed by measuring auditory fatigue after exposuring normal hearing persons to industrial noise of various intensities for the period of 30 minutes.

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The purpose of this study is to observe morphologically the facial muscles and the muscles which form the resonance cavity and to find the relations between the state of the former and the delicate change of the expression as well as the latter and that of the resonance cavity in the tone production.
The method which was adopted was to dissect the facial, lingual, pharyngeal and laryngeal muscle, and to observe in detail the states of the insertions of the bundles of these muscle fibers, i.e., the relations of these bundles to the cutis, the mucous membrane and the connective tissue, using the binocular magnifier.
The materials were (1) the skin of the face, the tongue, the pharynx and the larynx, which were gained by the pathological dissection, (2) the head of a Japanese male and (3) the head of airus monkey.
The following results were obtained: ......
1. Muscle bundles of the facial, some of the pharyngeal and the laryngeal muscles interlace or join with each other.
2. Slender muscle bundles of the facial, pharyngeal and laryngeal muscles radiate into the con-nective tissue, and are inserted indirectly into the cutis and the mucous membrane. But muscle bundles of the lingual muscle are attached firmly to the lingual aponeurosis.
3. The facial muscle is inserted in the various states, but the lingual, pharyngeal and laryngeal muscles are inserted comparatively monotonous.
4. The facicl and laryngeal muscles of the irus monkey are not so differentiated as those of the human, but as far as the states of the insertion are concerned, no essencial difference can be ob-served.
From the:results_above mentioned, it is reasoned that the features of the insertions of the muscles which form the resonance cavity control its delicate change in the tone production, just like as the states of the, insertions of the. facial muscles take part in the delicate change of the expression.

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Intrinsic laryngeal muscles of fourteen cases were dissected under the binocular microscope toobserve their disposition and arrangement. Serial microscopic sections of another five cases were made to compare with the findings obtained by above-mentioned method.
The results were as follows:
1. The thyro-membranous and the thyro-epiglottic muscles cross the minor ary-membranousand the minor ary-epiglottic muscles at the dorso-lateral part of the laryngeal ventricle, or on thefront of the triangular fovea of the arytenoid cartilage.As these four muscles intertwine one another at the intersecting point, the directions of thesemuscle action are changed so as to expand the quadrangular membrane and the wall of the laryngealventricle. Accordingly, the laryngeal vestibule and ventricle are dilatated.
2. The vocal muscle is divided into two portions: the thyro-vocal and thyro-oblongatic portions. The former arises from the caudal part of the thyroid cartilage, runs dorso-cranially and reaches the vocal process, while the latter arises the middle part of the thyroid cartilage, ' runs dorso- caudally and reaches the fover oblongata. These two portions intertwine with each other. This characteristic structure is found distinctly at the dorsal third of the vocal muscle. These muscle portions are not inserted to the vocal ligament. However, in four cases among fourteen on dissection, another muscle bundles, i. e., the ary ligamental portion is found inserting to the dorsal third of the vocal ligament. It is considerably difficult to divide the ending of muscle fibers on serial sections.
3. Thyro-vocal muscle which Goerttler stated in his paper that it arose from the thyroid cartilage and reached the vocal ligament was unable to be recognized.
4. Muscle bundles close to the vocal ligament are more slender than those of the lateral part, _and they are intermingled with elastic fibers, running parallel with them.
5. Muscle bundles inserted to the elastic cone are observed, but their quantity shows the individual difference and in some cases these bundles are not observable.
6. The structures of the lateral crico-arytenoid, the posterior crico-arytenoid, the arytenoid and the crico-thyroid muscles are observed and their functions are considered.
7. The submucous connective tissue of the vocal and the ventricular ligaments is dense, but the other part loose. The collagene fibers are intermingled firmly with the muscle and elastic fibers, taking part in the morphological change of the wall of the laryngeal cavity.
8. As far as dispositions of the laryngeal muscles are concerned, the several months old foetus and the adult show no essential differences.

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