Part I In spite of the recent development of the chemical substance theory on nerve impulse, very few biochemical investigations have been reported on the cochlear response.
The author studied the Cholinesterase (ChE) activity of the labyrinthine fluid of guinea-pigs by Conway's microdiffusion analysis.
The results obtained were as follows,
1. ChE in the labyrinthine fluid, both that in endolymph and perilymph, was "specific" Choli-nesterase.
2. ChE activity of endolymph was about 4.36 times as much as that of perilymph. Free acetic acid produced from acetylcholine by 1mg endolymph in 40minutes at 38° was 0.0183mg% and by 1mg perilymph, 0.0042mg%.
3. The injection of 2% Quinine hydrochloride solution (0.05gr per kg.) decreased gradually the ChE activity of endolymph and perilymph in parallel, but the diminution was slow and small in comparison with other cases.
4. The injection of Dihydrostreptomycin (0.4g per kg) decreased the ChE activity more remarka-bly and earlier than the case of Quinine. The diminution of ChE activity of perilymph was more remarkable than that of endolymph.
5. The sound stimulation (3000 cps 90db) for 60 hours diminished markedly the ChE activity of labyrinthine fluid and that of endolymph as if inhibited completely.
Without stimulation for 7 days after 60 hours stimulation, the ChE activity of endolymph was recovered remarkably, but that of perilymph still remained low.
In case of the experiment of repeated 12 hours stimulation and 7 day nonstimuration, the dimi-nution of ChE activity of labyrinthine fluid was slight.
Part II The author carried out the clinical experiments on the ChE activity of spinal fluid by Hesterin's method with Beckman's spectrophotometer.
The results obtained were as follows.
1. Normal ChE activity was 0.175±0.006 ElogIo/I in equilibrium at range λ500mμ, the upper limit was 0.200, and the lower limit was 0.140.
2. In 11 cases of conductive deafness, the ChE activities were normal or slightly below normal value except 2 cases of otitis media exsudativa acuta (0.200, 0.210).
3. In 19 cases of nerve deafness, a considerable diminution of ChE activity was observed except 2 cases. Especially, in deafness due to detonation, sudden, traumatic, streptomycin, Menier's syndro-me, following to cerebral abscess, Congenital deafmutism, the ChE activity decreased remarkably.
Two cases of Cholesteatoma-deafness and nerve deafness with central retinitis showed normal value.

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From the point of which the evoked potential was found to happen in the waking rabbit brain by acoustic stimulus, the measurement of hearing was given its application a trial and the mini-mum reaction value (threshold) was examined quantitively.
The observation for the evoked potential was carried out using the automatic superimposition technique to wich photo-transistor was applied.
The curve of the minimum reaction value to the acoustic stimulus ranged from the 250 to 8000 cps, with the interval of 10 seconds and 0.5 second stimulating time was shown by audiogram. The average value of each cycle obtained was between 50 to 60db.
Through a short and long continuous observation the change of threshold was revealed to be approximately within the extent of±1Cdb.
In the case of water or mercury being instilled in to the external auditory canal, the change of threshold was increased to 50db or more respectively in comparison with the condition before loading.
The change of reaction threshold was observed using 1, 000cps tone to mask 3, 000cps tone. The result obtained was that the reaction threshold of the masked tone elevated at 80db generally, and the difference of 10 to 20db was seen in comparison with human case.
From these results obtained, conclusion was drawn that the above evoked potential would be an index of the measurement of hearing to the rabbit and especially in the long period observa-tion, would be one of the most effective methods.

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The second phase of nystagmus in human appeared in 100 per cent with rotatory, in 72 per cent with caloric and in 80 per cent with optokinetic stimuli. In rabbits it appeared in 30 per cent with rotatory, in 78 per cent with caloric and in 100 per cent with optokinetic.
Secondary phase is one of fundamental patterns common to all retatory, caloric and optokinetic nystagmus. However, it can not be observed in the presence of such inhibitory factors as vision, noise and etc.
The value of minimal stimuli which is necessary to induce secondary nystagmus (secondary nystagmus threshold) varies under different conditions even in the same subjects. There is, however, a certain correlation between the threshold of rotatory and caloric secondary nystagmus. If one increases the other also increases, and vice versa.
In animal-experiments, secondary nystagmus is apt to be recorded on the side of directional preponderance.
It is thought that the secondary nystagmus is constituted by the primival tracts in the brain stem which are constantly influenced or controlled by the higher regulating vestibular nystagmus. tracts such as the cerebrum and the cerebellum.

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Peripheral nerve routes reaching to the lip and palate were studied in the guinea pig sacrificed by suboccipital puncture, and distribution of the nerve fibers, especially that of autonomic nerve fibers was studied systematically. The following is the findings obtained in these studies:
1) The trigeminal nerve which supplies the fibers to the lip and palate divide into three main brances, i. e., Nn. ophthalmicus, maxillaris and mandibulais, after emerging from the side of the pons and passing through the semilunar ganglion. The lip and palate are innervated by fine branches of the anterior superior alveolar nerve which branches off from the maxillary nerve, passes through Foramen lacerum anterior, reaches Fossa pterygopalatina and passes through the suborbital nerve canal with zygomatico-temporal branch and zygomatico-facial brach.
2) The sympathetic nerve fibers are contained in the maxillary nerve, and are communicating, in their course, with perivascular plexuses and are distributed abundantly in various areas along with small vessels. Parasympathetic nerve fibers are difficult to distinguish histologically from the sympathetic nerve fibers and it is difficult to pursue, their course in detail.
3) The lip is covered with cornifid squamous epithelium, with well-developed dermal papillae, and its cutis consists of loose connective tissue with a good supply of capillaries. Many striated muscle fiders running in an irregular fashion are seen in the subcutaneous adipose tissue. Skin appendages can also be seen, demonstrating the dermal nature of the lip.
4) With the aid of silvar stains, it is demonstrable that the nerve bundles which are the mixture of various nerve fibers, divide into smaller bundles after reaching the periosteum, traverse the muscle layer and reach the subcutaneous tissue where they from loose nerve plexuses. The fibers branching off from these plexuses form compact plexuses within the cutis. Smaller nerve. pixeuss can also be seen within the papillae and adjacent to the basal membrane.
Autonomic nerve fibers ere present mainly around the vessels in abundance, forming there fine vegetative terminal reticulum. Sensory nerve fibers form undividing or simply dividing terminal endings within the papillae. Intradermal fibers ars also demonstrable relatively in abnddance.
The palate belongs histologically to the mucous membrane with few papillae formation and poorer supply of nerve fibers compared to the human palate.
On the basis of these findings, histological studies of these regions of the guinea pig were made from the view-point of the comparative anatomy. Clinical significance of the anatomy of the neck, which was pointed out by H. Stolze, was discussed.
A numbers of studies on Reilly's phenomen have been under-taken in our department by Suzuki, Iida, Fukazawa, Takasaki and Suzuki. Inoue, also from our department, has performed a series of experimental studies in which he demonstrated Iesions in the cervical and abdominal ganglia in the animal receiving irritating stimuli to its pharyngeal mucous membrane.
The purpose of my studies has been to give support from anatoinieal-histolagical view-point to the results of these studies as well as to the concept that the autonomic nerve plays an impor-tant role in above mentioned studies.

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Fibrinolytic activity was measured in isotonic saline extract of such tissues as mucous memb-rane of maxillary sinus, inferior turbinate, nasal polyp, faucial tonsil, pharyngeal tonsil, and stomach mucous membrane.
The mucous membrane of maxillary sinus, inferior turbinate, nasal polyp, faucial tonsil, phary-ngeal tonsil and stomach mucous membrane were taken from the patients ailing such diseases as sinusitis, tonsillitis, gastritis, gastric ulcer and gastric cancer.
1. Results obtained indicated that
(1) the strongest activity was observed in the extract from the mucous membrane of the inferior turbinate,
(2) stronger activity was in the extract from the mucous membrane of the maxillary sinus,
(3) fibrinolytic activity was weaker in the nasal polyp.
(4) fibrinolytic activity was not observed at all in the faucial tonsil, the pharyngeal tonsil and the atomach.
2., Fibrinolytic activity in the extract of nasal mucous membrane using isotonic saline solution was in the globulin fraction, not in the albumin fraction.
3. Fibrinolytic activity of nasal mucous membrane was decreased to a certain extent by the addition of cystein; it was completely inhibited by the addition of ε-aminocapronic acid.
4. This fibrinolytic activity belongs to the plasmin enzyme system.
5. It is under the investigation that whether this fibrinolytic activity is due to plasmin itseff or the activator.
6. The relation of the plasmin-like substance in the nasal and paranasal mucous membrane and the inflammatoy changes in the tissue was also discussed.

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A 13 year old male deaf student who showed a hearing loss of 65db in the right ear by pure tone test and 75db in the left due to malformation of the external and middle ears on both sides.
Since the X-ray of the mastoid showed, moderately developed pneumatization, and the cochlear nerve seemed to have normal function, surgery was performed on the right ear on September 26, 1956, to create a conductive route to the inner ear. At the time of surgery, there was malformation of incus and stapes was missing. Fenestration was performed after the incus was removed. Fol-lowing the fenestration, his hearing in the right ear began to show tremendous recovery and his hearing acuity showed a 25db loss by pure tone testing on December 26, 1956 (3 months after the operation).
After the surgery, patient was observed carefully in regard to the development of voice, speech, intelligence and so on.
Three months' music training enabled him to sing some easy songs rythmically, though not so well. The range of voice which had been 5 semitones (b-e') was widened up to almost normal being 17 semitones (ges-b') 6 months after the surgery. It was not more than a half year when the differential sensitivity in pitch and intensity of sound was found to be recovered to normal. Six months after the operation, the ratio of amplitude of respiratory curves be tween one taken from the chest and the abdomen was 5 to 3 which was close to normal, while it was, 3 months after the operation, 2 to 1. The pronounciation of individual words became correct, which was che-cked with sonagraph, analizing every syllable of the words. But the conversational ability was not improved so much as expected. I. Q. according to WISC was 54 at 2 months after the surgery, but it was improved up to 72 after the surgery. Regarding the numbers and kinds of vocabulary, no remarkable improvement could be seen. The length of sentence (as mesured numbers of words) has gradually increased and became almost mormal.

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Two rare cases of audiogenic epilepsy following to head injury were reported. In both cases, organic lesions were found in the right temperal-parietal lobe, and diagnosis of perceptive deafness (labyrinthine and retrolabyrinthine) was made by hearing test.
In both cases, epileptic attacks appeared when tone stimuli were given to their left ear. The tone stimuli had to be 4000 cps pure tone, over 40 db. Electroencephalograph showed typical waves of epilepsy. From these facts, a conclusion was made disturbance in temporal lobe and auditoryorgan played an important role in audisogenic epilepsy.

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Among recruitment tests the author selected DL difference (DL.D) test and studied it for dete-rmining the presence or absence of recruitment. Namely, this selected DL difference is the rema-inder obtained after subtracting DL at 40db over the threshold from DL at 10db over the threshold, and examined 50 ears of 25 persons with normal hearing on the basis of this DL.D test using Maico MA-I.
1. DL's at 10db over the threshold show slight individual differences, but DL's at 40db over the threshold and DL. D's hardly show any individual difference.
2. The minimal limits of DL. D's in the normal ears. were 250cps. 0.6db; 500cps. 0.6db; 1000cps. 0.6db; 2000cps. 0.5db; and 4000cps. 0.5db.
3. The standard deviation of DL. D's by the frequency is small compaired with DL's, showing the least standard deviation at 1000cps. In selecting one frequency for the testing sound, the freq-uency at 1000cps is the most suitable one.
4. DL will yield different values according to different examiners and to the measuring methods, especially the way how the testing sound is given. Therefore, unless the determination of recruit-ment is conducted under the same conditions, the measured values will be meaningless and the actual determination of the presence or absence of recruitment will become difficult.

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Hearing test were performed on, 115 telephone operators in 1956, 134 operators in 1957, 133 operators in 1958 at Aomori Telephone Exchange Office, and on 116 operatiors in 1948 at Hirosaki Telephone Exchange Office. Following conclusion was obtained.
(1) Appearance of hearing disorders were found in 10.9%, 14.2%, 17.7%, and 22.4% respectively and in over 80% of them it was perceptive nature. Moreover, about 50% of the perceptive deafn-ess, they seemed to be hearing disorder caused by the use of recerver.
(2) About the hearing disorder due to the use of receiver, the following results were obtained.
a) More than 90% of them, hearing disorder was slight, being less than 30db hearing loss in average.
b) The incidence was remarkable in males, who had been working oner 5 years.
c) Among the operators who had been working less than 5 years, author could not find the cases, whose hearing loss average was morethan 30db. In most of them, it was less than 10db hearing loss in average.
d) About the shapes of audisgram, author found dip-form most frequently, and next (in order of) V-form, U-form and gradual sloping-form. The dip was found in c4 most frequently.
e) In the cases who h-ad been using receiver on one ear only for listening, the incidence of deaf-ness was higher than in the cases who had beenusedon ears alter natively.
f) During 2 years' observation, an increase of hearing loss especiall in 2000cps at 500, 1000, 2000, 4000cps was found. But there were no cases showing improvement or progression over 15db in average of 4 frequencies.
g) As the result of the detailed examination, more than 70% of cases were showed positive Onchi and DL test. In the test of the speach articulation by conversation rate, more than half of the mild eases showed slight hearing disorder at 40db of the speach sound power. In 3 cases with moderate orsevere grade hearing loss, the disorder was observed at even 90db.
(3) Hearing disorder of the telephone operators has the characteristics that it frequently shows the audiogram of C4-Dip. It is the authors conclusion that these facts are due to that most sound is around 1000cps, and the energy sometimes exceeds the limit of sound criterion.

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In 129 palatine tonsils obtained from 121 cases in operation and autopsy, physiological and pathological changes in the free surface and subepithelial basement membrane of the lacuna were examined histopathologically and histochemically, and the following results were obtained.
1. The free surface and subepthelial basement membrane of the lacuna of the palatine tonsil were comprised of argyrophil fibers and ground substance, and secondary hyaline layer was observed in no cases. The same was found in ciliated epithelium which was seen sometimes in the lacuna.
2. In the subepithelial basement membrane was remarkably seen physiological loosening, which corresponded with the changes in inflammation stadium of the free surface. This was closely related to reticulation in the epithelial layer, state of follicles and the amount of fibers in parenchyma.
3. The loosening in the basment membrane was remarkable in infants and children lator, nearly in parallel to the involution of the tonsils, the membrane became compact in structure.
4. In inflammation, the basement membrane showed remarkable changes ranging from hatch formation to partial disappearance. In many cases, these changes were seen in areas which were not directly subjected to inflammatory stimulation.
5. The physiological loosening in the basement membrane was assumed to have been secondarily produced by the passage of lymphocytes, lymph and tissue fluid. It is considered that these changes would facilitate protective action on one hand, and contact of lacunar antigen and tonsil parenchyma on the other, which would contribute to the formation of antibody.

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Using oral and intrasinal Na²⁴ Cl as a tracer, the author investigated the excretion and the abs-orption throngh the mucous membrane of maxillary sinus.
1. The radiation counts of the secretion from teh ostium of maxillary sinus after the oral administration revealed the excretion ability of mucous membrane of maxillary sinus.
2. The derease of the counts suggested the tendency of the mucous membrane to become fibrotic type from catarrhal and purulent type.
3. Similarly, the decrease of the counts suggested the change of glands of the mucous memb-rane from hypertrophic and dilated type to atrophic type.
4. The delay of absorption of Na²⁴. Cl through the membrane suggested the change of lesion in the mucous membrane from infiltrative type to productive or fibrotic type.

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A clinical and histopathological study of nasal polyps was made. At first, a clinical investi-gation of 200 cases with nasal polyps was made and compared with the patient with chronic sinusitis, so-called allergic rhinitis, and bronchial asthma, especially from the standpoint of pollen allergy.
As the result, it was found that the nasal polyps had a closer relation to chronic sinusitis than to bronchial asthma or allergic rhinitis. But, histopathological study of 102 polyps taken from above-mentioned 200 patients, showed edema and eosinophilic infiltration which suggest a close relationship to allergy.
Among 102 cases, 10 showed fibrinoid degeneration, in which 5 showed edema, eosinophilic infiltration and fibrinoid degeneration simultaneously.
Therefore, I consider that, though the number of the patient with nasal polyps who shows the allergic symptoms is very small and the reaction itself is mild, there must exist some compo-nents of allergy.
Furthermore, the nasal polyp was proved to be inflammatory nature rather than neoplastic nature through the investigation of alkali-phosphatase reaction.

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The treasment of the chronic sinusitis is still a new subject. This is due tstze fact that all the patients are not cured by operation alone, even with the use of penicillin because of individual character of the patients' consisbibion endowed by nasure.
The author has previously reporbed on the treatment of the asthma by application of ion gas, the resuet of which was found excellent. As in the case of the asthma, the majoriby of the chronic rinusitis are of the allercig nature: and this is why the author made a study, of the, treatment of this disease by application of ion gas.
The resuet was, as expected, excellent, showing completecure in aee of the cases.
1) The method adopted
After the operation, a special ion gas, generated by Mr. M. nagao's ozoneither, was injected daily.
a) Sites of the injection: The tkeek and, the bark of the neck.
b) Quantity injected: The tolal amount was 20-50cc, of which 5-10cc, on the tkeek and the rest of it on the back of the neck.
c) Litertures on ion gas: Magazines issued by the Navel medical. Corpor-ation: Reports by R Josa, M.D. on the rose: by T. Endo, M.D. on the gangrene: and J. shirota, M.D. on the neuralgia.
2) The results of experi ruents,
a) Number of the patients: 7 children and 18 adults.
b) after the operation and the injection: there was no bleeding.
c) After the operation and the injection: there was no pain felt.
d) pus in nose: distippcared in 2 or 3 duzs: irrigation was not required.
e) The period of the treatment was greatly shortened.
f) When ion gas injected, there was no nes cersity of operation in children.
g) cure rate was 100%. Percentage of the cured, who underwent operation, is 100%.
3) The author came to the conclusion that the chronir sinusitis is not in carble disease, if this treat ment is resorted.

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Nasal septi of 36 embryos and 8326 cases of all age groups from sucklings to adults in South Kyushu district were examined and, the following results were obtained.
1. Septi in embryos.
Deformation was recognized in 6 cases out of 36 embryos (16.6% in 2 cases on the left, and in 4 cases on the right).
These deformities were mostly slight C-deviation and deviations were observed in the posterior portion of septum in most cases.
2. Septi in sucklings and adults.
a) Frequency of the deformity was 20% in sucklings and ascended linealy afterwards, until the age of fifteen. After this age, it increased gradually and reached to peak of 90.6% at the age of forty-five to forty-nine in man and of 77.0% at the age of thirty to thirty-four in woman, and no change in the incidence was recognized in older agegroups.
Sexual difference was not recognized until the age of fifteen but after that age, more deviation was seen in man than in woman.
b) Slight deformity was observed at the rate of 30 to 40%.
Middle grade deformity was seen in less than 15% in children under the age of nine but after the age of twelve it increasedd gradually and ranging 20 to 35%.
Severe deformity was seen in less than 5% until the age of forteen but after that age it was seen in 10 to 20% in man and in about 10% in woman.
c) In youth, the deformity was in Crista in 30%, upper deviation and foward backward devia-tion in 20%, < deviation, C-type deviation, lower deviation, and forward lower ridge in 10% respectively, in Spur in less than 10%, and complex type and S-type deviation in less than 5%.
Spur, S-type deviation, upper deviation, and complex type began to appear at about the age of twelve to thirteen and at the same age, crista and upper deviation increased remarkably and complicacy also increased.

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Since appearence of penrcillin eveoy dortor must have undoubtedly experienced that there has been a great change in the otological treatment.
For instance, the duration in time of treatment of the otitis media has been greatly shortend: the accompanied mastoiditis to the said disease is becoming scarce.
Therefore operation on the mastoiditis (Schwartze's operation) is realy performed: and it seems to the writer that number of this operasion is rather smaller than that of the chronic otitis media.
Among the trcatments of this discase attendet by writer at the Umeda Hospilal see met with some patients accompanied by the leucopenia, which to the writer's knowledge, har not yet been reported hitherts: this is the reuson why the following article is laid befoore the pulir.
The experiment on four cases.
Tee recovery of the all above patients was not good: the wounps did not granulate; therfore teeir blood was examined and the patents were founb accompanied by the leucopenia.
When the quantity of blood mentioned in the table, was transfused to the respectiv patients, they quichly regained there health.
It scems to the writer that the canse the the aboye cases of the leueopenia are due to the abuse of penicillin or sulfamin.
Blood imbge of repestive patrints befor transfurion are as follows:

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