Analysis and evaluation of “Semon's law, ” based on a review of previous studies on the paralysis of the recurrent laryngeal nerve, including our recent clinical investigations were made. The author has come to the following conclusions: 1) According to Semon's conception on the position of the paralyzed vocal cords, the median position is regarded as a partial paralysis of the recurrent nerve, resulting from contraction of the adductor muscles, and the so-called cadaveric position, as total paralysis of the nerve. This interpretation could not be proved either by our studies or by those of other investigators. On the other hand, the opinion of Wagner and Grossman, maintaining that the median or paramedian position of the paralyzed vocal cords is due to the cricothyroid muscleremaining unimpaired, is inadequste to give a complete understanding on various figures of the paralyzed vocal cords. Clinical pictures of the paralysis of the recurrent laryngeal nerve are too complicated to be explained from the above mentioned theories. Further studies are considered necessary to arrive at a through understanding concerning these conditions. 2) Our clinical study of the recovery course of a patient with laryngeal paralysis presented evidence supporting Semon's concept on the greator vulnerability of abductor function of the larynx. To obtain a clear picture of the above concept of Semon, it is required to establish a proper understanding on the figure of pure abductor paralysis.
A thick moss layer was found covering the tumor which recurred 6 months after resection of a cancerous tumor in the left upper jaw of a man 66 years of age. Bacteriologically, blastospores were demonstrated, and histologic examination revealed filaments and what was considered to be fungous masses of true fungi. General debility brought on by the cancerous growth and reduction of resistance in addition to the tumor and ulcer formation in the mouth may have provided favorable conditions for the mycotic infection. Moreover, the prolonged use of large dosages of antibiotics following the operation cannot be disregarded but the biological changes occurring in the local tissue with radiation treatment might also be considered as one of the contributing factors.
1) A statistical observation was performed on 389 selected cases out of those who visited the Tokyo University Hospital complaining of vertigo, during the period of years, from 1953 to 1955. i) Preference of the vertiginous attacks was found among the 20-30 years agegroup, in the morning or evening, and during the winter season, Particularly, meteological observation revealed a close correlation between the attacks and passages of the front. ii) Statistical observation on the results of the results of the vestibular functional tests was performed in expectation of the possibility of simplifying the test procedures. ocedures. The tests were divided into three groups:(a) Simple tests of disturbances of equilibrium and coordination. (b) Inspection of spontaneous, positional and positioning nystagmus. (c) Observation on caloric and rotatory nystagmus.Percentage of the positive results obtained in either the (a) or (b) procedure was only 50%, in (a)+(b) 70%, and in (a)+(b)+(c) 90%. These results would indicate that the caloric or rotatory test reveals latent pathologic changes. 2) Clinical courses of the patients (244 cases selected out of ca. 1, 000) were followed up for the last 10 years. As a result, the patients in the meridian of life (3rd to 4th decades of age) showed more difficulties in being relieved of their vertiginous attacks than the younger or the older patients. This tendency appeared to be was pronounced in females than in males. Unexpectedly as many as fifty percent of the patients who visited the Hospital four years before, were found to be still suffering from a “chronic vertiginous condition, ” in spite of various sorts of conservative treatments.
A follow-up roentgenological functional examination was made on fifty-two patients with chronic maxillary sinusitis of varying intensity for more than three years and the improvement and worsening were studied in relation to season, age, episodes of cold, malformation of the nasal septum and others. From the above stated results, among the various factors which developed and stabilized chronic paranasal sinusitis, three, repeated slight inflammation, abnormal structure in the nasal cavity and predisposition of the sinus mucous membrane, presumably played an important part.