Neuro-otology

THIs British Council publication shows clearly, first, that otological research is in a very active state in the United Kingdom, and second, that the no-man's-land of the inner ear is at last being penetrated. Much of the research is now bear.ng fruit in the sense that many of the results are now applicable to clinical medicine. To understand hearing and equilibration fully it is necessary to examine in detail the component parts concerned. This the Bulletin does clearly with chapters on temporal bone microtomy, the labyrinthine fluids, and the electro-physiology of the central auditory pathway. The physiological mechanisms of equilibration and hearing are then explained. Loudness, recruitment, fatigue and adaptation-all of great importance to the clinician doing diagnostic audiometry-get a lucid chapter each. Nystagmus in its vestibular, optokinetic and positional forms is clearly explained. There 's a very clear exposition also of the methods of executing and evaluating caloric and rotation vestibular tests. Diseases of the eighth nerve system are excellently set out and the bulletin concludes with an interesting chapter on heredtary forms of labyrinthine disease in mice. Much of the detail is fascinating; for example, it has been proved that endolymph contains relat.vely high potassium and low sodium concentrations and is very similar to intra-cellular fluids elsewhere in the body. As the nutrition of the organ of Corti and other specialised structures depends largely upon this fluid, it follows that any damage to the secretory stria vascularis cells which produce it, e.g., by ischamia, toxIc substances, etc., may adversely affect the actual end organs of hearing and equilibration. In this connection the important work of J. C. Seymour on vascular disease of the cochlea and vestibule in animals and man and its connection with the clinical manifestations of Meniere's disease and other perceptive hearing d.sorders has not received the attention it deserves in this publication. The Bulletin is printed and illustrated clearly, and the team of experts wlho have produced it are to be congratulated. They have managed to produce something more than a resume of recent research, they have produced a work which will be a reference volume for some time to come. Every clinician dealing with the diagnosis of inner ear disorders should read this Bulletin. STTUDENT nurses meet venereal disease cases in the general wards as well as in special clinics and are expected to acquire a sound basic knowledge not only of the disease …