腦脊髄液多量Suboccipitalpumpingの内耳性難聽及び聾に對する臨床的觀察（第3報）—自律神經に及ぼす影響

　緒言

　内耳性難聽メニエル氏症候群及び聾の治療に用いられる腦髄液多量Suboccipitalpumpingの作用機轉は，内耳の末梢器官に對する機械的作用及び聽神經の終末神經装置に對する刺戟による作用大腦に於ける聽覺中樞への直接の刺戟による賦活作用等が考えられており，之等について臨床的方面から觀察しか結果は，巳に第1報（耳鼻咽喉科第21卷10號）に於て述べた。しかし，此のパンピンクを實施する部位及び方法より考え自律神經に對する作用よりの效果も決して除外することは出來ない．迷路が自律神經と密接なる關係を有する事は周知の事であり，之に對し已に多數の實驗が報告されている．又メニエル氏病の原因に於ても自律神經説（Hobrak），水分代謝異常説，（Mygind and Dederling）等ありパンピングが眩暈に對し特效ある事實から見ても自律神經に對しいかなる作用を及ぼすかについて一應檢討する必要があると思う．私は此の度内耳性難聽，聾，先天性内耳梅毒，メニエル氏病等9例の患者について，脳脊髓液多量Suboccipitalumpingを行い，其の術前術後の自律神經の状態及び入院時（治療前）より退院時（治療終了時）の自律神經機能の變化を藥物試驗によつて觀察し次の如き成績を得た．故に之を報告し第3報とする．

Honma says that, regarding large volume "subocci-pital pumping" of spinal fluid from anatomical loca-tion and the method with which it is employed in treatment of inner ear deafness of Meniere' a syndrome or other forms of hearing, the effects which it may produce upon the sympathetic nervous system can not be disregarded. With such a view in thought, 9 patients were examined by means of drug ractions for observations upon their sympathetic nervous systems with data relative to the time of admission to and discharge from the hospital, and, before and after the treatment. The results are as follows : That sympathetic nerves are definitely stimulated by "suboccipital pum-ping"; that autonmic nervous system as a whole is influenced by this stimulation as is shown by evidence of increased neurogenic tonus; that, while reactions evoked by parasympathetics are variable yet, at no time, is the tonus apparently decreased below that of the normal; and, that, when the patients are discharged from the hospital at completion of treatment, the state of their sympathetic nervous system is definitely altered.