Hallucinations are a well known aspect of chronic alcoholism. Visual hallucinations are much more common than auditory hallucinations, and both occur as part of the syndrome of sudden withdrawal following prolonged, heavy imbibition of alcoholic beverages, approximately the equivalent of one pint of ethanol per day for forty days. During the first 24–36 hours of alcohol withdrawal, acute visual and auditory hallucinations and grand mal seizures may occur prior to the disorientation and autonomic changes of delirium tremens, which need not follow invariably. Thus, some study of the patients in this stage is possible. The characteristic of the hallucinational content is its concreteness. The visual hallucination is of figures, faces and objects which the patient describes in concrete detail. The auditory hallucinations are of voices which the patient can describe, and quote what they are saying to him or to each other. Often the faces and voices are not familiar to the patient, and they may seem benign, although they are more commonly threatening. These hallucinations are distinctly different from those seen in schizophrenic patients. During the acute phase, the auditory hallucinations are localized as coming from the next room, or from the street, and not as being inside the head or in the ears.

An 82-year-old man developed an uncommon type of swallowing disturbance with tetanus. Initially, he could masticate his food but could not pass it into the esophagus. The mechanism of swallowing in this patient was studied radiologically and endoscopically. The disturbance in the second stage of deglutition was associated predominantly with his advanced age and the slow clinical progress of the tetanus. The patient was cured by treating the disease.

Primary mucous leishmaniasis of the tonsil with satellite lymphatic spread but without visceral diffusion is presented.

From fragments of the tonsils and from the satellite cervical lymph nodes it was possible to find, isolate and culture a strain of Leishmania Donovani ‘BO 72’.

The diagnostic problems are discussed caused by the lack of specific clinical findings and the rarity of mucous leishmaniasis in an area frequently the site of other pathological processes.

Three hundred ten randomly selected male shipyard workers, with an average age of 56 years, with an average of 19 years with their employer, excluding workers with evidence of other otologic or relevant neurologic disease, were analyzed in terms of hearing loss, tinnitus, vertigo, and family history of hearing loss. The audiograms showed bilateral, symmetrical mid to high frequency hearing loss with SRT of 21 db and 85 per cent PB word discrimination. Eleven per cent had a family history of hearing loss, but this did not correlate with the patients' hearing loss, tinnitus, or vertigo. Fifteen per cent of the patients gave a history of vertigo. Tinnitus occurred in 43 per cent of right ears and in 41 per cent of left ears. Statistical analysis showed that the tinnitus did not correlate with hearing loss at any frequency in the right ear but correlated significantly with hearing loss at 2000 and 3000 HZ in the left ear! These were significant but small. Multiple correlational analysis indicated.

A rare case of a cholesteattoma of the maxillary sinus is presented, together with a brief discussion of its aetiology.