On pathogenesis of symptoms in Ménière's disease.

A conception of the mechanism for initiating symptoms in Ménière's disease has been forwarded. According to this conception production of endolymph may vary also in normals. The hydrops in Ménière cases is brought about by a relative insufficiency in endolymphatic draining routes and the hydrops presents itself only at peak endolymph production periods. The attacks of vertigo are brought about at the distension of the sacs as well as of the regaining of normal shape of the sacs. The mechanism causing the vertigo could be an effect of mechanical push-and-pull effect on the sensory epithelium of the cristae. The early low-tone hearing loss and the persistant normal caloric reactivity also in advanced Méière cases may be due to simple physical laws : distensions of sacs with equal walls will more easily be brought about in wider than narrow compartments.