ACCORDING to the author it is the ‘transmyringal’ portion of the chorda tympani nerve which in practice remains exposed to the cold atmospheric air and triggers the pathologic process involved in Bell's palsy, affecting the facial nerve secondarily, rather than a primary condition of the facial nerve. This theory was proved by creating a Bell's palsy (paralysis a frigore) with cold-air-stimuli to the tympanic membrane in experimental animals (two monkeys). On the basis of this observation the author recommends ‘medical decompression’ of the facial nerve by means of infra-red fomentation of the drum, and eustachian insufflation of hydrocortisone, in cases of Bell's palsy before retrograde extension of oedema from the chorda tympani to the facial nerve can cause irreversible damage. Subsequently, the author has successfully managed fourteen cases (93.4 per cent) of Bell's palsy with a definite history of exposure to cold (paralysis a frigore). It is suggested that the ear canal be plugged with cotton as a preventive measure; and that chorda tympani neurectomy be performed to eliminate the chances of recurrence of the disease in cases of recurrent Bell's palsy.

IN the last decade hyperbaric oxygen has been recognized as an important therapeutic tool in a variety of instances in which either destruction of anaerobic bacteria is urgent or an improvement in the oxygenation level is mandatory. We have usede it successfully in a case of mediastinal anaerobic infection (gas gangrene) after medical and surgical measures had failed to eradicate the disease.

The causative organism of gas gangrene, Clostridium perfringens (Welchii), is widely distributed. It may be cultured from the soil, house dust, human skin and faeces, etc. For this reason infection with Clostridium is practically inevitable whenever suitable conditions arise. As an anaerobic bacterium Clostridium Welchii multiplies readily in damaged tissues without cantact with the air and devoid of a normal blood supply. This occurs especially in road accidents and war wounds in which broken bones and crushed muscles provide a suitable medium for the infection (Altmeier 1965). Sometimes this infection can occur too after abdominal or gynaecological operations (Hitchcock, 1965).

We present here a case of mediastinal gas gangrene which was caused by perforation of the oesophagus by a swallowed foreign body.