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Logo of procrsmedFormerly medchtJournal of the Royal Society of MedicineProceedings of the Royal Society of Medicine
Proc R Soc Med. 1929 May; 22(7): 965–986.
PMCID: PMC2102375



Symptoms revealing a state of consciousness, attributable to incoördination of afferent impulses connected with the vestibular system—disturbances of muscle-sense—vestibular ocular tracks—vestibular-spinal tracks.

Different Vertigo-Complexes.

Destructive lesions of labyrinth, or of vestibular tracks, partial or complete.—Heterogeneous stimulations of the paired intact vestibular-end organs.—The hypersensitive labyrinth.—Clinical manifestations of vertigo, associated with nausea, headache, visual disturbances, nystagmus, diplopia, staggering gait, vasomotor and cardio-vascular symptoms, pallor, flushing, sweating, dyspnœa, fainting, vomiting and diarrhœa.

Objective Examination.

The tympanic membrane.—Middle-ear track.—Upper air passages.—Hearing tests.—Oculomotor tests.—Labyrinthine reactions.—Postural, caloric, galvanic tests.—Differentiation between destructive and non-destructive disturbances of labyrinth.—Discrimination between peripheral and central lesions.—Vertigo associated with acute, non-perforative otitis media, with chronic otitis media, with labyrinthine fistula, with otosclerosis, post-suppurative adhesions; with peripheral nerve deafness, gun deafness; with rhinitis, ethmoiditis, sinusitis, nasal polypi, postnasal catarrh and dental infections.—Influence of general health on recurrent vertigo and vice versa.—Other factors. Syphilis, malaria, etc.

Principles of Treatment.

Seek the cause, which, if peripheral, may be removed by operations on the ear, nose, throat, or even by extraction of dead teeth.—If central, by intracranial surgery, decompression, or by neuropathic medical treatment.

Controversial Problems.

(1) Medicinal treatment: Iodide, bromides, atropine, quinine. (2) Attention to upper air-passages. (3) Fenestration of tympanic membrane. (4) Possible value of Küster's operation in certain cases. (5) Exploration of the saccus-endolymphaticus. (6) Fenestration of the external semicircular canal. (7) Indications for destroying the labyrinth.

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Selected References

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  • Müller I. Some Considerations of Vertigo based on Experience. Proc R Soc Med. 1928 Jun;21(8):1369–1376. [PMC free article] [PubMed]

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