THE WORK which has gone into the preparation of this paper has consisted largely of asking certain patients many questions. Their answers have been evaluated to form a theory, which must be controversial, since the material used is subjective in nature.
Few of us will argue with the theory, well supported by histological and clinical evidence, that endolymphatic hydrops, whatever may be its real cause, is the basic pathological factor in Ménière's syndrome. It is therefore not illogical to presume that hydrops may exist in the labyrinth without the classic dizziness of Ménière's syndrome.
Dr. H. L. Williams wrote upon this subject in 1950,1 under the title "Endolymphatic Hydrops Without Vertigo." In this very good article he points out that endolymphatic hydrops may be considered an extracellular edema involving primarily the scala media of the cochlea. Since it occurred in only 50 out of 1,000 patients in the Mayo