Transient Related Quotes

No story has a beginning, and no story has an end. Beginnings and endings may be conceived to serve a purpose, to serve a momentary and transient intent, but they are, in their fundamental nature, arbitrary and exist solely as a convenient construct in the minds of man. Lives are messy, and when we set out to relate them, or parts of them, we cannot ever discern precise and objective moments when any given event began. All beginnings are arbitrary.

Soon after I left the Canton I read, in an otherwise unsuccint paper on ecology: "Organisms themselves are relatively transient entities through which materials and energy flow and eventually return to the environment." In my more skittish moments I am currently inclined to think that I would rather like this sentence as my epitaph.

Absolute values are the things that are important whether you like them or not. Relative values depend on social contexts and personal preferences and conditions of life. Our current market system pursues relative transient values at the cost of absolute lasting values.

Almost for the first time in his life, Troy, as he stood by this dismantled grave, wished himself another man. It is seldom that a person with much animal spirit does not feel that the fact of his life being his own is the one qualification which singles it out as a more hopeful life than that of others who may actually resemble him in every particular. Troy had felt, in his transient way, hundreds of times, that he could not envy other people their condition, because the possession of that condition would have necessitated a different personality, when he desired no other than his own. He had not minded the peculiarities of his birth, the vicissitudes of his life, the meteor-like uncertainty of all that related to him, because these appertained to the hero of his story, without whom there would have been no story at all for him; and it seemed to be only in the nature of things that matters would right themselves at some proper date and wind up well. This very morning the illusion completed its disappearance, and, as it were, all of a sudden, Troy hated himself.

The posture we take when we meditate signifies that we are linking absolute and relative, sky and ground, heaven and earth, like two wings of a bird, integrating the skylike, deathless nature of mind and the ground of our transient, mortal nature. The

Sometimes I would rather get a transient glimpse or side view of a thing than stand fronting to it… The object I caught a glimpse of as I went by haunts my thoughts a long time, is infinitely suggestive, and I do not care to front it and scrutinize it, for I know that the thing that really concerns me is not there, but in my relation to that…

We all know how unreliable memory can be, how transient reminiscences are, and how inaccessible the past will always remain. Experiences can never be duplicated or revived...by those who took no part in the struggle. Herein lies the beauty and power of conflict-related objects, some of which withstand the ravages of time in a way that memories do not.

Finally we touch that Great Fact, which Goethe incorporated into his final words: the 'ever-womanly.' It is a sin against Goethe to say that here he means the female sex. He refers to that profundity signifying the human soul as related to the mystery of the world; that which deeply yearns as the eternal in man, the ever-womanly which draws the soul to the eternally immortal, the eternal wisdom, and which gives itself to the 'eternal masculine.' The ever-womanly draws us towards the ever-masculine. It has nothing to do with something feminine in the ordinary sense. Therefore can we truly seek this ever-womanly in man and woman: the ever-womanly which aspires to the union with the ever-manly in the cosmos, to become one with the Divine-Spiritual that inter-penetrates and permeates the world towards which Faust strives. This mystery of man of all ages pursued by Faust from the beginning, this secret to which Spiritual Science is to lead us in a modern sense, is expressed by Goethe paradigmatically and monumentally in those five words at the conclusion of the second part of Faust represented as a mystic Spirit Choir; that everything physical surrounding us in the sense world is Maya, illusion; a symbol only of the spiritual. But this spiritual we can perceive if we penetrate that which covers it like a veil. And in it we see attained what on earth was impossible of attainment. We see that, which for ordinary intellect is indescribable, transformed into action as soon as the human spirit unites with the spiritual world. 'The ineffable wrought in love.' And we see the significance of the moment when the soul becomes united with the eternal masculine of the cosmic world. That is the great secret expressed by Goethe in the words: 'All of mere transient date As symbol showeth; Here the inadequate To fullness groweth; Here the ineffable Wrought is in love; The ever-womanly Draws us above ...

In science, all important ideas need names and stories to fix them in the memory. It occurred to me that the market's first wild trait, abrupt change or discontinuity, is prefigured in the Bible tale of Noah. As Genesis relates, in Noah's six hundredth year God ordered the Great Flood to purify a wicked world. Then "were all the fountains of the great deep broken up, and the windows of heaven were opened." Noah survived, of course: He prepared against the coming flood by building a ship strong enough to withstand it. The flood came and went-catastrophic, but transient. Market crashes are like that. The 29.2 percent collapse of October 19, 1987, arrived without warning or convincing reason; and at the time, it seemed like the end of the financial world. Smaller squalls strike more often, with more localized effect. In fact, a hierarchy of turbulence, a pattern that scales up and down with time, governs this bad financial weather. At times, even a great bank or brokerage house can seem like a little boat in a big storm.

Criteria for Borderline Personality Disorder Frantic efforts to avoid real or imagined abandonment A pattern of intense and unstable interpersonal relationships characterized by alternating between extremes of idealization and devaluation Identity disturbance: markedly and persistently unstable self-image or sense of self Impulsivity in at least two areas that is potentially self-damaging Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior Affective instability due to a marked reactivity of mood Chronic feelings of emptiness Inappropriate, intense anger or difficulty controlling anger Transient, stress-related paranoid ideation or severe dissociative symptoms

Discoveries of such secrets typically bring on tumultuous crises. Ironically, however...it is often the person who lied or cheated who has the easier time. People who transgressed might feel self-loathing, regret or shame. But they have the possibility of change going forward, and their sense of their own narrative, problematic though it may be, is intact. They knew all along what they were doing and made their own decisions. They may have made bad choices, but at least those were their own and under their control. Now they can make new, better choices. And to an astonishing extent, the social blowback for such miscreants is often transient and relatively minor...Our culture, in fact, wholeheartedly supports such “new beginnings” — even celebrates them.

Criteria for Diagnosing Borderline Personality Disorder 1. Frantic efforts to avoid being or feeling abandoned by loved ones. 2. Instability in relationships, including a tendency to idealize and then become disillusioned with relationships. 3. Problems with an unstable sense of self, self-image, or identity. 4. Impulsivity in at least two areas (other than suicidal behavior) that are potentially damaging, such as excessive spending, risky sex, substance abuse, or binge eating. 5. Recurrent suicidal behavior, including thoughts, attempts, or threats of suicide, as well as intentional self-harm that may or may not be life-threatening. 6. Mood swings, including intense negative mood, irritability, and anxiety. Moods usually last a few hours and rarely more than a few days. 7. Chronic feelings of emptiness. 8. Problems controlling intense anger and angry behavior. 9. Transient, stress-related paranoid thoughts or severe dissociation.

here is one other element of the apocalyptic tradition to be considered, namely transition. I said a minute ago that one of the assumptions prevalent in sophisticated apocalyptism was what Yeats called 'antithetical multiform influx'--the forms assumed by the inrushing gyre as the old one reaches its term. The dialectic of Yeats's gyres is simple enough in essence; they are a figure for the co-existence of the past and future at the time of transition. The old narrows to its apex, the new broadens towards its base, and the old and new interpenetrate. Where apex and base come together you have an age of very rapid transition. Actually, on Yeats's view of the historical cycle, there were transient moments of perfection, or what he called Unity of Being; but there was no way of making these permanent, and his philosophy of history is throughout transitional. In this he is not, of course, original; but his emphasis on the traditional character of our own pre-apocalyptic moment, in contrast with those exquisite points of time when life was like the water brimming beautifully but unstably over the rim of a fountain, seems, for all the privacy of the expression, characteristically modern. It is commonplace that our times do in fact suffer a more rapid rate of change technologically, and consequently in the increase of social mobility, than any before us. There is nothing fictive about that, and its implications are clear in our own day-to-day lives. What is interesting, though, is the way in which this knowledge is related to apocalypse, so that a mere celebratory figure for social mobility, like On the Road, acquires apocalyptic overtones and establishes the language of an elect; and the way in which writers, that is to say, clerks, are willing to go along, arguing that the rate of change implies revolution or schism, and that this is a perpetual requirement; that the stage of transition, like the whole of time in an earlier revolution, has become endless.

Humans recognize the duality, autonomy, and latitude range of the mind and the body, and all humans comprehend their impending mortality. Unlike other animals, humankind knows despair brought about by understanding the inevitability of death of all living creatures. The radius of human thought touching upon the longitude of our transient existence causes infinite pain. Seeking to ameliorate existential anguish incites us to ponder spiritual matters, and this sphere of mental activity spurs us to contemplate the perimeter of unknown frontiers. Our ability to understand the compass of life and death allows us to view the circumference of the world as consisting of a past, a present, and a future in relation to our own lives. How a person views the range of their earthly life and how a person rationalizes their march towards a deathly outback creates a system of beliefs that separate people into classes, and the variations amongst class members’ belief systems supplements who we think we are.

When tragedy established itself in England it did so in terms of plots and spectacle that had much more to do with medieval apocalypse than with the mythos and opsis of Aristotle. Later, tragedy itself succumbs to the pressure of 'demythologizing'; the End itself, in modern literary plotting loses its downbeat, tonic-and-dominant finality, and we think of it, as the theologians think of Apocalypse, as immanent rather than imminent. Thus, as we shall see, we think in terms of crisis rather than temporal ends; and make much of subtle disconfirmation and elaborate peripeteia. And we concern ourselves with the conflict between the deterministic pattern any plot suggests, and the freedom of persons within that plot to choose and so to alter the structure, the relation of beginning, middle, and end. Naïvely predictive apocalypses implied a strict concordance between beginning, middle, and end. Thus the opening of the seals had to correspond to recorded historical events. Such a concordance remains a deeply desired object, but it is hard to achieve when the beginning is lost in the dark backward and abysm of time, and the end is known to be unpredictable. This changes our views of the patterns of time, and in so far as our plots honour the increased complexity of these ways of making sense, it complicates them also. If we ask for comfort from our plots it will be a more difficult comfort than that which the archangel offered Adam: How soon hath thy prediction, Seer blest, Measur'd this transient World, the race of Time, Till time stands fix'd. But it will be a related comfort. In our world the material for an eschatology is more elusive, harder to handle. It may not be true, as the modern poet argues, that we must build it out of 'our loneliness and regret'; the past has left us stronger materials than these for our artifice of eternity. But the artifice of eternity exists only for the dying generations; and since they choose, alter the shape of time, and die, the eternal artifice must change. The golden bird will not always sing the same song, though a primeval pattern underlies its notes. In my next talk I shall be trying to explain some of the ways in which that song changes, and talking about the relationship between apocalypse and the changing fictions of men born and dead in the middest. It is a large subject, because the instrument of change is the human imagination. It changes not only the consoling plot, but the structure of time and the world. One of the most striking things about it was said by Stevens in one of his adages; and it is with this suggestive saying that I shall mark the transition from the first to the second part of my own pattern. 'The imagination,' said this student of changing fictions, 'the imagination is always at the end of an era.' Next time we shall try to see what this means in relation to our problem of making sense of the ways we make sense of the world.

This is an empirical claim: Look closely enough at your own mind in the present moment, and you will discover that the self is an illusion. The problem with a claim of this kind, however, is that one can’t borrow another person’s contemplative tools to test it. To see how the feeling of “I” is a product of thought—indeed, to even appreciate how distracted by thought you tend to be in the first place—you have to build your own contemplative tools. Unfortunately, this leads many people to dismiss the project out of hand: They look inside, notice nothing of interest, and conclude that introspection is a dead end. But just imagine where astronomy would be if, centuries after Galileo, a person were still obliged to build his own telescope before he could even judge whether astronomy was a legitimate field of inquiry. It wouldn’t make the sky any less worthy of investigation, but astronomy’s development as a science would become immensely more difficult. A few pharmacological shortcuts exist—and I discuss some of them in a later chapter—but generally speaking, we must build our own telescopes to judge the empirical claims of contemplatives. Judging their metaphysical claims is another matter; many of them can be dismissed as bad science or bad philosophy after merely thinking about them. But to determine whether certain experiences are possible—and if possible, desirable—and to see how these states of mind relate to the conventional sense of self, we have to be able to use our attention in the requisite ways. Primarily, that means learning to recognize thoughts as thoughts—as transient appearances in consciousness—and to no longer be distracted by them, if only for short periods of time. This may sound simple enough, but actually accomplishing it can take a lot of work. Unfortunately, it is not work that the Western intellectual tradition knows much about. LOST

Organisms themselves are relatively transient entities through which materials and energy flow and eventually return to the environment.

Sometimes I wonder what would have happened if on that particular day, because of too much caffeine or a side effect of some medication he might have taken earlier or simply nerves, Major General Peter Young's hand had shaken just a trifle... Would the border have shifted a fraction of an inch up or down, inserting here, deleting there, and if so, might this involuntary change have affected my fate or that of my relatives? Would one more fig tree have remained on the Greek side, for instance, or an extra fig tree have been included into Turkish territory? I try to imagine that inflection point in time. As transient as a scent on the breeze, the briefest pause, the slightest hesitation, the squeak of a chinagraph pencil on the shiny surface of the map, a trail of green leaving its irrevocable mark with everlasting consequences for the lives of generations past, present and yet to come. History intruding on the future. Our future...

In his great book The Beginner’s Guide to Spiritual Gifts, author Sam Storms says, “Spiritual gifts are the presence of the Spirit Himself coming to relatively clear, even dramatic, expression in the way we do ministry. Gifts are God going public among His people.

The word 'vaccination' comes from vacca, the Latin word for 'cow'. This is a poignant recapitulation of the history of vaccines. The first vaccine properly so called had, as its active ingredient, the cowpox virus, a close relative of smallpox that however was much less likely to cause severe, disfiguring or lethal disease. Edward Jenner observed that milkmaids, who were often exposed to cowpox, suffered a relatively mild disease, but would be immune to the much more serious smallpox. In an experiment that would unlikely pass muster in the modern world, he infected James Phipps, then an 8-year-old, with cowpox. He suffered a mild and transient illness, but when he was later exposed to scabs from a smallpox patient, he proved immune. Unlike the earlier practice of variolation, which has been practised in late Song dynasty China that sought to induce the cutaneous form of smallpox, variola minor, to protect against the more severe forms of smallpox (variola major), Jenner's vaccination used a less pathogenic virus. He relied on what would later be called 'antigenic similarity', but which was at the time hardly understood.

Exactly how and why sleep disruption is linked to certain forms of cancer is also becoming clear. Part of the problem relates back to the agitating influence of the sympathetic nervous system as it is forced into overdrive by a lack of sleep. Ramping up the body’s level of sympathetic nervous activity will provoke an unnecessary and sustained inflammation response from the immune system. When faced with a real threat, a brief spike of sympathetic nervous system activity will often trigger a similarly transient response from inflammatory activity—one that is useful in anticipation of potential bodily harm (think of a physical tussle with a wild animal

Nieddu’s gesture came of the same mysterious, irresistible urge to make things better for other people. For a relative, for a stranger: the urge to make things better was in our marrow.

The perceived value of pets has been grossly exaggerated to stimulate demand and to create jobs and wealth. Although scarce for lack of public funding, the only decent research in the field has shown that the long-term benefits of pets are largely overrated, if not totally absent. The therapeutic value of zootherapy is of the same nature as that of gambling, binge-eating, and alcohol: it provides a transient, feel-good experience, but at a high cost to all involved.

The greater the degree of empathy experienced, the greater the activation of the empathy circuit. The ventromedial PFC and the dorsolateral PFC are two relatively small and specialized parts of the PFC. In meditators, the “selfing” parts of the PFC go offline during practice. Brain scans of meditating monks show that the parts of the PFC that construct our personalities go dark, with energy usage dropping by as much as 40%—the “transient hypofrontality” noted by neuroscientists in Chapter 2. Newberg finds that many different types of practitioners “get out of their heads,” from Brazilian shamans to Pentecostals who are “speaking in tongues.” While we’re in meditation, we lose our identification with our stories about ourselves and the world. For a while, we stop selfing. We forget I-me-mine. The bonds that keep our consciousness stuck in ego, in looking good, in remembering who we like and dislike, in playing our roles—and all the suffering that accompanies these things—are loosened. That frees us up to enter nonlocal mind, and bond with a consciousness greater than our local selves. Newberg describes it this way: “The person literally feels as if her own self is dissolving. There is no ‘I’—just the totality of a singular awareness or experience.” The paradox of enlightenment is that we have to lose our personalities to find bliss. While the thinking abilities of the PFC are our biggest asset in everyday life, they’re our biggest obstacle to experiencing oneness. It’s the ego that separates us from the universe, and when it goes offline, we join the mystery.

There are hence more or less productive, more or less imaginatively inspired, ways to idealize. An idealizing elaboration of qualities that the other to some degree possesses—and enjoys possessing—is less damaging than worshipping (and insisting on) qualities that do not in any way correspond to how the other views itself. And even with idealizations that reflect the other’s self-image, it is vital to allow ample room for disappointment. An expectation of consistency—an expectation that the other will always meet our ideal—is disastrous in robbing the other of the capacity to be less than perfect. It is, in other words, important to recognize the transient nature of all idealizations. Even though the other’s adored features may not be wholly illusory—even though they may connect to something deeply meaningful in the other’s being—the expectation that they are entirely dependable inevitably is. In the same way that we need to be able to tolerate multiple and conflicting readings of ourselves, we need to come to terms with the manifold and ever-evolving realities of the other. The worst we can do is to fix the other into a static ideal, or to measure it against an inflexible external standard. As Stephen Mitchell explains, whether fantasies “are enriching or depleting depends on the way they are positioned in relation to actuality. Do they encourage an episodic selectivity and elaboration of the beauty of the partner? Or do they foster the illusion that there are other potential partners in the world who are only beautiful and never disappointing?

The ideologists of the bourgeoisie - the bourgeois economists - failed to perceive the real nature of the capitalist mode of production and capitalist society because their class interests and class narrow-mindedness made them regard the historically transient social form as being eternal, natural and supra-historical. They could not discern behind the relations of things - commodities - the relations of people. Bourgeois ideologists are in the power of commodity fetishism. They attribute to things and products of human activity, supra-sensuous, mystical properties. This fetishism, this false viewpoint, inherent in capitalist society, bourgeois ideologists extend to the entire domain of social relations: to the relations of economy and politics, economy and law, being and consciousness. Bourgeois ideology represents these relations in a false topsy-turvy way.

Of course bad things had happened to Vikram. No one got a free ride in this troubled world. There were times when he was sad, but those spells were transient and almost always related to the death of someone he loved or admired. For as long as he could remember, he’d understood that happiness was a choice, that there were people who didn’t realize it was theirs to choose or who, for whatever reason, preferred to be perpetually discontented, even angry, even despairing.

The effort made to suppress sex would be difficult to understand if it were for the sake of sex as such. Not sex, however, but the breaking of human will is the reason for vilifying sex. A great number of the so-called primitive societies have no sex taboo whatever. Since they function without exploitation and domination, they do not have to break the individual’s will. They can afford not to stigmatize sex and to enjoy the pleasure of sexual relations without guilt feelings. Most remarkable in these societies is that this sexual freedom does not lead to sexual greed; that after a period of relatively transient sexual relations couples find each other; that they then have no desire to swap partners, but are also free to separate when love has gone. For these not-property-oriented groups sexual enjoyment is an expression of being, not the result of sexual possessiveness.

Marx’s central question was: how can a society that converts interpersonal material relations into impersonal relations among things, and reproduces economic life for the abstract purpose of value augmentation or profit making, simultaneously meet general norms of economic life as a byproduct? This is the question seeking the “logic” or “method” of capitalist madness in our earlier words. All other questions of the march of capitalism in human history, its process of becoming, and the conditions of its historical transitoriness, hinge on that. And answering it is systemically threatening because, firstly, it reveals what bourgeois economic thought from its inception in classical political economy has fought to conceal: that capitalism is not a natural order but a historically transient society. And secondly, it shows that capitalism is not just an asymmetrically wealth distributive, exploitative, alienating, crisis ridden society. Rather, it is an “upside-down”, “alien” order (as Marx put it), which reproduces human material existence as a byproduct of its “extra-human” goal of augmenting abstract, quantitative value – or profit making.

Moreover, there is no known reason why the geometry of space and time should be described by the particular types of curved geometry defined by Riemann. There exist other more complicated varieties that could in principle have been employed by Nature. Only observation can at present tell us which mathematics is chosen by Nature for employment in particular situations. This may of course merely be a transient manifestation of our relative ignorance of the bigger picture in which everything that is not excluded is demanded.

are constantly taking transient experiences, cramming them into prearranged slots, turning discontinuity into continuity, and making solid what is actually fluid. The technical term for what’s happening is reification—giving immaterial experiences “thingness.” So convincing is this transformation that rocks seem solid and heavy when, in fact, your mind reified them—you have created solidity and heaviness in your own awareness. This constitutes another outrageous conclusion to anyone who is out to reinforce and reaffirm the spell/dream/illusion. But you cannot thaw out the “thingness” of the physical world unless you break down the process that created it. I’m hesitant to use any kind of jargon, but we need to delve into how reification works. The dictionary definition of reify is “to make something more concrete or real.” The mental image of money gets reified into a dollar bill, which you can fold up and stick in your wallet. “Parenting” gets reified when you decide to have a baby you can hold in your arms. What’s earthshaking is that virtual reality owes its existence entirely to reification. The web of connections that entangles everything in the spell/dream/ illusion with everything else comes down to the mind, because connections are mind-made. No object is actually a physical thing, pure and simple. “Object” and “thing” and “physical” are strands of a mental web. People find it relatively easy to accept that a piece of paper currency is the reified form of a concept (money), but they balk when they are told that the same is true of body, brain, and universe. The key is to

It also makes us question the admonitions that carbohydrate restriction cannot “generally be used safely,” as Theodore Van Itallie wrote in 1979, because it has “potential side effects,” including “weakness, apathy, fatigue, nausea, vomiting, dehydration, postural hypotension, and occasional exacerbation of preexisting gout.” The important clinical question is whether these are short-term effects of carbohydrate withdrawal, or chronic effects that might offset the benefits of weight loss. The same is true for the occasional elevation of cholesterol that will occur with fat loss—a condition known as transient hypercholesterolemia—and that is a consequence of the fact that we store cholesterol along with fat in our fat cells. When fatty acids are mobilized, the cholesterol is released as well, and thus serum levels of cholesterol can spike. The existing evidence suggests that this effect will vanish with successful weight loss, regardless of the saturated-fat content of the diet. Nonetheless, it’s often cited as another reason to avoid carbohydrate-restricted diets and to withdraw a patient immediately from the diet should such a thing be observed, under the mistaken impression that this is a chronic effect of a relatively fat-rich diet. In

appearances are subject to limitations, while reality is limitless. And it follows that the former are imperfect, while the latter is perfect; that the former is transient, while the latter is eternal; that the former is relative, while the latter is absolute; that the former is worldly, while the latter is holy; that the former is knowable, while the latter is unknowable. These

Article F: Alternobaric Vertigo and Eustachian Tube Dysfunction. Charles D. Bluestone, MD; J. Douglas Swarts, PhD; Joseph M. Furman, MD, PhD; Robert F. Yellon, MD. Case Report: Persistent Alternobaric Vertigo at Ground Level due to Chronic Toynbee phenomenon. Laryngoscope 2012;122(4):868–72. The term “alternobaric vertigo” was coined by Lundgren in 1965 to describe vertigo in deep-sea divers, but also referred to aircraft pilots in 1966. It occurs during ascent and rarely descent and is a result of asymmetrical middle-ear pressures. Classically the vertigo due to this pathogenesis is transient but may last for several minutes. It is frequently associated with nausea and vomiting. It has been reproduced in pressure chamber experiments with some divers and fliers, but has not been reported spontaneously at ground level (Figure F–1). FIGURE F–1. Alternobaric vertigo can occur during ascent in an airplane or when scuba diving. We encountered a 15-year-old female with bilateral tympanostomy tubes who manifested persistent severe vertigo, at ground level, secondary to a unilateral middle-ear pressure of +200 mm H2O elicited by an obstructed tympanostomy tube in the presence of chronic nasal obstruction. She had had long-term tubes placed due to recurrent and chronic otitis media. Physical examination revealed achondroplasia, which is an autosomal dominate disorder characterized by abnormal bone growth, short arms and legs, short stature and a large head, which is associated with otitis media. The pathogenesis of otitis media in these individuals may be related to abnormal anatomy causing Eustachian tube dysfunction. Balance testing was abnormal, Eustachian tube function tests revealed dysfunction of tube. Surgery was performed to replace the obstructed tube with a patent one, and an adenoidectomy and bilateral inferior turbinate reduction to relieve the chronic nasal obstruction. Postoperatively balance testing was normal, Eustachian tube function remained dysfunctional, but she had complete resolution of her vertigo following the surgery. FIGURE F–2. Pathogenesis of alternobaric vertigo due to the “Toynbee phenomenon” One tympanostomy was obstructed and when swallowing, she developed high positive pressure in the middle ear, but in the ear with a patent tube, the pressure did not remain in the middle ear. We believed this was a previously unreported scenario in which closed-nose swallowing insufflated air into her middle ears, resulting in sustained positive middle-ear pressure in the ear with the obstructed tube. Swallowing, when the nose is obstructed, can result in abnormal negative or positive pressures in the middle ear, which has been termed the “Toynbee phenomenon.” We concluded that in patients who have vertigo, consideration should be given to the possibility that nasal obstruction and the “Toynbee phenomenon” are involved (Figure F–2). CHAPTER 7 PATHOLOGY The pathology of the ET may or may not be involved in the pathogenesis of otitis media, whereas the