Galvanism & Deafness

Galvanism is a medical treatment that involves the application of electric currents to body tissues in order to stimulate the contraction of muscles. First experimented in the late eighteenth-century by Luigi Galvani (1737-1798) who investigated frog legs twitching once sparked by an electric current, galvanism was believed to be a miraculous application of scientific prowess and capable of curing all sorts of medical disorders. It even had the capacity for animating a corpse, as narrated in Mary Shelly’s Frankenstein!

Aurists certainly saw the benefits of galvanism in cases of deafness they diagnosed as caused by paralysis of the auditory nerves. The paralysis prevented sound vibrations from being transmitted properly through the tympanic membrane (eardrum). Several nineteenth-century treatises on aural surgery discussed how galvanism could cure deafness by stimulating muscular action necessary for restoring the auditory nerves to function in the transmission of sound.

In his Elements of Galvanism, in Theory and Practice (1804), Charles Henry Wilkson outlined an apparatus for safely applying an electric current to cure deafness.

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Regarding his apparatus, Wikson wrote:

When it is ascertained hat the deafness is of that particular nature, in which galvanism may be usefully employed, p…two conducting wires, A & B, at end of each which is a small plate of ivory, about one inch & half in diameter. Through center of the plates is passed a silver wire, with a small ball at its extremity. To be insulated, silver wires are about an inch in length, enclosed, with each of them in an ivory tube. Inside of right ear moistened with water, and ball is introduced the ear, with the ivory plate preventing the wire from penetrating too far. Similar procedure on left ear. Once inserted, completion of the circuit is conducted by bringing the end of the conducting wires into occasional contact with the trough (the plates between A and B).

He warned that great care should be taken when using the apparatus for the first time on a patient. The physician should use gentle power through a small number of plates, and not exceed seven or eight plates. Power can be increased by adding plates, but it depended on the sensations experienced by the patient: “Some persons scarcely feel the power of twenty plates; while others experience from such a proportion of the fluid a very distressing giddiness.”

The merits of galvanism were discussed by aurists in numerous publicatons, assessing the benefits of the procedure, or criticizing its miraculous applications. The aurist John P. Pennefather, for instance, wrote in his Deafness and Diseases of the Ear (1873):

I allude to this vaunted remedy from the specious character it presents, and the conquest frequency with which persons suffering from deafness are tempted to give it a trial, in many cases a prolonged one, to find themselves in the end but disappointed dupes. The error which the majority of people fall into with regard to the cause of their deafness is, that some defect exists in the nerve of audition, and therefore galvanism cannot fail to cure, and this popular error is taken advantage of by quacks to cry up its application as a specific for all cases of deafness.

Galvanic current, Pennefather asserted, “cannot have the slightest remedial influence; on the contrary, is more likely to exercise an injurious tendency.” He further explained that he was not decrying the valuable agency of medical galvanism, nor contending that it was not beneficial for particular cases of deafness. Rather, he warned its application should only be ascertained by a proper diagnosis and undertaken by skilled and trained aurists. It was not, nor should be, a catch-all cure for all sorts of deafness.

Link

I wrote a new entry over at Nineteenth-Century Disability: A Digital Reader:

On September 1879, Richard Silas Rhodes (1842-1902), president of a publishing company in Chicago, received a patent for his “Audiphone for the Deaf” his various improvements to the device. (U.S. Patent No. 319,828). Rhodes had conductive hearing loss[1] for twenty years following a bout of illness and was frustrated with his continuous failed encounters with ear trumpets. He observed he could hear the ticking of his watch when he held it in his mouth, and this inspired his construction of the Audiphone, which exploited the fact sound waves can be transmitted through the teeth or cranial bones.

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Webster’s Otaphone

I wrote a new entry over at Nineteenth-Century Disability: A Digital Reader:

UK patent #7033, dated 17 March 1836, is the earliest British patent for a hearing aid device, granted to the aurist (19th century term for ear specialist) Alphonso William Webster, for his “curious” invention, the Otaphone (sometimes spelled “Otophone”). In his publication, A New and Familiar Treatise on the Structure of the Ear, and On Deafness (London: published by the author, sold by Simpkin & Marshall, 1836), Webster outlines he was first devised his invention by observing the common practice of cupping the hand to the back of the ear to enhance hearing. He wondered whether the practice could be obtained by “means less troublesome and unsightly” (132).

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The Artificial Tympanum

Perforation of the eardrum (tympanic membrane or tympanum) is a very common injury to the ear, often resulting from ear infection, trauma (damn those Q-tips!), loud noise, or blockages in the Eustachian tubes. Most cases the damage is minor and the drum heals quickly on its own, but other cases bring about hearing loss, and consequently, the rupture requires intervention to correct the damage.

The German physician Marcus Banzer (1592-1664) provided the first recorded account of correcting perforation of the tympanic membrane. In 1640, he published Disputatio de auditione laesa (Dissertation on Deafness) in which he describes the use of a tube made of elk hoof and connected to a pig’s bladder, to be used as a prosthetic eardrum. This construction replaced the rupture and aimed to protect the middle parts by preventing the funneling of external air, leading to further damage. This way, the eardrum could resume its function: air on both sides of the drum regulating sound.*

By the nineteenth century, however, there were no effective surgical treatments for perforation of the eardrum or the hearing loss that accompanied it. But there were many, many remedies recommended by physicians and aural surgeons, all applying the idea that the rupture needed to be closed somehow, but still allow sound to funnel through the ear drum. Some measures included: India rubber, lint, tin or silver foil, the vitelline membrane of an egg. Adhesion of the apparatus to the ear were used with: saliva, water, petroleum jelly, or glycerine.

Oh, that’s all, you say? Nope—how about cotton-wool inserted into the ear? Or onions? Pieces of fat bacon toasted over a candle then inserted into the ear along with some wax drippings? Pour some oil into your ear! Or when all else fails, just create your own homemade artificial eardrum with elk’s claw, pig’s bladder, fish bone, gold beater’s skin, or even some court plaster.[1]

Here’s when it gets interesting. In 1841, the aural surgeon James Yearlsey—who had just enough of quackery in aural surgery, by the way, and was advocating medical and surgical reform—became acquainted with the idea of constructing a surgical apparatus to treat perforation of the ear drum, when a patient from New York came to London for a consultation. Seven years later, he published a paper in The Lancet describing his new artificial tympanum made with cotton balls applied to the end of extraction cords.

However, whatever revolutionary sentiments Yearsley hoped with his innovation, were squashed by Joseph Toynbee (1815-1866), the charming and popular aural surgeon who once worked with Richard Owen at the Hunterian Museum. Toynbee is also father to the famous philosopher and economist Arnold Toynbee (1852-1883).

L0011028 Joseph Toynbee

Toynbee presented a paper on his artificial tympanum—making no reference to Toynbee—at the 1850 Annual Meeting of the Provincial Medical Association. His innovation was composed of gutta percha (natural latex made from South Asian trees of the same name—a very popular 19C material that eventually collapsed from overuse)  or vulcanized rubber, attached to a silver wire stem about 3cm. Toynbee followed his presentation with a paper, “On the Use of an Artificial tympanic Membrane,” published in 1853, which earned him a medal from the Society of Arts. The guidewire was used to install the device into the tympanic cavity, adhering the rupture and still allowing sound to funnel through the fine tube.

As you can imagine, Yearsley was outraged. Aural surgery during the 1850s was overwhelmed with priority disagreements between Yearsley and Toynbee, and many other enthusiastic aural surgeons chimed in their two cents on the efficacy of each of these new devices. Further surgical advancements would later demonstrate that artificial tympanic membranes have little value, for over time, the eardrum just heals itself naturally, or else grafts are recommended in cases of serious ruptures.

 

* Many thanks to Dr. Albert Murdy for the clarification.


[1] Eugene A. Chu and Robert K. Jackler, “The Artificial Tympanic Membrane (1840-1910): From Brilliant Innovation to Quack Device,” Otology & Neurotology 24 (2003): 507-518.

REVIEW: “Performing Medicine” by Michael Brown

Performing Medicine; Medical Culture and Identity in Provincial England, c.1760-1850 (Manchester & New York: Manchester University Press, 2011), 254pp.

I get excited when I receive a new book that so wonderfully engages with some of the major themes covered in my dissertation, and even better, a book that nicely contextualizes the background upon which I will narrate my story of aural surgery. I’ve long been a fan of Michael Brown’s works, particularly his paper “Medicine, Quackery and the Free Market: The ‘War’ against Morison’s Pills and the Construction of the Medical Profession, c.1830-c.1850,” published in Mark Jenner and Patrick Wallis’ Medicine and the Market in England and its Colonies, c.1450-1850 (New York: Palgrave MacMillian, 2007). Jenner and Wallis’ anthology sought to undertake a critical examination of the term “medical marketplace” and unpack its various ambiguous meanings. Broadly focusing on the nature of the medical provision and its economic, institutional, cultural and political contexts, this work presents a series of essays that evaluate the scale, scope, and boundaries of the internal dynamics of the market for medicine. Some of the key questions addressed are: what emergences in the medical marketplace? Is the term “medical marketplace” in due of a revision, as Margaret Pelling has argued? Is medicine to be viewed as a market or an economy of health care (and is there a difference)? How do we use a model of the marketplace to historicize and analyze the structure of therapeutic practice and its complex internal and external dynamics? Should historians shift their thinking from an abstract and generalized concept as “medical marketplace” towards a more focused concept of medical goods and services? Continue reading