In a previous post, I briefly outlined the history of the London Asylum for the Deaf and Dumb. In this post, I turn my attention to provide an overview of Curtis’ difficulties in implementing his medical authority within the Asylum. Part of this post is derived from the paper I presented at a joint panel for the Canadian Historical Association and the Canadian Society for the History and Philosophy of Science meeting, in May 2009. I am very grateful to my fellow panelists Erich Weidenhammer and Victor Boantza, our discussant Trevor Levere, and the audience for their comments and suggestions for my original paper.
According to Curtis, despite the good intentions of the Asylum, the prevailing prejudice and hostility against medical intervention on the part of the Committee of Governors meant many deaf children who weren’t otherwise “deaf” were forced into isolation and “doomed to perpetual silence and hopeless despair. In 1817, Curtis outlined his concerns in letter to the Committee, outlining three basic recommendations to merge medical treatment with the Asylum’s educational policies.
Firstly, Curtis argued that deafness required exclusive medical attention by an aural specialist, and not by “any practitioner in general practice, however distinguished his abilities or extensive his science.”[*] He suggested “the advantage that would result to the Institution, were an aurist appointed to attend, and minutely examine the particular defect in each child admitted to your establishment; by this means an opportunity would be given of trying such methods as appear best calculated to give relief.” [†]
Secondly, Curtis claimed that the system at the London Asylum was “totally inadequate to afford relief to the numerous applicants,”[‡] as children were chosen and admitted not from among the worst cases, but from a plurality of votes. He claimed the difficulty in selecting suitable candidates could be avoided with proper medical inspection, since a large number of children had minor ear ailments that could easily be treated.[§] By having the aurist minutely examine each child, Curtis asserted that such an examination would “demonstrate the necessity of inspection…in order to ascertain the nature of, and to relieve, such imperfections,”[**] and thus, limit the number of children entering the Asylum. Therefore, instead of being admitted into the Asylum and treated as incurably deaf, Curtis argued an earlier inspection and diagnosis of deafness—even as early as infancy—would lead to very different results, and render “useful members of society, who, under the present system, are objects of commiseration as long as they live.”[††] Furthermore, Curtis argued the Asylum’s rules for only accepting eligible children “before nine years of age, nor after fourteen”[‡‡] (when the disease is supposedly “confirmed”) could be better served if “all children suspected of deafness…be submitted to an early inspection by competent persons.”[§§]
Finally, inspired by the work at the Paris Institution to combine surgical and medical treatments with symbolic education, Curtis advised the Committee to set aside a part of the Asylum for medical and surgical treatments of deafness and not merely confined to symbolic education. He concluded that “by this plan I conceive many of the objects of your laudable charity might probably be found curable, restored to society, and rendered useful; by which the bounds of your humane establishment would be extended, and greater scope given to your highly benevolent views.”[***]
According to Curtis, prevailing social prejudices against the curability of deafness were grossly misunderstood, if not mistaken. While he admitted the lack of proper medical and surgical treatments available for deafness and the lack of professional progress made in aural surgery, Curtis argued that a greater understanding of deafness was required. During his early years as a practitioner, youthful ambition led him to claim that all cases of deafness was curable; however, experience led him to distinguish between congenital deafness (i.e. deafness from birth), variations of deafness caused by disease (e.g. herpes or bacterial infection), blockage (e.g. build up of wax), and structural deformities. He wrote that “No pains seem to have been taken to ascertain the real state of the organ itself; and thus, the ear being neglected, dumbness ensured to deafness,–the miserable sufferer is looked upon as one condemned, and is shut out from the sympathises of his fellow creatures.”[†††] By recognizing the distinctions between the causes of deafness, Curtis claimed that proper medical and surgical remedies could be applied; while he mistakenly believed that most variations of ear diseases could be cured by using a syringe for irrigation of the ear, many of his treatments did, at the very least, provide relief if he was heralded as a successful practitioner among his society.
In the context of the Asylum’s educational policies, unsurprisingly, Curtis’ letter did not have the effect it intended. While Curtis failed to transform the Asylum’s policies towards medical intervention, he did, at the very least, contribute to some changes. The Governing Committee at the London Asylum fully rejected Curtis’ third recommendation, declaring that the institution was established only for the purposes of instruction, and they “cannot permit the pupils received by them for education to be subjected to any medical treatment whatsoever in regards to their deafness while in the Asylum.”[‡‡‡] This response was based on the continuing perception of both the Asylum and the larger society that deafness was incurable and the insufficiency of the crude treatments proposed by both the Paris Institution and British aurists that were no nearer to curing deafness despite their claims to have done so. Yet the Committee accepted Curtis’ second recommendation for the minute examination of each child, and hesitantly applied the first. In the 1840s, Curtis acknowledged that his first recommendation was “still in vigorous operation,” and recognized that “the time will soon arrive when it will be found impossible any longer to resist the introduction a plan founded on more correct principles, and better calculated to benefit the human race.”[§§§] While it seems strange that the Committee would accept Curtis’ recommendations for medical examination but not for a place in the Asylum for medical practitioners, it is important to understand the context in which the Committee made their decisions: establishing part of their Asylum for medical and surgical treatment would undermine their efforts on improving the deaf through sign language. Public expectations and patronage would only support improvement through educational efforts.
[*] JH Curtis, A Treatise on the Physiology and Diseases of the Ear, 6th Ed (London: Sherwood, Neely & Jones, 1836), p.xxiii.
[†] Curtis, Treatise, p.xxiv.
[‡] Curtis, Treatise (6th Edition), p.166.
[§] In Advice to the Deaf: The Present State of Aural Surgery (1843), Curtis scornfully writes: “at a late half-yearly meeting, there were seventy-eight candidates, of whom thirty-five were elected. Were these thirty-five candidates those whose cases were most required, and were the best fitted to receive, relief from the mode pursued at the Asylum? or where they not merely those whose friends were the most powerful? (43)
[**] JH Curtis, An Essay on the Deaf and Dumb (London: Longman, Rees, Orme, Brown and Green, 1829), p.xxvi.
[††] Curtis, Observations on the Preservation of Hearing, p.46.
[‡‡] Asylum..for the Deaf, Plan of the Asylum, p.10.
[§§] JH Curtis, Observations on the Preservation of Hearing, and on the Choice, Use, and Abuse of Acoustic Instruments, 11th Ed. (London: Henry Renshaw, 1839), p.46.
[***] Curtis, Treatise, p.xxiv.
[†††] Curtis, Treatise (6th ed), p.161.
[‡‡‡] Quoted in Patrick Beaver, A Tower of Strength: Two Hundred Years of the Royal School for Deaf Children (Sussex: Books Guild, 1992), 42. Also, Hodgson, The Deaf and Their Problems, p.155.
[§§§] Curtis, Advice to the Deaf, p.43.