Refitting a Hospital during the Great War

During the Great War, several institutions in London were refitted as auxiliary hospitals to treat the wounded servicemen returning from the battlefields. With large numbers of hospital staff heading to the front lines or volunteering for the war effort, some smaller hospitals even refitted their premises to contribute to the war effort.

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One such volunteer hospital was the Royal Ear Hospital, formerly the Royal Dispensary for Diseases of the Ear. Located on 42-43 Dean Street, Soho, the hospital provided specialized treatments for aural diseases since its founding in 1816. As practically the entire staff of the institution was depleted by military duties or volunteer service during the Great War, the hospital closed down. In August 1914, the Governing Committee unanimously resolved that the building should be offered to the Red Cross Society and beds temporarily placed at the disposal of the War Office, for the benefit of soldiers suffering from deafness or ear injuries inflicted during the war. The offer was promptly accepted and 20 beds were reserved for the use of the Navy, though a smaller outpatient clinic overseen by the aural surgeon MacLeod Yearsley still operated in London.

An October 1914 report revealed that the committee debated whether the hospital should provide only specialist care:

It occurred to us that we must decide whether we should still require that only ear cases be sent or should admit other than ear cases. We are agreed I think that the administration should be entirely in the hands of the Committee and that if we reopen, all the medical arrangements [should] be left to the Medical Board.

It was decided that the hospital would deal with ear cases that were too complex for the physicians or surgeons to deal with at the Naval Hospitals, but also welcome general injuries if needed so by the Admiralty.

Yet, apparently there was still plenty of space being unused at the Royal Ear Hospital during the Great War. As I was examining the archives of the hospital, I came across interesting correspondence between the Committee and a Mr. Peter Gallina, proprietor of the Rendezvous Restaurant that occupied space next to the hospital.  The Franco-Italian restaurant was praised for its clean kitchen, economic cookery, and tasteful interior, and became one of the “landmarks” of Dean Street, catering up to 200 people.[1]

A letter dated 15 March 1915 from Gallina reveals that there some vacant rooms under the children’s ward of the hospital, and that Gallina inquired whether the Committee was willing to accept an offer or £50/annum plus rates and taxes for the use of these rooms for the purposes of storage and cellarage, possibly for a lease up to 21 years. A letter by Allan Collard, one of the Committee members and presumably their lawyer, indicates that the Committee was uncomfortable with the offer but found it difficult to ignore the financial benefits that could serve the institution. Collard’s letter reveals that he did

not regard the offer of £50 per annum for the two vacant floors of the rear of the hospital as particularly good. It would be much more tempting of he paid a premium of say £100. Even in that case it would be prudent for the hospital to insist upon payment of the rent in advance annually.

If Mr. Galilna were to use the premises solely for the purposes of storage and cellarage and not as lavatories for his staff, a former objection to his proposed tenancy would be eliminated…I think it would be quite easy for Mr. Gallina to have an opening cut in the party wall which separates the back of his restaurant from the room under your Children’s ward.

The Committee decided to decline the offer on the recommendation of Collard and Mr. G.H. Paine, another of the Committee members.

However, meeting records of the Royal Ear Hospital Committee of Management dated to March 1921 reveals that the Committee reconsidered the offer. They unanimously agreed to recommend that the proprietors of the Rendezvous Restaurant be offered two rooms at the rear of the hospital for a tenancy of one year, and such tenancy thereafter subject to termination by either party at 6 months’ notice, for a yearly rental of £150. The proprietors renegotiated the offer for storage purposes on a 7 year lease terminable at the end of three or five years at the option of the hospital.

Minutes from the January 1922 meeting outline that

The Clerk reported that no reply had been received from the Rendezvous Restaurant regarding the letting of the rooms at the rear of the Hospital. It was suggested by Mr. Lake that if the one room were turned into a ward, which had been the original scheme, it would be of the greatest service. Mr. Pain produced the original plans that had been draw up relating to that proposal…

Discussions continued on with the Committee, largely due with heavy costs associated with renovating the rear rooms into wards. They kept tabling the discussions to analyzing the cost-benefit ration of renovations, the amount of financial support, as well as for an analysis of waiting lists of patients. Changes recommended including another ward for isolation cases, a lavatory and bathroom strictly for the House Surgeon, and the addition of extra baths. Minor renovations were made, including the addition of four extra beds, and a makeshift waiting room with a curtain for the Sister-in-Charge. No major renovations were made: in 1920, it was announced that Mr. Geoffrey Duveen, supporter of the hospital and once on the Governing committee, donated £50,000 to build a new building for hospital on a piece of land purchased on Huntley Street.

NOTES

[1] Judith Walkowitz, Nights Out: Life in Cosmopolitan London (University Press, 2012), 101-2.

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Dieting Deafness Away

I’m sure some of you have heard of London-based undertaker William Banting (1797-1878), who was the first to popularize a low-carb diet that formed the basis of modern-day diets (think Atkins). Banting was an upper middle-class funeral director whose family held the Royal Warrant for burials for five generations, until 1928; George III, George IV, Prince Albert, and Queen Victoria were buried by the Banting family.

William Banting. (Wikipedia)
William Banting. (Wikipedia)

There’s plenty of commentaries on Banting’s diet floating around the Internet. A retired widower, he was obese, 5’5 and 202lbs at age 66, his heaviest weight. He wore a truss to hold in place an umbilical rupture. His weight—and the associated complications—was so bad he could not stop to tie his shoe, and had to go down the stairs backwards to limit the pain of weight on his knees and ankles. He tried various attempts to drop some pounds: “sea air and bathing in various localities, with much walking exercise; taken gallons of physic and liquor potassae, advisedly and abundantly; riding on horseback; the waters and climate of Leamington many times, as well as those of Cheltenham and Harrogate frequently…”[1] All of these were in vain.

In 1862, after finding his eyesight failing and his hearing greatly impaired, Banting consulted an aural surgeon, but was disappointed with the surgeon’s medical approach: He “made light of the case, looked into my ears, sponged them internally, and blistered the outside, without the slightest benefit, neither inquiring into any of my bodily ailments, which he probably thought unnecessary, nor affording me time to name them.”[2] After the surgeon went on holiday, Banting sought other assistance to relieve him from his ailments. He likely visited the Royal Dispensary for Diseases of the Ear (est. 1816), which in 1862, was directed by the aural surgeon William Harvey (1805/6-1876/9).

Harvey was a well-known aurist in London and had a steady career as a surgeon. He was educated at Guy’s Hospital and practiced general surgery for a few years before establishing himself as an aural specialist and publishing The Ear in Health and Disease in 1854. In addition to his post at the Royal Dispensary, Harvey was also aural surgeon to the Freemason’s Asylum for Female Children and the Great Northern Hospital. As he repeated often, he bore no relation to the physician William Harvey who experimented with blood circulation.

Upon examining Banting’s ears and assessing his obese stature, Harvey explained that the deafness was symptom of fat deposits in the Eustachian tubes. He advised Banting to overhaul his diet to lose weight, explaining that as the pounds came off, his hearing would be improved. Banting was advised to abstain from bread, butter, milk, sugar, beer, and potatoes, which had “been the main…elements of [his] existence.”[3] Instead, he was to eat four meals a day composed of meat, greens, fruit, and dry wine. The diet worked: Banting lost 46 pounds in a few months. He was so astounded by the results he gave Harvey an extra £50 to his usual fees, to be distributed amongst his favourite hospitals. In addition, Banting published a pamphlet in the form of an open testimonial, Letter on Corpulence, Addressed to the Public (1863).

Photo: University of Buffalo Libraries
Photo: University of Buffalo Libraries

The first edition was self-published at his own expense, but became so popular that he sold it; later editions were published by Harrison, London. The pamphlet and Banting’s dietary success became so well-known that “Do you bant?” became a referred to fashionable way of asking whether people were trying to drop a few pound.

Where did an aurist get the idea for dietary management as a way to improve hearing? According to Harvey, in 1856, while he was out for a walk in Paris, he came across an announcement for a lecture by Claude Bernard at the Paris School of Medicine. Through Bernard’s lectures, Harvey learned how starch could affect the body negatively and played a role in the production of insulin. Diabetics management in particular, could be handled with a proper diet—and of course, assist in losing weight.

Unfortunately for Harvey, false rumours spread in London that the diet had ruined Banting’s health, and that Harvey was to blame. Furthermore, his practice suffered as he was constantly ridiculed for being unable to explain why the diet worked; medical practitioners criticized the diet as “unscientific” and Harvey’s application of diet management as a process that could not be replicated under similar variables.

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In 1872, Harvey published his own account of the diet, On Corpulence in Relation to Disease as a way to address some of the critique against him. In particular, he outlined how his treatment was misapplied in many cases, applied rashly and indiscreetly without proper medical advice. And of course, he points out, it “was…natural to expect that a pamphlet on a dietary for the cure of Corpulence, coming from a lay source, would not have found much favour with the profession, and that it would receive some severe criticism.”[4]The book is technically detailed, with information on the physiology and anatomy of the body, how fat deposits affect tissues and muscles, and symptoms of illness that arise from obesity. He also provides an explanation of how fatty deposits can enter the Eustachian tubes and result in temporary deafness through the mucus membranes.

 

NOTES:

[1] William Banting, Letter on Corpulence, Addressed to the Public (1863), 12.

[2] Ibid, 16.

[3] Ibid, 17.

[4] William Harvey, On Corpulence in Relation to Disease (1872), vi.

Syphilitic Invasions of the Ear

The Chirurgeon’s Apprentice has a wonderful post on Georgian prostitution and syphilis, which inspired me to dig up my research notebooks and uncover what nineteenth-century aurists wrote about syphilis and deafness. Syphilis is a fascinating topic. In nineteenth-century London, people were quite aware of the gruesome and devastating aspects of the disease. The memoirs of Reverend Frederick Gilby (1865-1949), for instance, documented a “tragic case” of a poor deaf and dumb child at the Bow and Bromley Workhouse Infirmary who began to develop syphilitic symptoms.

Aurists were aware that syphilitic invasions of the ear were not uncommon occurrences. Most of them agreed on the symptoms of syphilitic deafness, though they may have disagreed on the stages of the disease or which part(s) of the ear the disease was presented. Matthew Berkeley Hill (1834-1892), for instance, argued deafness in syphilis occurred at the late stages of the disease and presented in the tiny bones of the ear.[1] By the 1870s, it was agreed that syphilitic deafness included symptoms of: damage to the eighth cranial nerve, tinnitus, a gradual loss of hearing, with periods of remission, and evidence of damage in the tympanic cavity.[2]

John Cunningham Saunders (1773-1810), founder of the London Infirmary for Eye and Ear Diseases, believed that proximate causes of syphilis and nervous deafness (hearing loss due to defective or damaged nervous system) were the same.  “Constitutional deafness” (selective, temporary deafness) also included deafness caused by syphilis. The Irish aurist William Wilde (1815-1878) defined syphilitic deafness as “syphilitic myringitis.” He described the disease as being rooted in the tympanum (bony cavity of the middle ear, behind the eardrum):

[T]he deafness which sometimes accompanies the secondary form of syphilis is generally believed to be caused by inflammation, and ulceration extending from the throat through the Eustachian trumpet [tube] into the middle ear.[3]

The aurist Joseph Toynbee (1815-1866) also discussed deafness arising from syphilis, though he didn’t go into much detail on its root causes. In The Diseases of the Ear (1860), he outlined a case of 28 year old “H.L.” who came to see him on June 25, 1853 for treatment of deafness and afflicted symptoms arising from syphilis:

[He has] suffered for several months from sore throat, consequent upon an attack of secondary syphilis: for two months has complained of deafness in both ears, so as not to hear any except a loud voice. The deafness is accompanied by constant singing [tinnitus], which is increased when the head is on the pillow, and it varies much…The treatment pursued was the use of the nitrate of silver to the fauces, and the administration of steel wine. On July 2d he told me that three or four days previously he heard quite well in the morning, and the improvement lasted for two days, since which he has been gradually getting deaf again. By perseverance in the treatment for a month he perfectly recovered.[4]

James Hinton (1822-1875), aural surgeon at Guy’s Hospital, also noted that 1 in 20 of his patients manifested symptoms of syphilitic deafness. Hinton also assisted in the research of English surgeon Jonathan Hutchinson (1828-1913), who was collecting data on inherited syphilis.

L0008502 Portrait of Sir J. Hutchinson.
Jonathan Hutchinson

Hutchinson studied at St. Bartholomew’s Hospital and was a member and fellow of the Royal College of Surgeons; his remarkable surgical career led to appointments in several of London’s hospitals, including the Lock Hospital, the London Hospital, and Blackfriars Hospital for Diseases of the Skin. His work on syphilis was the first to connect various symptoms to form diagnosis—what’s now called the Hutchinson Triad, in which symptoms of notched teeth, interstitial keratitis, and deafness, could provide a firm diagnosis of congenital syphilis.

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Types of interstitial keratitis, from Hutchinson’s A Clinical Memoir
L0021139 "Syphilitic malformations of the permanent teeth".
Types of notched teeth, from Hutchinson’s A Clinical Memoir

In A Clinical Memoir of Certain Diseases of the Eye and Ear as a Consequent of Inherited Syphilis (1863), Hutchinson states that deafness frequently follows the presence of keratitis and in the majority of cases, the deafness was complete and permanent. He found syphilitic deafness occurred in cases of diseases of the cranial bones extending towards the internal and middle ears; of these cases, otorrhoea (inflammation of the ear with excessive discharge) was an invariable symptom.

Deafness in greater or less degree is frequent in the subjects of inherited syphilis. In some instances it advances to the almost total abolition of the perception of sound. These extreme cases are however exceptional, and more commonly only the hearing is only partially lost.[5]

Symptoms of syphilitic deafness were indicative of the progressive nature of the disease. As Hutchinson explained, deafness is usually symmetrical, in that it appears in both ears at the same time. In none of his cases did he find any changes in the tympanic membrane (eardrum), although the membrane was often abnormal in some way. The stages of hearing loss are rapidly passed through; a patient’s hearing could drastically diminish in six months from perfect hearing, to totally deaf, without any marked degree of pain. In cases of inherited syphilitic deafness, Hutchinson observed that deafness usually appears in five years either before or after puberty.

“Herdito-syphilitic deafness,” Hutchinson declared, had a poor prognosis. Its progressive nature meant there was little chance of permanent improvement, even in spite of the “cautious use” of specific remedies prescribed from the onset of symptoms. Six months to a year was the usual time “for the completion of the process and the entire abolition of the function.”[6]

NOTES

[1] Matthew Berkeley Hill, Syphilis and Local Contagious Disorders (1868).

[2] Deborah Hayden, Pox: Genius, Madness, and the Mysteries of Syphilis (2003), p.80.

[3] William Wilde, Practical Observations on Aural Surgery (1853), p.252.

[4] Joseph Toynbee, The Diseases of the Ear: Their Nature, Diagnosis, and Treatment (1860), p.235.

[5] Jonathan Hutchinson, A Clinical Memoir of Certain Diseases of the Eye and Ear as a Consequent of Inherited Syphilis (London: 1863), p.174.

[6] Hutchinson, p.183.

10 Extreme 19th Century “Cures” for Deafness

The nineteenth-century introduced a tremendous number of treatments boasting cures for irremediable deafness. Some of these cures were advised by aurists (specialists of the ear); others were tested home remedies or marketed as proprietary nostrums. Below is a list of some of the most extreme measures that were once popular treatments:

1. MERCURY

L0058828 Packet of mercurous chloride tablets, Kassel, Germany, 1914-
Packet of mercurous chloride tablets, Kassel, Germany, 1914

The use of mercury for medical applications has been dated to the ancient Greeks, reaching its height in popularity in the 15th century. It was used for nearly every kind of ailment, from syphilis, to lung disorders, stomach complaints, and of course, deafness. It’s one of the most dangerous substances used in medicine; mercury poisoning includes symptoms such as psychotic reactions, violent muscle spasms, heart and lung issues, and explosive bowel movements!

As a “catch-all” cure, mercury was believed to be one of the most powerful remedies available for aurists–even the famed John Cunningham Saunders, founder of the London Infirmary for Diseases of the Eye and Ear (later Moorsfield Eye Hospital), favored mercury when surgical treatments were ineffective.

Compounds of mercury, such as calomel (mercurous chloride) were also prescribed in the form of a pill. They were, however, believed to be less harmful than mercury even though they slowly poisoned those who used it.

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2. SYRINGING 

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Source: Daniel Bennett St. John Roosa, A Practical Treatise on Diseases of the Ear (London: W. Wood, 1878).

Okay, this one is not that bad—or at least compared to others on the list. Syringing was done to remove excess wax out of the ear, which was explained as causing a blockage in the auditory canal, thus diminishing hearing. However, some practitioners actually used syringes filled with all sorts of medicaments (e.g. eucalyptus, water, oil, nitrate solutions) and inserted the fluid into the ears. After a period of time for letting the solution “settle,” the practitioner would then syringe out the fluid. Imagine the dizziness all that excess fluid caused!

3. ANIMAL PARTS

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Yes, you read that right. All sorts of organic things were inserted into the ear to either enhance hearing or to extract their powers. Animal parts were additionally used as ingredients in medical recipes. Elk’s claw, pig’s bladder, fish bone, oil of earthworms, fat of eel, wood lice, ant eggs, cow’s feet, fox lungs, fowl grease have appeared a a cure or part of a cure for deafness.

4. CATHETERIZATION 

Example of an air press & catheter set-up. From: William Wilde, Practical Observations on Aural Surgery (London, 1853).
Example of an air press & catheter set-up. From: William Wilde, Practical Observations on Aural Surgery (London, 1853).

Appearing in various forms since 1755, this was the process of inserting a catheter up the nostrils or through the mouth, in order to cure deafness through the Eustachian tubes (which connects the ear to the nose). 19th century French surgeons argued catheterization, followed with an injection of fluid through the nose, was the best means for restoring hearing. Other combinations included the use of smoke, coffee grounds, water, or even ether, in conjunction with catheterization. Yet, some French and British aurists insisted patients were better able to tolerate catheterization when it was combined with an air pump. 

5. BLISTERING & SETONS

Example of early 20th century plaster used for blistering. Hunterian Museum Collection.
Example of early 20th century plaster used for blistering. Hunterian Museum Collection.

Blistering was another very popular remedy for deafness. A caustic plaster made of fat or wax, was applied behind the ear (sometimes cut into a certain size) in order to raise a blister.  Any pus forming from the blister was highly desirable, as it was believed to be evident of toxins escaping from the body–in certain cases, the blister was cut, and re-cut, in order to bring forth pus. Or, further corrosive substances were applied to irritate the blister (e.g. to grow in size).

Speaking of irritating, another similar method was the use of setons, a thread placed underneath the skin behind the ear. The site was further inflamed in order to induce beneficial pus. Aurists believed blistering and setons were the best remedy for deafness arising out of the mastoid cells (hollowed out spaces in the ear’s temporal bone).

Use of a seton on the neck behind the ear. From Johannes Scultetus, Armamentarium Chirurgicum (1655)
Use of a seton on the neck behind the ear. From Johannes Scultetus, Armamentarium Chirurgicum (1655)

6. LUNAR CAUSTIC 

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Also known as “silver nitrate,” this was used as a cauterizing agent to remove blockages in the ear impeding hearing. For instance, an abnormal growth, irregular auditory canal, or herpes warts, were treated with an application of lunar caustic. It was also used for treating ulcers in the ear. And then there were the stranger applications… In the 1820s, the aurists John Stevenson recommended touching the tonsils with a solution of lunar caustic in order to treat deafness arising out of the Eustachian tubes.

7. ELECTRICITY 

Davis & Kidder's patented Magneto-Electric Machine, c.1880.
Davis & Kidder’s patented Magneto-Electric Machine, c.1880.

As electricity became a part of everyday lives in the nineteenth-century, practitioners became excited about its applications for medical ailments. Some aurists recommended a course of electrotherapy aided by weak solutions of iodine of zinc to simulate discharge. Other aurists applied electric currents directly into sites of ulcers in the ear to produce a rapid growth of healthy granulations and thus restore hearing. It was believed that electricity could correct deafness caused by paralysis of the auditory nerves, which prevented sound vibrations from being transmitted properly to the eardrum.

The powerful benefits of electric currency were certainly applied into all sorts of devices, especially at the end of the nineteenth-century although some aurists were critical of its useFor instance, Martin Kroger invented an Ear Bath, which applied electricity to the ear with stable electrodes soaked in warm water and medicinal properties!

8. VIBRATION

VIbration for ear disease using a tissue oscillator, 1920.
VIbration for ear disease using a tissue oscillator, 1920.

Vibration was another fashionable medical option during the nineteenth-century. It was particularly used to treat cases of dry middle ear catarrh (buildup of calcium in the small bones in the ear) by supplying small amounts of current to break up the calcification and restore sound waves.  All sorts of technologies and treatments were developed making use of the power of vibratory force, such as the phonograph or Lambert Synder Health Vibrator.

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9. UV LIGHT RAYS

An antique violet ray machine, 20th century.
20th century violet ray machine

Ultraviolet therapy arose during the late nineteenth-century and early twentieth century to compliment the growing use of electrotherapy by using high-frequency electric current. For deafness, it was believed to be beneficial in destroying bacterial growth, enhancing blood flow to the ear, and reducing any abnormal growths in the auditory canal. Violet ray devices included an electrode that shone a bright glow when energized; the ray was believed to cure anything. They were also quite popular as patent medicine and quack cures.

10. ARTIFICIAL EARDRUMS

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Speaking of patent medicine and quack cures, no remedy for deafness was more notorious in the late 1800s as artificial eardrums. These were tiny devices that were inserted in the ear in order to resonate sounds throughout the auditory canal and eardrum. However, they had immense financial potential for proprietary practitioners: numerous companies sprung up in the United States, offering mail-order service for artificial eardrums. These eardrums were made of all sorts of materials, but the most dangerous (and also most popular ones) were made of metal–painful when inserted in the ear, but also argued to be superior in resonating sound. In the 1920s,the US Propaganda Department deemed artificial eardrums as the worst of all quack cures available to the public.

Of course, you always had the option to avoid deafness in the first place…

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.