Experiences of a Deaf Man

From The Albion Magazine (1907):

When a man suddenly becomes deaf there is little or nothing he would shrink from if it afforded, or seemed to afford, the smallest chance that he would recover the enjoyment of a sense which he never properly valued until he lost it. About sixteen years ago, when well advanced in life, I suddenly lost my hearing, first in one ear and after a few days in the other; and so great was my desire for a cure, that in the course of the next twelve-month I had placed myself, consecutively, under no fewer than six medical men, most of them well-known specialists.

 

The writer then summarizes his treatments and remarks in a table:

Treatment 1: Politzer’s inflation and Eustachian Catheterism on both sides. Pilocarpine internally. Result: Deafness became absolute on both sides.

Treatment 2: Potassium Iodidum in heroic doses. Potassium Bromidum. Blisters behind Ears. Result: Depression to the verge of suicide.

Treatment 3: Phosphorus. Result: Exaltation to the verge of lunacy.

Treatment 4: Ferrum Perchloridum. Galvanic Chain. Stimulating Food, Wine. Result: none.

Treatment 5: Gaiffe’s Battery. Result: none.

Treatment 6: Nitro-Glycerine. Arsenic. Result: none.

Shock machine developed by Adolphe Gaiffe (1830-1903) for treating nervous diseases. (Gilai Collectibles)
Shock machine developed by Adolphe Gaiffe (1830-1903) for treating nervous diseases. (Gilai Collectibles)

A Chamber of the Stillness of Death: Phyllis M.T. Kerridge’s Experiments in the Silence Room

I’m beginning a new project on the historical contributions of women to otology, many of whom have been overlooked in scholarship. My current article investigates the physiological work of Dr. Phyllis Margaret Tookey Kerridge, who died on June 22, 1940, the only daughter of Mr. William Alfred Tookey of Bromley, Kent. She was educated at the City of London School of Girls and at University College London; her graduate studies commenced at the latter institution, first in chemistry and then physiology, where she was also appointed as lecturer. She also held posts in the London School of Hygiene and Tropical Medicine, the Marine Biological Association Laboratory at Plymouth, the Carlsberg Laboratories at Copenhagen, and at London Hospital. She received her M.D. from University College Hospital, in 1933 and became member of the Royal College of Physicians in 1937.[1]

During the 1930s, Kerridge conducted experiments to measure the residual hearing capacity of children in London County Council schools, as well as experiments in teaching with electronic hearing aids. Much of her research was on patients at the Royal Ear Hospital, who were tested in the hospital’s “Silence Room:” a 3,500 cubic room in the basement of the hospital’s new building on Huntley Street, with

“walls impenetrable to extraneous noises and which will never reflect, deflect nor refract sounds—a chamber of the stillness of death, where absolute accuracy and complete consistency in results will be obtained.”

The room was built so exact tests to measure degrees of deafness can be made in ideal and constant conditions. Such stillness in this room apparently allowed people to hear heartbeats and the “flick” of their eyelids! A small table and two chairs were placed in the room. There was a bell to call the Porter’s room and an electric fan affixed there as well.

The Committee of the Royal Ear Hospital occasionally granted permission to medical practitioners to use the Silence Room for their own research purposes. For instance, in 1929, they granted the otologist Dr. Charles Skinner Hallpike (1900-1979), a research scholar from Middlesex Hospital, to use the room free of charge. Hallpike is particularly known for his ground-breaking work on the causes of Meniere’s disease (a disorder that causes episodes of vertigo) and for the Dix-Hallpike test for diagnosing benign positional vertigo (sensation when everything is spinning around you).

The Western Electric 1-A Audiometer in clinical use at the Central Institute for the Deaf in St. Louis, c.1920s. Western Electric produced only about 25 of these audiometers, which retailed at about $1,500 in 1923. (Central Institute for the Deaf Collection)
The Western Electric 1-A Audiometer in clinical use at the Central Institute for the Deaf in St. Louis, c.1920s. Western Electric produced only about 25 of these audiometers, which retailed at about $1,500 in 1923. (Central Institute for the Deaf Collection)

The hospital’s 1938 Annual Reports reveals that Kerridge was appointed to research at the Silence Room, then renamed as the “Hearing Aid Clinic,” working alongside Mr. Myles Formby to conduct hearing test on the hospital’s patients. Though the Clinic was initially started on a 6-month trial period, Kerriddge’s work was so beneficial that the hospital Committee decided to let her continue her research work and audiometer tests, extending care to private patients as well. They provided her with two more rooms in the basement, one as a waiting room and the other as an office, as well as the services of Miss W.J. Waddge as an assistant. In 1939, Kerridge viewed 170 cases, and according to the reports, her work among deaf patients was successful in helping many of them to be fitted properly for hearing aids.

Wartime of course, changed the course of things. The clinic was abandoned during World War II, but the hospital still provided hearing tests with the audiometer to test the hearing of patients suffering from “bomb blast.”

NOTES

[1] Nature 146 (august 3, 1940).

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.

photo 2
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.

photo 1

2. SYRINGING 

photo
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

feet

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 

photo 5 (1)

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.

photo 5 (2)

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

photo (3)

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…

Institution for Curing Diseases of the Ear

In 1838, James Yearsley established the Institution for Curing Diseases of the Ear on 32 Sackville St., London. The institution would eventually be renamed the Metropolitan Ear Institute, and later the Metropolitan Ear, Nose, and Throat Hospital, moving to Fitzroy Square in 1911. The 1839 Annual Report of the Institution outlined Yearsley’s fundamental agenda: (1) to reform the “neglected state of aural surgery in this country,” and (2) to provide a school for specialists interested in studying aural diseases.

The governors at the first half-yearly meeting agreed on the importance of Yearsley’s institution. A Dr. Sigmund, for instance, remarked that since diseases of the ear received little attention from the medical community, the field has been, by “universal consent,” abandoned to the empirics. Such an institution, Dr. Sigmund continued, was best “calculated to assist in dispelling the obscurity in which the subject of aural surgery is enveloped.”[1]

In the Institution’s founding year, 305 patients were admitted, of which 105 were cured, 41 improved; there were 54 incurable cases, of which 31 were at least treated the remaining 51 cases were not known, and 23 were still admitted on the books at the time of the meeting for the Institution.[2] The Committee applauded not only Yearsley’s surgical skills, but also his conduct as a surgeon:

That he attempted no secrecy…but stated his plan of action with openness and candor. He told them what he could do, and do with safety and success, and did not set out like persons who were regarded as quacks by pretending to do too much.[3]

The 1839 report of the Institution also highlighted the importance of credibility of an aurist’s competence in regards to patient care, particularly to urge patients to seek medical treatment as early as possible.  As Yearsley explained,

[i]ndeed, many patients, with long-standing deafness, have thus replied to my censure for not earlier seeking assistance:—“Sir, I should have done so; but I was afraid of being made worse.”[4]

The hospital was the first in London providing specialty treatment for ear, nose, and throat (ENT) diseases. According to the London Metropolitan Archives, the hospital remained at its location on Fitzroy Street until the Second World War, when it was severely damaged by bombing. The hospital personnel and patients evacuated to Watford, but retained a small clinic in London for outpatients and emergencies during the course of the war. After the war, in 1949, the hospital relocated to 5 Collingham Gardens, Earls Court, then transferred to Saint Mary Abbot’s Hospital in 1953. In 1985, the hospital merged as the Ear, Nose, and Throat Department of the newly-built Charing Cross Hospital.

Unfortunately, the London Metropolitan Archives does not have any records of the hospital prior to 1875, so it’s difficult to ascertain what Yearsley’s position or experiences at the hospital were like.

See also Lost Hospitals of London for further details about the hospital’s locations around London.


NOTES

[1] Yearsley, Deafness Successfully Treated, xi; The Times (17 August 1839), 3.
[2] The Times Saturday 17 August 1839.
[3]The Times Saturday 17 August 1839.
[4] Yearsley, Deafness Successfully Treated, 5.