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.

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The Expulsion of “Lewis”

During fall of 1848, a practitioner imposed himself upon the inhabitants of Newcastle-on-Tyne, announcing himself as “Mr. Yearsley” and distributing posting-bills around the area. Sporting a mustache on the upper lip and an imperial on the nether lip, and a cherished crop and carefully-nourished tuft of hair, he strutted himself peddling his wares. Urging the inhabitants to make use of his services on “all diseases of the ear,” he assumed authorship of numerous books that were favorably reviewed in popular periodicals and boasted of his successes in relieving maladies of the ear. He loudly and widely proclaimed himself as “the curer of deafness.”

“A quack doctor selling his remedies on the streets of London – despite objections.” Wood engraving by E.L. Sambourne, 1893.

Charles Robert Larkin, a respectable surgeon of Newcastle, wondered about the individual. Upon investigating, he realized the man was supposedly called “Lewis,” hailed from London, and made a fraudulent living impersonating the aural surgeon James Yearsley. Revealing the quack, Larkin and the Mayor of Newcastle–and probably a few other angry men and women–drove “Lewis” out of town. Further, Larkin printed 300 large bills and placarded them wherever the advertising bills were posted around Newcastle, announcing the truth of the impudent impostor. Similar bills were placarded in North and South Shields; Larkin was about to send a man to Sunderland to post more bills, until he was told the impostor had fled. To convey the message even further, Larkin employed a man to wear a placard revealing the fraud, and paraded him before the “villain’s door.”

James Yearsley received word of these events from Larkin’s letters. Writing to the Mayor of Newscastle about the situation, Yearsley asked whether the Mayor had any means of redress, to which the Mayor replied: “We have no by-law to punish the party, and the only remedy you have is to indict him, and bring and action for damages.” But alas, the impostor had fled, no doubt to Larkin’s vigorous exertions of exposure.

Yearsley might have salvaged his reputation, but the lack of public spirit captured by the local press did not sit right with Larkin, who wrote to the editor of The Lancet (9 Dec 1848):

“In this affair, nothing could exceed the injustice of the newspapers. They refused to notice Mr. Yearsley’s letter of remonstrance; would insert nothing but as a charged advertisement; and though the imposture had been made notorious to the whole neighborhood, yet, out of mingled mercenary motives, and mean submission to the quacks, they have not made the slightest allusion to the affair. Na, they positively refused to insert either Mr. Yearsley’s caution, or my notice to the public, without such a mitigation of the language as would have taken away all the point and emphasis of both productions, and without a deposit of £40 as a security against any legal expenses that they might be exposed to, should at any time this miserable quack and impostor institute an action against them…The papers which refused my application were the Newcastle Courant and the Newcastle Chronicle.”

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.*

LifeMagazine
An example of the artificial eardrum, from Life Magazine 5 December 1949

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.

James Yearsley (1805-1869)

James Yearsley was an outspoken aurist who was known in mid-nineteenth century London for irritating other medical practitioners with his obnoxiousness. He’s a very interesting fellow to examine the field of aural surgery within the 1830s medical reform and march of progress movements in England–no wonder he’s become the subject of my last dissertation chapter.

Continue reading James Yearsley (1805-1869)