The difference between an aurist and a surgeon?

“…quacks, and aurists, get reputation for syringing the ear, when surgeons lose it; not because the quack has more knowledge of his profession, but because he takes more pains than the surgeon.”

-Unknown, c.1828/1829.

(Yes, I’m still holed up in the British Library reading 19th century treatises on aural surgery)

On Pretended and Itinerant Aurists

As focused as I’ve been on John Harrison Curtis, my current research focus has branched out, exploring a seeming network of aurists that also practiced in London during Curtis’ time.

William Wright (1773-1860), as I’ve mentioned previously, was one of Curtis’ contemporaries, and perhaps his most fierce and prominent competitor. Wright had a very long career–nearly 50 years–and published as many treatises on deafness and ear diseases as Curtis did. While his early work concentrated on warning the public against the dangers of using mercury as a treatment for deafness, much of his later work commented on various types of treatments described by other aurists at his time.

In fact, Wright’s writing actually serves as a commentary on the state of aural surgery during the early 19th century: his early publications remarks on the lack of expertise in the field, then he writes about the various treatments offered by aurists of his day, and during the latter part of his career, he scorns the level of quackery in the field and commends the newer generation of anatomists (like Joseph Toynbee) for taking a more “scientific” interest in the field. Pretty much every aurist during the period is mentioned in one or more of Wright’s publications!

I’ll write a longer essay in the near future examining the evolution or transformation of Wright’s perceptions of aural surgery. In the meantime, here’s one of Wright’s comments on “pretended and itinerant aurists”:

It is high time that some legislative enactment should put a stop to these nefarious practices, and to the evils which these impostors inflict through want of skill, upon many families among the poor. But it is almost hopeless to expect any change, whilst government receive so much from the advertisements issued by these empirics, and whilst the country newspapers are so materially benefited from the same source. Even Royalty itself has been imposed upon more than once, and made a medium for promulgating the names of some of the most notorious quacks to the world; which circumstances must be fresh in the recollection of the public.

Wright, Plain Advice for all classes of Deaf Persons, the Deaf and Dumb, and those having Diseases of the Ears (London, 1826)

Trust in Quacks

Lacking a proper medical degree or the right sorts of qualifications were often indicators for defining the quack medical practitioner. Or so it was accordingly to the Royal College of Physicians, who were always wary of their financial state in the medical marketplace. Yet the lay public were not always clear as to who the quacks were, or if they were, they tended to be more forgiving than the elite authorities. As long as their medical demands were met, the lay public were even willing to disagree with the College over who should or shouldn’t be labelled a quack.

Curtis, like many aurists of his day, was criticized for his ignorance of ear diseases and accused of being a quack. For the most part of his career, the criticisms did not hamper his popularity, for he was able to meet a public demand. Yet there were still men who held their suspicions, wary of blindly submitting their bodies over to someone who would only harm them. The editors of The Family Oracle of Health, for example, were highly critical of the services offered by aurists and often undertook investigational inquires into the practices of aurists in the hopes of exposing the quacks. The quote from 1824 below wonderfully highlights the ambiguous approach both the public and practitioners employed in their quest to define quack aurists:

An old Surgeon asks us, “Are you really in earnest about Mr. Curtis, or merely ironical?” He adds, “Mr. Curtis takes away both money and health.”—We think it is very strange, that his Majesty’s Aurist, the very Prince of Ear Doctors, who attends all the Drawing-rooms, and presents, in person, splendidly gilt copies of his works on the Ear to the King, could not have his portrait given in the Oracle, without such a distorted view of its real features. Why the “old surgeon” should insist on our calling Mr. Curtis a quack, we cannot imagine.—Is he not a regular half-pay army surgeon, and besides, a Fellow of the London Medical Society, Bolt-colt, while Stevenson was black-balled hollow, at Lincoln’s-Inn Fields? Mr. Curtis, indeed, sports advertisements of his lectures and his books on the Ear; and he gets up a Charity Sermon now and then for the Royal Ear Dispensary, as Whitlaw does for his Quack Asylum of Bayswater; and he lives in Quack Square, near Jordan and Dr. Eady. But in the name of legitimate Aurism, is this quackery? Mr. Curtis likewise uses blue pill; but he learned that from Abernethy. Is Mr. Curtis then a Quack?—“That is the question.”

However, it might have soon dawned on the editors of The Family Oracle of Health that they published their (somewhat sarcastic) support of Curtis without properly evaluating all the facts available to them. In the next volume, they produced a notice to their subscribers:

Was [Curtis] really rejected by the College for ignorance? Was he only a drug-boy at Halsar Hospital? Ah, Squire Curtis! We shall have you now. If you have no medical title, and but little Nisbetian knowledge, the law will not protect you from the scourge which we have applied to Whitlaw and Mother Johnson. Pray, how did Curtis get into the Medical Society, Bolt-Colt? And being in, how do they not institute a Scrutiny to purge their —–non? We shall not lose sight of the “Prince of Aurists!!”

The speed at which the editors changed their opinion on Curtis clearly reflects how the public still considered the importance of reputable and accredited medical licenses. For the public, licenses and diplomas symbolized trust—trust in the practitioner, trust in the treatment, and trust in the safety of medicine. Reputable practitioners feared that the lack of proper qualifications amongst London’s most popular aurists increased the risk of endangering the patients. Their fears soon transferred to the public, who then found it difficult to ignore the likelihood that ambitious men seeking to exploit public trust presented a threat to both the public and aural surgery.

(Side note: I just finished reading Follett’s World Without End and it beautifully highlights the conflict in the 15th century over the conservative humoural theory of medicine and the newer approaches to scientific medicine—what’s particularly interesting is that Follett also captures the perceptions of the public on the debate as well as their fears over treatments. While the plot, as I mentioned, lacked the passion and genius of The Pillars of the Earth, the details over medicine and treatment for plague victims was, in my opinion, the highlight of the book. Totally worth a read, all 1014 pages of it!)