A Census of the Deaf

Sir William Robert Wilde (1815-1876) was one of the most notable aural surgeons during the second half of the nineteenth-century. He made numerous to aural surgery, including tables on the hereditary basis of deafness and newer hearing tests to determine degrees of hearing loss. Wilde also made extensive use of statistics in his writing, using numbers to support his analysis. As such, some of his work provides remarkable insight into how deafness—and the deaf—were perceived by the medical profession, categorized, and even treated. His statistical work, particularly his Report upon the Tables of Death (1843), which outlined mortality rates in Ireland, as analyzed from the 1841 Irish general civil registration.

William Wilde, c.1870s (from Wikipedia Commons)
William Wilde, c.1870s (from Wikipedia Commons)

In 1850, Wilde was commissioned as Assistant Medical Census Commissioner, a position he would hold for the remainder of his life.[1] As part of his position, Wilde undertook a special study of the deaf, attempting to table not only the number of deaf individuals in Ireland, but also the number of families with deaf relations, the causes of their deafness, the length of their hearing loss, etc. In short, Wilde aimed to provide the first systematic and comprehensive data record of deafness in Ireland. Only 1 family refused to give informed consent (to which they would have been subjected to a fine). Wilde recorded there were 4,747 “true deaf and dumb” in a population of 6,553,386 (or 1 per 1,380).[2]

The data was formerly published as part of the census reports, in Part III: Report of the Status of Disease, Accounts and Papers (Ireland) 1854. Wilde also published his results in On the Physical, Moral, and Social Condition of the Deaf and Dumb (1854), a short pamphlet outlining the data as well as his own analysis as an aurist. In the beginning of the pamphlet, he notes that in undertaking an inquiry into the condition of the deaf and dumb, there are two “great objects present—a physiological and a social:”

Under the former the deaf mute may be classed among those afflicted with permanent disease, either congenital or acquired, and as such, demands the careful investigation of the statistician; and all the causes and phenomena of the affection solicit attention equally with those circumstances attendant upon lunacy, idiocy, blindness, or any of the other persistent maladies which affect certain portions of the community in all countries. Under the latter head the deaf mute claims the special attention of the philanthropist, and the protection of the State…

The pamphlet also lists the questions that were employed in the data collection, including “Whether the person was born deaf and dumb, or became so afterwards?” “Whether the person is educated, and if so, where and by what means such education is acquired?” “The mute person’s position in the family, whether first, second, or third child, in a family of so many, both living and dead?”[3] The questions served to collect as much data as possible, particularly on hereditary deafness, an interesting connotation to later data-collections of the deaf in the United States by the Eugenics Record Office.

Table of Causes of Mutism, from Wilde's On the Physical, Moral, and Social Condition of the Deaf and Dumb (1854)
Table of Causes of Mutism, from Wilde’s On the Physical, Moral, and Social Condition of the Deaf and Dumb (1854)

[1] Robert J. Ruben, “William Wildes Census of the Deaf: A 19th Century Report as a Model for the 21st Century,” Otology & Neurotology 31 (2010): 352-359; 354.

[2] Ruben, 356.

[3] William R. Wilde, On the Physical, Moral, and Social Condition of the Deaf and Dumb (London: John Churchill, 1854).

“Who shall decide when aurists disagree?”

As aural surgery became a “fashionable” trend amongst aristocratic households and several aurists increased in prosperity, conflict between aurists became characteristic of the field. Aurists fiercely competed with each other for positions, status, and patients, and accused each other of being quacks. “Quack” seemed to be less than an accusatory term than a label thrown around by irregular and regular practitioners alike as aurists constantly bickered with each other. The situation heightened to such an extent during the first half of the nineteenth century that the editors of The London Literary Gazette (1834) remarked

[w]ho should decide when aurists disagree? We shall not try, for we are so sick of the quackery practiced, almost beyond all branches, in this branch of surgical practice, that we must turn a deaf ear to them all.

One feature of the conflict among aurists resided in the increase in publications on ear diseases between 1810 and 1860. The majority of these publications were ridiculed in literary and medical periodicals for their obvious plagiarism and for their dishonesty attempts at providing the public with an effect cure. The Dublin aurist and surgeon William Wilde (1815-1879) was perhaps the most outspoken of all critics against what he regarded as quackery in aural surgery.

William Wilde Drawing by J.H. MacGuire, 1847

In his Contributions to Aural Surgery (1844), he writes:

Why is that the empyric and the pretender, either licensed, or unlicensed—for those days there are many and as impudent quacks with, as without diplomas—why is it, we are often asked, that the charlatan frequently succeeds in practice better than the honest practitioner? (p.15).

Wilde described many works in aural surgery as being too “similar in substance and composition” and “flagrant in plagiarism” (p.24). One reviewer even commented the plagiarism in aural surgery “indeed proves so clearly the low ebb at which the science of the aurist is in this country.” It was usual of these works, Wilde continued, “to preface whatever they had to offer to public notice as a cure for deafness by a lengthened description of the structure and physiology of the ear, copied form some of the general or special works upon anatomy” (p.24). Moreover, competition between aurists to become the first to find a “cure for deafness” became the root cause of conflicts, and left aural surgery as “an opprobrium to medicine” (p.5). Wilde concluded the competition and “empiricism” of many aurists threatened the credibility of the field and served “to bias the public mind against the treatment of aural diseases,” counteracting any scientific progress made by prominent and professional medical men.

Aurists also constantly attacked each other’s merits and their treatments. Wilde remarked that William Wright’s (1773-1860) New Observations on the Diseases of the Eye and Ear (1817) was simply recomposed the words of John Harrison Curtis’ Treatise and “as for new ideas, there were none, nor old ones to add them to.”[1] Wright and Curtis often bickered in periodicals and in their treatises, accusing the other of failing to properly treat their patients, or over-exaggerating their respective success. Curtis was also rumoured to have employed several ghostwriters for his Treatise; a more consistent criticism against him was that the chapter on diseases of the tympanum in his Treatise was copied entirely from the eminent eye and ear surgeon John Cunningham Saunders’ (11773-1818) Anatomy of the Human Ear (1806). Responding to the criticisms against him, Curtis explained that

a great hinderance [sic] to the progress of medical science is the jealously and rivalry of some of its members, which prevents many men of talents from entering the profession.[2]

Furthermore, while Wilde blamed aurists’ “empiricism” as weakening the reputation of aural surgery, Curtis claimed that the unharmonious unity among aurists was the source of conflicts, for how could they unify if they could barely agree on a classification of ear diseases, or even the methods for treating them? What was needed, he argued, was a sense of identity among aurists, based on a “science of medicine” and a social responsibility towards the deaf. Wright also contended that although he bore no hostility to any aurist, “the opinions or practices of public men are the property of society of society generally;” a “clear, dispassionate account” of aural surgery was needed, he emphasized, one which could avoid endangering the patients.[3]

[1] Wilde, Practical Observations on Aural Surgery (London, 1853), p.23.

[2] Curtis, Advice to the Deaf (5th ed., London, 1845), p.9.

[3] Wright, A Few Minutes Advice (London, 1839), p.5.