International Giants of Otology: The Earliest Years

The Philosophical Pioneers of Otology

While there are many pioneers of a discipline such as Otology that date back probably even before the earliest written material, Junior et al (2007) reviewed igo3the history of Otorhinolaryngology and found that it has rich literature dating back to the Egyptians. In one of the best-known Egyptian scientific documents, Ebers’s scrolls, they found descriptions of battle wounds on temporal bones and how these wounds affected hearing and speech. In the Egyptian pharmacopedia, from approximately 1,500 B.C., there is a chapter called Medications for the hard of hearing ear, where treatments are described for tinnitus, dizziness and hypocusia.

Later, Greek physicians and philosophers concocted primitive anatomical studies and theories in an attempt to explain diseases and how the body worked. They had various theories of hearing and how the auditory system was stimulated. In the mindsigo4 of the early Greeks, hearing happened as a result of air movements that penetrated the ear and hit the brain in a specific site which was responsible for hearing.  A bit simple, but not too bad for a theory from 500 BC.  Later, other philosophers described the cochlea as a sort of seashell and were intrigued igo5more by the perfection of its shape rather than its function in hearing. Hippocrates, around 400 B.C, was interested in the auditory system, but more for how ear infections related to the rest of the body.  Aristotle, without much anatomical information and capitalizing on the idea of air movements, described a theory of hearing suggesting there was a space within the inner ear, which vibrated in response to sound. Pure air was implanted in the ear as the person was born and congenitally deaf people did not have this air implanted there. As time passes, people would lose this pure air, thus reducing hearing.  While primitive and weird these days, considering the sophistication of knowledge of time, it’s somewhat accurate, if you discount the implanted pure air component.

Romans used the teachings of the Greeks and what they could obtain from the Egyptians for tinnitus, foreign bodies and surgeries for atresia of the external auditory canal.  After the fall of the Romans there was minimal information added to most of the medical disciplines, including Otology until the Renaissance of the 14th to the 17 century.

Otological Renaissance

Before the Renaissance, medicine in Europe was largely built upon theories with little igo6research into what actually worked to cure diseases and how various structures affected these cures. While knowledge from the Islamic world improved the situation somewhat, their contributions were based upon incorrect assumptions made by Aristotle and others. Studies relative to the auditory system and function of the system also became important, especially as to the structure effected hearing and disease.

The Renaissance was the beginning of scientific medicine movement.  In the 15th century, scientists and thinkers began to shake loose from the traditional views that governed medicine in both the east and the west. The focus of treatments was no igo7longer divinely ordained natural balance but designed through the scientific method of conducting experiments, collecting observations, reaching conclusions. The new information was then disseminated by means of an important new technology, printing.

The roots of scientific medicine were set and the Italians were the leaders.  Naples brought some famous discoveries such as Eustachio’s review of the tensor tympani, the cordata tympani and the famous tube that bears his name, even describing the cartilaginous and boney components.  Additionally, Carpi  and Ingrassia named the Malleus, Incus and Stapes bones.  While there are some controversies as to if Ingrassia actually discovered the Stapes bone as part of his detailed anatomical studies of the skull, he also presented details of the auditory nerve where for the first time the concept of sound being conducted by the nerve surfaces.  There are some that suggest that Ingrassia should be considered as important to the development of Otology as Eustachio and Valsalva.  Andras Versalio who eventually became the chair of of Anatomy at the University of Padua, (about 25 miles west of Venice) in 1543, described the oval and round windows as well as the malleus and the incus. Gabrele Fallopius, a contemporary of Versalio also from the University of Padua, discovered and explored the facial nerve canal and described and named the tympanum, for its similarity with a drum.  As the 16th century closes, Fabrizi, the most known of Fallopius’’s students, published the hearing theory, which merged Aristotle’s’ idea with a new concept of auditory nerve stimulation. Fabrizi also described for the first time, proper methods for otological surgery lighting, with devices used to guide the sun light or that from candles.

Next week at Hearing International we will review the 17th century and look at those who haped 18th century Otology.

References:

Junior, J.; Hermann, D., Americao, R., Filho, I., Stamm, A. Pifnatari, S., (2007).  A brief history of Otorhinolaryngology: Otology, Rhinology and laryngology.  Revisita Brasileira de Otorrinolaringologia.  Vol 73(5).  Retrieved October 19, 2015.

Images:

Ancient Egyptian Medicine (2015).  Retrieved October 19, 2015.

Douglas, J., (2008).  Renaissance Printing Press.  Writing the Renaissance.  Retrieved October 19, 2015.

Goss., M. (2015).  Global Unit 11:  The Renaissance and Reformation.  9th and 10th Grade Global History, Amherst Schools.  Retrieved October 19, 2015.

Hooker, R., (1996). Greek Philosophy.  World Cultures.  Retrieved October 19, 2015.

Kenny, J. (2015). Aristotle: Greek Philosopher.  Encyclopedia Britannica.  Retrieved October 19, 2015.

 

About Robert Traynor

Robert M. Traynor is a board certified audiologist with 45 years of clinical practice in audiology. He is a hearing industry consultant, trainer, professor, conference speaker, practice manager, and author. He has 45 years experience teaching courses and training clinicians within the field of audiology with specific emphasis in hearing and tinnitus rehabilitation. Currently, he is an adjunct professor in various university audiology programs.