Inner Ear and Explosions in the History of Otology

In their article "Audiometric Configurations Following Exposure to Explosions," Perez and coauthors¹ indicated that hearing loss as a result of excessive stimulation of the inner ear was first reported in 1872. Studies of the classical otology books of the beginning of the 19th century show that this problem is mentioned in most of them in a progressive way of understanding. Itard² in his Traité des Maladies de l'Oreille et de l'Audition published in 1821 wrote in the chapter concerning hearing loss that exposition to "loud detonations" is a predisposing factor to hearing loss. Kramer^{3 - 4} in his Die Erkenntniss und Heilung der Ohrenkrankheiten published in 1836 and translated into English in 1837 wrote, "I have even seen instances in which complete deafness succeeded to loud explosions of fire-works, artillery, . . . " Williams⁵ wrote in his Treatise on the Ear; Including Its Anatomy, Physiology, and Pathology published in 1840, "Artillerymen, blacksmiths, and the blasters in mines often become deaf; and this seems to be dependent upon defective energy of the acoustic nerve, from having been so frequently over excited." Toynbee⁶ wrote in 1860 in his The Diseases of the Ear: Their Nature, Diagnosis, and Treatment, "Injury to the nervous apparatus of the ear may be produced by a variety of sounds. Cases have been seen by me in which a cannonade at land or sea, or the firing a single cannon, has produced the injury." He also presented 6 cases to illustrate this fact. All these texts demonstrate that hearing loss following overstimulation of the inner ear was well known in the first part of the 19th century even if the knowledge of anatomy was not complete. In fact, Ambroise Paré (1510-1590), a war surgeon in the 16th century, seems to be one of the first to have recognized the damage that noise can cause to the ear and to hearing:

Isn't it a great thunderous noise, large bells or artillery, and thus one often sees gunners losing their hearing whilst drawing the machinery because of the great agitation of the air inside the ear which breaks the aforementionned membrane and moves to the bones known as ossicles out of their natural position: so that the air is implanted or absorbed within the sinuses of the mastoid cavity (called by some the tambourin) and the patient has a continuous noise and air within the ear.^{7 - 8}

I hope that these few comments will bring more light to the history of otology.