Medicine: How’s That?

“We must come out and claim our rights. We must deserve and get them. The day is past for a hard-of-hearing person to cling to solitude and slink through the world missing half of life because of a false sense of shame. So put on a hearing aid. Wear it with pride, not as a badge of disgrace!” Thus croaked deafened Novelist Rupert Hughes to fellow members of the American Society for the Hard of Hearing who met in Manhattan last week. On his own lapel he proudly wore one of his several electrical hearing aids.

Purpose of the society is to .encourage or sweeten the 20,000,000 U. S. citizens who are grouchy, timid or asocial because their ears are dull. For 50,000 hopeless U. S. deaf-mutes, the society can do nothing but cheer for bigger & better special training schools. Through newspaper campaigns and radio programs, the society, which claims such hard-of-hearing, hard-working members as Mrs. Calvin Coolidge, Owen D. Young, has 1) pushed the passage of laws in eleven States demanding hearing tests for all school children;* 2) campaigned for routine lipreading classes in all public schools, to give confidence to 3,000,000 hard-of-hearing U. S. children whose eyes are keener than their ears.

Shell to Nerve. The human hearing machine consists of three labyrinths: the outer, middle and inner ear. Mostly decoration, the pink shell of the outer ear collects sound waves, passes them through a long, protective canal to the eardrum. Sound waves striking the drum set up vibrations which are transmitted through the three delicate lever-bones of the middle ear—the “hammer, anvil and stirrup”—into the inner ear. There the main sound-wave receiver is sunk deep in a massive bone at the base of the skull. This receiver is a winding snail of bone, the cochlea, filled with fluid, lined with feathery nerve endings. These nerve endings pick up incoming sound waves, relay them to the auditory nerve, which carries them to the brain.

Middle Ear. Most common cause of dim hearing is middle-ear injury and scarring—caused in turn by violent nose-blowing, infection of the Eustachian tube or the heavy mastoid bone which bulges out behind the ear. Safest maxim for ear-picking children: “Nothing smaller than the elbow should ever be put into the ear.” Mastoid infections occur most frequently in children under twelve, for their delicate membranes are not tough enough to withstand bacterial assault. Standard procedure for mastoid infections is surgical removal of wedges of the infected bone.

That poor food has some connection with poor hearing in growing children has long been suspected. Last week, in the Lancet, Dr. Phyllis Toohey Kerridge of London University bolstered up this theory by publishing results of her hearing tests on 1,000 English school children. Middle ear deafness, found Dr. Kerridge, “is about four times as common, on the average, under poor social conditions as it is under good social conditions; in the poorest places … it may be nearly ten times as common as in a good environment, nearly a quarter of the child population being affected. Climate, housing, and the mixing of children seem to have little effect. . . .”

Inner Ear. People whose hearing is impaired by middle-ear injury and people past 30 who are gradually growing hard of hearing, are not really deaf. Medicine can do little to strengthen their damaged or aging middle-ear structures, but if their cochleae are sound and healthy, they can hear with the aid of bone-conducting devices which transmit sound waves directly through the skull to the inner ear.

True deafness can be caused only by injury to the inner ear, or to the auditory nerve. Inherited structural defects account for a large proportion of these cases; syphilis, scarlet fever, meningitis, measles, for many others. Skull fractures and the force of violent explosions may injure the cochlea or the auditory nerve.

*Standard machine to test hearing is the audiometer, a phonograph-like device with earphones instead of an amplifier. When records are played, with varying sound intensities, subjects write down what they hear. With an adequate number of earphones, an audiometer can test the hearing ranges of a classroomful of children in 25 minutes.