mmwjMWjjjjMWjjjMmMfjmm&m Hi u to ANNUAL REPORT OF DR. J. TOGNO'S INFIRMARY FOR THE CURE OF DEAFNESS, FROM 1834 TO 1835. " To prejudge other men's notions before we have looked into them, is not to show their darkness, but to put out our own eyes. "—Locke. BY J. TOGNO, M. D., UJV. PENN. Member of tlie P/dladelphia Medical Society and of the PJdladelphia CoUege of Physicians. ".LET THE DEAF HEAR." PHILADELPHIA: PRINTED BY SEYFERT & PHILLIPS, » BACK OF NO. 110 WALNUT STREKT. 1835. fmwmmiwmmmwmw^miwmmvi E^V T«r ^^^ G/re *+- t>eatn>e.SS ANNUAL saiaiBao^aa ^s^sssswsi&SL REPORT OF DR. J. TOGNO'S INFIRMARY W^\\ FOR THE CURE OF DEAFNESS, FROM 1834 TO 1935. " To prejudge other men's notions before we have looked into them, is not to show their darkness, but to put out our own eyes."—Locke. BY J. TOGNO, M. D., UN. PENN. Member of the Philadelphia Medical Society and of lite Philadelphia College of Physicians. "LET T,ff% C»»;ErA/V V HEAR.'* /' '' i PHILADELPHIA: PRINTED BY SEYFERT & PHILLIPS, BACK OF NO. 110 WALNUT STREET. 1835. PREFACE. The public being very little aware of the daily improvements in this —for a long time—very much neglected branch of the healing art, we think it our duty to give to the world a yearly report of the persons who have consulted us, of those who have been treated according to our views, and the proportion of those that have been benefited thereby. This will go to prove, that our efforts not only have been, but continue to be crowned with some success. In our popular essay on the laws of acoustics, &c, we only presented some of the successful cases, but in this yearly report, we give the whole of them; by which the persons afflicted with deafness, may see that the chances of improvement or of complete recovery, are far greater than they had any idea of. We give only the initials of the names of our patients, because many have objected to their names appearing. This does not, however, render questionable the actual fact, that many who were in a complete state of despair, are now restored to hearing, and to all the enjoyments of society and friendly conversation. We are daily consulted, by letter, by persons living at a distance, in the expectation that even before seeing them, we may afford them some re- lief; but their hopes are vain, we cannot; nor would we dare trust our success on the simple relation of any patient, however intelligent he may be, unless we ourselves have first carefully examined the case. The causes of deafness are so many, the actual state of the cases are so varioits, so peculiar, so dissimilar, in each individual, even when the patient thinks them perfectly alike, that we could wish that those per- sons who are afflicted in the least with deafness, instead of addressing us by letter, would consult us personally ; this would greatly facilitate the cure of their infirmity. ViV IS3S" Dr. Togno's Infirmary for the cure of deafness, and the deformities of the body, may be found at No. 98 Locust Street, above Ninth. He may be consulted every morning, from 9 o'clock, till 12 A. M. N. B. Advice to the poor, gratis. INTRODUCTION. " Let the deaf hear," is our motto, and to bring it to pass shall be the daily labour of our life ; such is our determination, till we close this worldly career, and if it may be any inducement to stimulate others to follow our example, by cultivating this neglected branch of the healing art, let it then be even inscribed on our humble tomb : " Let the deaf hear." No reader of the history of past, or observer of present events, can fail to remark, and his daily experience must teach him that the words of that great master of matter, mind, and human passions, Locke, are no fiction, but a reality. "Truth" says he, "scarce ever yet carried it by vote any where, at its first appearance. New opin- ions are always suspected, and usually opposed, without any other rea- son than because they are not common. But truth, like gold, is not the less so for being newly brought out of the mine. 'Tis trial and ex- amination must give it price, and not any antique fashion; and, though it be not current by public stamp, yet it may, for all that, be as old as nature, and certainly not less genuine." The history of medicine offers abundant examples of this blind-fold system of opposition to every thing that does not wear an " antique fashion," and the experience of the justly celebrated Harvey, Rush, Jen- ner, Bichat, Gall, and Broussais, afford remarkable instances of this blind spirit of opposition, so hostile to every suggestion of improvement or innovation. As our corporeal actions acquire precision in the manual operations of any one art, by being daily trained in that mechanical pursuit, so will mental training or discipline, the better prepare our minds successfully to grasp the most intricate and complicated subjects, by being able to fix and control our attention proportionably longer on any one of them. We can, by this means, comprehend better, see quicker through any one object that we are in the daily habit of contemplating, and arrive at more correct results in our investigations, than those minds that have never been bent to the same pursuit, or trained to given series of thoughts, and to whom every link of the chain of ratiocination to be followed, in order to arrive at the desired result, is perfectly incom- prehensible and invisible, for the want of the power of concentration and attention. Hence, in order to create this happy state of mind, the necessity of the division of labour, both mechanical and intellectual. It is, moreover, undeniable, that the division of labour is indispensably ( 6 ) necessary for the improvement of the individual, as well as that of the art or science he may cultivate. We, therefore, strongly advocate this system in the medical science, as conducive to greater improvement in all its details. Full of a zealous ambition for our profession, not puffed with pride or presumption, we are neither vain of the possession of attainments which have enabled us to relieve suffering humanity, nor slow or timid in asserting our rights. We emphatically claim the priority, in this country, in the restoration of deaf and dumb individuals to hearing and speech. We have entered upon this career with all the enthusiastic fer- vour of youth, and we shall not leave it until we have brought about a reform in the present injudicious, not to say cruel, practice of condemn- ing to eternal deafness, all mutes, without first trying whether they can- not be restored to hearing and to society. We are irresistibly urged forward in this course, in spite of physical obstacles, or interested op- position. The cause we have warmly embraced, is a sacred one, in our estimation, and must prevail. The public must be made aware of the fact, that many mutes can be restored to hearing, and that it is therefore criminal in the extreme to neglect these chances of improve- ment. We know, that there are individuals who think that they have stronger claims on public attention, for administering violent poisons, in medical doses, while others claim even greater merit, for making out the bills of mortality. We grant them their due share of merit, for doing it se- cundum artem; we only claim for ourselves, that of having cured, as stated by the following table, more than one-half of the most hopeless and desperate cases of deafness, given up as incurable by the profes- sion. This is a fact we publish without the fear of contradiction. We cannot prevent/acta ami figures from having their full weight, and giv- ing in their honest testimony, however unpleasant this may be to those who are unwilling to allow any merit to others ; but the statistical report of this infirmary shall go forth yearly to the world, because; as Dr. Rush says, " Whatever has a tendency to lessen the sum of human mi- sery, ought to be published, and placed within the reach of the dis- tressed." Truth is mighty, changeless, and immortal, like its Supreme Author: it must and will prevail. We have yet a word to say on the individuals belonging to the class of deaf and damb persons. We believe that they have never been, in this country, tlie object of medical attention, before last February, as stated in our letter to Condy Raguet, Esq., Editor of the Philadelphia Gazette. We shall introduce that letter and the remarks of the editor/ in this place, to give it a more extensive circulation: "THE DEAF AND DUMB. « We applied to Dr. Togno of this city, for the result of some operations ner- ormed by him some, months since, with which we were made accma nted™uL time, and have been favoured by him with the following letter aCqUainted at the ( 7 ) Philadelphia, September 28, 1835. Dear Sir, In answer to your communication of to-day, and in compliance with your request, I will trouble you with the following remarks. You are right in your impression of my having stated to you, last Fehrua- ary, the remarkable restoration of Albert Newsam's hearing, although a deaf and dumb individual twenty-seven years of age. I moreover so far developed his "powers of phonation, or speech, as to enable him distinctly to utter various words and phrases. Several gentlemen witnessed these experiments, among whom I will name W. M'llvaine, Clement C. Biddle, Esqs. and Mr. L. Meignen, Pro- fessor of Music. The precision with which Newsam uttered the simple elemen- tary sounds as well as the diphthongs of the English langnage, considering his age and limited instruction, was highly gratifying. So far as I am acquainted, the individual here referred to is the first deaf and dumb ever restored to hearing in the United States. Since the above case I had the good fortune, in April last, to restore to hearing another deaf and dumb person. I allude to Miss Helena Lyman, of Northamp- ton, Mass., only nine years old. Her powers of imitation, at this age, being very great, she soon, under my tuition, learnt how to utter all the elementary sounds of the English language, and before she returned home, pronounced dis- tinctly a catalogue of words, as well as some phrases. She could distinguish time and pitch in music. Miss Lyman is the second deaf and dumb individual ever restored to hearing in this country. Her powers of discriminating the va- rious sounds yielded by different bodies, was, before she left Philadelphia, very great; she could identify a body by the sound that it yields. There is no doubt in my mind, that at least one half of the deaf and dumb indi- viduals now condemned to eternal deafness, by the generally prevailing ignorance, might be restored to hearing by an appropriate treatment. My professional la- bours have, for a long time, been devoted to the solution of this important problem to humanity, and I hope they may be crowned with success. Very respectfully, your friend, JOSEPH TOGNO, 98 Locust Street. It is due to Mr. Togno to say, that when first made acquainted with the case of Albert Newsam, we were desirous of announcing it to the public as the first instance of a cure effected in the United States, but that Dr. Togno objected to its being done until he had made some further experiments. We can also con- firm his statement of the case of Miss Helena Lyman, whom we saw, and whose restoration so far as to hear distinctly the sound of a flute, was proved in our presence."—Philud. Gazette. We have still under our care, for vocal education, another re- markable case of a deaf and dumb boy, named Alfred Green, in his ninth year, that has already been restored to hearing by our treat- ment. His relations had concluded to place him at the Deaf and Dumb Asylum, in this city ; but, having yet some hope of his recovery, as he did hear when a babe, the grandmother resolved to consult us before he was definitively condemned to that miserable half-existence of mutes, even after they have been educated. He was therefore placed under our medical charge ; and he now can hear distinctly any word said to him even when turning his back to the speaker, and repeats it in as audi- ble and articulate a manner as any child of two or three years old, al- though one month only has elapsed since his vocal instruction began. We are now developing his vocal organs, and we doubt not that he will before long be completely restored to society with all his senses and with as great a share of intelligence as that which belongs to boys of his age. ( 8 ) He not only hears and distinctly repeats the articulations, but he imitates the pitch of the voice, that is to say, he even repeats with truth and correctness its intonations and modulations. The medical profession, in this country, has too long shown a com- plete apathy on the subject of the diseases to which the ear is liable. It is high time that it should be awakened from this state of lethargy, or at least, allow one of its members to warmly plead this cause unmo- lested by selfish motives, and pitiful jealousies. "Boerhaave," says the celebrated Morgagni, " has justly designated this the most complex of the organs of sense, and has represented its numerous parts as liable to injury in many different ways." He there- fore adds, " Surditas morbus unus sit, et millecuplus." This would seem to point out why the treatment of the diseases of the ear has been so much neglected, and the congenital deafness of deaf and dumb per- sons, considered as hopeless. We find in the last edition (1835) of Professor Wm. Gibson's Sur- gery, the following remarks on the " Diseases of the Ear," which also confirm our opinion with respect to the almost entire absence of know- ledge among the students, not only as to the best mode of treating the dis- eases to which the ear is liable, and by which deafness is superinduced; but he even complains of the " too common" neglect of the study of its structure. We cannot cite any higher authority on surgical science, in this country, than its eminent professor in the University of Penn- sylvania. " From the complex structure and diminutive form of the auditory organs, the older surgeons always despaired of arriving at any certain knowledge of the nature and treatment of their diseases. Hence, all the information we possess on the subject, may be considered, compa- ratively, of modern origin. Still we are much in the dark, and may, perhaps, for ever continue so, respecting many affections, especially those of the internal ear. For these very reasons, however, the student, instead of neglecting, as is too common, the anatomy of the ear, under the impression that he can never acquire an accurate knowledge of it, should strive to make himself minutely acquainted with its most intri- cate structure, as the only means of understanding its diseases," &c, We will add the authority of Dr. Samuel Cooper, author of the best English Surgical Dictionary. In the edition of 1834, of this work, will be found the following remarks under the head, " Ear, diseases of," which shows that the successful treatment of the diseases of the ear, in- ducing deafness, is far from being an easy task, not only with the practi- tioner in this country; but even with the English Surgeons, celebrated as they are for their skill and medical knowledge. Therefore, should we have been even less successful, we, as well as every other Surgeon in ihe land, might well be satisfied with a similar result in the treatment of an infirmity in which disappointment is so generally experienced. ( 9 ) " But notwithstanding the laudable endeavours of so many men of eminence, the pathology of the internal ear, and the treatment of its diseases, are far, I may say, very far, from a high state of improvement. To farther advances indeed some discouraging obstacles present them- selves : the auditory apparatus is extremely complicated ; the most im- portant parts of it are entirely out of the reach of ocular inspection; the anatomy of the organ is perhaps not yet completely unravelled ; the exact uses and action of several parts of it, anatomically known, are still involved in mystery; the opportunities of dissecting the ear in a state of disease are neither frequent nor duly watched; and even when they are taken, and when vestiges of disease or imperfection are traced to particular parts of the organ, the utmost difficulty is experienced in drawing any useful practical conclusion, because the natural uses of those parts, and the precise manner in which they contribute to the per- fection of the ear, are not known to the most enlightened physiologists. We are here nearly in the same helpless dilemma as a watchmaker would be, were he, in examining the interior of a watch, to find parts broken and out of order, the exact uses of which, in the perfection of the instrument, he had not first studied and comprehended. In fact, the physiology of the ear is but very imperfectly understood ; and, as Ro- senthal remarks (Journ. Complem. t. 6, p. 17,) if, notwithstanding the progress made in optics, and the complete knowledge of the structure of the eye, a perfect explanation has not yet been given of the phenomena of this organ as an instrument of vision, we cannot wonder that, with far more circumscribed information about acoustics, and the greater dif- ficulty of unravelling the structure of the ear, so little progress should have been made in the physiology of the latter organ. Were it practica- ble in acoustics to arrive at that precision and certainty which would enable us to establish laws in the theory of sound as fixed as those which relate to the light, this void in physiological science might per- haps be obviated. But Rosenthal justly argues, that hitherto the ap- proach to perfection has not been made, and this, notwithstanding the learned and valuable labours of Chladni.—(Jlkustik. 4to. Leipz. 1802.) Some facts, however, are admitted to be well ascertained, and the re- searches of Autenrieth and Kerder (RieVs Archivfur die Physiol, t. 9, p. 313—376) are honourably mentioned; for though they only elucidate the function of the conductor part of the ear, they are of unquestionable importance to the medical practitioner. It is clearly proved that the difference in the length and breadth of the meatus auditorius form of the membrana tympanis and the make of the cavity of the tympa- num, modify sound; that is to say, that the differences of structure of the auricle of the meatus auditorius externus, which merely receive and concentrate the sonorous undulations, as these emanate from a vibrating body, can only influence the degree of force or weakness of the sound ; while, on the contrary, the differences of structure in the membrane and 2 ( io ) cavity of the tympanum are not limited to this effect, but the greater or less tension of the one, and the more or less considerable capacity of the other, appear to alter in a greater or less degree the particular character of the sound.—(Jour. Complem. t. 6, p. 20j" We observed, in the last annual report of the " Massachusetts Cha- ritable Eye and Ear Infirmary," established in Boston, that although that valuable Institution has had "one hundred and twenty-six pa- tients, labouring under diseases of the Ear" not one case is reported as either entirely cured, or in any way improved. It may be an omis- sion on the part of the reporters; but, such as the report is now pre- sented to the public, goes to prove our position, namely: that the success- ful treatment of deafness is far more difficult than some individuals would make the unitiated believe. We hope that the eminent Surgeons of that philanthropic establishment, will not consider these remarks made in a malicious spirit, nothing could be more unjust to our feelings ; on the contrary, we hope and trust they may obtain for their next annual re- port, as brilliant a result for the Ear, as they had in this year's report for the Eye. We only quote the fact as given, simply to show, that the difficulties in the way to success are very great; and, therefore, it is not to be wondered at, that deaf persons should so generally give up all hopes of recovery. After these quotations we leave a certain Boston-critic-would-be-savant, to say whether the world is so very enlightened on this all-important subject, of which he himself is so totally ignorant ? Bantering may do on some light subjects of literature ; but the science of life, or of the healing art admits no trifling remarks; it only dwells on facts, while our contemporary daily feeds on fictions of his own creation. It is the common lot of those that are employed in the arduous search of truth, to be teased and vexed while their term of probation lasts. We willingly submit to this general law of necessity, however hard to bear; but we shall not be turned from our purpose, for we have already, perforce acquired and buckled on that fortitude of necessity, that is im- movably firm. We hope that hereafter the diseases that induce deafness will no longer be placed to the account of the opprobia medicorum; their nature begins to be better understood and their treatment is no longer fruitless attempts of empirics ; but rational permanent cures are daily produced, as the re- sults of our practice plainly show. ( 11 ) Tabular View of the Annual Medical Statistical Report of Dr. Togno's Infirmary for the Cure of Deafness. From 1834 to 1835. ■0; O H 1 i GC n o S o o a 3 tiose tre lsulte n •s.1 C 3 £. Names. Residence. B c" a 2- » s %3 £*• a * -• '£§ 3 3 *T 3 » 3 5"^ c c a o o 1 O (J- 2 a c n> « n 3 re £,£ ■ 7* a f — p. p. K Mr. Le R., Paris. 5 1 1 Mrs. A. G., Philadelphia. 2 1 Mr. F. S., Boston. 40 Mrs. S. S. J., Virginia. 12 1 Miss. S. A. K., Philadelphia. 5 1 Mr. C. C, Do. 2 1 Mr. S., Do. 1 mo. Miss S., Do. acute. Mr. R. I., Do. 11 Miss M., Do. 15 Mrs. S., Brooklyn. 7 MissM., New Brunswick. 5 Mr. L. S. Philadelphia. 22 1 Mr. R. T., New-York. 22 Mr. J. H., Philadelphia. acute. 1 Mr. W.J. E., Western (-ountry. 12 Mr. S. M., Alexandria. 20 1 Miss A. C, Philadelphia. acute. 1 Mr. D. B., Massachusetts. 20 Mr. W. B. S., Pennsylvania. 11 Mrs. M. S., Maryland. 1 Mr. J. N. B., Philadelphia. 7 Mr. D. C, Lancaster. 27 1 Mr. W. S. Jr., New-York. 2 Mr. W. S., Sr., Do. 20 1 Mr. J. R. K., Baltimore. 12 Mr. D., Maryland. 40 1 Mrs. B., Boston. 40 1 Mrs. C, New-York. 30 Mr. H. T. I., Newport. 25 4 Cat ried forward, 415 30 29 1 821 ( 12 ) ■ ~ o o H H re !» a o W 13 o I'll 3 t 3 ?? 3" o V or?' *5* 3 ■g. re" re 1 o i OS " Names. Residences. b c^ re * "■ Is* re £ B 3 3 re' S-. 3 ^3 re re re n o 3 1 O < re p. t o < re p. 8 1 re p. 21 o 2 re 4 Brou rht forward, 415 30 29 1 Mr. J. C, Virginia. 5 1 1 Mrs. P.. Delaware. 7 1 1 Mr. A. S. D. Missouri. 10 1 1 Mr. W. L. C, Hartford. 23 1 1 Miss N., Philadelphia. 35 1 1 Dr. S.W. C, Natchez, 23 1 Mr. G. W., New Jersey. 3 1 1 1 Mr. J. T., Philadelphia. 15 1 1 Mr. A. R., Do. 1 1 1 Mr. J. W., Do. 23 1 1 1 Mrs. M., Do. 1 1 1 1 1 Mrs. T., Do. 12 1 1 1 Mr. J. R., Do. 20 1 1 1 1 Miss L. G., Do. 1 1 1 1 Mr. T. S., New Jersey. 20 1 1 Miss L. B., Pittsburgh. 18 1 1 Mr. A., Philadelphia. 14 1 1 1 Jane, a slave, Virginia. acute. 1 1 Mr. T. B., Philadelphia. 12 1 1 Mr. C. B., Do. 2 Mr. F. W., Tennessee. 8 1 1 1 1 Miss S. R , Virginia. 7 1 1 1 Mr. B. D., Do. 30 Miss A. G., New Jersey. 16 A. F., Esq., New York. 8 1 1 1 Mr. H. W., Harrisburg. 4 Mr. P., Georgia. 8 Mrs. C, Philadelphia. 24 1 1 1 1 Mr. Wm. S., Do. 1 1 1 1 1 Mrs. E. F., Boston. 20 1 1 1 Mr. D. H., Troy. 8 1 1 Mr. A.G. K., Lancaster. 18 1 1 1 1 Mrs. P., Alabama. 7 1 1 1 Mr. H., New Jersey. 6 __ Carried forward, 825 64 57 16! 3 18 32 5 8 ( 13 ) *3 B o H o H re p 2 9 re o o 3 re o o Names. Residences. 85 a -•5 re p 3 o-"■ re v o 3. re . si re 3^ re O.S • o o 5. 3 i o 3 ■a o re" re 1 1 o si ►a p re -•2-re re re o re re re s s» r> re 3 1 p. p. p. re Brought forward, 825 64 57 16 3 18 32 5 8 Mr. J. K., Baltimore. 4 Mr. S. E. S., 1 Mrs. M. H., Baltimore. 2 Mr. S., Pennsylvania. 23 Mrs. M. K., Pittsburgh. 21 1 1 Mrs. C. H., Philadelphia. 12 1 1 1 Mr. W. R. H., New-Haven. 15 Mrs. R. W., Canada. 13 Mr. W. H., Pennsylvania. 8 Judge D. S., Do. 18 Mrs. C. J. Boston. 17 Mrs. A. T., Philadelphia. 8 Mr. J. B., New-York. 11 Miss R. P. B., New Jersey. 23 1 1 1 Mr. W. M. I., Philadelphia. 3 Mr. W. E. F„ Do. 4 1 1 1 Master F. H., Do. t 1 1 1 Mrs. S. G„ New Jersey. € Mr. T. W., Philadelphia. 2 1 1 Mr. D. J.. New York. 12 Mr. W. H. L., New Orleans. 21 Mr. W. C, Philadelphia. 2C 1 Mr. S. C, New Jersey. 4 Mr. B. H. L., Baltimore. 3 1 Mr. J. A., Pennsylvania. 11 Miss N. B., Connecticut. ie 1 Mr. A. J., Philadelphia. 2£ Mr. J. McC, Do. £ 1 ] Mr. W. C, Do. 2 1 1 1 1 Miss M. R., New Jersey. £ 1 1 Mr. N. J., Missouri. Miss E. K., Philadelphia. £ 1 1 1 1 1 Mrs. A. D., Do. 5 1 1 Mr. J. S., Do, 25 1 i Carried forward, 1186 98 67 19 4 22 36 7 20 ( 14 ) *3 re jj o o H H r/j o o W 13 o o 3- V> of?' re 3 "S. re" re "1 ff.§ 3 re O E? re ■a! sr 1 Names. Residences. 3 W 4 " re p. » 4 ft ? 0.0 a> 3 re m C a sS re' » o i i n B CM re re S» V c re SB ■-1 re i re o 3 o < re p. o < re p. re p. O *• 3 "J E re !*> 1 1 a Brought forward, 1186 98 67 19 4 22 36 7 20 Mr. D. H., Boston. 20 Mr. B. E., Philadelphia. 25 1 1 Mr. J. F. R., New Jersey. 7 1 1 1 1 Mrs. C. M., Philadelphia. 35 1 1 Mrs. M. C, Jamaica. 6 Mr. W., Philadelphia. 1 1 1 Mrs. E. I., Baltimore. 8 Mr. J. R. S., New York. 10 Mr. W. F., Philadelphia. 15 1 1 Judge J. J., Do. 50 1 1 Mr. F. A. S., Do. 6mos. 1 1 Mr. H. C, Do. 5mos. 1 1 Master C.E. Jr., Do. 4mos. 1 1 Mr. W. H„ New York. 17 1 1 Mrs. D.. Philadelphia. 12 Mr. C. L., Baltimore. 8 1 1 1 1 Mr. W. S. D., New Jersey. 20 1 Mrs. E. L., Philadelphia. 16 Miss D., Do. 13 1 Mr. J. A., Do. 5 1 Mrs. J. F., Do. 3 1 1 1 Mr. S. H., Do. acute. 1 1 1 Dr. F., Do. 1 1 1 Mr. H. L., Do. 1 1 1 1 Mr. F. T., France. 10 1 1 1 Mr. G.P., Boston. 23 Mr. J. H., Philadelphia. acute. 1 1 1 1 1 Mr. B. T., New Jersey. 5 Miss L. K., Do. 7 Mr. L. G. C, Delaware. 25 1 1 1 1 1 Mrs. E. B., Baltimore. 35 1 32 Carried forward, 1563 129 85 24 5 24J48 12 ( 15 ) Statement of the Cases yet under treatment. Names. Residences. re S "0 s R 6 re' 3 B % * o u O Z >-i 88 pi i o o B -d o 3 re e--a s» eg ft a re £ 3 ft 8 32 1 Brou Mr. J. P. E., Mrs E. L., ght forward, Philadelphia. Connecticut. 1563 5 20 129 85 24 5 24 Miss M. A. D., Hartford. 11 Mrs. E. P., Do. 30 Miss E. W., Mr. H. M., Philadelphia. Do. 2 17 Miss J. R. W., Miss S. A., Mrs. S., Northampton. Philadelphia. Do. 35 15 2 1 Mr. E. D. R., Do. 16 Mrs. M. A. B., Do. 16 Mr. A. B. A., Buffalo. 24 1 Miss P., New York. 18 1 Miss H. W., Miss A. M. H., Philadelphia. Do. 7 2 Mr. J. P., West Chester. 15 Miss W., Miss B., Philadelphia. Do. 10 3 Carried forward, 248 ie 16 2 16 2 Statement of the Deaf and Dumb Cases. « re o o H H re as 0 O o w O *3 3 re" 3 t 3" o Sre ■&! •5* re SB "5" 3 re" H T3 a? R Names. Residences. 3-re SB o 01 i-i m re o, a. 8 re«B-&o ' 4 re re re £.3 • o o 3 3 13 O <) re p. 3 ►d i o re a. re a 3 1 re p. i 3 o 3 3 re ft 3 «? re & re p. Brou ght forward, Mr. A. G., Pennsylvania. 6 1 Mr. A. N., Philadelphia. 27 1 1 Miss H. L., Northampton. 9 1 Mr. H. W. C, Philadelphia. 25 1 1 1 Mr. J. M., New York. 6 1 1 Miss M. E., Reading, Pa. 8 Mr. J. C, Philadelphia. 21 1 1 1 Mr. A. G., Do. 4 1 1 1 4 106 •8 7 4 4 3 Total amount of cases,| 19171 155| 1101 28|ll|40|51|12l 38 ( 16 ) S I'M MARY OF THE GENERAL DETAILED TABULAR REPORT. The whole number of Deaf persons that have consulted Dr. Togno, is - - - - " " 155 The number treated, - - - - 110? 139 | Those yet under treatment, - - - 205 S- 155 Those who have only consulted Dr. T., - - - 25 J Of the whole number treated, - 130 Completely cured, ... 51^1 Greatly improved, - - - 40 I Greatly improved, but who discontinued be- >130 fore the treatment was completed, - 28 Those who were only slightly improved, 11_ The whole amount of years these patients have been deaf is 1917, making an average of 12 years of usefulness of the life of 155 per- sons, of which society has been deprived. The proportion of poor patients treated gratis at this Infirmary, 38. The number of letters received from deaf persons and answered, 70. OBSERVATIONS ON THE RESULTS OF THE TABLES. Mr. J. P. E., reported only greatly improved, is now already entirely cured. Miss M. P. who was under treatment at the time the statement was drawn up, is now dismissed cured. Miss E. W. is now nearly cured, although reported only greatly im- proved at the time the report was made. Mr. E. D. R. is also nearly cured, although reported only greatly im- proved. It will be seen that of the seven mutes submitted to our treatment, four discontinued before it was completed, and that the remaining three were restored to hearing, and were made to utter words and phrases. Even under the present unfavourable trial we have had, the result ob- tained was, that nearly one half were restored. Thus on the supposi- tion, that one half can be made to hear and speak, and as there are, at least, six thousand deaf and dumb individuals in the United States, therefore three thousand might be restored to society with their full com- pliment of faculties. What we wish to see, for the sake of humanity, is, that these three thousand individuals should not be hereafter con- demned by blind ignorance to eternal deafness. After all that the zeal, talent, and exertions of the medical profession can do to restore this class of individuals to society, there will yet re- main a sufficient number of unfortunate mutes to exercise many Abbe de Leptes and Abbe Sicards, with the largest lump of benevolence and philanthropy. ( 17 ) The case of Mrs. Macartney is curious, inasmuch as it is the one that has presented the most complete state of deafness. When she came under our medical charge she could not hear her own voice, nor could she hear any sound, however loud and near it might be to her ; still, even in her case, we obtained so great an improvement as to enable her to hear her own voice distinctly, and that of any other person across the room, although she could not as yet distinguish the articula- tions or words. Had she not neglected her case, she would now be, in all probability, completely restored. The case of Judge J. J. who was fifty years deaf in the left ear, and ultimately became very hard of hearing in the right, is also a very cu- rious case that encourages the hope of success even in very long standing cases of the " diseases of the internal ear." This gentleman is now one of our Judges, whose hearing is as acute as any one in the land. The case of Miss E. B., yet under treatment, was by far the most aggravated case we have treated; for when she came under our medical care she was both deaf and blind in both her eyes. She can now hear very well any conversation across the room, and she sees with her left eye to read the smallest print. We entertain some hope for the re- covery of the right eye also. We remarked in a former publication, and it cannot be too often repeated, that " It is cruel and inhuman to condemn an individual to re- main forever deaf and dumb, before some attempts be first made to cure, or at least to improve him. We ought not to deem a patient incurable, and subject him to all the consequences of such deadly decisions, before being submitted to a rational mode of treatment. It is erroneous to suppose that every congenital deafness proceeds from malformation of the organ, or from a complete paralysis of the auditory nerves, and, in so doing, pronounce the deafness as incurable, and every attempt to re- store it as fallacious and nugatory." The mutes have only a miserable half existence until they are re- stored to hearing and speech. For, it is more especially to speech that we owe our sociability, and which emphatically distinguishes man from every other animal; and places him on the first and highest degree of intel- ligence. To him alone was this god-like gift bestowed. It is the ma- gical bond of Nations; the intellectual chain that binds man to man. The individuals who speak the same language have also an invisible link that unites them to each other, in one general community of in- terest. In a word, language is all-powerful, it is man in his moral ca- pacity ; it is his moral self, his very thoughts made palpable to the world. " Speak," said Plato, " that I may know you." The region of sounds feeds our souls, that of light our bodies. The only manner by which poets can impart an idea of the infinite beatitude of happy beings in another and better world, is by making them sound the praises of God in the harmony of their joy and in the gladness of their 3 ( 18 ) choral songs ; while the state of the wicked are more sensibly and for- cibly depicted by the harsh confusion of unmeaning sounds, so terribly described dy Dante, that even the magical pencil of a Buonarotti could not approach it in effect: " Here sighs, with lamentations and loud moans, Resounded through the air pierc'd by no star, That e'en I wept at entering. Various tongues, Horrible languages, the outcries of woe, Accents of anger, voices deep and hoarse, With hands together smote, that swell'd the sound, Made up a tumult, that forever whirls Round through that air with solid darkness stain'd, Like to the sand that in the whirlwind flies." The deaf and dumb person not only loses the sound of every object which surrounds him, but he also loses the use of another faculty, that of the exercise of the vocal organ, which is intimately connected with the free function of our intellectual faculties. He not only loses the emotion felt by a fellow being, and made manifest by the passionate sound ut- tered, but he cannot, like ourselves, sympathise and re-echo in his bo- som the sentiments of the speaker. The same idea or sentiment is made to pass from the speaker to every hearer with the rapidity of elec- tricity, and thrill instantaneously a thousand hearts in one moment. There is no doubt in our mind that the exercise of oral language has an intimate connection with, and influence on the operations of the mind ; but the idea that such a result can be expected or is observed in the unnatural efforts, or labial alphabet of the mute persons, as taught in some German deaf and dumb schools, can only be entertained by those who never reflected on the subject. Letters and words to us are representatives of things, of sounds that have life in us, and that come from us with all the fire of a creation, ac- companied with certain physical efforts in the vocal organ necessary to produce them, and with which we unconsciously associate the meaning of the sounds uttered, while a very extensive nervous system is called into play to produce them, causing at the same time emotions and sensations of which the mutes are totally ignorant; and, therefore, cannot/ee/ with us, and be in perfect harmony with our feelings. The mere motions of the vocal organ, and efforts made in producing horrible unmeaning sounds, as are screeched out by some mutes, cannot be considered speaking, nor can it create in them any of those enchanting feelings in harmony with our own. Therefore, we only see a senseless, unfeeling automaton in the deaf and dumb person that is made to screech out cries void of meaning, and sounds more resembling those of a wild beast, than those produced by the human voice. It is, however, very different with respect to those who have been restored to hearing. If they hear the human voice, they can imitate it, and if they hear sufficiently their own voice, they are able to modulate ( 19 ) it; in this case only are these unfortunate individuals capable of being taught oral language. To the philanthropic exertions, generous devotedness, and noble example of l'Abbe de L'Epee, do we owe the present benevolent insti- tutions for the instruction of the unfortunate mutes, who were, before his time, pretty much abandoned to themselves, like wild beasts. We have been taught to consider these institutions as a blessing for the mass of mutes; but in the present improved state of the medical science, we are forced to regard them, as they are now constituted, cal- culated to do as much harm as good to the very individuals for whose benefit they were first founded. No one will deny that the discovery of the mariner's compass was a useful discovery, by enabling us to bring from abroad, at great cost and peril, it is true, the very substances that science, and especially che- mistry, have since pointed out to exist at home. No one, however, will question the positive value and importance of the mariner's com- pass, in the hands of navigators; but at the same time, no sensible and candid man will refuse to grant that the discoveries of chemistry, by which we are enabled to procure at home, valuable substitutes, are not an inestimable blessing. So say we with respect to the education of mutes, but we say also, that their restoration to hearing is by far the more preferable state of things, and devoutly to be wished. We hope, erelong, that in every State, wherever there is a school for the education of mutes, there will be also attached to those institutions an infirmary, in which these unfortunate beings will have a fair trial for the recovery of their hearing, before being definitely condemned to eter- nal deafness, and placed in the asylum for instruction. When restored, they ought to be retained in the infirmary for oral instruction, and when their vocal organs shall have been developed, then sent home; when, however, they are so unfortunate as not to be restored, then, and only then, they should be transferred to the deaf and dumb department, to be instructed in the language of gesticulatory signs, the best substi- tute for oral languages. If the different States can appropriate large sums, to educate as mutes six thousand individuals, one-half of which, we firmly believe, may be restored to hearing, and be made to speak, why should not the respec- tive Legislatures of these States, spend the same proportion of money to have them cured of their infirmity, to have the satisfaction of return- ing them to society speaking human beings, in perfect sympathy and re- lation with the human family ? Until some such plan of reform, as we have suggested, shall be adopted in every school for mutes, we shall not cease to plead warmly the cause of these unfortunate beings, one- half of whom could be restored to hearing and to society, if taken in time, and who, now, under the plea of philanthropy, are shut up in an asylum, to be there taught how to become complete mutes. Should the ( 20 ) Legislatures turn a deaf ear to our suggestions, we shall then make an appeal to mothers, whose affection for their offspring, is never ad. dressed in vain, and to beg them not to permit their children to be placed in these institutions for mutes, unless they have first made the utmost efforts to having them restored to hearing and speech. The superiority of speech over mere signs is incalculably great. The former is caused by an infinitely delicate organ that can produce an im- mense variety of sounds, while the latter, or signs, or gesticulations, only brings into play the grosser organs of locomotion. There is the same difference between them as between a well educated and fine gen- tleman and a North American Aboriginal. The use of speech requires neither light nor tools, we speak in the dark; but the deaf and dumb persons cannot communicate their ideas in the same situation unless they touch each other. Light is the dearest of the four elements to the mute person ; without it he has a Wretched physical existence. We can dispense with light, to a certain extent; its absence is unimportant in many instances ; because we can discriminate what occurs about us by the perception of the various sounds that are produced and made sensible by hearing, conveying to our minds as precise an idea, as if we did see the things themselves actually transacted before us. The celebrated Lecat, in his treatise on the senses, says : "There are more things to be seen in the world than to be heard ; but in matters of knowledge, few are the truths that are seen, almost all are heard." We think with the help of sounds; the mute person conceives by the help of forms, dimensions, distances, and colours; therefore, in darkness, the mute person is a senseless statue. In this moves, and has existence, his world of ideas ; hence the deaf and dumb is an excellent observer of physiognomies, and succeeds very well in the graphic art. Beckedorff, in his observations on the superiority of speech over signs, remarks that: " To hearing alone belongs the power of placing man in relation with the superior and eternal world ; by the other senses, he depends entirely upon the tangible and destructible or perishable world. Speech creates things, and truly lives." This is particularly true in the words of an Improvisatore or an orator, when indeed words are things that have life, and move about and around us, so lively are the colours, and so true are the created forms of the inspired imagina- tion of the poet and of the orator. He farther remarks: "God has spoken to man, and his words stand forever the rule of his duties, and the spring of his knowledge. As light reveals to the eye the visible universe, so speech reveals to the soul the invisible universe." Speech has even attended the creation of the world; for, " God said, and all things were created." We have lately read a letter of a lady who happens to be afflicted with deafness. We allude to Miss H. Martineau's letter to the Deaf. Wre sincerely believe that its contents are calculated to do much mis- chief to her "fraternity," contrary to her expectations; we, therefore, ( 21 ) think it incumbent on us to point out in these pages, at least some of its many erroneous positions. Had Miss Martineau been a person whose writings had no influence in society, we should have passed it unno- ticed; but, as her wide and weighty influence on public opinion, with respect to matters in which she is justly celebrated, has imparted to her dicta an imaginary authority, even in a science to which she is a per- fect stranger. We, therefore, think it necessary to try to avert in this place, its mischievous tendency, knowing that her epistle has had an in- jurious effect on some individuals. Her advice on this subject, is value- less; it belongs to the medical science, and she cannot speak on it au- thoritatively. Whenever we shall display our ignorance, by writing on Political Economy, we hope Miss M. will deal with us with equal can- dour, and freely indicate our errors. Addressing ourselves to Miss Martineau, we should remark :—" You announce, Madam, that you address your letter merely to the Deaf, and to those only ' who are deeply concerned;' although not deaf, I am 'deeply concerned,' that it should not pass without comment. I regret to be obliged to differ with you in opinion, and to show that the utility of many of your opinions, that could be apprehended by me, is highly questionable. As I do wish to be considered one of those * phy- sicians humane enough to tell the truth,' you will not find fault with me now, for telling it to you, by plainly saying that you have com- pletely missed your benevolent aim, and that you have done much harm to your afflicted fellow-sufferers. This I shall now prove, as briefly and as pointedly as your long and diffuse letter will allow. " That the physician will tell the truth whenever it maybe necessary for the recovery of his patient, there is no doubt; still, no sooner have you made this unqualified and unjustifiable charge against the medical profession, than in the next few lines, you attack your Doctor for not deceiving you. " You say, ' every body has a vast deal of advice to give, if the sub- ject be barely mentioned.' This is undoubtedly true ; but you know- ing, and then criticising this amiable, although injurious foible of man- kind, why did not your experience dictate to you more wisdom, and why did you not avoid their example ? For, be it said, with all respect due to you, your opinion on this subject is just as misplaced as theirs. You add, ' we must cross-question our physicians;'—why? Is it for the laudable purpose of exposing their ignorance, or of displaying yours to the world, by writing a letter on it? " You are wrong when you even touch on the subject of music. Time and pitch are two distinct things:—time is referable to movement or feel- ing; pitch to the simple elevation or descent in the scale of sounds, and of which the ear alone can determine its correctness. It would be like the blind judging of colours, for the deaf to decide on the true pitch of sounds. You would have persons who are affected with deafness, to ( 22 ) dismiss oratory and vocal music. Your advice is erroneous, both on physiological principles, and proved so by my daily experience. " The philosophical and christian resignation you would inculcate upon the deaf, may do for the old, but certainly must be considered as a lamen- table advice, when unresistingly adopted by the young, who would have before them a long life of privations. You, moreover, labour through many mystifying paragraphs, to prove to the deaf, that the best thing they can do, is to remain deaf, and make use of an ear-trumpet; because you, yourself, derive some advantage from both. You are pleased to confess a consciousness of an ' intellectual perversion, which I can never'—you say,—' remedy in this world, and of which neither I nor any one else can ascertain the extent, nor even the nature.' But I know very many deaf persons, with a perfectly clear mind, in whom there is not the least ' intellectual perversion,' of which you complain; therefore your levelling principles are absurd, and a libel on your fra- ternity, nor have they all the same degree of deafness, enabling them to make use, to advantage, of an ear-trumpet. " You erroneously ascribe to your deafness, the great advantage you think you have, in common with the deaf, ' over others, in the power of abstract reasoning,' as if it were necessary to be deaf to reason on ab- stract subjects, and as if ' abstract reasoning' were the peculiar domain of the deaf. The ' opportunity for meditation' is, there is no doubt, ' one of the chief means of wisdom,' but we may reasonably doubt whether deafness is the best road to it. The deaf, therefore, to enforce your argument, had better put out their eyes, also, to augment their power and ' opportunities for meditation.' The deaf can do no less, when your experience and high authority leads to it." We beg Miss M. to consider whether it would have been better for the individuals relieved by us, to have remained deaf, in order to have, 'over others,' a greater 'power of abstract reasoning,' and a greater • opportunity for meditation?' We may inform Miss M., that the in- dividuals who consulted us, had that opportunity, in the aggregate, for the space of one thousand nine hundred and seventeen years, and that tired of ' meditations,' they very naturally showed the desire, contrary to her advice, to meditate no longer on their infirmity, leaving Miss M. fully at liberty to follow her own precepts, and to meditate for all man- kind. V NLM041407122