18th Century & 19th Century

History of Otolaryngology Medicine & Surgery

Antonio Scarpa (1747-1832) discovered the membranous labyrinth. He described the hearing anatomy of fishes, birds, reptiles, and man. He showed that the membranous labyrinth was basically a replica of the bony labyrinth within the cochlea and semicircular canals. Scarpa described the saccule and utricle, and distinguished the fluid contents of the bony and membranous labyrinth as perilymph and endolymph. Scarpa was an excellent artist so his illustrations with his writings were very detailed and accurate. 

Quelmaltz in 1750 published a treatise on the deviations of the nasal septum. The causes of the obstruction he considered to be pressure upon the nose in difficult labor, falls in infancy, continually pushing the finger into the nose in childhood, and inflammatory conditions.

Jonathan Wathen, in 1755, described the method of passing the Eustachian catheter by way of the nose through to the Eustachian tube.

A. Ferrein, in 1742, was the first to apply the name "vocal cords" to the lips of the glottis and saw them as the main instrument for the modification of the voice. 

Haller, in 1761, wrote about the role the nose and throat played in voice production. He suggested the nasal sinuses made the voice more resonant .

Benjamin Guy Babington (1794-1865) invented a laryngoscope that he used on many patients. He used a hand-mirror to reflect the light.

Philip Syng Physick (1768-1837) of Philadelphia in 1828 modified an instrument designed by Benjamin Bell as a uvulotomy and used it as a tonsillectomy. It is the predecessor of all tonsil guillotines. Physick's tonsillectomy had two plates, with a knife sliding between them. Physick's method was modified by William B. Fahnestock who introduced a guillotine with a prong or fork to catch the tonsil. This became known in France as Mathieu's guillotine and was used into the early 1900's.

M.J. P. Flourens (1794-1867), of Paris, was the first to suggest that the acoustic nerve consisted of two parts, a cochlear part that influenced hearing, and a vestibular part that influenced the equilibrium.

Prosper Meniere (1799-1862) original observation showed that vertigo could be due to a disorder with the internal ear. This disease bears his name. Prior to Meniere, vertigo was looked upon as an intracranial disorder only.

France was the first country to take otology from surgery and give it a place of its own. One of the first to specialize in this branch was Jean Marie Gaspard Itard (1774-1838). He wrote a textbook in 1821 that placed otology as a separate scientific discipline. Itard's book, the result of 20 years of observation and experience, provided a clear and accurate testimony of the known facts about deafness.

The first tuning-fork test for hearing was that of E.H. Weber, of Leipzig along with the assistance of his physicist brother, Wilhelm. The exact description of the test known by Weber’s name was published in 1834. It is acknowledged that in 1546 Ingrassia was the first to be aware that a vibrating tuning-fork could be heard when pressed against the teeth.