History of Myringotomy and Grommets: A Perpetuation of Inaccuracies?

Abstract

This letter discuss the inaccuracies contained in the recent paper about history of myringotomy and grommets

I read the article “The History of Myringotomy and Grommets” with great interest. ¹ It was the philosopher, Friedrich Nietzsche who said that we are all doomed to perpetuate the lies and myths of history. Are we also condemned to perpetuate the inaccuracies that we have already read about in the history of otolaryngology? Surely the value of discussion and thrashing out these myths should lead to their correction and/or expulsion. Clearly, this has not been the case here, since we addressed these very issues as long ago as 2008. ²

It is outside the ambit of this letter to discuss all the inaccuracies in this paper; suffice it then to mention but a few. The statement “This condition was first described by Hippocrates and Aristotle…could be relieved by incising the eardrum” is quite wrong. This case referred to in On joints of the Hippocratic Corpus, ³ misquoted at least 4 times, relates to “ganglionic tumours which are flabby and have mucoid flesh” which many opened “thinking to have a flux of humours in such parts.” This could not (even with the greatest flight of imagination) be taken as a paracentesis of the eardrum.

The proposition that “The first formal myringotomy” was performed in 1649 by Jean Riolan the Younger is also a total travesty; neither did he hypothesize “that artificial perforations of the tympanic membrane might be a cure for congenital deafness.” The case described by Riolan was not an intentional myringotomy at all but in fact a case “of pushing an ear pick too deep into the ear” and accidentally lacerating the eardrum and ossicles. As a result, the hearing improved. Riolan described it as an unexpectedly happy outcome in a case of “natural deafness.” ⁴ A historian might more reasonably consider Riolan as the first man to suspect mobilization of the ossicles than as the first myringotomist.

One seriously wonders if the authors have actually seen and studied the original texts which they cite as (primary) references.

To continue: Eli is described as a “strolling quack.” This is a secondary reference taken straight from Black. ⁵ Where is the primary historical evidence for this unfair assertion? If one actually reads Haller’s original text, ⁶ Eli is nowhere represented as a quack. Indeed, far from it! Deleau describes him as a “master in surgery” who “died young in Paris.” ⁷

Politzer was not the first to use suction to remove fluid from the middle ear; it was probably James Hinton, ⁸ and when Politzer eventually did describe his “vulcanite eyelet,” it was in 1868 and not in 1860. ⁹ But let us leave the arguments for the importance of studying primary sources there.

The authors note that this article was first published in 2007 in The Journal of Laryngology and Otology with minor amendments. ¹⁰ Why then did they not take the opportunity (and trouble) to completely review the text, check the primary references, and correct all the inaccuracies? I am certainly not opposed to the idea of revisiting scholarly reviews. As Nietzsche also said, we must continually strive to revalue our values. Indeed it is the duty of a historian to clear out all the old inaccuracies.