19 17] on The Organs of Hearing in Relation to War 97 



He found that in the absence of direct injury labyrinthine con- 

 cussion was rarely followed by lasting deafness, and that deafness 

 from concussion was much more frequent in those who had 

 pre-existing ear-disease than in those whose ears were previously 

 normal. 



The results of treatment were in proportion. Of those vrith 

 previous disease 50 per cent were able to return to full duty, while of 

 those with previously healthy ears all but 5 per cent recovered in 

 whom the drum was not ruptured, while all recovered in whom the 

 drum had given way. Early and appropriate treatment is obviously 

 of the greatest importance both from the physical and the moral 

 points of view. 



The prevention of war -deafness is a question associated with that 

 of ear-protectors. These were dispensed with as a rule, or after use 

 were usually discontinued. A number of officers have, however, 

 borne testimony to the effectiveness of the Mallock-Armstrong 

 protector in deadening the effect of explosions, while permitting of 

 the hearing of orders. Lake, Jenkins, and others have devised 

 ingenious plugs for the ears, and of course cotton-wool and plasticine 

 have also found favour. The objection to many of these is the risk 

 of their being driven in. Cases have occurred in which a plug of 

 ear-wax in the ear has appeared to have protected the internal ear 

 from damage by explosion, although of course the driving in of the 

 plug of wax has caused temporary complete deafness, hearing being 

 restored on removal of the wax. Habituation to the noise was 

 usually established after a time, the subjects apparently acquiring a 

 power of discrimination and of attending to or disregarding noises. 

 An officer stated that during the continual rumbling din of a bom- 

 bardment the report of a heavy gun close at hand was scarcely 

 observed, while away from such bombardment the firing of a single 

 small gun was startling enough to make the hearer jump. [The 

 lecturer demonstrated this by having a rumbling roll on two kettle- 

 drums played crescendo. Loud bangs on a big drum given at 

 irregular intervals were scarcely perceived as anything more than a 

 dull thud. When the kettledrums were silenced the bangs on the 

 big drum were almost ear-splitting.] 



The after-condition of the deaf soldier depended on the degree of 

 his deafness. If moderate it might not prevent the continuance of 

 occupation in many trades or businesses, though in others it might be 

 absolutely prohibitive. In very many it was a more serious handicap, 

 such as thebusinessof barristers, salesmen, canvassers, booking-clerks, 

 and in general any business caUing for rapid oral communication or 

 comprehension of orders or instructions. 



A deaf writer has expressed the opinion that the dull of hearing 

 are apt to forget the amount of trouble their affliction causes to other 

 people. Hence employers are chary of employing them, not so much 

 on account of their deafness as of the favours and privileges they 



YoL. XXII. (Xo. Ill) H 



