Preface About the cover

100 Pages·2017·7.15 MB·English

Preface
This supplement commemorates the sesquicentennial of The goal of the present compendium is to extend
the American Otological Society (AOS), the second oldest earlier AOS histories by considering a wide spectrum of
medical society in America. Eminent historian Arnold J. contemporary sources beyond the Transactions. This more
Toynbee, grandson of 19th century London otologist Joseph comprehensive perspective helps to put the emergence of
Toynbee who is widely credited as the father of scientific otology as a specialty into the context of medical knowledge
otology, famously said that “Some historians hold that history at the time in relation to the roots of modern surgery with
is just one damned thing after another.” Our goal in assembling seminal advancements such as the introduction of antisepsis
this monograph is to illuminate more than merely the dates and anesthesia. The foundation of the AOS was influenced
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Foreword
“The only thing new in the world is the history you do not es as well as synopses are available to interested readers. The
know”, Harry S. Truman, 35th President of the United States. primary source – the Transactions of the American Otologi-
From the vantage point of the present, President Truman’s cal Society date back to the society’s fi rst scientifi c session
oft quoted adage rings true. We must know our past to bet- held during the second annual meeting on July 21, 1869 at the
ter understand where we are now. The past of the American Atlantic House in Newport, Rhode Island (Figures 1, 2). The
Otological Society’s (AOS) is long and noteworthy with a AOS Transactions, which summarized the proceedings of the
lengthy list of contributions over the last century and a half most recent annual meeting, are available for nearly all of
which shaped otologic practice around the world. As the history of the AOS.1
America’s second oldest medical society, founded in 1868, The Transactions of the American Otological Society be-
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from
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1tQ microscope or even an audiometer. Our predecessors were of the AOS in the mid-1990s, there was no longer a need for
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FIG. 1. The organizational meeting of the American Otological Society was held on Wednesday, July 22, 1868, at the Ocean House (opened 1868) Newport,
Rhode Island.
Copyright © 2018 Otology & Neurotology, Inc. Una3uthorized reproduction of this article is prohibited.
FIG. 2. The fi rst scientifi c meeting of the American Otological Society (July 21, 1869 ) was held at the Atlantic House (opened 1867) in Newport, Rhode Island.
formation, in 2007 the Council decided to cease publication tion is given to the people, events, practices, and ideas of the
of the Transactions. The thousands of scholarly manuscripts society’s formative years and to the gradually increasing role
which appeared in the Transactions include many the seminal of women in the AOS. Taken together, this group of nine
works in otology and represent a time capsule of the state- historical papers gives us an enhanced perspective on the role
of-the-art during the later half of the 19th and throughout the the AOS played in the evolution of the specialty. To make
20th centuries. this supplement accessible to the broad community of otolo-
Historical publications have been produced at two impor- gists and historians of medicine the Society plans to make this
tant AOS anniversaries – the 100th and the 125th. The 100th, publication accessible via PUBMED and also freely available
edited by the renowned otologist Edmund Prince Fowler, was on the AOS website.
published in 1968, and the 125th was edited by Wesley H. As part of our longstanding traditions, the membership
Bradley and published in 1993. Both contain concise sum- of the AOS takes pride in our Society’s illustrious history.
maries, most often several paragraphs long, of the most sa- Those serving now, and in future generations, owe a debt of
lient points from each annual AOS Transaction distilled from gratitude to the authors and editors of this compendium for
more than a hundred pages of meeting minutes and scientifi c enriching our understanding of how our Society helped to
papers. The 125th publication reprinted the 100th and added shape modern otological practice. While the contributors to
material from the most recent 25 years. These monographs this supplement have examined our collective past, the real
nicely summarized the foremost achievements of their re- excitement lies ahead. The AOS is a robust, fi nancially stable,
spective eras. productive, and growing organization. While our future has
There are several goals for this sesquicentennial supple- yet to be written, the AOS is well positioned for what lies
ment. Respecting prior tradition, one of the papers provides ahead. As so well-articulated by another US President, Thom-
a summary of scientifi c advances in otology over our most as Jefferson in a letter to one his predecessors, John Adams on
recent quarter century while another conveys the perspective August 1, 1816, ” I like the dreams of the future better than
of recent past AOS Presidents. The other seven contributions the history of the past”.
seek to expand our knowledge of AOS history by encompass- So do I.
ing a broader context than the earlier volumes. These uti-
lize contemporaneous literature including books and journal Samuel H. Selesnick MD FACS
articles published by AOS members, biographical material, President of the American Otological Society
other documents which enhance our understanding of the at the 150th Annual Meeting.
evolution of American otology over the last 150 years. The
scope is intentionally broad covering the role of the AOS in Reference
the evolution of otological research and education as well as 1. Transactions of the America Otological Society 1868–2006:
chronicling its varied scholarly publications. Special atten- http://www.americanotologicalsociety.org/transactions
4
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Otology&Neurotology
39:S1–S9(cid:2)2018,Otology&Neurotology,Inc.
The American Otological Society at its Sesquicentennial:
Insights Into the Society’s Formative Years
Robert K. Jackler, Jennifer C. Alyono, and Albert C. Mudry
Department ofOtolaryngology–Head&Neck Surgery, StanfordUniversity Schoolof Medicine,Stanford, California
Objective:To elucidate the sequence of events which led to 30 years old New York physician Daniel Bennett St John
the formation of the American Otological Society (AOS) in Roosa, recently returned from a grand tour of the leading
1868 and to examine the lives and contributions of the nine European otological centers, was the principal advocate for
foundingmembers of theSociety. thecreation oftheAOS.
Methods:Study of primary historical documents, biographi- Conclusions: The 1860s were a pivotal period in the
cal material,and previous historiesof theAOS. maturation of American Otology. Previously, most ‘‘aurists’’
Results: Earlier treatments of the history of the AOS were widely considered to be charlatans who practiced
minimally covered the events and personalities from the unscientifically and often unscrupulously. The AOS founder
Society’s formative period. The founders of the AOS were generation were a group of Ophthalmologists who strove to
much influenced by recent advances in European Otology elevate otology from being a lesser appendage of the mother
and the success of the nascent American Ophthalmological field to becoming a respected and scientifically based
Society which had been founded in 1864. The AOS has long medical specialty in its own right. Key Words: American
credited Elkanah Williams as its first president of the AOS, Otological Society—History—Sesquicentennial.
although he never actually served in this role and was not a
contributor to otological literature. Documents suggest that OtolNeurotol 39:S1–S9,2018.
Bythe1860s,ophthalmologyhadbeenwellestablished Duringthe1850sand1860sanawakeningofinterestin
asaspecialtybothinEuropeandAmerica.Thespecialty’s eardiseasesroseamongagroupofEuropeanphysicians
maturation was catalyzed by technical advances, most whobecameinterestedinmedicineandsurgeryoftheear.
notablybytheinventionoftheophthalmoscopebyHelm- These pioneers of scientific otology included German
holtz in 1851 (1). By contrast, the majority of ‘‘aurists’’ (Schwartze, Kramer, von Tro¨ltsch), Austrian (Politzer),
practiced unscientifically and had little in the way of British (Toynbee), and Irish (Wilde) who emphasized
effective therapeutics to offer. They were widely viewed otology in their practices and who authored textbooks
amongthemedicalprofessionasquacks.Ophthalmologists in the field during the 1850s to 1870s. In 1863, the first
focusedprincipallyoneyediseasesandviewedotologyasa medical journal dedicated to otology, Archiv fu¨r Ohren-
sidelineatmost.Amongtheprofession,otologywaswidely heilkunde,wasfoundedandbeganpublicationin1864(3).
perceived as a poor step child of ophthalmology. The Theformativeperiod oftheAmericaOphthalmologi-
preface of the first volume of the Transactions of the calSocietyin1864to1865iswelldocumented(4–7).By
AmericanOtologicalSocietyVolumeI(1868–1874)sum- contrast, the details of the American Otological Society
marizedthewoefulstateofthefieldofotologyatmid-19th (AOS)formationin1868to1869areminimallycovered
century:‘‘Untilwithinaveryfewyears,thescienceandart inthetwootherwiseexcellentmonographswhichchron-
of otology had been almost entirely neglected by the icleitshistory(8,9).WhilethemembersoftheAOSare
medical profession of the United States. In this respect, justlyproudathowwellourhistoryhasbeenpreserved,
however,wearenotmuchbehindmostotherpartsofthe much of this fascinating story of the Society’s birth
civilized world. In its very best position, otology was an remainsuntold.Thepurposeofthispaperistoelucidate
appendage,notalwaysverygracefullyworn,totheDepart- the sequence of events which led to the society’s foun-
mentofOphthalmology.’’(2) dationandtoexaminethelivesandotologicalcontribu-
tions of the nine founding members of the AOS.
AddresscorrespondenceandreprintrequeststoRobertK.Jackler,
METHODS
M.D., Otolaryngology–Head & Neck Surgery, Stanford University
School of Medicine, 801 Welch Road, Stanford, CA 94305; E-mail:
[email protected] The principal sources were primary historical documents
Theauthorsdisclosenoconflictsofinterest. including meeting minutes and scientific transactions of the
DOI:10.1097/MAO.0000000000001702 American Otological Society (1868–1911) and American
S1
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S2 R. K. JACKLER ET AL.
TABLE 1. Nine foundingmembersof theAmericanOtological Society(July 22,1868)
AgeatAOS Meeting
Founding Attendancea AOSPresident
ElkanahG.Williams(Chair) (1822–1888) Cincinnati 46 0/5 1868–1869b
HenryDruryNoyes (1832–1900)c NewYorkCity 36 4/5 1870–1873
D.B.St.JohnRoosa (1838–1908)c NewYorkCity 30 3/5 1875–1876
OrenDayPomeroy (1834–1902) NewYorkCity 34 3/5 1890
JohnGreen (1835–1913) StLouis 33 4/5
CharlesA.Robertson (1829–1880)c Albany 39 1/5
CorneliusReaAgnew (1830–1888)c NewYorkCity 38 2/5
FreemanJosiahBumstead (1826–1879)c NewYorkCity 42 0/5
CharlesEvertsRider (1839–1909) Rochester 29 2/5
aFirstfiveAOSscientificmeetings1869–1874.
bWilliamschairedtheorganizationalmeetingof1868,butdidnotattendmeetinginhispresidentialyearof1869(theSociety’s1stscientific
meeting).
cAlsoservedasfoundingmembersoftheAmericanOphthalmologySocietyin1864.
Note:TwoAOSfoundingmembersalsoPresidentoftheAmericanOphthalmologicalSociety:C.R.Agnew(1874–1878)andH.D.Noyes
(1879–1884).NoyeshasthedistinctionofhavingbeentheonlyindividualtoserveasPresidentofbothSocieties.
Ophthalmological Society (1864–1911). Biographical materi- membership list 1871 and 1872, perhaps from non-payment
als for the nine AOS founders were derived from their pub- of dues, only to reappear 1873 onward. During his career,
lications, comments by their contemporaries and later WilliamsdidnotcontributeanypublicationstotheAOSTrans-
historians,andobituariesinmedicaljournalsandnewspapers. actions.AsWilliamsdidnotappeartohaveanyspecialinterest
Earlierhistoricaltreatmentsreferringtotheformativeperiodof in the ear, the senior members of the Ophthalmology Society
both eye and ear societies were also consulted. The scholarly mayhaveaskedhimtoparticipateintheorganizationalmeeting
contributions of the nine AOS founding members to the oto- to monitor the young advocates for otology and represent the
logical literature were assessed by evaluating the number of interests of the parent Society. Freeman Josiah Bumstead,
publications in the AOS transactions over the initial 14 years theonly otherparticipant inthe1869formativemeeting over
(1868–1881) oftheof theSociety’smeetings. the age of 40, never attended an AOS scientific meeting and
resignedhismembershipin1870.BumsteadandWilliamsmay
The Emergence of the American Otological Society have been asked to oversee the proceedings on behalf of the
from the American Ophthalmological Society OphthalmologySocietytoinfluencesuchimportantformative
decisionsashavingtheAOSmeetinconcertwiththeOphthal-
WhentheAmericanOphthalmologicalSocietywasfoundedin
mologySocietyandtopublishtransactionsofthetwosocieties
the summer 1864 in New York it became the first American
together.
medical specialty society (4). At the Annual meeting of
the American Ophthalmology Society at the Ocean House in
Newport,RhodeIslandonTuesday,July21,1868,amotionwas BiographiesoftheNineFoundingMembersandtheir
made to add the term ‘‘Aural’’ to the society’s name (i.e., Contributions to Otology
American Ophthalmology and Aural Society). According ElkanahG.Williams(1822–1888):Williamswasbornin
to Newell, ‘‘There was extended debate but the motion Bedford,Indiana(10–13).HegraduatedfromAsburyCollege
finally failed.’’ (7) Interestingly, neither the motion nor the (nowDePauwUniversity)inIndianain1847andobtainedhis
substance of the discussion which followed was recorded in medicaldegreefromtheUniversityofLouisvillein1850.After
theminutesofthe1868meetingpublishedintheOphthalmology 2yearsingeneralpractice,WilliamsleftforEuropein1852for
Transactions.Havingbeenrebuffedbythemembership,agroup additional study in ophthalmology in Paris, London, Vienna,
ofninemembersstayedoninNewportanextraday(Wednesday Prague, and Berlin. He is credited with introducing Hermann
July22,1868)andheldanorganizationalmeetingduringwhich vonHelmholtz’sophthalmoscopeinLondonandwasanearly
it was decided to launch a separate society dedicated to the advocateforthedeviceintheUnitedStates(5).Hispaper‘‘The
ear—the American Otological Society. Those meeting were a Ophthalmoscope: The principles on which it is based—The
younggroup,evenfortheday,withoneinthe20s,sixinthe30s, manner of its application—And its practical advantages’’
andonlytwointheir40swiththeseniormemberatage46.Most helped to introduce the device in America (14). Williams
wereveteransoftheAmericanCivilWar(1861–1865)having wasdescribedbyDruryas‘‘Aboveaverageheight,withbroad
servedinthemedicalservicesoftheUnionArmy. shoulders, slightly stooped, his genial face and kind eyes
The Chair of this organizational session was the senior inspired confidence in his patients.’’ (11) He became famous
memberElkanahWilliamsofCincinnati.Duringtheproceed- in Ohio and surrounding states for expertise in care of eye
ings Williams was elected the first President of the AOS to diseases.In1856,hewasnamedthefirstProfessorofophthal-
serveduringthe1869inauguralscientificmeetingtobeheldthe mology in the United States at Miami Medical College in
next summer. Williams, however, did not attend the AOS Cincinnati. He was a member of the International Ophthal-
inaugural meeting, even though he was the nascent Society’s mologicCongressandelectedasitspresidingofficerin1876.
President.Healsodidnotattendthefirstfiveannualscientific He was also an honorary member of the United Kingdom
meetings (Table 1). Williams was listed as an AOS member Ophthalmology Society. Williams chaired the organizational
from 1868 to 1870, but was inexplicably dropped from the meetingoftheAOSin1868.AlthoughhewaselectedPresident
Otology&Neurotology,Vol.39,No.4S,2018
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FORMATION OF THE AMERICAN OTOLOGICAL SOCIETY S3
FIG.1. FoundersoftheAmericanOtologicalSociety.
fortheinauguralscientificmeetingin1869,heneitherattended for college, was dismissed due to ill health, and much later
duringhisPresidentialyearnormanysubsequentmeetingsof receivedanhonorarydegreefromYale.Hecompletedmedical
thenewSociety.Whilehepresentedatotalofninepapersatthe school at the University of the City of New York in 1860.
AmericanOphthalmologicalSocietyheneverpublishedinthe DuringtheCivilWarheservedintheNewYorkNationalGuard
AOStransactions.Inanunusualhonor,Williamswasnamedan andwasatthebattleofGettysburg(1863).Roosapracticedat
honorarymemberoftheAOSshortlybeforehisdeathin1888. theNewYorkEyeandEar(founded1820)andwasafounding
The minutes of the meeting explained: ‘‘The resignation of member of the Manhattan Eye and Ear Infirmary (1869). He
Dr.E.WilliamsofCincinnati,O.,onaccountofillhealth,was also served as a founding member of the American Ophthal-
presented by the Secretary. The resignation was accepted. mology Society in 1864. While he was very productive as a
Under suspension of the By-Laws, on motion of Dr. W. H. scholar in otology, he also published important works in
Carmalt, Dr. E. Williams was then unanimously elected to ophthalmology.Hehad11publicationsintheAOStransactions
Honorary Membership in the Society.’’ (15) As honorary overitsearlyyearscoveringadiverseseriesoftopicsincluding
membership in the AOS was customarily conveyed to distin- mastoid surgery, myringotomy, external otitis, use of tuning
guished non-members, such as Alexander Graham Bell, this forks, and the effects of quinine onthe ear. Moreon Roosa’s
most special honor may have been awarded in recognition in leadershiproleintheformationoftheAOSisdescribedinthe
William’s chairing the Society’s organizational meeting two nextsection.
decades before.(see Table 1, Fig.1). Charles Archibald Robertson (1829–1880): Robertson
Oren Day Pomeroy (1834–1902): Pomeroy was born in was born in Mobile, Alabama (24–27). He graduated from
Somers,Connecticut(16–18).HeattendedBerkshireMedical Harvard University in 1850 and from Jefferson Medical
College and graduated from the College of Physicians and College in 1853. He studied diseases of the eye and ear at
Surgeons in New York in 1860. He served as Director of the thePerkinsInstitutionfortheBlind,MassachusettsCharitable
ManhattanEyeandEarHospital.HewasPresidentoftheNew Eye and Ear Infirmary, and Wills Hospital in Philadelphia.
York Ophthalmological Society in 1872 and President of the Robertson studied abroad in Dublin and Paris. His memorial
AmericanOtologicalSocietyin1890.Indicativeofhisprimary describeshimas‘‘amanofstrongsocialinstincts,and,conse-
interest inotology, in theearly years Pomeroyread a totalof quently,hadhostsofwarmfriends.’’(24)Hepracticedatthe
12 papers at the AOS and only five papers at the American St Peter’s and Albany Hospitals in Albany. He also served
OphthalmologicalSociety.Hispapersaddressedissuessuchas as a founding member of the American Ophthalmology
auricular abscesses, hemorrhagic otitis, paracentesis of the Society in1864and later itsPresident (1874–1878). Hepub-
tympanicmembrane,Politzerization,Eustachiantubecatheter- lishedanumberofpapersintheophthalmologicliterature,with
ization,tenotomyofthetensortympanimuscle,andearprob- topics ranging from glaucoma to reflex phenomena after eye
lems among the insane. Pomeroy is best known for his book, injury (27). He presented only one paper at the AOS, a case
TheDiagnosisandTreatmentofDiseasesoftheEar,whichwas report of malignant disease of the ear. He resigned from the
publishedintwoeditionsin1883and1886andwasusedasa AOSin1879.
guidebymanymedical schoolsatthetime(19). Cornelius Rea Agnew (1830–1888): Agnew was born in
Daniel Bennet (DB) St. John Roosa (1838–1908): Roosa NewYorkCity(28,29).HegraduatedfromColumbiaCollege
was born in Bethel, New York (20–23). He attended Yale in1849andfinishedhismedicaldegreein1852attheCollege
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S4 R. K. JACKLER ET AL.
of Physicians and Surgeons in New York. He completed Medical College. Noyes also served as a founding member
postgraduatestudyinDublin(underSirWilliamWilde),Lon- oftheAmericanOphthalmologySocietyin1864.Accordingto
don, and Paris before establishing practice in New York. A the official history of the Ophthalmological Society, Noyes
biographer commented that Agnew was: ‘‘A man of strong wasthe‘‘guidingspirit’’wholedtheformationofthesociety
markedandwhollynaturalexecutiveability’’andthat‘‘Hewas (7).Hismemorialintheophthalmologytransactionsdescribed
gentlydignifiedinamannerandeveninseriousconversation him as ‘‘a graceful and forcible speaker, and a brilliant
had a way of smiling softly. . .’’ (28) Agnew served as a teacher.’’ (37) Noyes was also President of the New York
foundingmemberoftheAmericanOphthalmologicalSocietyin OphthalmologicSociety.Hepresented47papersattheAmer-
1864 and later as President from 1873 to 1878. He was a icanOphthalmologicalSociety,themostprolificofanyfound-
foundingsurgeonforboththeBrooklynEyeandEarHospital ingmember,butonlyfiveattheAOS.Hishandfulofearpapers
andManhattanEyeandEarHospital.Hepresented13papersat coveredtopicssuchasEustachiantubecathetersandbougies,
the American Ophthalmological Society but only two at the facial paralysis, and Menie`re’s disease. Noyes was the Oph-
American Otological Society. His papers on ear disease thalmologicalSocietyrecordingsecretaryfromitsfoundingin
involvedatumoroftheauricleandtrephinationofthemastoid. 1864 until 1874. He served as AOS President from 1870 to
Hewasknownforhisdevelopmentsinstrabismussurgeryand 1873 and subsequently served as Ophthalmological Society
cantholysis(30).Hedemonstratedaninterestinpublichealth Presidentfrom1879to1884—thelongesttermofanyPresi-
throughouthiscareer,servingasSurgeonGeneraloftheState dent. Noyes has the distinction of being the only individual
of New York, as Secretary of the first New York Society for to serve as President of both eye and ear societies, a feat
Sanitary Reform, and as a member of the committee that unlikely ever to be repeated. He was well known for his
preparedthe firstdraftof thecityhealth laws. Treatise on Diseases of the Eye on which he based his later
Freeman Josiah Bumstead (1826–1879): Bumstead was TextbookonDiseasesoftheEye,whichwaspublishedintwo
born in Boston, Massachusetts (31,32). He graduated from editions(40,41).
Williams College in 1847 and from Harvard Medical School CharlesEvertsRider(1839–1909):RiderwasborninNew
in 1851. He studied venereal diseases abroad in London and Haven, Vermont (42). He attended Oberlin and Middlebury
ParisforseveralmonthsbeforereturningtoNewYorkCityfor Colleges,andcompletedhismedicaldegreeattheUniversityof
practice. Although he was a founding member of both the Vermontin1863beforeestablishingpracticeinRochester,New
American Ophthalmological and Otological Societies, he is York.RiderwasProfessorofophthalmologyatGenevaMedi-
bestknownforhiscontributionstourology.Heresignedfrom calSchool(NewYork)andlateratSyracuseUniversity.Hewas
theAmericanOtologicalSocietyin1870,only2yearsafterits notparticularlyacademichavingreadnopapersattheAOSand
foundingin1868,andneverpublishedintheAOStransactions. only one at the American Ophthalmological Society on the
He published important translations of French urologic text- subjectofthe‘‘TheWinkingTest.’’(43)Ofinterest,hewenton
books,includingM.A.Cullerier’sAtlasofVeneralDiseasesin to develop the world’s largest hardwood floor manufacturing
1868(33).Helaterpublishedhisowntextbook,ThePathology business and obtained a patent in parquetry, a wood inlay
andTreatmentofVenerealDiseaseswhichwasreleasedinfive technique.
editions(34).
John Green (1835–1913): Green was born in Worcester,
LEADING THE EFFORT TO CREATE THE
Massachusetts. He graduated from Harvard College in 1855,
andHarvardMedicalSchoolin1866(35,36).Followingtravel AMERICAN OTOLOGICAL SOCIETY
to Europe for postgraduate medical studies in London, Paris,
Berlin,Vienna,andUtrecht,hebeganpracticeinBostonbefore The AOS was founded upon the impetus of Daniel
settlinginSt.Louisin1866.AbiographerdescribedGreenas Bennet(DB)St.JohnRoosa(1838–1908)(Fig.2).Roosa
‘‘Bynaturegentle,refinedandretiring,possessingaclearand traveled for a year (1862–1863) to Europe to the great
logical mind, great learning and ability, an exceptionally cul- centersofEuropeanmedicine(ViennaandBerlin)during
tureddiction,andanabsolutehonestyofpurpose...’’(36)He which time he visited many of the leading otologists of
was professor of ophthalmology and otology at the St Louis his day. Roosa was heavily influenced by the more
CollegeofPhysiciansandSurgeons.GreenservedasChairof
advanced otological care he witnessed during his Euro-
the Ophthalmology Society Membership Committee for an
pean travels and was inspired to champion otology as a
impressive 38 years (1868–1906). He was chairman of the
worthy field of endeavor among his fellow ophthalmo-
St. Louis Ophthalmological Society, and became known for
logists upon his return home to America. Wilhelm
entropion operations, lachrymal duct treatment, and orbital
exenterations.Heread35papersattheAmericanOphthalmo- Kramer (1801–1875) of Berlin was a famous otologist
logical Society, and three at the AOS on the subjects such as who published two sentinel books in the field: The
Aspergillus infection, use of salt in the treatment of draining Knowledge and Treatment of Ear Diseases (1838) and
tympanic membrane perforations, and the function of the AuralSurgeryofthePresentDay(1863)(44,45).Writing
Eustachiantubesubjected topressure. in1864,4yearsbeforetheformationoftheAOS,Roosa
HenryDruryNoyes(1832–1900):NoyeswasborninNew praisedhisEuropeanhosts:‘‘Throughtheextremecour-
York City (37,38). He graduated fromNewYork University
tesyofDr.Kramer,whileinBerlin,Ihadtheopportunity
in 1851 and completed medical school at the College of
ofseeingagooddealofhislargeprivatepractice,andthe
Physicians and Surgeons in New York in 1855. After a year
pleasure of his peculiar views at some length.’’ (46) In
of postgraduate study in Europe, he began practice in New
his writings, Roosa paid homage to European authors
York.Hewasanearlyadvocatefortheuseofcocaineaslocal
anestheticinophthalmicsurgery(39).HepracticedattheNew who made important contributions to the maturation of
York Eye and Ear Infirmary for 41 years and was Professor the field of otology (46). From connections made
of ophthalmology and otology at the Bellevue Hospital during his time in Germany, Roosa served as translator
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FORMATION OF THE AMERICAN OTOLOGICAL SOCIETY S5
describedhimas: ‘‘Of strong dominantpersonality,full
of sonorous voice and forceful expression; he made
himself felt in all affairs in which he took part.’’ (23)
SpauldingdescribedRoosaas‘‘Amanremarkableforhis
vigorous expressions of opinion in the two specialties
which began to flourish at the time when he started in
practice, specialties which he assiduously and success-
fullycultivatedduringtherestofhismedicallife.’’(21)
EdmundPrinceFowler(1872–1976),writinginthe1968
Centennial History of the AOS, described Roosa’s per-
sonality: ‘‘Dr. Roosa possessed a dynamic personality
and dominated, at least for many years, most of the
societies and hospitals to which he belonged, especially
thosehehadplayedamajorpartinfounding.Naturally,
somedidnotagreewithhisideas,andwheneverhewas
on the scene many exciting debates and discussions
ensued.’’ (8) In discussing Roosa, Fowler went on to
describethedynamicnatureofthesociety’searlymeet-
ings which was quite different from our more sedate
deliberationstoday.‘‘Therewereotherso-called‘giants’
inthosedays,andtheyenjoyed‘‘animated’’discussions;
they pulled no punches at the meetings.’’ Clearly, the
courteous and respectful tone typical of today’s AOS
meetings is a tradition of more recent origin.
OneindicationofRoosa’sprominentroleinfounding
the AOS is that he presented the first paper at the
Society’s inaugural scientific meeting in 1869 (49).
His ‘‘Progress in Otology’’ represented a substantial
22pagelongreviewofthecurrentliterature.Fordecades
FIG.2. DanielBennettSt.JohnRoosa. hewasaprolificcontributortotheAOStransactionsona
wide variety of otological topics. Roosa went on to
become the Society’s third president serving from
1874 to 1876. Roosa’s textbook ‘‘A Practical Treatise
for two editions (1864, 1869) of one major German ontheDiseasesoftheEar,IncludingtheAnatomyofthe
otology textbook authored by Anton von Tro¨ltsch of Organ.’’ was first published in 1873 and appeared in
Wu¨rzburg (47,48). seveneditionsthrough1891(50).Histextrepublishedin
Of relevance to his future role in forming the AOS, London and was translated into German. In 1876, the
Roosa participated in the two planning meetings which nation’scentennialyear,RoosaservedasPresidentofthe
led to the formation of the American Ophthalmological firstcongressoftheInternationalOtologicalSocietyheld
SocietyinJanuary1864heldinNoyes’medicalofficeon in New York (51).
4th Avenue in New York and in June 1864 during the Asecondindividualwhodeservesspecialcreditforhis
annualmeetingoftheAmericanMedicalAssociationin leading role in the formation of the AOS was Henry
New York (4,5). Through this experience he became DruryNoyes(1832–1900).HeservedastheAOSPresi-
familiar with the steps involved in creating a medical dent from 1870 to 1873 and was the first President to
specialtysocietyincludingtheelementsofaconstitution, actually preside over an annual scientific meeting. In
committee structure, and annual meeting organization. contrast to Roosa, Noyes’ career remained focused in
AtthetimeRoosawaslessthanayearofreturningfrom ophthalmology. The greatmajority of his scholarly out-
his grand European tour and a mere 26 years old. Five put appeared in the ophthalmological literature and his
years after his return to America, at age 30, Roosa textbooks concerned eye diseases. Noyes was both a
attended thefifthannual meeting ofthe American Oph- founder and of the Ophthalmological Society and its
thalmologicalSocietyin1868.Eventhoughhewasstilla longest serving President.
juniormember,hemadethemotionproposingtheaddi-
tionof‘‘Aural’’totheorganization’stitle.Disappointed TheEvolvingAttitudesTowardsOtologyinthe1860s
by the failure of his motion, Roosa and eight other and 1870s
members met the next day to give birth to the AOS. Theperceptionofotologyasafieldevolvedconsider-
Observers described Roosa as a forceful and persua- ably throughout the 1860s to 1870s. This is well illus-
sive individual—the type of character to push forward tratedbythewritingsofD.B.StJohnRoosa.Intheearly
new ideas and persevere to overcome opposition. 1860s he was not shy regarding describing what he
Roosa’s memorial in the AOS transactions of 1909 perceived as deficiencies in contemporary American
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S6 R. K. JACKLER ET AL.
otological practice. In 1864 he wrote: ‘‘I believe aural TABLE 2. Annual meetings oftheAmerican Otological
surgery to be a comparatively neglected field, and my Society:the firsttwodecades
ownexperiencehasalreadybeenampleenoughtoshow
Members Active
thatamuchlarger number ofchronic cases cometothe Present Membership
surgeon’s eye than in other branches of our art; conse-
1868 Newport 9 9 (Organizational
quently,wecannotexpectthesametherapeuticresults,as meeting)
forinstance,inophthalmology,andourrewardforlabor 1869 Newport 9 17 (1stScientific
cannotjustnowbethedazzlingonethatfallstothelotof meeting)
successful practitioners in other departments; but if we 1870 Newport 10 33
1871 Newport 7 36
butsucceedinwakinguptheprofessiontothecurability
1872 Newport 6 29
of recent ear cases, and to the fallacy of the idea of
1873 Newport 17 42
outgrowing these affections, perhaps our work will be
1974 Newport 13 42
done.’’ (46) He added the Latin phrase: Arbores seret
1876 NewYorkCity 17 47
diligens agricola, quarum adspiciet baccam ipse nun-
1877 NiagaraFalls 4 (NoQuorum,
quam(translation:theindustrioushusbandmanwillplant
railroadstrike)
trees, a berry of which he will himself never behold) 1878 Newport, 18 47
suggesting that he anticipated that the full flowering of 1879 Newport 18 46
the specialty will occur beyond his own time. 1880 Newport 16 48
In 1868, Roosa expressed more optimism: ‘‘The sci- 1881 Newport 18 51
ence of otology is fast taking its place in the van of the 1882 LakeGeorge 19 55
great movement in the ranks of Medicine. Diseases of 1883 CatskillMountains 23 59
the ear are now receiving the attention which humanity 1884 CatskillMountains 23 61
had vainly demanded of our profession for centuries.’’ 1885 NewLondon 27 60
(52) By 1873, Roosa’s tone had become even more 1886 NewLondon 26 65
optimistic including a somewhat congratulatory tone 1887 NewLondon 25 67
based upon progress over the previous decade. ‘‘The 1888 NewLondon 27 69
practiceofotologyinthiscountrywas,afewyearssince,
almost exclusively confined to charlatans; but now it is
cultivatedbyaclassofmenwhoareequalstoanyinthe
profession. Ten years ago, in most parts of the country, of the Society ‘‘Otological’’ follows that of the
those who wished advice upon disease of the ear were ‘‘Ophthalmological’’ and others such as the American
forced to seek aid outside of the profession. At the ‘‘Surgical’’ Society (1880). By contract, the American
present time, there can be found those in large cities Neurotology Society, founded over a century later in
who are constantly and successfully treating aural dis- 1974,usesthespecialty’snameratherthanadescriptive
eases;andalloverthelandtheoldfamiliaradvice,‘‘Not term.
tomeddlewiththeear,’’isgrowingfarlessfrequent.The Thefirstfivemeetings(1868–1872)oftheAOSwere
day will soon arrive—if indeed it be not already upon surprisinglysmallwithonly9,9,10,7,and6membersin
us—whenotologywilltakeequalrankwithophthalmo- attendance (Table 2). Nevertheless, the active member-
logy, to which department it has so long been a mere shiplistprogressivelygrewfromtheinitialninein1868
appendage, and when some knowledge of the diseases to36 in1871,48in1880,and69in1888. Participation
and treatment of the ear, will be required of every was such a challenge in the early years that the quorum
practitioner.’’ (50) reducedfromeighttofivemembersin1870.Theinitial
sevenmeetingswereallheldinNewport,RhodeIsland.
THE EARLY YEARS OF THE AMERICAN Intheearlyyears,themembersoftheAOSwereallfrom
OTOLOGICAL SOCIETY theEastCoastexceptforafew‘‘westerners’’fromthefar
away cities of Cincinnati, St Louis, and Chicago. In the
The meetings of the AOS were scheduled the day minutes of the 1875 meeting a comment appears: ‘‘Dr.
before the ophthalmology Society in the same location, Williams called attention to the fact that the Western
mostoftenNewport,RhodeIsland.Thetwosocietiesmet States felt themselves somewhat neglected in the selec-
togetheruntil 1911 when the AOS metinAtlanticCity, tionoftheplaceforthemeetingofthisSociety.’’(53)By
New Jersey, and the Ophthalmology Society in New western states he was likely referring to mid-western
London, Connecticut. Thereafter, the eye and ear socie- statessuchashishomestateofOhioasintheearlyyears
tiesmettogethereverythirdyearaspartoftheCongress theAOShadno membersfromthe farwest.Thisis not
ofAmericanPhysiciansandSurgeons,butthiscoupling surprising in that the transcontinental railroad was not
ended in 1933 (7). The first AOS transactions completed in 1869, took nearly a week to cross the
(2’ndmeeting,butfirstscientificsession)werepublished nation, and ticket rates for one way as of June 1870
jointly with the Ophthalmological transactions in 1869 were$136forfirstclassinaPullmansleepingcar;$110
(2). From 1870 onward, the AOS transactions were for second class; $65 for third (54). The transactions of
published separately. The ‘‘-ical’’ naming convention the44thannualmeetingin1911listsDr.JosephAndrews
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FORMATION OF THE AMERICAN OTOLOGICAL SOCIETY S7
of Santa Barbara, California, evidently the first AOS themselves as specialists whereas specialization in rural
member from the west coast. settings was rare (57). An 1866 report of the American
The1869minutesreflectanannual‘‘tax’’onmembers Medical Association Committee (AMA) on Medical
of $1, equivalent to approximately $28 in 2017 dollars EthicsofSpecialtiesrevealsmuchofprevailingattitudes
(2).Bycomparison,in1865theOphthalmologySociety at the time (58). While recognizing the value of the
assessed its members $3 (4). In the mid-19th century superior knowledge and skill of specialists, the report
physician incomes were comparable with middle class cautions that: ‘‘There is often seen in specialists a
wages,generallyunder$1000peryear(55).Financially tendencytoundervaluethetreatmentofspecialdiseases
welloffphysicians generallyhadinheritedtheirwealth. bygeneral practitioners.’’ Thereport endorses the prac-
In1872,theAOStransactionsminutesreflectthepolicy tice of ‘‘partial specialism’’ as opposed to ‘‘exclusive
of the Society that ‘‘any member neglecting to pay the specialism.’’ In 1869, the AMA took a strong position
annualassessmentsforthreeyearsshallbeconsideredto against advertising by specialists: ‘‘That it shall not be
haveforfeitedhismembership.’’(2)The1876minutesof properforspecialistspubliclytoadvertisethemselvesas
theAOSmentionedthatthecostoftheauditoriumanda such, or to assume any title not specially granted by a
clerk for the day at Chickering Hall on 5th Avenue in regularly chartered college.’’ (59)
New York was $52 (53). One expression of the emerging trend towards spe-
In 1881, the AOS asserted primacy for all papers cializationinthemid-19thcenturywastheformationof
presented at its annual meetings. ‘‘Dr. C. H. Burnett specialty societies. Ophthalmology was inthe advanced
movesthatmemberspresentingpapersmaybeallowedto guardofspecializationbothinEuropeandAmerica.The
publishthemelsewhere,eitherintotoorinabstract.Dr. formationoftheAmericanOphthalmologicalSocietyin
H.D.Noyesoffersasasubstitute,thatpapersreadbefore 1864representedthefirstspecialtysocietyintheUnited
the Society shall become its property, and shall, at the States with the American Otological Society in 1868
discretionoftheSociety,bepublishedinitstransactions. becoming the second. The advancement of otology as a
Theauthorofapapermayhavetheprivilegeofpublica- specialtyintheUnitedStateswasclearlycatalyzedbyits
tion in any other manner, provided he make request to closerelationwithophthalmology.Thefoundinggener-
that effect to the Business Committee at the meeting of ation of the AOS were all ophthalmologists who devel-
theSocietywhenitshallhavebeenread.Whenpublished oped an enhanced interest in otology. Most of the 19th
inanothermanner,thefactofhavingbeenreadbeforethe century leaders in otology continued to practice in both
American Otological Society shall be stated.’’ (53) fields. The sequence of events leading to the AOS
Intheformative years,it appears that anymemberof formationderiveddirectlyfromexperienceinanalogous
theAmericanOphthalmologySocietywithaninterestin actions by ophthalmologists in organizing their Society
otologywasroutinelyacceptedintotheAOS.Nearlytwo 4 years earlier.
decadeslater(1885)themorerigorousselectioncriteria During the19th century, surgicalspecialties began to
were applied: ‘‘Candidates for membership shall differentiate from the all encompassing field of general
have been engaged in the practice of Aural surgery for surgery. According to Friedenwald, while ophthalmol-
atleastfiveyears,shallhavegivenevidenceofsatisfac- ogyhada‘‘rapiddivorcefromsurgery’’duringthe19th
tory scientific attainments, and shall have conducted century,itremained‘‘wedded’’tootology(5).Thiswas
themselves in conformity with the ethical rules of this exemplifiedbythecreationofeyeandearhospitals.The
Society.’’ (56) prototypeforeyeandearinfirmariesinAmericawasone
It is noteworthy that Alexander Graham Bell, the establishinLondonin1805byJohnCunninghamSaun-
famedinventorofthetelephone,whoconsideredhimself ders (60). The New York Eye Infirmary was founded
aneducatorofthedeaf,wasanhonorarymemberofthe 1820 with an otology service added in 1824. The name
AOS. The transactions of 1885 comment: ‘‘Prof. A. waschangedtoNewYorkEyeandEarInfirmaryin1864
Graham Bell, of Washington, DC, honorary member (61). The Massachusetts Charitable Eye and Ear Infir-
of the Society, addressed the Society with regard to mary was founded in 1824 with the word charitable
the large number of Deaf-Mutes in the Institutions for removed in 1924 (60). The Manhattan Eye, Ear, and
Deaf-Mutes,thatcouldyetheartoacertain degree, and Throat Hospital was created in 1869 (62). In 1870, the
thereforeweresimplyhard-of-hearingmembersofsoci- institution treated 1227 eye and 430 ear cases.
ety,alsotothepossibilityofeducatingthehearingpower A German Otological Society (Deutsche Otologische
in these persons and recommended the subject to the Gesellschaft)wasformedin1881andasimilarAustrian
consideration of the Members of the American Otolog- Societyin1895.LondonotologistGeorgeP.Fieldsgave
ical Society.’’ (56) an address before the Section of Otology of the British
Medical Association inAugust 1883 lamentingthe lack
DISCUSSION of a British Otological Society (63). ‘‘I am strongly
inclined, indeed, to conclude, from the benefits which
The 19th century saw the emergence of medical I perceive to accrue form our Association meetings,
specialization, although theprevalence ofspecialization that great good would result from the formation of an
remainedfarlessthanitistoday.Bythemid-1880s,10to Otological Society of Great Britain. Our nearest Conti-
15% of physicians in large American cities listed nental neighbors, and our American friends, have their
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