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Phyllis M. Tookey Kerridge and the science of audiometric standardization in Britain

  • JAIPREET VIRDI (a1) and COREEN MCGUIRE (a2)
Abstract
Abstract

The provision of standardized hearing aids is now considered to be a crucial part of the UK National Health Service. Yet this is only explicable through reference to the career of a woman who has, until now, been entirely forgotten. Dr Phyllis Margaret Tookey Kerridge (1901–1940) was an authoritative figure in a variety of fields: medicine, physiology, otology and the construction of scientific apparatus. The astounding breadth of her professional qualifications allowed her to combine features of these fields and, later in her career, to position herself as a specialist to shape the discipline of audiometry. Rather than framing Kerridge in the classic ‘heroic-woman’ narrative, in this article we draw out the complexities of her career by focusing on her pursuit of standardization of hearing tests. Collaboration afforded her the necessary networks to explore the intricacies of accuracy in the measurement of hearing acuity, but her influence was enhanced by her ownership of Britain's first Western Electric (pure-tone) audiometer, which she placed in a specially designed and unique ‘silence room’. The room became the centre of Kerridge's hearing aid clinic that, for the first time, allowed people to access free and impartial advice on hearing aid prescription. In becoming the guardian expert and advocate of the audiometer, Kerridge achieved an objectively quantified approach to hearing loss that eventually made the latter an object of technocratic intervention.

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1 Kerridge Phyllis M. Tookey, ‘Speech defects and deafness’, Speech (October 1935) 1(2), pp. 1620, 20.

2 Mackenzie William, ‘Diagnosis and treatment of chronic deafness’, Post-graduate Medical Journal (January 1947) 23, pp. 315 , 5.

3 Roberta Bivins, ‘Medresco: hearing aid and the National Health Service?’, People's History of the NHS, at http://peopleshistorynhs.org/encyclopaedia/the-national-hearing-service.

4 For a detailed history of the development of the Medresco see Sean McNally, ‘Medresco: the history of state-sponsored auditory assistance’, University of Leeds PhD thesis, forthcoming.

5 Dawes Laura, 100 Years of Deaf Education and Audiology at the University of Manchester, 1919–2019, Manchester: University of Manchester Press, 2014, p. 26 .

6 Medical officer memo, 17 April 1937, Medical Research Committee and Medical Research Council Files, National Archives, Kew, FD1/2329, Folder ‘Hearing: Mrs. P.T. Kerridge’ (subsequently MRC Kerridge I). On mechanical objectivity see Daston Lorraine J. and Galison Peter, Objectivity, New York: Zone Books, 2007 .

7 Porter Theodore M., ‘Objectivity as standardization: the rhetoric of impersonality in measurement, statistics, and cost–benefit analysis’, in Megill Allan (ed.), Rethinking Objectivity, Durham, NC and London: Duke University Press, 1994, pp. 197237 .

8 Kerridge Phyllis M. Tookey, Hearing and Speech in Deaf Children (Medical Research Council: Reports of the Hearing Committee, No 221), London, 1937, p. 8 .

9 Mills Mara, ‘Deafening: noise and the engineering of communication in the telephone system’, Grey Room (2011) 42, pp. 118143 .

10 Bruno Latour and Steve Woolgar refer to the end product as literary inscription’ in Laboratory Life, Princeton, NJ: Princeton University Press, 1979, p. 63 .

11 Her collaboration was tied to her interest in electric hearing aids, particularly micro-telephone and valve amplifier hearing aids, which incorporated the same technology as the Post Office repeater telephones. See Coreen McGuire, ‘The “deaf subscriber” and the shaping of the British Post Office's amplified telephones 1918–1939’, University of Leeds PhD thesis, 2017.

12 Gooday Graeme, The Morals of Measurement: Accuracy, Irony, and Trust in Late Victorian Electrical Practice, Cambridge, Cambridge University Press, 2004 .

13 Davis Lennard J., Enforcing Normalcy: Disability, Deafness and the Body, New York: Verso, 1995, p. 30 .

14 Audiology, the offspring of speech pathology and otology, traces its professional roots to post-Second World War rehabilitation en masse of soldiers returning home with significant hearing loss. Though experiments in hearing acuity and standardization of hearing loss date to the 1910s, it was not recognized as a field in the UK until the 1960s. Audiometry concentrates on measuring hearing acuity. See Brueggemann Brenda Jo, Lend Me Your Ear: Rhetorical Constructions of Deafness, Washington, DC: Gallaudet University Press, 1999 .

15 Kerridge, op. cit. (8).

16 Woods Brian and Watson Nick, ‘In pursuit of standardization: the British Ministry of Health's Model 8F wheelchair, 1948–1962’, Technology and Culture (2003) 45(3), pp. 540568 .

17 Mills, op. cit. (9), p. 125.

18 Stephens S.D.G., ‘David Edward Hughes and his audiometer’, Journal of Laryngology and Otology (January 1976) 93, pp. 16 .

19 Watson T.J., ‘Breaking the silence: the development of audiology in Britain during the last hundred years’, in Taylor Ian G. and Markides Andreas (eds.), Disorders of Auditory Function, vol. 3, London: Academic Press, Inc., 1980, pp. 122 ; Mudry Albert, ‘The role of Adam Politzer (1835–1920) in the history of otology’, American Journal of Otolaryngology (2000) 21, pp. 753763 .

20 Mara Mills traces the development of the ‘normal’ threshold on the audiogram in ‘Signal and noise: the history of the audiogram’, Chapter 1 of ‘The dead room: deafness and communication engineering’, Harvard University PhD dissertation, 2008. See also Mills, op. cit. (9).

21 Sterne Jonathan, MP3: The Meaning of a Format, Durham, NC: Duke University Press, 2012, p. 36 . See also Sterne , The Audible Past: Cultural Origins of Sound Reproduction, Durham, NC: Duke University Press, 2003 ; Grajeda Tony, ‘Early mood music: Edison's phonograph, American modernity and the instrumentalization of listening’, in Quiñones Marta García, Kassabian Anahid and Boschi Elena (eds.), Ubiquitous Musics: The Everyday Sounds That We Don't Always Notice, Aldershot and Burlington, VT: Ashgate, 2013 ; Morat Daniel (ed.), Sounds of Modern History: Auditory Cultures in 19th- and 20th-Century Europe, New York: Berghahn Books, 2014 .

22 Esmail Jennifer, Reading Victorian Deafness: Signs and Sounds in Victorian Literature and Culture, Athens: Ohio University Press, 2013, p. 164 .

23 Love James Kerr, Deaf–Mutism: A Clinical and Pathological Study, Glasgow: J. MacLehose and Sons, 1896 .

24 Day Herbert E., Fusfeld Irving S. and Pinter Rudolf, A Survey of American Schools for the Deaf, 1924–1925, Washington, DC: National Research Council, 1928 . ‘The deaf’ is a historical phrasing and is still used today in some instances to identify schools for deaf children. Within Deaf culture there is a distinction of referring to the culturally Deaf with a capital D and deafness in medical terms with a lower-case d. Throughout this paper we have reproduced the historically accurate phrasing which may not correspond with the modern distinction. For an overview of d/Deaf history and the history of hearing loss see Gooday Graeme and Sayer Karen, Managing the Experience of Hearing Loss in Britain, 1830–1930, London: Palgrave Macmillan, 2017 .

25 Partridge Ruth C. and MacLean Donald L., ‘A survey of hearing in school children’, Canadian Public Health Journal (November 1933) 24(11), pp. 524539 .

26 Ewing A.W.G., Educational Guidance and the Deaf Child, Manchester: Manchester University Press, 1957 .

27 Anderson Julie, War, Disability and Rehabilitation in Britain, Manchester: Manchester University Press, 2011 . See also Linker Beth, War's Waste: Rehabilitation in World War I America, Chicago: The University of Chicago Press, 2011 .

28 Annual report of the Medical Research Council, 1936–7, MRC Kerridge I.

29 MRC report, 26 January 1937, MRC Kerridge I.

30 Dyhouse Carol, ‘Driving ambitions: women in pursuit of a medical education, 1890–1939’, Women's History Review (1998) 7(3), pp. 321343 , 334.

31 Kerridge Phyllis M.T., ‘The use of the glass electrode in biochemistry’, Biochemical Journal (1925) 19(4), pp. 611617 .

32 A selection of publications: Bayliss L.E. and Kerridge Phyllis M.T., ‘Recent developments in physical instruments for biological purposes’, Journal of Scientific Instruments (1935) 12, pp. 15 ; Bayliss L.E., Kerridge Phyllis M. Tookey and Russell Dorothy S., ‘The excretion of protein by the mammalian kidney’, Journal of Physiology (1933) 77, pp. 386398 ; Furusawa K. and Kerridge Phyllis M. Tookey, ‘The hydrogen ion concentration of the muscles of marine animals’, Journal of the Marine Biological Association of the United Kingdom (1927) 14(3), pp. 657659 . The National Archives contains memos in reference to Kerridge's involvement on projects on nutrition and colour blindness (MRC Kerridge I). In 1934 Kerridge was recommended by Dr Poulton at the London School of Hygiene and Tropical Medicine to assess the physiological benefits of an artificial respiration apparatus constructed by Sir William Henry Bragg (1862–1842) and Robert W. Paul (1869–1943). William Henry Bragg RI Admin Correspondence 1933–39, Royal Institution of Great Britain.

33 Kerridge Phyllis M.T., ‘Instrumental aids for defective hearing’, Reports on Progress in Physics (1938) 5, pp. 150163 .

34 Kerridge Phyllis M. Tookey, ‘Hearing and speech in deaf children’, Proceedings of the Royal Society of Medicine (October 1937) 30(12), pp. 14941511 , 1494.

35 Kerridge, op. cit. (34), p. 1507. Kerridge expressed that teachers of the deaf would benefit the most from the finding, for the detailed reports conclusively demonstrated the importance of electric sound magnifier apparatus, leading several schools to keep accurate record of deafness in pupils and conduct their own studies on hearing acuity. The Ministry of Education for the province of Ontario, Canada, for instance, obtained a copy of Kerridge's report and conducted a survey based on her methodology, discovering that 117 pupils in junior schools had significant hearing loss requiring special educational assistance. ‘Report of the minister of education, province of Ontario’ (Toronto, 1937), p. 72, Archives of Ontario.

36 The minutes of the committee for 27 November 1936 reveals a discussion over Kerridge's proposal for a four-scheme research project: (1) to collaborate with otologist Dr Max Ellis to investigate deafness in relation to middle-ear disease; (2) to investigate deafness due to middle-ear disease arising from infectious fever, a project in conjunction with the Fever Hospital; (3) to outline more accurate prescription of hearing aids; and (4) to investigate the incidence of industrial deafness. The first and third proposals were accepted, while the others were deferred for further details. Minutes of the MRC Hearing Committee, 27 November 1936, MRC Kerridge I.

37 Braun Lundy, Breathing Race into the Machine: The Surprising Career of the Spirometer from Plantation to Genetics, Minneapolis: University of Minnesota Press, 2014 .

38 Gregory Susan and Hartley Gillian M., Constructing Deafness, London: Bloomsbury Publishing, 1990 . For a longer history of the debate over the standard of normal hearing see Noble W.G., Assessment of Impaired Hearing: A Critique and a New Method, New York, San Francisco and London: Academic Press, 1978, pp. 173198 .

39 Phyllis M.T. Kerridge to David Munro, 11 November 1935, MRC Kerridge I.

40 David Munro to Sir Alexander Ewing, 13 November 1935, MRC Kerridge I.

41 Sir Alexander Ewing to David Munro, 21 November 1935, MRC Kerridge I.

42 In a letter to his colleague Dr Cleminson, David Munro writes, ‘I think too, that it would be as well to let the Ewings have their blow in first, partly because they have been working at the subject for a long time, and partly because if their work is published first it may make Ewing less inclined to be “dog-in-the-mangerish”!’ David Munro to Dr Climinson, 28 May 1936, MRC Kerridge I.

43 Meeting of the Medical Committee of the National Institute for the Deaf, 6 March 1931, Action on Hearing Loss Library (subsequently AOHL).

44 Sir Henry H. Dale to Edward Mellanby, 21 November 1935, MRC Kerridge I.

45 A. Landsborough Thomson to Sir Henry H. Dale, 22 November 1935, MRC Kerridge I.

46 Proposal by Dr Kerridge and Dr Formby, Medical Sub-committee, 28 January 1937, AOHL. Formby was appointed to UCH in 1937. Ringo Starr, whose tonsils he removed in 1964, is among one of his most notable patients.

47 Kerridge and Formby, op. cit. (46)

48 Kerridge and Formby, op. cit. (46).

49 Royal Ear Hospital minutes of governors’ meeting and annual reports, Royal Ear Hospital, University College Hospital Special Collections, National Archives, Kew UCH/MED/H/REH/1–2 (subsequently REH).

50 He That Hath Ears to Hear, pamphlet, REH. The building on Huntley Street was formerly named the Royal Ear Hospital before its amalgamation with University College Hospital as its new ENT department. In 2016, the building was demolished.

51 He That Hath Ears to Hear, op. cit. (50), p. 11.

52 Newspaper clipping, n.d., REH.

53 The room is described as such: ‘This room is 22 by 10 by 8 feet and is constructed with an outer shell of 9 inch brickwork with a concrete floor, inside which there is a framed timber box forming the Silence Room. This box is carried on the concrete floor, and has no contact with the outer brickwork shell or the floor above. This inner timber shell has, therefore, an airspace of about 4 inches extending all around the walls and ceiling. All the inner surfaces of the outer shell are covered with a lining of cabot quilting (a sound-deadening material made from seaweed). The outer and inner surfaces of the inner timber shell are covered with the same material and finally, the inside walls and ceiling of the Silence Room itself are plastered with Sabanite, a porous acoustic plaster. There are double entrance doors with felt-lined rebated frames and each door is cork-lined on both sides. In spite of this special construction the room is not completely sound-proof, and the ears of the subjects were stopped with cotton wool as an additional precaution’. Greenbaum Abraham, Kerridge Phyllis M. Tookey and Ross Eric John, ‘Normal hearing by bone conduction’, Journal of Laryngology and Otology (1939) 54(2), pp. 8892 , 88. Bell Labs’ anechoic chamber, built in 1940 in Murray Hill, New Jersey, is considered the first chamber of the sort, as it absorbed over 99.95 per cent of incident acoustic energy over 200 Hz.

54 1938 annual report of the Royal Ear Hospital, REH.

55 1939 annual report of the Royal Ear Hospital, REH.

56 The idea for a hearing aid clinic was originally implanted by H.M. Wharry at UCH, though it is unclear whether it was widely used before Kerridge took over. By 1938, similar clinics opened in connection with aural departments at Middlesex Hospital and St Thomas Hospital.

57 Kerridge Phyllis M. Tookey, ‘Hearing aids’, The Practitioner (1935) 135, pp. 641654 , 654.

58 In the 1930s, hearing-impaired persons seeking aids could select amongst (1) a non-electric aid, (2) a microtelephone with an air-conduction earpiece, (3) a microtelephone with a bone-conduction earpiece or (4) a valve amplifier with a crystal microphone.

59 Kerridge Phyllis M. Tookey, ‘Recent advances in hearing aids’, The Practitioner (1938) 141, pp. 625632 .

60 Kerridge Phyllis M. Tookey, ‘The administration of a hearing aid clinic’, Journal of Laryngology and Otology (June 1938) 53(6), pp. 370385 , 370.

61 The confusing messages received by hearing-impaired persons were an important issue that Kerridge repeatedly addressed: ‘The subject of instrumental aids for the deaf is one which has caused great interest and greater confusion. Most of both is due to exaggerated and even fraudulent commercial advertisement’ Kerridge Phyllis M. Tookey, ‘Aids for the deaf’, British Medical Journal (29 June 1935) 1(3886), pp. 13141317 , 1315.

62 Sumner James and Gooday Graeme J.N., ‘Introduction: does standardization make things standard?’, History of Technology (2008) 28, pp. 113 .

63 Kerridge Phyllis M. Tookey, ‘Medical inspection and deafness’, The Lancet (20 May 1939) 233(6028), p. 1178 .

64 Kerridge's husband, William Henry Kerridge, whom she married in 1922 and who was nearly twenty years her senior, was a professor of music and a choir master, so music may have been central to her life. Four years after marriage, she petitioned the court for divorce on grounds that her husband was still married to Irene Agnes Emma Kerridge of Fraudenstadt, Germany, and had been since 1910 as the marriage was never formally dissolved. Kerridge later withdrew her petition. MRC Kerridge I.

65 ‘The exploitation of deafness’, in ‘Eleventh annual meeting of the National Institute for the Deaf’, 30 July 1935, AOHL.

66 Kerridge Phyllis M. Tookey, ‘Hearing aids and social problems of the deaf’, Ulster Medical Journal (October 1939) 8(4), pp. 244248 .

67 Kerridge op. cit. (61), p. 1315.

68 Research report no 9150, ‘Aids to telephone reception for partially deaf subscribers’, Post Office Research Station, 21 April 1936, BT Archives, TCB 422 09150. Older-style candlestick models had a separate transmitter and receiver so it was possible to press the transmitter to the mastoid bone and listen to the telephone while easily speaking into the receiver.

69 Research report no 9150, op. cit. (68).

70 Kerridge, op. cit. (61), p. 1314. Moreover, Kerridge's paper outlines her proposal for a method of audiometric measurement that would be followed by GPs as a standard, in line with her work on increased standardization of hearing testing and hearing aid provision.

71 For example, in relation to ‘quack’ hearing aid manufacturers, she stated, ‘Much of the trouble would be avoided if the medical profession could advise their patients more precisely on the subject, but there is no source of information readily obtainable, either in textbook or in hospital teaching’, and ‘ideally it should be possible to prescribe a hearing aid according to each patient's requirements. With modern methods of testing deafness accurately this end is perhaps within sight’. Kerridge, op. cit. (61), p. 1315.

72 Research report no 9150, op. cit. (68).

73 Internal memo, the Telecommunications Department, 15 April 1937, BT Archives, POST 33/1491C.

74 Telecommunications Department memo, op. cit. (73).

75 Memorandum, ‘Amplifier telephone for deaf persons’, 3 May 1938, BT Archives, POST 33/1491C.

76 Telecommunications Department (TP branch) 15 April 1937, BT Archives, TCB 2 172.

77 Internal memo from the Engineering Department to the Telecommunications Department, telephone branch, 16 August 1937, BT Archives, POST 33/1491C.

78 Kerridge, op. cit. (61), 1315. On testing, she added, ‘The question of a suitable test is by no means simple. It is possible to use a series of nonsense syllables pronounced by a trained speaker, as used by the Post Office Research Laboratory for testing telephone apparatus’. Kerridge, op. cit. (34), 161.

79 Kerridge, op. cit. (33), 162.

80 Memo, ‘Clinical tests of working models of experimental hearing Aids’, 2 April 1946, ‘Reports of the Committee on Electro-acoustics: hearing aids and audiometers’, Medical Research Committee and Medical Research Council Special Research Projects, National Archives, Kew, D4/261.

81 Kerridge wrote to Mr Cleminson of the MRC outlining that she received preliminary interest from the Research Laboratories of General Electric Co. to design a calibrated filter apparatus that would enable deaf persons to adjust the testing set until they perceived the voice of the operator as intelligible. She claimed such an apparatus would possibly work best as a diagnostic apparatus and replace the audiometer as it relied heavily upon user intervention and adjustment, making for more accurate testing perception. Phyllis M. Tookey to Mr Cleminson, 18 October 1935, MRC Kerridge I.

82 Timmermans Stefan and Berg Marc, The Gold Standard: The Challenge of Evidence-Based Medicine and Standardization in Health Care, Philadelphia, Temple University Press, 2003, pp. 138139 .

83 Wilson Daniel, ‘Calculable people? Standardising assessment guidelines for Alzheimer's disease in 1980s Britain’, Medical History (2017) 61(4), pp. 500525 , 500.

84 1940 annual report of the Royal Ear Hospital, REH. By 1941, Kobrak used the silence room to engage in research on ‘the intra-tympanic musculature and the manner in which it can be affected by drugs’. 1942 annual report of the Royal Ear Hospital, REH.

85 Memo, ‘Further research by Dr Phyllis Kerridge’, Medical Research Committee and Medical Research Council files, National Archives, Kew, FD1/2330, Folder ‘Hearing: Mrs. P.T. Kerridge II’ (subsequently MRC Kerridge II).

86 Kerridge's father, William A. Tookey, was named executor of her will upon her death. On 22 June 1940 he wrote to the Medical Research Council to say, ‘I regret to inform you that my daughter Dr Phyllis M. Kerridge passed away this evening at the London Chest Hospital Bonner Road after a short illness’. That she was placed at a specialized chest hospital indicates it might have been a respiratory illness that led to her passing; her death certificate, however, lists the cause of death due to ulcerative colitis. Thanks to Dominic Stiles for drawing our attention to this.

87 Tookey family archive.

88 Virdi Jaipreet (as Virdi-Dhesi), ‘Curtis's cephaloscope: deafness and the making of surgical authority in London, 1815–1845’, Bulletin of the History of Medicine (2013) 87(3), pp. 349379 .

89 Julia Bell to Richard Himsworth, 6 July 1962, MRC Kerridge II.

90 Bell, op. cit. (89).

The authors are grateful to Graeme Gooday, Elizabeth Neswald, Barbara Becker, Richard Bellis, Geoff Bil, Robert Ruben, Charlotte Sleigh and the two anonymous referees for their constructive criticism and editorial remarks on earlier drafts. Special thanks are owed to Cherry Milne for her gracious friendship and for sharing materials from the Tookey family archive. We are indebted to the generosity of archivists David Hay at BT Archives and H. Dominic Stiles at the Action on Hearing Loss Library, whose assistance allowed us to uncover rare fragments of Phyllis Kerridge's life.

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