Aural surgery has not long been raised to the rank of an honoured specialty. Joseph Toynbee was told on one occasion by an eminent member of the profession that he would make nothing of aural surgery. He replied, “I will work at it for ten years, and then if nothing can be made of it, I will tell you why.” On another occasion he said, “I’ll rescue aural surgery from the hands of the quacks” (Medical Times, July 14, 1866). Prematurely cut off though he was, he added largely to the scientific knowledge of the ear and its maladies, and vastly improved their treatment.
Joseph Toynbee was born in 1815, at Heckington, in Lincolnshire, his father having been a large farmer. After being for some years under a private tutor at home, he went to King’s Lynn Grammar School. At seventeen he was apprenticed to Mr. William Wade of the Westminster General Dispensary, Soho, and studied anatomy under Mr. Dermott. His assiduous and careful dissections were of essential benefit in preparing him for his lifelong minute dissections of the ear in health and disease. He further studied at St. George’s and at University College hospitals. Even during his student life aural studies powerfully attracted him, and as early as 1836 several letters of his under the initials J. T. appeared in the Lancet. In 1838 he became a member of the College of Surgeons, and was selected as assistant-curator of its museum under Professor Owen. He obtained the Fellowship of the Royal Society in 1842 for researches demonstrating the non-vascularity of articular cartilage, the cornea, crystalline lens, vitreous humour, and epidermoid appendages, which were published in the Philosophical Transactions for 1841.
Toynbee early entered upon aural practice in Argyll Place, becoming also one of the surgeons to the St. James’s and St. George’s Dispensary. He was included in the first list of Fellows of the College of Surgeons on the issue of its new charter. At the Dispensary he founded a Samaritan Fund for supplying the sick poor with necessaries of life and warmth. All sanitary matters were subjects of his profound interest, and he spent much time in improving the condition of things in the parishes around him, especially promoting means of securing adequate ventilation, and the erection of model lodging-houses near Broad Street, Golden Square.
Toynbee’s practice gradually became very large, but he continued to dissect, and also to support administratively as well as pecuniarily many benevolent societies. He found that so little was really known of the diseases of the ear from actual dissection, that his only hope of framing a system of aural surgery was by personal and persevering examination and record of morbid specimens. This was carried on for more than twenty years, until he had dissected about 2000 human ears. Many of these were derived from his patients in the large Asylum for the Deaf and Dumb, whose condition he had examined previously to their death. Many medical men also supplied him with specimens of diseased ears, as well as notes of cases. He further inquired closely into the history of very many cases of patients with diseased ears.
In 1860 Toynbee published an extended work on “The Diseases of the Ear,” which placed the subject on a firm basis, and will always remain of great value from the interesting details of cases and treatment which it contains. The list of his own published papers on which it is based, about sixty in number, testifies to Toynbee’s great industry in research. They include papers on the structure and functions of the tympanic membrane, on the muscles which open the Eustachian tube, and on the mode of conduction of sound from the tympanic membrane to the labyrinth of the ear, contributed to the Royal Society, many researches on the diseases of the ear in the Medico-Chirurgical Transactions, and a crowd of series of cases or special memoirs contributed to the Pathological Society and medical journals. In 1857 he had published a descriptive catalogue of the preparations illustrating diseases of the ear contained in his own museum.
On the establishment of St. Mary’s Hospital, Mr. Toynbee was elected aural surgeon and lecturer on diseases of the ear; and he published in 1855 and 1856 courses of clinical lectures, which he delivered there. He took a deep interest in the condition of idiots, and of the deaf and dumb, and in many cases, to his great delight, devised plans by which those who were not totally deaf were taught to speak when their case had been regarded as hopeless, causing a corresponding improvement in their mental faculties.
Two of his most zealously pursued hobbies were ventilation, and the formation of local museums. It was said that patients who went to him for the benefit of their hearing, whether they improved in that respect or not, came away full of the most advanced views on ventilation. At Wimbledon, where he took a country-house, he was indefatigable in developing a village club, and in forming an educative and recreative museum. He published valuable “Hints on the Formation of Local Museums” (1863), as well as “Wimbledon Museum Notes.” His enthusiastic advocacy was actively engaged in furthering the establishment of similar clubs and museums in various parts of the kingdom. He continued through life an active microscopist and zoologist, and was elected just before his death President of the Quekett (Microscopical) Club. At the same time he was treasurer of the Medical Benevolent Club, to which he himself largely contributed.
One of Toynbee’s most valuable contributions to the treatment of deafness was his invention of a method of forming an artificial tympanic membrane when that part had been destroyed or perforated. This is fully described in his pamphlet on the subject, which went through many editions, as well as in his general treatise. He first demonstrated the existence of many osseous and other tumours of the parts of the ear and of the ossicles of the tympanum, and also the fact that the Eustachian tube leading from the back of the throat into the tympanum remains always closed except during the momentary act of swallowing.
A premature end came to Toynbee’s energetic and benevolent life. Always active in experimental research, and much concerned in aural therapeutics, he experimented on himself with chloroform, and it is believed, prussic acid vapour, which he wished to cause to enter by the Eustachian tube into the tympanum for the relief of tinnitus aurium or noises in the ears. He unfortunately pursued his experiments while alone, and was found dead on July 7, 1866, in his consulting room at Savile Row, with a pad of cotton wool over his face, and chloroform and prussic acid bottles, his open watch, and various memoranda of experiments near him. His death excited universal sympathy for Mr. Toynbee’s widow and nine children, with whom he had lived most happily.