To describe the manner in which hearing was evaluated in American Otological Practice during the late 19th and early 20th centuries before introduction of the electric audiometer.Primary sources were the Transactions of the American Otological Society and American textbooks, especially those authored by Presidents of the Society.In the era before electric audiometry multiple methods were used for evaluating the thresholds of different frequencies. Tuning forks were important for lower frequencies, whisper, and speech for mid-frequencies, and Galton's whistle and Konig's rod evaluated high frequencies. Hearing threshold was often recorded as in terms of duration of a sound, or distance from the source, rather than intensity. Hearing ability was often recorded a fraction, for example, with the distance a watch tick could be heard over the distance of a normal hearing individual. A variety of devices, such as Politzer's Acoumeter, attempted to deliver sound in a calibrated manner, thus enhancing the accuracy and reproducibility of test results.The early years of the American Otological Society were marked by a number of ingenious efforts to standardize hearing assessment despite the technical limitations. These efforts facilitated the development of the audiometer, and continue to influence clinical practice even today.
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