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Every year, several readers write to complain that they have the same problem as Beethoven had: "My ears whistle and buzz constantly day and night. I am leading a wretched life."
Their tinnitus (from the Latin for "ringing") remains intrusive despite the best efforts of one - or frequently more - specialists, and they wonder whether I know of any magic cures.
There are, as always, many possible causes, as virtually any ear condition can give rise to the "whistle and buzzing", but for most - and by a very large margin - it is associated with the almost universal, age-related decline in hearing known as presbyacusis.
Thus, the presumption has always been that the problem lies in a disturbance of the delicate hearing mechanism of the inner ear, the cochlea, which is certainly how it seems to those affected. This turns out, however, not to be so, and the more recent theory that the defect lies in the brain offers a better rationale for present and future treatments.
Hearing, as with all the senses, is a profoundly and inscrutably complex phenomenon, involving an interaction between the nerve impulses from the cochlea and the part of the brain where the sounds are interpreted.
Put simply, the cochlea's perception of higher frequency sounds declines with age, which deprives, as it were, the equivalent interpretative area in the brain of sufficient stimuli. This then responds by generating a constant background noise to fill the vacuum, which is perceived as tinnitus.
Hence, the value of "masking" - silencing the tinnitus with a countervailing sound. This was first astutely recognised by the philosopher Aristotle in the 5th century BC: "Buzzing in the ears ceases when a greater sound drives out the less," he observed.
Hence, too, the supposedly miraculous cures experienced by tinnitus sufferers who make the pilgrimage to the Breton town of Stival, where the hand bell of the Celtic saint, Mériadec, was (and, on request, still is) rung loudly in the supplicant's ear and placed over the head.
Once the bell was removed, they found the buzzing had stopped - if only temporarily. Nowadays, it is probably easier to buy a Walkman (or, following George W. Bush's example, an iPod) and let its "greater sound drive out the less".
This new theory can also account for the benefits of antidepressant drugs, originally prescribed on the not unreasonable grounds that the wretched lives of tinnitus sufferers made them vulnerable to depression.
It now seems more likely that these drugs work by dampening down the chemical neurotransmitters whose activity gives rise to the imaginary sounds.
The alternative wonder remedy ginkgo biloba has its advocates, and, for reasons unkown, others find that a dental brace that improves their bite also relieves their tinnitus. Any other suggestions would be much appreciated.
Further to the recent comments on the dramatic impression made by cardiopulmonary resuscitation in its early days in restoring the dead to life, a Yorkshire man, Jim Hopkinson, reports how his Aunt Edith did the same for his father in the summer of 1944.
Mr Hopkinson Senior was invalided out of the Army at the end of the First World War after three-and-a-half years in the trenches and his subsequent poor health culminated in a major heart attack in 1941, from which he made a good recovery.
Three years later, when holidaying with his family in Blackpool, he had another, and the doctor, when finally located, turned out to be "drunk and quite useless".
"We gathered round the bed as Dad slowly expired. He said his farewells, his eyes rolled up and he stopped breathing," Mr Hopkinson writes. But Aunt Edith, a "strong, dominant character", had other ideas.
"She seized him by his shoulders and shook him vigorously, shouting: 'Come on, Albert, you can't go now!' She then gave his chest a violent thump. To our joy, he started breathing again."
Dad carried on for another two decades, making it to 76 and outliving the formidable Aunt Edith by two years.
Not all, of course, will wish to be resuscitated, and I recently described how a retired family doctor wears a disc around his neck signifying his intentions in this important matter.
Mrs Margaret Picco, from Surrey, suggests some further instructions that might be added.
She started simply enough by having only her blood group inscribed on a silver medallion, to which she added subsequently "no transplant surgery". A few years later she included "no resuscitation".
By now there was no room left, so she had to purchase another medallion for her final instruction: "Euthanasia permitted."
From Telegraph
Their tinnitus (from the Latin for "ringing") remains intrusive despite the best efforts of one - or frequently more - specialists, and they wonder whether I know of any magic cures.
There are, as always, many possible causes, as virtually any ear condition can give rise to the "whistle and buzzing", but for most - and by a very large margin - it is associated with the almost universal, age-related decline in hearing known as presbyacusis.
Thus, the presumption has always been that the problem lies in a disturbance of the delicate hearing mechanism of the inner ear, the cochlea, which is certainly how it seems to those affected. This turns out, however, not to be so, and the more recent theory that the defect lies in the brain offers a better rationale for present and future treatments.
Hearing, as with all the senses, is a profoundly and inscrutably complex phenomenon, involving an interaction between the nerve impulses from the cochlea and the part of the brain where the sounds are interpreted.
Put simply, the cochlea's perception of higher frequency sounds declines with age, which deprives, as it were, the equivalent interpretative area in the brain of sufficient stimuli. This then responds by generating a constant background noise to fill the vacuum, which is perceived as tinnitus.
Hence, the value of "masking" - silencing the tinnitus with a countervailing sound. This was first astutely recognised by the philosopher Aristotle in the 5th century BC: "Buzzing in the ears ceases when a greater sound drives out the less," he observed.
Hence, too, the supposedly miraculous cures experienced by tinnitus sufferers who make the pilgrimage to the Breton town of Stival, where the hand bell of the Celtic saint, Mériadec, was (and, on request, still is) rung loudly in the supplicant's ear and placed over the head.
Once the bell was removed, they found the buzzing had stopped - if only temporarily. Nowadays, it is probably easier to buy a Walkman (or, following George W. Bush's example, an iPod) and let its "greater sound drive out the less".
This new theory can also account for the benefits of antidepressant drugs, originally prescribed on the not unreasonable grounds that the wretched lives of tinnitus sufferers made them vulnerable to depression.
It now seems more likely that these drugs work by dampening down the chemical neurotransmitters whose activity gives rise to the imaginary sounds.
The alternative wonder remedy ginkgo biloba has its advocates, and, for reasons unkown, others find that a dental brace that improves their bite also relieves their tinnitus. Any other suggestions would be much appreciated.
Further to the recent comments on the dramatic impression made by cardiopulmonary resuscitation in its early days in restoring the dead to life, a Yorkshire man, Jim Hopkinson, reports how his Aunt Edith did the same for his father in the summer of 1944.
Mr Hopkinson Senior was invalided out of the Army at the end of the First World War after three-and-a-half years in the trenches and his subsequent poor health culminated in a major heart attack in 1941, from which he made a good recovery.
Three years later, when holidaying with his family in Blackpool, he had another, and the doctor, when finally located, turned out to be "drunk and quite useless".
"We gathered round the bed as Dad slowly expired. He said his farewells, his eyes rolled up and he stopped breathing," Mr Hopkinson writes. But Aunt Edith, a "strong, dominant character", had other ideas.
"She seized him by his shoulders and shook him vigorously, shouting: 'Come on, Albert, you can't go now!' She then gave his chest a violent thump. To our joy, he started breathing again."
Dad carried on for another two decades, making it to 76 and outliving the formidable Aunt Edith by two years.
Not all, of course, will wish to be resuscitated, and I recently described how a retired family doctor wears a disc around his neck signifying his intentions in this important matter.
Mrs Margaret Picco, from Surrey, suggests some further instructions that might be added.
She started simply enough by having only her blood group inscribed on a silver medallion, to which she added subsequently "no transplant surgery". A few years later she included "no resuscitation".
By now there was no room left, so she had to purchase another medallion for her final instruction: "Euthanasia permitted."
From Telegraph
