Cauliflower Ear - History

History

An extensive literature and serious science on this condition developed between the 1860s and the turn of the century. It was defined as "An effusion of blood or of bloody serum between the cartilage of the ear and its perichondrium, occurring in certain forms of insanity and sometimes among the sane". Alienists (psychiatrists) argued ardently that it was a symptom of insanity and had nothing to do with mechanical causes. Some thought it was involved in all types of insanity, while others thought it to be worse "in those forms of insanity in which the mental excitement runs high for any length of time". It was thought to affect the left ear more often than the right. Psychiatrists advanced various theories linking it to abnormalities of bone, blood, or brain in the insane. Others argued that it resulted from an interaction between nervous system degeneration in the insane, and mechanical causes such as the insane hitting themselves or being boxed around the ear by asylum staff (and it was pointed out that this might be the easier explanation for the higher prevalence in the left ear, since most staff were right-handed, rather than convoluted arguments linking it to the origin of the left common carotid artery). It was noted that it could occur to a lesser extent in sportsmen due to an interaction between mechanical blows and the heat and excitement of physical combat. By the end of the First World War the topic disappeared from the medical press and the experts moved onto new fashions. Its mainstream acceptance as a psychiatric symptom has been said to have relevance to scientific and conceptual concerns over psychiatric diagnosis today.