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” People who can hear think it is rather comic not to be able to, instead of a bitter tragedy” – Felix Joubert’s Royal Ear Hospital memorial, “Deafness Listening”

Hugh Dominic WStiles4 October 2019

In 1927, Neville Chamberlain, then Minister for Health, opened the new Royal Ear Hospital building in Huntley Street.  Ninety-two years later, the Royal National Throat Nose and Ear Hospital, which incorporated the Royal Ear Hospital, is moving back to Huntley Street in two phases.

The Huntley Street site was paid for by Sir Geoffrey Duveen (1883-1975) who was a barrister and, like his father, a philatelist.  The hospital was a memorial to his parents.

WAR AGAINST DEAFNESS. There is great sympathy as well as great friendship, between the two men who are putting up a memorial to the conquest of deafness at the Royal Ear Hospital in London Felix Joubert, the artist who designed the charming group of “Deafness Listening,” has had to give up the art of the foils, at which he won international fame, owing to ear trouble. Geoffrey Duveen, the man who gave the memorial and has rebuilt add re-endowed the hospital at his own expense, is a business magnate of varied interests, who has found deafness a great burden and is determined to alleviate it where he can. “You’ve no idea how widespread it is,” he told me, “especially among the children in the elementary schools. Deafness gets no sympathy! People who can hear think it is rather comic not to be able to, instead of a bitter tragedy.”—”Mr. Gossip” In the “Daily Sketch” (Belfast Telegraph)

The artist of the attractive bronze plaque, Jules Felix Amedée Joubert, was born in London in 1872, son of Henri, an upholsterer who had a business in the Kings Road, Chelsea.  Henri’s father, Jean Baptiste Amidée Joubert, also  an upholsterer, born in Paris in 1796.  He came to London, where he married Louise Pariens in 1828, and died in Marylebone, in 1866.  He was certainly not described as deaf when younger, but in 1927 he was fifty-five, and presumably age-related hearing loss meant he could not hear the judges when fencing, which is what we might suppose caused  him to give it up.  Duveen obviously felt his hearing loss keenly, and thousands of patients ever since have cause to thank him for his generosity.

I have found scattered records of Felix Joubert, as he seems to be most commonly known, but I am sure that someone could probably put together an interesting essay on him with a little archival work.  Many newspaper records mention him for his fencing, and while he was on the initial team for the 1912 Olympics, he was not in the team that finally competed.  One of Joubert’s passions was for old arms and armour, and he made a collection which he donated to the Musée Masséna in Nice, in 1925.  He is also supposed to have ‘forged’ items – perhaps it would be kinder to say ‘imitated’, but maybe he just took his chances to make some money from gullible people with money.  During the Great War he designed a trench knife that was supposed to follow an ancient Welsh pattern but was in reality his own design, with influence from ancient swords.

For many years the Jouberts lived in a house at 2 Jubilee Place, Chelsea.  I do not know where Joubert studied, but he married Blanche Cappé in 1907.

Joubert was it seems friendly with many famous people, including the Prince of Monaco and the Rothschild family.  He designed scenes for the theatre in 1912 (The Stage – Thursday 03 October 1912), a stained glass window in 1918, the first with a khaki clad soldier according to the Illustrated London News (Saturday 08 June 1918), and he even made a film in 1922.  Clearly he was a talented and interesting man.

Incidentally, it seems Duveen’s wife was the first person to have a radio in her car – a cadillac – in Britain, in 1926, but this involved her chauffeur slinging a 50 foot aerial between the car and a tree (The Times, 1997)!

Joubert died in Nice on the 1st of June, 1953, and is buried in Brompton cemetery.

The idea of the ‘conquest of deafness’ is one that might still appeal to some in the medical profession, but a greater understanding of Deaf people and deafness suggests that it is probably a form of words we now best avoid.

Joubert is seen here dressed as a knight presumably in his own armour, at the Chelsea Arts Club Ball (The Sketch – Wednesday 13 March 1912).

Belfast Telegraph – Wednesday 04 July 1928

Eason, Kevin The Times (London, England), Saturday, February 1, 1997, Issue 65802, p.1[S1] 

Illustrated London News – Saturday 19 February 1927 

Leeds Mercury – Thursday 10 February 1927

Ancestry.com. UK, Outward Passenger Lists, 1890-1960 [database on-line]

https://saintyrieixlaperche.wordpress.com/2018/03/05/felix-joubert-lorfevre-londonien-famous-london-art-restorer-auteur-de-la-copie-du-chef-reliquaire-de-saint-yrieix/

https://sculpture.gla.ac.uk/view/person.php?id=msib1_1271953076

1851 Census – Class: HO107; Piece: 1475; Folio: 380; Page: 8; GSU roll: 87798

1881 Census – Class: RG11; Piece: 82; Folio: 112; Page: 41; GSU roll: 1341018

1891 Census – Class: RG12; Piece: 59; Folio: 156; Page: 6

1901 Census – Class: RG13; Piece: 72; Folio: 143; Page: 43

1911 Census – Class: RG14; Piece: 381

“but being deaf, the Spirit not the Body tires” – the Duke of Wellington’s Hearing Loss

Hugh Dominic WStiles3 May 2019

Arthur Wellesley, the Duke of Wellington, who was born 250 years ago, in 1769, suffered from noise-related hearing loss caused by artillery.  William Wright tells us,

The Duke of Wellington was inspecting an experimental carriage for a howitzers and whilst in advance of the gun, gave the word ” Fire ;” the result was the rupture of the membrane of the drum of the left ear. The Duke went immediately to Mr. Stevenson who told his Grace the story, about thickening the drum of the ear. The solution of caustic was applied; instant pain ensued, from the caustic passing through the ruptured membrane amongst the ossicula, and very sensitive internal tissues. Within six hours the Duke was conveyed home from Lord Liverpool’s, in a state of insensibility, and it was only by most careful, skilful treatment that his life was then preserved. He went to Verona, a great sufferer, and the country had very properly to make a handsome compensation to Dr. Hume, and his family, for giving up his practice to attend the Duke on his mission. (Wright, 1860, p.75-6)

Graham Smelt says that this was on On August the 5th, 1822.  His hearing loss was made considerably worse by the botched treatment, a story related by a Mr Gleig, in an anecdote that suggests it was Hume who was to blame –

The Duke, many years ago, being deaf, sent for his medical man, who poured some stuff into his ear, not knowing that the drum of the ear was broken. This proved very mischievous in its results. The Duke said it was not sound that was restored to him; it was something terrifically beyond sound: the noise of a carriage passing under his window was like the rolling of thunder. Thus suffering, he returned home about the middle of the day, and went to bed. Next day, Dr. Hume called and found the Duke staggering about the room. Dr. Hume, although he well knew the Duke’s temperate habits, supposed that he had taken a little too much wine overnight, and had not recovered from it. He was leaving the room, when the Duke said to him : Hume, I wish you would look to my ear ; there is something wrong there.’ Hume looked and saw that a furious inflammation had begun, extending to the brain ; another hour, and the stuff would have done for the Duke what all his enemies had failed to do : it would have killed him. Hume bled him copiously, sent for Sir Henry Halford and Sir Astley Cooper, who treated him with great skill, and brought him round. The poor man came next day and expressed his great regret. The Duke spoke to him in his kindest manner and said, I know you did not mean to harm me ; you did your best, but I am very deaf.’ Upon which, the Doctor said, I am very sorry for it ; but my whole professional prospects are at stake, and if the world hears of it I shall be ruined.’ ‘The world need not hear at all about it,’ said the Duke; ‘keep your counsel, and I’ll keep mine.’ The Doctor, encouraged by this, went a little further : Will you let me attend you still, and let the world suppose that you still have confidence in me ?’ ‘No, no,’ said the Duke, ‘I cannot do that ; that would not be truthful.’ (Davies, 1854 p.16-17)

To me this sounds like a well-rehearsed anecdote, but there is something ‘missing,’ it seems to me, in Wright’s account, in that he seems to imply that Hume had some hand in the affair without explicitly saying so.  Or is he just omitting Stevenson’s name, and ‘the poor man’ is Stevenson?  Smelt says that Stevenson was to blame, and that Hume treated him afterwards.  In an earlier book, Wright tells us –

Deleau states that he can reach the cavity of the tympanum by a bent probe, or catheter. If he even can do so, which I consider is very problematical, I am convinced the operation is attended with considerable danger, for the ossicula (the small bones) which extend from the inside of the membrana tympani, to the opposite side of the cavity, would be in great danger of being forced from the situation in which Providence has been pleased to place them, or their functions would be otherwise diminished, or destroyed, and such would be the effect of any injury being inflicted on this delicate organization, that inflammation of the brain, and even death, would be a probable consequence. An example of this was unfortunately nearly afforded about the end of 1822, or beginning of 1823, in the case of the Duke of Wellington, a lotion of lunar caustic had been dropped into the external auditory passage, there was an opening at the time through the membrane (or drum), from an accidental cause, and the caustic lotion entered the cavity beneath, containing the highly sensative [sic] integuments, and machinery therein placed ; the results were intense pain; in a few hours inflammation of the brain, with symptomatic fever, and his life was only preserved by the most prompt and efficient treatment pursued by his Physician, aided by other medical and surgical advice derived from the first men of the age. In June, 1823, I was called into attendance on his Grace, as his aurist, and continue still to attend him when necessary ; even at this distant period from the unfortunate occurrence, the Duke feels sufficient unpleasant effects occasionally, not to allow him to forget it, independent of the privation of his left ear.* Similar, if not even worse, must necessarily be the consequence of introducing an instrument into the cavity of the tympanum, even if the patient be in a state of health; but if there exist any tendency to inflammatory action, scrofula, or erysipelas, the danger is increased, and the disastrous effects, or even fatal termination of the experiment, for it is nothing more in ninety-nine cases out of a hundred, unavoidable. (Wright, 1839, p.55-7)

* In pp. 159 and 160, of “An Exposition of Quackery and Imposture in Medicine,” written by Dr. Caleb Ticknor, of New York, republished in this country, which I edited, and upon which I wrote copious notes, will be found a further account of the Duke of Wellington’s case.

Note how free doctors were then with patient information, while the patient was still alive. Smelt suggests as well as the seriously damaged ear, he also had noise-induced hearing loss in his other ear as he got older.

In 1852 the Duke wrote in a letter,

I have none of the infirmities of old age I excepting Vanity perhaps. But that is a disease of the mind, not of the Body ! My deafness is accidental ! If I was not deaf, I really believe that there is not a youth in London who could enjoy the world more than myself or could bear fatigue better, but being deaf, the spirit, not the body, tires. One gets bored, in boring others, and one becomes too happy to get home. (Wellington, 1854, p.314-5)

Losing his hearing had other consequences, as we see from this on February 20th, 1848 from the Greville memoirs –

At the House of Lords on Friday night, for the Committee on the Diplomatic Bill. Government beaten by three, and all by bad management ; several who ought to have been there, and might easily have been brought up, were absent : the Duke of Bedford, Duke of Devonshire, Lord Petre, a Catholic, dawdling at Brighton, and Beauvale. The Duke of Wellington, with his deafness, got into a complete confusion, and at the last moment voted against Government. (Greville, 1888, p.129)

When he was in his eighties, as members of Derby’s 1852 government were announced, the now quite deaf Duke kept repeating, “Who? Who?”  It became known as the “Who? Who?” ministry.

Davies, George Jennings, The completeness of the late duke of Wellington as a national character, 1854

Greville, Charles Cavendish Fulke, The Greville Memoirs: A Journal of the Reigns of King George IV, King … 1888

Hazlitt, William, ed, Arthur Wellesley Duke of Wellington, The Speeches of the Duke of Wellington in Parliament, Volume 2, 1854

Smelt, Graham, Wellington’s Deafness. Abstract presented at the meeting British Society for the History of ENT, Held December 1st 2011 In the Toynbee McKenzie Room, at the Royal Society of Medicine, London

Wright, William, A few minutes’ advice to deaf persons…, 1839

Wright, William, On the varieties of deafness and diseases of the ear, 1829

Wright, William,  Deafness and Diseases of the Ear: The Fallacies of Present Treatment Exposed … 18

How Do Storms Affect Asthma?

Hugh Dominic WStiles18 June 2018

by Abir Mukherjee

D’Amato and colleagues discuss the idea that thunderstorms in pollen season can induce severe asthma attacks in susceptible pollinosis patients.
The scientific background to this observation is that that storms can concentrate pollen grains at ground level, which may then release allergenic particles of respirable size in the atmosphere after their imbibition of water and rupture by osmotic shock. During the first 20-30 minutes of a thunderstorm, a large amount of pollen is dispersed into the atmosphere as a bioaerosol of allergenic particles, which can induce asthmatic reactions, often severe. Subjects without asthma symptoms, but affected by seasonal rhinitis can also experience an asthma attack
A key message for susceptible patients is increasing awareness of being outdoors during a thunderstorm in the pollen season could trigger an asthma attack.
Davies et al in the BMJ (2018) also discuss the phenomenon of epidemic thunderstorm asthma. They suggest proactive measures to identify and pre-emptively protect susceptible people are critical to mitigating the effects of thunderstorm asthma. Whilst known previous asthma seems to be an inadequate predictor of risk, seasonal allergic rhinitis (hay fever) from grass pollen allergy, and degree of sensitisation, appears to be a universal risk factor among affected patients.

References

How Do Storms Affect Asthma?
Author(s) D’Amato G; Annesi-Maesano I; Vaghi A; Cecchi L; D’Amato M
Source Current Allergy and Asthma Reports; Mar 2018; vol. 18 (no. 4); p. 24

Thunderstorm asthma: controlling (deadly) grass pollen allergy
Author(s) Davies, J.M., Thien, F. and Hew, M., 2018.
Source BMJ: British Medical Journal (Online), 360.5

Asthma Patient Information

Hugh Dominic WStiles1 May 2018

A post from our Clinical Librarian, Abir Mukherjee @ClinicalLibUCLH 

Some basic patient information on asthma as a condition and management can be found at the following sites:

  • Patient Info provides a printable overview of asthma as well as how to manage it and what things may act as triggers. https://patient.info/health/asthma-leaflet
  • NHS Choices also discusses causes, triggers and complications in simple language. https://www.nhs.uk/conditions/asthma/
  • The British Lung Foundation provides a range of information on causes, symptoms , management and has a specific section for asthma in children. https://www.blf.org.uk/support-for-you/asthma
  • The AAIR Charity (Asthma, Allergy & Inflammation Research) focusses on effective treatments and cures for allergic diseases, notable research has included the identification of an asthma gene. It has some basic background information for patients on its website. http://www.aaircharity.org/

Asthma – 5 articles on treatment from 2018

Hugh Dominic WStiles1 May 2018

A post from our Clinical Librarian, Abir Mukherjee  @ClinicalLibUCLH

Here are five recent articles on asthma treatment from 2018:

  • Akhbari, M., Kneale, D., Harris, K.M. and Pike, K.C., 2018. G460 (P) Interventions for autumn exacerbations of asthma in children: a systematic review. Cochrane Reviews
  • Chang, Y.S., 2018. Non-pharmacologic Therapies for Severe Asthma. In Severe Asthma (pp. 123-129). Springer, Singapore.
  • Larsson, K., Ställberg, B., Lisspers, K., Telg, G., Johansson, G., Thuresson, M. and Janson, C., 2018. Prevalence and management of severe asthma in primary care: an observational cohort study in Sweden (PACEHR). Respiratory research, 19(1), p.12.
  • Licari, A., Castagnoli, R., Brambilla, I., Marseglia, A., Tosca, M.A., Marseglia, G.L. and Ciprandi, G., 2018. New approaches for identifying and testing potential new anti-asthma agents. Expert opinion on drug discovery, 13(1), pp.51-63.
  • Sobieraj, D.M., Weeda, E.R., Nguyen, E., Coleman, C.I., White, C.M., Lazarus, S.C., Blake, K.V., Lang, J.E. and Baker, W.L., 2018. Association of Inhaled Corticosteroids and Long-Acting β-Agonists as Controller and Quick Relief Therapy With Exacerbations and Symptom Control in Persistent Asthma: A Systematic Review and Meta-analysis. JAMA, 319(14), pp.1485-1496.

Chang (2018) identifies inhaler technique and adherence as the the key factors of successful management in severe asthma. He discusses factors to aid self-management such as patient education to maintain regular medications; a written action plan and awareness of environmental triggers such as inhalant allergens, smoking, air pollution, respiratory infections, and obesity.

Licari et al (2018) in their review provide a comprehensive and updated overview of the currently available, new and developing approaches for identifying and testing potential treatment options for asthma management. They discuss future therapeutic strategies for asthma needing the identification of reliable biomarkers that can help with diagnosis and endotyping, in order to determine the most effective drug for the right patient phenotype. Furthermore they conclude that a better understanding of the mechanisms of airway remodeling will likely optimize asthma targeted treatment.

Pike et al (2018) in their Cochrane systematic review found that seasonal omalizumab treatment from four to six weeks before school return may reduce autumn asthma exacerbations. Negative associations included injection site pain and treatment costs.

Sobierj and colleagues (2018) in a systematic review and meta-analysis discuss combined use of inhaled corticosteroids and long-acting beta-agonists (LABAs) as the controller and the quick relief therapy termed single maintenance and reliever therapy (SMART) which could be a potential therapeutic regimen for the management of persistent asthma.

A Swedish study by Larsson found that patients with severe asthma had few regular contacts with both primary and specialist care, and more than half of them experienced poor asthma control.

Please contact Hearing Library staff if you have any trouble accessing or finding these articles (or others!).

Hearing Awareness Day – Patient Information

Hugh Dominic WStiles27 February 2018

By Abir Mukherjee @ClinicalLibUCLH

This second post of this series highlights a small selection of reliable patient information resources for hearing loss in general. Once again, these sources either meet the NHS Information Standard or are produced by reputable organisations.

Action on Hearing Loss (formerly the Royal National Institute for Deaf People – RNID) estimates that one in six people in the UK has hearing loss or is deaf, and increasingly people are accessing help to hear better. Their website discusses in clear terms, the different types and causes of hearing loss and deafness, as well as what people can do if they are worried about hearing loss – from seeing a GP to getting hearing aids or a cochlear implant. They also have a very useful glossary for hearing disorders and symptoms. NHS CHOICES also provides a relevant overview of hearing loss including symptoms and treatment options. In line with this year’s World Hearing Day theme of ‘Hear the Future’ they also discuss some simple but common sense ways of reducing the risk of damage to hearing such as:

· not having the television, radio or music on too loud

· using headphones that block out more outside noise, instead of turning up the volume

· wearing ear protection (such as ear defenders) in a noisy environments

· using ear protection at loud concerts and other events where there are high noise levels

· not inserting objects ears – this includes fingers, cotton buds, cotton wool and tissues

· Get a hearing test as soon as possible if worried about hearing loss -the earlier hearing loss is picked up, the earlier something can be done about it.

ENT UK, produced by the Royal College of Surgeons also has easy to understand information on ear anatomy and how the ear works to explain hearing disorders and common causes. Patient Info also has a range of pertinent information on hearing disorders and downloadable leaflets.

Background for World Hearing Day

Hugh Dominic WStiles26 February 2018

By Abir Mukherjee

World Hearing Day is held on 3 March each year in order to raise awareness and understanding of deafness and hearing loss, and to promote ear health and the care provided by audiologists across the world.

This year’s theme is “Hear the future”, and World Hearing Day 2018 hopes to draw attention to the anticipated rise in people with hearing loss around the world in the coming decades.

The WHO’s figures estimate 466 million people worldwide live with disabling hearing loss. Unless action is taken, by 2030 the number will rise to nearly 630 million.

Key initiatives for #WorldHearingDay2018 include preventative strategies to stem the rise in hearing loss and steps to ensure access to the necessary rehabilitation services; communication tools and products for people with hearing loss.

All of these are important areas of research for Action on Hearing Loss, the UCL Ear Institute, the Royal National Throat, Nose and Ear Hospital, and many other colleagues and organisations in the UK and further afield.

Throughout the week we will be writing blogs highlighting evidence and information in support of “Hear the future”, and World Hearing Day.

References: World Health Organization. (2018). 3 March 2018: World Hearing Day. [online] Available at: http://www.who.int/deafness/world-hearing-day/whd-2018/en/ [Accessed 23 Feb. 2018].

Tinnitus in the media…

Hugh Dominic WStiles9 February 2018

Tinnitus frequently appears in newspapers and online news sources. Because anyone who suffers from a chronic condition can get frustrated, despressed and angry at the inabilty of medical science to cure the condition, that makes people ready to grasp at anything that could give them hope, offering to alleviate or cure the condition. Tinnitus is no exception, and below are a few recent stories that cover it, all in this case from the Daily Mail, though other papers and websites could equally have been included.

It pays to be a little sceptical with health stories.  Always ask yourself the questions –

  • who produced the study or studies behind the story?
  • are they reputable researchers, or are they selling something?
  • has the article given the original source where the study is published?
  • is the newspaper story written by someone who knows what they are writing about, or is it a staff writer who is regurgitating a press release which has a positive spin?
  • If the study is based on a group of patients, was it a small number or a large number?

I am not saying these stories are invalid, but the headlines are never written by the author, and they often disguise the facts.  People come away remembering the headlines, not the complete story.  Read these stories, but with caution.

Do YOU suffer from tinnitus? Study reveals ‘resetting’ brain cells using electric currents can alleviate the misery of phantom sounds
Read more: http://www.dailymail.co.uk/health/article-5232433/Study-reveals-resetting-brain-cells-cure-tinnitus.html#ixzz56cL3gYau

Google alert helps to end a former Royal Marine’s 10-year tinnitus hell: Notification highlighted pioneering IPOD-based therapy that has allowed veteran to ‘function again as a human being’
Read more: http://www.dailymail.co.uk/health/article-5030949/Royal-Marine-tinnitus-finds-relief-IPOD-therapy.html#ixzz56cMfslW7

Fed up with the noise of modern life? FEMAIL reveals how at home EAR YOGA can help
Read more: http://www.dailymail.co.uk/femail/article-5337717/Fed-noise-modern-life.html#ixzz56cV58VzY

Tinnitus Awareness Week 2018 – Suggested reading

Hugh Dominic WStiles8 February 2018

Tinnitus is an active area for research, because it bothers so many people.  Even if you do not have it, there is a good chance you know someone who has it in some form, ranging from a minor irritation to a serious frustration.  People are looking for cures, but management of the condition seems the most realistic solution for most people.  Here are a few suggested books that might help those who have tinnitus.

For non-experts –

Living with tinnitus and hyperacusis, by Laurence Mckenna, David Baguley and Don McFerran, 2010.

This book has 4 or 5 stars in 75% of the Amazon.co.uk public reviews.

Tinnitus: Questions and Answers, by Jack Vernon and Barbara Sanders, 2001. ISBN-13 978-0205326853

“The questions in this book are from patients. The answers are written for patients and for interested health care providers too. The book covers causes, treatments, and other topics with a format similar to the column written by the author in “Tinnitus Today” magazine.”

For Experts –

Tinnitus Retraining Therapy: Implementing the Neurophysiological Model, by Pawel Jastreboff and Jonathan Hazell, 2004.  ISBN 0521592569

‘One of the nice things about being asked to review a book is that you get to keep a copy if it – and this is certainly a book well worth keeping. This is a thought-provoking and stimulating book for dipping into, for referring to, for speed-reading and for reading thoroughly from cover to cover. It will be a useful addition to the shelves of professionals who work with people with tinnitus.’ Tinnitus Focus

Tinnitus, by by David Baguley, Gerhard Andersson,‎ Don McFerran,‎ Laurence McKenna, 2nd edition 2013. ISBN-13: 978-1405199896

‘The 2nd edition has been thoroughly updated and revised in line with the very latest developments in the field. The book contains 40% new material including two brand new chapters on neurophysiological models of tinnitus and emerging treatments.’

Tinnitus Awareness Week – Patient Information

Hugh Dominic WStiles8 February 2018

By Abir Mukherjee @ClinicalLibUCLH

Tinnitus Week is an international event raising global awareness of this condition taking place from 5-11 February 2018. The aim of the week is to raise awareness of the condition. This blog post gives a quick overview of some patient information sources, all of which meet NHS England’s patient information standard.

The Action on Hearing Loss website has a number of free factsheets on its website in addition to a tinnitus helpline number: https://www.actiononhearingloss.org.uk/hearing-health/tinnitus/

The British Tinnitus Association believes the condition affects approximately 1 in 10 of the population in the UK. Other details about tinnitus awareness week, information sheets, and a helpline can be accessed at their website: https://www.tinnitus.org.uk/h-blog

The website also has a case study of living with tinnitus which is now on BBC news.

NHS Choices defines tinnitus as ‘hearing sounds that come from inside your body, rather than from an outside source’ with sufferers describing ‘ringing in the ears’ or ‘buzzing; humming; grinding; hissing or whistling.’ As a starting point for most patient information it can be accessed at: https://www.nhs.uk/conditions/tinnitus/

An overview of symptoms and treatment options is also available from the Patient.co.uk website at: https://patient.info/health/tinnitus-leaflet

ENT UK, a professional membership body that represents Ear, Nose and Throat and its related specialities also has patient information on tinnitus that can be downloaded from: https://www.entuk.org/sites/default/files/files/ENT/About%20Tinnitus%206pp%20DL%20%2809028%29_7_16.pdf.