Introduction
Boxing of the ears, most often referred to as telefono, is a means of hurting an individual by simultaneously slapping both ears with cupped hands. This leads to a sudden, rapid increase in pressure in the ear canal with obvious, painful consequences.{1}
Punishment
Lovers of Lewis Carroll’s Alice’s Adventures in Wonderland are unwittingly familiar with telefono:-
"It's--it's a very fine day!" said a timid voice to Alice.
She was walking by the White Rabbit, who was peeping anxiously into her face. "Very," said Alice. "Where's the Duchess?" "
Hush! Hush!" said the Rabbit. "She's under sentence of execution."
"What for?" said Alice.
"She boxed the Queen's ears--" the Rabbit began.{2}
Carroll’s original readership knew about boxing of the ears as it was a popular form of child punishment in Victorian times. However, even in an era when the physical chastisement of children was considered both acceptable and normal, this particular punishment was known to be risky:-
For not only is deafness caused by “boxes,” which rupture the drum of the ear, but the inflammation of the internal cavity, which is so frequent a result, may be followed by disease of the bone, giving rise to abscess of the brain, and having a fatal termination.{3}
Knowledge of these dangers were not confined to the academic elite. Across the Atlantic in America, a Mormon housewives’ magazine article quoted a poem by the Victorian poet Elizabeth Browning that ‘commemorates the act of an old Earl of Arundel’ whose child became ‘imbecile from the effects of the blow’.{4} The article’s author concluded, ‘It would be well for every parent… to commit these verses to memory; for the injury done to children by the quick and careless box of the ear, that is thought nothing of at the time, is something incalculable’.{5}
Combat
In the 1960s telefono made it into popular culture when Captain Kirk deployed it to stun the lizard-like Gorn in the opening season of Star Trek.{6} A staple of self-defence courses and military manuals, it was even taught to World War II British commandos:-
Cup your hands, keeping the thumb and fingers bent, and close together. Strike your opponent simultaneously over both ears, using five to ten pounds force with both hands. This will probably burst one of (sic) both ear-drums and at least give him a mild form of concussion, and make him what is known in boxing circles as punch-drunk. You will then have no difficulty in dealing with him in any way you wish.{7}
Analysing the technique in Black Medicine, The Dark Art of Death, a 1970s self-defence guru wrote, ‘The ear contains a high concentration of sensory nerves associated with hearing and balance. Striking the ear with a cupped hand sends a shock wave down the ear canal which ruptures the tympanum and shocks the delicate inner ear mechanisms, producing severe pain, dizziness, and unconsciousness’.{8}
Torture
Boxing of the ears is widely practised as a form of torture.{9} Referred to by various names including telefono in Spanish, chakoshi (‘the hammer’) in Japanese and kalot marasa (‘the twins’) in Haitian Creole, there is documentation of its use as a form of torture in more than 20 countries across the world.{10} Little is known about its true prevalence but some interesting data does exist. In 1999, 17% of people referred to a Danish rehabilitation centre were thought to have been victims of telefono; they came from Afghanistan, Chile, Iran, Iraq, the occupied Palestinian territories, Turkey and the former Yugoslavia.{11} And a Swedish study from 2003 examined 160 refugees from six countries and found that 18.8%, all from Peru, had been tortured with telefono.{12}
Consequences
Telefono’s intended physiological consequences are caused by the rapid build-up of pressure inside the ear canal, leading to injuries reminiscent of explosive trauma. There will likely be rupture of the tympanic membranes with consequent short-term pain and hearing loss, and the temporal bone may fracture. The sequelae of this include middle ear infections (especially in dirty places of detention), which in turn may result in chronic ear and bone infections as well as cholesteatoma.{13} And destruction of the inner ear’s hair cells may cause long-term and even permanent tinnitus, dizziness and hearing loss.{14}
Synonyms
Testimony
I am used to finding evidence of telefono that took place in non-European countries. But I got a surprise the first time that I heard of it taking place within a European high income country. My patient was telling me about a ‘welcoming ceremony’ that he and the other new prisoners received upon arrival at his current jail. He described being hit around both ears by a prison guard wearing black gloves. It all sounded a bit familiar and so I wondered, ‘Is he just describing a general beating or could this in fact be telefono?’ His answers to my further open questions left me in no doubt: the blows were simultaneously bilateral and repeated, he had been in severe pain at the time, blood had trickled out of both ears, and months on he still couldn’t hear well and got dizzy at times. And my examination of his tympanic membranes showed bilateral perforations, which of course are consistent with telefono.
(Dr Rachael Pickering)
References
1. United Nations (editor). Istanbul Protocol: manual on the effective investigation and documentation of torture and other cruel, inhuman, or degrading treatment or punishment. Revision 1. United Nations, New York; 2004: 76
2. Carroll, L. Alice’s Adventures in Wonderland. Macmillan, London; 1865: 8: 96
3. Unknown. Boxes on the Ear. The London reader: of literature, science, art and general information. 1878; 31.801:449
4. Unknown. A Box on the Ear. Woman’s Exponent. 1891; 20.3: 19.
5. Unknown. A Box on the Ear. Woman’s Exponent. 1891; 20.3: 19.
6. Star Trek The Original Series. Episode 1x18: Arena. Paramount Television, United States; 1967.
7. Fairbairn, W. All-in Fighting. Naval and Military Press, City; 2009 (reprint edition)
8. Mashiro, N. Black Medicine: The Dark Art of Death. Paladin Press, United States of America; 1978
9. Nowak, M. Promotion and protection of all human rights, civil, political, economic, social and cultural rights, including the right to development. Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Manfred Nowak. Mission to Sri Lanka. United Nations, United States of America; 2008: A/HRC/7/3. [Online]. [Accessed 28th November 2020]. Available from: https://www.refworld.org/docid/47c2c5452.html
10. Rejali, D. Torture and democracy. Princeton University Press, United States of America; 2007: 849
11. Sinding, R., Smidt-Nielsen, K. The late ear, nose, and throat region sequelae of torture. Torture. 1999; 1/99(9)
12. Moisander, P., Edston, E. Torture and its sequel - a comparison between victims from six countries. Forensic Sci Int. 2003; 137(2–3): 133–40.
13. Graessner, S. Tinnitus in torture survivors. Torture. 1994; 1/94(4): 19-22.
14. Sinding, R., Smidt-Nielsen, K. The late ear, nose, and throat region sequelae of torture. Torture. 1999; 1/99(9)