Small compact metal ear trumpet hearing aid, with ivory earpiece, made by Hawksley and Sons Ltd, London, 1869-1900.
The user would place the ivory earpiece inside the ear canal. The ear trumpet amplified sounds down the tube acting as a type of parabolic reflector. This reflective device projects energy onto a focal point, in this case the ear drum, through refraction and reflection. This enables the ear trumpet to be an effective hearing aid while remaining relatively small.