Prosper Menière
Prosper Ménière is an important name in the fields of Otology and Neurotology. In 1861 he presented a paper before the French Academy of Medicine in which he described a series of patients with episodic vertigo and hearing loss. He also mentioned the postmortem examination of a young girl who experienced vertigo after a hemorrhage into the inner ear. Before that time, vertigo was thought to be a cerebral symptom similar to epilepsy. Menière pointed out that vertigo frequently had a benign course. He was not attempting to define a disease or syndrome but rather to emphasize that vertigo originated from damage to the inner ear.
The disease that he described in 1861 is still named after him. And he is praised by his precise clinical description of its symptoms. The French neurologists of that time, however, firmly believed that vertigo was a brain disorder. In fact, their belief was so intense that they attacked Menière in a vicious manner. The French neurologists of that time were renowned physicians and their contribution to medical science was significant. But this time they were wrong. Menière wrote four papers in defense of his findings, and did not write others because he died in 1862, less than one year after his famous monograph.
Another reason that we still praise Menière was his use – probably the first – of basic sciences in his clinical approach. There was always a gap between medical researchers and clinicians, and at that time the gap was enormous, practically no interchange existed. And yet Menière was acquainted with the work of Flourens and this knowledge was essential to his conclusions.
He was born on June 18th, 1799, a son of a merchant in the city of Angers, France. He received an excellent education in classics and humanities.
He was seventeen years old when he entered the school of medicine at the University of Angers. At the end of his third year, he moved to Paris to complete his medical studies. In 1828 he received his doctorate and was appointed assistant to Guillaume Dupuytren, a famous surgeon that worked at the Hotel-Dieu Hospital. In 1832 he became an associate professor at the University of Paris. Interestingly, he was a close friend of some very well known people, like Victor Hugo, Honoré de Balzac, Prosper Mérimée, Jean-Jacques Ampère (a historian, son of the physicist André-Marie Ampère), and Alphonse de Lamartine.
In 1838 he was appointed Head of Institut des Sourds-Muets, after Jean Itard’s death. From this time dates his particular interest in the diseases of the ear.
Many years later, in 1914, the Nobel Prize in Medicine was given to a Hungarian physician named Robert Bárány, the father of Neurotology. It is interesting to quote a small portion of Bárány’s speech at the Karolinska Institute in Stockholm, when received the prize:
“As neither of these two great research scientists (Flourens and Purkinje) was able to find the solution to the mystery, it is small wonder that none of their contemporaries were able to do so either. Science stood still in this respect for nearly 40 years. Only in the year 1861 was a Frenchman, Menière, able to take a bold step forward.
“Menière proceeded along totally different lines from his predecessors ... He observed this kind of patient (patients with vertigo) for years and saw absolutely no symptoms of brain disease. Menière now had the idea that the vertigo phenomena were symptoms of disease in the semi-circular canal apparatus and he now succeeded, where Flourens and Purkinje had failed, in seeing through the confusing diversity of the vertigo manifestations in humans and in animals and recognizing that those animals whose semi-circular canals had been operated upon by Flourens had vertigo. This was the principal great achievement of the man who, unfortunately, did not survive to enjoy the fame of his discovery, since he died in the same year.”
I would like to mention some famous persons that had Menière’s disease. We will begin with Julius Caesar. Historically he was believed to have epilepsy. Sir Terence Cawthorne studied his books Commentarii de Bello Gallico and Commentarii de Bello Civico and concluded that the “falling sickness” of which he complained and the symptoms of which he described were actually Menière’s disease.
Another was Vincent van Gogh. It was I. Kaufmann Arenberg who conducted a exhaustive research on his life and reached the same diagnosis. It must be stressed, however, that Julious Caesar belonged to Antiquity, while van Gogh was a contemporary of Menière. And yet his neurologists and psychiatrists misdiagnosed him and placed him in several different institutions for insane patients. It is quite surprising that this did not affect his artistic output, even though it ruined his life.
I also want to mention Alan B. Shepard, Jr., America's first man in space on the spaceship Freedom 7. He was originally selected to command the spaceship Gemini 3 but, just like it happened to other astronauts, he acquired Menière's disease after his first orbital flight. He was operated by William House and was then restored to flight status. He commanded Apollo 14, the third successful trip to the Moon. Bill House told me that he was concerned that some problem could originate, in space, from the subarachnoid endolymphatic shunt, but the NASA people told him that even if he had some unexpected problem the other two astronauts would be able to handle the mission. Bill, as a special guest of NASA, stayed in Cape Canaveral during the whole expedition. Shepard had no problems at all and, as we all know, the mission was quite successful.
Menière’s disease remains a mystery. We learned to treat it but we know very little about its causes and its pathogenical mechanisms. This great scientist gave us a model disease that will stimulate the best efforts of clinicians and researchers for many years.
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| A portrait of Prosper Menière |
Another reason that we still praise Menière was his use – probably the first – of basic sciences in his clinical approach. There was always a gap between medical researchers and clinicians, and at that time the gap was enormous, practically no interchange existed. And yet Menière was acquainted with the work of Flourens and this knowledge was essential to his conclusions.
He was born on June 18th, 1799, a son of a merchant in the city of Angers, France. He received an excellent education in classics and humanities.
He was seventeen years old when he entered the school of medicine at the University of Angers. At the end of his third year, he moved to Paris to complete his medical studies. In 1828 he received his doctorate and was appointed assistant to Guillaume Dupuytren, a famous surgeon that worked at the Hotel-Dieu Hospital. In 1832 he became an associate professor at the University of Paris. Interestingly, he was a close friend of some very well known people, like Victor Hugo, Honoré de Balzac, Prosper Mérimée, Jean-Jacques Ampère (a historian, son of the physicist André-Marie Ampère), and Alphonse de Lamartine.
In 1838 he was appointed Head of Institut des Sourds-Muets, after Jean Itard’s death. From this time dates his particular interest in the diseases of the ear.
Many years later, in 1914, the Nobel Prize in Medicine was given to a Hungarian physician named Robert Bárány, the father of Neurotology. It is interesting to quote a small portion of Bárány’s speech at the Karolinska Institute in Stockholm, when received the prize:
“As neither of these two great research scientists (Flourens and Purkinje) was able to find the solution to the mystery, it is small wonder that none of their contemporaries were able to do so either. Science stood still in this respect for nearly 40 years. Only in the year 1861 was a Frenchman, Menière, able to take a bold step forward.
“Menière proceeded along totally different lines from his predecessors ... He observed this kind of patient (patients with vertigo) for years and saw absolutely no symptoms of brain disease. Menière now had the idea that the vertigo phenomena were symptoms of disease in the semi-circular canal apparatus and he now succeeded, where Flourens and Purkinje had failed, in seeing through the confusing diversity of the vertigo manifestations in humans and in animals and recognizing that those animals whose semi-circular canals had been operated upon by Flourens had vertigo. This was the principal great achievement of the man who, unfortunately, did not survive to enjoy the fame of his discovery, since he died in the same year.”
I would like to mention some famous persons that had Menière’s disease. We will begin with Julius Caesar. Historically he was believed to have epilepsy. Sir Terence Cawthorne studied his books Commentarii de Bello Gallico and Commentarii de Bello Civico and concluded that the “falling sickness” of which he complained and the symptoms of which he described were actually Menière’s disease.
Another was Vincent van Gogh. It was I. Kaufmann Arenberg who conducted a exhaustive research on his life and reached the same diagnosis. It must be stressed, however, that Julious Caesar belonged to Antiquity, while van Gogh was a contemporary of Menière. And yet his neurologists and psychiatrists misdiagnosed him and placed him in several different institutions for insane patients. It is quite surprising that this did not affect his artistic output, even though it ruined his life.
I also want to mention Alan B. Shepard, Jr., America's first man in space on the spaceship Freedom 7. He was originally selected to command the spaceship Gemini 3 but, just like it happened to other astronauts, he acquired Menière's disease after his first orbital flight. He was operated by William House and was then restored to flight status. He commanded Apollo 14, the third successful trip to the Moon. Bill House told me that he was concerned that some problem could originate, in space, from the subarachnoid endolymphatic shunt, but the NASA people told him that even if he had some unexpected problem the other two astronauts would be able to handle the mission. Bill, as a special guest of NASA, stayed in Cape Canaveral during the whole expedition. Shepard had no problems at all and, as we all know, the mission was quite successful.
Menière’s disease remains a mystery. We learned to treat it but we know very little about its causes and its pathogenical mechanisms. This great scientist gave us a model disease that will stimulate the best efforts of clinicians and researchers for many years.
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