Introductory Comments on Ménière's Disease

Abstract

In 1861 Prosper Meniere first reported a new and epoch-making theory that human vertigo can be caused by inner ear disturbance.The probable factors which might have led him to this excellent theory can be recapitulated as follows. (1) First of all, we must consider him to be a genius endowed with excellent power of inspiration and insight. (2) Because he was a doctor in the Institute for Deafness for a long time, he saw many patients suffering from deafness and tinnitus combined with vertigo. (3) His senior doctor in the institute, J. M. Itard, had also been interested in this disease and had often told him about it, which aroused and fortified his interest in it. Itard, however, had no idea that the cause of vertigo lay in the inner ear. (4) Meniere's was an excellent, particularly attentive and thoughtful observer of patients. (5) He knew well and was extremely interested in Prof. Flourens's experiment on pigeons showing ataxia from inner ear destruction. (6) His excellent power of speculation could connect human vertigo with this pigeon ataxia. (7) Through the kindness of a doctor friend, he fortunately encountered an autopsy case of a patient suffering from vertigo and could discover the pathological change—bleeding—in the inner ear, which was unaccompanied by any changes in the brain.One of the most remarkable topics in Menierology is that his apparently lost tomb and descendants have recently been discovered in Paris. Mme. Baroness Meniere is the 5th generation of the Meniere's family. It is admirable that 5 members of the Meniere's family including him received the medal of “la legion d'honneur”.Although the existence of endolymphatic hydrops in the inner ear has been confirmed since the first reports of Yamakawa and Hallpike in 1938, the real cause of this disease still remains obscure.We speculate that its real cause is not a simple one, but a compound of several factors which form a serial or/and parallel pattern.