"Jean" writes:

I am very interested in the question of whether Van Gogh had Meniere's Disease, both because I love his work and suffer from the Disease. I thought I'd share my own knowledge of the disease with you in the hope that you could share any knowledge you may have of his health with me.

Meniere's Disease is a disease of the middle ear. The major symptoms of are: 1. low frequency (pitch) hearing loss that fluctuates but worsens and spreads across the spectrum over time
2. tinnitus - ringing in the ears
3. fullness in the ears - as if on an airplane and unable to clear one's ears
4. vertigo

One does not have to have all these symptoms to have Meniere's. Though most people have the hearing loss. Did Van Gogh complain of having difficulty hearing people - particularly in crowded rooms? Or did he complain of not being able to hear male voices in particular (the lower pitches)?

I know he was described as a "clumsy youth who walked like an old man". Did he have vertigo spells? The spells themselves can cause one to be thrown to the ground. It can take weeks to recover from them. It is very typical to feel dizzy, uneasy, and exhausted afterwards. Many Meniere's patients, including myself, have blurred vision afterwards and have difficulty focusing. It is almost as if I've had too much to drink, only my mind is lucid. Perhaps what was perceived as drunken behavior may at times have been vertigo and the symptoms that typically follow episodes of vertigo.

I have very limited experience with tinnitus. My tinnitus is brought on by stress and does not last long. It is horrible however when I do have it. Some Meniere's patients have it constantly. I think I would lose my mind. If the stress of the incident with his friend brought on another attack of tinnitus, I can understand why someone who was suffering so much in so many other ways would resort to what seems so drastic to most people - cutting off one's ear. Did he complain of a ringing sound in his ears?

The fullness in the ears is annoying but the least debilitating of the four major symptoms. Did he complain of feeling like his ears were always stuffy? Or did he say there was pressure in his ears?

There are several surgeries performed today for sufferers of Meniere's. One of them leaves the patient completely deaf! It is only performed when the hearing is extremely bad anyway and the tinnitus and/or vertigo has reached a debilitating point. Not too different from cutting off one's ear.

Stress and allergies seems to affect Meniere's. Heredity is a big component as well. It is very common in the U.K., 1 in 1000 people are afflicted with it, vs. 1 in 200,000 in the U.S. Obsessive-compulsive personalities tend to be afflicted more often. A common personality trait for many people with Meniere's is "intense". We still have a very limited understanding of the disease. There is a vast array of treatments, none of which are uniformly successful. Go to ten different doctors and they will have ten different remedies. We know more about the brain then the ear. There is a lot of stigma attached to the condition (i.e. many doctors will refer patients to a psychiatrist). I can understand how, if Van Gogh did have Meniere's, it would help to worsen any psychological illnesses with which he may have been afflicted. Many people with Meniere's develop depression. I know it has caused me to become far more introverted that I ever was. In and of itself, Meniere's can do a lot of harm to one's psyche.

Addendum

The symptom of vertigo alone can be caused by a long list of maladies, ranging from Migraine headaches to many autoimmune diseases, including rheumatoid arthritis. It is usually the most noticeable symptom at the onset of Menieres Disease and the symptom most likely to cause someone to seek medical attention. The onset of the disease typically occurs in people when they are in their 40s or 5os, though the range, with a few outliers, is from 25 years of age to 55 years (I was 27). For the majority of people with Menieres (70% I think), the symptom of vertigo subsides several months after the onset of the disease.

Low frequency hearing loss, however, is specific to very few diseases. Most yes"> (90+% I think) hearing loss starts at the high frequencies and spreads downward. The hearing loss for a Menieres patient starts at the low frequencies and spreads upward. Given his age at death, it may be that the disease hadnt progressed far enough to cause a noticeable loss in hearing, particularly if the vertigo began in his later years of life. At what age did he first complain of vertigo?

I know he complained of hearing noises. Are we sure this was just the typical symptoms of a psychotic episode or could he have been referring to either:

1) a high-pitch ringing (most common)
2) the sound of wind in ones ear or
3) a muffled hum.

These are common descriptions of tinnitus. He just may not have had the vocabulary to describe what was happening (particularly if he thought that the noises he was hearing was just another symptom of insanity). I had a lot of difficulty at first describing to my doctor what I was going through. It took weeks before the proper diagnosis was made and that was with a lot of help from him in articulating the new sensations I was experiencing and after a lot of tests were performed to lead him on the right track. Im not sure of the exact date when Menieres was first diagnosed. (You can easily find it on the Web. Washington University here in St. Louis has a particularly good site.). I think it was the mid-1800s. It was made by a French doctor of the same name. It is amazing how little is known about the disease even today even by a good many ENTs. Therefore, even if he had articulated these things well, it is safe to assume that the Menieres diagnosis would not have been made!

My doctor, by the way, disagrees with my statement about the prevalence of the disease in the U.K. vs. the U.S. He is of the opinion that the U.K. may include in the Menieres diagnosis things that we would categorize as something else. Its a valid point. You might want to leave out that comparison.

Also, subsequent to sending you my initial email, I came across somewhere on the Web, I think a medical site on tinnitus, that severe cases of tinnitus can cause psychotic episodes. I dont know Van Goghs history enough. But it doesnt seem too far-fetched to me that he may have been misdiagnosed.

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