Prosper Menière

While references to episodic paroxysmal giddiness have extended to Roman times in literary and historical circles, it was an eminent 19th century French physician, Prosper Menière, who first made the connection between the inner ear and an affliction characterized by sudden attacks of vertigo, tinnitus, nausea, and unilateral deafness. Menière's descriptions of clinical and pathologic features have been the subject of intense scrutiny by medical historians of the present century, spawning a number of publications analyzing each of Menière's cases in intricate detail. A significant body of literature aimed at clarifying the precise definition of Menière disease has also emerged.Prosper Menière (1799–1862) was born on June 18, 1799, in Angers, in southwestern France to a tradesman. He was an exceptional student and excelled in the sciences and classics. In 1819, he commenced his medical training at Hôtel-Dieu in Paris, France. He won a gold medal from the Hôtel-Dieu in 1826, and obtained his doctorate in 1828. At Hôtel-Dieu, Menière served as clinical assistant to the illustrious Guillaume Dupuytren. In 1832, he was appointed as assistant professor at the University of Paris.His academic career was soon interrupted and Menière's life took an unusual twist when King Louis Philippe assigned him as personal physician to the Duchess of Berry, who had aspirations of the French throne for her own son. The Duchess asked Menière to confirm if she was pregnant. When the Duchess delivered a daughter and her clandestine marriage to an Italian nobleman became known, she left for Italy escorted by Menière, who remained in her service for some time. In 1835, Menière was sent on a mission to combat an outbreak of cholera in France, which won him the title of Chevalier of the Legion of Honor.In 1838, Menière was appointed chief physician at the Institute for Deaf-Mutes in Paris, succeeding the renowned Gaspard Itard. While he continued to maintain varied medical interests, from this point on his professional activities focused on otology.Drawing on the experience of Flourens in his work with pigeons and on his own experience at the Institute for Deaf Mutes, Menière formulated a new explanation for the condition now bearing his name. His first mention of the condition appeared in 1848 in the form of an inconspicuous note in his French translation of Wilhelm Kramer's German text on diseases of the ear. In his note, Menière described a young girl afflicted with sudden deafness who died shortly thereafter; at postmortem examination, Menière found in the “whole labyrinth a sort of plastic, reddish lymph.” Years later, in January 1861, Menière presented a paper, entitled “On a Particular Kind of Hearing Loss Resulting From Lesions of the Inner Ear,” to the Imperial Academy of Medicine in Paris. The presentation did not receive the attention it deserved. All his writings on the subject were published in 1861 in Gazette Médicale de Paris, representing his most famous contributions to otology.In the publication entitled “A Report on Lesions of the Inner Ear Giving Rise to Symptoms of Cerebral Congestion of Apoplectic Type,” Menière acknowledged that he was not describing a new disease, but identifying accurately the locus of pathology to the semicircular canals. He concluded in this article that the auditory apparatus may be affected suddenly, causing tinnitus and diminution of hearing, and that the inner ear could also be affected suddenly, resulting in attacks of vertigo, dizziness, and unsteady gait, which may be accompanied by nausea, vomiting, and syncope. He recognized that the pathology associated with these “attacks reputedly of cerebral origin” was not central, and he localized it to the semicircular canals.Menière married Mademoiselle Becquerel, who was related to the famous discoverer of radioactivity. Their son, Emile, also made a mark in the field of otolaryngology, succeeding his father at the Institute for Deaf-Mutes.Menière had an abiding interest in the intellectual life of Paris and frequented its literary circles. His own lifelong love of the humanities and Greek and Latin classics was evident in his many literary works, including one entitled “Études Médicales sur Les Poètes Latins,” published in 1858. Menière was well known to writers like Victor Hugo and Honoré de Balzac.Menière died of pneumonia after a short illness in 1862, the year after publication of his most famous work. While a household name in medicine today, Menière did not receive the recognition due to him in his own lifetime.

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