- 耳鼻と臨床 (ISSN:04477227)
- vol.25, no.6, pp.1427-1439, 1979-11-20 (Released:2013-05-10)
In his twilight years, painter VINCENT VAN GOGH (1853-1890) was often attacked by paroxysms of illness and he committed suicide after treatment of one and a half years' duration. GOGH'S ailment has been considered as a mental disease but the author, from an otological viewpoint, reviewed his letters, behaviors and works and reached a conclusion that GOGH probably was plagued by MÉNIÈRE's disease.I. The reasons for diagnosing him to have MÉNIÈRE'S disease.1) There was vertigo.In his letters, GOGH often complained that he was frequently having dizzy spells.“Vertigo was felt with me always.”(j'avais toujours des vertiges, W4)“The vertical tremors began attacking me since early this month.”(le tangage, qui a accompagné le commencement de ce mois-ci. 546)“Having so frequent attacks of vertigo, ”(ayant si souvent le vertige, 605)“An attack of vertigo comes on in the long run.”(c'est à avoir le vertige. 638)2) There was a recruitment phenomenon.The following sentence is well describing the existence of recruitment. This explanation was made by GOGH by observing his inmates of the mental hospital but at the same time it can be interpreted as recollecting his own experiences.“The acoustic nerve of the man probably is so hypersensitive that he feels he can even hear voices and words that echo in corridors.”(il crois entendre des voix et des paroles dans l'echo des corridors, probablement parce que le nerf de l'ouis est malade et trop sensible, 592)3) Stomach got upset while attack was on.GOGH often wrote in his letters that due to bad stomach conditions while attack was persisting, he couldn't eat at all (569, 602a, 606). This could be considered as gastric symptoms that occur during an attack of MÉNIÈRE's disease.4) Attacks were of seasonal occurrence and had precipitating causes.The first attack on GOGH began in December 1888 and exactly one year later, that was in December 1889, there was a relapse. Also in July 1889, a severe attack struck him and in July 1890 he killed himself. One of the causes of his suicide was thought to be the recurrence of attacks or its prognostication. In other words, one can see a fairly distinct quality of being seasonal in GOGH'S attacks (Fig. 1). On many occasions fatigue stemming from painting and travelling could be considered as a precipitating cause of his attacks.Attacks having a quality of being seasonal and demonstrable precipitating causes are known to be one of the characteristics of MÉNIÈRE's disease.II. Puzzles involving GOGH that can be explained by MÉNIÈRE'S disease theory.1) Why did GOGH cut his ear lobe?It was a puzzle why GOGH, with his own hands, cut through his ear lobe. However, supposing GOGH was plagued by MÉNIÈRE's disease and he cut it off in trying to escape from distressing symptoms of aural stuffiness, tinnitus and recruitment accompanying attacks, this can be well understood.2) In the center of his painting entitled “The starry night”(212, Fig. 2) are depicted stars as if they are floating from left to right like whirling waves. If the stars can be seen like this, it might have been when an attack of MÉNIÈRE'S disease was on with the occurrence of horizontal-rotatory nystagmus. It is conceivable that GOGH compounded in this painting the impression of the stars he saw when he was struck by the attack.