Saturday, May 15, 2010

Prosper Meniere an apostle of humility

Prosper Meniere:

Prosper Meniere described clearly the symptoms of Meniere's disease. Even now the description of Meniere's of this disorder holds good. Very little has been added to the description of Meniere's disease.

Prosper Meniere was born in Angers a French town in 1799. He underwent basic education at Lycee. Later he joined the university of Angers. He completed his medical studies at the Hotel-Dieu in Paris which was one of the most prestigious hospitals of Europe those days. He received gold medal for excellence in medicine in 1826. He received his doctorate in medicine in 1828.

He was really popular with the ruling elite. He attended to Duchess Caroline Louise, the widow of the second son of Charles X who was pregnant while imprisoned at Blaye. His popularity with the ruling elite alienated him from main stream academic medicine.

In 1835 epidemic of cholera swept over Europe. Meniere organized regional health care against cholera epidemic. He introduced the concept of barrier nursing while treating these patients. He was awarded the Chevalier of the Legion d'Honneur for this work. During this very period juniors superseded him to professorial chair at the Hotel – Dieu.

1838 happened to be a turning point year in the life of Meniere. It was during this year that Jean Marc Gespard (one of the fathers of otology) died while serving as director of the Institute of Deaf – Mutes in Paris. Meniere who had no formal otological training was appointed to the post. His marriage to the daughter of Becqauerel, an influential member of the Institute of Deaf – Mutes in Paris helped his cause. From now on he dedicated the rest of his life to the care of deaf mutes.

His greatest contribution to medical science came in 1861. It was during this year he presented a paper at the Imperial Academy of Medicine in Paris. In that paper he questioned the then existing theory that vertigo was a form of cerebral apoplexy or epilepsy. He argued in favor of inner ear dynamics. This paper was heavily criticized those days. This paper was based on some astute observations made by him while treating deaf patients who had associated giddiness. He also heavily borrowed from the work of Pierre Flourence who proved by his methodical dissection of pigeon's labyrinth that ablation of various portions of labyrinth caused loss of balance in these birds. He also precisely recognised that vertigo of central origin was not associated with hearing loss. He also observed that patients with aural vertigo did not lose consciousness during attacks of vertigo.

He died at the ripe age of 62 following an attack of pneumonia in 1862. The triad of tinnitus, vertigo and deafness became recognized as “Maladie de Meniere”. This term was coined by Charcot in 1874.

Menier's was a man of great humility. One of his famous quotes runs like this:

I am certain that the best works have been burned, that
the sweetest verses have never been printed . . . whereas
the shameless, the impertinent, the pre-eminent show off
with insolence in the sun of publicity without any right to
do so.”

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