Vincent van Gogh, whose artistic brilliance and supposed madness have made him a focus of popular fascination, suffered not from epilepsy or insanity but from an inner-ear disorder that causes vertigo and ringing ears, a new analysis of his letters suggests.
The authors of the study, reported today in the Journal of the American Medical Assn., suggest that the 19th-Century Dutch painter suffered from Meniere's disease, a condition that was little known at the time and has often been misdiagnosed as epilepsy.
"Van Gogh's handwritten statements describing his attacks and his illness are compelling evidence for a diagnosis of Meniere's disease and not epilepsy," the authors concluded. They said his behavior "should forever banish the notion that he was an epileptic or 'mad.' "
The Meniere's disease theory, put forward by specialists at the International Meniere's Disease Research Institute and others, is the latest in a series of explanations offered for Van Gogh's erratic behavior, including his suicide at age 37 and a now-famous incident in which he sliced off one of his ears.
Other explanations have included epilepsy, dementia, schizophrenia, manic depression and sunstroke. Two years ago, a Kansas biochemist announced that he believed that Van Gogh's problems stemmed at least in part from addiction to a liqueur, absinthe.
The latest hypothesis surfaced in 1979 when a Japanese ear specialist published a paper linking Van Gogh to Meniere's disease, a condition caused by an increase in the amount of fluid in the canals of the inner ear that control a person's balance.
The main symptom of Meniere's disease is a sudden attack of vertigo, often so severe that the person collapses. The dizziness can be accompanied by nausea, vomiting and jerky eye movement, as well as deafness, ringing and a feeling of acute pressure in the affected ear.
The disease is believed to affect about 7 million Americans.
In the new paper, the authors contend that a diagnosis of Meniere's disease could account for the symptoms Van Gogh described in his voluminous correspondence--letters that the researchers describe as "an untapped retrospective clinical history of his illness."
For example, the researchers found that Van Gogh described in letters written between 1884 and 1890 disabling attacks of what he called "vertige." Those bouts were accompanied by nausea, vomiting and noise intolerance.
As with Meniere's disease, the bouts were separated by symptom-free periods lasting for months.
Similarly, Van Gogh appears to have heard strange sounds in his ear--perhaps the ringing, or tinnitus, that is a symptom of the disease. The researchers quote a physician who treated Van Gogh and reported that the painter was "assailed by auditory hallucinations."
While one psychologist has suggested that Van Gogh cut off his ear in frustration with those noises, the authors of the new paper would not go that far. They did, however, note that Meniere's disease sufferers have reported an urge to cut off or poke a hole in their ear.
Finally, the researchers contend that patients with chronic, recurring vertigo and dizziness "can develop severe secondary psychological problems, including bizarre behavior." Patients often become despondent, like Van Gogh, after being told they cannot be cured.