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A. G. Gordon, BSc
London, United Kingdom

JAMA. 1997;277(16):1276.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Drs Barloon and Noyes¹ excluded Meniere disease in Darwin in the alleged absence of aural fullness, tinnitus, or hearing loss. However, there is overwhelming evidence for subclinical Meniere disease with a very plausible cause: acoustic trauma. Before 1861 Meniere disease was "gastric vertigo" (Charcot²) or "suppressed gout,"³ Darwin's 1848 diagnosis.⁴

Perceived pressure in the head or ear is often ignored by patients and physicians.^2,5 For example, Van Gogh² had "the profound feeling at times that his mind was a turbid pool" and "a feeling of emptiness or fatigue in the head." Hughlings-Jackson³ reported that after firing 2 shots at a bird, a fit young surgeon had chronic Meniere symptoms³ "with a full heavy dull feeling in my head, and it seems to deaden my intellect, and render me powerless for consecutive thought." Darwin⁴ wrote, "I have now been six days with . . . [Full Text PDF of this Article]

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