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B-ENT, 2006, 2, 99-102 A Historical Vignette “Be proud of yourself: you have a History!” Turbulence around the otoliths Sappey’s hostility and Breschet’s defence J. Tainmont W. Churchill Avenue 172, 1180 Brussels, Belgium Key-words. Vestibular apparatus; otoliths; Breschet; Sappey; history of otology Abstract. Turbulence around the otoliths. Sappey’s hostility and Breschet’s defence. Nowadays, the animosity between medical scholars is seldom apparent. However, during the XIXth century it was not necessarily so. We find an example of this in Sappey’s hostility against his colleague anatomist Gilbert Breschet. It concerned the discovery of the otoliths of the inner ear that Breschet attributed to himself. We present here Breschet’s defence. Sappey’s hostility (Figure 1) Marie-Philibert-Constant Sappey was a French anatomist who received from the 1900 Larousse Encyclopaedia the honour of an article with a pen-and-ink draw- ing. He was born at Bourg (Ain department) in 1810 and he died in Paris in 1896. He published important works concerning the lymphatic vessels. He described their anatomy, physiology, pathol- ogy and iconography. We owe him the knowledge of the lymphatic vessels and nodes of the supra- glottic part of the larynx (1889) AB that was the basis of the radical neck dissection for laryngeal can- Figure 1 cer. Nevertheless, Sappey was also A. Sappey (1810-1896). B. Lymphatic vessels of head and neck with the great lymphatic vein1. an irascible man! In his treatise on descriptive anatomy (1845-1863), in the chapter “sense of hearing”, we find a history of the discovery “After the work of Scarpa, was very simple, to mention it was of the membranous labyrinth into Breschet’s one appeared… In that enough. To magnify it, Breschet which we read some surprising extremely voluminous disserta- decided to rebuild all the story of lines that censure another tion, you find only one new fact: the labyrinth on a few of these anatomist, Gilbert Breschet, con- the existence of the calcareous grains of dust. Considering that cerning the discovery of the dust of the vestibule… This fact work, Breschet had no personal otoliths of the inner ear: had probably some importance; it investigations at his disposal. 100 J. Tainmont However, he had into his hands Scarpa’s work, a fruitful mine and scarcely known in France. Breschet draws largely on it, and he disguises his borrowing under new names… and as many readers think that new words are only made up to say new things, Breschet could hope that a work built on these pillars should be received with the favour attached to works of progress; such was the welcome that he received indeed. Certainly, it was not a work of progress, but it was a work full of A B daring and skilfulness. Daring was necessary to seize, right in the Figure 2 XIXth century, the search of A. Breschet (1784-1845). 2 Scarpa who possessed a European B. Inner ear of Man . name. Skilful was necessary to Breschet to build on such a base Scarpa and that the latter had even 3. Then Breschet claims his per- for himself the fame of a great compared with the auditory stones sonal role as an anatomist of anatomist. of fishes”. the inner ear when he makes Moreover, there was another At the end the truth finally comes: clear the identity of several trouble with Breschet… In order “… but that he (Scarpa) finished structures: to not extend this critical examina- by considering as a mass of neural “We followed Linné’s example tion that someone could find too fibrils. The merit of Breschet was when correcting the nomenclature severe, though I tried to reduce it the fact of discovering that the cal- of the diverse parts of the inner very much, I shall quote just one careous powder of the utricle and ear”2 example taken at random…”1 the saccule was independent of the In addition, Breschet isolates and utricular and saccular nerves identifies several structures by Breschet’s defence (Figures though corresponding to them.1 giving them a name: 2,3,4) the columella: the cone-axis of the 2. Let us give the word now to cochlea (Valsalva introduced the Gilbert Breschet was born in Breschet personally, who de- term “modiolus” which prevails Clermont-Ferrand (Puy de Dôme fends himself first by attacking today) department) in 1784. He died in the work of his predecessors: the helicotrema : “helicotrema, Paris in 1845. He was teaching “Comparetti like Scarpa allocates from helix, helikos, from the verb Anatomy at the Faculty of to these maculae (the whole of the helissô: to roll, and trema, Medicine of Paris and was an otoliths) the structure of the dried trematos, the gap; it is to say: the ordinary Surgeon at the Hotel- out pulp of the acoustic nerve… gap of the helix”. Dieu. he considers that macula as the the perilymph: “it is that liquid expansion of the acoustic nerve. surrounding the membranous 1. In fact Sappey recognizes in Mr Geoffroy Saint Hilaire writes: labyrinth and occupying the whole the paper quoted here1 the per- these lithoid organs are part of the of the cochlea, to which we give sonal contribution of Breschet acoustic organ as a result and not the name of perilymph” in the discovery of the otoliths as an active agent, they are some the endolymph: “the interior of the and otoconias , at first with secretions provoked by the membranous labyrinth contains some reluctance: accomplishment of the auditory the endolymph, a clear liquid” “… a dust that had seen briefly process which is the origin of such the otoliths: “several calcareous first by Morgagni and then by stones”.2 concretions, sometimes like Historical Vignette 101 stones, sometimes like dust that are swimming in the endo- lymph (1). When these concretions are solid, calculous as seen in the osseous fishes, we call them Otoliths (ous, ôtos, ear; lithos, stone)”. the otoconias: “if the concretion inside membranous labyrinth is dusty, as seen in most of the carti- laginous fishes and in the verte- brates animals of the three superi- or classes, we give them the name of Otoconias (from ous, ôtos, ear and konis, koneôs, dust or ash)”.2 4. Then finally comes the essen- tial part of Breschet’s work Figure 3 concerning the otoconias, in One of the first drawings of the otoliths in Man published by Cruveilhier from his friend Breschet’s work particular at the level of the “ Les otoconies de Breschet ou sable auditif : une multitude de utricle (named “medial sinus” corpuscules microscopiques... de véritables prismes à six pans by Breschet): terminés en pointe à leurs extrémités”3. “Inside the medial sinus, under and a little behind the place where the two anterior ampullae are, a maintains the cohesion of the the spotlight. However, people small mass of calcareous sub- otoconias: didn’t pay attention to the name of stance is swimming, a substance “When one places the mass of the the man who brought them to the never described until now and calcareous powder cautiously on fore. Why? The answer to that which establishes a supplemen- the slide under the microscope, question must be explained. tary analogy between the ear of one sees that the powder lies on a 1. First, we must put Breschet’s man and these of the inferior ver- strip of soft and spongy tissue discovery in its context. tebrates. This light dusty mass is which holds the calcareous granu- Despite Breschet’s claim “So more visible in the foetus than in lations together. Therefore, the there are two nuclei of concre- the adult; it is distinguishable by a concrete mass has always a round tions in the human ear and we bright whiteness. It consists only or a little elongated shape. The think to be the first to notice of a little calcareous and very thin whole of the mass seems to be that curious fact considering powder. Under the microscope, hold in its position by the neural the anatomy and so important one observes that it becomes endings that go on it.”2 considering the physiology”2, effervescent in the presence of the otoliths were already acids and it seems that it is made known before, in man and in of carbonate of lime. Several Some comments on the attack animals. If we listen to times, under the microscope, we and on the defence Politzer,4 in 1824, in Germany, thought that we recognized a crys- Huschke verified anatomically talline form concerning that dusty The positional vertigo of the the presence of otoliths in man5 matter…”2 (Figure 3). benign paroxysmal type has its and in 1832, he demonstrated historical figures. Among them, the crystalline shape of the 5. Further, Breschet evokes the Hallpike and Schuknecht. The otoliths of birds.6 Did Breschet gelatinous substance that otoliths and otoconias are also in know these works in 1836? ————— (1) “are floating” should be preferable. Besides, Breschet uses this last verb in other parts of his work. 102 J. Tainmont 3. Furthermore, considering his contemporaries’ advice, Breschet lacked any charisma. He looked as a very annoying scholar! This was probably the cause of the poor transmission of his souvenir: “Mr. Breschet cannot teach: that is the right word. He chants his les- son on a drawling voice without any eloquence. The humerus sad- dens him, he moans with the femur, he laments over the tibia. His monotonous voice never leaves the accents of a sermon. He recites a homily. It is meant to be a lesson Figure 4 of anatomy but it is just a way to Figure 2.

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