The July 25 news story "New Theory on van Gogh's Ills" was a timely comment on the 100th anniversary of the artist's suicide. However, the "new" suggestion that van Gogh suffered from a debilitating inner-ear problem repeats a specialist's thoughts of some 11 years ago. Those speculations received little support then, because the diagnosis of Meniere's disease was based on a limited selection of symptoms and dubious interpretation. The situation has not changed.

In a July 25 issue of Journal of the American Medical Association, I. Kaufman Arenberg construed certain medical complaints as hallmarks of an ear disease. Thus van Gogh's gastrointestinal problems were formalized as strictly nausea and vomiting, and several references to auditory hallucinations (hearing voices) were relegated to tinnitus (ringing in the ears).

Further, the psychosis that was grave enough to cause self-mutilation and eventually suicide was grossly underplayed. The claim that van Gogh cut off part of his left ear lobe as an attempt to relieve tinnitus "at the source" does not hold up -- van Gogh claimed he had no recollection of the incident.

The van Gogh family history of neuropsychiatric problems and all of the exacerbation factors that influenced the painter's medical history should not be ignored as they were in the JAMA article. Malnutrition and fasting, environmental exposure, abuse of caffeine, nicotine and alcohol (particularly the toxic liqueur, absinthe) and development of an abnormal craving for terpenes influenced the onset and duration of van Gogh's medical crisis. The last also explains some of the artist's bizarre episodes of trying to drink turpentine, nibbling at paints and using reckless amounts of crude camphor oil on his pillow for insomnia, all of which are difficult to accommodate as an "inner ear disorder."

The prominent place that van Gogh occupies in any analysis of creativity has aroused much interest in his medical problems. However, any reasonable working hypothesis on the nature of an illness must address all the information rather than selective symptoms that fit a syndrome. -- Wilfred N. Arnold -- Loretta S. Loftus The writers are doctors at the University of Missouri-Kansas City School of Medicine.