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On bruits, hums, and sounds in the ear and in the head: the Polish forgotten contribution.

In 1968, Gareeboo reported on: "Cranial bruits in adults have not so far been reported as a result of severe anaemia. Over the past nine months I have noted the presence of cranial bruits in adults suffering from severe anaenia due to various causes-from pernicious anaemia to anaemia resulting from acute blood loss in bleeding peptic ulcers" [1]. He reviewed the literature: bruits can be a normal phenomenon in infants, and pathological intracranial bruits in can be found in adults suffering from anemia, a-v malformation or fistula, angiomata, carotid stenosis, cardiac valvular problems, Paget disease of bone and aneurism.

The neurologist Christopher Gardner-Thorpe, the previous editor of Journal of Medical Biography, has added two case reports, in a letter to the editor of the BMJ [2].

Downie [3] added that Gareeboo was not the first to report on anemia causing bruit in the head, but rather Allen in 1962.

A month later, Sears also referred to authors that were unknown to Gareeboo [4]: JD Fisher 1833 and L P Hamburger in 1931. John Dix Fisher (March 27, 1797 - March 3, 1850) was a physician and founder of Perkins Institution for the Blind in Boston, Massachusetts. Previously, he was a pupil in Paris of RTH Laennec, Gabriel Andral and A. Velpeau. He called the phenomenon of bruits in the head- "cephalic bellows-sound" [5].

It seems that all authors were not aware of an extensive review and clinical report on cranial bruits, that was made in Poland back in 1893.

The Jewish-Polish laryngologist Samuel Meyerson (1851-1939), a pupil of Adam Politzer (1835-1920) and Leopold Schroetter von Kristelli (1837 - 1908) of Vienna and the famous Jewish-Polish neurologist Samuel Goldflam (1852-1932), presented in a medical conference in Nuremberg, their clinical experience with two women who suffered from cranial bruits. Later the lecture was published in Polish [6].

The article brought references written by ,Sir William Richard Gowers (1845-1915), a British neurologist; C. Pilz "By 1868 Pilz was able to collect 600 recorded cases of carotid ligation for cervical aneurysm or hemorrhage with a mortality rate of 43%" [7]; George Hayem (1841-1933); the German otologist Salomon Moos (1831-1895), and the Austrian otologist Viktor Urbantschitsch (1847-1921).

The authors discuss the differential diagnosis:

* arterial aneurisms

* anemia

* intra cranial elevated pressure

* tumors.

Their first patient underwent ligation of the common carotid artery [8] on the same side of the bruit, by Prof. Wladyslaw Krajewski (1855- 1907). Before the operation, external pressure on the artery relieves the headache and the bruit, and the bruit intensified while turning the head, and correlated with the systolic pulse. A few weeks after the operation, her eyesight was blurred, and the bruit heard over the left ear and the head. It remained but weaker. Using a stethoscope, the bruit was heard through the bandage. The father of the patient decided to discharge his daughter and a few weeks later she died at home. The authors presumed that the cause of the bruit was an intracranial tumor or a ruptured aneurism.

When S. Goldflam died, a memorial booklet was published [9]. Famous people contributed to this booklet: Nahum Sokolow (1859 - 1936) a Zionist leader, author, translator, and a pioneer of Hebrew journalism; Leon Lewite (18781944), a Zionist leader in Poland, who devoted himself to acquiring pledges for shares in the Jewish Colonial Trust and worked with the Centralny Komitet dla Antyhitlerowskiej akcji Gospodarczej; Maurycy Mayzel (1872-1940?), the last president of the Warsaw Jewish community; Janusz Korczak, (1878-1942); Mateusz Hindes (of the Lodz Deposit Bank in Warsaw);.

Conflicts of interest

The authors declare no conflict of interest.

Financial disclosure/funding

No funding.


Ohry A


The author wishes to thank Dr. Filip Marcinowski Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665, Warsaw, Poland, that upon the author's request, found the original articles and transferred it to the author.


(1.) Gareeboo H. Severe anaemia as a cause of cranial bruit in adults. B M J 1968 Feb;1(5587):294.

(2.) Gardner-Thorpe C. Cranial bruits. BMJ 1968;2: 445-6.

(3.) Downie AW. Cranial bruits. BMJ 1968 Feb; 1(5589):446.

(4.) Sears WG. Cranial bruits. BMJ 1968 Mar;16; 1(5593):708.

(5.) Fisher JD, Observations on the cephalic bellows-sound. Medical Magazine, Boston, 1833.

(6.) Goldflam S, Meyerson S. O przedmiotowych szmerach w uchu i glowie. Medycyna 1893; 1, 46 i 47, pp. 922-7 i 939-46. (Polish). (translated by Dr. Ada Horowitz, retired consultant pathologist).

(7.) History of stroke: [6 Nov 2019].

(8.) Wechsler IS, Gross SW, Cohen I. Arteriography and carotid artery ligation in intracranial aneurism and vascular malformation. J Neurol Neurosurg Psych 1951 Feb;14(1):25-34.

(9.) Pamieci Dra Samuela Goldflama 1852-1932). Reprezentacja Agencji Zydowskiej dla Palestyny w Polsce, Warszawa, 1932. (Polish)

Ohry A. (A-F)

Emeritus professor of Rehabilitation Medicine, Tel Aviv University, Israel

(A) - Conception and study design; (B) - Collection of data; (C) - Data analysis; (D) - Writing the paper; (E) - Review article; (F) - Approval of the final version of the article; (G) - Other (please specify)

(*) Corresponding author:

Emeritus professor of Rehabilitation Medicine, Tel Aviv University, Israel


Received: 16.11.2019

Accepted: 02.12.2019

DOI: 10.5604/01.3001.0013.7229
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Author:Ohry, A.
Publication:Progress in Health Sciences
Geographic Code:4EXPO
Date:Dec 1, 2019
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