Robert Bárány | Biography

Robert Bárány made significant contributions to the understanding of the vestibular apparatus, part of the inner ear that plays an important role in maintaining balance. He devised ingenious tests to diagnose inner-ear disease, and he investigated the relationship between the vestibular and nervous systems. Because of his ground-breaking research in this area, he is credited with creating a new field of study, otoneurology. Bárány's achievements were recognized in 1914 with the Nobel Prize in physiology or medicine.

Bárány was born in Rohonc (near Vienna), Austria-Hungary (now Austria), the eldest of six children. His father, Ignaz Bárány, was a bank official. His mother, Marie Hock Bárány, was the daughter of a well-known Prague scientist, and it was her intellectual influence that predominated in the family. When Bárány was young, he contracted a form of tuberculosis that left him with a permanent stiffness in his knee, but also first awakened his interest in medicine.

Always a top student, Bárány began attending medical school at the University of Vienna in 1894. In 1900, he received a doctor of medicine degree. He then spent two years studying internal medicine, neurology, and psychiatry at clinics in Frankfurt, Heidelberg, and Freiburg. Next, he returned to Vienna, where he received hospital surgical training. Finally, in 1903, he accepted a post at the Ear Clinic, also in Vienna, which was then directed by Adam Politzer. Bárány's association with Politzer, a leading figure in the history of otology (the study of the ear and its diseases), proved to be highly fruitful.

It was the chance observation that clinic patients often became dizzy after having their ears irrigated that led Bárány to develop one test that still bears his name. The Bárány caloric test involves stimulating each of a patient's inner ears separately by syringing one with hot liquid and the other with cold. Normally, this results in rapid, involuntary movements of the eyeballs, termed nystagmus. Bárány demonstrated that the direction of the nystagmus is determined by the temperature of the water and the position of the head. He also showed that the absence or delay of nystagmus indicates a problem with the balance structures of the ear. The test was an eminently practical technique for diagnosis, since it could easily be performed at a patient's bedside.

Another diagnostic procedure introduced by Bárány was the chair test. The patient is turned in a rotating chair with a specially designed headrest that inclines the head slightly forward. Once again, any deviation from the normal pattern of nystagmus afterward indicates a problem. Yet another of Bárány's inventions during this period was the noise box, a much-used device that effectively isolates the hearing performance of one ear by creating a masking noise in the other.

Bárány's phase of great productivity was to be interrupted by the start of World War I. Bárány was dispatched by the army to the fortress of Przemysl on the border between Poland and Russia, where he served as a medical officer. While there, Bárány continued to study the connection between the vestibular apparatus and the nervous system. He also developed an improved surgical technique for dealing with fresh bullet wounds to the brain.

However, in April 1915, the Russians occupied Przemysl, and Bárány was transported along with other prisoners by cattle car to Merv in central Asia. Conditions there were unsanitary and difficult, and Bárány came down with malaria. Still, he was relatively fortunate: the medical commander in Merv knew him by reputation and placed him in charge of otolaryngology (the medical specialty concerned with the ear, nose and throat) for both Russian natives and Austrian prisoners. The Russians were grateful patients. Alter Bárány had successfully treated the local mayor and his family, he became a daily dinner guest in their home.

It was while he was still a prisoner of war that Bárány received the news that he had won the Nobel Prize. Thanks to the personal intervention of Prince Carl of Sweden, Bárány was released in 1916. He returned to Vienna that same year, but was bitterly disappointed by the reception he received from colleagues there. They claimed he had inadequately cited their own contributions to his work. These accusations were investigated by the Nobel Prize Committee, which found them groundless. Nevertheless, the attacks prompted Bárány to accept a post as professor at the University of Uppsala in Sweden in 1917, where he remained for the rest of his life. Eventually, he rose to the position of chairman of the department of ear, nose, and throat medicine there.

While at Uppsala, Bárány studied the role of the part of the brain called the cerebellum in controlling body movement. He had previously devised another test for disturbances in cerebellar function, known as the pointing test, in which the patient points at a fixed object with the eyes alternately open and closed. Consistent errors while the eyes are closed indicates a possible brain lesion.

Bárány also developed a surgical technique for treating chronic sinusitis. For this, he was awarded the Jubilee Medal of the Swedish Society of Medicine in 1925. Among his numerous other awards were the Belgian Academy of Sciences Prize, the ERB Medal from the German Neurological Society, and the Guyot Prize from the University of Groningen in the Netherlands. He also received honorary degrees from several universities, including the University of Stockholm. Austria issued a stamp in his honor in 1976, to commemorate the 100th anniversary of his birth.

Bárány was described as a quiet and solitary man, fanatically devoted to his work. Yet at home, he also enjoyed music and played the piano well; he particularly liked the music of composer Robert Schumann. And despite having had a stiff knee since childhood, he was an avid mountain hiker and tennis player.

Bárány married 1909. The couple had three children, all of whom went on to become physicians or medical scientists. Bárány's last years were marred by a series of strokes, which resulted in partial paralysis. He was aware of an international meeting that was organized to celebrate his sixtieth birthday, but, sadly, he died in Uppsala only a few days before the occasion on April 8, 1936. Yet his memory has been kept alive with the Bárány medal, first awarded by the University of Uppsala in 1948, honoring deserving scientists for investigations of the vestibular system. In addition, the Bárány Society was established in 1960 to conduct international symposia on vestibular research.