The cause of Beethoven’s deafness

I’ve always been curious about the cause of Ludwig van Beethoven’s deafness. The genious of music died on March, 26, 1827 and the record of his postmortem examination was lost and rediscovered in 1970. Beethoven had plenty of problems, but now I focus on his neurological symptoms. First, please read a portion of the autopsy report:

The external ear was large and irregularly formed, the scaphold fossa but more especially the concha was very spacious and half as large again as usual…the external auditory canal was covered with shining scales… The Eustachian tube was much thickened, its mucous lining swollen and somewhat contratced about the osseous portion of the tube… The facial nerves were of unusual thickness, the auditory nerves, on the contrary, were shiveled and destitute… The convolutions of the brain were full of water and remarkably white; they appeared very much deeper, wider and more numerous than ordinary.

Here is the list of the suggested diagnoses: syphilis, otosclerosis, sarcoidosis, Paget’s disease, typhus, measles, scarlatina, Whipple’s disease, Systemic lupus erythematosus.

Wikipedia article says:

Around 1801, Beethoven began to lose his hearing. He suffered a severe form of tinnitus, a “roar” in his ears that made it hard for him to perceive and appreciate music; he would also avoid conversation… Beethoven’s hearing loss did not affect his ability to compose music, but it made concerts — lucrative sources of income — increasingly difficult.

As a result of Beethoven’s hearing loss, a unique historical record has been preserved: he kept conversation books discussing music and other issues, and giving an insight into his thought. Even today, the conversation books form the basis for investigation into how he felt his music should be performed, and his relationship to art — which he took very seriously.

 

The American Journal of Medicine has an article on the subject. They stated that no diagnosis has been accepted as the universal etiology of his complaints, but not only one disease caused all of his symptoms. According to close friends of Beethoven, he was particularly never out of love. That’s why the most probable cause of his deafness was the exposition to Treponema pallidum. So the best explanation for most if his complaints is syphilis.

References:

  • London SJ. Beethoven: case report of a titan’s last crisis. Arch Intern Med. 1964;113:442-448
  • Forbes E, ed. Thayer’s Life of Beethoven. Princeton, NJ: Princeton University Press,1973.
  • The Sound that Failed; The American Journal of Medicine, Volume 108, April 15, 2000.

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