A Modern Case Sheds Light on a Classical Enigma: Beethoven's Deafness

Abstract

Two hundred and fifty years have passed since the birth of Ludwig van Beethoven, and the enigma about his hearing loss and overall health status seems to be not completely solved. However, the admission to the hospital of a 64‐year‐old woman in 2018 with symptoms extremely similar to those experienced by the great composer may add further evidence to a theory previously underestimated. The health issues of the modern patient were found to be due to chronic lead intoxication. The lead was released during daily cooking using a ceramic‐coated frying pan with worn surface that poisoned her breakfast most probably for years. Abdominal pain, asthenia, and hearing loss affecting the high frequencies with a many impact on speech intelligibility tormented the patient, as they had Beethoven. An extensive review of the music and medical literature was performed, as well as re‐examination of manuscripts, correspondence, and autopsy reports of the famous composer; and great similarities have been found. The soundness of the most‐cited classical theories about Beethoven's hearing loss will be discussed. After close scrutiny of the theories, our analysis points toward a progressive sensorineural hearing loss due to lead intoxication as the most probable cause of not only Beethoven's hypoacusis but his overall health status as well. Laryngoscope, 131:179–185, 2021

Aetiology of Ludwig van Beethoven’s hearing impairment: hypotheses over the past 100 years – A systematic review

“…Other sequelae of chronic lead intoxication such as abdominal colic, hepatotoxicity, and kidney damage as reported by Beethoven support this hypothesis. Recently, Brotto underlined this hypothesis with regard to Beethoven’s autoptic findings of wrinkled cochlear nerves that lacked pith without a medulla [ 50 ]. However, up to now the scientific data regarding the prevalence and extent of hearing loss induced by chronic lead exposure is still rare.…”

In Reference to Beethoven's Deafness

“…Although lead poisoning has been considered previously, it has been dismissed because wrist drop, a common finding in lead poisoning, was not found in Beethoven. Brotto 1 suggests that lead poisoning causes a variety of symptoms that, depending on the time of exposure and healthcare support, are extremely variable from person to person. 1 However, Reubens 3 indicates there is another explanation for Beethoven's lack of wrist drop.…”

In memoriam Ludwig van Beethoven. Clinical history and possible diagnoses of the genius of musical composition in silence

“…The hypoacusis was associated with unbearable tinnitus, poor discrimination, and recruitment, characteristics that are consistent with sensorineural hearing loss. 2 , 3 The hearing defect caused Beethoven to have low self-esteem, emotional lability, and progressive isolation, leading to suicidal ideations (the Heiligenstadt Testament). He was irritable, combative, and arrogant.…”