The composer was a seriously ill man

O You people who consider me to be hostile, stubborn or misanthropic or explain how wrong you are to me, you do not know the secret cause … just consider that I have been in a desperate state for 6 years. “Actually, Ludwig van Beethoven should be in Heiligenstadt near Vienna in April 1802 when he wrote these lines. It is the beginning of his “Heiligenstadt Testament”, which the 32-year-old addressed to his brothers but never sent. His doctor had advised him to stay in the country, but his “desperate condition” drove him to despair here as well: “What humiliation when someone stood next to me and heard a flute from a distance and I heard nothing.”

Johanna Kuroczik

Editor in the “Science” section of the Frankfurter Allgemeine Sonntagszeitung.

Beethoven’s deafness is not the only one, but it is the most famous of his ailments, which doctors and historians are trying to fathom to this day: Why did he lose his hearing? Where did the abdominal pain come from? Did he suffer from syphilis, did alcohol drive him to death? This year, in particular, it is being discussed again, because the day of his baptism, December 17, 1770 in Bonn, marks the 250th anniversary. His exact date of birth is not known, but we know all the more about his medical history. From numerous letters to friends and doctors, contemporary notes, the conversation books with which the deaf musician talked at the end.

The deafness dragged on for over two decades

“My ears, they rush and roar away day and night … I cannot hear the high notes of instruments, singing voices; … and yet as soon as someone screams, I can’t stand it ”, Beethoven wrote in June 1801 in a letter to his childhood friend, the doctor Franz Wegeler. It is considered to be the first contemporary testimony to Beethoven’s hearing problem and already gives the first medical information: The “whizzing” would be called tinnitus today, and the beginning of high-frequency hearing loss and sensitivity to noise are noticed. That speaks against a sudden hearing loss or an infection that would have affected the hearing more suddenly. Beethoven’s deafness apparently began in his left ear at the age of 27 and progressed slowly. After deteriorating in 1802, his hearing seems to have stagnated for ten years, but from the age of 48 he was then probably completely deaf. Around 400 conversation books in which his visitors wrote their questions testify to this, 139 of which have survived.

The famous portrait of the composer by Karl Joseph Stieler (1781-1858)


The famous portrait of the composer by Karl Joseph Stieler (1781-1858)
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Bild: Picture-Alliance

But why did Ludwig van Beethoven lose his hearing? Various diagnoses have been proposed here, including infectious diseases such as syphilis or Paget’s disease, in which the bones of the skull thicken. Otosclerosis has long been favored. When sound hits the eardrum at the end of the auditory canal in healthy hearing, it causes tiny ossicles in the middle ear behind it to vibrate, which are then transmitted to the inner ear. This is where the so-called cochlea is located, in which the so-called hair cells trigger electrical impulses and pass them on to the brain via the auditory nerve. This process only takes a few hundredths of a second, the ear is our fastest sensory organ and probably also the most sensitive. In otosclerosis those ossicles are now affected. They stiffen up with new bone material. Today, the process can be stopped with an operation in which a small bone is replaced with a prosthesis. However, otosclerosis rarely occurs in both ears and does not necessarily result in complete hearing loss. What did Beethoven have instead?

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