Beethoven: A Symphony of Illness

A history resource article by Mary Harrsch © 2015

Portrait of Ludwig Van Beethoven by Joseph Karl Stieler, 1820.
Image courtesy of Wikimedia Commons.

"A 56-year-old Beethoven sought medical care after suffering chills, fever, respiratory distress, and spitting up blood. He complained of chest pain on the right side. He said he had been in good health until two weeks before when he noted a loss of appetite, diarrhea, weight loss, increased thirst, and a swelling of his feet and abdomen. He admits he had been working in the cold at his brother's country home dressed in only flimsy clothing and returned in an open-air cart."

Thus begins a study to determine what may have caused Beethoven's death as a clinical exercise at a 1999 clinical pathologists' conference at the University of Maryland School of Medicine. Each year, a team of practicing pathologists select a famous individual from the past whose manner of death remains speculative and attempt to derive a definitive cause of death.

Beethoven's case is examined by Drs. Michael S. Donnenberg, Michael T. Collins, R. Michael Benitez and Philip K. Mackowiak with their results entitled "The Sound That Failed" ultimately published in The American Journal of Medicine in 2000 (Volume 108, p. 475-480).

The pathology team continues:

"In addition to suffering from progressive deafness that began in his early twenties, the patient suffered recurrent bouts of depression, social isolation and personal neglect. He also began suffering from abdominal pain that he relieved with alcohol. The patient had survived smallpox as a child as well as typhus or typhoid fever. He subsequently claimed to have intermittent winter attacks of "asthma" since the age of 17. In his late forties he noted the onset of chronic headaches and recurrent joint pains which were thought to be rheumatism or gout. At age 51 he suffered an episode of jaundice that lasted six weeks. He also developed a painful eye affliction that was resolved after nine months of patching and noted that he experienced increasing swelling of the lower extremities accompanied by intermitten bouts of nosebleeds, vomiting blood, and coughing or spitting of blood."

"Physical examination revealed a stocky, powerfully built but somewhat emaciated man of swarthy complexion. His face was flushed and prominently pockmarked. His lips were thin and parched, his tongue dry and coated. The skin was hot, flushed , and dry and showed evidence of hair loss."

What was the instrument of the famous composer's death?  (PDF of original article reprinted with permission)