What has a recent case, along with an extensive review of music and medical literature, revealed about Ludwig van Beethoven’s deafness?
BOTTOM LINE: Extensive research points toward a progressive sensorineural hearing loss due to lead intoxication as the most probable cause of Beethoven’s hypoacusis and overall health.
BACKGROUND: The case of 18th-century composer Ludwig van Beethoven, whose early-onset deafness was one of his numerous health issues, is one of humankind’s most intriguing medical mysteries. However, the recent case of a woman with symptoms similar to Beethoven’s, along with an extensive literature review, supports a previously underestimated theory.
STUDY DESIGN: Literature review and theoretical analysis.
SETTING: ENT Unit, Neurosciences Department, University of Padua, Padova, Italy.
SYNOPSIS: Drawing on the 2018 case of a 64-year-old woman diagnosed with lead intoxication whose symptoms were similar to Beethoven’s, researchers re-examined early manuscripts, correspondence, and clinical reports on the composer. Beethoven’s first symptoms of typhoid fever-related tinnitus and hearing loss occurred at age 26, and he had full bilateral deafness by age 46, as well as lifelong struggles with gastrointestinal symptoms, depression, and alcohol dependency that ultimately led to advanced cirrhosis. In the 2018 lead toxicity case, the patient reported progressive hearing loss, asthenia, paresthesia in the upper limbs, and abdominal pain. Charting the main theories regarding Beethoven’s condition, researchers concluded that chronic lead poisoning most likely caused his hearing loss and gastrointestinal issues. They also noted the composer’s habit of consuming large quantities of low-quality Hungarian wine, to which lead was frequently added to improve flavor. A recent study of Beethoven’s exhumed body showed elevated levels of lead. Although other researchers have dispelled the theory based on the composer’s lack of neurological symptoms, authors cite the variability of symptoms in such cases.
CITATION: Brotto D, Fellin R, Sorrentino F, et al. A modern case sheds light on a classical enigma: Beethoven’s deafness. Laryngoscope. 2021;131:179-185.