Abstract

In the summer of 1797, at the age of 27 and at the time of acoustic symptoms onset, the musician got gastrointestinal typhus, with partial remission and frequent relapses in the following years. Only in October 1802 Beethoven acknowledged his deafness, accompanied by tinnitus; his acoustic disease started with the initial involvement of the left ear only, until right ear involvement and total deafness. Beethoven underwent several pharmacological treatments without any relief also due to his stubbornness and lifestyle (wine and coffee abuse). The use of acoustic devices in his left ear, due to his complete right ear deafness, did also not improve his condition. To amplify the sound intensity, the musician tried to use a wooden cover placed between the piano and the ears. In 1822, during Fidelio's tests, Beethoven could not hear anything sang by the actors. In May 1824, at the end of his exhibition, he didn't realize that all bystanders were actively clapping. In 1825, signs and symptoms of hepatic involvement appeared with hematemesis due to esophageal variceal bleeding. In 1826, his general conditions worsened and abdominal pain, diarrhea, jaundice, and ascites appeared followed by several paracentesis (removing up to 14 L of liquid). On March 27th 1827, Ludwig van Beethoven died, and 2 days later more than 20,000 people (including Franz Schubert) attended his funeral. A final characterization of Beethoven's deafness was actually not collected: otosclerosis, acoustic nerve degeneration, post-infective disease, luetic complications or Paget's disease were also postulated. Autoptic evidences suggest hepatic or kidney disease to be the cause of Beethoven's death. It has been postulated that Beethoven's imagination and creativity was greatly influenced by his deafness.

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