One of the most surprising facts about Ludwig van Beethoven is that he was deaf. How can a musician, a composer, lack what we would imagine to be his most important sense?

The first people he confided in were those who were gorgraphically far from him, but in whom he had absolute confidence: those who lived at Bonn.

When he could no longer hide his handicap, Beethoven used notebooks in which visitors could write what they wanted him to know, or equally ask what they wanted to know. Because of this, we lack, of course, the most important part to understanding better his personality: what he replied...

Here are some extracts from two letters, dated 1801, in which Beethoven revealed to his friends his increasing deafness.

Lettre of Beethoven to Karl Amenda
dated July 1st 1801

"... My hearing has grown steadily worse over the last three years, which was said to be caused by the condition of my belly..."

"... For two years I have avoided almost all social gatherings because it is impossible for me to say to people "I am deaf". If I belonged to any other profession it would be easier, but in my professsion it is a frightful state.."

"... It is curious that in conversation there are people who do not notice my condition at all; since I have generally been absent-minded, theey account for it in that way. Often I can scarcley hear someone speaking softly, the tones yes, but not the words. However, as soon as anyone shouts it becomes intolerable..."

Extracts from a letter from Beethoven to Franz Gerhard Wegeler,
a friend from Bonn and a doctor who moved to Vienna and married Eleonore von Breuning.

The letter is dated 29 juin,
most probably from 1801.

Beyond the fact that Beethoven's deafness was exaggerated and dramatized, it is important to note that it was not complete deafness from the start. To be true, it was an infirmity that established itself slowly, and also developed itself quite erratically. What was really dramatic indeed, was the moment in which the young and successful composer and virtuoso had to accept that he was suffering from a chronic, incurable illness with which he will have to live. And that was going to get worse.

Later no, when he could not hide his deafness anymore, he accepted it. It was in the midst of his heroic period and it was documented by himself, in a quote written in the margins of the Razoumovsky Quartets.

We could safely state that even to the end of his life, there were days in which he could hear a bit. Many many others in which he was stone deaf. Then finally when the communication difficulties became really great, --more or less around 1818-- Beethoven got to use leafs of paper, or tablets, where his friends and visitors could write what they wanted to tell him, or ask him. These are known now as the "Conversation Books". Naturally we lack the answers the Master provided to the questions written there. except for a few cases, all we can do is guess what he might have said.

Let Beethoven himself tell us of the treatments he was advised by his doctors for his deafness and his "entrails" (an extract from the same letter from Beethoven to Franz Gerhard Wegeler as above, dated 29 juin 1801):

"The cause of this must be the condition of my belly which as you know has always been wretched and has been getting worse, since I am always troubled with diarrhoea, which causes extraordinary weakness. Frank wanted to tone up my body by tonic medicines and restore my hearing with almond oil, but prosit, nothing happened, my hearing grew worse and worse, my bowels remained as they had been. This lasted until the autumn of last year and I was often in despair.

Then came a medical ass who advised me to take cold baths for my health;

A more sensible one advised the usual lukewarm Danube bath. That worked wonders, my belly improved, but my deafness remained and became even worse.

This last winter I was really miserable, since I had frightful attacks of colic and again fell back into my previous condition. Thus I remained until about four weeks ago, when I went to Vering, thinking that my condition demanded a surgeon, and besides I had great confidence in him.

IHe succeeded almost wholly in stopping the awful diarrhoea. He prescribed the lukewarm Danube bath, into which each time I had to pour a little bottle of strengthening stuff. He gave me no medicine of any kind until about four days ago when he prescibed pills for my stomach and a kind of herb for my ear. Since then I can say I am feeling stronger and better, except that my ears sing and buzz constantly, day and night".

We know that Beethoven's talent never diminshed, despite his failing hearing. But what are the origins of this problem?

No deafness specialists existed at this time: all was waiting to be discovered. So, whilst we will never know for certain the cause of Beethoven's illness, here are some opinions...

The Doctor Wagner made the autopsy of Beethoven on March 27th 1827.

Although the original of his report has been lost, a copy was preserved.

Here is a short extract: "... The ear cartilage is of a huge dimension and an irregular form. The scaphoïde dimple, and above all the auricle, were vast and had one and a half times the usual depth...".

Conversation notebook used by Beethoven

One hundred years later, Doctor Marage brought up Beethoven's deafness at the conference of the French Academy of Sciences on January 9th and 23rd 1928, as well as December 2nd 1929.

He thought that Beethoven's deafness was due to a labyrinthitis of intestinal origin, that is to say that he had a lesion of the inner ear. According to Doctor Marage, who has studied Beethoven's letters, buzzing noises and other sounds started at around 1796. Deafness broke out in 1798 and Beethoven had lost 60% of his hearing by 1801. In 1816 he was completely deaf.

Doctor Marage goes on to explain that Beethoven's whole hearing system was, in effect, hyper-sensitive and that, due to this, he was more prone to illness.

Marage's theory is therefore that of the labyrinthitis: "... When deafness begins with high sounds, and overall when they are preceeded by buzzing noises, whistling noises and an exaggerated sensitivity to the screaming voice, it is due to an internal lesion, that is to say that there is a problem with the ear labyrinth and the cerebral centres, from where emerge the branches of the acoustic nerve..."

Professeur Porot and Doctor Miermont Bring up Beethoven's deafness in their study from 1986 "Beethoven et les Malentendus".

The authors state: "... In particular, we will never know the state of the ossicles...". Nevertheless, going by Beethoven's writings - the dates and the symptoms he describes, they make the following observations: "...This is about the beginnings of deafness in a young man, without previous inflammation of the ear, and without hearing problems in the family, a progressive devolution, without improvement despite various remedies prescribed by his doctors..."

The two authors diagnose: "... either neurolabyrinthitis, or otospongiose (or labyrinthitis)...". And, concerning the probable cause, estimate: "... the great cause of deafness at the time: syphilis...", but it's never been proved that "... Beethoven would have been hit by syphilis by the end of his adolescence...".

The complete definition of labyrinthitis can be found on the Vulgaris Médical site (in French).

A particular symptom of those who have caught labyrinthitis is that of vertigo.

No document that we have, neither by Beethoven nor by his friends mentions anything about vertigo.

The mystery deepens...

"labyrinthitis: term comes from the greek laburinthos.

Inflammation of the labyrinth of the inner ear, which is a group of cavities and canals communicating between one another.

The labyrinth or bony labyrinth is divided into three sections: the vestibule, the semi-circular canals and the cochlea.

The labyrinth membrane is made up of a network of little pockets containing the endolymph (natural lymphatic liquid) and the semi-circular canals (which are the organs for balance), the vestibule with the utricle and the saccule, as the cochlear canal (wich is the organ of hearing).

The different types de labyrinthitis are:

• Acute labyrinthitis (neuronitis), probably caused by a rhino-pharyngeal infection. This causes a brutally intense rotatory vertigo which augments, progressively, during a period of about thirty minutes, and which is associated with vomiting and nausea, but which is not accompanied by cochlear signs, i.e. hearing difficulties. In some conditions the victim can be completely immobilised in his bed. The symptoms can last several days , but in general natural healing starts after the usage of antihistaminics and tranquillizers.

• Suppurate labyrinthitis , which is probably caused by an inflammation of the middle ear (seromucous infammation). It is caused by a liquid effusion in the middle ear (behind the tympanum) due to which the patient complains of a sensation that the ear is 'full', and of abnormal reverberations of his own voice. In this case it is necessary to look for troubles in the ventilation of the tympanum usually caused by a blockage in the Eustachian tube (a canal which links pharynx to the middle ear, allowing the balance of pressure). This complaint is sometimes an allergic reaction. The development of suppurate labyrinthitis can lead to the destruction of the tympanum or to a mastoïditis (inflammation of the mastoïd: a bone situated at the back of the ear).

• Chronic labyrinthitis, also known as labyrinthic fistula, and probably due to the wearing down of the labyrinth by a cholesteatoma: this is due to a small epithetial tumour , usually benign; sometimes these are exceptional tumours (more frequent in horses) and result in the proliferation of the cells which line the space under the meninges (the arachnoïd). Finally, there exists a third version of cholesteatoma which consists of a mass infiltration of cholesterol which spreads to the middle of the tympanum; this is not of cancerous origin.

General symptoms of labyrinthitis:

• Vertigo
• Nausea
• Nystagmus (movement in the ocular globe)
• Deterioration of hearing
• Whistling sounds
• Humming / buzzing drones in the ear.

Complications:

• Definitive deafness
• Meningitis: inflammation of the meninges (membrane which covers and protects the central nervous system).

Treatment:

• Spontaneous recovery in the case of viral labyrinthitis.
• Concerning bacterial labyrinthitis, it is sometimes necessary to resort to antibiotics or to surgical treatment.

Some more information

The more common term is otosclerosis. This is a condition of the middle ear in the the stapes (stirrup bone) is fixed in place where it attaches to the inner ear. This prevents sound transmission. It usually starts at an early age and can progress to deafness. It can effect one or both ears. Today, it is treated surgically, ususally with a stapedectomy.

Mack Hicks