On this day celebrating his birth, some might choose to mourn over the great works of music that might have been had Beethoven only lived longer. Although the maestro suffered from so many physical maladies, he was still able to create a huge body of work that represents humanity at its best and most joyful.
Fortunately, we have the transcendent, intellectually rich, and sonorous pieces of music he did give to the world — a gift that continues to enrich us. Howard Markel writes a monthly column for the PBS NewsHour, highlighting momentous historical events that continue to shape modern medicine. Support Provided By: Learn more. Thursday, Nov The Latest. World Agents for Change.
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I almost put an end to my life sometimes. Music was what entertained me. It seemed to me impossible to abandon this world before creating all the operas I felt an imperious need to compose.
This was my life, a distressing life. When you read these lines you will know that those who spoke of me committed a great injustice. Ask Dr.
Schmidt to describe my disease so that the world may reconcile with me, at least after my death 1. This document witnesses perfectly the psychological drama of the great composer and fully justifies his nature involution. However, the deafness did not interfere whatsoever with the creative vein that ended up to express in a sublime manner all his inside world, all feelings, all passions, emotions and each perception of his soul and nature.
The conductor's introspective nature was part of his disease's reflex, but it is evident that his formation was also influenced by his childhood and adolescence 2. Beethoven was born on December 16 , in Bonn, his father was a mediocre tenor with alcohol addiction, his mother, Maria Madalena Keverich, was 19 years old when he was born, she was the daughter of a cook and already widow of a court's chamberlain.
His childhood was rigid and sad. As he early manifested his talent for music, he was not even 8 years old, and his father, unable to preview the genius in formation and trying to obtain personal profits, presented him as a six-year-old prodigy in the Music Academy of Cologne.
At the age of 11 he was part of the orchestra of Bonn and of 13 he was organist. It is no doubt his father bothered the beginning of his career, by obliging him to make money.
Aged 22 years he left Bonn and moved to Vienna, the music capital. It was in Vienna that he quickly achieved notoriousness and success as a concertist and composer. In there came Beethoven's musical life apogee, when in the Congress of Vienna, during the Europe's restructuring, after Napoleon, he was claimed as the greatest living musician. The Austrian Emperor Francis Joseph I brother of the Brazilian Princess Leopoldina placed at his disposal two salons in his palace in Vienna and granted him Viennese honorary citizenship.
But it was also then that the aggravation of his deafness made him abandon the career of concertist. Weissenbach, who became interested in his case. The doctor was composer and poet and was also affected by hearing loss. The treatments imposed to him were the silliest and the most bizarre and curious treatments, obviously empirical and helpless.
Sweating, tourniquets, washings, smoke steaming, diuretics, field seasons, instillation of several chemicals into the auditory meatus, diets, thermal cold and hot baths, continuous current electric stimulations. The acoustic horns built up by the court's mechanic Joahann Maelzel were not either much helpful. He used his acoustic apparatus in the left ear, because the right ear was totally deaf.
He always said the sound did not enter through the channel but throughout the cranium. He also used a wooden drumstick between the teeth and supported it on the piano's resonance box to feel the vibrations. He used pieces of cotton in the ears because by modifying the resonance of the tubular system of the external auditory meatus these assured favorable sensations, and filtered filtering some frequencies and relieved part of the tinnitus. Between and , his health worsened with other manifestations such as diarrhea, epistaxis and other evident signals of hepatic manifestations.
He became an undisciplined patient, by drinking too much wine and strong coffee. With pneumonia, his general state got worse with ascites with several punctures to relieve and from then on he never recovered. Historians, biographers, doctors, scholars always attempted to come to definitive conclusions of the causes that led to Beethoven's deafness and the etiopathological mechanisms of his evolutionary nature in order to verify the possibilities of the disease's interference with his character, his life and his musical production.
The most important reference we have to justify his deafness followed by tinnitus is the autopsy carried out on the day after his death by Prof. Johann Wagner and his disciple Karl Rokitansi who became one of the greatest authors of his time. The part of the ears was briefly described as follows: -"The pavilion cartilage is large and irregular. The external acoustic meatus close to the tympanum shows epithelial desquamations.
The Eustachian tube has a thick mucosa and a narrow osseous part. The mastoid cells and the temporal bone petrous part, mainly close to the cochlea, is hyperemic. The acoustic nerves are atrophic and demyelinated. The auditory arteries are dilated and sclerotic". The presence of sclerosis in the auditory vessels may lead to the hypothesis of vascular insufficiency of the inner ear.
We could know with precision if it was possible to find the temporal bones conserved in formaline, which Wagner kept for further studies. In , Beethoven's sepulture was open, but Adam Politzer only found some fragments of his cranium. The middle ear autopsy data could only supply information that excludes chronic inflammatory pathology.
Which is equivalent to a classical otosclerosis. In a large study published in , called Beethoven's deafness, Guglielmo Bilancioni states: "The middle ear could have a lesion, although obscure in its pathogenesis, the auricular sclerosis", otosclerosis, which determines a reduction of the progressive hearing, without evaluable cause and relevant symptoms, except for a very high degree of deafness and tinnitus, and is eminently familiar and hereditary.
There is no description of deafness in Beethoven's family. He did not present with symptoms of Willis' paracusis nor Weber's phenomenon symptoms. The conductor himself mentions that in the beginning the loss was in the acute frequencies, which is less common in otosclerosis. In spite the tinnitus has a common symptom in otosclerosis, the patients with this disease do not mention distress with high intensity sounds, as he does, and it is a classical phenomenon of recruitment. Other authors even mention the possibility of a auto-immune disease, obviously very difficult to confirm at that time.
Nowadays, Beethoven would probably have a better sound quality, and consequently a better life quality, mainly for the possibilities created by acoustic engineering and more recently electric implants and computing stimulation. Sadly, he died of liver complications due to heavy alcohol use. Could Beethoven's fate have been different had he been fitted with a hearing aid? At one point, Beethoven tried to ease his hearing problems by wearing a rather crude device of the time called a "hearing trumpet.
Luckily, composers of today don't have to suffer the problems that Beethoven did. Digital hearing aids are sophisticated enough to distinguish between speech and noise and can be programmed to adapt to different environments. Unlike Beethoven, if you suffer from hearing loss, you too can take advantage of recent hearing aid advancements.
Wolf, P. Creativity and chronic disease Ludwig van Beethoven Western Journal of Medicine, 5 , Meet Our Staff.
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