When Beethoven entered his thirtieth year, he began to suffer from an annoying roaring and buzzing in both ears. Soon his hearing began to fail and, for all he often would enjoy untroubled intervals lasting for months at a time, his disability finally ended in complete deafness. All the resources of the physician’s art were useless. At about the same time Beethoven noticed that his digestion began to suffer. …


At no time accustomed to taking medical advice seriously, he began to develop a liking for spirituous beverages, in order to stimulate his decreasing appetite and to aid his stomachic weakness by excessive use of strong punch and iced drinks. … He contracted a severe inflammation of the intestines which, though it yielded to treatment, later on often gave rise to intestinal pains and aching colics and which, in part, must have favored the eventual development of his mortal illness.
–Andreas Wawruch, physician attending Beethoven’s final illness, 1827


My hearing has become weaker during the last three years. Frank wished to restore me to health by means of strengthening medicines, and to cure my deafness by means of oil of almonds, but, prosit! nothing came of these remedies; my hearing became worse and worse. … Then an Asinus of a doctor advised cold baths, a more skillful one, the usual tepid Danube baths. These worked wonders; but my deafness remained or became worse. This winter I was truly miserable; I had terrible attacks of Kolik, and I fell quite back into my former state.
–Beethoven to Franz Wegeler, 1801


For the last six years I have been afflicted with an incurable complaint, made worse by incompetent doctors. From year to year my hopes of being cured have gradually been shattered … I must live like an outcast; if I appear in company, I am overcome by a burning anxiety, a fear that I am running the risk of letting people notice my condition. … How humiliated I have felt if somebody standing beside me heard the sound of a flute in the distance and I heard nothing. … I have such a sensitive body that any sudden change can plunge me from the best spirits into the worst of humors. …

When I am dead, request on my behalf Professor Schmidt, if he is still living, to describe my disease, and attach this written document to his record, so that after my death at any rate the world and I may be reconciled. …
–Beethoven to brothers Karl and Johann, 1802 (Heiligenstadt Testament)


Medical science is divided as to whether Beethoven’s deafness was due to direct damage to the auditory nerve (sensori-neural deafness) or to thickening and fixation of the bones which conduct sound through the middle ear (otosclerosis). … Otosclerosis is the commonest cause of deafness in a man of twenty-eight years, but the high-frequency hearing loss described by Beethoven is not typical of the condition and makes the diagnosis doubtful. …

Johann Wagner in his autopsy report identified the auditory nerves; he clearly thought they were implicated in the pathological process. The appearance of the auditory arteries seems more typical of atherosclerosis (hardening of the arteries) than of endarteritis obliterans, which would have been seen in a chronic inflammatory condition such as syphilis.
–John O’Shea, Was Mozart Poisoned? Medical Investigations into the Lives of the Great Composers, 1991


According to Huttenbrenner, who was in the room, there was a sudden flash of lightning which garishly illuminated the death-chamber–snow lay outside–and a violent thunderclap. At this startling, aweful peal of thunder, the dying man suddenly raised his head and stretched out his right arm majestically, ‘like a general giving orders to an army.’ This was but for an instant; the arm sank down; he fell back. Beethoven was dead.
–A. W. Thayer, Life of Beethoven, 1866


The story of Beethoven apparently ‘shaking his fist at the heavens’ in one final act of defiance before oblivion has been dismissed as a romantic fiction by most Beethoven biographers. Surprisingly, it is an accurate clinical observation: people who die of hepatic failure often react in an exaggerated way to sudden stimuli such as bright light. This is due to the accumulation of toxic waste products normally excreted by the liver. Beethoven’s gesture may be seen as having been due to the cerebral irritation which accompanies hepatic failure, not as a conscious act.

The cause of Beethoven’s death–liver failure due to cirrhosis–was confirmed by the autopsy performed by Johann Wagner and Karl von Rokitansky. … The essential feature was macronodular cirrhosis of long standing with concomitant portal hypertension. Macronodular cirrhosis is less common than micronodular cirrhosis in alcoholic liver disease but certainly occurs frequently. … Chronic active hepatitis due to viral or auto-immune disease is a possibility, but it is not necessary to invoke this as an explanation in a patient known to have been drinking heavily over a thirty-year period.
–O’Shea, 1991


Beethoven’s was a long-term hepatitis, as the history from 1821 shows, which had flared up after the exposure during the journey from Gneixendorf. Such a chronic active hepatitis associated with colitis, rheumatism, repeated catarrhs, abscesses, cryopathy (attacks precipitated by chilling), the ophthalmia, and the skin disorder are extremely suggestive of connective tissue immunopathy [auto-immune disease]: such a diagnosis explains all his numerous illnesses. Arterial disease is constant in immunopathy; the atrophy of the auditory nerves could be due to arterial disease.
–Edward Larkin, Beethoven’s Medical History, 1970


Beethoven once had a terrible Typhus [fever with clouding of the mind]. From this time on dated the ruin of his nervous system and probably the ruin of his hearing, so calamitous in his case.
–Aloys Weissenbach, surgeon and Beethoven’s friend, 1820


Beethoven may well have had the specific form of immunopathic disease known as Systemic Lupus Erythematosus, which typically commences in early adult life with a fever accompanied by mental confusion. Typical symptoms are destructive rash (‘lupus’) and redness (‘erythema’) of the butterfly area of the face. Any of the immunopathic disorders may occur, notably colitis. The excellent life-mask of 1812 shows an elongated atrophic scar particularly suggestive of Lupus. The portraits clearly show flushing of the cheekbones and nose. Beethoven’s high color was frequently commented on and may have aroused suspicions of heavy drinking.
–Larkin, 1970 

When Beethoven announced his deafness

One of the most surprising facts about 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 geographically 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 to his friends, dated 1801, in which we get an idea about the deaf composer talking about his increasing deafness.



Letter of Beethoven to Karl Amenda
dated July 1st 1801

“… Know that my noblest faculty, my hearing, has greatly deteriorated…”

“… How sad is my lot, I must avoid all things that are dear to me…”

“… Oh how happy I should be if my hearing were completely restored, then I would hurry to you…;”

“… Of course, I am resolved to rise above every obstacle, but how will it be possible? …”

“… I beg of you to keep the matter of my deafness a profound secret to be confided to nobody, no matter whom…”



Beethoven Landstraßer Hstr Kopie



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Währinger Schubertpark Gedenktafel Beethoven Schubert


“… 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 profession 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, they account for it in that way. Often I can scarcely 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 june,
most probably from 1801.

Beyond the fact that Beethoven deafness was exaggerated and dramatized, it’s 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 was the moment in which the young, successful composer and virtuoso had to accept that he was suffering from a chronic, incurable illness with which he will have to live… and it was going to get worse.

When it became clear that Beethoven was deaf, he accepted it. It was in the midst of his heroic period, and it documented in some authentic Ludwig van Beethoven quotes written in the margins of the Razoumovsky Quartets.

It could safely be stated that even to the end of his life, there were days in which he could hear a bit. Was Beethoven deaf? In many other accounts, it was believed that he was stone deaf. When the communication difficulties finally became too great, more or less around 1818, Beethoven used leafs of paper or tablets, where his friends and visitors wrote down what they wanted to tell him, or ask him. These are known now as the “Conversation Books”. Though these are some interesting facts about Beethoven, 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.

Attempts to heal his deafness, as told by Beethoven

Realien: Schreibtisch BeethovensLet 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 June 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 diarrhea, 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.

sterfhuis5Then 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.

teltscherHe succeeded almost wholly in stopping the awful diarrhea. 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 prescribed 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”.

What are the origins of Beethoven’s deafness?

We know that Beethoven’s talent never diminished despite his failing hearing but what are the origins of this problem? Here are some more Ludwig van Beethoven facts.

No deafness specialists existed at that time, and all was waiting to be discovered. While we will never know for certain what made Beethoven deaf, 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 preceded 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 centers, from where emerge the branches of the acoustic nerve…”

Professor 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…”.

Klaviersonate nr. 30

What is a labyrinthitis?

Surdite_Labyrinthite_EnA 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.burinthos.

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:

  • danhausAcute 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.


hoorappGeneral symptoms of labyrinthitis::

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


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


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


So if Beethoven was completely deaf, how did he compose?


Ludwig was still pumping out the masterpieces – even when he was completely deaf. Here’s how he did it.

“For the last three years my hearing has grown steadily weaker…” – so wrote Beethoven, aged 30, in a letter to a friend.

The young Beethoven was known as the most important musician since Mozart. By his mid-20s, he had studied with Haydn and was celebrated as a brilliant, virtuoso pianist.

Beethoven’s life timeline: 1770 – 1802 >

By the time he turned 30 he had composed a couple of piano concertos, six string quartets, and his first symphony. Everything was looking pretty good for the guy, with the prospect of a long, successful career ahead.

Then, he started to notice a buzzing sound in his ears – and everything was about to change.


How old was Beethoven when he started going deaf?

Around the age of 26, Beethoven began to hear buzzing and ringing in his ears. In 1800, aged 30, he wrote from Vienna to a childhood friend – by then working as a doctor in Bonn – saying that he had been suffering for some time:

“For the last three years my hearing has grown steadily weaker. I can give you some idea of this peculiar deafness when I must tell you that in the theatre I have to get very close to the orchestra to understand the performers, and that from a distance I do not hear the high notes of the instruments and the singers’ voices… Sometimes too I hardly hear people who speak softly. The sound I can hear it is true, but not the words. And yet if anyone shouts I can’t bear it.”

Beethoven tried to keep news of the problem secret from those closest to him. He feared his career would be ruined if anyone realised.

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

Once Beethoven was out for a country ramble with fellow composer Ferdinand Ries, and while walking they saw a shepherd playing a pipe. Beethoven would have seen from Ries’s face that there was beautiful music playing, but he couldn’t hear it. It’s said that Beethoven was never the same again after this incident, because he had confronted his deafness for the first time.

Beethoven could apparently still hear some speech and music until 1812. But by the age of 44, he was almost totally deaf and unable to hear voices or so many of the sounds of his beloved countryside. It must have been devastating for him.

Picture: Still from ‘Das Leben des Beethoven’ (1927)

Why did Beethoven go deaf?

The exact cause of his hearing loss is unknown. Theories range from syphilis to lead poisoning, typhus, or possibly even his habit of plunging his head into cold water to keep himself awake.

At one point he claimed he had suffered a fit of rage in 1798 when someone interrupted him at work. Having fallen over, he said, he got up to find himself deaf. At other times he blamed it on gastrointestinal problems.

“The cause of this must be the condition of my belly which as you know has always been wretched and has been getting worse,” he wrote, “since I am always troubled with diarrhoea, which causes extraordinary weakness.”

An autopsy carried out after he died found he had a distended inner ear, which developed lesions over time.

Here’s Beethoven’s famous Symphony No.5, written in 1804. Its famous opening motif is often referred to as ‘fate knocking at the door’; the cruel hearing loss that he feared would afflict him for the rest of his life.

Quiz: How well do you REALLY know Beethoven’s 5th? >

What treatment did Beethoven seek for his deafness?

Taking a lukewarm bath of Danube water seemed to help Beethoven’s stomach ailments, but his deafness became worse. “I am feeling stronger and better, except that my ears sing and buzz constantly, day and night.”

One bizarre remedy was strapping wet bark to his upper arms until it dried out and produced blisters. This didn’t cure the deafness—it only served to keep him away from his piano for two weeks.

After 1822, he gave up seeking treatment for his hearing. He tried a range of hearing aids, such as special hearing trumpets. Take a look:

Victorian Hearing Trumpets

If he couldn’t hear, how did he write music?

Beethoven had heard and played music for the first three decades of his life, so he knew how instruments and voices sounded and how they worked together. His deafness was a slow deterioration, rather than a sudden loss of hearing, so he could always imagine in his mind what his compositions would sound like.

Beethoven’s life timeline: 1803-1812 >

Beethoven’s housekeepers remembered that, as his hearing got worse, he would sit at the piano, put a pencil in his mouth, touching the other end of it to the soundboard of the instrument, to feel the vibration of the note.


Did Beethoven’s deafness change his music?

Yes. In his early works, when Beethoven could hear the full range of frequencies, he made use of higher notes in his compositions.  As his hearing failed, he began to use the lower notes that he could hear more clearly. Works including the Moonlight Sonata, his only opera Fidelio and six symphonies were written during this period. The high notes returned to his compositions towards the end of his life which suggests he was hearing the works take shape in his imagination.

Here’s Beethoven’s String Quartet No. 14, written by the deaf Beethoven in 1826, formed entirely of those sounds of his imagination.

Did Beethoven continue to perform?

He did. But he ended up wrecking pianos by banging on them so hard in order to hear the notes.

After watching Beethoven in a rehearsal in 1814 for the Archduke Trio, the composer Louis Spohr said: “In forte passages the poor deaf man pounded on the keys until the strings jangled, and in piano he played so softly that whole groups of notes were omitted, so that the music was unintelligible unless one could look into the pianoforte part. I was deeply saddened at so hard a fate.”

When it came to the premiere of his massive Ninth Symphony, Beethoven insisted on conducting. The orchestra hired another conductor, Michael Umlauf to stand alongside the composer. Umlauf told the performers to follow him and ignore Beethoven’s directions.

The symphony received rapturous applause which Beethoven could not hear. Legend has it that the young contralto Carolina Unger approached the maestro and turned him around to face the audience, to see the ovation.

This is how the moment might have looked, with Gary Oldman playing Beethoven in the film, Immortal Beloved:

Het leven & de muziek van Ludwig van Beethoven (1770 – 1827) op Compact Discs, DVD's en Boeken

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