Academic journal article The Beethoven Newsletter

Beethoven's Medical History: Themes and Variations

Academic journal article The Beethoven Newsletter

Beethoven's Medical History: Themes and Variations

Article excerpt

"Now what Beethoven did, and what made some of his greatest contemporaries give him up as a madman with lucid intervals of clowning and had taste, was that he used music altogether as a means of expressing moods .... And there you have the whole secret of Beethoven ... he could write music whose beauty will last you all your life ... [but] the thing that marks him out from all the others is his disturbing quality, his power of unsettling us and imposing his giant moods on us."1

SO WROTE GEORGE BERNARD SHAW in March 1927, the centenary of Beethoven's death. He begs the question: what factors were responsible for these "giant moods"? Every creative life is influenced by myriad circumstances - environmental, social, and psychological, to name but a few but it remains difficult to prove that a relationship exists between suffering and the flourishing of genius. In this article, I deal with the physical side of Beethoven's life as affected by his many, increasing, and painful progressive illnesses. A number of parallels can be drawn between his declining health and his musical evolution; whether or not bridges can be constructed between these parallels, the individual must decide. A considerable medical biography already exists, dating back to records and reminiscences of Beethoven's own doctors.2 Much has been made of his deafness, which makes his greatness seem all the more incomprehensible, even though it has never been adequately explained.

This is possible only, I believe, when considered in the context of Beethoven's numerous other ailments. In any multi-system diagnosis, the clinician is faced with many parts of a jigsaw puzzle. In Beethoven's case, some pieces seem to be absent, or to have been overlooked, while others that do not fit well have been ignored. There has been an increasing tendency toward attempting a single diagnosis for Beethoven's illnesses - most notably by Edward Larkin, who hinted in 1970 that one of the rheumatic diseases might account for the many pieces of the diagnostic puzzle.3 In light of advances in the classification of diseases, I have tested this hypothesis from the vantage point of a practising clinician in internal medicine and rheumatology. The result is some fresh conclusions, the most important being a new allencompassing diagnosis that includes an explanation of the deafness.4 Such a diagnosis has not previously been suggested in any of the medical writings on Beethoven.

Ludwig van Beethoven was baptized in Bonn on December 17, 1770, suggesting that he was born the day before. He died in Vienna on March 26,1827. Beethoven's father, Johann, was a tenor and music teacher in the service of the Elector of Cologne, based in those days in Bonn. According to many accounts, Johann was an alcoholic tyrant. Beethoven's mother, Maria Magdalena, had already been widowed when at the age of twenty she married Johann. She was a meek, gentle woman, adored by Beethoven; her death from tuberculosis on July 17, 1787 affected him profoundly.

The marriage produced six other children. One, also named Ludwig, died the year before Beethoven's birth, and of the other five, only two boys survived. The younger brother, Nikolaus Johann, was baptized on October 2, 1776, and outlived Beethoven. The older brother, Casper Carl, was baptized on April 8,1774; he died from tuberculosis on November 15, 1815, naming his wife and brother Ludwig as coguardians of his son Karl. Beethoven considered the widow to be immoral, inadequate, and unsuited to the task; his well-known quixotic struggle to secure sole guardianship over Karl resulted in a relationship between nephew and uncle that was neither successful nor happy. Much has been made of the effect this relationship may have had on Beethoven's mental and physical health. It is probably fair to say that Beethoven acted with misguided good faith, yet demonstrated in ample measure his characteristic bigotry and intransigence.

The family deaths from tuberculosis were by no means exceptional in their day. …

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