Did Paget's Disease cause Beethoven's deafness?
Hearing loss was recognised as a complication in Sir James Paget’s original description of Paget’s disease. Partial or total hearing loss can occur because the physical sound waves are blocked (“conductive” type of loss) before they reach the nerves that convert them to electrical signals and/or because the nerves carrying the electrical signals themselves are blocked (“sensorineural” type of loss). Although the exact mechanisms which underlie hearing loss in Paget’s disease are still debated, both conductive and sensorineural hearing loss can be seen if the skull is involved by the disease, even if total deafness is unusual.
It is a well-known fact that German composer, Ludwig van Beethoven, became completely deaf. Born in 1770, in Bonn, Germany, Beethoven gradually lost his hearing and by the time he was in his mid-forties, was completely deaf. Amazingly, some of his most important works were composed during this time, when he was unable to hear.
Beethoven's medical problems were many and he died in 1827, at the age of 56. Over the years, various papers have been written about his health and possible cause/s of his deafness. The most recent was written by Dr Stanley Oiseth, who is an Assistant Professor of Pathology at New York Medical College and Director of Pathology at Phelps Memorial Hospital in Sleepy Hollow, New York, USA. The article titled, ‘Beethoven’s autopsy revisited: A pathologist sounds a final note’, was published last year in the Journal of Medical Biography and it gives a detailed and knowledgeable review of the original autopsy report. Dr Oiseth considered each aspect of the report in detail correlating each observation to documented signs and symptoms.
Dr Oiseth explains, "Paget’s disease and its associated problems, complicated by the use of alcohol and possibly other drugs to relieve the symptoms, can explain most or all of Beethoven’s medical problems. Any illness with sufficient severity will always have both psychological and physical dimensions. Beethoven suffered much during the last half of his life, and had actually pleaded with his brothers to have his doctor find and make public a medical explanation for his ‘disease’ after his death, since he thought the world would judge him differently if the underlying physical reasons for his behaviour could be explained". Dr Oiseth's paper fulfills Beethoven's wish.
Professor Roger Francis, Chairman of the Paget’s Association, said: “This new analysis of Beethoven’s autopsy is fascinating. This suggests that he suffered common complications of Paget’s disease. Unfortunately, even today, relatively few patients with Paget’s disease are referred to specialists with expertise in the diagnosis and treatment of the condition. The Paget’s Association offers information, advice and support to anyone concerned about Paget’s disease.”