Beethoven Autopsy Report

 After he conducted an autopsy on Beethoven's body - on March 27, 1827 - Dr. Johann Wagner prepared his report.  He noted the following regarding the auditory organs and skull structure:

The auditory nerves were shrunken and indistinguishable; the auditory arteries that paralleled them were thickened and cartilaginous as though stretched over a raven's quill. 

The left, much thinner, auditory nerve originated in three very thin grey fibrils and the right nerve in a single thicker pure white strand, both arising from the substance of the fourth ventricle, which in this area was of a firmer consistency and more vascular. 

The convolutions of the brain, ordinarily much softer and more oedematous, here appeared twice as deep and more numerous (more spacious) than usual.  The cranial vault was of a great thickness throughout and approximately one-half inch thick.

Beethoven's deafness had not ended his life, however.  What do modern physicians think of the autopsy results and a possible cause of death?

Analyzing Beethoven's autopsy report, which reflects the composer had (among other things) cirrhosis of the liver, FMM Mai notes the following (broken apart, here, for ease-of-reading):

...The autopsy data indicate that Beethoven had cirrhosis of the liver; and probably also renal papillary necrosis, pancreatitis and possibly diabetes mellitus.  His lifestyle for at least the final decade of his life indicated that he overindulged in alcohol in the form of wine.  Alcohol was by far the most common cause of cirrhosis at that period.

Toxicological analysis of his hair [recently conducted] showed that the level of lead was elevated.  During the eighteenth and early nineteenth centuries, lead was added illegally to inexpensive wines to sweeten and refresh them.

These findings strongly suggest that liver failure secondary to alcoholic cirrhosis, associated with terminal spontaneous bacterial peritonitis, was the cause of death.  This was complicated in the end stages by renal failure.  If the presence of endogenous lead was verified by analysis of Beethoven's skeletal remains, it would suggest that the lead was derived from wine that he drank.  Lead poisoning may account for some of his end-of-life symptoms.  There is little clinical or autopsy evidence that Beethoven suffered from syphilis.

Media Credits

Autopsy report passage, quoted in Beethoven as I Knew Him, by Anton Schindler, edited by Donald W. MacArdle, page 327.

Quoted passage, interpreting Beethoven's autopsy findings, from Beethoven's Terminal Illness and Death, by FMM Mai (published online by the Royal College of Physicians of Edinburgh, September 2006.)

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