The death of Ludwig van Beethoven

Ludwig van Beethoven

Ludwig van Beethoven was a German composer and pianist. A crucial figure in the transition between the Classical and Romantic eras in Western art music, he remains one of the most famous and influential composers of all time.Born in Bonn, then the capital of the Electorate of Cologne and part of...

on 26 March 1827 followed a prolonged illness. It was witnessed by his sister-in-law and by his close friend Anselm Hüttenbrenner

Anselm Hüttenbrenner

Anselm Hüttenbrenner , was an Austrian composer. He was on friendly terms with both Ludwig van Beethovenhe was one of only two people present at his deathand Franz Schubert, his recollections of whom constitute an interesting but probably unreliable document in Schubertian biographical...

, who provided a vivid description of the event. Beethoven's funeral was held three days later, and the procession was witnessed by a large crowd. He was buried in the cemetery at Währing

Währing

Währing is the 18th district of Vienna, Austria. It is in the northwest part of the city. In addition to currently hosting a number of Vienna's foreign embassies, Währing was the site of the original burial places of composers Ludwig van Beethoven and Franz Schubert.-Location:Währing lies in the...

, although his remains were moved in 1888 to Vienna

Vienna

Vienna is the capital and largest city of the Republic of Austria and one of the nine states of Austria. Vienna is Austria's primary city, with a population of about 1.723 million , and is by far the largest city in Austria, as well as its cultural, economic, and political centre...

's Zentralfriedhof

Zentralfriedhof

The Zentralfriedhof is one of the largest cemeteries in the world, largest by number of interred in Europe and most famous cemetery among Vienna's nearly 50 cemeteries.-Name and location:...

.

Hüttenbrenner's account has been used to ascribe motivations of resistance and anger to Beethoven in his final moments. Beethoven's last words, and the exact cause of Beethoven's death have also been the subject of some disagreement.

Final illness

Beethoven

Ludwig van Beethoven

Ludwig van Beethoven was a German composer and pianist. A crucial figure in the transition between the Classical and Romantic eras in Western art music, he remains one of the most famous and influential composers of all time.Born in Bonn, then the capital of the Electorate of Cologne and part of...

 suffered declining health throughout the last years of his life, including the so-called "Late period" when he produced some of his most admired work. The last work he was able to complete was the substitute final movement of the String Quartet No. 13

String Quartet No. 13 (Beethoven)

The String Quartet No. 13 in B major, op. 130, by Ludwig van Beethoven was completed in November 1825. The number traditionally assigned to it is based on the order of its publication; it is actually the fourteenth quartet in order of composition. It was premiered in March 1826 by the Schuppanzigh...

, deemed necessary to replace the difficult Große Fuge

Große Fuge

The Große Fuge , Op. 133, is a single-movement composition for string quartet by Ludwig van Beethoven. A massive double fugue, it originally served as the final movement of his Quartet No. 13 in B major but he replaced it with a new finale and published it separately in 1827 as Op...

. Shortly thereafter, in December 1826, illness struck again, with episodes of vomiting and diarrhea that nearly ended his life.

As it became apparent that Beethoven would not recover, his friends gathered to help and to pay their final respects. Beethoven's doctors conducted four minor operations to relieve ascites

Ascites

Ascites is a gastroenterological term for an accumulation of fluid in the peritoneal cavity.The medical condition is also known as peritoneal cavity fluid, peritoneal fluid excess, hydroperitoneum or more archaically as abdominal dropsy. Although most commonly due to cirrhosis and severe liver...

 (abdominal swelling), of which the first resulted in infection, the others not. On 24 March, he was given his last rites

Last Rites

The Last Rites are the very last prayers and ministrations given to many Christians before death. The last rites go by various names and include different practices in different Christian traditions...

, and two days later slipped into an unconscious state and then died the same day, 26 March 1827. While others, including Beethoven's brother and some friends, were probably in the house, Hüttenbrenner reports in his 1860 account that only he and Beethoven's sister-in-law were present in the room at the time of death.

Final words

Beethoven's last recorded words were "Pity, pity—too late!", as the dying composer was told of a gift of twelve bottles of wine from his publisher. One common belief was that his last words were "Plaudite, amici, comedia finita est" ("Applaud, my friends, the comedy is over"), the typical conclusion to performances of Italian Commedia dell'arte

Commedia dell'arte

Commedia dell'arte is a form of theatre characterized by masked "types" which began in Italy in the 16th century, and was responsible for the advent of the actress and improvised performances based on sketches or scenarios. The closest translation of the name is "comedy of craft"; it is shortened...

; this was specifically denied by Hüttenbrenner in 1860. Some sources have listed his last words as, "I shall hear in heaven", but this is also almost certainly apocrypha

Apocrypha

The term apocrypha is used with various meanings, including "hidden", "esoteric", "spurious", "of questionable authenticity", ancient Chinese "revealed texts and objects" and "Christian texts that are not canonical"....

l.

Beethoven biographer A. W. Thayer

Alexander Wheelock Thayer

Alexander Wheelock Thayer , was a librarian and journalist who became the author of the first scholarly biography of Ludwig van Beethoven, still after many updatings regarded as a standard work of reference on the composer.-Life:Originally a librarian at Harvard law school, Thayer became aware of...

, in his notebook, recorded Hüttenbrenner's account of Beethoven's death. Hüttenbrenner's eye-witness report is sometimes recast to imply that Beethoven "shook his fist at the heavens" in the moment before death. Since any imputations as to the dying man's emotional state are impossible to verify, they tend to be glossed over or ignored as irrelevant by modern-day Beethoven scholars.

Preparation of the body

An autopsy

Autopsy

An autopsy—also known as a post-mortem examination, necropsy , autopsia cadaverum, or obduction—is a highly specialized surgical procedure that consists of a thorough examination of a corpse to determine the cause and manner of death and to evaluate any disease or injury that may be present...

 was performed on 27 March by Dr. Johann Wagner. While it is unclear who ordered the autopsy, a specific request by Beethoven in his Heiligenstadt Testament

Heiligenstadt Testament

The Heiligenstadt Testament is a letter written by Ludwig van Beethoven to his brothers Carl and Johann at Heiligenstadt on 6 October 1802....

 may have played a role in the decision. The autopsy revealed a severely cirrhotic and shrunken liver

Liver

The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...

, of which ascites

Ascites

Ascites is a gastroenterological term for an accumulation of fluid in the peritoneal cavity.The medical condition is also known as peritoneal cavity fluid, peritoneal fluid excess, hydroperitoneum or more archaically as abdominal dropsy. Although most commonly due to cirrhosis and severe liver...

 is a common consequence. Scholars disagree over whether Beethoven's liver damage was the result of heavy alcohol consumption, hepatic infection, or both. Hepatitis B and C

Hepatitis C

Hepatitis C is an infectious disease primarily affecting the liver, caused by the hepatitis C virus . The infection is often asymptomatic, but chronic infection can lead to scarring of the liver and ultimately to cirrhosis, which is generally apparent after many years...

 are causes of cirrhosis, but they spread from contact with contaminated body fluids and were almost unknown in Beethoven's day. Hepatitis A

Hepatitis A

Hepatitis A is an acute infectious disease of the liver caused by the hepatitis A virus , an RNA virus, usually spread the fecal-oral route; transmitted person-to-person by ingestion of contaminated food or water or through direct contact with an infectious person...

 on the other hand can be contracted from food and water that were not handled properly and was very common in the 19th century, although it does not cause liver cirrhosis or permanent organ damage.

Heavy metal contamination is thought to be a contributing factor in Beethoven's death as these were commonly used in the medicine of the time. It has also been theorized that he consumed large amounts of lead from illegally-fortified wine. This was a very common practice to sweeten cheap wines, and despite being outlawed in most European countries during the 18th century, the prohibition was difficult to enforce and production of lead-fortified wine (which originated in Roman times) continued unabated. There is no indication the composer had syphilis beyond a mercury treatment prescribed to him around 1815, but these were used for various other ailments as well.

The autopsy indicated damage to his aural nerves as well as hardening of their accompanying arteries, although the latter appears to be consistent with natural aging and not inflammatory damage from syphilis

Syphilis

Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...

. Beethoven's brain was described as possessing "exaggerated folds", an excess of fluid in the skull, and some thickening of the membranes inside the left ventricle. Scholars believe he may have had a degree of cerebral atrophy, although he showed no sign of cognitive impairment to the end. The skull was described as "possessing unusual thickness".

Beethoven's kidneys had calcareous growths in them, indicating that he was likely developing renal papillary necrosis

Renal papillary necrosis

Renal papillary necrosis is a form of nephropathy involving the necrosis of the renal papilla, which is supplied by the vasa recta.-Causes:Analgesic nephropathy is a cause of renal papillary necrosis. The damage is cumulative and most patients of renal papillary necrosis would have ingested at...

, a common result of analgesic

Analgesic

An analgesic is any member of the group of drugs used to relieve pain . The word analgesic derives from Greek an- and algos ....

 abuse (it is known that he used large amounts of drugs obtained from his brother Johann, a pharmacist

Pharmacist

Pharmacists are allied health professionals who practice in pharmacy, the field of health sciences focusing on safe and effective medication use...

). Diabetes is also a cause of RPN, and scholars have not ruled out the possibility that the composer had diabetes mellitus

Diabetes mellitus

Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced...

. His spleen

Spleen

The spleen is an organ found in virtually all vertebrate animals with important roles in regard to red blood cells and the immune system. In humans, it is located in the left upper quadrant of the abdomen. It removes old red blood cells and holds a reserve of blood in case of hemorrhagic shock...

 was swollen to twice the normal size and he had portal hypertension

Portal hypertension

In medicine, portal hypertension is hypertension in the portal vein and its tributaries.It is often defined as a portal pressure gradient of 10 mmHg or greater.-Causes:Causes can be divided into prehepatic, intrahepatic, and posthepatic...

, all consistent with end-stage liver failure. He also appears to have had severe pancreatitis

Pancreatitis

Pancreatitis is inflammation of the pancreas. It occurs when pancreatic enzymes that digest food are activated in the pancreas instead of the small intestine. It may be acute – beginning suddenly and lasting a few days, or chronic – occurring over many years...

, as the doctors described his pancreas

Pancreas

The pancreas is a gland organ in the digestive and endocrine system of vertebrates. It is both an endocrine gland producing several important hormones, including insulin, glucagon, and somatostatin, as well as a digestive organ, secreting pancreatic juice containing digestive enzymes that assist...

 as "shrunken and fibrous", with the exit duct being very thin and narrowed. Large amounts of reddish fluid had accumulated in Beethoven's abdomen, likely from spontaneous bacterial infections mixed with some blood. This was possibly a result of draining fluid from his abdomen in his last days, a practice that very often caused infection and death of the patient in a time before antibiotics and bacterial pathology were known.

In the days immediately preceding and following his death, a number of people, including Anton Schindler and Ferdinand Hiller

Ferdinand Hiller

Ferdinand Hiller was a German composer, conductor, writer and music-director.-Biography:Ferdinand Hiller was born to a wealthy Jewish family in Frankfurt am Main, where his father Justus was a merchant in English textiles – a business eventually continued by Ferdinand’s brother Joseph...

, cut locks of hair from Beethoven's head. Most of Hiller's lock is now in the Center for Beethoven Studies at San Jose State University

San José State University

San Jose State University is a public university located in San Jose, California, United States...

. One of Beethoven's friends incorrectly thought that "strangers had cut all of his hair off"; in fact, the apparent lack of hair was due to a cloth cap that covered the hair while the body was lying in state.
On 28 March, castings for a death mask

Death mask

In Western cultures a death mask is a wax or plaster cast made of a person’s face following death. Death masks may be mementos of the dead, or be used for creation of portraits...

 were taken. The body was clothed and placed in an oaken coffin, with the head given a wreath of white roses. Its hands held a wax cross and a lily.

Funeral and burial

The funeral was held on 29 March 1827 at the parish church in Alsergrund

Alsergrund

Alsergrund is the ninth district of Vienna, Austria . It is located just north of the first, central district, Innere Stadt. Alsergrund was incorporated in 1862, with seven suburbs. The area is densely populated, with a lot of government-built housing. According to the census of 2001, there were...

, and he was buried in the Währing

Währing

Währing is the 18th district of Vienna, Austria. It is in the northwest part of the city. In addition to currently hosting a number of Vienna's foreign embassies, Währing was the site of the original burial places of composers Ludwig van Beethoven and Franz Schubert.-Location:Währing lies in the...

 cemetery, northwest of Vienna. Many thousands of citizens lined the streets for the funeral procession. As with all crowds, estimates vary, with witnesses reporting anywhere from 10,000 to 30,000 onlookers. Theaters were closed, and many notable artists participated in the funeral procession as pallbearers or torch bearers, including Johann Nepomuk Hummel

Johann Nepomuk Hummel

Johann Nepomuk Hummel or Jan Nepomuk Hummel was an Austrian composer and virtuoso pianist. His music reflects the transition from the Classical to the Romantic musical era.- Life :...

, Franz Grillparzer

Franz Grillparzer

Franz Seraphicus Grillparzer was an Austrian writer who is chiefly known for his dramas. He also wrote the oration for Ludwig van Beethoven's funeral.-Biography:...

, Carl Czerny

Carl Czerny

Carl Czerny was an Austrian pianist, composer and teacher. He is best remembered today for his books of études for the piano. Czerny's music was profoundly influenced by his teachers, Muzio Clementi, Johann Nepomuk Hummel, Antonio Salieri and Ludwig van Beethoven.-Early life:Carl Czerny was born...

, and Franz Schubert

Franz Schubert

Franz Peter Schubert was an Austrian composer.Although he died at an early age, Schubert was tremendously prolific. He wrote some 600 Lieder, nine symphonies , liturgical music, operas, some incidental music, and a large body of chamber and solo piano music...

.

In the days following the funeral, one of the grave-diggers was reportedly offered a substantial sum of money to remove the head from the grave. As a result, Beethoven's friends had a watch put on the grave.

In 1863 Beethoven's body (and also that of Schubert, who was buried nearby) was exhumed, studied and reburied, in proceedings paid for by the Gesellschaft der Musikfreunde

Gesellschaft der Musikfreunde

The Gesellschaft der Musikfreunde in Wien , was founded in 1812 by Joseph von Sonnleithner, general secretary of the Court Theatre, Vienna, Austria. Its official charter, drafted in 1814, states that the purpose of the Society was to promote music in all its facets...

. At that time, fragments from the back of his skull, which had been separated during the autopsy, were acquired by the Austrian doctor Romeo Seligmann, which are also now in the Center for Beethoven Studies. His remains were moved in 1888 to the Zentralfriedhof

Zentralfriedhof

The Zentralfriedhof is one of the largest cemeteries in the world, largest by number of interred in Europe and most famous cemetery among Vienna's nearly 50 cemeteries.-Name and location:...

.

Lead poisoning overdose

There is dispute about the cause of Beethoven's death; alcoholic cirrhosis

Cirrhosis

Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrosis, scar tissue and regenerative nodules , leading to loss of liver function...

, syphilis

Syphilis

Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...

, infectious hepatitis

Hepatitis A

Hepatitis A is an acute infectious disease of the liver caused by the hepatitis A virus , an RNA virus, usually spread the fecal-oral route; transmitted person-to-person by ingestion of contaminated food or water or through direct contact with an infectious person...

, lead poisoning

Lead poisoning

Lead poisoning is a medical condition caused by increased levels of the heavy metal lead in the body. Lead interferes with a variety of body processes and is toxic to many organs and tissues including the heart, bones, intestines, kidneys, and reproductive and nervous systems...

, sarcoidosis

Sarcoidosis

Sarcoidosis , also called sarcoid, Besnier-Boeck disease or Besnier-Boeck-Schaumann disease, is a disease in which abnormal collections of chronic inflammatory cells form as nodules in multiple organs. The cause of sarcoidosis is unknown...

 and Whipple's disease

Whipple's disease

Whipple's disease is a rare, systemic infectious disease caused by the bacterium Tropheryma whipplei. First described by George Hoyt Whipple in 1907 and commonly considered a gastrointestinal disorder, Whipple's disease primarily causes malabsorption but may affect any part of the body including...

 have all been proposed. In 2008, Austria

Austria

Austria , officially the Republic of Austria , is a landlocked country of roughly 8.4 million people in Central Europe. It is bordered by the Czech Republic and Germany to the north, Slovakia and Hungary to the east, Slovenia and Italy to the south, and Switzerland and Liechtenstein to the...

n pathologist

Pathology

Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....

 Christian Reiter asserted that Beethoven's doctor, Andreas Wawruch, accidentally killed the composer by giving him an overdose of a lead-based cure. According to Reiter, Wawruch used the cure to alleviate fluid in the abdomen; the lead penetrated Beethoven's liver

Liver

The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...

 and killed him. Reiter's hypothesis however is at odds with Dr. Wawruch's written instruction "that the wound was kept dry all the time". Furthermore human hair is a very bad biomarker for lead contamination and Reiter's hypothesis must be considered dubious as long as proper scholarly documentation remains unpublished.

External links

• Center for Beethoven Studies at San Jose State University
  San José State University
  San Jose State University is a public university located in San Jose, California, United States...
  
  , including pages on the Beethoven skull fragments and a lock of hair in the center's possession.