OTD in Medical History - Beethoven's Funeral

Beethoven's Funeral

On this day, March 29th in 1827, Ludwig Von Beethoven’s funeral was held. Estimates suggest between 10,000 and 30,000 people may have attending the ceremony for the famous composer. He died three days before on March 26th.

Of interest to medical history is some debate over the cause of his death. What seems to be clear is that Beethoven likely died as a result of liver disease. The cause of that liver disease is the source of said debate.

An autopsy performed two days after his death by Dr. Johann Wagner suggested Beethoven had liver cirrhosis, a term for scarring of the liver. The liver becomes damaged and eventually shrinks into a scarred less-functional version of itself. The scarring obstructs smooth blood flow through the liver and often results in the fluid from the blood getting extruded into the abdominal cavity, called “ascites.” Multiple procedures were done at the time prior to his death to remove the ascites fluid which can build up considerably to cause discomfort to the point where it can be difficult to breathe due to the excess of fluid. Additionally that fluid is a good broth for bacteria and can become infected which, even today in the age of antibiotics, is a serious condition.

What’s not clear is what led to the cirrhosis. Some argue that alcohol and infections such as viral hepatitis may have played a role in Beethoven’s liver disease. There is also some interesting speculation that lead poisoning may have contributed. Beethoven was known to enjoy wine and so-called “lead sugar” was often used to sweeten cheaper wines of the day. It’s also suggested that damage to his hearing may have resulted from chronic lead exposure leading to nerve damage.

In reality it’s probable that multiple of the above factors may have caused his liver disease, scarring and ultimately the demise of the celebrated composer.

Pictured here are a normal liver, cirrhotic liver, Beethoven as well as an image of his death mask.

Max

[Doctor with a mustache]