Death of Ludwig van Beethoven
The death of Ludwig van Beethoven on 26 March 1827 followed a prolonged illness. It was witnessed by his sister-in-law and by his close friend Anselm Hüttenbrenner, 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, although his remains were moved in 1888 to Vienna's Zentralfriedhof.
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.
Beethoven 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, deemed necessary to replace the difficult Große Fuge. 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 (abdominal swelling), of which the first resulted in infection, the others not. On 24 March he was given his last rites, and on 26 March he slipped into unconsciousness and died. 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.
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; this was specifically denied by Hüttenbrenner in 1860. Some sources have listed his last words as, "I shall hear in heaven".
Beethoven biographer A. W. Thayer, 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 Beethoven scholars.
Autopsy and post-mortem findings
An autopsy was performed on 27 March 1827 by Dr. Johann Wagner. While it is unclear who ordered the autopsy, a specific request by Beethoven in his Heiligenstadt Testament may have played a role in the decision. The autopsy revealed a severely cirrhotic and shrunken liver, of which ascites 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 are causes of cirrhosis, but they spread from contact with contaminated body fluids and were almost unknown in Beethoven's day. Hepatitis A 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. 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, a common result of analgesic abuse (it is known that he used large amounts of drugs obtained from his brother Johann, a pharmacist). Diabetes is also a cause of RPN, and scholars have not ruled out the possibility that the composer had diabetes mellitus. His spleen was swollen to twice the normal size and he had portal hypertension, all consistent with end-stage liver failure. He also appears to have had severe pancreatitis, as the doctors described his pancreas 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, 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. 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.
In 1970 Dr. John Spencer Madden, the editor of the Journal of Alcohol and Alcoholism wrote a port-mortem analysis, in which entirely professionally he made no mention of Beethoven's music. This post-mortem became well-known by being referenced by a short comical essay by the humorist Alan Coren entitled "Careful, Mr. Beethoven, that was your fifth!"
Funeral and burial
The funeral was held on 29 March 1827 at the parish church in Alsergrund, and he was buried in the Währing 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, Franz Grillparzer, Carl Czerny, and Franz Schubert.
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. 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.
Lead poisoning overdose
There is dispute about the cause of Beethoven's death; alcoholic cirrhosis, syphilis, infectious hepatitis, lead poisoning, sarcoidosis and Whipple's disease have all been proposed. In 2008, Austrian pathologist 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 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.
A lead-poisoning expert at Mount Sinai School of Medicine in New York tested the same piece of Beethoven's skull that had been examined in 2005, along with another, larger, fragment. The researcher, Dr. Andrew C. Todd, said that overall he had found no more lead than in the average person's skull. "Beethoven didn't have long-term high lead exposure," Dr. Todd said, "so I think we can stop looking at lead as being a major factor in his life." Dr. Todd's findings at Mount Sinai surprised Dr. William R. Meredith, a Beethoven scholar who had carried the skull fragments to New York from his base in California. He said he had expected Dr. Todd's tests to show elevated lead levels, because the previous tests had reported the amount in Beethoven's hair as well above normal. "It's back to the drawing board for the scientists and the doctors," Dr. Meredith said. He said the value of Dr. Todd's tests was that they told how much—or, as it turned out, how little—lead was in the skull fragments. Dr. Todd had promised precise measurements, and after two days of tests at Mount Sinai, he said that the larger of the two skull fragments had 13 micrograms of lead per gram, "not markedly above what we would expect" in a man of Beethoven's age, 56. The smaller fragment registered considerably more—48 micrograms per gram—and he could not explain the difference. Lead exposure is cumulative, Dr. Todd said, so the level can be expected to increase as a person ages, even if he or she is not exposed to abnormal concentrations from, say, lead paint. Dr. Meredith said that if the tests did not show what had killed Beethoven, at least they indicated what to rule out as a cause of death. "People ask whether he died from drinking plum wine, from chewing on his pencil, from eating fish that were poisoned," said Dr. Meredith, a professor at San Jose State University and the director of the Ira F. Brilliant Center for Beethoven Studies. "Now we know all of those questions are unnecessary. We don't need to go fishing around for toxic exposure to lead." Dr. William J. Walsh, a forensic researcher in Illinois who coordinated the earlier tests, noted that Dr. Todd had tested only skull fragments, not the hair samples. But he agreed with the notion that Beethoven's exposure to lead was a short-term problem that had come toward the end of his life. Like Dr. Walsh's tests, some of which were conducted at the Argonne National Laboratory in Illinois, the Mount Sinai analysis involved multiple measurements with X-ray fluorescence. Dr. Todd said the matter in the skull was similar to the matter found in leg bones that he studies to determine whether someone has lead poisoning. The condition is known to cause irritability, low energy, headaches and to make muscles seem weak: all symptoms consistent with Beethoven's.
- Thayer (1921), volume 3, p. 308
- Thayer (1921) volume 3, p. 307
- Thayer (1921) volume 3, p. 306
- Meredith, p. 1
- Meredith, p. 2
- Meredith, p. 3
- Ritson, Bruce (12 June 2012). "Obituary: J. S. Madden". J. Alcohol and Alcoholism 47 (4). doi:10.1093/alcalc/ags061. Retrieved 18 February 2014.
- Madden, John Spencer (1970). "Ludwig van Beethoven". J. Alcohol and Alcoholism 5 (3): 101–103. Retrieved 18 February 2014.(subscription required)
- Moss, Peter (27 November 2008). "Review: Chocolate and Cuckoo clocks: The Essential Alan Coren". Jewish Chronicle.
- Gibbs (2000), p. 139
- Meredith, p. 4
- Meredith, pp. 5–6, 17
- Mai, F.M. (1 October 2006). "Beethoven's terminal illness and death". J R Coll Physicians Edinb. 36 (3): 258–263. PMID 17214130.
- Jahn, George (28 August 2007). "Pathologist: Doctor Killed Beethoven". The Washington Post. Retrieved 29 December 2008.
- Eisinger, Josef (1 January 2008). "The lead in Beethoven's hair". Toxicological & Environmental Chemistry 90: 1–5. doi:10.1080/02772240701630588.
- Beethoven May Not Have Died of Lead Poisoning, After All
- Gibbs, Christopher (2000). The Life of Schubert. Cambridge University Press. ISBN 0-521-59426-X.
- Meredith, William (Spring & Summer 2005). "The History of Beethoven's Skull Fragments". The Beethoven Journal 20 (1 & 2). Retrieved 27 March 2009.
- Thayer, Alexander Wheelock; Krehbiel, Henry Edward; Deiters, Hermann; Riemann, Hugo (1921). The life of Ludwig van Beethoven, volume 3 (2nd ed.). The Beethoven Association. OCLC 422583.
- "Beethoven's hair". San Jose State University. Retrieved 27 March 2009.
- Center for Beethoven Studies at San Jose State University, including pages on the Beethoven skull fragments and a lock of hair in the center's possession.