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Beethoven’s Triad: Diarrhoea, Deafness and Cirrhosis

Short Note | Open Access Volume 9 | Issue 5 |

  • 1. SA Pathology at Flinders Medical Centre, Bedford Park, South Australia, Australia
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Corresponding Authors
Allen PW, SA Pathology at Flinders Medical Centre, Bedford Park, South Australia 5024, Australia, Email: philvalallen@bigpond.com
CITATION

Allen PW (2022) Beethoven’s Triad: Diarrhoea, Deafness and Cirrhosis. Ann Otolaryngol Rhinol 9(5): 1299.

INTRODUCTION

Beethoven suffered from chronic relapsing diarrhoea from his early twenties and in his early thirties, from progressive deafness, which his late eighteenth-century doctors believed was related to his diarrhoea. He died from cirrhosis of the liver aged 57 in 1820. The multiple diagnoses suggested since he died have included lead poisoning, alcoholic cirrhosis, viral hepatitis, inflammatory eye disease, rheumatism, inflammatory bowel disease, Paget’s disease of bone, Cogan’s syndrome, systemic lupus erythematosus, otosclerosis, chronic pancreatitis, tuberculosis, sarcoidosis, Whipple’s disease, renal papillary necrosis and syphilis. Beethoven described his various illnesses in his letters, which have been translated into English by Emily Anderson (Figure 1)

Figure 1 Photograph of the dust cover of volume 1 of Emily Anderson’s English translation of Beethoven’s collected letters.

Figure 1: Photograph of the dust cover of volume 1 of Emily Anderson’s English translation of Beethoven’s collected letters.

[1]. Details of his contemporaries’ observations are recorded in Thayer’s monumental Life of Beethoven [2].

No one had postulated that a single disease could explain the triad of diarrhoea, deafness and cirrhosis until 2005, when Karmody and Bachor suggested that Beethoven suffered from chronic inflammatory bowel disease and its sequelae [3]. It is now known that ulcerative colitis may be complicated by sensorineural deafness and sclerosing cholangitis which progresses to cirrhosis, liver failure and death. These apparently diverse diseases are now believed to share an autoimmune pathogenesis. This explanation neatly joins together Beethoven’s triad of diarrhoea, deafness and cirrhosis. Despite what seems to me to be a strong case [4], Karmody and Bachor’s hypothesis has received virtually no other support. This short communication is intended to draw attention to Karmody and Bachor’s paper and to elicit the views of 21st Century otorhinolaryngologists.

REFERENCES

1. Anderson E. The letters of Beethoven collected, translated and edited with an introduction, appendices, notes and indices in three volumes. Macmillan, 1961.

2. Thayer A. Life of Beethoven revised by Elliot Forbes, Ian Curties, Ed. Folio Society, 2001.

3. Karmody CS, Bachor ES. The deafness of Ludwig van Beethoven: an immunopathy. Otol Neurotol. 2005; 26: 809-814.

4. Allen PW. Beethoven’s triad: Diarrhoea, deafness and cirrhosis. A plausible solution to the 195-year-old controversy. Ann Diagn Pathol. 2022; 58: 151904.

Allen PW (2022) Beethoven’s Triad: Diarrhoea, Deafness and Cirrhosis. Ann Otolaryngol Rhinol 9(5): 1299.

Received : 27 Jul 2022
Accepted : 23 Aug 2022
Published : 23 Aug 2022
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