In November 1792, at the age of 21, Beethoven moved from his hometown of Bonn to the Austrian capital of Vienna to begin studying music under the composer Joseph Haydn. Once there, he quickly earned a reputation as an exceptional pianist, renowned for his performances of Mozart and Bach, and he began giving public performances of his own early piano concertos just three years later. With the publication of his first compositions in 1795, Beethoven’s reputation as both performer and composer was apparently assured.

It was also around this time, however, that Beethoven’s hearing began to fail him. Initially suffering from tinnitus—“my ears whistle and buzz all day and night,” he wrote—over the next two decades his hearing steadily worsened. Visitors to his home were obliged to communicate with him in writing, using a set of notebooks known as his “conversation books,” and when composing at the piano he would hold a pencil between his teeth and rest the opposite end on the piano lid so as to amplify the sound via the bones in his jaw.

Undeterred, he continued performing and composing as best he could, but as his performances became worse and worse, in 1815 Beethoven was forced to give up public performance altogether. Having dedicated the remainder of his life to composing and conducting, he died in Vienna in 1827 at the age of 56. By that time, he was profoundly deaf.

Precisely what caused Beethoven’s deafness has long been debated, with various theories pointing to syphilis, typhus, lupus, alcoholism, and even the slow ingestion of lead and other heavy metals used to improve the taste of cheap wine at the time. After his death, an autopsy found that his auditory arteries looked like they were “stretched over a raven’s quill," and that his auditory nerves were “shrunken and indistinguishable”—but the cause remained a mystery. 

When it had become clear that his condition was not going to improve on its own, however, Beethoven sought the advice of some of Europe’s foremost doctors, surgeons, and physicians. Each, in turn, administered a bizarre array of treatments that they believed would help restore, or at least improve, his hearing. With little alternative, Beethoven agreed to them all.

1. ALMOND OIL EARPLUGS

When he first sought medical advice in the late 1700s, Beethoven turned to Dr. Johann Frank, a local professor of medicine. He attributed his worsening hearing to his abdominal trouble, since he'd been suffering debilitating bouts of colic, pancreatitis and diarrhea even before leaving Bonn. Frank prescribed a number of traditional herbal remedies, including pushing balls of cotton soaked in almond oil into his ears, but none helped. Beethoven wrote:

"Frank has tried to tone up my constitution with strengthening medicines, and my hearing with almond oil, but much good did it do me! His treatment had no effect, my deafness became even worse, and my abdomen continued to be in the same state as before." 

2. DANUBE BATHS

The 12th Armored Division Memorial Museum Historical Collection, Wikimedia Commons

When Frank’s treatments failed, Beethoven turned to Dr. Gerhard von Vering, a former German military surgeon who was now Director of the Viennese Health Institute, and who listed Emperor Joseph II among his previous patients. Vering recommended that Beethoven take daily “Danube baths”—namely, tepid baths of river water, as well as a small vial of herbal tonic. The treatment apparently “miraculously” improved Beethoven’s digestive ailments, but his deafness not only “persisted … [but] became even worse.” 

3. TOXIC PLANTS

Sten Porse, Wikimedia Commons // CC BY-SA 3.0 

Beethoven continued to visit Dr. Vering over the months that followed, but grew tired of his increasingly bizarre—and increasingly unpleasant—cures. Among them was the application of the toxic bark of the Daphne mezereum plant to his skin. Using tourniquet-like belts, Vering strapped Daphne bark to Beethoven’s forearms, which caused the skin to blister and itch painfully for several days at a time, leaving him unable to write and play. In a letter to his best friend Franz Wegeler in November 1801, Beethoven wrote:

"Vering, for the last few months, has applied blisters to both my arms, consisting of a certain bark … This is a most disagreeable remedy, as it deprives me of the free use of my arms for two or three days at a time, until the bark has drawn sufficiently, which occasions a good deal of pain. It is true the ringing in my ears is somewhat less than it was, especially in my left ear where the illness began, but my hearing is by no means improved; indeed I am not sure but that the evil is increased … I am upon the whole much dissatisfied with [Vering]; he cares too little about his patients."

He might not have thought much of Vering’s treatments, but Beethoven nevertheless took a liking to his daughter, Julie, who was herself a fine pianist. She eventually married Beethoven's childhood friend Stephan von Breuning. 

4. LEECHES

Another of Beethoven’s medical advisors was Dr. Johann Schmidt, who apparently recommended leeches and bloodletting as a means of treating the composer's failing health. Although Beethoven himself makes no reference to this treatment in his own letters, in one letter to Beethoven Dr. Schimdt wrote “from leeches we can expect no further relief.” Schmidt’s letter goes on to refer to a “gout-related” headache from which Beethoven had also been suffering (and for which he had also recommended having one of his teeth pulled), but it’s unclear whether the leeches were used to help his headaches, his deafness, or more likely, both.

5. GALVANISM

Wikimedia Commons // Public Domain

In another letter to his friend Wegeler, Beethoven asked his opinion of the newest trend sweeping medical science at the time—galvanism. Named after Luigi Galvani, the Italian scientist who discovered the phenomenon in the 18th century, galvanism involved the passing of a mild electric current through an afflicted part of the body as a means of stimulating normal bodily activity and kick-starting the healing process. Beethoven wrote:

"People talk about miraculous cures by galvanism; what is your opinion? A medical man told me that in Berlin he saw a deaf and dumb child recover its hearing, and a man who had also been deaf for seven years recover his—I have just heard that Schmidt is making experiments with galvanism."

Although it has long been questioned whether or not Beethoven agreed to galvanic treatment, his conversation books appear to show that he did. In April 1823, Beethoven had a meeting with a local Viennese man, known simply as “Herr Sandra,” who was also suffering from worsening deafness. In their conversation—which was, as always, conducted entirely in writing—Beethoven advised, “Do not start using hearing aids too soon,” before going on to list all the various treatments he had so far endured. “Lately,” he continued, “I have not been able to stand galvanism. It is sad: doctors do not know much, one tires of them eventually.” 

6. ISOLATION

Julius Schmid, Wikimedia Commons // Public Domain

With his treatments seeming to have little effect, Dr. Schmidt advised Beethoven to move away from the hustle and bustle of the capital and retire to the country to rest his ears. He left for Heiligenstadt on the outskirts of the city, but the sudden solitude, the deterioration in his hearing, and the growing realization that his deafness could soon end his career all took their toll, and Beethoven fell into a deep depression. 

In 1802, he wrote a long letter to his two brothers, Carl and Johann, in which he explained his feelings and his condition in great detail, and admitted to having contemplated suicide. “For six years I have been a hopeless case,” he wrote, “aggravated by senseless physicians, cheated year after year in the hope of improvement, finally compelled to face the prospect of a lasting malady whose cure will take years or, perhaps, be impossible.” He went on:

"What a humiliation, when one stood beside me and heard a flute in the distance and I heard nothing, or someone heard the shepherd singing, and again I heard nothing. Such incidents brought me to the verge of despair, but little more and I would have put an end to my life. Only art it was that withheld me … and so I endured this wretched existence—truly wretched … It was virtue that upheld me in misery, to it, next to my art, I owe the fact that I did not end my life with suicide.

Farewell and love each other. I thank all my friends … how glad will I be if I can still be helpful to you in my grave—with joy I hasten towards death. If it comes before I shall have had an opportunity to show all my artistic capacities, it will still come too early for me, despite my hard fate, and I shall probably wish it had come later—but even then I am satisfied, will it not free me from my state? Come when thou will, I shall meet thee bravely. Farewell and do not wholly forget me when I am dead."

Written when he was just 32 years old, The Heiligenstadt Testament, as the letter is known, marks a turning point in Beethoven’s life. Although his hearing never improved, he somehow managed to battle his way back from his lowest point, and fought against his condition for another 24 years—during which he wrote some of the world’s greatest classical music.