{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T22:01:40Z","timestamp":1790373700655,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2013,5,17]],"date-time":"2013-05-17T00:00:00Z","timestamp":1368748800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To reexamine the cause of Beethoven's hearing loss because of significant recent articles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>Medical and musical literature online, in print, and personal communication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Relevant literature review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Evidence of otosclerosis is lacking because close gross examination of Beethoven's middle ears at autopsy did not find any otosclerotic foci. His slowly progressive hearing loss over a period of years differs from reported cases of autoimmune hearing loss, which are rapidly progressive over a period of months. He also lacked bloody diarrhea that is invariably present with autoimmune inflammatory bowel disease. The absence of mercury in Beethoven's hair and bone samples leads us to conclude that his deafness was not due to syphilis because in that era syphilis was treated with mercury. High levels of lead deep in the bone suggest repeated exposure over a long period of time rather than limited exposure prior to the time of death. The finding of shrunken cochlear nerves at his autopsy is consistent with axonal degeneration due to heavy metals such as lead. Chronic low\u2010level lead exposure causes a slowly progressive hearing loss with sensory and autonomic findings, rather than the classic wrist drop due to motor neuropathy from sub\u2010acute poisoning. Beethoven's physicians thought that he had alcohol dependence. He particularly liked wine that happened to be tainted with lead.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Beethoven's chronic consumption of wine tainted with lead is a better explanation of his hearing loss than other causes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>N\/A. <jats:italic>Laryngoscope<\/jats:italic>, 123:2854\u20132858, 2013<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.24120","type":"journal-article","created":{"date-parts":[[2013,5,17]],"date-time":"2013-05-17T21:36:40Z","timestamp":1368826600000},"page":"2854-2858","source":"Crossref","is-referenced-by-count":32,"title":["Lead and the deafness of Ludwig van Beethoven"],"prefix":"10.1002","volume":"123","author":[{"given":"Michael H.","family":"Stevens","sequence":"first","affiliation":[{"name":"University of Utah School of Medicine Salt Lake City Utah U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teemarie","family":"Jacobsen","sequence":"additional","affiliation":[{"name":"University of Utah School of Medicine Salt Lake City Utah U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia Kay","family":"Crofts","sequence":"additional","affiliation":[{"name":"University of Utah School of Medicine Salt Lake City Utah U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,5,17]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"60","volume-title":"The Letters of Beethoven","author":"Anderson E","year":"1961"},{"key":"e_1_2_6_3_1","volume-title":"Beethoven in Person: His Deafness, Illnesses, and Death","author":"Davies PJ","year":"2001"},{"key":"e_1_2_6_4_1","first-page":"1","article-title":"The Deafness of Beethoven: an Audiologic and Medical Overview","volume":"11","author":"Shearer PD","year":"1990","journal-title":"Am J of Otol"},{"key":"e_1_2_6_5_1","first-page":"329","article-title":"Beethoven's Deafness","volume":"45","author":"Scorsby M","year":"1930","journal-title":"J Laryngol Otol"},{"key":"e_1_2_6_6_1","first-page":"1735","volume-title":"Opera, hoc est, tractatus de aure humana","author":"Valsalva AM"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mao.0000178149.36881.df"},{"key":"e_1_2_6_8_1","first-page":"585","article-title":"Autoimmune Sensorineural Hearing Loss","volume":"88","author":"McCabe BF","year":"1979","journal-title":"Laryngoscope"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1979.00790170041011"},{"key":"e_1_2_6_10_1","first-page":"371","article-title":"Disturbances of loudness perception","volume":"9","author":"Phillips DP","year":"1998","journal-title":"J Am Acad Adiol"},{"key":"e_1_2_6_11_1","first-page":"107","volume-title":"Diagnosing Genius: The Life and Death of Beethoven","author":"Mai FM","year":"2007"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940411300702"},{"key":"e_1_2_6_13_1","first-page":"56","volume-title":"Beethoven Krankheiten und ihre Beurteilung","author":"Forster W","year":"1956"},{"key":"e_1_2_6_14_1","unstructured":"U.S. Department of Energy News Release of the Argonne National Laboratory. 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