Before he died, Beethoven asked that doctors conduct a postmortem examination
to find out why he had gone deaf. The autopsy took place in Beethoven's house
the day after his death on 26 March 1827, with Dr. Johann Wagner presiding.
Also present was Beethoven's physician Wawruch. In addition to examining Beethoven's
auditory apparatus, they looked into what might have killed him. He died after
a 4-month illness marked by diarrhaea and emaciation: the latter being especially,
and poignantly signalled by Wagner and other witnesses.
Astonishingly, a record of the procedure exists, signed by Wagner. I am not
a doctor, so I cannot interpret what Wagner saw: and perhaps the sometimes primitive
terminology of Beethoven's day makes things hard to interpret even for a professional.
It snowed the evening Beethoven
died, so although decomposition must have gotten underway,
it was at any rate not aided by great heat.
In an examination of the exterior of Beethoven's ears, they found that the
auditory canal "was covered in shining scales, particularly in the area
of the tympanum, which was concealed by them." Wagner then dissected Beethoven's
head, examining the composer's auditory apparatus, eustachian tube, and related
structures. "Dimpled scars" were to be seen near the orifice of the
eustachian tube and the tonsils; the tube itself was swollen and somewhat constricted.
Beethoven's facial nerves were of "unusual thickness." They must
have looked to create a basis for comparison with the auditory nerves, which
were "shriveled and destitute of neurina." The arteries associated
with them were "dilated more than the size of a crow quill," and the
left auditory nerve was attenuated to "three very thin greyish striae,"
while the right had "one strong clear-white stria from the substances of
the right ventricle."
They had a look at Beethoven's brain: "the convolutions of the brain were
full of water, and remarkably white; they appeared very much deeper, wider,
and more numerous than ordinary."
The thoracic organs were normal, but in the abdominal cavity "four quarts
of grayish brown turbid fluid were effused." The liver was shrunk to half-size
and greenish-blue, "and beset with knots, the size of a bean, on its tuberculated
surface, as well as in its substance. All its vessels were very much narrowed,
and bloodless."
Beethoven had gallstones, and an enlarged, darkened, and "firm" spleen,
as were the pancreas. Wagner reports that the stomach and bowels were greatly
distended with air (beginning of gas buildup from decomposition?). "Both
kidneys were invested by a cellular membrane of an inch thick, and infiltrated
with a brown turbid fluid; their tissue was pale and opened out. Every one of
their calices was occupied by a calcareous concretion of a wart-like shape and
as large as a split pea."
Wagner's report ends with the sad remark "the body was much emaciated."
Bibliography.
Schermann, Thomas K, and Biancolli, Louis. 1972. The Beethoven Companion.
Doubleday. (An abridged form of Wagner's report: pp. 1099-1101.)
Thayer, Alexander Wheelock. 1967. Thayer's Life of Beethoven, revised
by Elliot Forbes. Princeton. (Death and autopsy description, p. 1050-1052; and
Wagner's full report, pp. 1059-1060.)
Bibliographical note.
Forbes refers to a medical study (to which I don't have access): S.J. London, M.D., "Beethoven,
Case Report of a Titan's Last Crisis," in Archives of Internal Medicine
113 (1964): 442-448.
One of the writeups at decomposing composers states that an exhumation suggests lead poisoning as the cause of Beethoven's fatal illness.
And, of course, there is the diagnosis of renal failure published by Mauler directly below.