Mental and Physical Health Concerns of Beethoven

When we think of Ludwig van Beethoven, we often think of his great musical works and what he is known for the last decade of his life: progressive deafness. Not only was his deafness worsening, it was also the beginning of his emotional, psychological, and physical hardships. His hearing loss became more profound in 1802 when he wrote the Heiligenstadt Testament and onwards till his death in 1827. This paper will explore the mental and physical health aspects of Beethoven’s life, how it impacted his musical career and an examination of one of his piano sonatas better known as the Moonlight Sonata.

Beethoven was a German composer of several complex orchestral works and well-known piano sonatas while establishing the musical style of the First Viennese School. The First Viennese School was based in Vienna, Austria and incorporated a musical style of lyrical melodies with simple harmonies and elegance. Beethoven’s compositions are categorized into three periods: Early (1770-1802), Middle (1802-1814), and Late (1815-1827). He spent his youth in Germany and established his career in Vienna, mastering a wide range of the musical language and its genres including the scherzo. In the Middle period, he composed several orchestral works but also composed piano sonatas and established a new style of drama and expression which can be heard in his Piano Sonata No. 14 in C-Sharp Minor, “Moonlight” Op. 27 No. 2. Beethoven had several patrons but his most important aristocrat was Emperor Leopold II’s youngest son, Archduke Rudolph. He began to study piano and composition with Beethoven in the early 1800s; Beethoven dedicated fourteen compositions to Archduke Rudolph. At this time, he also wrote the Heiligenstadt Testament, a letter that he wrote to his brothers regarding how his mental health and other health concerns greatly affected him. In the final decade of his career, Beethoven’s compositions became longer, more dissonant, and complex.

On October 6th, 1802, Beethoven wrote the Heiligenstadt Testament and it has been said to be as “one of the most heartbreaking documents to be found in the long literature of lamentations.” This testament was written in Heiligenstadt, a small village in Northern Vienna, where Beethoven took long walks in the forests. He wrote this letter to his brothers Carl and Johann revealing his emotional, physical and psychological hardships and how it played an impact on his career. In the letter, he describes his worries of social humiliation and how he did not have the courage to tell the public about his deafness. Although he had the desire for companionship, his deafness was what made him draw back at these opportunities; Beethoven never married but did have romantic encounters with women. Further in the letter, Beethoven saw suicide as an option but instead wrote that “he would have ended his life had it not been his art that held him back.” The Heiligenstadt Testament shows how poor Beethoven’s mental health state was at the time and revealed great depression and the escalation of his deafness. Beethoven did not stop composing but professional settings such as concerts became a large complication for him. He never performed in public until the premiere of his Ninth Symphony in 1824 where he realized that his hearing loss had become immensely profound. As mentioned before, Beethoven struggled with health concerns that put him through a difficult time. His deafness was not all what caused his death as there were other hardships that played an impact as well.

In the movie, Immortal Beloved (1994), directed by Bernard Rose – the profundity of his hearing loss can be seen in the scene where the orchestra premieres Beethoven’s Symphony No. 9, “Ode to Joy” in Vienna, Austria. It shows what the audience hears versus what Beethoven hears which is absolute silence. Near the end of the scene, it is suggested that Beethoven was several bars late in conducting and the conductor had to turn Beethoven around to the cheering crowd.

Although deafness impacted his career, several other health concerns also played a role such as Paget’s Disease of the Bone and Hepatic-Terminal Cirrhosis. In an original autopsy report of Beethoven’s body, a pathologist explains and describes the possible health complications that Beethoven may have had. The article Beethoven’s Autopsy Revisited: A Pathologist Sounds a Final Note by Stanley J. Oiseth states that Beethoven’s skull was found to be quite dense and twice the average thickness. The vessels were dilated and facial nerves were enlarged which caused his hearing loss to increase immensely. Beethoven often complained of abdominal and gastrointestinal pains. At the age of fifty-six, he encountered symptoms of hepatic cirrhosis. He suffered from abdominal pain, diarrhea, constipation, “bizarre misanthropic behaviour and painful eye condition” and several headaches due to the progressiveness of the loss of his hearing. This condition, which became terminal by the time of his death, was mainly caused by the excessive intake of alcohol. Beethoven’s liver was greatly affected and his enlarged spleen turned into a darker colour. The same article suggests that Beethoven may have had a bipolar disorder as he did show “signs of bizarre and eccentric thought and behaviour in his own letters and actions with bouts of melancholy and irritability.”

Beethoven was twenty-nine years old when he proposed to Giulietta Giucciardi. She was married to a count and moved to Italy with him. In 1800, Giulietta Giucciardi, an aristocrat who took piano lessons with Beethoven, captivated his heart. In 1801, Beethoven proposed to Giucciardi but instead of accepting the proposal, Giucciardi’s father objected, giving reasons that Beethoven’s financial status was unstable. Torn with heartbreak, Beethoven composed his Piano Sonata No. 14 in C-Sharp Minor, “Moonlight” Op. 27 No. 2 which was then dedicated to Giulietta Giucciardi in 1800. During this time, Beethoven wrote the Heiligenstadt Testament which depicts his poor mental health state and emotional struggles as well as health concerns that emerged and impacted his career greatly. Because the Moonlight Sonata begins with triplets in the right hand, it sets a melancholic and mournful atmosphere; it sounds as if the pianist is yearning for the last few breaths of their life. The first chord of each triplet increases the mysteriousness of the movement. As the chords change, the harmony turns into what seems like a darker mood. This creates a controlled prolongation of the chord.

The first note of each group of triplets is slightly accented to create a melancholic mood. The last two notes of each group of triplets are played with a delicate touch. The chords in the left hand are prolonged or otherwise indicated to create a darker and more controlled sound. The dotted-eight followed by sixteenth notes are played with a slight hesitation yet still played as pianissimo.

The second movement moves into a lighter mood, almost humorous with simple lyrical melodies. In the third movement, Beethoven uses abrupt sforzandos on the last two chords of the sixteenth-notes that lead up to it to emphasize the intensity throughout the piece. The continuous disquiet can be heard in the sixteenth notes in the right hand and then shifted to the left hand, building intense crescendos up the scale. This movement sounds like a flood of emotions taking over the soul or a never ending race of Beethoven running away from the constant emerging health concerns and struggles. The continuous growing disquiet in the sixteenth-notes begins in the right hand (green rectangles) and then shifts to the left hand (purple rectangles).

Ludwig van Beethoven is known for composing impeccable large-scale orchestral works while his deafness increased in the last decade of his life. Despite his musical achievements, Beethoven suffered several diseases and health conditions when he wrote the Heiligenstadt Testament in 1802. Paget’s Disease of the Bone was quite possibly one of the main causes of his hearing loss and the excessive intake of alcohol caused hepatic cirrhosis which then became terminal at the time of his death. Beethoven established the addition of the scherzo and for dramatic expression which can be heard in the last movement of the Moonlight Sonata. Perhaps it was Beethoven’s lonely life that supplied some of the inspiration for the range of emotions in his music from the somber first movement, to the playful second movement, and finally the emotionally volatile dance of the third movement.

Bibliography

1. “All About Ludwig Van Beethoven: Beethoven's Heiligenstadt Testament .” Beethoven's Heiligenstadt Testament, 2004. http://www.all-about-beethoven.com/heiligenstadt_test.html.
2. “Beethoven's Moonlight Sonata - Profundity and Grace.” The Life and Works of the World's Favorite Classical Composers, 2010. http://www.favorite-classical-composers.com/beethoven-moonlight-sonata.html.
3. “Cirrhosis of the Liver - Scarring of the Liver, Causes.” Canadian Liver Foundation. Accessed November 10, 2019. https://www.liver.ca/patients-caregivers/liver-diseases/cirrhosis/.
4. “Creativity and Chronic Disease Ludwig Van Beethoven (1770-1827).” US National Library of Medicine National Institutes of Health. BMJ Publishing Group, November 2001. https://www-ncbi-nlm-nih-gov.ezproxy.library.uvic.ca/pmc/articles/PMC1071597/.
5. “Music 101.” Ludwig van Beethoven | Music 101. Accessed November 13, 2019. https://courses.lumenlearning.com/suny-musicapp-medieval-modern/chapter/ludwig-van-beethoven/.
6. “Paget's Disease of Bone Overview.” National Institutes of Health. U.S. Department of Health and Human Services, December 2018. https://www.bones.nih.gov/health-info/bone/pagets/patient-info.
7. Schwarm, Betsy. “Moonlight Sonata.” Encyclopædia Britannica. Encyclopædia Britannica, inc., April 10, 2016. https://www.britannica.com/topic/Moonlight-Sonata.
8. Sharma, Bashar. “Hepatic Cirrhosis.” StatPearls Internet. U.S. National Library of Medicine, June 3, 2019. https://www.ncbi.nlm.nih.gov/books/NBK482419/.
9. “The Life of Beethoven: Beethoven's Heiligenstadt Testament (1802).” Beethoven's Heiligenstadt Testament (1802). New York: Beethoven Association, 1921. https://www.cengage.com/music/book_content/049557273X_wrightSimms/assets/ITOW/7273X_50_ITOW_Heiligenstadt.pdf.