Diagnosing Genius: The Life and Death of Beethoven (review)

Beethoven’s life, illnesses, and death are a subject of endless fascination, and this book is the latest in a number of recent studies that focus more on his medical history than his music. Written by a professor of psychiatry, its five chapters approach different aspects of the subject, and if there had been more cohesion between them this could have been a much more useful contribution to the field. What we are offered instead, however, is five largely self-contained accounts, with relatively little reference to their interconnections.

The first chapter, ‘The Setting’, outlines a portrayal of life in Beethoven’s day. Though it is extremely difficult to give a succinct and balanced picture of such a broad topic, Mai covers much ground, ranging over the political scene, culture, and philosophy (including Kant, Goethe, Rousseau, and others), medical advances ( Jenner, Brown, Mesmer), sometimes bringing music or Beethoven’s life into the picture. There seems to be nothing significantly new here, and the quality is patchy. The account of music in Vienna before and during Beethoven’s time is clearly not written by a music historian. Beethoven was certainly not ‘the world’s first free-enterprise composer’ (p. 6; one thinks of Handel and Clementi as earlier examples), and Vivaldi did not settle away from Italy (p. 8), even though he happened to die in Vienna. Anton Schindler’s improbable claim that composition of the Eroica was suggested to Beethoven by General Bernadotte is accepted uncritically as fact. In discussing medicine of the period, Mai quotes Beethoven’s 1825 letter referring to John Brown and Max Stoll, and outlines Brown’s work; but he says absolutely nothing about Stoll, who is not even in the index and whose name is misspelt as Stohl (p. 24)—one of over a dozen misspellings of names in the book. The chapter contains some interesting reading but has huge omissions.

The following chapter is a seventy-five-page account of Beethoven’s life, concentrating mainly though by no means exclusively on his health problems and personal relationships. It is difficult to see much point in producing yet another summary of this subject, when there are so many good and readily available biographies of Beethoven already around, and there is no new material here. Occasionally there are new speculations, but often these are flawed; an example is the suggestion that Beethoven’s visit to his brother Johann in Linz in 1812 ‘likely had some impact on Beethoven’s health’ (p. 70), when there is no evidence to indicate that it did and no reason to suppose that it should have done. There are also quite a few factual errors, such as the number of Beethoven’s siblings who died in infancy (there were four, not just two: Anna Maria and Franz Georg are completely overlooked here). Mai proposes that the Ninth Symphony was ‘likely conceived in 1821’, when it is well established that it was begun around 1817.

The next two chapters at last come to the heart of the matter—Beethoven’s health and Mai’s diagnoses. Tables are compiled, based on Beethoven’s correspondence, of all his recorded illnesses. These are divided according to type: gastrointestinal, ear/nose/throat, psychiatric, respiratory, and ocular. Yet there are plenty of omissions, such as headaches, toothache, fingernail infection, various chills, and unspecified illnesses. Beethoven’s ‘violent attack of rheumatism’, which he mentions in a letter of 7 March 1821 and which laid him up for six weeks or more, is completely ignored in chapter 3, for we are told that he was either unaffected or only minimally affected by musculoskeletal illness (which includes rheumatism), although in the following chapter his rheumatism is at last mentioned briefly. Thus the lists of illnesses, though useful as far as they go, do not form an adequate coverage of the subject.

Chapter 4 sets about offering a likely diagnosis for each of Beethoven’s illness...