Vivenot was a physician. In all probability Beethoven had exhausted the list of physicians of his acquaintance (Smetana, a surgeon, may not have been considered and Malfatti could not be at the time for reasons which Beethoven knew and was made painfully to feel later), before Holz succeeded in securing the attendance of Wawruch.[163] According to the accepted story, Braunhofer, who had been the last physician to treat Beethoven before the misfortunes of the summer, had declined the call because of the too great distance between his house and Beethoven’s, and Staudenheimer, whom Braunhofer had displaced, promised to come but did not. The latter, probably both, took part later in the consultations. Wawruch was an amateur violoncello player and an ardent admirer of Beethoven’s music. When he comes to his august patient, though he permits Karl to write the questions, he takes the pencil himself to tell who he is: “One who greatly reveres your name will do everything possible to give you speedy relief—Prof. Wawruch.” In his history of the case Wawruch writes:
I found Beethoven afflicted with serious symptoms of inflammation of the lungs. His face glowed, he spat blood, his respiration threatened suffocation and a painful stitch in the side made lying on the back a torment. A severe counter-treatment for inflammation soon brought the desired relief; his constitution triumphed and by a lucky crisis he was freed from apparent mortal danger, so that on the fifth day he was able, in a sitting posture, to tell me, amid profound emotion, of the discomforts which he had suffered. On the seventh day he felt considerably better, so that he was able to get out of bed, walk about, read and write.
Dr. Gerhard von Breuning, who was concerned in proving that Dr. Wawruch was a bungling practitioner, protests that Beethoven was not suffering from inflammation of the lungs but from inflammation of the peritoneum, which alone, he says, could have brought on the dropsy of the belly from which it has been thought until recently Beethoven died. He based his opinion on the fact, which, though only a boy of 13, he may have observed in the sick-room, that the patient did not cough, had no difficulty in breathing, and that afterwards his lungs were found to be sound. Wawruch, however, an experienced physician, is speaking of what he observed on his first visit and is not likely to have erred in so obvious a matter as incipient lobar pneumonia, the general history of which as now understood agrees with the recorded account of Beethoven’s case, even in such details as the critical period reached on the fifth day. The subsequent strength of the lungs is not inconsistent with the theory that in the first week Beethoven weathered an attack of pneumonia.
Beethoven’s Health in the Country
There are few references to the state of Beethoven’s health during the sojourn at Gneixendorf, but that he was ill when he arrived there is indicated by an early remark by Johann attributing an improvement in the condition of his eyes to the good air “without rosewater.” Johann wrote later that, when with him, Beethoven ate little. When the food was not prepared to his taste he ate soft-boiled eggs for dinner “and drank all the more wine.” He had frequent attacks of diarrhœa. His abdomen also became distended so that he wore a bandage for comfort. Wawruch had no knowledge of his patient’s previous medical history and was compelled to discover for himself what his colleagues, to whom the sick man’s call was first extended, would have known from their earlier experiences with him. Schindler attacks Wawruch on the ground that he had said that Beethoven was addicted to the use of spirituous liquors. The Conversation Books and other testimony plentifully indicate that the great composer was fond of wine and that his physicians had difficulty in enforcing abstinence upon him; but the only one who, by indirection, accused Beethoven of drinking to excess, was Schindler, whose statements on that point are not free from the suspicion that they were made only for the purpose of hitting Holz over Wawruch’s shoulders.[164]
Wawruch’s report continues:
But on the eighth day I was alarmed not a little. At the morning visit I found him greatly disturbed and jaundiced all over his body. A frightful choleraic attack (Brechdurchfall) had threatened in the preceding night. A violent rage, a great grief because of ingratitude and undeserved humiliation, was the cause of the mighty explosion. Trembling and shivering he bent double because of the pains which raged in his liver and intestines, and his feet, thitherto moderately inflated, were tremendously swollen. From this time on dropsy developed, the segregation of urine became less, the liver showed plain indication of hard nodules, there was an increase of jaundice. Gentle entreaties from his friends quieted the threatening mental tempest, and the forgiving man forgot all the humiliation which had been put upon him. But the disease moved onward with gigantic strides. Already in the third week there came incidents of nocturnal suffocation; the enormous volume of collected water demanded speedy relief and I found myself compelled to advise tapping in order to guard against the danger of bursting.
After Dr. Wawruch had reached this decision, Dr. Staudenheimer was called in consultation and he confirmed the attending physician’s opinion as to the necessity of an operation. Beethoven was told. “After a few moments of serious thought he gave his consent.” The servant Thekla, who had, apparently, come from Gneixendorf (as her name appears in the Conversation Book used there), in the midst of the preparations for the operation had been found to be dishonest and dismissed. The composer’s brother had arrived in Vienna about December 10 and thereafter is found constant in his attendance, a fact which it becomes necessary to mention because of the obvious effort of Schindler to create the impression that the burden of the care of Beethoven had been assumed by him, von Breuning and the latter’s son Gerhard. Wawruch had retained Dr. Seibert, principal surgeon (Primärwundarzt) at the hospital, to perform the operation. The date was December 20 (not 18, as Schindler says). Those present were Johann, Karl and Schindler. Beethoven’s sense of humor did not desert him. When, the incision having been made, Dr. Seibert introduced the tube and the water spurted out, Beethoven said: “Professor, you remind me of Moses striking the rock with his staff.”[165] Wawruch writes in the Conversation Book:
Thank God, it is happily over!—Do you already feel relief?—If you feel ill you must tell me.—Did the incision give you any pain?—From to-day the sun will continue to ascend higher.—God save you! [This in English.] Lukewarm almond milk.—Do you not now feel pain?—Continue to lie quietly on your side.—Five measures and a half.—I hope that you will sleep more quietly to-night.... You bore yourself like a knight.
Multiplication and Handel’s Scores