The natural history of Beethoven's deafness, together with a judicious examination of pertinent necropsy findings, provides adequate evidence for a chronic, progressive perceptive deafness. Marked eighth nerve atrophy was present, and most recent authors have considered this idiopathic. Recorded gross pathologic findings, to which it would seem too little attention has been paid, indicate a chronic granulomatous inflammation producing a basilar piarachnoiditis and eighth nerve arteritis, capable of eventuating in auditory neural atrophy. Syphilis is the most likely cause of this low grade meningitis which existed without other central nervous system signs.