Introduction

In 1723, Johann Sebastian Bach, aged38 years, left Anhalt-Kothen for Leip-zig. He was appointed teacher anddirector of music at St.Thomas’Church with duties to teach singingto the students and to direct choirand orchestra at weekly services. Hehad to compose new music for eachSunday. He remained in Leipzig forthe rest of his life, 27 years. Duringthis period, he composed several mag-nificent works, St.Matthew Passion,St.Jon Passion, Christmas Oratorio,Magnificat in D, Goldberg variationsand the second book of Das Wohl-temperierte Klavier (Huchet-Bishop1972).

Eye surgery

Bach was known to have playedorgan without glasses even in his pres-byopic age. Hence, it has been postu-lated that he had been myope ofaround )2.o dioptres (Zegers 2005).

At the age of 64 years, his visionhad started to decline. The Mayor ofLeipzig had been asked for measuresin case Bach would become unable totake care of his duties. After persua-sion of his friends, Bach had his botheyes operated by a travelling Britisheye ‘surgeon’ John Taylor (1703–1772)who happened to be in Leipzig.

Taylor had after his surgical train-ing started his practice in Switzerland

where he had blinded hundreds ofpatients. In London, he had operatedon Georg Friedrich Handel (1685–1759), who became blind (Jackson1968). Taylor was travelling all overEurope, Russia and Persia. He wasmarketing effectively his services. Hiscoach was painted with eyes and thewords ‘qui dat videre dat vivere’ (giv-ing sight is giving life). His serviceswere expensive. He charged largeamounts of money and accepted evenvaluables such as gold watches as thepayment. In ophthalmic surgery, hewas ahead in strabismus surgery. Hewas also the first to describe keratoc-onus (Zegers 2005).

Cataract couching could be carriedout in open air such as markets infront of the spectators. The patientwas sitting in upright position andone or two helpers kept him steady.No anaesthetics were available, onlyalcohol and opium to relieve pain.Taylor made an incision a little largerthan 4 mm about 3.5 mm posterior tothe limbus. A planoconvex needle wasintroduced into the posterior chamberand the lens luxated inferiorly into thevitreous (Zegers 2005).

Taylor’s first operation on Bach hastaken place between March 28 and 31,1750, and the second between April 5and 7. (Zegers 2005). About a weekafter the first operation, a reoperationhad to be performed because of ‘reap-pearance of the cataract’. The postop-erative therapy consisted of bloodletting, laxatives and eye drops fromslaughtered pigeons, pulverized sugaror baked salt. Taylor could alsoperform periocular incisions whichwere covered with bandages that

Historical Article

Blindness of Johann SebastianBach

Ahti Tarkkanen

Helsinki University Eye Hospital, Helsinki, Finland

ABSTRACT.

Johann Sebastian Bach (1685–1750) was one of the greatest composers of all

time. Apart from performing as a brilliant organist, he composed over 1.100

works in almost every musical genre. He was known as a hardworking, deeply

Christian person, who had to support his family of 20 children and many stu-

dents staying at his home. At the age of 64 years, his vision started to decline.

Old biographies claim that it was the result of overstressing his vision in poor

illumination. By persuasion of his friends, he had his both eyes operated by a

travelling British eye surgeon. A cataract couching was performed. After sur-

gery, Bach was totally blind and unable to play an organ, compose or direct

choirs and orchestras. He was confined to bed and suffering from immense

pain of the eyes and the body. He died <4 months after surgery. In this

paper, as the plausible diagnosis, intractable glaucoma because of pupillary

block or secondary to phacoanaphylactic endophthalmitis is suggested.

Key words: cataract coughing – history of music – history of ophthalmology – Johann Sebastian Bach

Acta Ophthalmol.ª 2012 The Author

Acta Ophthalmologica ª 2012 Acta Ophthalmologica Scandinavica Foundation

doi: 10.1111/j.1755-3768.2011.02366.x

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incorporated baked apple or corn. Forinflammations, large doses of mercurywere prescribed (Zegers 2005).

Certainly, Hippocrates’ universalinjunction to all physicians ‘Primunnon necere’ – ‘above all, do no harm’which is valid also today, was contin-uously violated by Taylor.

After the second operation, Bachwas blind and suffered of immensepain of the eyes and the body. He wasconfined to bed and unable even toplay an organ. At this moment, Tay-lor had moved on and disappearedfrom Leipzig. Bach asked his son Joh-ann Cristoph Friedrich to write downa chorale Vor Deinen Thron tret ichhiermit (Before the Throne of God Istand). This is often performed as14th movement of the partiallyuncompleted Die Kunst der Fugen.A few days before his death, Bachclaimed that for a few moments hecould see his wife Anna. She began tosing on her husband’s wish ‘All menhave to die’ and the people in theroom joined. Bach developed a strokeand died on 28 July 1750 3 monthsand 3 weeks after his eye surgery.

In aftermath, Bach had bad luck in1750, because in 1747 Daviel in Parishad performed the first extracapsularcataract extraction, which was madepublic in 1753. Further, 5 years later,Sharp in London introduced the con-cept of intracapsular surgery by press-

ing with his thumb the entire lens outfrom the eye. General anaesthesia wasused for cataract surgery in 1840s andcocain drops for local anaesthesia in1884 (Aruta et al. 2009).

Discussion

As there is no postoperative informa-tion available of Bach’s eyes, one hasto consider the main complications ofcataract couching. Against the com-mon belief, couching has still beenpractised by the traditional healers inChina (Liu & Su 1992; Liu & Meng2001), in Nigeria (Ademola-Popoola &Owoeye 2004; Omoti 2005; Rabiu &Muhammed 2008) and in West Darfur,Sudan (Siddig & Ali 2009). The reasonis that the available surgical servicesfor cataract do not cover the increasingneed. Siddig & Ali (2009) have con-ducted a follow-up examination of 60patients who had underwent couchingin 2006–2007. The main findings weresecondary glaucoma with optic nerveatrophy (38%) and endophthalmitis(22%). A majority of the patients(60%) were blind with no perception oflight. Main causes of glaucoma werepupillary block either by the lens or thevitreous, phacolytic or phacoanaphy-lactic glaucoma and uveitis (Saxena1965). Because Bach was blind afterthe second operation and suffered fromimmense pain of the eyes and the body,the symptoms could be compatiblewith acute secondary glaucoma causedby pupillary block by the lens or thevitreous. Couching may lead to the dis-ruption of the lens capsule and the lib-erated lens protein may becomeantigenic leading to a T-cell-mediatedgranulomatous endophthalmitis. Clini-cally, it may present with a spectrumthat may range from a mild anterioruveitis to severe hypopyon uveitisresembling infectious endophthalmitis.This may take place already in 24 hrand is common after 3–5 days afterlens capsule injury. Glaucoma is com-mon and the inflammation will go onfor months (Marak 1992).As asepsiswas not known, there was a high riskfor a bacterial endophthalmitis. It isthough unlikely that a bacterial end-ophthalmitis would have smoulderedfor four months causing a fatal sepsis(Zegers 2005). In conclusion, intracta-ble secondary glaucoma could havebeen the cause of Bach’s symptoms andblindness.

Posthumous

Bach’s works were soon forgotten. Thefamily was poor. Anna Bach sold can-tatas for organ in bundles and WilhelmFriedeman Bach 60 other compositionsfor a few marks. Violin sonatas (Fig. 1)were found in a paper pile to be usedas wrap-up paper by a butcher (Wolff2001). In 1829, almost 80 years afterBach’s dead, Felix Mendelssohn Bart-holdy performed St.Matthew Passionspurring a wide interest in Bach. TheBach Society has collected, publishedand numbered all his works, BWV 1-1126, telling about Johann SebastianBach’s vast production.

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Received on September 12th, 2011.

Accepted on December 11th, 2011.

Correspondence:

Ahti Tarkkanen

Kapylantie 36

Helsinki 00600

Finland

Tel: + 358400709804

Fax: + 358947175569

Email: ahti.tarkkanen@kolumbus.fi

Fig. 1. Hand-writing of Johann Sebastian

Bach. Sonata for Solo Violin, G major.

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