By the beginning of his fourth decade, if not before, Robert Schumann suffered from hearing disorders and vertigo. In Schumann’s pathography, the associated symptoms have usually been regarded independently and are thought to have been caused by a psychological/ functional disorder; in view of a suspected syphilis in Schumann, vertigo attacks and hearing disorders can also be explained by a syphilitic affection of the inner ear (otosyphilis). Within the framework of this hypothesis, the symptoms of an inner ear disorder can not only be attributed to a hitherto rarely considered joint cause, but, beyond that, to a primarily somatic disease. This essay examines the medical plausibility and musicological significance of a presumed otosyphilis in Schumann, drawing on diary entries, letters, and contemporary accounts.