Bedřich Smetana's illness associated with complete hearing loss has been linked to various diseases in a long-running discussion. Senile dementia, atherosclerosis, progressive paralysis in lues are mentioned, while the ototoxicity of mercury is neglected. Its high concentration in the composer's skeletal remains was demonstrated by the authors of this article immunohistochemically and especially by the neutron activation analysis (NAA) method 23 years ago. The significance of this find has been neglected in connection with the dominant effort to prove the composer's venereal disease, the diagnosis of which, however, has not yet been unequivocally verified. Therefore, the existing results of the osteological examination were revised and the available sample was supplemented with an immunohistochemical examination using an antibody against treponemes and a silvering method with a negative result. On the other hand, an expert literature search focused on mercury ototoxicity confirmed our assumption that chronic intoxication with this metal, which was probably part of ointments applied not only in childhood but also later in adulthood, could contribute to hearing loss. This metal, until recently used in dermatology as a component of ointments, is resorbed and, as has recently been proven, causes various neuropsychic disorders, including disorders and even hearing loss. With this communication, we would like to initiate a new discussion on all aspects of the composer's illness.