Ludwig van Beethoven was a composer and concert pianist whose symphonies and other compositions are still among our most-beloved and often-performed classical music. Beethoven started to lose his hearing at age 31 and spent his last years feeling very sick, but he continued to compose incredible music until his horrible death at age 56 of liver failure, kidney failure and pneumonia (Otology & Neurotology, October, 2020;41(9):1305-1308). More than 150 years after his death, scientists at the University if Chicago’s Argonne National Laboratory analyzed a sample of his hair and offered an explanation: lead poisoning.

• Most likely, his hearing loss was caused by lead poisoning from a lifelong habit of  drinking lead-containing wines and mineral waters, and bathing in lead-containing spa waters. Various sources report that he often drank an entire bottle of wine with each meal. Lead was added to wine to sweeten it by reducing the vinegar content (J R Coll Physicians Edinb, Oct 2006;36(3):258-63), and wines and other alcoholic beverages were often stored and served in lead-containing crystal. 

• Standard treatments for kidney and liver ailments at that time included pills and lotions made with lead, so his own doctors helped to cause the problem (Wien Med Wochenschr, 2021; 171(15-16): 356–362).

Early Life and Health Issues
Beethoven was healthy during his early years and studied with Mozart and Hayden. When he was 17, he started a life-long practice of visiting spas and drinking its mineral waters. In his early 20s, he developed belly pain for the first time, and these terrible pains tormented him throughout the rest of his life. At age 31, he started to lose his hearing and became totally deaf at age 42. He was able to communicate only by passing written notes to his colleagues and friends. Then he developed serious mental symptoms of manic depression. His friends described Beethoven as very gruff with a good sense of humor. Those who visited him didn’t know whether to expect him to be just charming or to go into irrational rage. Lead poisoning causes nerve damage and that could explain his deafness, brain damage, manic depression, horrible intestinal cramps and death.

In 1824, when Beethoven finished conducting the first performance of his magnificent Ninth Symphony, he could not understand why there was no applause. His concert master had to turn him around to see the audience standing, clapping and cheering his great performance, because he couldn’t hear anything.

Confirming the Diagnosis with Hair Analysis
Nobody really knows what killed Beethoven. Various medical articles have suggested that he may have had alcoholic liver damage, syphilis, infectious hepatitis, lead poisoning, sarcoidosis, and Whipple’s disease; a bacterial infection that impairs digestion. His last days were characterized by yellow jaundiced skin and eyes, a belly full of fluid, swollen ankles, and severe belly pain. His autopsy data indicate that Beethoven had permanent scarring of his liver, severe kidney damage called papillary necrosis, a damaged pancreas and possibly diabetes. These conditions are associated with both excess alcohol intake and lead poisoning. His lifestyle for at least the final decade of his life indicated that he drank large amounts of wine. Alcohol was by far the most common cause of cirrhosis at that period, and lead could have caused both his deafness and the organ failures that killed him.

After his death in 1827, a young Jewish musician named Ferdinand Hiller snipped some hair from Beethoven’s head. For a century, the hair was kept by descendants of the Hiller family. During the Holocaust, a Danish doctor named Kay Alexander Fremming helped to rescue Jews by arranging transport to Sweden by boat. The Hiller family gave the hair to Dr Fremming in gratitude for her heroic efforts. After Dr. Fremming died, her daughter consigned the hair for auction to Sotheby’s in London, and 582 strands of hair, 3-6 inches long, were sold for $7,300 to Ira Brilliant, Alfredo Guevera and other members of the Brilliant Center for Beethoven Studies at California’s San Jose State University. The hairs were analyzed at the Argonne National Laboratory and found to contain large amounts of lead. Lead poisoning can cause nerve damage and that could explain his deafness, brain damage and manic depression, horrible intestinal cramps and death from multiple organ failure.

Lead Poisoning is Still a Concern
Today wine does not contain lead, and it would be malpractice for a physician to prescribe any medication that was made with lead. However, we still have people sickened by lead poisoning. In 2014, the city of Flint, Michigan, tried to save money by switching its municipal water supply system from the Detroit Water and Sewerage Department to the Flint River. The corrosiveness of insufficiently treated Flint River water was causing lead to be leached from aging pipes. Tests showed that the drinking water had lead concentrations more than 25 times higher than the level deemed actionable by the U.S. Environmental Protection Agency. The victims were awarded a settlement of more than $600 million, with 80 percent going to the families of children affected by the poisoning.

Ludwig van Beethoven
December 17, 1770 – March 26, 1827