Ludwig van Beethoven was a German composer and concert pianist (1770-1827) whose symphonies and other compositions are still among our most-beloved and often-performed classical music. In 1824, when Beethoven was 54, he finished conducting the first performance of his magnificent Ninth Symphony, and 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 at his great performance, because he couldn’t hear anything.

At age 31, he started to lose his hearing and became totally deaf at age 44. 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. He spent his last years feeling very sick, but he continued to compose incredible music until his horrible death in 1827 at age 56 from liver and kidney failure and pneumonia (Otology & Neurotology, October, 2020;41(9):1305-1308).

Recent research has used sequencing of his genome from locks of his hair to try to explain his progressive hearing loss, chronic gastrointestinal complaints and severe liver disease (Current Biology, April 24, 2023;33:1–17). These studies found that he had hepatitis B that can destroy his liver and cause nerve damage, which could explain his deafness, brain damage, manic depression, horrible intestinal cramps and death.  He also drank huge amounts of wine daily for at least the final decade of his life. Alcohol was by far the most common cause of cirrhosis of the liver at that time.

Earlier Claim of Lead Poisoning Was An Error
Lead poisoning can be diagnosed by analyzing a person’s hair (Anal Bioanal Chem, 2005;383(3):500–508). After Beethoven’s death in 1827, a young musician named Ferdinand Hiller was reported to have snipped some hair from Beethoven’s head. The hair sample was kept by descendants of the Hiller family. In 2005, more than 150 years after Beethoven’s death, scientists at the University of Chicago’s Argonne National Laboratory analyzed this hair sample and found large amounts of lead in it. However in 2023, DNA tests of the hair specimen that was loaded with lead showed that it did not have a Y chromosome, meaning that the Hiller’s hair sample came from a woman, not a man. That specimen is also genetically different from five other sources of Beethoven’s hair (Current Biology, April 24, 2023;33:1–17).

An Illegitimate Child?
The five identical sources of Beethoven’s hair also differ from those of male Van Beethoven relatives in Belgium, which strongly suggests that the recorded paternal linkage for Beethoven was not to his biological father. His baptismal record has never been found.

Beethoven never married and had no known legal descendants. In his letters, he called a lady his “immortal beloved.” This woman was married to someone else and her daughter may have been Beethoven’s child. His famous piece, “Fur Elise,” may have been for this woman or their daughter.

Hepatitis B: Probable Cause of Death
The DNA analysis of Beethoven’s hair suggests that he died from severe liver damage caused by hepatitis B infection, and possibly from excess alcohol intake. Researchers still do not know what caused his deafness, and the recent studies have not shown any evidence of lead poisoning.

Hepatitis B is the most common serious liver infection in the world. It is caused by the hepatitis B virus that attacks and injures the liver. Hepatitis B is acquired through very close exposure to an infected person, often by sexual contact, or by exposure to the blood of an infected person. Two billion people have been infected and 300 million people are living with a chronic hepatitis B infection. Each year up to one million people die from hepatitis B, even though it is preventable and treatable.

A Theory On Beethoven’s Hearing Loss
A theory for a possible cause of Beethoven’s deafness is a squeezing of the eighth cranial hearing nerve caused by Paget’s bone disease (West J Med, Nov 2001;175(5):298). Beethoven had a large head, prominent forehead, large jaw, and protruding chin, characteristics of Paget’s disease. An autopsy performed by Karl Rokitansky, the father of modern pathology, on March 27, 1827, demonstrated that Beethoven had a thick skull and compressed hearing nerves, consistent with Paget’s bone disease (Eur J Lab Med, 1997;5:47-57).

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