Ludwig van Beethoven, the unparalleled musical genius, died in 1827 at the age of 57. We all remember he was deaf. What a bitter disability for a composer. It is hard to imagine he composed his famous 9th Symphony (including the monumental Ode to Joy) after he lost all hearing. We also know he was emotional and temperamental. What many people don’t know is he was surprisingly unhealthy most of his life.
He noticed early hearing difficulties by the time he was in his 20s. As his hearing failed, he developed terrible tinnitus. He continued to compose and perform, but by age 45, he was totally deaf. He kept “conversation books”, little notebooks people wrote in so he could carry on conversations. He became more private and insular once he could no longer hear, and only spent time with close friends.
But deafness was not his only illness. His letters and those of others are filled with references to his many and intermittent illnesses. He had frequent “rheumatic attacks” (involving jaundice and indigestion). He had years of abdominal pain accompanied by diarrhea, starting when he was 25. He complained of spasms in his hands and feet, vertigo, back and side pain. He continued to be amazingly productive, composing and conducting, saying that composing was the only thing that kept his mind off how bad he felt.
By 1826, near the end of his life, he moved in with his brother’s family, where his usual complaints continued and he developed dramatic leg swelling. After some months, he decided to move back to Vienna. The trip was a nightmare; his legs were so swollen and huge he had trouble fitting into a carriage. He developed pneumonia. A “rigorous antiphlogistic therapy” was prescribed by his doctor. We are not sure exactly what this was, but good guesses, based on medicine of that day, include bloodletting, purging and vomiting (often with extreme laxatives like mercury), or blistering. The next 2 months were a spiral of worsening health and escalating symptoms. He developed ascites (free fluid in the abdomen), requiring drainage by a surgeon four times. He developed infection of his skin at those drainage sites. He became jaundiced. His kidneys failed. He finally died March 26, 1827. Autopsy showed cirrhosis of the liver, combined with severe ascites, peritonitis, chronic pancreatitis, kidney stones and chronic kidney infection, and atrophied acoustic nerves on both sides.
Many scholars have wondered if there was a unifying diagnosis that could explain all of Beethoven’s life-long health problems. Perhaps.
In 1994, Sotheby’s auction house sold a lock of Beethoven’s hair, kept in a sealed glass locket for over 150 years. (As an aside, it was common in the 1800s to snip a lock of a loved one’s hair as a keepsake. There are over 30 supposed locks of Beethoven’s hair.) Ira Brilliant, a real estate broker and Alfredo Guevara, a urologist, both serious scholars of Beethoven, bought the locket, donating most of the hairs to the Ira Brilliant Center of Beethoven Studies in San Jose, California.
This locket has a fascinating provenance. Ferdinand Hillar, also a composer, was a friend of Beethoven’s. The day after his death, he snipped some hair and had it enclosed in a wooden locket. Sixty years later, in 1883, his son Paul inherited the locket. Supposedly, he donated it to a museum before his death in 1934, but all records have been lost. It is impossible to follow the path of the locket through the chaos of WWII in Germany and Austria. However, years later, in 1970s, it resurfaced in Gilleleje, Denmark. Gilleleje is a small fishing village on the eastern Danish coast. Heroic Danes living there during WWII sheltered Jews trying to escape Germany and Austria, helping them get the few miles across the water to Sweden. A doctor there, Kay Fremming, who was active in the resistance, came into possession of the locket. He never spoke of it; his adult daughter found it in a drawer after he died in 1969. It was clearly the same locket; it had a unique handwritten inscription on the back. After 25 years, the daughter, needing money, decided to sell it at Sotheby’s. We will never know how it traveled to Gilleleje and how the doctor got it. Perhaps a fleeing Jewish family gave it to him in thanks for his help. Were they Viennese musicians, or museum curators? It is unknowable.
At any rate, Brilliant and Guevara wanted to know as much as possible about Beethoven, so they funded research. Over the next six years, rigorous examinations of some of these hairs were conducted by leading experts. Initial tests showed no mercury, and no trace of opiates (odd for someone as sick as Beethoven had been). In 2000, the particle accelerator at Argonne National Laboratory revealed lead levels in the hair almost 100 times higher than normal! Additional testing in 2004 using Laser Ablation Plasma Mass Spectrometry (don’t ask me), revealed something almost like tree rings, or a timeline, showing when there were peaks in lead exposure. It was actually possible to correlate peaks in lead levels to specific incidents in the last several months of Beethoven’s life, including that “rigorous antiphlogistic therapy”, the episodes of paracentesis (having fluid drained from the abdomen) and several other events.
Russell Martin’s spellbinding book Beethoven’s Hair, written in 2001, reads like a detective story, and traces the details of Beethoven’s death, the lock of hair, the lives of those who inherited it, the madness of Germany in the 1940s, the Jewish exodus through Denmark, and the deep research done to try to find those who may have given up the locket in Gilleleje.
Much has been written in the scientific literature as well as music literature about Beethoven and chronic and acute lead poisoning. Many of his problems are neatly explained by lead poisoning. What are the symptoms? Irritability, abdominal pain, vomiting, constipation, joint pain, mood disorders and most of all, hearing loss! How would Beethoven have gotten lead poisoning? He loved wine and drank as much as a bottle at each meal! In ancient Rome, cheap wine was sometime adulterated with sapa, a syrup made by boiling down grape juice in lead pots. The sugar lead, as it was called, tamed the harsh tannins in cheap wine. It wasn’t until the 1600s that the toxicity was discovered, and sugar lead was banned. But “sugaring” wine was still done illegally. Perhaps this was a lead source for Beethoven. Additionally, lead was known to have healing properties. In the pharmacopeia of the 1800s physician, poultices made by mixing lard with lead would have been standard. These may have been used to treat his infected abdominal wounds. He may have been given small doses of lead acetate orally to treat the pneumonia. So, a long life with lots of wine, with the addition of lead poisoning, could surely explain his deafness, as well as all the findings at autopsy. Right?
NOT SO FAST!
In the 25 years since Martin’s book, it has become possible to do more testing on Beethoven’s hair. In 2023, a major genetic study by an international team led by Tristan Begg at Cambridge successfully mapped the composer’s genome from ultra-short DNA fragments. Genomic analysis of hair from this locket we have been talking about showed, without a doubt, the HAIR WAS NOT BEETHOVEN’S; it was hair from a Jewish woman!! So, everything you just read involving lead was a wild goose chase!!
Additionally, genomic studies of many other lockets of hair believed to be Beethoven’s have authenticated only 5 locks of hair. These are now safely housed in Beethoven-Haus in Bonn, Germany, the Ira Brilliant Center for Beethoven Studies in San Jose, California, and the Kevin Brown Collection (private).
What else were these genetic studies able to tell us? They found Beethoven had a number of significant genetic risk factors for liver disease. They also found evidence of an infection with Hepatitis B virus. The combination of genetic risk factors for liver disease, Hepatitis, and heavy alcohol consumption would certainly explain the liver cirrhosis and pancreatic damage found at autopsy. They were unable to find a definitive cause of Beethoven’s chronic abdominal complaints; testing showed he had some genetic protection against celiac disease, lactose intolerance, and irritable bowel syndrome. As for his early onset deafness, there were no genetic clues, so that is still a mystery. But who knows? Future tests that don’t exist today may tell us more.
And there are plenty of those hairs, just waiting to be tested!