Around the time of Ludwig van Beethoven’s death in 1827, admirers of the renowned composer snipped numerous locks of his hair. Originally, these locks served more or less as “souvenirs,” explains William Meredith, founding director of the Beethoven Center at San José State University, who adds that “the 19th century was very big on collecting” such keepsakes.

Nearly 200 years later, the locks served new purpose: helping to unravel the long-debated mysteries surrounding Beethoven’s ill health. An international team of researchers, who published a 2023 paper in the journal Current Biology, used the hair to sequence Beethoven’s genome and found him to be genetically predisposed to liver disease.

Moreover, the researchers provided the first proof that Beethoven was infected with the hepatitis B virus, which inflames the liver and could have spread to him during childbirth, sexual intercourse, or surgery with contaminated instruments.

“If you have hepatitis B today, then your doctor is going to tell you not to drink a single glass of wine,” says Meredith, a co-author on the paper.

Yet, though most evidence suggests Beethoven was a moderate drinker for the era, “it’s safe to assume he was drinking practically daily,” says Tristan Begg, a biological anthropologist at the University of Cambridge in England and the paper’s lead author. In all likelihood, the researchers say some combination of alcohol consumption, hepatitis B, and his genetic predisposition to liver disease caused cirrhosis, from which he never recovered.

Indeed, Beethoven suffered from so many ailments that myriad theories have sprung up surrounding their underlying cause. Some researchers, for example, blame syphilis, whereas others have proposed everything from lead poisoning to alcoholism to sarcoidosis to Whipple’s disease (in addition to liver damage, which Beethoven’s own doctors knew about).

“There’s so much wrong with him, and there’s so much source material,” Begg says, leading to “a lot of very plausible ideas.”

Beethoven Developed Medical Problems in His 20s

Born in 1770 in Bonn, Germany, Beethoven pushed European music from the so-called Classical period of Mozart and Haydn to the Romantic period of Chopin and Wagner. Prior to him, the point of music was merely to please the listener, Meredith says, whereas Beethoven believed “music can transform human beings through its power.”

By age 22, Beethoven had begun experiencing gastrointestinal symptoms, including abdominal pain and diarrhea, that would plague him for the rest of his life. He then started going deaf around age 26 or 27, which, though initially kept secret, prompted him to fall into a depression.

In a letter to his brothers, discovered upon his death, he admitted to contemplating suicide, but felt he couldn’t leave the world before producing “all the works that I felt the urge to compose.” (In the same letter, he asked for his hearing loss to be described and publicized posthumously.) Some of Beethoven’s most lauded pieces, such as his Ninth Symphony, came after he had lost all—or nearly all—hearing.

Death and Autopsies

The beginning of the end for Beethoven came in December 1826, when he fell ill upon returning home to Vienna via carriage. Mostly bedridden thereafter with a fever, cough, shortage of breath, and splitting aches in his side, he also began spitting up blood. His abdomen swelled so badly that his doctors drained it of copious amounts of fluids. Meanwhile, he developed jaundice and swollen feet, possible signs of liver failure.

Beethoven died at age 56 on March 26, 1827, after which, as Meredith put it, a “gruesome” autopsy was performed in which “they really roughly cut off the top of his head,” as well as his ear bones, in order to examine his brain and deafness.

In addition to the autopsy report, much is known about Beethoven’s health from his letters, diaries and doctors’ notes. Moreover, skeletal examinations were performed after his body was exhumed in 1863 (to be moved to a new coffin) and again in 1888 (to be moved to a new cemetery). Toxicological analyses of his hair and bones were also been done, though these samples were not always properly authenticated.

DNA Analysis of Beethoven

As time passed and certain mysteries persisted, it occurred to Begg, a self-proclaimed “Beethoven nutcase,” that DNA sequencing technology had advanced enough to undertake a genetic study. “We had techniques developed during the Neanderthal genome project … that were tailor-made for recovering the types of DNA found in hair,” Begg says.

In late 2014, he shared his idea with Meredith, whom he had met five years earlier while working as a docent at a Beethoven exhibit in San Jose, California. Intrigued, Meredith and a colleague got to work, buying or borrowing eight of the 35 known locks of hair attributed to Beethoven, most of which had purportedly been collected as he lay dead or dying.

Five of the eight locks were later determined to be “almost certainly authentic,” having originated from the same European man and having “moderate” to “impeccable” records of ownership.

A sixth lock, however, was found to have originated from a Jewish woman, thus casting serious doubt on a popular hypothesis, based on previous analyses of this hair sample alone, that Beethoven had suffered from lead poisoning. Another lock was likewise deemed probably inauthentic, whereas the final lock lacked sufficient DNA to interpret.

For the next phase of the study, which eventually grew to include over 30 co-authors from several countries, the researchers scrutinized Beethoven’s genome, diagnosing a number of risk factors for liver disease, along with evidence of a hepatitis B infection.

They had less success identifying an exact cause for Beethoven’s deafness or digestive difficulties. Even so, they narrowed down the gastrointestinal possibilities, all but ruling out celiac disease and lactose intolerance and finding modest genetic protection against irritable bowel syndrome as well. 

All in all, Meredith says, between a malfunctioning liver, increasing deafness, and constant gastrointestinal problems, it was “a pretty bad deck of cards to be dealt."

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