How Did Beethoven Die? Liver Disease and Other Causes of Death

| | January 29, 2024

It’s no secret that Ludwig van Beethoven died as a result of liver problems. However, he also experienced many other health problems during his life. The classical composer had to deal with a combination of viruses, intestinal problems, and hearing problems, which were catalyzed by his health habits.

This toxic combination is at the foundation of the composer’s eventual incurable illness. On another note, the events after his death and leading up to his death are also quite remarkable.

What were Beethoven’s last words and how did Beethoven die exactly?

How Did Beethoven Die?

A bust statue of Ludwig van Beethoven by Hugo Hagen

For a long time, scientists believed that Ludwig van Beethoven died from lead poisoning. However, new research shows that he probably had other liver problems whilst being infected with a Hepatitis B virus just months before his death. Beethoven’s health problems started at a young age and accumulated over time, eventually leading to an unavoidable early death.

When and Where Did Beethoven Die?

On December 1826, the health situation of Ludwig van Beethoven was rapidly deteriorating. In a couple of months, Beethoven developed jaundice (a skin disease) and experienced severe swellings in his limbs. Both are a sign of liver failure, which would eventually be the official cause of his death. He died between 5 AM and 6 AM on March 26th in Vienna, Austria.

The deterioration of his health started on the 1st of December after Beethoven was exposed to the freezing winter weather of Austria. He was journeying to Vienna but didn’t anticipate the consequences it would have on his health. After a feverish night in an unheated resting place and lacking medical attention, the death of the composer was approaching quickly.

On the 5th of December, Beethoven’s doctor, Andreas Wawruch, gave an account of his terminal decline, saying thathis feet were tremendously swollen. From this time on dropsy developed, the segregation of urine became less, the liver showed plain indication of hard nodules, and there was an increase of jaundice’.

In a couple of days, Beethoven’s body parts would fill up with fluids. The fluids had to be released at some point to relieve him from the pressure. The doctor did so on four different occasions.

Nowadays, an anesthetic helps with the draining of fluids. Unfortunately, these did not exist in the early 1800s. So we can say with quite some certainty that the treatment itself wasn’t very pleasant. Still, it brought some relief to the classical composer.

He received the doctor’s treatments at his last residence, which was an apartment in the Schwarzspanierhaus. Unfortunately, the house was taken down in the early 1900s. Some of the things from the house are still showcased, however. For example, the entrance door can be seen in the Kunsthistorische Museum in Vienna.

Portrait of Ludwig van Beethoven by Christian Horneman

How Old Was Beethoven When He Died? 

On his death day in 1827, Ludwig van Beethoven was 56 years old. His sister-in-law, secretary Karl Holz, and close friend Anselm Hüttenbrenner witnessed his death and were able to provide a vivid description of the event.

According to the ones present, a violent thunderstorm struck Vienna in the hours when Beethoven was dying. During a sudden flash of lightning, Beethoven ‘suddenly raised his head, stretched out his own right arm majestically—like a general giving orders to an army. This was but for an instant; the arm sunk back; he fell back; Beethoven was dead.

What Did DNA Reveal about Beethoven?

In 2014, DNA sequencing technology was applied to eight locks of Beethoven’s hair to gain a better understanding of what caused Beethoven’s death. Tristan Begg and his team of researchers were able to narrow down the probable gastrointestinal diseases that Beethoven had to deal with on his deathbed. More importantly, they found that the German composer was genetically predisposed to liver diseases.

In particular, the extracted DNA had two copies of the gene PNPLA3, which is linked to liver cirrhosis: a late-stage liver disease in which healthy liver tissue is replaced with scar tissue and the liver is permanently damaged.

Beethoven’s genome also had single copies of two variants of the HFE gene, which causes hereditary hemochromatosis: a blood disorder that causes your body to absorb too much iron from the food you eat.

A lock of Beethoven’s grey hair

Lead Poisoning or Not?

The idea that Ludwig van Beethoven died from a liver-related disease has been his official cause of death for quite some time. For a long time, it was believed that Beethoven suffered from lead poisoning. However, new research makes this assumption questionable.

Part of the research carried out by Tristan Begg focussed on the lead and iron levels in Beethoven’s skull. They didn’t find extraordinary amounts when compared to any other average person at the time. Because of this, the researchers can say with some certainty that lead poisoning wasn’t the thing that caused Beethoven’s death.

But, then again, researching a skull that is hundreds of years old can be tricky at times. This is also evident in the case of Beethoven, whose skull has been mixed up more than once. So, truth be told, it would be a bit contested to assume that the skull research was a hundred percent legitimate.

Hepatitis B Virus

The DNA from Beethoven’s hair samples also contained fragments of Hepatitis B. The virus that was found in the locks of hair is notorious for its deteriorating effect on the liver. It’s unclear when Beethoven obtained this infection, which also means that it’s unclear if Hepatitis B was the underlying cause of his liver problems.

Some suggest that Beethoven had a chronic infection of Hepatitis B. In that sense, it would’ve simply started acting up again just months before Beethoven died. It might be that the virus actually came before the start of his liver disease, or is in fact the underlying cause of his liver disease.

Extramarital Affair

There are some other findings from studying Beethoven’s genome. However, these weren’t necessarily health-related. It had to do with a probable extramarital affair somewhere on Beethoven’s paternal side.

According to the researchers, this extramarital affair must’ve taken place between the conception of Hendrik van Beethoven in Belgium in c.1572 and the conception of Ludwig van Beethoven in c.1770.

Such an extramarital affair might actually have had a lasting impact on the health problems of the legendary composer. Of course, environment and habits play a big part when it comes to health and illnesses. However, some illnesses are simply inherited.

Beethoven was genetically predisposed to liver diseases, something which isn’t very prevalent if you take a look at the genealogical records of the Beethoven lineage. So the fact that his ancestors had an affair might have contributed to the bad health of the composer.

Beethoven’s parents

What the DNA Analysis Didn’t Reveal

While the DNA analysis did uncover some new things regarding Beethoven’s death, there are still a lot of questions left unanswered. Amongst the most prominent ones is the exact gastrointestinal problems that the German composer experienced.

The researchers were able to rule out a large number of diseases and even found a genetic protection against irritable bowel syndrome. The research team identified lactose intolerance and celiac disease as the two probable diseases that were a big part of Beethoven’s health problems. Its eventual effect on Beethoven’s death remains unanswered, however.

Another focus of the study was to understand the progressive hearing loss of Beethoven. As you might know, Beethoven was completely deaf by the time he died. It’s not hard to see why this makes his accomplishments even more remarkable. Unfortunately, the researchers were unable to uncover what caused Beethoven’s deafness.

Beethoven’s Last Letter

Ludwig van Beethoven wrote many letters during his life, and he would continue to either write or dictate letters to his close friends until the very end. The last letter he wrote was to Ignaz Moscheles, a composer and piano virtuoso from Bohemia.

The date on a letter to Moscheles is 18th of March, 1827. Beethoven wrote

No words can express my feelings on reading your letter of the 1st of March.
The noble liberality of the Philharmonic Society, which almost anticipated my
request, has touched me to my inmost soul. I beg you, therefore, dear
Moscheles, to be my organ in conveying to the Society my heartfelt thanks
for their generous sympathy and aid.

I was compelled at once to draw for the whole sum of 1000 gulden, being on
the eve of borrowing money.

Your generous conduct can never be forgotten by me, and I hope shortly to
convey my thanks to Sir Smart in particular, and to Herr Stumpff. I beg you
will deliver the metronomed 9th Symphony to the Society. I enclose the proper markings.

Your friend, with high esteem,

Ignaz Moscheles
Ignaz Moscheles

Almost His Last Words

After his last letter, he soon fell into a delirium because of sleep deprivation and his continuous sickness. On the 24th of March, he snapped out of his delirious state and announced in Latin ‘Plaudite, amici, comedia finita est!’. It was a quote that the Romans used at the end of a theater play, translating to ‘Applaud, friends, the comedy is over!’.

So it’s safe to say that Beethoven saw the joy of life up until the very last moment. He would stay awake for a couple more hours, after which he spoke his last sentence.

What Did Beethoven Say Before He Died?

Schade, schade, zu spät!’ were the famous last words of Ludwig van Beethoven. It translates to ‘Pity, pity, too late!’ and was a response to a message from his publishers. They indicated that the wine he had ordered had arrived. Although an alcoholic, Beethoven wasn’t able to drink wine anymore on his deathbed. Hence, his last words.

Beethoven specifically ordered wine from the region he grew up in – Rhineland. The wine arrived on the 24th of March, but his doctor suggested on the 22nd of March that the end is near and that he should receive his last rites.

Beethoven’s doctor called in the priests, who performed the Christian ceremony. After the ceremony Beethoven thanked him joyfully: ‘I thank you ghostly sir! You have brought me comfort!’.

Beethoven’s Funeral

The funeral of Beethoven was held on the 29th of March at the parish church in Alsergrund; a district of Vienna. Afterward, he was buried in the Währing cemetery close to the city.

The funeral was a huge public event, which might’ve surprised the anti-social Ludwig van Beethoven. Some commentators estimated attendance of 10,000 to 30,000 people lining the streets from Beethoven’s final residency all the way to the cemetery.

The funeral started at three in the afternoon and was one of the most imposing ceremonies ever witnessed in Vienna. Of course, all the notable people in the world of classical music were present, as well as other notable artists. Because everybody was attending anyway, the schools were closed for the day.

The size of the crowd was somewhat expected since the military was asked to provide support. While they didn’t have to execute big actions, crowd control was definitely necessary. At one point, the influx of new people had to be halted so that the procession could move in peace and silence.

Beethoven’s Funeral by Franz Xaver Stöber

Music at the Funeral

Although Beethoven is the beacon of classical music, he failed to specify the music that had to be played at his funeral.

Ignaz von Seyfried was entrusted with the honorable task to choose the classical music to be played at the funeral. The conductor and composer of choice managed to arrange two of Beehoven’s own pieces to be practiced and performed during his funeral.

All musicians want fame, and so did Ignaz, who included a composition of his own named ‘Libera me.’ Some notable artists that performed the different compositions include Hummel, Czerny, and Schubert.

The Will of Beethoven

Effectively, Beethoven wrote at least two different wills during his life. The very first one was already written before his fame, the now-famous Heiligenstadt Testament.

It was written in 1802 when Beethoven was about 32 years old. It speaks about the severity of his illnesses and talks about his thoughts of suicide. Also, it elaborates on his increasing inability to hear his own music.

The letter was directed to his brothers. Specifically, Beethoven wrote:

But what a humiliation for me when someone standing next to me heard
a flute in the distance and I heard nothing, or someone heard a shepherd singing and again I heard nothing. Such incidents drove me almost to despair, a little more of that and I would have ended my life.’

Up until this point in the letter, it was just a testament to the life of Beethoven and how sad he was at the time. After this point, however, the letter actually turned into somewhat of a will. Most prominently, the German composer indicates that his instruments should be divided among his brothers.

While it was simply a letter, the Heiligenstadt Testament met all the legal requirements to be treated as a will. So if he actually died, it would be accepted as valid by any court of law.

Beethoven’s Heiligenstaedter Testament

Beethoven’s Second Will

As should be evident, Beethoven would go on to live 24 more years. Later on in his life, his will would change quite a bit, especially in relation to his new family members.

On March 6th, 1823, Beethoven’s lawyer Dr. Johann Baptist Bach wrote a new will in which he appointed his nephew Carl as his sole heir and therefore, the subsequent owner of his estate. At the beginning of 1827, he would adjust his will yet again. While there were some changes, they mostly concerned small paraphernalia that he divided among his friends.

While the letter to Moscheles was his actual last letter, the last signature that Beethoven produced was under an even later version of his will. With this signature on the 24th of March, he confirmed that his nephew Carl was his sole heir.

Life Leading Up to Death

The German composer had quite an eventful life. From Beethoven’s deafness to his incurable heartbreaks, a lot of things contributed to his eventual early death. However, it is undeniable that his alcoholism played a substantial part. Actually, alcohol poisoning was initially believed to be one of the reasons for Beethoven’s death.

Beethoven got into drinking at a very young age, so eventual alcohol poisoning wouldn’t be too big of a surprise. His father Johann van Beethoven and his grandmother were notorious alcoholics, so it would only make sense that Ludwig was influenced by them.

It goes to show through one of his last wishes. One of the reasons that Beethoven requested wine from Rhineland as his last wish was because it reminded him of his childhood. Why would the taste of wine remind you of your childhood?

It is well known that Beethoven suffered from the consequences of alcohol consumption throughout his life, like mood swings and paranoia. After his hearing decreased, alcohol became an even bigger part of his life and probably played a significant part in the development of his several liver diseases.

However, while alcohol was definitely a big part of his deterioration, Beethoven also had to deal with many other diseases during his life.

Other Diseases During His Life

From adolescence onwards, the composer had episodes of asthma, headaches, and most likely pansinusitis (the inflammation of the paranasal sinuses).

Thirteen-year-old Beethoven

Another childhood illness resulted in the scarring of his face. Although never officially confirmed, the scars were probably a result of smallpox. Another explanation could be lupus pernio, which causes the hardening of the skin.

From his late 20s onwards, diarrhea alternating with constipation was a daily occurrence for Ludwig. Doctor’s treatments were ample, but none of them really ever had the desired effect.

This, too, played a significant role in the development of his depression and suicidal thoughts. The problems turned up a notch in his 40s, when he started to experience episodes of polyarthralgia (or, rheumatism).

Another ongoing theme in Beethoven’s life was his inability to establish healthy relationships. It’s a story for another day, but in combination with his terrible health, it resulted in the fact that he started to neglect personal appearances altogether.

Also, he became obsessed with his finances, to the point that he would argue over the smallest amounts of cash. Actually, he was arrested by the police because they thought he was a homeless beggar and had to be taken off the streets.

Beethoven’s Deafness

And, of course, Beethoven’s deafness might be the most troublesome condition he ever experienced. Or at least, for his own well-being.

In his Heiligenstadt Testament, he admitted to his brothers that he was functionally deaf. Still, he’d continue to compose his music and even produced some of his best work while completely deaf, like the Sixth Symphony.

He began losing his hearing somewhere in his mid-20s. By then, he was already known as a musician and composer, but not yet as the superstar we know him today. By the age of 45, he was completely deaf. Simultaneously, he’d stop going out and only allowed a select group of friends to visit him.

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