To the 250th birthday of Ludwig van Beethoven: How sick was the genius musician really in his life?

Background: Ludwig van Beethoven was born 250 years ago on December 17th, 1770 in Bonn, Germany. Although he was one of the most brilliant composers of all time, his life was shaped by many illnesses. Many know that Beethoven was hard of hearing and later deaf and that he could not longer hear his own works. However, there are many diseases that were little and or not known and that still shaped his life significantly.Methods: This article reports the medical history of this artist, based on authoritative scientific sources.Results: Even when he was young, Beethoven fell ill with smallpox, which gave his face a typical appearance. Since 1804/1805 he had been unable to see properly and was wearing glasses. The first hearing disorders appeared in 1796, treatment began in 1800. From 1814, hearing loss worsened significantly. The cause of hearing disorders is still unclear. From the age of 25, there was colic, diarrhea and fever, probably caused by a chronic pancreatitis. It is certain that Beethoven suffered from hepatitis and cirrhosis of the liver, certainly significantly influenced by alcohol consumption. Liver cirrhosis and esophageal varices were the consequences, and certainly also psychological changes to his difficult personality. In 1825, there was a cough of blood, nosebleeds and ascites and until 1827, 30-40 l of ascites were punctured.. On March 26, 1827, Beethoven died in the liver coma.Conclusions: Beethoven was a brilliant musician and composer who had many illnesses in his life. Above all, his hearing impairment significantly influenced his life. He had also frequent gastroenterological diseases, especially pancreatitis, hepatitis and live cirrhosis. Alcohol certainly played an important role in his life and influenced many illnesses.