Today we're heading not into history, where Ludwig van Beethoven composed some of history's greatest music, but into the science lab, where researchers are trying to answer a question that has evaded historians: How did the master die? His famous deafness, rudeness, and foul temper were so neatly symbolized by his other renowned trademark, his great head of wild unkempt gray hair. That very same hair, it turns out, is central to the popular theory surrounding Beethoven's death: that he died of lead poisoning, found by testing surviving locks of his hair. Popular the tale is; but does it stand up to the scrutiny of science?
It was March 27, 1827, the day after the great composer's death, when fifteen-year-old music student Ferdinand Hiller went with his mentor to see the body. It was a surreal experience, for young Hiller had met Beethoven two weeks earlier at the side of his teacher, a friend of the great man's. Then, Hiller had found him in great pain, but still speaking and lively, his famous head of wild curly hair intact. Now, the corpse lay still, no longer talking, no longer in pain, oddly distorted from the autopsy, and with some of its hair having already been clipped away as souvenirs by others. Hiller took the scissors he brought for the purpose, grasped a handful of the famous locks, and cut. It was 582 strands.
Many of those locks taken by all those curious visitors are still found today in various public and private collections, but Hiller's was the one that passed all the way down through history and came to us to be the centerpiece of today's discussion. In 1911 it was restored in Cologne, Germany and sealed into a beautiful black oval-shaped wooden frame with the lock of hair wound inside a glass bubble in its center. Its journey took turns as dramatic as being a gift to a Danish doctor for aiding hundreds of Jews escaping World War II. It finally ended up at a Sotheby's auction house in London in 1994. For the sum of £3,600, four members of the American Beethoven Society acquired it and brought it to the United States. The new owners donated the hair to The Ira F. Brilliant Center for Beethoven Studies at San Jose State University, with one of the four, Dr. Alfredo Guevara, retaining a portion of his share for himself, which he now keeps.
Soon after, the locket of hair enjoyed its greatest 15 minutes of fame, when author Russell Martin published a 2000 book titled Beethoven's Hair: An Extraordinary Historical Odyssey and a Scientific Mystery Solved. A TV documentary followed five years later, titled more simply Beethoven's Hair, telling the same intriguing historical tale. But, perhaps more significantly, the book and movie also revealed that during its time at San Jose State, the hair had been undergoing careful chemical analysis in hopes of answering the question of how Beethoven had died.
In 1827, the cause of Beethoven's death was listed as dropsy on his autopsy report. Dropsy is an antiquated term for an edema, or swelling, which can be caused by many different things. In short, they had no useful diagnosis at the time which would have much medical value today. However, Beethoven's deafness had one silver lining for historians. Most of his conversations were written, and many of those survive today in what are known as his "conversation books". An enormous amount of paperwork tells us the details of his later years, both in his own voice, and in that of his friends and biographers. As a result, we know a great deal about his symptoms. He was not at all a well man; and many diagnosticians, both armchair and professional, have cast their hats into the ring with nominations for what probably ailed the master.
And this was where Martin's book Beethoven's Hair shook things up. Hair retains certain chemical signatures from the blood, and it's one way we can do things like drug testing, albeit with a number of important caveats. Guevara had engaged the services of a doctor in Los Angeles to test Beethoven's hair for morphine, and of Dr. Bill Walsh in Illinois to test for mercury, as mercury poisoning from treating syphilis was one hypothesis of the cause of death. Both came back negative. In fact, all the tests came back negative, except one: lead. Walsh had the McCrone Research Institute and also scientists from the Advanced Photon Source at Argonne National Laboratory perform X-ray fluorescence analysis on the hair, and it turned out that Beethoven's hair contained an average of 42 times as much lead as did control samples.
Hearing loss, irritability, abdominal pain, headache, joint pain, mood disorders — all the symptoms that absolutely dominated every day of the latter half of Beethoven's life, according to the documents — are all symptoms of lead poisoning. The pieces all fit. Martin's book trumpeted the findings, the TV movie repeated them, and the belief that Beethoven died of lead poisoning became a fixture in pop culture.
But outside of public circles, many in the science community found this unlikely, if not outright wrong. For one thing, the doctors who autopsied Beethoven, according to Martin's thorough research, found:
Also noted was that Beethoven did not exhibit most of the other symptoms of lead poisoning, nor was there any special reason to suspect he had any unusual exposure to lead. He did drink a lot, and wine was often fortified with lead; but his drinking was not out of line with the standards of the day, and history doesn't record any notable incidence of lead poisoning from the time and place.
Curious about this, a forensic pathologist in Austria, Dr. Christian Reiter, acquired some of the hair from Guevara in 2007, and used a laser to vaporize the hair along its length, analyzing the vapor with a spectrometer to create a temporal profile for the lead in Beethoven's body over the final months of his life. What Reiter found was a number of prominent spikes, which, turning to the literature, he correlated with several medical procedures Beethoven went through. Again, the press rejoiced in this additional fine-tuning of the lead poisoning theory.
And once again, outside the spotlight of publicity, the scientific community was skeptical. The utility of hair sampling for trace metals had been coming under increasing criticism for being both unreliable and inconsistent. There is a lot of variability from person to person, and even from hair to hair; and mainly, when a contaminant is detected, it can't reliably be determined whether the exposure was internal or external. In one sting published in the Journal of the American Medical Association, skeptical doctor Stephen Barrett sent hair samples from two healthy teenagers anonymously to thirteen different commercial laboratories for analysis. Results, he said, "varied considerably between identical samples sent to the same laboratory and from laboratory to laboratory."
Hair, particularly hair that's 180 years old, is notoriously susceptible to external contamination by lead. Keratin proteins, the major component of hair, have numerous chemical binding sites for lead. It is this same chemical affinity for lead that makes humans so susceptible to lead poisoning. Once lead is chemically bound to the hair, it is virtually impossible for a researcher to determine whether the lead was systemic or extraneous. It is worth pointing out that no record survives of how the Hiller locket was originally sealed before its 1911 restoration, but lead solder would most likely have been used.
Reiter's method in particular has come under fire. The peaks he detected along the length of the hair were far too sharp to be correlated to internal lead levels. If Beethoven had suddenly ingested a huge amount of lead — something for which there is no evidence — it would have come out in the hair gradually, and not in sharp peaks. The general reaction from the scientific community to Reiter's analysis, based on at least two papers, is that the peaks of lead he found were due to external contamination.
Complicating the whole question is that correlating evidence has also been presented from pieces of a skull, believed to be Beethoven's. Like the Guevara lock of hair, the Kaufmann skull fragments are supported by a detailed provenance. We trace them back to Beethoven based on their documented history. Here is what happened.
When Beethoven died in 1827, Dr. Johann Wagner performed an autopsy, which included a craniotomy, a sawing off the top of Beethoven's skull. The temporal bones around the ears were removed, in hopes of being able to determine the cause of his deafness, but unfortunately they were lost to history.
In 1863, the body was exhumed. A detailed (and widely available) photograph was taken of the skull, showing the saw cut around the crown. At this time, the skull cap was divided into approximately nine pieces, in light of the popularity of phrenology at that time in history. Two of these large fragments came down through history to their current owner, Paul Kaufmann. In 1985, these fragments were certified as belonging to Beethoven with the "greatest probability" by two Austrian doctors, Hans Bankl and Hans Jesserer, though their methodology is not clear.
In 2005, DNA testing was done on the Kaufmann fragments in Germany by Dr. Bernd Brinkmann. Unfortunately, Brinkmann was not able to recover any nuclear DNA, only a limited amount of mitochondrial DNA. Might it have been possible to match this with the hair, and prove that the skull could be corroborating evidence of the lead poisoning?
Fortunately, DNA testing had been done on the hair, back in 1999. We need to get DNA from root follicle, not from the shaft; but Beethoven's hair lock had been cut, not yanked, so it shouldn't have had any follicles. But upon closer examination, apparently young Hiller had pulled good and hard, because a few follicles were found. But as with the skull, no nuclear DNA was recovered; it was too old and deteriorated. The mitochondrial DNA was a match, but only in the sense that it was impossible to rule out that the samples had come from different people. The bones and hair might have come from the same person, but no greater certainty could be discovered.
Riding the wave of the PR from the movie in 2005, Walsh took the skull fragments back to Argonne and had them tested for lead as well, and the same high concentration was found. Walsh issued a press release stating that "massive amounts of lead found in his hair... confirm the cause of his years of chronic debilitating illness."
But again, behind the scenes, the theory continued to unravel. In 2012, the director of the Beethoven Center, Dr. William Meredith, took the Kaufmann fragments to Dr. Tim White at UC Berkeley, a paleontologist and one of the world's leading experts in anthropology and osteology. Dr. White in turn shared the fragments with a large number of his colleagues. The result was unanimous: the larger of the Kaufmann fragments could not possibly be from Beethoven. It was a right frontal bone; and if had been from the Beethoven skull, Dr. Wagner's craniotomy cut would have gone right through its middle. The Kaufmann skull fragments, and any lead data garnered from them, had nothing to do with Beethoven.
The final stages of fatal lead toxicity are quite horrible, as it destroys the central nervous system. Paralysis, blindness, and insanity lead to an undignified and excruciating death. Beethoven's death, though it exhibited none of these symptoms of fatal lead poisoning, was still equally grotesque, as the fluids from his systemic edema saturated his mattress when the doctors frequently punctured him to release them. He was constantly in abdominal pain, he was jaundiced, and he emitted the foulest odor. His thoroughly documented symptoms matched what we'd expect from the state of his liver and other organs found in his autopsy: severe chronic liver disease, probably with viral hepatitis — and no need to introduce lead toxicity into his diagnosis. But we don't know for sure, and probably never will. It is a secret unlikely to be revealed by Beethoven's hair. The Guevara lock took a fantastical ride through the nineteenth and twentieth centuries, and provided much entertainment and a forensic roller coaster. But any answers it may hold have so far not been revealed — if it holds any at all.
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