Ludwig van Beethoven was a prodigious composer. He’s credited with 722 individual works, including symphonies, sonatas, and choral music — creations that pushed the boundaries of composition and performance, and helped usher in the Romantic era of music. But away from the fortepiano, Beethoven’s life was plagued by deafness, debilitating gastrointestinal troubles, and jaundice.
A little more than a year ago, scientists announced that they’d sequenced Beethoven’s genome from preserved locks of his hair. They found genetic risk factors for liver disease, but nothing else terribly conclusive.
But some researchers have long wondered whether some of the answers lay beyond his genes — specifically, whether toxicity from heavy metals might have had something to do with his many ailments.
Now, after testing a few more strands of the composer’s hair, a team of scientists suggest in the journal Clinical Chemistry that Beethoven was almost certainly exposed to lead — and that it may have contributed to the health issues that were such a feature of the storied composer’s life.
The struggles of Ludwig van Beethoven
Lead is a toxic metal that’s naturally found in the Earth’s crust. However, “its widespread use has resulted in extensive environmental contamination, human exposure and significant public health problems in many parts of the world,” according to World Health Organization.
“Lead has no useful purpose in the body,” says Howard Hu, a physician-epidemiologist at the University of Southern California. “But unfortunately, it also mimics some of the other more essential elements. It’s an imposter. It gets incorporated into various enzyme and molecular structures in the body and then screws them up.”
And that can lead to all kinds of issues, from brain damage to hypertension to kidney problems.
Beethoven began losing his hearing in his mid to late 20s and was fully deaf by his mid 40s. In addition, he suffered from jaundice and crippling GI problems. At one point he wrote his brothers a letter, now named the Heiligenstadt Testament, asking that his health problems be described after his death.
“He had wanted the world to know the truth behind the cause of his ailments,” explains Paul Jannetto, the director of the Metals Laboratory at the Mayo Clinic.
The Metals Laboratory usually tests blood and urine samples for exposure to heavy metals, like lead, mercury, and arsenic. “Clinically, our test menu is essentially the periodic table,” says Jannetto. Among the lab’s typical responsibilities is screening kids for lead to try to determine if a patient’s symptoms might be due to heavy metal toxicity.
So Jannetto vividly recalls the moment a colleague sent him a very different request: Would he be willing to test Beethoven’s hair for heavy metals?
When someone is exposed to lead, some of the harmful metal gets deposited in their hair. This means that even without a blood sample, scientists can use someone’s hair to determine their lead levels posthumously.
So the owner of two separate locks of Beethoven’s hair put something like two or three dozen strands in a special collection kit and shipped it to the Mayo Clinic — where Sarah Erdahl, Technical Coordinator at the Metals Lab, received it.
“I used tweezers,” says Erdahl, who said she felt zero temptation to touch the composer’s hair with her bare hands. “My heart was fluttering and I was like, ‘Oh my goodness, this is so significant.’ When you have that small amount of hair, every strand counts.”
Jannetto agreed, adding that this approach is one that extends to the lab’s customary, living patients.
“Behind every sample — whether it’s blood [or] hair — is a person,” he says. “And that’s why it’s precious and we handle it with care.”
Erdahl carefully rinsed and treated the hair before running it through the instrument that measures heavy metals. The levels of arsenic and mercury in Beethoven’s hair were slightly elevated.
The lead levels, on the other hand, were a startling 64 to 95 times higher than the hair of someone today.
It was a dramatic reveal — which could explain why, in that moment, the opening bars of Beethoven’s 5th Symphony crashed through Erdahl’s brain:
“Dun dun dun dun.”
“This is so much more elevated than any other patient samples we’re seeing,” she recalls thinking. “This is extremely significant.”
Where classical music meets heavy metal
That substantial buildup of the toxic metal likely came from the goblets and glasses Beethoven drank out of, certain medical treatments of that age, and his consumption of wine.
“We do know Beethoven loved his wine,” says Jannetto. “And back then, it was not uncommon to actually add lead acetate to the less expensive wines because it binds the acids to add a sweeter flavor to the wine.”
Jannetto says that even for people of his time period, the lead levels in Beethoven’s hair would have been about 10 times higher than average. “What this showed is he had a chronic exposure to high concentrations of lead,” he says.
The lead wouldn’t have killed him, but it likely contributed to his health problems.
“A lot of those documented ailments that Beethoven had,” says Jannetto, “those are traditional signs and symptoms that a neurologist or clinician could see in a patient that was exposed to lead.” These include liver disease (which would have been aggravated by his genetic risk factor, regular drinking, and infection with hepatitis B), gastrointestinal challenges, and hearing loss.
Hu, who wasn’t involved in the research, praised the work.
“That’s some good science,” he says. “I think it was pretty darn rigorous.”
Hu has studied lead exposure and toxicity for almost 40 years, including in the context of some low- and middle-income countries where lead contamination can still be a problem.
“It’s still a major problem globally,” he says, “because of lead contamination in spices and cookware and all sorts of other sources around the world.”
Still, Hu can’t help but reflect on how Beethoven managed his virtuosic composing in spite of the lead.
“It makes you even more awestruck by what he was able to accomplish,” Hu says.
He wonders whether perhaps the very struggle with his health helped shape the emotional contours of some of Beethoven’s compositions.
“I don’t know,” Hu chuckles. “It’s fun to speculate about it.”
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