Beethoveniana

Beethoven’s Lead Poisoning (May 6, 2024)

Introduction

To see recent articles on the lead study in The New York Times and the Viennese Der Standard, see:

A report in the journal Clinical Chemistry (Oxford University Press) published today contains the first detailed information about the composer’s high lead concentrations in the last year of his life (and perhaps earlier). A team of Beethoven experts from the American Beethoven Society (Kevin Brown) and the Beethoven Center, SJSU (emeritus director William Meredith), and scientists from Boston Children’s Hospital and Harvard Medical School (Nader Rifai) and the Mayo Clinic, Rochester, New York (Paul Jannetto) studied two authenticated locks of Beethoven’s hair. They report that:

“Using the Centers for Disease Control and Prevention proposed conversion formula of values from hair lead concentration to blood lead concentration, the estimated Beethoven’s blood lead concentration would have been 69-71 µg/dL [microgram/deciliter]. Such lead levels are commonly associated with gastrointestinal and renal ailments and decreased hearing but are not considered high enough to be the sole cause of death. Suggested primary sources of lead exposure include plumbed [i.e. lead adulterated] wine, dietary, and medical treatments.”

No lead source has been confirmed to date; adulterated wine (see below) seems most likely.

A graph of the effects of lead poisoning at ascending levels can be seen at:

https://nap.nationalacademies.org/read/9168/chapter/6#62

The report, which is open access for six weeks, can be read at:

https://doi.org/10.1093/clinchem/hvae054

History of the Lead Study

The lead study was undertaken immediately after the publication of the landmark report by Tristan Begg et al., “Genomic Analyses of Hair from Ludwig van Beethoven,” Current Biology (March 23, 2023) that authenticated five locks of the composer’s hair.

https://www.cell.com/current-biology/fulltext/S0960-9822(23)00181-1

In April 2023 the owner of three of the five authenticated locks, Kevin Brown, began working with William Meredith to identify a scientific team to test for heavy metals. These tests would be especially important because previous published reports of lead poisoning were conducted on samples that either are not authentic (the Hiller Lock of Hair, which came from a Jewish woman) or have been disputed for osteological reasons (the Romeo Seligmann skull fragments, currently undergoing DNA analysis). With Brown’s permission, Meredith wrote to Dr. Nader Rafai, a lead expert, on April 18, 2023, to ask for his help in identifying a laboratory that could test samples for heavy metals. Dr. Rifai wrote back right away, invited Dr. Paul Jannetto to join the team, and Dr. Jannetto agreed to test the samples at the Mayo Clinic in Rochester with Sarah Erdahl. The tests were undertaken during the summer of 2023.

The two authenticated locks came from the collection of the famous Beethoven scholar Alexander Wheelock Thayer (1817-1897) and were acquired by Brown when the American Beethoven Society also bought other remaining pieces of the Thayer family collection in 2016. Thayer was given the first lock in 1851 by Bermann and the second by Anton Halm in 1859 (from a lock of hair requested his wife Maria). For more details on both locks, see: https://beethovenscholar.com/index.php/2023/03/22/three-authentic-beethoven-locks/

The American Thayer expert Grant Cook shared this story from Thayer about the Bermann Lock:

“One pleasant morning, with an autograph or two, and a rare print of Beethoven after his death in my hand, which I just succeeded in obtaining, I stepped onto an omnibus for Währing. Just before starting, three gentlemen entered. We had not ridden far when I touched my hat to one of them, and said, ‘Excuse me, sir, perhaps you can tell me if I am right; I wish to visit Beethoven’s grave?’ He seemed pleased and with true German kindness said he would see that the driver left me at the right place. … The idea of one from America being there bound on a pilgrimage to the grave of Beethoven, interested them exceedingly. They examined my autographs, and a little lock of gray hair, which an admirer of Beethoven had given me [Bermann]; congratulated me upon their acquisition, and expressed their regret that such things should be allowed to leave Vienna. One of the gentlemen, a middle-aged, fine looking man, himself a composer, and who had known Beethoven well, assured me that my memorials of the composer were genuine—an assurance however that I did not need. The gentleman was the brother of FRANZ SCHUBERT! Our acquaintance was soon cut short, to my sorrow, by our arrival at the cemetery—the ‘Währinger Friedhof.’ Ring at the door of the keeper’s house, said Mr. Schubert, and when it is open pass directly through, and up the walk, and in the upper part of the enclosure you will find the monument against the wall, and just beyond that of Franz Schubert. … Advancing, perhaps two thirds up this path, a monument on the right caught my eye, inscribed with the name of Ritter von Seyfried, the friend and biographer of him whom I sought, and just beyond, on the left, almost hidden by the foliage of a small willow was the single word in gilded letters, sunk into the granite block, BEETHOVEN. … I have seldom been more affected by tender sorrowful emotions than during my two visits to the grave of Beethoven.”

(See Cook’s article in The Beethoven Journal [Winter 2016]: 77-78)

Little did Thayer know that his “little lock” would help solve questions about the composer’s death 173 years later.

Significance and Conclusions of the New Lead Study

The new lead report is significant because it:

(1) for the first time, establishes lead levels in two authenticated locks of Beethoven’s hair;

(2) points towards another potential cause of Beethoven’s kidney failure in the months before his death in March 1827 (the other cause may have been alcohol use);

(3) reveals a fourth factor that could have contributed to Beethoven’s liver failure at the end of his life (the first three are a genetic predisposition to liver failure, Hepatitis B, and the composer’s alcohol consumption).

After beginning with a potential limitation, the team of researchers conclude:

“… the procedure used in this study is consistent with that recommended by the Society of Hair Testing which included aqueous solvents with detergent to remove external contaminants.  Furthermore, low hair lead concentration may be a poor predictor of blood lead values and the potential associated ailments. However, higher hair lead concentrations, such as those seen in this study, have been shown to correlate with kidney and liver disease. While the concentrations determined are not supportive of the notion that lead exposure caused his death, it may have contributed to the documented ailments that plagued him most of his life.  We believe this is an important piece of a complex puzzle that historians, physicians, and scientists have been trying to better understand the medical history of the great composer.”

Mentions of Adulterated Wine in Schindler’s Biography and Beethoven’s Conversation Books

According to Beethoven’s volunteer secretary Anton Schindler, “His favorite drink was fresh spring water, which he drank in large quantities in the summertime. Among wines he preferred mountain wines from Budapest. Unfortunately, he relished adulterated wines the most, which caused great mischief in his weakened abdomen. No amount of warning against them helped.” [italics mine; translation mine] The original: “Von Weinsorten war es der Ofener Gebirgswein, den er vorgezogen. Leider mundeten ihm am besten die verfälschten Weine, die in seinem geschwächten Unterleib veil Unheil angerichtet. Dagegen half kein Warnen.” (Anton Schindler, Ludwig van Beethoven, ed. Frtiz Volbach, 5 ed., 2 vols. (Münster: Aschendorff, 1927), 2:194). The most famous Hungarian wine was Tokay (or Tokaj), an unusually sweet white wine made in the Tokaj district of northeastern Hungary. (For an up-to-date evenhanded assessment of Schindler’s reputation and reliability in general, see the section “The Schindler Problem” in Theodore Albrecht’s new Beethoven’s Ninth Symphony: Rehearsing and Performing Its 1824 Premiere [Woodbridge, Suffolk: Boydell Press, 2024], xvii-xxxiv.) Several examples of friends and his nephew warning Beethoven given below verify Schindler’s claim.

https://www.offbeatbudapest.com/hungarian-wines/tokaj-beginners-guide

Beethoven’s heaviest drinking appears to have been in the year when he was close friends with Karl Holz from the summer of 1825 through September 1826 (four months before before his final illnesses surfaced). Five earlier mentions of adulterated wines are found in the conversation books from 1820-1823.

1. Around January 26, 1820, Beethoven’s friend Oliva, who had been ill, wrote, “My doctor has prescribed for me a good Spanish or Tokay wine; therefore I shall have to turn to Herr Seelig [proprieter of Zur Stadt Triest].” Around January 28, 1820, Oliva wrote to Beethoven: “I thank you for the wine, but I cannot drink it. It is so bad it is shocking; I would become completely sick from it. A connoisseur says that a third of this bottle is ethyl alcohol [Weingeist]. Only 1 1/2 glasses have been taken out. You should give the rest back.” [italics mine] A bit later in the conversation Oliva wrote, “I am sending the wine back.” Probably on Sunday, January 30, Beethoven was in the cafe Zur Stadt Triest. The proprieter Seelig wrote to Beethoven, “My Tokay is certainly good and generally acknowledged as such. Indeed you yourself have drunk it. [italics mine] Von Oliva should send it back to me, though. Especially because he said my seal was not on it, I want to exchange it. Von Peters is a wine connoisseur who should also examine my Tokay, because the judgment of the Doctor is incorrect.” Three days later Oliva reported to Beethoven, “He [Seelig] sent Menescher rather than Tokay.” (Menescher is a Hungarian red dessert wine.)

Source: Theodore Albrecht, ed. and trans., Beethoven’s Conversation Books, Volume 1: Nos. 1-8 (February 1818 to March 1820) (Woodbridge, Suffolk: Boydell Press, 2018), 1:221, 226-28, see also 234. Heft 7, Blatt 2r. Weingeist is defined as “spirits of wine” in Johannes Ebers, ed., Neues Hand=Wörterbuch der Deutschen Sprache für die Engländer und der Englischen Sprache für die Deutschen, 2 vols. (Halle: Rengerschen Buchhandlung, 1802), 2:1459; in Ein neues Englisch=Deutsches und Deutsch=Englisches Wörterbuch … (Philadelphia: Georg W. Mentz und Sohn, 1840), 621, Weingeist is defined as “spirit of wine, ardent spirit.”

2. Around February 5, 1820: Beethoven’s friend Oliva to Beethoven: “The wine from Seelig is as bad as the last stuff was; it burns in the chest and in the stomach.”

 Source: Albrecht, Beethoven’s Conversation Books, 1:241, Heft 7, Blatt 28r.

3. April 12, 1823: Schindler to Beethoven: “ Don’t drink any of this wine, because it is scandalously adulterated [schändlich verfälscht]; I already wanted to say, the other day, that it made the whole roof of my mouth full of blisters.”

Source: Albrecht, Beethoven’s Conversation Books, 3:267; Heft 29, 12v. Verfälschen means “to falsify, to alter, to imbase, to interpolate, to adulterate, to sophisticate, to corrupt, to counterfeit” (Ebers, Neues Hand=Wörterbuch, 2:1373)

4. June 22, 1823: nephew Karl to Beethoven: “ The other [wine] seems to me to be adulterated [geschmiert] but not this one. Believe me, I am a connoisseur.”

Source: Ebers defines “den Wein schmieren, verfälschen, to sophisticate or adulterate Wine” (Ebers, Neues Hand=Wörterbuch, 2:1167.) Albrecht, Beethoven’s Conversation Books, 4:64, Heft 34, 18v. Albrecht updated from: “The other [wine] seems to me to be ‘enhanced,’ but not this one.”

5. around June 29, 1823: nephew Karl to Beethoven: “Now they will surely be wary of sending bad wine. // For me, that’s a joke. // That is not Erlauer [wine].”

Source: Albrecht, Beethoven’s Conversation Books, 4:78, Heft 35, 2r.

Wine was adulterated with many different substances during Beethoven’s lifetime, some harmless and others toxic. In his famous Treatise on Adulterations of Food, and Culinary Poisons, Exhibiting the Fraudulent Sophistications of Bread, Beer, Wine, Spirituous Liquors, Tea, Coffee … (2nd. ed., London, 1820), Fredrick Accum (1769-1838) stated straightforwardly that “It is sufficiently obvious, that few of those commodities, which are the objects of commerce, are adulterated to a greater extent than wine. … Several well-authenticated facts have convinced me that the adulteration of wine with substances deleterious to health, is perhaps practised oftener than is, perhaps, suspected …” (pp. 92, 99-100). Some of the additives he listed include alum, bilberry and elderberry husks, gypsum, oak wood sawdust, bitter almonds, raisin seeds, and super-tartrate of potash. “The most dangerous adulteration of wine is by some preparations of lead, which possess the property of stopping the progress of acescence [the process of acetous fermentation] of wine, and also of rendering white wines, when muddy, transparent” (p. 102). The treatise is often referred to as There is Death in the Pot from an illustration and quote on the title page.

https://www.google.com/books/edition/A_Treatise_on_Adulterations_of_Food_and/bb46AAAAcAAJ?hl=en&gbpv=1&dq=death+in+the+pot&printsec=frontcover

A Concise Introduction to Adulterating Wine with Lead Acetate (Sapa)

The use of lead acetate to sweeten and to preserve wine dates back at least to the ancient Romans. The practice was described by Cato (234-149 BCE), Columella (4-c.70 CE), Pliny (23-79 CE), and Palladius (ca. 363-before 431 CE). According to Palladius’s recipe, unfermented grape juice (called “must”) is boiled down in a lead vessel until it reduced to a thickened liquid by one third. This reduced liquid was called sapa, defrutum, or caroenum (the different names sometimes designated the degree by which the syrup had been reduced). Palladius’s recipe was “reproduced in 1977 and resulted in a paste containing 1000 mg lead/L. A single teaspoon of this material per day could cause chronic lead poisoning, particularly because lead acetate is one of the few soluble lead salts, and therefore, more biologically available (Esisinger [sic Eisinger] 1977).” (This quote is from Finch, Sublime Lead, p. 416. Also see: Josef Eisinger “Lead and Man,” Trends in Biochemistry Science, July 1977, 2:N147-N150, p. N148)

Sapa was appealing because of its color, fragrance, and sweet taste. The high lead content made sapa effective in preserving the wine, because the lead ions inhibit the enzyme systems of the wine and also of living organisms. In 1979 Josef Eisinger and Jorge Flores undertook an experiment based on Columella’s recipe and determined that “Roman sapa contained approximately 1 gram of lead per litre. … The lead content of Columella’s wines must therefore have been approximately 20 mg/l, so that a person consuming one litre of wine per day would ingest about 20 mg. of lead per day. This intake could be compared with 0.5 mg per day which is considered to prodiuce chronic lead poisoning.” (See Eisinger, “Lead and Wine,” 288.) Columella’s book  De Agricultura circulated in six editions in Latin and German until 1769, the year before Beethoven’s birth. In 1824 Al. Henderson noted that:

“If [the use of unsafe ingredients is] employed at all, it can only be for the purpose of correcting the harshness incident to some of the lighter white wines, such as those of the Rhine, Moselle, or the Cape, and the inferior kinds of Teneriffe. When these wines have an unusual degree of sweetness, a darker colour than their age and body seem to warrant, and particularly when the use of them is followed by pains of the stomach [italics mine], we may presume, that they have been adulterated with lead [p. 340]. … According to some authors, lead is not the only poisonous metal used in the preparation of wines. The Spaniards are charged with having recourse to arsenic, and even to corrosive sublimate, in order to fine their vintages, and render them more firm and durable … [341] … As a high colour is generally, though sometimes erroneously, considered a criterion of the excellence of particular wines; …. it is frequently supplied by artificial means. … Vogel recommends the acetate of lead for the same purpose [341-42].”

In a personal communication of April 19, 2024, Dr. Jerome Nriagu (a lead expert at the University of Michigan) informed me that “Beethoven did not have to be alcohol-dependent to get lead-poisoning. Because lead is a non-essential element with no homeostatic control on its cellular or extracellular concentration, it has the tendency to bioaccumulate in the body. If Beethoven was a regular consumer of lead-tainted wines, it would not take long for the lead to accumulate in his bloodstream and body tissues to levels that could be toxic.”

The information above is distilled from these sources:

Al. Henderson, The History of Ancient and Modern Wines. London: Baldwin, Vradock, and Joy. 1824. See especially Chapter XIII, “Of the Mixture and Adulteration of Wines, 329-44.

https://www.google.com/books/edition/The_History_of_Ancient_and_Modern_Wines/-K44AQAAMAAJ?hl=en&gbpv=1

Josef Eisinger, “Lead and Wine: Eberhard Gockel and the Colica Pictonum,” Medical History 26 (1982): 279-302. esp. 284-88

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1139187/pdf/medhist00086-0053.pdf

Alanah Finch. Sublime Lead: The Biography of a 5000 Year Toxic Love Affair. Loyola University. 2004. See Chapter 9: “Suspicions: Historical Lead Poisoning,” especially pp. 414-16

https://afitch.sites.luc.edu/Sublime%20Lead/CHAP9A.2003.pdf

A report titled Lead and Human Health: An Update that was prepared for the American Council on Science and Health by Daland Juberg (1st ed., 1997, 2nd ed. 2000) provides additional helpful information on lead absorption:

  • “Lead may be absorbed by the body through inhalation, ingestion, or dermal (skin) contact; it can be transferred to the fetus through the placenta (Goyer, 1990). Adults absorb approximately 5–15 percent of ingested lead into the circulation; of this amount, less than 5 percent is retained in the body (Goyer, 1996).” (p. 9)
  • “Blood lead levels respond relatively rapidly to changes in lead intake and are generally considered to show a linear relationship with exposure. Blood lead levels associated with chronic exposure may underestimate total body burden because the majority of body lead may be stored in teeth or bone and these are more difficult to sample.” (p. 9)
  • “Nutritional status and eating behavior appear to influence the absorption and toxicity potential of lead in several ways. Lead ingested from water and other drinks tends to be absorbed to a greater extent than lead ingested from solid food, while lead ingested under fasting conditions is absorbed to a greater extent than lead ingested during food consumption (Mahaffey, 1990; ATSDR, 1992).” (italics mine, p. 10)
  • “Once absorbed in the bloodstream, lead is primarily distributed among two compartments—the more rapid turnover pool with distribution to the soft tissues such as the liver, lung, spleen, and kidney, and the slower turnover pool with distribution to the skeleton (Rabinowitz, 1991). Lead can accumulate over time, particularly in bone, and the fractional distribution of lead in bone (as contrasted with other body stores) increases with age from about 70 percent of body lead in childhood to as much as 95 percent with advancing age. Thus, lead in bone may contribute a significant amount to blood lead and serves as a key storage site and source of internal lead exposure, particularly in situations involving chronic exposure.” (italics mine, p. 11)
  • “The significance of internal organs as a source of lead is reflected by their respective biological half-life times (the time it takes for one half of an amount to be eliminated or removed from the body). In bone, the half-life is quite long, approximately 17–20 years (Heard and Chamberlain, 1984; Goyer, 1996), while in blood, the half-life is about 2–3 weeks (Chamberlain et al., 1978; Rosen, 1985).” (p. 11)

See: https://www.academia.edu/5884748/LEAD_AND_HUMAN_HEALTH_An_Update_Prepared_for_the_American_Council_on_Science_and_Health_ACSH?email_work_card=view-paper