Doctors of Doom

[Gary Sisco]

Mystery of medicine and music: Accidental death of a genius
New research suggests that, far from dying of natural causes, Ludwig van Beethoven was hastened to his end by his doctor. And he is not the only prominent figure to have suffered such a misfortune. Tony Paterson reports
Published: 30 August 2007
By the standards of today's medicine, Ludwig van Beethoven's death was a horrible and degrading affair. On 26 March 1827, the deaf composer met his end after spending more than four months in agony lying on a filthy straw mattress in a Viennese apartment, his skin jaundiced yellow from the liver cirrhosis he had contracted. He was 56.

In the days that followed, Beethoven's friends and admirers made pilgrimages to the open coffin bearing the body of the great composer to pay their respects. As was the custom in the early 1800s, several removed locks of their dead friend's hair as keepsakes.

The surviving brittle grey strands, 180 years on, that were sheared from Beethoven's head have provided new and convincing evidence that the composer did not die as a result of his worsening illnesses. He appears to have been killed – albeit inadvertently – by his own doctor.

"Beethoven's death was due to the treatments he was given by his own physician," said Christian Reiter, a forensic scientist and author of a new study on Beethoven's hair, yesterday. "The treatments amounted to lethal doses that permeated Beethoven's ailing liver and ultimately killed him," he added.

The locks have their own story. Back in 1989 a group of American Beethoven enthusiasts bought some of the hair at an auction held by Sotheby's. Then 160 strands were handed over to San Jose State University, California. Scientific research on those locks established that, among his other ailments which included deafness and cirrhosis, Beethoven also suffered from lead poisoning which may have contributed and ultimately led to his death. This fact was further underlined following scientific analysis of the composer's remaining bones two years ago which also pointed to lead poisoning.

It was not until the San Jose locks were placed in the hands of Mr Reiter in Vienna late last year that another additional cause of Beethoven's death – namely the composer's physician – began to emerge.

Mr Reiter went to Vienna University's Institute for Chemical Analysis, which has decades of experience in forensic research on hair, to study the locks. The strands were exposed to a microscopically thin laser beam. The resulting smoke was put through a spectrograph and analysed.

Two of the hairs provided evidence of the last 267 days of Beethoven's life, but it was the final 111 days that produced the crucial findings that support Mr Reiter's theory that the composer was inadvertently killed by his own physician .

Beethoven's demise started around 1796, aged only 25, when he began suffering from a severe form of tinnitus, a ringing in his ears that made it difficult for him to listen to, let alone appreciate music. By 1802, his condition was so severe total deafness was certain.

Ironically, it was the composer's decision in that year to move to the small Austrian town of Heiligenstadt, where he wrote an impassioned testament or public letter on his condition, that led to the subsequent extensive research into his illnesses and ultimately the causes of his death. Unusually for that era, Beethoven gave permission in his will for his remains to be handed over to medical research so that the causes of his debilitating illnesses might be established.

After Heiligenstadt, the 32-year-old Beethoven resolved thereafter to continue living for his art. However, by the time of his Ninth Symphony, his deafness was advanced. Eyewitness accounts of the premiere report that the composer had to be turned around on his chair to witness the tumultuous applause that followed the performance. Beethoven could hear nothing and wept tears of frustration.

His hearing loss did not affect his ability to compose music, but his role as a pianist, from which he gained much of his income, was increasingly handicapped. Even when composing, he used a rod attached to the soundboard of his piano which he could bite, enabling him to feel the vibrations of the notes he played and increase his perception of his own music.

By 1814, aged 44, Beethoven was totally deaf and forced to keep "conversation books" in which friends wrote down what they were saying to him. He often responded in writing. Today the composer's conversation books provide a vital insight into how he felt his music should be played.

As well as being deaf, Beeth-oven never married. His father objected to the only woman he was engaged to and his only other recorded love affair lasted for just two years. By the late 1820s, drinking heavily and after losing custody of his nephew Karl, he went into physical decline that eventually led to his death during a thunderstorm in Vienna in March 1827.

The composer had been spending October and November of 1826 in the small Austrian town of Gneixendorf. Records show that, at around this time, Beeth-oven had developed a liking for sweet Mosel wines. Research has shown that this could have also contributed to his illnesses: at the time vintners adopted the habit of "refining" their produce with a "sugar" containing lead particles that sweetened the taste of otherwise dry wines.

At the end of November he began his return to Vienna, travelling in an open, horse-drawn carriage in wet weather. He spent one night of his return journey soaking wet from a downpour, in an unheated room at an inn.

By early December 1827, he had pneumonia. A physician called Andreas Wawruch began treating him. His medical notes give details of an "anti-inflammatory" substance that was meted out to the composer to reduce his ailing lungs. Unfortunately, the substance had debilitating side effects.

Lying on a dirty straw mattress, Beethoven's stomach began to fill up with liquid that had apparently drained from his sickly lungs. The volume of fluid was so large it constricted his diaphragm to such an extent that he had severe breathing difficulties.

In order to relieve this condition, Wawruch was forced to pierce the bloated stomach with a lancet in order to drain off litres of fluid. Such methods were dangerous as they risked causing an infection of the patient's stomach which, without antibiotics and proper sterilisation, would have led to almost certain death.

Analysis of 19th century medicines shows that doctors used lead salts to treat lung infections as these were effective in reducing fluid build-up. In general, lead, mercury and arsenic functioned as the antibiotics of the time. Their side effects were considered the lesser evil. Yet for Beethoven, lead appears to have been the primary evil.

According to Mr Reiter's latest findings, the side effect of Wawruch's decision to give Beethoven lead salts was a critical overloading of the composer's cirrhosis-wracked liver which reacted by producing more fluid build-up. Wawruch responded by lancing the stomach to draw off the fluid and applied a lead-paste poultice to the wound – designed to ward off infection.

Mr Reiter's detailed laser analysis of the surviving hairs provided a daily diary of the last three months of life. Beethoven was given four abdominal punctures on his death bed which drained between 7.7 and 14 litres of fluid. Mr Reiter's hair analysis showed a clear correlation as the lead content in the composer's hair rose dramatically after each puncture.

"Dr Wawruch was acting to the best of his knowledge and with a clear conscience, according to the medical standards of the time," Mr Reiter said yesterday, "but as soon as the body began to reabsorb the lead from the poultices, terminal liver failure could no longer be prevented. The lead doses were not poisonous enough to kill a healthy person, but what Wawruch clearly did not know was that his treatment was attacking an already diseased liver."

Yet exactly what caused Beethoven to be poisoned with lead even before Wawruch's treatments has still to be finally established. Some attribute the cause to lead-"sugared" wine, others claim that as a young man the composer drank large amounts of lead-contaminated spa water. "We do not know the ultimate cause – but for years before his death Beethoven was a very sick man," Mr Reiter said.

Other medical mishaps

Thomas Chatterton (20 November 1752 to 24 August 1770)

The gifted young poet, called "the marvellous boy" by Wordsworth, was widely assumed to have committed suicide by taking arsenic because he was too proud to beg for money or food. However, recent research suggests the poison may have been administered to the 17-year-old Chatterton in an attempt cure a sexually transmitted disease.

Napoleon Bonaparte (15 August 1769 to 5 May 1821)

The exiled Emperor of France died on the island of Saint Helena, with the most widely accepted cause of his death being stomach cancer. However, US research suggests it may have been a treatment by doctors that killed him. Doses of the poisonous salt tartaric acid, also called antimony potassium tartrate, were administered to induce vomiting. However, these would have caused a severe potassium deficiency that might have led to him developing Torsades de pointes, a potentially fatal heart complaint that disrupts the blood flow to the brain.

Johann Sebastian Bach (21 March 1685 to 28 July 1750)

Bach's eyesight began to deteriorate in his later years, so he called on the services of ophthalmologist John Taylor. Taylor carried out two operations on Bach's eyes, both of which were unsuccessful and left the composer completely blind and with failing health. His death less than a year later is seen as a direct consequence of these botched operations.

James Garfield (19 November 1831 to 19 September 1881)

The 20th US President was shot twice by Charles Guiteau, a religious fanatic, but neither bullet which hit him caused his death. Alexander Graham Bell invented a metal detector specifically to locate a bullet lodged in Garfield's spine but it was rendered useless by the patient's metal bed frame. Surgeons instead tried to search for the bullet invasively, using dirty metal tools which poisoned the President's blood and killed him.

George Washington (22 February 1732 to 14 December 1799)

The first US President contracted a vicious sore throat and breathing problems after riding his horse in freezing weather. He died two days later. Modern doctors have diagnosed acute inflammation of the epiglottis. However, Washington's condition was almost certainly exacerbated by having 3.75 litres of blood – more than half his blood volume – taken by physicians in the space of ten hours.

Compiled by Jen Wainwright

[groover]

[Gentle Giant]

Theodoric Of York

Theodoric of York.....Steve Martin
William.....Dan Aykroyd
Broom Gilda.....Gilda Radner
Joan.....Jane Curtin
Hunchback.....John Belushi
Drunkard.....Bill Murray

Announcer: [ over scolling SUPER ] "In the Middle Ages, medicine was still in its infancy. The art of healing was conducted not by physicians, but by barbers. The medieval barbers were the forerunners of today's men of medicine, and many of the techniques they developed are still practiced today. This is the story of one such barber."

William: Hello, Theodoric of York. Well, it's springtime, and I've come for my haircut and bloodletting.

Theodoric of York: Hello, William, Son of Malcolm the Tanner. Have a seat. Broom Gilda, you start on William's hair, and I'll open a vein here.

Broom Gilda: Yes, Theodoric.

Theodoric of York: How's that baby I delivered last Christmas when your wife died?

William: Oh, the little fellow is deformed.

Theodoric of York: Oh, that's right. I remember now. [ cuts William's vein, as his blood spills into a bowl ]

William: Ahhh..

Announcer: And now, it's time for another episode of "Theodoric of York: Medieval Barber".

Theodoric of York: There you go. Looks like I have another patient. I'll be back in a minute to see how you're doing.

William: Right. Thank you.

[ Theodoric approaches Joan, who stands next to her daughter ]

Joan: Hello, Theodoric, Barber of York.

Theodoric of York: Hello, Joan, Wife of Simkin the Miller. Well, how's my little patient doing?

Joan: Not so well, I fear. We followed all your instructions - I mixed powder of staghorn, gum of arabic with sheep's urine, and applied it in a poultice to her face.

Theodoric of York: And did you bury her up to her neck in the marsh and leave her overnight?

Joan: Oh, yes. But she still feels as listless as ever, if not more.

Theodoric of York: Well, let's give her another bloodletting. Broom Gilda.

Broom Gilda: Yes, Theodoric.

Theodoric of York: Take two pints.

Broom Gilda: Yes, Theodoric.

Joan: Will she be alright?

Theodoric of York: Well, I'll do everything humanly possible. Unfortunately, we barbers aren't gods. You know, medicine is not an exact science, but we are learning all the time. Why, just fifty years ago, they thought a disease like your daughter's was caused by demonic possession or witchcraft. But nowadays we know that Isabelle is suffering from an imbalance of bodily humors, perhaps caused by a toad or a small dwarf living in her stomach.

Joan: Well, I'm glad she's in such good hands.

Hunchback: [ pulls Drunkard forward in a cart ] Is this Theodoric, Barber of York?

Theodoric of York: Say, don't I know you?

Hunchback: Sure, you worked on my back.

Theodoric of York: What's wrong with your friend here?

Hunchback: He broke his legs.

Drunkard: I was at the festival of the vernal equinox, and I guess I had a little too much mead.. and I darted out in front of an oxcart. It all happened so fast. They couldn't stop in time.

Theodoric of York: Well, you'll a lot better after a good bleeding.

Drunkard: But I'm bleeding already!

Theodoric of York: Say, whos the barber here?

Drunkard: Okay, okay, just do something for my legs.

Theodoric of York: Well, the three of us will get you up on the gibbet here. [ turns Drunkard upside-down, then spreads his legs apart ] Okay, now this is gonna hurt a little. What we're doing is separating your broken bones, and if you don't feel better tomorrow, we'll just cut his legs off about here.

Drunkard: Okay. I'm pretty sure I'm gonna feel better tomorrow!

Theodoric of York: I guess this will teach you to go easy on the mead. Broom Gilda put a few leeches on his forehead.

[ Broom Gilda complies ]

Drunkard: Thank you.

Theodoric of York: [ to William ] When was the last time you came in for a worming?

William: I guess I'm due.. but I don't have time today. Please accept my payment - this fine, fat goose. [ hands over goose ]

Theodoric of York: Thank you. Broom Gilda will give you your change. [ returns to Joan ] So, how's the little patient doing?
Joan: She's worse. She's looking pale.

Theodoric of York: Well, if she's not responding to treatment, I'm afriad we'll have to run some more tests. Broom Gilda, bring me the Caladrius Bird.

Joan: Caladrius Bird?

Theodoric of York: Yes. The Caladrius Bird is placed beside a patient. If the bird looks at a patient's face, she will live; but if it looks at her feet, she will die. Okay, now, Freddy, come on out. [ unleashes bird from cage, but it just flies off ] I don't know how to interpret that. Did you see Broom Gilda?

Broom Gilda: No.

Theodoric of York: Well, I guess, take another pint from Isabelle - and while you're at it, take two pints from the bird.

Broom Gilda: [ feels paitnet ] She's dead.

Joan: Dead! Dead! I can't believe it! My little daughter dead!

Theodoric of York: Now, Mrs. Miller, you're distraught, tired.. you may be suffering from nervous exhaustion. I think you'd feel better if I let some of your blood.

Joan: You charlatan! You killed my daughter, just like you killed most of my other children! Why don't you admit it! You don't know what you're doing!

Theodoric of York: [ steps toward the camera ] Wait a minute. Perhaps she's right. Perhaps I've been wrong to blindly folow the medical traditions and superstitions of past centuries. Maybe we barbers should test these assumptions analytically, through experimentation and a "scientific method". Maybe this scientific method could be extended to other fields of learning: the natural sciences, art, architecture, navigation. Perhaps I could lead the way to a new age, an age of rebirth, a Renaissance! [ thinks for a minute ] Naaaaaahhh!

Announcer: Tune in next week for another episode of "Theodoric of York: Medieval Barber", when you'll hear Theodoric say:

Theodoric of York: A little bloodletting and some boar's vomit, and he'll be fine!

[ pan to fade ]

[Monte Smith]

[Dr. Dooom]
Yeah, and you say! (1 Adam 12, all cars)
From the streets (assailant seen carrying two tec-9's)
This is what's goin on (and several semi-automatic machine guns)
(Everybody get extreme from backup)
The revolution will not be televised (I got some snipers)
(Bring on the whole..)

[Motion Man]
Aqua gill leg, shark bite, beach towel
Bay Area conquistador, negro reservation
Sniper tree trunk squirrel monkey agility
Ultimate Fight night, pay per view ability
Angel flight superhero, platform shoes
Stomp down, return smacks, sniffin afro hairy chest
Being, often seen, the Atlantic ocean, scared of motion
Bulletproof flips, I'm slappin 'em, you shoot your best shot
Roll the pearl, all world, lovin Oakland girls
Vinny Testaverde style, I'm tossin balls dirty
All form in swim, telepathic with amphibians
Avenue warlord, I'm at the public sellin fat sacks
Pockets on double, profit will triple
Keep my piece tucked, low-plated nickel
Bullets hit me they tickle, actual Terrordome
Tossed my hall door keeper
Italian, Columbian, Chinese black afro gangster
Authentic ball collector, Euro-Asian afrocentric
Bohemian being, third busted eye seeing
Nada on papi, boil latte in the chrome
My folks'll ride yo, down with Nicky, Custom Auto
Able access, dislocate my larynx
Change my vocal from millld to loco
Half African, wild lion cheetah spotted
Connect the dots, gazelle gallop, wolf kick

[Chorus 2X: Dr. Dooom] + (Motion Man)
Brothers from the housing authority!
(No heat and hot water, cold freezing every evening)
Brothers from the housing authority!
(Naked roaches and stank humans, unhygenial ruins)

[Dr. Dooom]
Rappin out warlord, Dr. Dooom, from the Bronx
Rappers get petrol, see me with the black afro
Project invader, squad lights in the elevator
Cross-Bronx Express, mack 11 bulletproof vest
One-seventy street with Tony Lou, loadin big heat
Victor Convelta DiSanchez, with Rosey Perez
One for the road, with goosedown sportin stick-up kiko
Dominican fly girls, with Bobby Jo, rockin escrows
Westside highway callin OJ cabs, doin it my way
People with masks robbin Brinks trucks out in Jersey
Nobody's nervous rockin freestyles, chocolate Hershey
Servin quarters up on the concourse, like James Worthy
Feathers with Stetson, my nickname, George Jetson
Right in the baby doll with treasure under Taft High School
RICO squealed, neck broke, in a twelve D pool
Usin the infrareds and waterbeds, chewin Big Red
Out of the strange Diamond District, missin big rings
We doin big things, I'm out of here like Vladamir
Devestation equation, information for the crack patient
Y'all will feel my abrasion

[Chorus]

[Dr. Dooom]
Back off probation, bailin Frank out from Rahway State
Suckers see Flintstone, smokin wheat with Mr. Slate
Action you pack up, in Ziplocks, you bring yo' bag up
Open the first one, rehearsal, I'm bound to hurt you
Bust out yo' briefcase, you and your wife start to freebase
Break our your mansion, I'm on the phone with Charlie Manson
With porno tapes, jerkin hard off to Kristy Canyon
You need to convert a witness, 20 different Bronx murders

[Motion Man]
Angles trap home arrest, hangin feet up out the window
I strike the National Guard, the helicopter light
Shaggy and Scooby, with Velma Daphne laughin at me
Mystery Machine sittin lowered with, trues and Vogues
Miami bass bump "Ghetto D," advocated
Spider-Man suction upside down, on the elevator
Porno star hold up, my stroke's worth too much
Just for a brush, I need ten grand, for the rush

[Chorus]