At 7pm on May 7, 1824, Ludwig van Beethoven, then 53 years old, took to the stage at Vienna's magnificent Theater am Kärntnertor to help conduct the world premiere of his Ninth Symphony, the last he would ever complete.
That performance, which marks its 200th anniversary on Tuesday, was unforgettable in many ways. But it was marred by an incident at the start of the second movement that revealed to the audience of around 1,800 just how deaf the revered composer had become.
Ted Albrecht, professor emeritus of musicology at Kent State University in Ohio and author of a recent book on the Ninth Symphony, described the scene.
The movement began with loud kettledrums and the crowd applauded wildly.
But Beethoven was oblivious to the applause and his music. He stood with his back to the audience, beating time. At that moment, a soloist grabbed him by the sleeve and spun him around to see the raucous adulation he couldn't hear.
It was a further humiliation for a composer who had been mortified by his deafness since he began to lose his hearing in his twenties.
But why had he become deaf? And why was he tormented by incessant abdominal cramps, flatulence and diarrhea?
A cottage industry of enthusiasts and experts have debated various theories. Was it Paget's disease of bone, which in the skull can impair hearing? Did irritable bowel syndrome cause his gastrointestinal problems? Or could he have had syphilis, pancreatitis, diabetes, or renal papillary necrosis, a kidney disease?
After 200 years, the discovery of toxic substances in the composer's hair strands may finally solve the mystery.
This particular story began a few years ago, when researchers realized that DNA analysis was advanced enough to warrant an examination of hair said to have been cut from Beethoven's head by anguished fans as he lay dying.
William Meredith, founding director of the Ira F. Brilliant Center for Beethoven Studies at San Jose State University, began looking for locks at auctions and museums. He and his colleagues eventually ended up with five locks that, as confirmed by a DNA analysis, came from the composer's head.
Kevin Brown, an Australian businessman with a passion for Beethoven, owned three locks and wanted to honor Beethoven's request in 1802 that when he died doctors would try to understand why he had been so ill. Mr Brown sent two locks to a specialist laboratory at the Mayo Clinic which has the equipment and expertise to test for heavy metals.
The result, said Paul Jannetto, the laboratory's director, was surprising. One of Beethoven's strands contained 258 micrograms of lead per gram of hair and the other 380 micrograms.
A normal level in hair is less than 4 micrograms of lead per gram.
“It definitely shows that Beethoven was exposed to high concentrations of lead,” Dr. Jannetto said.
“These are the highest values in hair I have ever seen,” he added. “We receive samples from all over the world and these values are an order of magnitude higher.”
Beethoven's hair also had arsenic levels 13 times the normal amount and mercury levels 4 times the normal amount. But high amounts of lead, in particular, may have caused many of his ailments, Dr. Jannetto said.
The researchers, including Dr. Jannetto, Mr. Brown and Dr. Meredith, describe their findings in a letter published Monday in the journal Clinical Chemistry.
The analysis updates a report from last year, when the same team said Beethoven did not have lead poisoning. Now, thanks to extensive testing, they say he had enough lead in his system to explain, at the very least, his deafness and his illnesses.
David Eaton, a toxicologist and professor emeritus at the University of Washington who was not involved in the study, said Beethoven's gastrointestinal problems “are entirely consistent with lead poisoning.” As for Beethoven's deafness, he added, high doses of lead damage the nervous system and could destroy his hearing.
“It's hard to say whether the chronic dose was enough to kill him,” Dr. Eaton added.
No one suggests that the composer was deliberately poisoned. But Jerome Nriagu, an expert on lead poisoning in history and professor emeritus at the University of Michigan, said lead had been used in wines and foods in 19th-century Europe, as well as in medicines and ointments.
One likely source of Beethoven's high lead levels was cheap wine. Lead, in the form of lead acetate, also called “lead sugar,” has a sweet taste. In Beethoven's time it was often added to poor-quality wine to improve its flavor.
The wine was also fermented in kettles soldered with lead, which leached out as the wine aged, Dr. Nriagu said. And, he added, the wine bottle corks were pre-soaked in lead salt to improve their seal.
Beethoven drank copious amounts of wine, about a bottle a day, and later in his life even more, believing it was good for his health, and also, Dr. Meredith said, because he had become addicted to it. In the last days before his death at the age of 56 in 1827, his friends offered him wine by the spoonful.
His secretary and biographer, Anton Schindler, described the scene on his deathbed: “This mortal struggle was terrible to see, for his general constitution, especially his chest, was gigantic. He drank some more of your Rüdesheimer wine by the spoonful until he died.
As he lay on his deathbed, his publisher gave him 12 bottles of wine. At that point Beethoven knew he could never drink them. He whispered his last recorded words: “Mercy, mercy-too late!”
For a composer, deafness was perhaps the worst affliction.
At the age of 30, 26 years before his death, Beethoven wrote: “For almost 2 years I have stopped attending any social functions, only because I find it impossible to tell people: I am deaf. If I had another profession perhaps I would be able to cope with my infirmity, but in my profession it is a terrible handicap. And if my enemies, of whom I have a good number, found out, what would they say?
When he was 32, Beethoven cried that he could not hear a flute or a shepherd singing, which, he wrote, “brought me almost to despair. A little more and I would have committed suicide: only Art held me back. Ah, it seemed unthinkable to leave the world until I had brought to light everything I feel lies within me.
Over the years Beethoven consulted many doctors, tried one cure after another for his ailments and his deafness, but found no relief. At one point, he was using ointments and taking 75 medications, many of which most likely contained lead.
In 1823 he wrote to an acquaintance, also deaf, about his inability to hear, calling it a “grave misfortune” and observing: “doctors know little; eventually you get tired of them.
His Ninth Symphony was most likely a way to reconcile his pain with his art.
Since he was a teenager, Beethoven had been fascinated by a poem, “Ode to Joy”, by Friedrich Schiller.
He sets the poem to music in the Ninth, sung by soloists and a choir, considered the first example of singing in a symphony. It was the culmination of the symphony, depicting a search for joy.
The first movement is a representation of desperation, Beethoven wrote. The second movement, with its clanging timpani, is an attempt to break through the desperation. The third reveals a “tender” world in which despair is put aside, Beethoven writes. But putting aside desperation is not enough, he concluded. Instead “we need to look for something that calls us to life”.
The finale, the fourth movement, was that call. It was the Ode to Joy.
In the years that followed, Beethoven's Ninth deeply moved millions of people, even Helen Keller who “listened to it” by pressing her hand against a radio:
As I listened, with the darkness and the melody, the shadow and the sound filling the whole room, I could not help but remember that the great composer who poured such a flood of sweetness into the world was deaf like me. I marveled at the power of his unquenchable spirit with which from his pain he created so much joy for others – and there I sat, feeling with my hand the magnificent symphony that crashed like a sea on the silent shores of his soul and mine. .