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Rzymski P, Zarębska-Michaluk D, Flisiak R. Could chronic HBV infection explain Beethoven's hearing loss? Implications for patients currently living with hepatitis B. J Infect 2023; 87:171-176. [PMID: 37302659 DOI: 10.1016/j.jinf.2023.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 06/13/2023]
Abstract
The cause of Ludwig van Beethoven's health deterioration, i.e., hearing loss and cirrhosis, have been subject to various studies. The genomic analysis of his hair indicates infection with the hepatitis B virus (HBV) at least 6 months prior to death. However, considering his first documented case of jaundice in the summer of 1821, second jaundice months prior to his death, and increased risk of hearing loss in HBV-infected patients, we offer an alternative hypothesis of chronic HBV infection as a cause of deafness and cirrhosis. According to it, HBV was acquired early, progressed from immune-tolerant to an immune-reactive phase, and triggered Beethoven's hearing issues when aged 28. Later, HBV infection entered the non-replication phase with at least two episodes of reactivation in the fifth decade of life accompanied by jaundice. More studies examining hearing loss in patients with chronic HBV infection are encouraged to better understand their potential otologic needs.
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Affiliation(s)
- Piotr Rzymski
- Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznań, Poland.
| | - Dorota Zarębska-Michaluk
- Department of Infectious Diseases and Allergology, Jan Kochanowski University, 25-317 Kielce, Poland
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, 15-540 Białystok, Poland
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2
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Lee D, Meredith W, Lebwohl B. Alcohol and the death of Ludwig van Beethoven: comparison of general biographies to the medical literature. Wien Med Wochenschr 2023:10.1007/s10354-023-01010-y. [PMID: 37071302 DOI: 10.1007/s10354-023-01010-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/06/2023] [Indexed: 04/19/2023]
Abstract
Beethoven's autopsy findings of cirrhosis may have been due to alcoholism. This condition may have been underemphasized historically, given its stigma and the incongruence with the often heroic portrayal of Beethoven. We therefore aimed to compare how medical experts and biographers writing for a non-medical audience describe his final illness in the context of alcoholism. English-language biographies were identified using a survey of biographies of Beethoven and supplemented by the authors. English-language medical publications were identified by searching for "Beethoven" in the PubMed® MEDLINE database. We included studies that mentioned Beethoven's final illness and death. We recorded statements regarding alcohol consumption, alcoholism, or alcohol use disorder, and the role of alcohol in Beethoven's death. The most commonly cited final illness was liver disease. Alcohol use was more frequently mentioned in biographies, but alcoholism less so. Alcohol use was invoked as a possible cause of final illness more frequently by medical publications.
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Affiliation(s)
- Dongwon Lee
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.
| | | | - Benjamin Lebwohl
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
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3
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Begg TJA, Schmidt A, Kocher A, Larmuseau MHD, Runfeldt G, Maier PA, Wilson JD, Barquera R, Maj C, Szolek A, Sager M, Clayton S, Peltzer A, Hui R, Ronge J, Reiter E, Freund C, Burri M, Aron F, Tiliakou A, Osborn J, Behar DM, Boecker M, Brandt G, Cleynen I, Strassburg C, Prüfer K, Kühnert D, Meredith WR, Nöthen MM, Attenborough RD, Kivisild T, Krause J. Genomic analyses of hair from Ludwig van Beethoven. Curr Biol 2023; 33:1431-1447.e22. [PMID: 36958333 DOI: 10.1016/j.cub.2023.02.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 10/11/2022] [Accepted: 02/13/2023] [Indexed: 03/25/2023]
Abstract
Ludwig van Beethoven (1770-1827) remains among the most influential and popular classical music composers. Health problems significantly impacted his career as a composer and pianist, including progressive hearing loss, recurring gastrointestinal complaints, and liver disease. In 1802, Beethoven requested that following his death, his disease be described and made public. Medical biographers have since proposed numerous hypotheses, including many substantially heritable conditions. Here we attempt a genomic analysis of Beethoven in order to elucidate potential underlying genetic and infectious causes of his illnesses. We incorporated improvements in ancient DNA methods into existing protocols for ancient hair samples, enabling the sequencing of high-coverage genomes from small quantities of historical hair. We analyzed eight independently sourced locks of hair attributed to Beethoven, five of which originated from a single European male. We deemed these matching samples to be almost certainly authentic and sequenced Beethoven's genome to 24-fold genomic coverage. Although we could not identify a genetic explanation for Beethoven's hearing disorder or gastrointestinal problems, we found that Beethoven had a genetic predisposition for liver disease. Metagenomic analyses revealed furthermore that Beethoven had a hepatitis B infection during at least the months prior to his death. Together with the genetic predisposition and his broadly accepted alcohol consumption, these present plausible explanations for Beethoven's severe liver disease, which culminated in his death. Unexpectedly, an analysis of Y chromosomes sequenced from five living members of the Van Beethoven patrilineage revealed the occurrence of an extra-pair paternity event in Ludwig van Beethoven's patrilineal ancestry.
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Affiliation(s)
- Tristan James Alexander Begg
- Department of Archaeology, University of Cambridge, CB2 3ER Cambridge, UK; Institute for Archaeological Sciences, University of Tübingen, 72070 Tübingen, Germany; Max Planck Institute for the Science of Human History, Kahlaische Str. 10, 07745 Jena, Germany.
| | - Axel Schmidt
- Institute of Human Genetics, University Hospital of Bonn, Bonn 53127, Germany
| | - Arthur Kocher
- Max Planck Institute for Evolutionary Anthropology, Deutscher Platz 6, 04103 Leipzig, Germany; Transmission, Infection, Diversification and Evolution Group, Max Planck Institute for the Science of Human History, 07745 Jena, Germany; Max Planck Institute for the Science of Human History, Kahlaische Str. 10, 07745 Jena, Germany
| | - Maarten H D Larmuseau
- Department of Human Genetics, Katholieke Universiteit Leuven, 3000 Leuven, Belgium; Laboratory of Human Genetic Genealogy, Department of Human Genetics, Katholieke Universiteit Leuven, 3000 Leuven, Belgium; ARCHES - Antwerp Cultural Heritage Sciences, Faculty of Design Sciences, University of Antwerp, 2000 Antwerp, Belgium; Histories vzw, 9000 Gent, Belgium
| | | | | | - John D Wilson
- Austrian Academy of Sciences, 1030 Vienna, Austria; University of Vienna, 1010 Vienna, Austria
| | - Rodrigo Barquera
- Max Planck Institute for Evolutionary Anthropology, Deutscher Platz 6, 04103 Leipzig, Germany
| | - Carlo Maj
- Institute of Human Genetics, University Hospital of Bonn, Bonn 53127, Germany; Center for Human Genetics, University Hospital of Marburg, Marburg, Germany
| | - András Szolek
- Applied Bioinformatics, Department for Computer Science, University of Tübingen, Sand 14, 72076 Tübingen, Germany; Department of Immunology, Interfaculty Institute for Cell Biology, University of Tübingen, Tübingen, Germany
| | | | - Stephen Clayton
- Institute for Archaeological Sciences, University of Tübingen, 72070 Tübingen, Germany; Max Planck Institute for the Science of Human History, Kahlaische Str. 10, 07745 Jena, Germany
| | - Alexander Peltzer
- Quantitative Biology Center (QBiC) University of Tübingen, Tübingen, Germany
| | - Ruoyun Hui
- MacDonald Institute for Archaeological Research, University of Cambridge, Cambridge CB2 3ER, UK; Alan Turing Institute, 2QR, John Dodson House, London NW1 2DB, UK
| | | | - Ella Reiter
- Institute for Archaeological Sciences, University of Tübingen, 72070 Tübingen, Germany
| | - Cäcilia Freund
- Max Planck Institute for the Science of Human History, Kahlaische Str. 10, 07745 Jena, Germany
| | - Marta Burri
- Max Planck Institute for the Science of Human History, Kahlaische Str. 10, 07745 Jena, Germany
| | - Franziska Aron
- Max Planck Institute for the Science of Human History, Kahlaische Str. 10, 07745 Jena, Germany
| | - Anthi Tiliakou
- Max Planck Institute for Evolutionary Anthropology, Deutscher Platz 6, 04103 Leipzig, Germany; Max Planck Institute for the Science of Human History, Kahlaische Str. 10, 07745 Jena, Germany
| | - Joanna Osborn
- Department of Archaeology, University of Cambridge, CB2 3ER Cambridge, UK
| | - Doron M Behar
- Estonian Biocentre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | | | - Guido Brandt
- Max Planck Institute for the Science of Human History, Kahlaische Str. 10, 07745 Jena, Germany
| | - Isabelle Cleynen
- Department of Human Genetics, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - Christian Strassburg
- Department of Internal Medicine I, University Hospital Bonn, 53127 Bonn, Germany
| | - Kay Prüfer
- Max Planck Institute for Evolutionary Anthropology, Deutscher Platz 6, 04103 Leipzig, Germany
| | - Denise Kühnert
- Transmission, Infection, Diversification and Evolution Group, Max Planck Institute for the Science of Human History, 07745 Jena, Germany; European Virus Bioinformatics Center (EVBC), Jena, Germany; Max Planck Institute for the Science of Human History, Kahlaische Str. 10, 07745 Jena, Germany
| | - William Rhea Meredith
- American Beethoven Society, San Jose State University, San Jose, CA 95192, USA; Ira F. Brilliant Center for Beethoven Studies, San Jose State University, San Jose, CA 95192, USA; School of Music and Dance, San Jose State University, San Jose, CA 95192, USA
| | - Markus M Nöthen
- Institute of Human Genetics, University Hospital of Bonn, Bonn 53127, Germany
| | - Robert David Attenborough
- MacDonald Institute for Archaeological Research, University of Cambridge, Cambridge CB2 3ER, UK; School of Archaeology & Anthropology, Australian National University, Canberra, ACT 0200, Australia
| | - Toomas Kivisild
- Department of Archaeology, University of Cambridge, CB2 3ER Cambridge, UK; Department of Human Genetics, Katholieke Universiteit Leuven, 3000 Leuven, Belgium; Estonian Biocentre, Institute of Genomics, University of Tartu, Tartu 51010, Estonia.
| | - Johannes Krause
- Institute for Archaeological Sciences, University of Tübingen, 72070 Tübingen, Germany; Max Planck Institute for Evolutionary Anthropology, Deutscher Platz 6, 04103 Leipzig, Germany; Max Planck Institute for the Science of Human History, Kahlaische Str. 10, 07745 Jena, Germany.
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Allen P. Beethoven's triad: Diarrhoea, deafness and cirrhosis. A plausible solution to the 195-year-old controversy. Ann Diagn Pathol 2022; 58:151904. [DOI: 10.1016/j.anndiagpath.2022.151904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 01/21/2022] [Indexed: 11/01/2022]
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5
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For each hypothesis on the aetiology of Beethoven's hearing disorder, there remain pro's and con's. Eur Arch Otorhinolaryngol 2021; 278:5111-5112. [PMID: 34623499 DOI: 10.1007/s00405-021-07029-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/01/2021] [Indexed: 10/20/2022]
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Spence C, Carvalho FM, Howes D. Metallic: A Bivalent Ambimodal Material Property? Iperception 2021; 12:20416695211037710. [PMID: 34540193 PMCID: PMC8447111 DOI: 10.1177/20416695211037710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/19/2021] [Indexed: 12/01/2022] Open
Abstract
Many metallic visual stimuli, especially the so-called precious metals, have long had a rich symbolic meaning for humans. Intriguingly, however, while metallic is used to describe sensations associated with pretty much every sensory modality, the descriptor is normally positively valenced in the case of vision while typically being negatively valenced in the case of those metallic sensations that are elicited by the stimulation of the chemical senses. In fact, outside the visual modality, metallic would often appear to be used to describe those sensations that are unfamiliar and unpleasant as much as to refer to any identifiable perceptual quality (or attribute). In this review, we assess those sensory stimuli that people choose to refer to as metallic, summarising the multiple, often symbolic, meanings of (especially precious) metals. The evidence of positively valenced sensation transference from metallic serviceware (e.g., plates, cups, and cutlery) to the food and drink with which it comes into contact is also reviewed.
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Affiliation(s)
- Charles Spence
- Centre for Sensory Studies, Concordia
University, Montreal, Quebec, Canada
| | | | - David Howes
- Centre for Sensory Studies, Concordia
University, Montreal, Quebec, Canada
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Thomas JP, Dazert S, Prescher A, Voelter C. Aetiology of Ludwig van Beethoven's hearing impairment: hypotheses over the past 100 years - A systematic review. Eur Arch Otorhinolaryngol 2021; 278:2703-2712. [PMID: 33230590 PMCID: PMC8266716 DOI: 10.1007/s00405-020-06467-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 10/28/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Even 250 years after Beethoven's birth, the irrevocable cause of his hearing impairment remains unclear despite multiple publications by different professional groups. This study aimed to analyse the development of the most likely aetiologies during the last 100 years by a systematic review of the relevant medical literature. METHODS A systematic review of medical literature in PubMed®, PubMed Central®, and Web of Science® for the period 1920-2020 was conducted. Medical publications between 1920 and 1935 were additionally searched manually by review of reference lists. Studies were eligible when a statement regarding the most likely aetiology of the hearing loss of Beethoven was the aimed objective of the publication. RESULTS 48 publications were included. The following aetiologies were supposed: otosclerosis (n = 10), syphilis (n = 9), Paget's disease (n = 6), neural deafness (n = 5), immunopathy with inflammatory bowel disease, neural deafness with otosclerosis, sarcoidosis or lead intoxication (n = 2), and systemic lupus erythematosus, trauma, labyrinthitis or inner ear disease (n = 1). There is an ongoing effort with a mean publication frequency in this topic of 0.48/year. From 1920 to 1970, otolaryngologists were the group with the highest interest in this field (67%), whereas since 1971 most authors have belonged to non-otolaryngologic subspecialities (81%). CONCLUSION Over the past 100 years, otosclerosis and syphilis were predominantly supposed to be the underlying causes. The hypothesis of syphilis-although rejected for a long time-has had a remarkable revival during the past 20 years. Regarding the outcome following therapeutic intervention by cochlear implantation, the differential diagnosis of neural deafness would be relevant today.
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Affiliation(s)
- Jan Peter Thomas
- Department of Otorhinolaryngology, Head and Neck Surgery, Katholisches Klinikum, Ruhr University Bochum, Bleichstr. 15, 44787, Bochum, Germany.
- Department of Otorhinolaryngology, Head and Neck Surgery, St.-Johannes-Hospital, Academic Teaching Hospital of the University of Münster, Johannesstr. 9-17, 44137, Dortmund, Germany.
| | - Stefan Dazert
- Department of Otorhinolaryngology, Head and Neck Surgery, Katholisches Klinikum, Ruhr University Bochum, Bleichstr. 15, 44787, Bochum, Germany
| | - Andreas Prescher
- Institute of Molecular and Cellular Anatomy, RWTH Aachen University, Wendlingweg 2, 52057, Aachen, Germany
| | - Christiane Voelter
- Department of Otorhinolaryngology, Head and Neck Surgery, Katholisches Klinikum, Ruhr University Bochum, Bleichstr. 15, 44787, Bochum, Germany
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8
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Does lead take the lead as the best explanation for Beethoven deafness? Eur Arch Otorhinolaryngol 2021; 278:5109-5110. [PMID: 34287713 DOI: 10.1007/s00405-021-07006-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
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Abstract
Two different strands of hair taken from Beethoven’s head after his death were examined for heavy metals using scanning electron microscopy (SEM) and laser ablation-ICP-MS (inductively coupled plasma–mass spectroscopy). The results revealed the presence of small lead particles on the surface of Beethoven’s hairs and fluctuating lead levels in hair medulla along the length of the hair due to alternating lead exposure, with an average lead exposure of 100 times the normal value. The time-line attached to the peaks of these fluctuating values correlate with the pneumonia treatment and the paracenteses performed, including the subsequent treatment of the procedure wounds. While the administration of lead-containing drugs and treatments had been proven to resolve the pneumonia, it had simultaneously caused massive liver failure, accelerated by pre-existing cirrhosis. The question as to whether Beethoven’s death was a case of malpractice can only be answered from a forensic point of view ex ante, since the state of the medical knowledge of the time has to be taken into account.
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Brotto D, Fellin R, Sorrentino F, Gheller F, Trevisi P, Bovo R. In Response to In Reference to A modern Case Sheds Light on a Classical Enigma: Beethoven's Deafness. Laryngoscope 2021; 131:E2045. [PMID: 33645735 DOI: 10.1002/lary.29469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Davide Brotto
- Otorhinolaryngology Section, Neurosciences Department, Università degli Studi di Padova, Padua, Italy
| | - Renato Fellin
- Internal Medicine, University of Ferrara, Ferrara, Italy
| | - Flavia Sorrentino
- Otorhinolaryngology Section, Neurosciences Department, Università degli Studi di Padova, Padua, Italy
| | - Flavia Gheller
- Otorhinolaryngology Section, Neurosciences Department, Università degli Studi di Padova, Padua, Italy
| | - Patrizia Trevisi
- Otorhinolaryngology Section, Neurosciences Department, Università degli Studi di Padova, Padua, Italy
| | - Roberto Bovo
- Otorhinolaryngology Section, Neurosciences Department, Università degli Studi di Padova, Padua, Italy
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11
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Stevens MH, Jorgensen T, Crofts AK. In Reference to Beethoven's Deafness. Laryngoscope 2021; 131:E2696. [PMID: 33635565 DOI: 10.1002/lary.29493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 02/09/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Michael H Stevens
- Division of Otolaryngology, University of Utah School of Medicine, Salt Lake City, Utah, U.S.A
| | - Teemarie Jorgensen
- Division of Otolaryngology, University of Utah School of Medicine, Salt Lake City, Utah, U.S.A
| | - Alicia Kay Crofts
- Division of Otolaryngology, University of Utah School of Medicine, Salt Lake City, Utah, U.S.A
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12
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Brotto D, Sorrentino F, Gheller F, Trevisi P, Bovo R, Fellin R. In Response to Beethoven's deafness. Laryngoscope 2021; 131:E2697. [PMID: 33635547 DOI: 10.1002/lary.29492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 02/18/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Davide Brotto
- Otorhinolaryngology Section, Neurosciences Department, Università degli Studi di Padova, Padova, Italy
| | - Flavia Sorrentino
- Otorhinolaryngology Section, Neurosciences Department, Università degli Studi di Padova, Padova, Italy
| | - Flavia Gheller
- Otorhinolaryngology Section, Neurosciences Department, Università degli Studi di Padova, Padova, Italy
| | - Patrizia Trevisi
- Otorhinolaryngology Section, Neurosciences Department, Università degli Studi di Padova, Padova, Italy
| | - Roberto Bovo
- Otorhinolaryngology Section, Neurosciences Department, Università degli Studi di Padova, Padova, Italy
| | - Renato Fellin
- Internal Medicine, University of Ferrara, Ferrara, Italy
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13
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Pirkwieser P, Behrens M, Somoza V. Metallic Sensation-Just an Off-Flavor or a Biologically Relevant Sensing Pathway? JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2021; 69:1775-1780. [PMID: 33373224 DOI: 10.1021/acs.jafc.0c06463] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Metallic off-flavors are a frequent theme in discussions of food product quality, with publications dating back over 90 years. The causes of this unpleasant perception are diverse, ranging from unfavorable concentrations of micronutrients, the use of artificial sweeteners, processing, packaging, and storage, to side effects of pharmaceutical or chemotherapeutic agents. However, the mechanisms behind metallic sensing and its contributions to taste, smell, and trigeminal nerve sensations are still poorly understood. Although even defining oral/nasal metallic sensation has proven difficult, thought should also be given to possible biological activities of food constituents eliciting a metallic sensation though activation of ectopically expressed chemoreceptors. This perspective seeks to summarize and connect research conducted on different food-borne stimuli of metallic sensation, their sensory evaluations up to more recent contributions addressing the mechanistic approaches to identify chemosensory-active food constituents, and their biological effects mediated by ectopically expressed chemosensory receptors. With this perspective, we hope to spark interest in fully characterizing the mostly unwanted metal off-flavor, thereby laying grounds for increased product quality on one hand and providing novel insights into chemosensory-associated biological functions of metallic sensation on the other hand, which might help to understand and combat these sensations experienced in various diseases and therapies, e.g., platinum-based chemotherapy.
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Affiliation(s)
- Philip Pirkwieser
- Leibniz-Institute for Food Systems Biology at the Technical University of Munich, 85354 Freising, Germany
| | - Maik Behrens
- Leibniz-Institute for Food Systems Biology at the Technical University of Munich, 85354 Freising, Germany
| | - Veronika Somoza
- Leibniz-Institute for Food Systems Biology at the Technical University of Munich, 85354 Freising, Germany
- Nutritional Systems Biology, Technical University of Munich, 85354 Freising, Germany
- Department of Physiological Chemistry, Faculty of Chemistry, University of Vienna, 1090 Vienna, Austria
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14
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Brotto D, Fellin R, Sorrentino F, Gheller F, Trevisi P, Bovo R. A Modern Case Sheds Light on a Classical Enigma: Beethoven's Deafness. Laryngoscope 2021; 131:179-185. [PMID: 31904878 DOI: 10.1002/lary.28464] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 11/22/2019] [Indexed: 11/06/2022]
Abstract
Two hundred and fifty years have passed since the birth of Ludwig van Beethoven, and the enigma about his hearing loss and overall health status seems to be not completely solved. However, the admission to the hospital of a 64-year-old woman in 2018 with symptoms extremely similar to those experienced by the great composer may add further evidence to a theory previously underestimated. The health issues of the modern patient were found to be due to chronic lead intoxication. The lead was released during daily cooking using a ceramic-coated frying pan with worn surface that poisoned her breakfast most probably for years. Abdominal pain, asthenia, and hearing loss affecting the high frequencies with a many impact on speech intelligibility tormented the patient, as they had Beethoven. An extensive review of the music and medical literature was performed, as well as re-examination of manuscripts, correspondence, and autopsy reports of the famous composer; and great similarities have been found. The soundness of the most-cited classical theories about Beethoven's hearing loss will be discussed. After close scrutiny of the theories, our analysis points toward a progressive sensorineural hearing loss due to lead intoxication as the most probable cause of not only Beethoven's hypoacusis but his overall health status as well. Laryngoscope, 131:179-185, 2021.
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Affiliation(s)
- Davide Brotto
- ENT Unit, Neurosciences Department, University of Padua, Padova, Italy
| | - Renato Fellin
- Department of Internal Medicine, University of Ferrara, Ferrara, Italy
| | - Flavia Sorrentino
- ENT Unit, Neurosciences Department, University of Padua, Padova, Italy
| | - Flavia Gheller
- ENT Unit, Neurosciences Department, University of Padua, Padova, Italy
| | - Patrizia Trevisi
- ENT Unit, Neurosciences Department, University of Padua, Padova, Italy
| | - Roberto Bovo
- ENT Unit, Neurosciences Department, University of Padua, Padova, Italy
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15
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Gaman L, Delia CE, Luzardo OP, Zumbado M, Badea M, Stoian I, Gilca M, Boada LD, Henríquez-Hernández LA. Serum concentration of toxic metals and rare earth elements in children and adolescent. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2020; 30:696-712. [PMID: 31184504 DOI: 10.1080/09603123.2019.1626353] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 05/26/2019] [Indexed: 06/09/2023]
Abstract
Biomonitoring studies are important for quantifying the body burden of pollutants and their possible effects on health. Serum concentration of 42 elements was assessed by ICP-MS in 89 children (7.2 ± 3.4 years old) from Bucharest (Romania). Levels of pollutants were compared with the clinical data obtained from routine blood tests. Clinical parameters were in the physiological range. Deficiencies of manganese, selenium, and zinc were discovered. Blood levels of elements were low. The highest levels were observed among children younger than six years. The sum of iron, selenium, barium, nickel, antimony, and cerium was positively associated with hemoglobin (Spearman rho = 0.217, P-value = 0.041), while the sum of copper, thallium, niobium, and tantalum was negatively associated (Spearman rho = -0.228, P-value = 0.032). Given the inherent sensitivity of the child population, additional studies are needed to assess the effects of these elements on their health.
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Affiliation(s)
- Laura Gaman
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila , Bucharest, Romania
| | - Corina Elena Delia
- Department of Fundamental, Prophylactic and Clinical Disciplines, Alfred Rusescu Institute for Mother and Child Care , Bucharest, Romania
| | - Octavio P Luzardo
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria , Las Palmas de Gran Canaria, Spain
| | - Manuel Zumbado
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria , Las Palmas de Gran Canaria, Spain
| | - Mihaela Badea
- Faculty of Medicine, Transilvania University of Brasov , Brasov, Romania
| | - Irina Stoian
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila , Bucharest, Romania
| | - Marilena Gilca
- Faculty of Medicine, University of Medicine and Pharmacy Carol Davila , Bucharest, Romania
| | - Luis D Boada
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria , Las Palmas de Gran Canaria, Spain
| | - Luis Alberto Henríquez-Hernández
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Department of Clinical Sciences, Universidad de Las Palmas de Gran Canaria , Las Palmas de Gran Canaria, Spain
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Kauffman-Ortega E, Valdovinos-Díaz M. In memoriam Ludwig van Beethoven. Historia clínica y posibles diagnósticos del genio de la composición musical en el silencio. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2020; 85:375-378. [PMID: 32826115 PMCID: PMC7434410 DOI: 10.1016/j.rgmx.2020.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 07/14/2020] [Indexed: 11/25/2022]
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Abstract
: To celebrate the 250th anniversary of the birth of the great classical composer, Ludwig van Beethoven (1770-1827), we point out how his hearing loss affected him and how the primitive hearing aids at that time helped mitigate his hearing loss. From the age of 26, Beethoven began to suffer from a fluctuating, progressive hearing loss ("my hearing grew worse and worse"), This started in his left ear ("in my left ear, with which this illness of my ears had started"), where he had difficulty hearing higher pitched tones ("I don't hear the high notes of the instruments and voices") and words ("Sometimes, I cannot hear people who speak quietly, I can hear the sounds, but not the words") and associated with tinnitus ("my ears, they still keep buzzing and humming day and night") and loudness recruitment ("if someone yells, it is unbearable to me").However, in spite of his hearing loss, Beethoven never lost his love for music and continued composing music, at times using some of the acoustic hearing aids that were just being developed. We analyze and describe the ear trumpets, and the resonant plate that engineer Johan Nepomuk Maelzel and piano-maker Conrad Graf, respectively, constructed to try to improve Beethoven's hearing. Moreover, we discuss the possible use of a wooden drumstick Beethoven might have used to improve his perception of the piano's sound.
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Ma Y, Sikdar D, He Q, Kho D, Kucernak AR, Kornyshev AA, Edel JB. Self-assembling two-dimensional nanophotonic arrays for reflectivity-based sensing. Chem Sci 2020; 11:9563-9570. [PMID: 34094221 PMCID: PMC8161679 DOI: 10.1039/d0sc02877k] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
We propose a nanoplasmonic platform that can be used for sensing trace levels of heavy metals in solutions via simple optical reflectivity measurements. The considered example is a lead sensor, which relies on the lead-mediated assembly of glutathione-functionalized gold nanoparticles (NPs) at a self-healing water/DCE liquid | liquid interface (LLI). Capillary forces tend to trap each NP at the LLI while the negatively charged ligands prevent the NPs settling too close to each other. In the presence of lead, due to chelation between the lead ion and glutathione ligand, the NPs assemble into a dense quasi-2D interfacial array. Such a dense assembly of plasmonic NPs can generate a remarkable broad-band reflectance signal, which is absent when NPs are adsorbed at the interface far apart from each other. The condensing effect of the LLI and the plasmonic coupling effect among the NP array gives rise to a dramatic enhancement of the reflectivity signals. Importantly, we show that our theory of the optical reflectivity from such an array of NPs works in perfect harmony with the physics and chemistry of the system with the key parameter being the interparticle distance at the interface. As a lead sensor, the system is fast, stable, and can achieve detection limits down to 14 ppb. Future alternative recognizing ligands can be used to build sister platforms for detecting other heavy metals. We propose a nanoplasmonic platform that can be used for sensing trace levels of heavy metals in solutions via simple optical reflectivity measurements at the liquid–liquid interface.![]()
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Affiliation(s)
- Ye Ma
- Department of Chemistry, Imperial College London, Molecular Science Research Hub, White City Campus 80 Wood Lane W12 0BZ UK .,School of Materials Science and Engineering, Ocean University of China Qingdao 266100 China
| | - Debabrata Sikdar
- Department of Chemistry, Imperial College London, Molecular Science Research Hub, White City Campus 80 Wood Lane W12 0BZ UK .,Department of Electronics and Electrical Engineering, Indian Institute of Technology Guwahati Guwahati-781039 India
| | - Qian He
- Key Lab of Marine Chemistry Theory & Technology, Ministry Education, Ocean University of China Qingdao 266100 China
| | - Daniel Kho
- Department of Chemistry, Imperial College London, Molecular Science Research Hub, White City Campus 80 Wood Lane W12 0BZ UK
| | - Anthony R Kucernak
- Department of Chemistry, Imperial College London, Molecular Science Research Hub, White City Campus 80 Wood Lane W12 0BZ UK
| | - Alexei A Kornyshev
- Department of Chemistry, Imperial College London, Molecular Science Research Hub, White City Campus 80 Wood Lane W12 0BZ UK
| | - Joshua B Edel
- Department of Chemistry, Imperial College London, Molecular Science Research Hub, White City Campus 80 Wood Lane W12 0BZ UK
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Fellin R, Richert J. "Haven't I always been a sickly person?" Controversies about L. van Beethoven's illnesses. Eur J Intern Med 2020; 78:147-148. [PMID: 32279978 DOI: 10.1016/j.ejim.2020.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 04/01/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Renato Fellin
- University of Ferrara, Corso Vittorio Emanuele II n°19, Padova, 35123, Italy.
| | - Jürgen Richert
- Hugo-Junkers-Strasse 15, Munich, Grünwald, D-82031, Germany.
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Oiseth SJ. Beethoven's autopsy revisited: A pathologist sounds a final note. JOURNAL OF MEDICAL BIOGRAPHY 2017; 25:139-147. [PMID: 26508624 DOI: 10.1177/0967772015575883] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This review of the original autopsy report of Beethoven's remains indicates Paget's disease within the skull, which was dense and twice normal thickness, with dilated vessels at the petrous bone. The facial nerves were enlarged and the eighth nerves atrophied despite their sharing a common meatus at the internal auditory canal. Nephrolithiasis and pyelonephritis with cortical and perinephric abscesses were also reported. The hypercalcaemia was probably caused by hyperparathyroidism, which may be associated with Paget's disease, and both may have played a role in his psychiatric symptoms as well as in his abdominal pain and gastrointestinal complaints. Since Paget's disease may also be associated with gout, some of the joint pains could be attributable to this as well. Hypovitaminosis A from chronic pancreatitis is suggested as a cause of painful eyes and either quinine abuse or severe hypercalcaemia as a cause of arrhythmias. Beethoven died of terminal cirrhosis with chronic pancreatitis, most likely related to chronic excessive intake of alcohol. Thus, Paget's disease, complicated by hyperparathyroidism, gout, and attempts to find relief of symptoms through the use of alcohol, quinine, and possibly salicylates can explain virtually all of Beethoven's medical problems, some of which appear to have influenced his musical compositions.
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21
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Castellanos MJ, Fuente A. The Adverse Effects of Heavy Metals with and without Noise Exposure on the Human Peripheral and Central Auditory System: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E1223. [PMID: 27941700 PMCID: PMC5201364 DOI: 10.3390/ijerph13121223] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 11/22/2016] [Accepted: 12/07/2016] [Indexed: 11/16/2022]
Abstract
Exposure to some chemicals in the workplace can lead to occupational chemical-induced hearing loss. Attention has mainly focused on the adverse auditory effects of solvents. However, other chemicals such as heavy metals have been also identified as ototoxic agents. The aim of this work was to review the current scientific knowledge about the adverse auditory effects of heavy metal exposure with and without co-exposure to noise in humans. PubMed and Medline were accessed to find suitable articles. A total of 49 articles met the inclusion criteria. Results from the review showed that no evidence about the ototoxic effects in humans of manganese is available. Contradictory results have been found for arsenic, lead and mercury as well as for the possible interaction between heavy metals and noise. All studies found in this review have found that exposure to cadmium and mixtures of heavy metals induce auditory dysfunction. Most of the studies investigating the adverse auditory effects of heavy metals in humans have investigated human populations exposed to lead. Some of these studies suggest peripheral and central auditory dysfunction induced by lead exposure. It is concluded that further evidence from human studies about the adverse auditory effects of heavy metal exposure is still required. Despite this issue, audiologists and other hearing health care professionals should be aware of the possible auditory effects of heavy metals.
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Affiliation(s)
- Marie-Josée Castellanos
- École D'orthophonie et D'audiologie, Faculté de Médecine, Université de Montréal, Montreal, QC H3C 3J7, Canada.
| | - Adrian Fuente
- École D'orthophonie et D'audiologie, Faculté de Médecine, Université de Montréal, Montreal, QC H3C 3J7, Canada.
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22
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Cooper AZ, Nair SS, Tremaglio JM. Diagnosing Beethoven: A New Take on an Old Patient. Am J Med 2016; 129:126-7. [PMID: 26291909 DOI: 10.1016/j.amjmed.2015.07.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 07/28/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Avraham Z Cooper
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Mass
| | - Sunil S Nair
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Mass
| | - Joseph M Tremaglio
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Mass
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23
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Abstract
BACKGROUND Age-related hearing loss is remarkably common, affecting more than 60% of adults over the age of 75. Moreover, hearing loss has detrimental effects on quality of life and communication, outcomes that are central to palliative care. Despite its high prevalence, there is remarkably little written on the impact of hearing loss in the palliative care literature. OBJECTIVE The objective was to emphasize its importance and the need for further study. We use a case as a springboard for discussing what is known and unknown about the epidemiology, presentation, screening methodologies, and treatment strategies for age-related hearing loss in palliative care. DISCUSSION The case describes a 65-year-old man with acute myelogenous leukemia (AML) that has progressed despite treatment. No concerns are raised about communication challenges during conversations between the palliative care team and the patient in his quiet room. However, in the midst of a family meeting, shortly after discussing prognosis, the patient reports that he cannot hear what anyone is saying. CONCLUSION We describe simple methods of screening patients for hearing loss, and suggest that practical approaches should be used universally in patient encounters. These include facing the patient, pitching one's voice low, using a pocket talker, and creating a hearing-friendly environment when planning a family or group meeting.
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Affiliation(s)
- Alexander K Smith
- 1Division of Geriatrics, University of California San Francisco, San Francisco, California.,2Geriatrics, Palliative, and Extended Care, Veterans Affairs Medical Center, San Francisco, California
| | - Nelia Jain
- 1Division of Geriatrics, University of California San Francisco, San Francisco, California.,2Geriatrics, Palliative, and Extended Care, Veterans Affairs Medical Center, San Francisco, California
| | - Margaret L Wallhagen
- 3Department of Physiological Nursing, University of California San Francisco, San Francisco, California
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