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贝多芬的死因——医疗事故的结果?

Beethoven's death-the result of medical malpractice?

机构信息

Center for Forensic Medicine, Medical University of Vienna Center for Forensic Medicine, Medical University of Vienna, Sensengasse 2, 1090, Vienna, Austria.

Chair of General and Analytical Chemistry, Montanuniversität Leoben, 8700, Leoben, Austria.

出版信息

Wien Med Wochenschr. 2021 Nov;171(15-16):356-362. doi: 10.1007/s10354-021-00833-x. Epub 2021 Mar 25.

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.

摘要

两根取自贝多芬去世后头部的不同头发,使用扫描电子显微镜(SEM)和激光烧蚀 ICP-MS(电感耦合等离子体质谱)检测重金属。结果表明,贝多芬头发表面存在少量铅颗粒,头发髓质沿头发长度的铅含量波动,这是由于交替的铅暴露所致,平均铅暴露水平是正常值的 100 倍。这些波动值峰值的时间线与肺炎治疗和穿刺术相关,包括后续的手术伤口处理。虽然含铅药物和治疗已被证明可以治愈肺炎,但同时也导致了大量的肝衰竭,而肝硬化加速了这一过程。关于贝多芬的死因是否属于医疗事故,只能从法医学角度进行事前判断,因为当时的医疗知识状况必须考虑在内。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f4b/8553724/a4dda77737cc/10354_2021_833_Fig1_HTML.jpg

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