Music and Medicine
Title: Music and Medicine, Volume 1
Author: Dr Anton Neumayr, translated by Bruce Cooper Clarke
Publisher: Medi-Ed Press, Bloomington, Illinois
Other Details: ISBN 0-936741-05-8, 448pp, illustrated
Date Published: 1994
Introduction
This fascinating book is the English translation of a work originally published in Austria in the German language as 'Musik und Medizin, Am Beispiel der Wiener Klassik'. Three volumes have been published in German, and this is the first to appear in English. The second English translation (on Hummel, Weber, Mendelssohn, Schumann, Brahms and Bruckner) is now also published, (see below). The 3rd volume in the series, on Chopin, Smetana, Tchaikovsky and Mahler will be published later in 1996. Dr Neumayr has also published a similar book "Dictators in the Mirror of Medicine" on Napoleon, Hitler and Stalin, and on a recent trip to Vienna, I spotted a similar book by him on famous painters.
The author, Dr. Anton Neumayr is a renowned Viennese doctor of internal medicine, who is also a first class musician, a graduate of the Salzburg Conservatory of Music, no less. He has devoted the last 25 years or so to the study of medical-historical aspects of the diseases and deaths of famous composers. He presented the results of these studies in a series of lectures, and this series is the published version of this research.
It's hard to see how this book could fail. The concept of medical musical biographies is sufficiently unusual and interesting to attract readers. When the biography is about 4 of the greatest composers ever to have lived, it makes it more compelling. But when there is human intrigue about them all, from syphilis to liver cirrhosis and poisoning to grave robbing, you can imagine the publisher rubbing his hands together in glee. The good news, though, is that there is no sensationalism. The book is a well written, serious commentary, written for the intelligent reader with some interest in medicine, but no real knowledge.
The book is comfortably over 400 pages, with indices, bibliographies and appendixes, a scattering of illustrations and one or two gruesome pictures. There is an introductory chapter (more below) and then the 4 major sections on the composers. There are 2 longer sections of around 125 pages on Mozart and Beethoven, and 2 shorter sections half that size on Haydn and Schubert. The composer sections are of a consistent format: a short biography with a major focus on documented illnesses, a medical review of some of those illnesses (often discussing and dismissing various theories that have been put forward), and then very brief biographies on the composer's doctors.
The introductory chapter 'Music and Medicine: Reflections on the Historical Relationship' gives a few fascinating insights to the links historically thought to exist between music and medicine. Many of these seem laughable now. For example, Roger Bacon in the 13th century called attention to the "delay of aging's symptoms" through music, and demanded that all doctors have a thorough knowledge of music.
I have but a superficial knowledge of the lives of the Haydn, Mozart and Beethoven, but I can certainly comment on their sections as a reasonably informed and interested spectator! The Schubert section will be reviewed in more detail.
Joseph Haydn (1732-1809)
This is one of the smaller biographical sections, amounting to 65 pages or so. There is relatively little biographical (or medical) detail of his early life (just 7 or 8 pages up to the point when he first made contact with the Esterhazy's). There is no documentation of his having had smallpox, but several mentions of the pockmarks left all over his face. There are mentions of a couple of other medical problems (including operations on a nasal polyp) in the 30 or so years in the middle of the swamp in Schloss Esterháza, and the trips to England are covered in a little more detail, but the bulk of the medical interest and biographical detail comes after he reached old age.
There is mention of his dwindling creative powers whilst writing The Seasons, his frailty at its first performances, and his unfulfilled hopes for improvements in his health. In his old age, he became very forgetful, this is explained in detailed medical terms.
The final section explains that the poor attendance at his funeral was not due to any lack of respect, but because of the regulations of the French occupying forces. We then get details of the disgraceful grave robbing, by robbers who cut the head from the corpse, and hid it for many years. This came to light in 1820, when the body was exhumed to be transferred to Eisenstadt. The skull, via a roundabout route, was eventually presented to the Gesellschaft der Musikfreunde, and remained there until it was eventually reunited with the rest of his body in 1954!
Wolfgang Amadé Mozart (1756-1791)
The immediate thing that hits you about this section (the largest at 129 pages), is the author's insistence on using the middle name of Amadé rather than the usual Amadeus. I've not seen this before, but there is some reasonably convincing evidence, including a number of illustrations of documents to support it. Nevertheless, right or wrong, it irritated me!
Lots of detail is given of the various illnesses (including tonsillitis, catarrh, erythema nodosum, rheumatoid arthritis, typhoid fever and finally smallpox) that Mozart had in his childhood, particularly during his travels on concert tours. There is plenty of evidence of these from Leopold Mozart's travel diary and letters. Wolfgang does seem to have contracted a lot of serious illnesses during this time - when he had his dose of typhoid fever his sister 'Nannerl' was so ill with it, that she was given the last rites.
Once Mozart reached adulthood there a far fewer documented medical problems, until the puzzle of his death. Neumayr dismisses the view that is often reported that Mozart was morbidly depressed towards the end of 1791, or that there were any major illnesses until the fatal one. He does, however, suggest the Mozart was tired through overwork (short deadlines on La clemenza di Tito and die Zauberflöte) and highly stressed through financial worries and his wife's illness.
It is in the discussions about Mozart's final illness that Neumayr gets most agitated, clambering into a number of theories, including poisoning and kidney failure. After detailed analysis, he argues with great conviction that the final illness was acute rheumatic fever.
The final section of this chapter debunks some of the myths around Mozart's burial in 'a communal paupers grave'. It explains how his burial without family members present in an unmarked grave shared by 5 or 6 bodies was the normal middle class burial at the time.
Ludwig van Beethoven (1770-1827)
Reading Beethoven's medical history is hardly an enjoyable experience. There is little documentary evidence of his medical problems during his childhood and adolescence. However, from then on, there is constant reference to his ailments. For much of his life he suffered from severe abdominal problems, to the extent that he referred to them as his 'usual problem'. He also, as every schoolboy knows, became deaf, the first signs of which appear to have occurred in his twenties possibly after a bout of typhoid fever, and which gradually worsened, to the extent that he was totally deaf in the last years of his life.
His letters make frequent reference to illnesses, and periods when he was unable to work as a result of them (though he admitted that he sometimes laid it on a bit thick to gain sympathy from his publishers). It also seems likely that his personality was affected in particular by his deafness, and later on by the effect of the conflict over the guardianship of his nephew Karl. Neumayr dismisses suggestions that Beethoven may have suffered from syphilis.
The description of Beethoven's last few months makes very distressing reading. He caught pneumonia on the return from a visit to his brother, when his health was already rapidly deteriorating. He then took over 3 months to die, in considerable pain, having had to have 4 operations to drain gallons of fluid from his abdomen.
That he died from cirrhosis of the liver has been generally accepted for some time. Prof. Neumayr puts the reason for the cirrhosis down to 'regular consumption of alcohol' and takes great pains to distance himself from those unwilling to accept this. He nevertheless argues that tolerance for alcohol varies greatly (and both Beethoven's father and paternal grandmother abused alcohol), and that he was not, therefore, a 'drunkard in any sense of the word'.
There is also considerable discussion on the nature of the severe abdominal problems that he suffered for much of his life. Neumayr feels that these has not been satisfactorily explained before, and after rejecting a number of other theories, proposes that Beethoven suffered from Crohn's disease, which was not defined and described until the 1930s, although its existence in Beethoven's time can be substantiated. This 'spectacular diagnosis' is fully supported by the Medi-Ed Pres Medical Editor.
Franz Peter Schubert (1797-1828)
Unfortunately, this is one of the shorter sections, weighing in at just 67 pages. This is largely due to the fact that Schubert's medical history is fairly straightforward, though as we will see, Neumayr has a couple of new slants on it. As a biography it is a very high level overview, and it gives the feeling of not being completely up to date. I don't know when it was written, but discussions of certain points (for example whether he was banished from the parental home, whether he became a schoolmaster to avoid the draft, the issue of the Gstein/Gmunden symphony) feel dated. There are also some inconsistencies and inaccuracies- for example he states that only 5 children of Franz Theodor and Elisabeth lived past their 1st year, and later mentions a sixth (Josef). In fact, there were 5 who survived to adulthood, and 3 others who lived from 2 to 5 years.
The medical history is quite straightforward. He assumes that Schubert had smallpox as a child, simply from the statement that candidates for the Konvict had to certify that they were past the danger of smallpox. He assumes that Franz probably caught it at the same time as his brother Josef, who died from it, aged 5, in 1798. There are no further mentions of illnesses, until we hit the syphilis in 1822.
That Schubert suffered from syphilis seems to be beyond dispute, though there is little, if any, direct documentary evidence of this (probably much was destroyed by friends). Otto Deutsch was, however, told that Schubert had syphilis by a number of descendants of Schubert's friends. Many biographers have implied, or stated, that Schubert was led into a dissolute life style by Schober. Neumayr takes this a little further, and states, without quoting any reason, that Schober caught syphilis at the same time as Schubert. It would be interesting to know his justification for this statement, particularly as I have not seen it mentioned elsewhere.
Neumayr makes a number of comments about the psychological effects of key events in Schubert's life - death and moving as a young child, the death of his mother, contracting syphilis, etc. He quotes both My Dream and My Prayer in full, and large lumps of other documents, including the 'most wretched man in the world' letter to Kupelwieser. He also argues that the evidence on Schubert's 'dissolute way of life' is ambiguous, He proposes 'freedom' as the underlying reason for Schubert's bachelor life style, and dismisses suggestions of oedipal complexes or homosexuality.
Neumayr leads us through most of the medical references in the rest of Schubert's life. Most commentators have attributed symptoms such as headaches and pains in his arms, to the side effects of syphilis. Neumayr will have none of this; and suggests that the pains in his arm were probably periostitis, caused by too much piano playing. The headaches are put down to eyestrain, and the likelihood that his glasses were not a perfect prescription. Indeed, he uses this argument against that used by Marek, that his glasses (which have been examined recently and are not particularly strong) show that he only had slight myopia.
However, the most startling remark from Neumayr is his belief, contrary to most other commentaries that I have read, that "from 1824 on, his syphilis could be regarded as healed". Some writers have suggested that the final illness was syphilitic, though it would seem to be rather quick for the tertiary phase of syphilis, which, according to the Encylopaedia Brittanica generally has a longer gestation period, and does not always follow from the second phase. This conclusion leads Neumayr to reject the idea that Schubert had premonitions of death in his final years, a point strongly put by John Reed in, amongst other places, Schubert: The Final Years, who argues that it is 'all in the music'.
He puts the final illness down to typhoid fever, which is a diagnosis accepted without argument by many commentators. In Neumayr's mind, this is not in doubt. There are some heavy medical description of this (and indeed of syphilis).
Schubert was disinterred in 1863 (and again in 1888), at the same time as Beethoven, to 'secure the mortal remains against further decay'. As well as a gruesome picture of his skull from this time (there are previous pictures of Beethoven's and Haydn's skulls as well), there are reports from the anatomical examinations done at this time. These show no evidence of the alterations to bones that would have occurred with the tertiary phase of syphilis. Amongst other points, this report describes his teeth as being 'healthy and beautiful', which is most curious, given the remarks by Anselm Hüttenbrenner to Luib that Schubert neglected his teeth.
There is a detailed bibliography of this, and other sections. Curiously, he does not mention, and therefore presumably has not seen, the 1980 Musical Times article by Eric Sams on "Schubert's Illness Re-examined", which is a great shame, since he seems to disagree with a number of the conclusions from this article.
So, this short section on Schubert presents some new conclusions, well argued from a man whose technical medical expertise must be respected. Nevertheless, I don't think that we can conclude that the definitive statement has now been made. There will be lots more ink flowing on these subjects before (if ever) there is universal agreement!
Conclusions
So, all in all a very different book, which makes fascinating reading, and is heartily recommended. It is available from:
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Medi-Ed Press |
Rosemary MS Dooley |
ph. (1) 800 500 8205 |
ph. (44) 015395 52286 |
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Music and Medicine, Volume 2
I now have a copy of the 2nd volume, and it maintains the same level of interest and consistency. This time there are 6 composers from the German Romantic School, and the format is identical to the first volume. Hummel occupies just 45 pages - he suffered from left sided heart failure and died in his late fifties. Weber takes up about 85 pages. He was a sickly child with a congenital dislocation of the hip joint, and was never well as an adult. He died aged 39 of Pulmonary Tuberculosis on a trip to England for the premiere of the Opera Oberon - a trip he did not expect to survive, but which he went on to earn lots of money for his family. Mendelssohn also died young (38) - he occupies 70 pages. Despite the romantic literature's suggestion that he died of a broken heart after the death of his sister Fanny (from a stroke just 6 months before), Neumayr puts Felix's death down to a cerebral aneutysm.
The largest section in the book is for Schumann - a very complex case, which takes up 150 pages. The recently rediscovered autopsy allows Neumayr to conclude that Schumann's madness and death was indeed caused by Syphilis. Brahms (85 pages) appears to have had the constitution of a horse, and was never really ill until he got the cancer of the pancreatic duct which killed him in his early 60s. Bruckner (100 pages), on the other hand, got into his 70s before heart disease caught up with him.