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mozart in 1777
Mozart in 1777
(Wikimedia Commons)

Mozart died in the early morning hours of 4 December 1791. He was two months from his 36th birthday. Official Viennese documents listed the cause of his death as "hitziges Frieselfieber" — meaning very high fever with rash, which describes the symptoms, not the cause. Over the centuries since his death, medical experts have tried to analyze exactly what it was that took Mozart’s life.

On Monday (17 August 2009), researchers from the University of Amsterdam added their theory to the list. They think it may have been complications from strep throat. They say that in December of 1791, Vienna was experiencing a minor epidemic of strep throat, and that it may have begun in the city’s military hospital.

This is the latest chapter in an ongoing mystery story. In fact, the public began second-guessing Vienna’s official paperwork and news reports almost immediately.

One newspaper account from late in December 1791 held sway for generations. It suggested that the real cause of Mozart’s death was poison — that someone did him in. Everybody loves a good conspiracy theory, and the early 19th century was more than ready to believe it.

They were able to find some corroboration, of sorts. In 1829, for example, an English music publisher interviewed Mozart’s widow, Constanze, then 67. She claimed that, though she herself didn’t think Mozart had been poisoned, Mozart had been convinced of it. She said he’d told her 6 months before his death that "someone has given me acqua toffana." Acqua toffana was an arsenic-based preparation.

Death Notice 1792
Death notice, 1792, unidentified newspaper
(Mozart Forum)

Mozart’s second son, Karl Thomas, was also sold on the poisoning story. He wrote years later that the painful and extreme swelling that Mozart experienced was a likely symptom of poisoning. He also pointed to Mozart’s acute foul odor around the time of death — he claimed this is the reason that the coroner didn’t carry out an autopsy — and to the fact that Mozart’s body allegedly didn’t stiffen after his passing. (It’s worth mentioning here that Karl was all of 7 years old when his father died.)

If Mozart really was poisoned, whodunnit? The most common answer: composer Antonio Salieri. Salieri allegedly confessed to the deed while ill and despondent; Beethoven’s conversation books (in which his guests wrote to him after he’d lost his hearing) contain exactly this report.

But other accounts suggest that these were nothing more than wild, unsubstantiated rumors. Certainly Salieri wasn’t prosecuted as Mozart’s murderer. Besides, what motivation would he have had? "Professional jealousy" gets the rap, but by that argument it would have made more sense for Mozart to have poisoned Salieri. After all, Salieri had a steady (and lucrative) court job, and Mozart had to scrape together pennies to pay his rent. Sad to say, by then Mozart’s career was on the wane.

If not Salieri, then whom? There was no shortage of other theories. Most of them tell us more about the writer’s attitudes than about Mozart. One rumor suggested that the Freemasons were somehow offended by The Magic Flute and its Freemasonry theme, and came after its composer. (Why not the librettist Schickaneder, too?) Others attributed his death to various alleged sinister cabals of Masons, Catholics, and Jews.

Some sources even suggested that Mozart poisoned himself. One story is that he was trying to treat a case of syphilis, and accidentally took too much mercury. This falls flat for the lack of evidence that Mozart ever had the disease. Another notion, maybe a bit more plausible, is that Mozart overdosed himself with patent medicines containing antimony.

If not poison, could it have been heart disease? Some newspaper obituaries mentioned "dropsy of the heart." Mozart did indeed suffer from edema in the weeks before his death, but his other listed symptoms don’t fit too well with that diagnosis.

One doctor’s report mentions "a deposit in the brain" — perhaps some kind of tumor. Intriguing, but again, the reported symptoms don’t support this notion.

One physician who had attended Mozart suggested "rheumatic inflammatory fever." A few years ago, this led physicians at the University of Maryland to an obvious conclusion: rheumatic fever. The University of Amsterdam researchers arrived at their strep throat theory by building on this diagnosis and by examining other health records from 1790s Vienna.

Over two centuries after Mozart’s death, the cause continues to fascinate and puzzle health experts. Since we have no way of exhuming his remains — the cemetery in which he was buried was later plowed — it’s not too likely that we’ll ever know for certain.

Further reading:

Strep throat may have killed Mozart from Reuters

What Killed Mozart? by Jan V. Hirschmann, MD

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