On 20 November, 1791, during a fever epidemic¹, Wolfgang Amadeus Mozart unexpectedly took ill - developing a high fever, headache, sweats, and severe swelling and pain in his hands and legs. By the 14th day of his illness, his swelling had worsened to the extent that his entire body had gained 'Pillsbury Doughboy' proportions. With the swelling came nausea and vomiting, diarrhoea, a persistent rash and an abominable reek which rose from his body to greet his visitors. A sudden change in character drove him to banish his pet canary from his sick room in irritation.

On the 5 December, just fifteen days after the onset of illness, the great musician suffered a convulsion, lapsed into a coma and died². He was 35 years old.

The funeral was held two days later at St. Stephen's Cathedral, where Mozart had married his wife Constanze only nine years earlier. His body was never autopsied although Eduard Guldener von Lobes, the physician who examined it, found no evidence of foul play. Contrary to popular (romantic) belief, Mozart was not given a pauper's funeral. His widow had purchased a third-class funeral which, although certainly the cheapest, was the most common in Vienna³. And, far from being destitute and ignored, hordes of people - fans and admirers of the great composer - showed up at Wälscher Platz and St. Stephen's to pay their last respects to one of the greatest geniuses of classical music.

And yet, more than 200 years after his death, the cause of Mozart's demise remains a mystery. More than two centuries' worth of historians, anthropologists, musicologists and doctors have debated this mystery in books, journals and conferences - and yet the solution eludes them. Meanwhile, the public, stirred by romantic imagination, wonders: was Mozart murdered, or was it disease that killed him?

Why Mozart's Death Remains a Mystery

The greatest hurdle that investigators have faced in determining the cause of Mozart's death was that they had no corpse to deal with. Even very old bodily remains can give hints as to the afflictions or inflictions that were the cause of death. Unfortunately, Mozart's body was never autopsied by his physician, and thanks to his third-class funeral and exhumation and subsequent shuffling about, his remains are now lost to modern researchers as well.

This would not have been so much of a problem had Mozart's physician been more thorough in his investigations. Unfortunately, all the researchers have to work with are the various testimonies of his doctors and those who had watched him die. This has presented the researchers with two obvious problems:

1. The difference in medical standards and terminology

Back in Mozart's day, medical standards were comparatively primitive - equipment common in modern-day medicine, such as stethoscopes and thermometers, were not introduced until the 19th Century. There was no objective way of measuring a person's vital statistics, nor could a patient's heart and lungs be monitored clearly or easily. (And if your patient was as bloated and foul-smelling as Mozart in his last days, you probably would not want to press your ear against his chest either). Thus, observations of a patient's symptoms were subjective, and not standardised.

Medical terminology and the theories of disease were also radically different from what is accepted in today's medical practice, making it difficult for anybody who has no knowledge of the history of medicine to follow the course of the medical discussion. Therefore, diagnoses of disorders made in the past may by no means be accurate today, and might even refer to completely different illnesses altogether. Also, as Dr. Hirschmann has pointed out, even when these early physicians made a diagnosis that still applies today, they may have included under the rubric of a single disease several illnesses that are similar to one another but are now considered distinctly different afflictions. Occam's razor was often incited when assessing an illness. Also known as the 'law of parsimony', it encouraged physicians to attribute all observed symptoms and signs to a single disorder or disease, rather than to several concurrent ones. This is further complicated by the fact that these early clinicians were mostly unable to discriminate between illness symptoms and the adverse effects of treatment.

2. Conflicting testimonies

The greater part of the medical records available to those investigating Mozart's death are in the form of testimonies originating from family members and friends who were not knowledgeable in the science of medicine, and who were only interviewed years after Mozart's demise. Garbled by faltering memory and dramatisation, these testimonies present conflicting pictures of Mozart's last days.

According to Sophie, Constanze's sister, the cold poultices that the physician Dr. Closset had placed upon Mozart's burning head had rendered Mozart unconscious right up until the moment of death, and Mozart's last movement was an attempt to express vocally the drum passages in the Requiem he was writing.

Constanze herself, however, maintained that just before death overcame him, Mozart had told her, 'I shall die... Ah, now I will leave you unprovided for,' and had subsequently vomited and died.

On the other hand, Mozart's friend Benedict Schack said that Mozart had asked for the score of the Requiem to be brought to his bed, and that he, Mozart and a few others had sung it up to the first bars of the Lacrimosa, whereupon Mozart burst into sudden tears - which would imply that Mozart had actually finished the Lacrimosa, which most sources maintain he never completed.

Mozart's son Karl, who was seven at the time of Mozart's death, recollected that 'a few days before he died, his whole body became so swollen that the patient was unable to make the smallest movement; moreover there was a stench which reflected an internal disintegration which, after death, increased to the extent that an autopsy was rendered impossible.'

It is not known just how much of these testimonies are uncorrupted, but at least all parties agreed on one thing: that Mozart had suffered severe swelling in his hands and feet that had progressed to his whole body and that he had been in pain and had been subsequently unable to move.

Speculations on the Cause of Death

1. Murder

Because Mozart had been nothing short of a musical phenomenon, it is only natural for romantic speculations of murder by insane, jealous rivals to arise. Mozart himself had fuelled these rumours of murder by telling Constanze in 1789 that 'I am only too conscious [that] my end will not be long in coming; for sure, someone has poisoned me!' Six months before his death, he was known to confide in a source that 'someone has given me acqua toffana⁴ and has calculated the precise time of my death.' Mozart's son Karl also offered the following corroborative testimony: '...the corpse did not become stiff and cold but, as was the case with Pope Ganganelli and those who die from poisoning by plants, remained soft and elastic.'

Postulations of murder conspiracies, ranging from vaguely plausible to downright ridiculous, have long since been discounted in the absence of evidence; however, for the sake of discussion, they are included in this article. The most popular theories point fingers at:

Antonio Salieri

For most people, Salieri was the perfect perpetrator. He was the Kapellmeister to the court of composers at the time and was in a position of power; and yet he was bested by the very immature lowlife he resented. Driven to insanity in his later years, he had allegedly confessed to poisoning Mozart. Indeed, Constanze herself was reported to have ranted to anybody who would listen that Salieri had conspired to kill her husband⁵.

This rumour was pushed by the Russian author Aleksandr Pushkin (1799 - 1837), who in 1830 wrote a short play called Mozart and Salieri, in which envy and resentment⁶ drove Salieri to murder his rival. Peter Shaffer later incorporated this theme into his play Amadeus, which later became an award-winning film - although in this version, Salieri drove Mozart to his death by sabotaging his career and then provoking him to finish the Requiem even when Mozart was obviously ill.

However, Ignaz Moscheles, who was a pupil of Beethoven's and Salieri's and who visited Salieri in 1823, claimed that his teacher had told him '... I can assure you on my word of honour that there is no truth in that absurd rumour: you know, that I was supposed to have poisoned Mozart.' Indeed, Dr Guldener von Lobes, who had examined Mozart's body, had found no evidence of foul play. The two nurses who had cared for Salieri continuously from the winter of 1823 had also testified that only they and the physicians had seen Salieri, and that the patient had never at any time confessed to poisoning Mozart.

Despite the alleged envy and resentment, there is no clear motive as to why Salieri should be compelled to kill Mozart. After all, it was Salieri, and not Mozart, who had been the Emperor Joseph II's chief musician. It was Salieri who had a higher salary, greater wealth, and a reputation almost equivalent to that of Mozart. Additionally, contrary to the rumours pushed by Amadeus, Salieri's music was (although no work of genius) not the abominable mess it was portrayed in the play, but was in fact rather good. Furthermore, the relationship between the two composers at the time of Mozart's death had been amiable, and one of Salieri's students had maintained that Salieri 'did not harbour a grudge against Mozart, who eclipsed him.'

Franz Hofdemel

It is widely known that Mozart had always been a notorious womaniser. He'd carried on for quite a bit with his cousin before moving on to Aloysia - who one day suddenly became cold to him - and later married her sister Constanze (and lest you think the flirtations stopped there and then, there are sources that say otherwise). However, rumour had it that Mozart had gone a little too far with Magdalena Hofdemel⁷, his 23-year-old student and wife of his Masonic lodge brother Franz Hofdemel. Indeed, Ludwig van Beethoven alleged that the two had a love affair, and later on had refused to perform in her presence because 'too great an intimacy had existed between her and Mozart.'

An argument apparently broke out in the Hofdemel household on the day after Mozart's funeral, and when a visitor entered the house, he found Magdalena lying in a pool of her own blood, her face, arms and neck brutally hacked. Franz, who had cut his own throat with the same razor, was found in the next room. Magdalena, who was in the fifth month of pregnancy, was later revived, and gave birth to a baby boy whom she named Johann von Nepomuk Alexander Franz. Because she'd named the boy after both Mozart and her husband, rumours began to spread that Magdalena had been Mozart's mistress, and that the child she had been pregnant with had been his. Franz had allegedly found out about the affair and poisoned Mozart before attempting to kill Magdalena and committing suicide.

The Freemasons and the Jews, and just about everybody else

When all else fails, blame the Freemasons and the Jews.

Mozart became a freemason in 1784 and had written several works for the organisation. It was rumoured that the freemasons had Mozart killed after he wrote The Magic Flute, as the opera either challenged their doctrines or disclosed their secret rituals. Erich Ludendorff, a German World War I general, took it one step further by bringing the Jews into the picture, claiming that they had conspired with the masons in poisoning Mozart. This accusation almost certainly had its roots in anti-Semitic prejudice.

Ludendorff's wife Mathilde, who was a neuropsychiatrist, suggested that the conspiritors consisted of the Jews, freemasons and Catholics. (And you thought Erich Ludendorff's speculation was far-fetched.)

Mozart himself

Interestingly enough, there are also those who believe that Mozart had been suffering from syphilis and that, while medicating himself with mercury, he had miscalculated the dose and consequently killed himself. As Dr. Faith Fitzgerald quipped, 'And of course, Mozart died of syphilis as well as everything else, because every great man dies of syphilis.'

Why the poisoning theories have been discounted

The stories about Mozart being poisoned may be highly appealing, but unfortunately they fail to explain his symptoms. Moreover, arsenic and mercury poisoning have their own set of symptoms which, alas, do not quite add up.

Had Mozart really been poisoned with arsenic, he would have indeed suffered from nausea, vomiting, diarrhoea and coma as his witnesses had described; however, he would have also experienced throat-burning, difficulty in swallowing, abdominal pain, hypotension, cyanosis⁸, difficulty in breathing, delirium, sensorimotor abnormalities, and erythroderma⁹ - all of which had been absent.

Likewise, had Mozart's death been due to mercury poisoning, observers should also have noted memory loss, excessive salivation, emotional oversensitivity, forgetfulness, timidity and delirium. His handwriting should also have shown tremors, which is the most common sign of mercury poisoning. All things considered, it is a whole lot more likely that Mozart had suffered an ailment of some sort, than that he had been poisoned by a jealous rival.

2. Accident

A couple of investigators have surprisingly broken from the norm of attributing Mozart's death to murder and strange ailments by announcing that Mozart died from complications arising from accidents.

The first to push this story was French anthropologist Pierre-Francoise Puech, who claimed to have positively identified a skull at Salzburg's Mozarteum to be that of Mozart. Puech drew attention to a fracture in the skull, claiming that it had been sustained from one of Mozart's many falls in 1791, and that it had caused a chronic bruising that had eventually put Mozart in a coma and killed him. The skull was supposed to have been rescued by a gravedigger named Joseph Rothmayer during the reorganisation of the composer's grave, who later gave it to the Salzburg Mozarteum. Three years later, the American physician Niles E. Drake concurred with Puech's theory in an article that was published in the journal BioScience. This theory would indeed help explain why Mozart was depressed and dizzy not long before his death.

The obvious problem with this theory is that there is still no consensus as to whether the skull actually belonged to Mozart. Rothmayer had allegedly wrapped wire around the neck of Mozart's corpse before burying it, and had retrieved the skull ten years later when it was exhumed. Research had concluded that the skull belonged to a 20-40 year old South German male who suffered a developmental abnormality called premature synopsis of the metopic suture (PSMS). This abnormality is characterised by the bone of the forehead developing in two halves, and the failure of the metopic suture to close after birth, resulting in a broad midface and a small, abnormally-shaped skull. As Mozart's portraits depicted a straight, vertical forehead, bulbous nose, prominent cheekbones and upper lip, and prominent brow arches, it was supposed that the skull did indeed belong to him. Further research involving the superimposition of a photograph of the cranium of the skull on portraits of Mozart painted between 1778 and 1788 indicated conformity with all side proportions of the head.

However, Nova Scotian neurologist Professor TJ Murray, who founded the Dalhousie Society for the History of Medicine, denied that the skull was that of Mozart as seen in portraits. Walter Brauneis, archivist of the Office for the Preservation of Historical Monuments in Austria, undertook to carry out his own research by locating official medical records concerning Mozart's death. Surprisingly he found a doctor's description of the body, which noted that Mozart (the dentist's worst nightmare!) had only seven teeth remaining in his mouth (the rest having rotted or fallen out!) When the Mozarteum skull was re-examined, it was found to have four more teeth than had been recorded by the doctor. Puech supporters countered that the doctor probably counted only the healthy teeth.

The only way to be sure just whose skull it is would be to perform DNA analysis on the skull; unfortunately, all of Mozart's children died childless, and it would be unwise to disturb his parents' grave.

3. Disease

The Dalhousie Society for the History of Medicine held a symposium entitled 'Medicine in the Age of Mozart' in 1991, 200 years after Mozart's death. The symposium, organized by Dr. Edward Carl Abbott (a distinguished physician, cardiologist and endocrionologist) gathered a multidisciplinary team that included historians, anthropologists, medical specialists from various fields and epidemiologists to discuss the mystery of Mozart's death, and to study the disease profile of the second half of the 19th century. The symposium's book, 'Mozart and Medicine' was published as a special issue of the Dalhousie Report.

Nine years later, the University of Maryland held the most unusual postmortem in the history of medicine - the peculiarity being that the corpse to be examined was missing. Unlike standard autopsies, this University holds annual historical clinical pathology conferences, where a physician is invited to diagnose the mysterious maladies of historical figures. The historical figure for that year was Mozart.

It is clear to physicians that Mozart died of a disease of some sort. Many possible diseases of varying degrees of plausibility have been proposed, ranging from typhoid fever to tuberculosis to syphilis to hepatitis. However, the disease in question is not communicable directly from person to person - had it been so infective, then Sophie would probably caught it, and even more so Constanze, who had crawled into bed with her husband, hoping to catch his disease and die from it as well¹⁰. On the other hand, it has to be capable of causing an epidemic - a most interesting contradiction.

The possibilities that physicians, historians and musicians have speculated upon over the years include:

Uremia

Constanze's younger sister Sophie spent a great deal of time tending to Mozart during his final days as, by this time, he was quite incapable of movement. During this time an interesting exchange took place between them when, told by Sophie to be brave and that he would not die, Mozart replied, 'Why, I already have the taste of death on my tongue.'

Assuming that Mozart was lucid and not harbouring paranoid delusions¹¹ at the time, this might, as some physicians have suggested, indicate that Mozart was suffering from uremia. Investigators who belong to this school of thought have highlighted two things that point in this direction:

1. a description by Mozart's father, Leopold Mozart, of an illness that Mozart had suffered sometime in 1784: '...he perspired so profusely that his clothes were drenched...had a violent attack of colic, which ended each time in violent vomiting', and
2. Mozart's malformed ear, reasoning that since ears and kidneys develop at roughly the same time in the human embryo, then a malformed ear would imply kidney problems as well.

Uremia is a term loosely given to a cornucopia of symptoms and physical abnormalities arising from the kidney's failure to remove nitrogenous waste products normally excreted in the urine. Its toxic effects affect almost all human organs, manifesting in the form of swelling of the ankles (oedema), nausea, vomiting, convulsions, coma and - ultimately - death, which would explain Mozart's symptoms at the end of his days. The 'death' he tasted on his tongue would have been caused by the accumulation of waste products in his mouth, causing foul breath.

However, Mozart had not been described as anaemic (anaemia is always present in cases of uremia because the high blood levels of urea shorten the lifespan of red blood cells), nor did he suffer itching and fits, which are other common symptoms of uremia. Furthermore, although renal failure may cause oedema without shortness of breath, it is scarcely an epidemic disease associated with fever, rash, swelling of the limbs and preserved mentation. Mozart was also not known to have a history of renal dysfunction. And, contrary to typical progression of uremia, his coma was also not prolonged, and he was in considerably good health until shortly before his death. Perhaps, if he had been born two hundred years later, tests might have indicated an increase in blood pressure and elevation in certain blood components such as urea, uric acid and creatinine; however, because Mozart had been born in a dark age of medicine, his blood chemistry can only be speculated upon.

Henoch-Schönlein Purpura

Dr. Peter J Davies, who authored the book Mozart in Person: His Character and Health, firmly believes that Mozart died of a hypersensitivity disease called Henoch-Schönlein Purpura (HSP). Named after doctors Lucas Schönlein and Edward Henoch who identified the disease in the 19th Century, HSP is caused by an abnormal response of the immune system, triggering hypersensitivity vasculitis and inflammatory response within the blood vessel. This disease affects the capillaries in the skin and frequently the kidneys as well, resulting in skin rash, abdominal pain, diarrhoea, bloody stools and arthritis, the joints most frequently affected being those of the ankles and the knees. Davies argues that it is this disease that Mozart came down with in 1784, which resulted in kidney failure at the end of his days. Aggravated by bloodletting, Mozart was supposed to have developed a brain haemorrhage and died of pneumonia¹², which 'usually develops when the patient is already moribund.'

The problem with this theory is that, despite Dr. Davies's allegations, it does not quite explain half of Mozart's symptoms – or why Mozart failed to exhibit some of the major signs. In the first place, nobody had ever mentioned purple spots on Mozart's body¹³, which are a dead giveaway of this disease. Then there is the prevalence factor - although this disease is more frequently observed in boys than girls, the age of onset is usually younger than 21 years (this being associated chiefly with children), which makes it unlikely for Mozart to have developed it at 35. And even if Mozart had HSP, it would have been unlikely, even in a primitive age of medicine, for him to develop acute or chronic renal failure, let alone die from the disease. Even if Mozart beat the odds and developed this disease, HSP epidemics do not occur, and he should have been mentally unsound at the end of his days.

Infective endocarditis

Another theory that has been discarded but was, for a time, popular, is that Mozart died of infective endocarditis, which is an inflammation of the interior surfaces of the heart and the heart valves, usually caused by a bacterial infection. This hypothesis would explain Mozart's fever and skin lesions¹⁴, the swollen hands and feet, his preserved mentation until death - and the fatality of the disease. On the other hand, the oedema would have been brought forth by heart failure caused by valvular damage, and would have certainly been accompanied by shortness of breath. Furthermore, infective endocarditis is rarely associated with nephritic syndrome and is certainly not an epidemic disease!

Rheumatic fever

Until the 1990s, the most plausible - and most satisfying - explanation for Mozart's death was that he died of rheumatic fever. The diagnosis was first made by Dr. Eduard Guldener von Lobes, who described Mozart as having succumbed to an epidemic of 'rheumatic and inflammatory disease' and dying of a 'deposit on the brain'. Dr. Faith T Fitzgerald, who was the visiting physician at the University of California's sixth clinical pathologist conference, came to the same conclusion after ruling out a number of diseases such as liver disease (Mozart did not suffer from jaundice). Among the professionals who backed her diagnosis was Neal Zaslaw, who is the Cornell University professor of music and renowned Mozart scholar.

At the time Mozart fell ill, an epidemic similar to Mozart's disease was said to have plagued Vienna. This disease, identified by some physicians to be rheumatic fever, is caused by a bacteria called Streptococcus pyogenes, which is also associated with other diseases such as strep throat and necrotising fasciitis (aka the flesh-eating syndrome). Triggered by the invading bacteria, the host's body produces antibodies which, while helping wipe out the bacteria, occasionally¹⁵ inadvertently attack the host's own heart, skin, joints and brain in a phenomenon known as cross-reaction. Although ninety percent of rheumatic fever cases resolve in 12 weeks or so, recurrences can occur, each time further weakening the heart and other affected areas.

Investigators have cited a letter dating back to 1784 in which Leopold Mozart described his son as suffering from 'acute rheumatic fever' and a 1790 letter written by Mozart himself that stated, 'my head is covered with bandages due to rheumatic pains.' If these statements are indicative of rheumatic fever, this might infer that these were recurrences of the disease he'd suffered back in 1763 when he 'fell ill and was very sick...finally the trouble settled in his feet, where he complained of pains and so forth...he could not stand on his feet or move his toes or knees...for four nights he could not sleep.'

Indeed, much of Mozart's symptoms do correspond to the manifestations of rheumatic fever, and which seem to satisfy the Jones' criteria for the clinical diagnosis of rheumatic fever¹⁶. He had the fever and rash which are common signs of the disease, as well as the inflammation of the extremities¹⁷. Another possible telltale sign of the disease is Mozart's unusual irritability - which drove him to banish his pet canary from his sickroom - which implies a neurological disturbance caused by chorea. Fitzgerald pointed out that the swelling would have been brought on by the weakening of Mozart's heart, which would have caused fluid retention - and concluded that Mozart ultimately died of congestive heart failure.

However, for someone who had allegedly suffered repeated episodes of the disease, Mozart was in excellent health. Here is where the contradiction lies: acute rheumatic disease does not have a substantial mortality rate (in the 19th century when rheumatic fever broke out in America and Britain, only 1-5% of those afflicted died of the disease - and these were those who were actually ill enough to require hospitalisation); death is usually caused by the chronic form of rheumatic fever after years and years of heart damage. Moreover, if it had been rheumatic fever that afflicted Mozart, it would have been the chronic form which affects the heart, since the acute form primarily afflicts children, predominantly causes arthritis and does not recur. Investigators have already argued that Mozart suffered recurring bouts of the disease. However, arthritic and cardiac conditions of the disease are inversely related - the disease either attacks the heart and mildly affects the joints, or attacks the joints and mildly affects the heart. Since Mozart's childhood illness complaints are centered about joint pain, then it should be inferred that he should not have been afflicted with heart problems later on in life. Furthermore, had Mozart died of congestive heart disease, he should have exhibited signs of respiratory disorder during the earlier manifestations of the disease as well as impaired health due to a weak heart long before he died.

Pork chops...???

In 2001 speculations upon the nature of the disease that killed Mozart took an abrupt turn when infectious disease specialist Dr. Jan V Hirschmann argued that Mozart's death was caused by - pork chops. Hirschmann, of Puget Sound Veterans Affairs Medical Center and the University of Washington in Seattle, who discussed this subject in the journal Archives of Internal Medicine, pointed out what he believed to be a significant clue in a letter dated 7-8 October, 1791 from Mozart to his wife:

'...What do I smell? Why, here is Don Primus with the pork cutlets! Che gusto!¹⁸ Now I am eating to your health! It is striking eleven o'clock...'

Mozart's favourite food had always been pork. In this case, it may have been his favourite pork chops that killed him - or rather, what was in them.

The disease trichinosis, caused by a parasitic worm called Trichinella and spread by improperly-cooked tainted meat, was not discovered until 1860¹⁹ when a woman who died of a mysterious disease with symptoms similar to Mozart's - fever, weakness, anorexia, constipation and excruciating muscle pain - was found to harbour a large number of wriggling worms in her muscles. When the pathologist, Friedrich von Zenker, discovered that others at the inn where she worked had developed a similar disease (including a butcher who had prepared the meat for a Christmas meal she had attended), he set about examining the ham and sausage from a pig slaughtered for the festivities - and found the same worms in the muscle tissue. When Zenker fed the tainted meat to animals, he found worms in their alimentary canal.

The incubation period for trichinosis is usually between eight and 15 days, although it can take up to 50 days for the worms to start wreaking havoc. Liberated from their cysts by the digestive juices in the host's stomach, the larvae travel to the small intestine and invade the columnar epithelium layer where they moult four times before maturing. Five days after mating, the females give birth to live larvae, which penetrate the intestinal wall, enter the lymphatic system, and move via the bloodstream to areas of implantation - namely, tissue, although they can only survive in skeletal muscle where they form cysts. Typical symptoms include muscle and joint pain, high fever, weakness, nausea and vomiting, diarrhoea, swelling of the face, headache, fatigue and generalised swelling due to the leakage of fluid from damaged vessels into surrounding tissue - all of which echo Mozart's symptoms in his final throes of disease. The patient typically has preserved mentation, although in the final stages of the disease may develop strokes, seizures, encephalitis and coma, and death usually occurs within the second or third week of the disease from pneumonia or from neurological or cardiac complications. Although death is rare in our age of medicine where a battery of drugs can restore a person to health within 5-6 weeks, in Mozart's time the disease would have been fatal. It killed 18% of the 153 people who were infected in Hettstädt in 1863 following the 50th anniversary celebration of the Battle of Leipzig, and 30% of the 337 afflicted in Hedersleden just two years later. If this had been the cause of the epidemic²⁰ that hit Vienna in the late 18th century - which caused symptoms that matched Mozart's - it would have definitely been an unknown disease at the time.

The only problem with this theory of course is that, while it explains virtually all of Mozart's symptoms, it does not quite follow the progression of Mozart's disease, assuming that the testimonies of his witness can be relied upon. The earlier stage of the disease should have been largely asymptomatic, but accompanied by diarrhoea and abdominal pain as the worms lodged themselves in the intestine, it was only when the immune system geared up against the invaders that the rash, swelling and pain should have begun. Furthermore, despite Hirschmann's contention that no shortness of breath had been observed, it is highly unlikely that a cardioneurological disorder that caused Mozart's death would not be associated with respiratory difficulty. A medical practitioner who was consulted regarding this matter confirmed that the arrhythmia would have brought about fluctuations in blood pressure and consequently in the amount of oxygen transported as well, not to mention disturbances in the bloodstream's electrolyte balance. In any event, it is inconceivable that anyone should die of pneumonia or heart complications without suffering breathing problems!

Interestingly enough, Dr. Fitzgerald commented with regard to Dr. Hirschmann's diagnosis: 'there were already 150 different theories and now there is one more.' Is Dr. Hirschmann's diagnosis the one, or could it possibly be 'just one more'?

Endnote

Mozart had been a child prodigy who stunned royalty and public alike, gifted with the inhuman ability of composing incredible feats of music in impossibly short periods of time. Adored by many and yet detested by some, Mozart certainly had the makings of an 18th century superstar. So when his life was tragically curtailed long before his prime, it was only natural that people should, in their mourning, romantically speculate on why and how he died so young, when he might have been destined to accomplish so much more.

And yet at the end of the day, it does not really matter how Mozart died. What matters is that here was a brilliant young musician who gave the world so much beautiful music, but did not live to see his 36th birthday. Mozart may have been one of the greatest geniuses and the most talented musicians history had to offer, but at the end of the day, he was still human, as we all are - and it was his own human mortality that caught up to him in the end.

Acknowledgements

The author wishes to thank Dr K K Wee for his professional medical opinion regarding the matter of Mozart's death by trichinosis - (and for concurring with the author on the reasoning of the matter).

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