The Banal Death of a Genius

By Josie Glausiusz|Tuesday, March 01, 1994
Mozart’s death had nothing to do with Salieri, says a new theory. It had to do with his cracked skull and his choice of doctors.

Ever since Wolfgang Amadeus Mozart died in December 1791 at the age of 35, there has been no end of debate as to the cause of his untimely death. His doctors diagnosed a heated miliary fever (eighteenth-century medical jargon for beats us), but the theories since then have been more elaborate and colorful. Mozart has variously been poisoned by his mediocre rival, Antonio Salieri (according to Salieri himself); carried off by kidney disease, tuberculosis, rheumatoid arthritis, or streptococcal infection; or assassinated by a conspiracy of Freemasons. What next, you ask? Chronic subdural hematoma is what, along with misguided eighteenth- century medicine.

According to this latest theory, Mozart probably acquired his illness--a slow leakage of venous blood into the space between the skull and the brain--when he got drunk and fell on his head. But it didn’t kill him until he made the mistake of seeking medical treatment. Or so says neurologist and frustrated musician Miles Drake of Ohio State University Hospital, who has studied the Divine One’s skull.

Although it has commonly been assumed that Mozart’s remains were lost to posterity--like most folk of his time and station, he was buried in a communal grave--a skull reputed to be Mozart’s was actually unearthed ten years after his death by the gravedigger who had interred him. The skull thereupon had a succession of owners, including a phrenologist. Around the turn of the century it ended up in Salzburg’s Mozarteum, with its authenticity still in dispute.

A few years ago, though, the skull was analyzed by French anthropologists from the University of Provence. Wear on the teeth confirmed that the skull had belonged to a man between 25 and 40 years of age. And when the researchers superimposed photographs of the skull on portraits of Mozart, they found that the skull’s features--notably the high cheekbones and the egg-shaped forehead--matched perfectly.

What interests Drake, however, is the crack in the skull’s left temple. The fracture is only partly healed, indicating that it happened in 1790 or early 1791, not long before Mozart’s death (assuming the skull is in fact his). Mozart was drinking heavily at the time, so the fracture may well have resulted from a fall. And, says Drake, it could have torn veins leading from the surface of the brain, allowing blood to leak into the subdural space, which lies between the dura mater (the brain’s protective membrane) and the skull. As the blood accumulated and dried, it would have put increasing pressure on Mozart’s left hemisphere. That would have made him subject to mood swings and depression. It could also have impaired the faculties controlled by the left hemisphere, including his ability to coordinate movements of the right side of his body--and to compose music.

As it happens, there is no evidence that Mozart’s musical abilities were impaired toward the end of his life--quite the opposite: it was in 1791 that he wrote one of his greatest operas, The Magic Flute. On the other hand, says Drake, his relatives did record that he could not dress himself, and they had to help him because his right hand was uncoordinated. Chronic depression, black thoughts, and headache figure prominently in Mozart’s 1790 letters to Michael Puchberg, a wealthy merchant whom he repeatedly begged for loans. Finally, his doctors’ accounts show that they suspected he had a deposit on the brain. In eighteenth-century neurological terms, says Drake, that could have been anything from a brain abscess to a stroke to a brain tumor--or a chronic subdural hematoma.

According to Drake, Mozart could have survived the hematoma. But he contracted some kind of infection and a high fever and called in his doctors. Their prescription was apparently heavy bloodletting--the eighteenth-century physician’s favorite treatment for illnesses he could not understand. With a chronic leak in his skull, Drake says, Mozart could not afford a drastic loss of blood. The sudden fall in blood pressure probably caused a stroke. If Drake’s theory is right, then, it was a banal act of medical ignorance--and not an infection or a jealous rival--that left the world with an unfinished Requiem.
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