The enigma of Tchaikovsky’s illness and death: An epistemological and historical perspective Eva Cybulska Independent scholar, Lindon, United Kingdom Abstract Pyotr Ilyich Tchaikovsky (1840-1893), a celebrated Russian composer, died... more
The enigma of Tchaikovsky’s illness and death: An epistemological and historical perspective
Eva Cybulska
Independent scholar, Lindon, United Kingdom
Abstract
Pyotr Ilyich Tchaikovsky (1840-1893), a celebrated Russian composer, died unexpectedly on 6th November in St.
Petersburg, after a short illness. Only nine days prior, he conducted the premiere of his last symphony, and appeared
to be in good health. At the time, there was an epidemic of cholera in the city, and the treating physician put ‘cholera
infection’ as the cause of his death. Sudden and unexpected death in a famous person can give rise to various
conspiracy theories, and rumours of suicide started to circulate soon afer the composer’s death. Yet, any evidence
that he died of his own hand, or that the Pathétique symphony was his ‘musical suicide note’, is lacking. Death from
cholera is usually a consequence of severe dehydration, but Tchaikovsky received no treatment aiming at fluid and
electrolyte restoration. In addition, his immune system may have been compromised by the loss of his beloved
mother in childhood, an abandonment by his intimate friend and benefactor Nadezhda von Meck, and recent deaths
of several close friends. From the perspective of current medical knowledge and practice, Tchaikovsky died from
cholera, amidst failure of appropriate medical treatment.
Key Words: Tchaikovsky, cholera, treatment failure, suicide, Pathétique symphony
Eva Cybulska
Independent scholar, Lindon, United Kingdom
Abstract
Pyotr Ilyich Tchaikovsky (1840-1893), a celebrated Russian composer, died unexpectedly on 6th November in St.
Petersburg, after a short illness. Only nine days prior, he conducted the premiere of his last symphony, and appeared
to be in good health. At the time, there was an epidemic of cholera in the city, and the treating physician put ‘cholera
infection’ as the cause of his death. Sudden and unexpected death in a famous person can give rise to various
conspiracy theories, and rumours of suicide started to circulate soon afer the composer’s death. Yet, any evidence
that he died of his own hand, or that the Pathétique symphony was his ‘musical suicide note’, is lacking. Death from
cholera is usually a consequence of severe dehydration, but Tchaikovsky received no treatment aiming at fluid and
electrolyte restoration. In addition, his immune system may have been compromised by the loss of his beloved
mother in childhood, an abandonment by his intimate friend and benefactor Nadezhda von Meck, and recent deaths
of several close friends. From the perspective of current medical knowledge and practice, Tchaikovsky died from
cholera, amidst failure of appropriate medical treatment.
Key Words: Tchaikovsky, cholera, treatment failure, suicide, Pathétique symphony
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Independent Researcher, London, UK HTML PDF Friedrich Nietzsche (1844-1900), a preeminent German philosopher, was crushed by mental illness at the age of 44. In accordance with a prevailing paradigm of the time, this was diagnosed as... more
Independent Researcher, London, UK HTML PDF Friedrich Nietzsche (1844-1900), a preeminent German philosopher, was crushed by mental illness at the age of 44. In accordance with a prevailing paradigm of the time, this was diagnosed as tertiary syphilis, a diagnosis that endured for more than a century despite no evidence for it. In the last two decades, several alternative diagnostic hypotheses, such as bipolar affective disorder, schizophrenia, brain tumour, frontotemporal dementia and rare genetic conditions have been proposed instead. The aim of this study was to discuss them critically against the historical and epistemological backdrop and to suggest the most likely diagnosis. An in-depth study of Nietzsche's biography, his published and unpublished writings, his correspondence, accounts of his friends and colleagues and an examination of the fluctuating pattern of his creativity and handwriting has been undertaken for this purpose. Criteria for a credible and meaningful posthumous diagnostic hypothesis are also outlined. Diagnoses of organic conditions with established verification tests, such as brain tumour or genetic disorders, are rejected on the basis of undeliverability of such tests. Diagnoses of schizophrenia and frontotemporal dementia are discarded due to the lack of leading symptoms and the biographical impossibility. The overall clinical picture of Nietzsche's mental illness, based on historical sources, points towards bipolar disorder with onset in young adulthood. It was probably followed by multi-infarct dementia. Being posthumous, the diagnosis remains hypothetical. The form and the content of Nietzsche's writings may have been influenced by bipolar disorder, and this would have bearing on the interpretation of his philosophy.
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Independent Researcher, London, UK HTML PDF Friedrich Nietzsche (1844-1900), a preeminent German philosopher, was crushed by mental illness at the age of 44. In accordance with a prevailing paradigm of the time, this was diagnosed as... more
Independent Researcher, London, UK HTML PDF Friedrich Nietzsche (1844-1900), a preeminent German philosopher, was crushed by mental illness at the age of 44. In accordance with a prevailing paradigm of the time, this was diagnosed as tertiary syphilis, a diagnosis that endured for more than a century despite no evidence for it. In the last two decades, several alternative diagnostic hypotheses, such as bipolar affective disorder, schizophrenia, brain tumour, frontotemporal dementia and rare genetic conditions have been proposed instead. The aim of this study was to discuss them critically against the historical and epistemological backdrop and to suggest the most likely diagnosis. An in-depth study of Nietzsche's biography, his published and unpublished writings, his correspondence, accounts of his friends and colleagues and an examination of the fluctuating pattern of his creativity and handwriting has been undertaken for this purpose. Criteria for a credible and meaningful posthumous diagnostic hypothesis are also outlined. Diagnoses of organic conditions with established verification tests, such as brain tumour or genetic disorders, are rejected on the basis of undeliverability of such tests. Diagnoses of schizophrenia and frontotemporal dementia are discarded due to the lack of leading symptoms and the biographical impossibility. The overall clinical picture of Nietzsche's mental illness, based on historical sources, points towards bipolar disorder with onset in young adulthood. It was probably followed by multi-infarct dementia. Being posthumous, the diagnosis remains hypothetical. The form and the content of Nietzsche's writings may have been influenced by bipolar disorder, and this would have bearing on the interpretation of his philosophy.
Oedipus, as portrayed by Sophocles in Oedipus Tyrannus, is probably the most paradoxical and controversial character in Western literature. A hero who saved the ancient city of Thebes from the menacing Sphinx by solving her riddle is... more
Oedipus, as portrayed by Sophocles in Oedipus Tyrannus, is probably the most paradoxical and controversial character in Western literature. A hero who saved the ancient city of Thebes from the menacing Sphinx by solving her riddle is declared a polluter, responsible for the plague. Oedipus conducts the investigation in public, declares himself guilty and is sentenced to exile. In the process, not only does he discover his identity but he also creates it and becomes who he is. The figure of Oedipus is interpreted here as an answer to the riddle of existence: pain and suffering are not a punishment from the gods but the price humanity pays for consciousness, autonomy, compassion, and daring. A brief critique of Sigmund Freud's concept of Oedipus Complex is also presented. Dreadful deeds, as well as magnanimity of the spirit, are at the heart of man.
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Research Interests: Psychology and Philosophy
Some names appear to stick to syndromes or diseases like a proverbial glue, regardless of their total inappropriateness. Gross self-neglect in old age characterised by domestic squalor, social withdrawal, apathy, tendency to hoard rubbish... more
Some names appear to stick to syndromes or diseases like a proverbial glue, regardless of their total inappropriateness. Gross self-neglect in old age characterised by domestic squalor, social withdrawal, apathy, tendency to hoard rubbish (syllogomania) and a lack of shame was originally reported by Macmillan & Shaw in 1966 and subsequently ‘christened’ by Clark et al as Diogenes∗ syndrome in 1975. Post (1982) preferred the term ‘senile recluse’ and argued that this is not a syndrome but merely an end stage of personality disorder. It was usually extremely difficult to help these patients, as one's care and goodwill often met with hostility and blunt refusal to cooperate (Cybulska & Rucinski, 1986). More recent studies, however, have shown a strong association of this condition with frontal lobe dysfunction (Orrell & Sahakian, 1991), thus giving a psychiatrist of old age a somewhat firmer basis for action.
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© The Author(s). This Open Access article is distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0]. The IPJP is published in association with NISC (Pty) Ltd and the Taylor & Francis Group. www.ipjp.org
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This essay examines the thoughts and actions of the eponymous hero Hamlet of Shakespeare's tragedy from the perspective of existential philosophy. The death of his father, the prompt remarriage of his mother and Ophelia's... more
This essay examines the thoughts and actions of the eponymous hero Hamlet of Shakespeare's tragedy from the perspective of existential philosophy. The death of his father, the prompt remarriage of his mother and Ophelia's rejection of his love are interpreted as Jaspersian boundary situations. Burdened with the responsibility to avenge his father's murder, Hamlet faces an existential dilemma of either being a dutiful son or being true to himself. As he loses faith in the goodness of the world and confronts death, Hamlet enters a protracted phase of foundering, suffused with despair and self-loathing. The customary rational way of thinking fails him and his soul becomes shipwrecked. But this is also the beginning of Hamlet's journey toward authentic selfhood and becoming the Existenz that he potentially is. Affirming life with all of its absurdity in a moment of transcendence, he attains a kind of happiness that Camus addresses in The Myth of Sisyphus.
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This is a critical examination of the diagnosis of syphilis in Schubert's case, a diagnosis for which there has never ben any medical evidence. It was a cnjecture made by an art historian at the begining of the twentieth century that... more
This is a critical examination of the diagnosis of syphilis in Schubert's case, a diagnosis for which there has never ben any medical evidence. It was a cnjecture made by an art historian at the begining of the twentieth century that has since been uncritically repeated by subsequent biographers and commentators. This is an attempt to challenge it from the epistemological point of view. At the time of Schubert's death, not only were there no tests for this condition, but even its pathogen, Treponema Pallidum, had not yet been isolated. The composer's nonsepcific, multi-system signs and symptoms are compatible with many conditions not yet identified in his time.
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The term Übermensch, often translated as Superman or Overman, was not invented by Nietzsche. The concept of hyperanthropos can be found in the ancient writings of Lucian. In German, the word had already been used by Müller, Herder,... more
The term Übermensch, often translated as Superman or Overman, was not invented by Nietzsche. The concept of hyperanthropos can be found in the ancient writings of Lucian. In German, the word had already been used by Müller, Herder, Novalis, Heine, and most importantly by Goethe in relation to Faust (in Faust, Part I, line 490). In America Ralph Waldo Emerson wrote of the Oversoul, and, perhaps with the exception of Goethe’s Faust, his aristocratic, self-reliant ‘Beyond-man’ was probably the greatest contributor to Nietzsche’s idea of the Übermensch. Nietzsche was, however, well familiar with all the above sources.
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Gustav Mahler (1860-1911), a renown Austrian composer, died of subacute bacterial endocarditis, when antibiotic treatment was not yet available. Earlier in his life, he developed a mitral stenosis with systolic murmur which was a legacy... more
Gustav Mahler (1860-1911), a renown Austrian composer, died of subacute bacterial endocarditis, when antibiotic treatment was not yet available. Earlier in his life, he developed a mitral stenosis with systolic murmur which was a legacy of frequent throat infections and rheumatic fever which he had as a child. This condition was diagnosed accidentally when he was age forty-seven. Throughout his adult life, however, Mahler was asymptomatic and became a very successful conductor and musical director, as well as a prolific composer. His preoccupation with fate and death was notorious, probably having its roots in many deaths of his young siblings. The fatal blow came in a form of betrayal by his beloved wife, Alma, who had a love affair with a younger man. This sudden abandonment constituted a severe emotional stress, which superimposed on other past and present adverse events in his life, weakened his immune system. He developed bacteraemia-cum-endocarditis and finally succumbed to a ...
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Obsessive-compulsive disorder, classified as an anxiety disorder, arises from malfunctioning of the fronto-striatal-pallido-thalamic-frontal circuit in the brain. As well as perseverative thoughts and acts, there are other signs of... more
Obsessive-compulsive disorder, classified as an anxiety disorder, arises from malfunctioning of the fronto-striatal-pallido-thalamic-frontal circuit in the brain. As well as perseverative thoughts and acts, there are other signs of 'organicity'. Delay in treatment is often a result of patients' reluctance to seek help, and doctors' insufficient knowledge and experience in this clinical area. Electroconvulsive therapy is effective in severe and refractory cases.
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This article represents a personal discussion about Nietzsche's mental illness, which formed part of a larger paper 'The masks of Nietzsche and eternal return of the repressed'. This was presented at the 6th Annual... more
This article represents a personal discussion about Nietzsche's mental illness, which formed part of a larger paper 'The masks of Nietzsche and eternal return of the repressed'. This was presented at the 6th Annual Conference of The Friedrich Nietzsche Society, September 1996, Manchester UK, as reported by Nussbaumer-Benz (1998).
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Obsessive-compulsive disorder, classified as an anxiety disorder, arises from malfunctioning of the fronto-striatal-pallido-thalamic-frontal circuit in the brain. As well as perseverative thoughts and acts, there are other signs of... more
Obsessive-compulsive disorder, classified as an anxiety disorder, arises from malfunctioning of the fronto-striatal-pallido-thalamic-frontal circuit in the brain. As well as perseverative thoughts and acts, there are other signs of 'organicity'. Delay in treatment is often a result of patients' reluctance to seek help, and doctors' insufficient knowledge and experience in this clinical area. Electroconvulsive therapy is effective in severe and refractory cases.
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Maurice Ravel (1875–1937), a musician of the highest order, died in a state of dementia. A genius of orchestration, a successful experimenter in musical forms and styles; he was at his best when given to composing small-scale... more
Maurice Ravel (1875–1937), a musician of the highest order, died in a state of dementia. A genius of orchestration, a successful experimenter in musical forms and styles; he was at his best when given to composing small-scale constructions. His musical miniatures combine an extraordinary expressiveness with an unparalleled, almost mechanical precision. The latter quality provoked Stravinsky into calling him a “Swiss clock-maker of music”.
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An association of "globus hystericus" with depressive illness has already been established. Successful treatment with antidepressants has been previously reported but this is the first report of globus symptom responding... more
An association of "globus hystericus" with depressive illness has already been established. Successful treatment with antidepressants has been previously reported but this is the first report of globus symptom responding to electroconvulsive therapy (ECT) followed by long-term remission on maintenance dose with tricyclic antidepressant. A detailed retrospective study of an elderly patient's General Practice medical notes revealed 45-year history of recurrent globus symptom, interspersed with other somatic complaints. Patient's frequency of consultations with her family physician was noted before treatment and during the 5-year follow-up period. Using DSM-III diagnostic categories, the patient was diagnosed as suffering from major depressive disorder with globus symptom. The notes were insufficient to ascertain whether past episodes of globus occurred in a setting of depressive disorder. A prompt response of globus symptom to ECT was observed with 5-year symptom-free follow-up period as long as the patient remained on a maintenance dose of antidepressant. A marked reduction in frequency of medical consultations for other somatic complaints was noted. The case illustrates a strong association of globus symptom with depressive disorder and other somatic concerns. Patients with recurrent globus symptom and family history of depressive illness should be screened for a possibility of depressive disorder. ECT and antidepressants may be successfully used in treatment of globus in a setting of depressive illness. Long-term maintenance with antidepressive medication may keep at least some of these patients symptom-free. It is suggested that globus hystericus could be more appropriately viewed as a somatic symptom of depression rather than a conversion disorder.
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Nietzsche's name has become almost synonymous with militant atheism. Born into a pious Christian family, this son of a Lutheran pastor declared himself the Antichrist. But could this have been yet another of his masks of hardness?... more
Nietzsche's name has become almost synonymous with militant atheism. Born into a pious Christian family, this son of a Lutheran pastor declared himself the Antichrist. But could this have been yet another of his masks of hardness? Nietzsche rarely revealed his innermost self in the published writings, and this can be gleaned mainly from his private letters and the accounts of friends. These sources bring to light the philosopher's inner struggle with his own, deeply religious nature. Losing his father at a young age was a calamity from which Nietzsche never recovered, and I argue that his famous thought-image " God is dead " was a transfiguration of the painful memory of this loss. In this essay, I trace Nietzsche's tortuous path from an ardent devotee of God to a vociferous critic of Christianity, a path that was punctuated with veiled longings for a loving deity. Deep in his heart, he remained faithful to Christian ideals. Rather like Cordelia, the only truly...