Wolfgang Amadeus Mozart--controversies regarding his illnesses and death: a bibliographic review.

More has been written about Mozart's illnesses and death than for any other composer. An exploration of PAMA's Bibliography of Performing Arts Medicine provides the data for this review. The bibliography contained 136 entries that pertained to Wolfgang Amadeus Mozart. Of these, 81 were available to the author, either in printed or electronic copy. In order to provide a clearer historical perspective on this topic, this review assembles information pertaining to illnesses and other medical problems that occurred during Mozart's life as well as those purportedly contributing to his death.

Perspectiva histórica de la clasificación de las vasculitis / Historical perspective on the classification of vasculitis

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[Health and death of Wolfgang Amadeus Mozart]. / Gezondheid en dood van Wolfgang Amadeus Mozart.

Not much is known about the medical history and cause of death of the composer Wolfgang Amadeus Mozart (1756-1791). Contrary to popular opinion, Mozart was not an exceptionally ill child and as an adult he generally enjoyed good health. At the age of 9 years he experienced a life-threatening illness, which was probably typhoid fever. On the left-hand side he had what has since become known as 'Mozart's ear', a pinna with under-development of the anthelical fold. His psychological condition gives rise to the notion that he was not exceptional, but that he responded to the events in his life in a normal manner. His terminal illness was characterised by edema of hands and feet, without any associated dyspnoea being described. The medical treatment was aggressive: enema, bloodletting on several occasions and treatment with a laxative substance. He was burried in an anonymous grave. The skull that was later ascribed to him was not his own, as no element of the denture fits with the tooth abscess he was known to have experienced. An overdose of mercury during the treatment of syphilis seems to be unlikely, as equally Henoch-Schönlein-purpura and the consequences of acute rheumatism. Trichinosis is a recent hypothesis which fits the terminal symptoms and the fact that Mozart was fond of pork. The diagnosis of his physician Closset was 'hitsiges Frieselfieber', which was possibly caused by one of the many infectious diseases prevalent at that time.

William Osler and development of the concept of systemic lupus erythematosus.

OBJECTIVE: This historical review summarizes the understanding of lupus erythematosus (LE) during the time of the career of William Osler and analyzes factors that may have retarded the clinical identification of this disease. METHODS: All of Osler's writings related to diseases that he defined as the "erythema group" were studied, in conjunction with relevant writings on Schönlein-Henoch purpura and erythema multiforme. RESULTS: Osler did not knowingly describe cases of LE, nor did he discuss the disease in general. He proposed that a primary skin disease, which in some cases has visceral manifestations, may develop as a purely visceral disease, using cases from his "erythema group" cohort as evidence. CONCLUSIONS: The reluctance into the 1940s to diagnose systemic LE was primarily a consequence of the erroneous belief that a skin eruption was required to establish the diagnosis. Osler's teaching the possible dissociation of visceral from cutaneous symptoms with regard to the erythema group was not analogized to LE. The interpretation that Osler had elucidated aspects of LE has developed since 1937 and attributes insights to Osler that his writings do not substantiate.

The pathobiography and death of Wolfgang Amadeus Mozart: from legend to reality.

Mozart, perhaps one of the greatest geniuses of modern age, died mysteriously at the age of 35 in Vienna in 1791. The causes of his death are still somewhat obscure and debated since we do not have any documentation acceptable by current scientific standards. Inevitably, the conclusions reached are highly debatable. In the present article the various interpretations of Mozart's death are taken into consideration-from his possible poisoning to causes of death more acceptable by the present diagnostic criteria. We suggest that the terminal cause of death was brain hemorrhaging or stroke, complicated by broncopneumonia and associated with renal failure induced by proliferative glomerulonephritis and glomerulosclerosis.

Johann Lukas Schönlein and his contribution to nephrology and medicine.

Schönlein published few papers, and most of what is known of his achievements in nephrology comes from notes and publications of his students. It seems, however, that he described the combination of rheumatic fever, affection of internal muscular organs, a typical exanthem and oliguria, coining the name purpura rubra to describe this syndrome. Although patients with symptoms of Schönlein's syndrome had been described earlier, Schönlein was the first to describe purpura rheumatica as an entity. Schönlein's greatest contribution was the discovery of the anthropophilic pathogenic fungus Trichophyton schönleinii as the cause of the contagious skin condition favus (honeycomb ringworm). This opened a new field--mycology--and allowed therapy to be aimed specifically at the cause of the disease.

[Johann Lucas Schönlein (1793-1864), a researcher and clinician]. / Johann Lucas Schönlein (1793-1864), Forscher und Kliniker.

From 1833 to 1840, Johann Lucas Schönlein, a native of Bamberg, Germany, was Professor of Internal Medicine at the newly created University of Zurich, Switzerland. His career and professional personality are described succintly in this paper. Schönlein was a most successful clinical teacher. He was the first German professor to teach at Würzburg, 1819-1832) clinical percussion and auscultation. On the other hand, he obviously hated writing and publishing. His 3 important discoveries, all made during his years in Zurich, were published on a total of 3 printed pages: so-called typhoid crystals in patients' stools (1836), "peliosis rheumatica" (1837), and - most important - the causative agent of favus (1839), a fungus later named Achorion schoenleinii. This was the first instance of a human disease that could be clearly attributed to the action of a micro-organism.