Hektoen International

A Journal of Medical Humanities

Schubert, Schumann, and the Spirochete

Franz Schubert (1797 – 1828) 
Robert Schumann (1810 – 1856)

Their names sound Germanic and are somewhat similar, as are their portraits. They wrote beautiful music and rank high among the great composers of the romantic era. To confuse their names would constitute an unforgivable crime, especially in the eye of music lovers. Yet in 1956 fallible East German authorities issued a stamp featuring an image of Schumann accompanied by a score of Schubert’s music. They promptly corrected their mistake by issuing a new stamp.

Both composers died young, especially Schubert (1797 – 1828).  It is said that on hearing of his death young Robert Schumann sobbed all night in despair. For Schubert the official cause of death was “nervous fever”; later it became typhoid fever; but it appears that in the Vienna of his youth Schubert had numerous contacts with the oldest of professions. In 1823 he was first noted to have socially embarrassing recurring rashes and hair loss requiring the wearing of a wig. In that year his symptoms caused him to be hospitalized. He had fevers, ulcers in the mouth and throat, pains in the bones, and his left arm became too painful to play the piano. He improved, but later became ill again. In 1828 he began drinking heavily, became prone to excessive rages, had giddiness and insomnia. In September of that year he suddenly declared that all food made him nauseous and that he was being poisoned, then stopped eating and only took medicines. Delirium set in soon afterwards and he died in November.

Robert Schumann, born in 1810, appears to have suffered from mental problems all his life, now variously though to have been schizophrenia or manic-depressive illness of the bipolar type. He had delusional ideas, especially of being poisoned by metals, but also episodes of severe depression alternating with periods of excitement and “exaltation”, leading to his hospitalization in 1833.  At age 40, his health began to deteriorate. He had continuous malaise, dizziness, headaches, tingling sensations and convulsions, weight loss and also pains in the bones and joints. In 1854 he attempted suicide, and was admitted to a mental hospital at his own request. His condition gradually worsened, speech and personality deteriorated, progressive paralysis set in, and he died two years later.

Schumann’s illness has given rise to considerable controversy, continuing even after his medical records emerged in 1991 and were published in 2006. His history of mental illness was an embarrassment to the Nazi authorities, whose laws mandated compulsive sterilization of schizophrenics and manic-depressives, giving rise to the claim that he had hypertension leading to vascular dementia. But surviving records indicate otherwise. In his diary he wrote that ”in 1831 I was syphilitic and treated with arsenic.” It has been postulated that he may been infected as a student. Less credibly, that he caught the infection from his sister (who had a chronic skin disease and mental problems) perhaps by contact with wet towels or sharp objects – so-called syphilis innocens. More likely, he was infected by conducting an affair with the maid of his prospective father. At one time he seems to have had a chancre on his penis. He had to stop playing the piano because the fingers of his right hand were paralyzed. He received treatment with heavy metals, which themselves may cause mental and other symptoms. But the course of his illness is consistent with advancing neurosyphilis, supported by the description by his doctors of unequal pupils, the classical Argyle Robertson pupils of that disease. Also, autopsy reports describe a yellow gelatinous mass at the base of the brain, possibly a gumma, as well as involvement of the aortic valve, a common finding in tertiary syphilis.

To ascertain what illnesses afflicted the great men of the past remains an interesting popular exercise fraught with unsurmountable difficulties. Not only were modern diagnostic tests not available, but even descriptions of disease long remained imprecise and confused. For both Schubert and Schumann heavy metal poisoning (mercury, arsenic) from the treatment they received has been considered as an alternative diagnosis. Yet it is most likely that both these geniuses, whose music still resounds in our modern concert halls, were victims of the great killer of their time, the spirocheta pallida.

GEORGE DUNEA, MD, Editor-in-Chief

Winter 2014 



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