Medical and Musical Byways of Mozartiana (review)

Henry Caleb Powell

Bulletin of the History of Medicine, Volume 76, Number 2, Summer 2002,

pp. 376-378 (Review)

Published by Johns Hopkins University Press

DOI: https://doi.org/10.1353/bhm.2002.0091

For additional information about this article

https://muse.jhu.edu/article/4895

[ Access provided at 26 Oct 2020 05:50 GMT from Fondren Library, Rice University ]
376 book reviews Bull. Hist. Med., 2002, 76

criticism of this volume. Indeed, Tröhler’s work serves as an exemplary case study
of the critical approach to medical reasoning within the British context. Not only
is it of considerable value for historians, it deserves to be read alongside current
medical periodical literature by all clinicians who are bracing themselves against
the rushing tide of medical reform according to EBM “standards.” It will certainly
help clinicians appreciate, as I discussed at a recent medical conference, that
EBM is quintessentially history-based medicine. Clinicians, like historians, piece
together information from past events, discriminating between credible and
incredible sources as they seek the “best evidence” upon which to base their
interpretive diagnoses and practices.

Philip K. Wilson
Penn State College of Medicine

Benjamin Simkin. Medical and Musical Byways of Mozartiana. Santa Barbara, Calif.:
Fithian Press, 2001. 237 pp. Ill. $14.95 (paperbound, 1-564-74-349-7).

For more than ten years Dr. Benjamin Simkin, an endocrinologist and former
concert master of the Los Angeles Doctors Symphony Orchestra, has written
about Mozart’s possible affliction with Tourette’s syndrome (TS), using family
letters and contemporary biographical information. In his new book, he provides
a broader musical context for his case, adding fresh information to suggest that
Mozart may have suffered from attention deficit–hyperactivity disorder (ADHD),
thyroid disease, and pediatric autoimmune neuropsychiatric disorders associ-
ated with streptococcal infections (PANDAS).
The case for TS has already been questioned by several authors, including
Oliver Sacks—their conclusion being that the usual form of TS, associated with
motor and sensory tics and convulsive cursing, is not supported by the evidence,
but leaving open the possibility that the more subtle “phantasmagoric” type of TS
affected Mozart and may help explain his remarkable attachment to bizarre
forms of wordplay and physical hyperactivity. Simkin looks to medicine for an
explanation of Mozart’s famous verbal lapses of taste, so striking in contrast to the
unvarying elegance of his music.
Most of Mozart’s short life was filled with musical composition. In spite of this
he found time for love and friendship, marriage and children, billiards, bowls,
and parties, as well as endless uncomfortable travel—all without apparent dimi-
nution in, or interruption of, his extraordinary creative output. How did he do it?
Simkin argues that a complex of neurobehavioral disorders and inherited traits
helped to form a mind in which exceptional natural talent and an unceasing flow
of musical ideas were linked to external traits such as tics, grimaces, and odd
patterns of wordplay, including the famous letters and vocal compositions invok-
ing scatology. To support his argument Simkin analyzes the family correspon-
 book reviews Bull. Hist. Med., 2002, 76 377

dence for references to organs of excretion, defecation, and deflation, as well as

nonsense rhymes and phrases like “oragna fiagata fa,” the child composer’s
nighttime mantra. A new edition of the Mozart family correspondence, compiled
in a biographic format by Robert Spaethling (Mozart’s Letters, Mozart’s Life, 2001)
allows a different explanation: translating the letters afresh, Spaethling includes
all the misspellings, reminding readers that Mozart, an exceptionally traveled
child, had little time for nonmusical education, let alone the socialization that
goes with it. From a post-Victorian viewpoint it is harder to appreciate the easy
familiarity of the Mozart family with vulgar speech, but living in unplumbed
houses and facing the daily disposal of human waste, perhaps they let it be raw
material for the humor mill. Rather than coprolalia, the excremental references
appear in writing and sometimes were set to music, such as K.231, “Leck mich am
Arsche” (lick me in the arse) and “Bona Nox,” a lullaby in which Mozart put
music to his mother’s naughty nighttime verses.
The social offenses that may have damaged Mozart’s career are also reviewed
by Simkin, who reasonably argues that by aggressively pursuing his career—first
as a child prodigy, and later as a star performer—he tested the limits of a
patronage system over which the veneer of enlightenment was not thick enough
to allow artistic freedom. An early supporter of the Mozarts, Empress Maria
Theresa, later dismissed them as “useless,” complaining of their “going around
the world like beggars” (p. 44). The repetitive speech patterns characterized as
echolalia and pallilalia are not necessarily tourettisms; as a composer of vocal
music Mozart constantly explored the vocabularies of several languages, knitting
words to music and searching for pleasing euphonious combinations. He could
not resist buffoonery, but he knew that it caused him trouble.
The medical “byways of Mozartiana” in this book include new suggestions
regarding familial thyroid disease such as generalized resistance to thryoid hor-
mone (GRTH), a condition linked to attention deficit disorder. However, sister
Nannerl Mozart’s goiter, referred to by her father as a “true national mark of
beauty” (p. 190), was common in the iodine-poor mountainous region around
Salzburg, and while she was treated with “thyroid pills” it is unlikely that they
included iodine, since the dietary deficiency more likely to explain her goiter was
not recognized during the composer’s lifetime. Another idea, that Mozart had a
neurologic triad of perfect pitch, hyperactivity, and headache, presumes that the
headaches mentioned in the letters were due to migraine. He may have experi-
enced migraine, but references to severe toothache are frequent and can reason-
ably be attributed to dental abscess. The May 1790 letter to Puchberg says “I am
sorry that I cannot go out . . . but my toothaches and headaches are still too
painful and altogether I still feel very unwell” (p. 189). Dental health is a crucial
requirement for systemic good health, and this kind of pain is more likely due to
infection, such as group A hemolytic streptococcal disease (GABHS).
To the extent that medical speculation about Mozart’s life and health is of any
value, GABHS is an important consideration, linked to the pathogenesis of other
clinical problems—including rheumatic heart disease, glomerulonephritis, and
Henoch-Schönlein purpura—implicated at various times by medically oriented
378 book reviews Bull. Hist. Med., 2002, 76

biographers. GABHS is a requirement for the last of Dr. Simkin’s hypothetical

diseases afflicting Mozart: pediatric autoimmune neuropsychiatric disorders as-
sociated with streptococcal infections, bearing the charming acronym PANDAS.
Here again the case is made with circumstantial evidence; however, since PANDAS
are linked to obsessive-compulsive disorders and other behavioral problems,
speculation is likely to continue in this vein. The rest of the book provides an
enjoyable read and reflects the author’s deep love of the music and a performer’s
sense of discovery.

Henry Caleb Powell

University of California, San Diego

Penelope Gouk, ed. Musical Healing in Cultural Contexts. Aldershot, U.K.: Ashgate,
2000. xi + 223 pp. Ill. $69.95 (1-84014-279-0).

In this volume of essays, Penelope Gouk has placed music alongside the science
of healing. As in her most recent book, Music, Science and Natural Magic in
Seventeenth-Century England (1999), exploring the influence of music on natural
magic and early modern experimental science, Gouk seeks to confirm centuries
of anecdotal evidence concerning the relationship between two seemingly dis-
parate disciplines (p. 4). In the current book, the outgrowth of a symposium,
“Music, Healing, and Culture,” held in London in 1997, Gouk has brought
together a diverse group of distinguished scholars, each contributing an essay on
a topic related to the power of music to heal within a particular culture or time
period.
In addition to Gouk’s fine introduction and final chapter “Sister Disciplines?
Music and Medicine in Historical Perspective,” there are eight other essays:
Henry Stobart, “Bodies of Sound and Landscapes of Music: A View from the
Bolivian Andes”; John M. Janzen, “Theories of Music in African Ngoma Healing”;
Steven M. Friedson, “Dancing the Disease: Music and Trance in Tumbuka Heal-
ing”; Charles Burnett, “‘Spiritual Medicine’: Music and Healing in Islam and Its
Influence in Western Medicine”; George Rousseau, “The Inflected Voice: Attrac-
tion and Curative Properties”; Linda Phyllis Austern, “‘No Pill’s Gonna Cure My
Ill’: Gender, Erotic Melancholy and Traditions of Musical Healing in the Modern
West”; Cheryce Kramer, “Soul Music as Exemplified in Nineteenth-Century Ger-
man Psychiatry”; and Lyn Schumaker, “The Dancing Nurse: Kalela Drums and
the History of Hygiene in Africa.”
Gouk’s rationale for this present volume is that it is difficult to find material
that places the healing and therapeutic applications of music in historical or
cultural settings. The introduction, in addition to setting clear definitions and
parameters, presents a critical review of the literature, followed by a meticulous
summary of the framework for the symposium, reiterating a series of questions