EXPERTS ALLEGE (AGAIN) CHOPIN’S “ROMANTIC DEATH” CAUSED BY THE WHITE PLAGUE TO BE CONSIDERED “CASE CLOSED” AFTER RECENT "EXAMINATION" OF A NEARLY TWO CENTURIES' OLD HEART, PRESERVED IN COGNAC, MAKES THE PAGES OF THE AMERICAN JOURNAL OF MEDICINE

"The Death of Chopin." Chopin surrounded himself with close family and friends (including
his physician) whilst on his deathbed. Among them were George Sand's daughter
Solange, and one Princess Marcelina Czartoryska, pictured at the head of the bed. This
engraving, after the painting by Félix Joseph Barrias, re-tells the pitiable scene recalled by
Solange: "One October evening in 1849, the 16th, approximately twenty people were
fearfully waiting in the living room..Chopin had someone ask whether Countess
Potocka was also in the living room, and if she would sing. The piano was moved closer,
the doors were opened, and the beautiful countess began to sing. She sang with a
broken heart, a voice full of tears! The gathered guests fell on their knees, stifling a sob."

17th of October, 1849, Place Vendôme 12, Paris, sometime after midnight: a grievously ailing Frédéric Chopin lay on his deathbed, soaked in sweat and appearing gaunt and pale in his sickly pallor (telltale signs of advanced "consumption" - the colloquial term for Tuberculosis - that highly “romantic” yet exceedingly infectious disease which earned its moniker from the sufferer appearing to onlookers to be "consuming from the inside." 

It was considered a "fashionable" pestilence, beloved by an uninformed public who bore witness to the various stages of “beauty”  which the vile scourge would temporarily extol in it’s victims - many of them poets, artists, writers, composers - stricken during the so-called “romantic era” of music and art: those poor victims who, as the disease progressed, would experience a brief period of external grandeur: a tauter waistline (due to anemia) and more porcelain complexion. It seemed a gift from heaven for men and women alike seeking to edge off a few years - an otherworldly elixir of youth.

For actual suffers of the disease, however, the slow moving contagion was anything but a gift from the gods. Chopin knew this all too well: when prompted that fateful autumnal evening at the Place Vendôme, the very mortal Chopin had seemingly accepted his early mortality and must have known the end was drawing near. He at once informed his physician, who had gathered at his deathbed, that he was suffering “no longer”.

Within hours, he would be dead.

With his passing, the Polish-born, French idol joined a large cast of artistic carriers of the disease, all of whom expired before their time, and before the advent of penicillin (antibiotics) (see: Louis Pasteur here at Unraveling Musical Myths) and the discovery of the illness’s progression by German physician and microbiologist Robert Koch (pictured below, right) in the late 19th century.

Prior to Koch’s discovery in the 1882 of the slow growing bacterium Mycobacterium tuberculosis, it was widely believed amongst the public (and even among physicians themselves) that “TB” (code for Tuberculosis) was an inherited disease – the public taking it one step further, claiming it a disease inherited only by the minds of great men, and could be “healed” only by the divine touch of a Royal Monarch (which quite a few Kings were known to have taken advantage of, providing the "healing service" - for a pretty penny, of course). Parisian women and men alike were known to mask their faces in a veil of lead-ridden white paint (makeup: a disaster of its own), starve themselves and tighten their corsets to the point of asphyxiation and repeated cases of syncope to mimic the mysterious disease which inflicted their exalted idols.

With his passing, Chopin found himself in the company of fellow composers Alfredo Catalani – the Italian mastermind behind the 1892 opera La Wally; The exquisitely gifted and much admired German composer and musician Carl Maria von Weber of Der Freischütz fame; the young and immensely talented Giovanni Batista Pergolesi - just 26 when he perished from the infernal white plague, and whose glorious Stabat Mater remains to this day one of the greatest sacred works ever composed; Igor Stravinsky – that Russian-born mover and shaker that revolutionized the modern orchestra and ballet not only in Paris but around the globe, and, just over a century and a half earlier to Chopin’s demise, the great English composer Henry Purcell, beloved – and employed by - Britain’s reigning Royal family – and that's just to name a few.

Listen below to the exquisite voice of Renata Tebaldi as she sings from Catalani's opera La Wally "Ebben! Ne andrò lontana:"



Tuberculosis, Consumption, Phthisis, The White Plague, The White Death, “TB” - a disease of many names - even made appearances on the theatrical and operatic stage. Italian composer Giacomo Puccini famously (and erroneously) referred to it as a “social disease,” in his 1896 opera La bohème: abandoned by her lover for fear of catching TB via sexual transmission, the opera’s heroine, Mimi, ashamed, ailed, and anguished, perishes without seeking medical intervention.

Hammering home the unknown etiology of Tuberculosis prior to Koch’s discovery in 1882, French composer Jacques Offenbach’s famous Tales of Hoffmann treats the often fatal disease with a sense of satirical humor – in which the character Antonia, stricken by consumption, is made to sing herself to death – doctors orders, of course – whilst simultaneously conjuring up the dead spirit of her mother (who was once an opera singer).

Italian composer Giuseppe Verdi infamously featured the disease through the consumptive Violetta, in his 1853 opera, aptly titled “La Traviata” (or, “The Fallen Woman”).

Readers of Unraveling Musical Myths may remember my post on the famous French playwright Molière, who served under France's "Sun King," Louis XIV, who not only (unintentionally) incorporated the white plague into what would be his final play – and ultimately, his final performance as an actor on stage – in his 1673 work “The Imaginary Invalid,” a play that centered around maniacal hypochondriac, Argan – played by Molière himself. In one pivitol scene, as Molière sits hacking bloody phlegm into a handkerchief – a well placed prop to add to the character’s downward spiral into psychosomatic illness - he is surrounded by a farcical group of outlandishly dressed “doctors”, who, to add a dizzying aspect to the main characters' inner turmoil, dance and twirl around the sullen clown – one moment, in full view, spitting up blood, the next, Argan (Molière) cleverly masked by ‘doctors’ mocking the "insane one" – shielding the audience - and therefore society’s - view from the depths of unchecked madness. It was a brilliant performance - a grand idea – or so the audience thought – even the characters surrounding the ever convincing actor hacking away  on stage were late to realize the blood in the napkin was real, the sweat dripping from his brow the sign of a fever that would reach such a height that it would stricken the playwright/performer with a series of hemorrhages (two of which he suffered on stage: it was at the point of his second hemorrhage/collapse that he was carried away by his co-stars, still seated - or slumped over – in his chair to the backstage area for transport). Worse was to come for poor Molière, a series of violent seizures would wind up killing him later that evening. The White Plague had secured another victim. Perhaps most ironic is Argan (Molière’s) dialogue itself: after complaining about receiving numerous enemas to little avail, and griping about various undiagnosed “imaginary” ailments suffered upon him, he blurts out the prophetic line:

 "Your Molière’s an impertinent fellow… If I were a doctor, I’d have my revenge… when he fell ill, I’d let him die without helping him. I’d say: “Go on, drop dead!” 

Talk about injecting the pathos of life-like fragility into a role!


Molière's final moments on the theatrical stage, and the hemorrhages and audience/co-star confusion which surrounded the countdown to the beloved playwright's death, which would later turn into violent seizures were brilliantly re-created for modern audiences in the French Masterpiece biopic Le Roi Danse (Read more about Molière here at Unraveling Musical Myths, and check out the recreation below):

Camille sur son lit de mort (Camille on her Deathbed),
Claude Monet, 1879, Musée d'Orsay, Paris.

Even the artistic and academic intelligentsia were not immune from the wrath of the white plague: Poets such as John Keats and Edgar Allan Poe; Novelists Jane Austen, the Brontë sisters (Anne, Emily and Charlotte), W. Somerset Maugham, Robert Louis Stevenson, Fyodor Dostoevsky and Franz Kafka all fell victim to consumption; whilst artists such as Edvard Munch, whose mother died of TB when he was but a young 5 year old lad, would become stricken by the same disease – which, fortunately for him, did not rob him of his life – he would perish at 30 of pneumonia. Both he and Rembrandt, whose wife was stricken with Tuberculosis captured the “consuming” of the living and dying corpses of their beloved in their works. Monet, whose wife’s life was claimed by the hand of TB, chose to immortalize both the destruction caused by the disease, and the fragility of man when he infamously painted his wife on her on deathbed. The list of victims of note is seemingly endless.

Even members of royalty weren’t immune: King Henry VIII’s only legitimate son, later crowned King Edward VI, whom he had sired after having broken with Rome, ignited a violent religious turmoil in Europe by establishing the Church of England, annulled one wife and beheaded another who couldn’t produce a son only to impregnate the latters’ lady-in-waiting Jane Seymour, would die at the tender age of 15 from the disease.

Just think of how many heads were lost due to religious turmoil for a mere six years on the throne of England! 

Fast forward to 2014 – whilst tuberculosis remains the second largest killer on a global scale (predominately due to inadequate healthcare in underdeveloped nations), modern science has rendered the disease not only curable, but entirely preventable through vaccination. This would not have been made possible however, without the intervention of Koch in 1882 and his formation of “four postulates," coined by the microbiologist during his investigations on anthrax, and later, tuberculosis:

from Wikipedia:

“During his time as government advisor, Koch published a report, in which he stated the importance of pure cultures in isolating disease-causing organisms and explained the necessary steps to obtain these cultures, methods which are summarized in Koch’s four postulates. Koch’s discovery of the causative agent of anthrax led to the formation of a generic set of postulates which can be used in the determination of the cause of most infectious diseases. These postulates, which not only outlined a method for linking cause and effect of an infectious disease but also established the significance of laboratory culture of infectious agents, are listed here:

• The organism must always be present, in every case of the disease.

• The organism must be isolated from a host containing the disease and grown in pure culture.

• Samples of the organism taken from pure culture must cause the same disease when inoculated into a healthy, susceptible animal in the laboratory.

• The organism must be isolated from the inoculated animal and must be identified as the same original organism first isolated from the originally diseased host.”

Koch's method of discovery would help isolate and identify the bacteria responsible for the White Plague, which he coined Mycobacterium tuberculosis.

And, lest we forget, we have Louis Pasteur, the French microbiologist to thank for developing the world’s first vaccination. Developed over a period of some 13 years, it would not be until the mid 20th century that French bacteriologists Albert Calmette and Camille Guérin developed a preventative vaccination, known as BCG, to be administered shortly after birth to high-risk infants. Whilst not always effective and still highly controversial, the vaccine is widely regarded as having prevented the deaths of many of those who were infected, provided they meet strict guidelines.
To date, discoveries are being made and fruitful attempts at developing other potentially life saving vaccinations for Tuberculosis: it appears the de-facto cure-all may not be that far away in the future (see: Wikipedia - Tuberculosis Vaccines).

Pillar said to contain the preserved heart of Chopin, at
The Holy Cross Church in the composers' beloved
birthplace of Warsaw, Poland.

Back to the evening of April 2014, a team of genetic and forensic scientists, like sleuths masked by the cover of night, attended a top secret ceremony in Warsaw, Poland – birthplace of the legendary composer Frédéric Chopin, who famously left his body for burial in his beloved second home of Paris (at the very same resting place of Marcel Proust,  no less: the Père Lachaise cemetery); but left his heart – smuggled into Poland by the composer’s sister Ludwika - in his homeland, specifically, at the Holy Cross Church in Warsaw.

Why top secret? The experts involved faced much in the form of real and potential backlash to Poland’s beloved hero – who would have considered it sacrilege to open the urn and manhandle the organ. Chopin also had a living descendant, a great-great granddaughter of one of the composer’s sisters, who, alongside the former director of Poland’s Chopin Institute – and even the Archbishop of Warsaw – deeply opposed the excursion into the ever lofty one’s remains.

Nevertheless, the team pursued with their exhumation.

The composers’ heart, preserved in a crystal urn filled with alcohol – presumed to be Cognac – had allegedly been untouched – secured in one of the church’s pillars - for some 160 years at the time of the experts’ arrival, and untouched, it would remain. Using only visual cues, and relying on the legend of the sacredly preserved heart having belonged to Chopin himself (and, assuming, if the legend be true, that no substitute had been made in nearly two centuries - in spite of the fact that the heart was famously captured by a high ranking SS Officer during the Warsaw uprising in 1944, and later held at German high command headquarters until the defeat of Nazis at the end of the Second World War), the scientists set to work.

They knew the composer had perished at La Place Vendôme in Paris, on October 17 1849, they knew he was 39 at the time of his death, and they knew, according to contemporary sources that “France’s greatest authority” on TB, the physician Jean Cruveilhier, had diagnosed Chopin months before his death with the often fatal disease, and that the very same doctor rendered it as the cause and manner of death on the composer's official death certificate – only to later rescind his post-mortem diagnosis by removing Chopin’s heart during autopsy (allegedly, at the behest of one of Chopin's sisters, who claimed her famous brother so feared being buried alive, he demanded of her to “Swear to make them cut me open, so that I won’t be buried alive”), and, according to reports, noted the composers untimely death to have been caused by a “disease not previously encountered.”

Rumors began to swirl at the true cause of Chopin’s demise: everything from cystic fibrosis, to emphysema – in particular an "alpha-1-antitrypsin deficiency, a relatively rare genetic ailment that leaves individuals prone to lung infections; and mitral stenosis, a narrowing of the heart valves.”^{[source: the Guardian]} began making the rounds.

Some five months after that ‘top secret’ nighttime excursion to the Holy Cross Church to look upon what was allegedly Chopin’s heart (mind you, through the crystal urn, which never left the church, was never opened, and never had any biological tissue removed for microscopic or other examination), called for a press conference. At last, a concrete conclusion as to what killed Chopin would be announced to the world.

The well preserved heart, the team of experts announced, bore “TB nodules,” (a coating of white, fibrous materials and lesions) and was "much enlarged, suggesting respiratory problems, linked to a lung disease." Hence, Chopin died of Tuberculosis. Case closed.

But, it seemed not all were convinced.

Sebastian Lucas, Emeritus Professor of Pathology at Guy's and St Thomas' Hospital in London told the press shortly after the public hearing had commenced, that

"If the heart was involved in the TB, it would in many cases be affected by pericarditis, an inflammation around the heart...TB pericarditis can be nodular or a diffuse process. Nodules sound good for TB as the diagnosis, but other diseases can mimic that appearance - cancer, and a fungus infection such as aspergillosis. You can't tell which one by the naked eye."

The scientists' much contested, highly restrained visual examination of what was allegedly Chopin’s heart back in 2014, finally made the American Journal of Medicine, which published a “concrete” diagnosis in November 2017. Whilst the final conclusion remained that of tuberculosis, the addition of pericarditis – a rare complication of the disease was held as the chief cause of death, with TB merely the conduit that led to the inflammation of the heart that killed Chopin.

After all of this scientific brouhaha, I am left to muse: has any conclusion really been reached here at all?

Portrait of Ludwika Jędrzejewicz (née
Chopin), sister to the late composer, is
alleged to have smuggled her brothers'
heart from Paris to Warsaw by concealing
the crystal urn beneath her skirts.

I falter at the thought of donning the role of skeptic, but assuming one believes the second hand testimony of Chopin’s sister who “ordered” the alleged "Parisian authority on TB" (inasmuch as one can be "an authority" on a disease not fully understood until some 33 years after Chopin’s death thanks to Koch’s research), and assuming the heart was neither confiscated by said doctor, and then stretching the imagination even further to assume it was successfully smuggled into a pillar in Warsaw shortly after death under the skirts of the composer’s sister – and add to that the curiously optimistic belief that the enemy nation of WWII preserved, and did not substitute, nor defile the Polish born composer's remains (a Slavish ethnic group in whom Hitler and the SS themselves would have seen as degenerates): a notion which can only be substantiated by believing in the highly dubious and questionable "honor and integrity" in which not only one but many SS officers (the highest ranking, leanest and meanest Officials to come out of WWII Germany to be precise) treated the heart with dignity. And, for this hypothesis to hold even the slightest modicum of veracity, one must not forgo of the fact that we still have no biological material on which to test for not just the disease itself (since opening the urn was strictly verboten), but first and foremost – to test the DNA of the 170 year old relic to determine whether the organ belonged to Chopin at all!

I find myself perplexed as to how such an inconclusive, highly restrained ‘examination’ of questionable biological material could even make the pages of the esteemed American Journal of Medicine in the first place. If this so-called evidence were held up in a court of law to prove the cause of death, I’m quite sure that hear-say, legend, smuggling, and the passing through of Nazi hands would have rendered the case thrown out of court!

But hey, that’s just my opinion.

I thought it quite fitting to include in this post a performance of Chopin's "Polonaise in G minor," believed to be the Frédéric's first attempt at composition, penned in 1817, at the tender age of 7; published posthumously thanks to the materials left behind after the death of the composer's father, Nicolas, who had, in secret published the work prior to his death - also of tuberculosis in 1844.



DISCOVER MORE (EXTERNAL LINKS):

• What is the "White Plague" (Tuberculosis) exactly, why was it considered "romantic," and how is it spread?
   
View below an informative lecture from Gresham College, led by Professor Sir Richard J. Evans: 

"The White Plague: A Social History of Tuberculosis"

Follow the "examination," process (chronological, as published by the British Press):

• Scientists descend upon Warsaw to solve Chophin death riddle: @ BBC (2014)
• Case closed? Chopin's "Pickled Heart" mystery solved: @ The Guardian (2017)
  
• American Journal of Medicine Report: contributer - forensic's team leader from the 2014 visual inspection, Dr. Michal Whitt: @ AMJMED.COM

-Rose.

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