Medical and Musical Byways of Mozartiana (review)

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 associated 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 diminution 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 invoking scatology. To support his argument Simkin analyzes the family correspondence 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 hormone (GRTH), a condition linked to attention deficit disorder. However, sister Nannerl Mozart's goiter, referred to by...