Frédéric Chopin's illness
Encyclopedia
Frédéric Chopin
's disease, and the reason for his premature death at age 39, remain unclear. Though he was diagnosed in his lifetime with tuberculosis
and treated for it, since his death in 1849 a number of alternative diagnoses have been suggested.
and weight loss. Later he endeavored to avoid such symptoms with diet; he obtained substantial improvement with ingredients such as honey
and oat bran. Chopin attained a height of 170 centimetre — the 25th percentile
; and at age 28 he weighed 45 kilograms (99.2 lb) — below the 3rd percentile.
Chopin is known at 22 to have had no facial hair
: as he wrote in the winter of 1832, he grew sideburns
on only one side of his face. In 1826 he was sick for six months, suffering from enlarged cervical lymph nodes
and severe headache
s. In 1830 a chronic cold caused nasal swelling
which prompted him to cancel planned concerts in Vienna.
In 1831, in Paris, 21-year-old Chopin experienced his first hemoptysis
(coughing up of blood). In 1835 he suffered a severe two-month laryngitis
and bronchitis
, and the resulting interruption in his correspondence with Warsaw gave rise to gossip that he had died.
In early youth he treated himself with belladonna. In the final decade of his life, he treated the coughing fits from which he had suffered all his life, with a blend of sugar and opium
. Chopin coughed up abundant mucus
, especially about ten in the morning. He occasionally drank alcohol, sometimes smoked and – as some authors noted – suffered the consequences of inhaling others' smoke while enjoying the company of his Parisian friends. In the last year of his life, he endured diarrheas, caused either by cor pulmonale
or by exocrine pancreatic insufficiency
(see below).
On 17 October 1849, at 2 a.m., after a sudden coughing fit, Chopin died in the 40th year of his life. His physician, Jean Cruveilhier
, confirmed his death by holding a mirror to Chopin's mouth and by illuminating his pupils with light from a candle. Pursuant to Chopin's will, Dr. Cruveilhier, a renowned professor of pathology
, carried out an autopsy
. The postmortem report was destroyed either in the Paris fire of 1871 or during World War Two. The death certificate
stated the cause of Chopin's death as tuberculosis of the lungs and larynx. However, Wojciech Grzymała, in a letter to Auguste Leo dated October 1849, wrote that the autopsy had not confirmed tubercular pulmonary changes and that his actual disease was unknown to contemporary medicine. The postmortem findings were also communicated to Chopin's sister Ludwika
, Adolf Guttmann and Jane Stirling
, and their later letters were consistent as to the findings.
In Warsaw
, Chopin's physicians were Jan Fryderyk Wilhelm Malcz, Franciszek Girardot and Fryderyk Adolf Roemer. In Vienna
, Chopin was provided medical care by Johann Malfatti. Chopin's physicians in Paris
included Aleksander Hofman, Jean-Jacques Molin, André François Cauviere, Jan Matuszyński, Adam Raciborski, Pierre Gaubert, Gustave Papet and Coste. During his 1848 stay in London
– Mallan and James Clark. In Paris, in 1848–49, he was treated by Léon Simon, Fraenkel, David Koreff, Louis and Roth. Chopin's last physician was Jean Cruveilhier
.
Of Frédéric’s three sisters, Izabela died at age 70 and had no illnesses; Ludwika
suffered from recurrent respiratory infections and died at 47; the youngest, Emilia, was of frail health from earliest childhood. Emilia suffered from recurrent coughs and dyspnea
; at 11 she began having hemorrhages from the upper gastrointestinal tract, and she died of a massive hemorrhage at 14.
and purging. Tuberculosis figured in his death certificate, despite the alleged absence of typical organ changes. Critics of alternative hypotheses about Chopin's disease point out the abundant evidence for tuberculosis. Chronic coughs and hemoptysis are common symptoms of tuberculosis; complications may include both pericarditis
, causing right-heart insufficiency, and bronchiectasis
, manifesting in productive cough and respiratory failure.
A 20-year history of hemoptysis
is rare in tuberculosis, but not impossible. Similarly, cavernous tuberculosis is rare in childhood, but cannot be excluded in the case of Emilia Chopin. Frédéric could have contracted tuberculosis from his younger sister. Against the diagnosis of tuberculosis stands the fact that some physicians who cared for Chopin did not diagnose him with that common, well-known disease. Another argument against tuberculosis would be the absence, in Cruveilhier’s report, of organ changes typical of tuberculosis, and gastrointestinal symptoms that cannot be explained by tuberculosis.
A monograph on historic methods of treating tuberculosis has discussed individual treatments on the example of Chopin, since his history well illustrates mid-19th-century views on treating tuberculosis.
The hypothesis that Chopin suffered from cystic fibrosis
was first presented by O’Shea in 1987. It has been supported and popularized by physicians from the Medical University of Poznań
. Arguments for cystic fibrosis as the chief cause of Chopin’s complaints are: the onset of the condition in early childhood, possible familial occurrence (Emilia), gastrointestinal symptoms, intolerance of fat-rich meals, recurrent infections of the lower respiratory tract, also suppurative, with exacerbations in winter, recurrent infections of the upper respiratory tract (laryngitis, sinusitis), barrel chest (visible in some photographs and caricatures), low tolerance of physical exercise, an episode of heatstroke (more frequent in cystic fibrosis), caries (more pronounced in this disease), putative infertility
.
There is no evidence for clubbed fingers – a symptom of hypertrophic osteoarthropathy, frequent in cystic fibrosis – but hand and ankle arthralgia
in his last year of life may relate to this condition. It has been suggested that Chopin suffered from a mild form of cystic fibrosis, its course worsened by coexisting tuberculosis or another mycobacteriosis. Confirmation for the cystic fibrosis
hypothesis might be obtained by genetic testing of preserved body tissues, but so far scientists have not been granted permission to take samples from Chopin's heart, which is immured in a pillar inside Warsaw's Holy Cross Church
. A full review of the possible causes of Chopin's illness has recently been published.
was proposed by Kuzemko in 1994. According to this hypothesis, Emilia's fatal hemorrhage was caused by ruptured esophageal varices
, secondary to liver cirrhosis in the course of alfa 1-antitrypsin deficiency. Frédéric's symptoms of liver insufficiency would be hypoproteinemia
, feminization features
(no facial hair) and gastrointestinal bleeding
. His death would be explained by liver failure and respiratory failure due to chronic obstructive pulmonary disease
.
Supporters of the cystic-fibrosis
hypothesis argue, against Kuzemko, that cystic fibrosis would explain Chopin’s symptoms equally well. Kuzemko himself has conceded that typical symptoms of liver cirrhosis in the course of alfa 1-antitripisin deficiency would be jaundice
and ascites
.
Kuzemko’s hypothesis has been cited by Reuben and Eriksson in 2003.
is a possible, if unlikely, cause for the artist’s complaints and was discussed by Kubba and Young in 1998. The most important argument against this hypothesis is the absence of evidence that Chopin suffered from rheumatic fever
in childhood, which is the most common cause of mitral valve stenosis.
, allergic bronchopulmonary aspergillosis
, hypogammaglobulinemia
, idiopathic pulmonary haemosiderosis, lung abscess
es, and pulmonary arteriovenous malformation
s.
, which would tend to strengthen the cystic-fibrosis
hypothesis.
(now termed schizophrenia
), but he emphasized the absence of evidence for severe psychosis
and the fact that single symptoms may only suggest a predisposition to such mental illnesses.
Frédéric Chopin
Frédéric François Chopin was a Polish composer and virtuoso pianist. He is considered one of the great masters of Romantic music and has been called "the poet of the piano"....
's disease, and the reason for his premature death at age 39, remain unclear. Though he was diagnosed in his lifetime with tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
and treated for it, since his death in 1849 a number of alternative diagnoses have been suggested.
Case history
Frédéric Chopin was, from childhood, sickly and under medical care. He showed intolerance of fatty foods, especially pork – these caused stomachaches, diarrheaDiarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...
and weight loss. Later he endeavored to avoid such symptoms with diet; he obtained substantial improvement with ingredients such as honey
Honey
Honey is a sweet food made by bees using nectar from flowers. The variety produced by honey bees is the one most commonly referred to and is the type of honey collected by beekeepers and consumed by humans...
and oat bran. Chopin attained a height of 170 centimetre — the 25th percentile
Percentile
In statistics, a percentile is the value of a variable below which a certain percent of observations fall. For example, the 20th percentile is the value below which 20 percent of the observations may be found...
; and at age 28 he weighed 45 kilograms (99.2 lb) — below the 3rd percentile.
Chopin is known at 22 to have had no facial hair
Facial hair
Facial hair is a secondary sex characteristic of human males. Men often start developing facial hair in the later years of puberty or adolescence, approximately between 17–20 years of age, and most do not finish developing a fully adult beard until their early 20s or even later...
: as he wrote in the winter of 1832, he grew sideburns
Sideburns
Sideburns or sideboards are patches of facial hair grown on the sides of the face, extending from the hairline to below the ears and worn with an unbearded chin...
on only one side of his face. In 1826 he was sick for six months, suffering from enlarged cervical lymph nodes
Cervical lymph nodes
Cervical lymph nodes are lymph nodes found in the neck.-Classification:There are approximately 300 lymph nodes in the neck, and they can be classified in many different ways.Henri Rouvière produced an influential classification in 1938...
and severe headache
Headache
A headache or cephalalgia is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck. The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the...
s. In 1830 a chronic cold caused nasal swelling
Swelling (medical)
In medical parlance, swelling is the transient enlargement or protuberance in the body and may include tumors. According to cause, it may be congenital, traumatic, inflammatory, neoplastic or miscellaneous....
which prompted him to cancel planned concerts in Vienna.
In 1831, in Paris, 21-year-old Chopin experienced his first hemoptysis
Hemoptysis
Hemoptysis or haemoptysis is the expectoration of blood or of blood-stained sputum from the bronchi, larynx, trachea, or lungs Hemoptysis or haemoptysis is the expectoration (coughing up) of blood or of blood-stained sputum from the bronchi, larynx, trachea, or lungs Hemoptysis or haemoptysis ...
(coughing up of blood). In 1835 he suffered a severe two-month laryngitis
Laryngitis
Laryngitis is an inflammation of the larynx. It causes hoarse voice or the complete loss of the voice because of irritation to the vocal folds . Dysphonia is the medical term for a vocal disorder, of which laryngitis is one cause....
and bronchitis
Bronchitis
Acute bronchitis is an inflammation of the large bronchi in the lungs that is usually caused by viruses or bacteria and may last several days or weeks. Characteristic symptoms include cough, sputum production, and shortness of breath and wheezing related to the obstruction of the inflamed airways...
, and the resulting interruption in his correspondence with Warsaw gave rise to gossip that he had died.
In early youth he treated himself with belladonna. In the final decade of his life, he treated the coughing fits from which he had suffered all his life, with a blend of sugar and opium
Opium
Opium is the dried latex obtained from the opium poppy . Opium contains up to 12% morphine, an alkaloid, which is frequently processed chemically to produce heroin for the illegal drug trade. The latex also includes codeine and non-narcotic alkaloids such as papaverine, thebaine and noscapine...
. Chopin coughed up abundant mucus
Mucus
In vertebrates, mucus is a slippery secretion produced by, and covering, mucous membranes. Mucous fluid is typically produced from mucous cells found in mucous glands. Mucous cells secrete products that are rich in glycoproteins and water. Mucous fluid may also originate from mixed glands, which...
, especially about ten in the morning. He occasionally drank alcohol, sometimes smoked and – as some authors noted – suffered the consequences of inhaling others' smoke while enjoying the company of his Parisian friends. In the last year of his life, he endured diarrheas, caused either by cor pulmonale
Cor pulmonale
Cor pulmonale or pulmonary heart disease is enlargement of the right ventricle of the heart as a response to increased resistance or high blood pressure in the lungs ....
or by exocrine pancreatic insufficiency
Exocrine pancreatic insufficiency
Exocrine pancreatic insufficiency is the inability to properly digest food due to a lack of digestive enzymes made by the pancreas. This disease is found frequently in dogs. EPI is also found in humans afflicted with cystic fibrosis and Shwachman-Diamond Syndrome. EPI is caused by a progressive...
(see below).
On 17 October 1849, at 2 a.m., after a sudden coughing fit, Chopin died in the 40th year of his life. His physician, Jean Cruveilhier
Jean Cruveilhier
Jean Cruveilhier was a French anatomist and pathologist.In 1816 he earned his doctorate in Paris, where in 1825 he succeeded Pierre Augustin Béclard as professor of anatomy...
, confirmed his death by holding a mirror to Chopin's mouth and by illuminating his pupils with light from a candle. Pursuant to Chopin's will, Dr. Cruveilhier, a renowned professor of pathology
Pathology
Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....
, carried out an autopsy
Autopsy
An autopsy—also known as a post-mortem examination, necropsy , autopsia cadaverum, or obduction—is a highly specialized surgical procedure that consists of a thorough examination of a corpse to determine the cause and manner of death and to evaluate any disease or injury that may be present...
. The postmortem report was destroyed either in the Paris fire of 1871 or during World War Two. The death certificate
Death certificate
The phrase death certificate can describe either a document issued by a medical practitioner certifying the deceased state of a person or popularly to a document issued by a person such as a registrar of vital statistics that declares the date, location and cause of a person's death as later...
stated the cause of Chopin's death as tuberculosis of the lungs and larynx. However, Wojciech Grzymała, in a letter to Auguste Leo dated October 1849, wrote that the autopsy had not confirmed tubercular pulmonary changes and that his actual disease was unknown to contemporary medicine. The postmortem findings were also communicated to Chopin's sister Ludwika
Ludwika Jędrzejewicz
Ludwika Jędrzejewicz was the eldest sister of Polish composer Frédéric Chopin.- Early years :Ludwika was born in Warsaw, Poland, in 1807....
, Adolf Guttmann and Jane Stirling
Jane Stirling
Jane Stirling was a Scottish amateur pianist who is best known as a student and later friend of Frédéric Chopin; two of his nocturnes are dedicated to her. She took him on a tour of England and Scotland in 1848, and took charge of the disposal of his effects and manuscripts after his death in 1849...
, and their later letters were consistent as to the findings.
Physicians
It is uncertain how many physicians Chopin had; various authors have given the number as 14, 31 or "nearly 50". In addition, the composer had friendly relations with other physicians, who may also have occasionally provided him with assistance.In Warsaw
Warsaw
Warsaw is the capital and largest city of Poland. It is located on the Vistula River, roughly from the Baltic Sea and from the Carpathian Mountains. Its population in 2010 was estimated at 1,716,855 residents with a greater metropolitan area of 2,631,902 residents, making Warsaw the 10th most...
, Chopin's physicians were Jan Fryderyk Wilhelm Malcz, Franciszek Girardot and Fryderyk Adolf Roemer. In Vienna
Vienna
Vienna is the capital and largest city of the Republic of Austria and one of the nine states of Austria. Vienna is Austria's primary city, with a population of about 1.723 million , and is by far the largest city in Austria, as well as its cultural, economic, and political centre...
, Chopin was provided medical care by Johann Malfatti. Chopin's physicians in Paris
Paris
Paris is the capital and largest city in France, situated on the river Seine, in northern France, at the heart of the Île-de-France region...
included Aleksander Hofman, Jean-Jacques Molin, André François Cauviere, Jan Matuszyński, Adam Raciborski, Pierre Gaubert, Gustave Papet and Coste. During his 1848 stay in London
London
London is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...
– Mallan and James Clark. In Paris, in 1848–49, he was treated by Léon Simon, Fraenkel, David Koreff, Louis and Roth. Chopin's last physician was Jean Cruveilhier
Jean Cruveilhier
Jean Cruveilhier was a French anatomist and pathologist.In 1816 he earned his doctorate in Paris, where in 1825 he succeeded Pierre Augustin Béclard as professor of anatomy...
.
Family history
Little is known about the health of Frédéric’s father. Mikołaj Chopin lived to age 74 and suffered several times from respiratory infections. The composer's mother had no chronic illness and reached the age of 87.Of Frédéric’s three sisters, Izabela died at age 70 and had no illnesses; Ludwika
Ludwika Jędrzejewicz
Ludwika Jędrzejewicz was the eldest sister of Polish composer Frédéric Chopin.- Early years :Ludwika was born in Warsaw, Poland, in 1807....
suffered from recurrent respiratory infections and died at 47; the youngest, Emilia, was of frail health from earliest childhood. Emilia suffered from recurrent coughs and dyspnea
Dyspnea
Dyspnea , shortness of breath , or air hunger, is the subjective symptom of breathlessness.It is a normal symptom of heavy exertion but becomes pathological if it occurs in unexpected situations...
; at 11 she began having hemorrhages from the upper gastrointestinal tract, and she died of a massive hemorrhage at 14.
Tuberculosis
Chopin was diagnosed with tuberculosis and treated for it in accordance with contemporary practice, including bloodlettingBloodletting
Bloodletting is the withdrawal of often little quantities of blood from a patient to cure or prevent illness and disease. Bloodletting was based on an ancient system of medicine in which blood and other bodily fluid were considered to be "humors" the proper balance of which maintained health...
and purging. Tuberculosis figured in his death certificate, despite the alleged absence of typical organ changes. Critics of alternative hypotheses about Chopin's disease point out the abundant evidence for tuberculosis. Chronic coughs and hemoptysis are common symptoms of tuberculosis; complications may include both pericarditis
Pericarditis
Pericarditis is an inflammation of the pericardium . A characteristic chest pain is often present.The causes of pericarditis are varied, including viral infections of the pericardium, idiopathic causes, uremic pericarditis, bacterial infections of the precardium Pericarditis is an inflammation of...
, causing right-heart insufficiency, and bronchiectasis
Bronchiectasis
Bronchiectasis is a disease state defined by localized, irreversible dilation of part of the bronchial tree caused by destruction of the muscle and elastic tissue. It is classified as an obstructive lung disease, along with emphysema, bronchitis, asthma, and cystic fibrosis...
, manifesting in productive cough and respiratory failure.
A 20-year history of hemoptysis
Hemoptysis
Hemoptysis or haemoptysis is the expectoration of blood or of blood-stained sputum from the bronchi, larynx, trachea, or lungs Hemoptysis or haemoptysis is the expectoration (coughing up) of blood or of blood-stained sputum from the bronchi, larynx, trachea, or lungs Hemoptysis or haemoptysis ...
is rare in tuberculosis, but not impossible. Similarly, cavernous tuberculosis is rare in childhood, but cannot be excluded in the case of Emilia Chopin. Frédéric could have contracted tuberculosis from his younger sister. Against the diagnosis of tuberculosis stands the fact that some physicians who cared for Chopin did not diagnose him with that common, well-known disease. Another argument against tuberculosis would be the absence, in Cruveilhier’s report, of organ changes typical of tuberculosis, and gastrointestinal symptoms that cannot be explained by tuberculosis.
A monograph on historic methods of treating tuberculosis has discussed individual treatments on the example of Chopin, since his history well illustrates mid-19th-century views on treating tuberculosis.
Cystic fibrosis
Cystic fibrosis
Cystic fibrosis is a recessive genetic disease affecting most critically the lungs, and also the pancreas, liver, and intestine...
was first presented by O’Shea in 1987. It has been supported and popularized by physicians from the Medical University of Poznań
Poznan University of Medical Sciences
Poznan University of Medical Sciences is a prominent Polish medical university, one of the oldest in Europe, located in the city of Poznań in western Poland. It traces its beginnings to the foundation of Poznań University in 1919, and was formed as a separate institution in 1950...
. Arguments for cystic fibrosis as the chief cause of Chopin’s complaints are: the onset of the condition in early childhood, possible familial occurrence (Emilia), gastrointestinal symptoms, intolerance of fat-rich meals, recurrent infections of the lower respiratory tract, also suppurative, with exacerbations in winter, recurrent infections of the upper respiratory tract (laryngitis, sinusitis), barrel chest (visible in some photographs and caricatures), low tolerance of physical exercise, an episode of heatstroke (more frequent in cystic fibrosis), caries (more pronounced in this disease), putative infertility
Infertility
Infertility primarily refers to the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term...
.
There is no evidence for clubbed fingers – a symptom of hypertrophic osteoarthropathy, frequent in cystic fibrosis – but hand and ankle arthralgia
Arthralgia
Arthralgia literally means joint pain; it is a symptom of injury, infection, illnesses or an allergic reaction to medication....
in his last year of life may relate to this condition. It has been suggested that Chopin suffered from a mild form of cystic fibrosis, its course worsened by coexisting tuberculosis or another mycobacteriosis. Confirmation for the cystic fibrosis
Cystic fibrosis
Cystic fibrosis is a recessive genetic disease affecting most critically the lungs, and also the pancreas, liver, and intestine...
hypothesis might be obtained by genetic testing of preserved body tissues, but so far scientists have not been granted permission to take samples from Chopin's heart, which is immured in a pillar inside Warsaw's Holy Cross Church
Holy Cross Church, Warsaw
The Church of the Holy Cross is a Roman Catholic house of worship in downtown Warsaw, Poland. Located on Krakowskie Przedmieście opposite the main Warsaw University campus, it is one of the most notable Baroque churches in Poland's capital....
. A full review of the possible causes of Chopin's illness has recently been published.
Alfa 1-antitrypsin deficiency
A hypothesis of alpha 1-antitrypsin deficiencyAlpha 1-antitrypsin deficiency
Alpha 1-antitrypsin deficiency is an autosomal recessive genetic disorder caused by defective production of alpha 1-antitrypsin , leading to decreased A1AT activity in the blood and lungs, and deposition of excessive abnormal A1AT protein in liver cells...
was proposed by Kuzemko in 1994. According to this hypothesis, Emilia's fatal hemorrhage was caused by ruptured esophageal varices
Esophageal varices
In medicine , esophageal varices are extremely dilated sub-mucosal veins in the lower esophagus...
, secondary to liver cirrhosis in the course of alfa 1-antitrypsin deficiency. Frédéric's symptoms of liver insufficiency would be hypoproteinemia
Hypoproteinemia
Hypoproteinemia is a condition where there is an abnormally low level of protein in the blood.One common cause is due to excess protein in the urine , which can be a medical sign of nephrotic syndrome....
, feminization features
Feminization (biology)
In biology and medicine, feminization refers to the development in an organism of physical or behavioral characteristics unique to the female of the species. This may represent a normal developmental process, contributing to sexual differentiation....
(no facial hair) and gastrointestinal bleeding
Gastrointestinal bleeding
Gastrointestinal bleeding or gastrointestinal hemorrhage describes every form of hemorrhage in the gastrointestinal tract, from the pharynx to the rectum. It has diverse causes, and a medical history, as well as physical examination, generally distinguishes between the main forms...
. His death would be explained by liver failure and respiratory failure due to chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease , also known as chronic obstructive lung disease , chronic obstructive airway disease , chronic airflow limitation and chronic obstructive respiratory disease , is the co-occurrence of chronic bronchitis and emphysema, a pair of commonly co-existing diseases...
.
Supporters of the cystic-fibrosis
Cystic fibrosis
Cystic fibrosis is a recessive genetic disease affecting most critically the lungs, and also the pancreas, liver, and intestine...
hypothesis argue, against Kuzemko, that cystic fibrosis would explain Chopin’s symptoms equally well. Kuzemko himself has conceded that typical symptoms of liver cirrhosis in the course of alfa 1-antitripisin deficiency would be jaundice
Jaundice
Jaundice is a yellowish pigmentation of the skin, the conjunctival membranes over the sclerae , and other mucous membranes caused by hyperbilirubinemia . This hyperbilirubinemia subsequently causes increased levels of bilirubin in the extracellular fluid...
and ascites
Ascites
Ascites is a gastroenterological term for an accumulation of fluid in the peritoneal cavity.The medical condition is also known as peritoneal cavity fluid, peritoneal fluid excess, hydroperitoneum or more archaically as abdominal dropsy. Although most commonly due to cirrhosis and severe liver...
.
Kuzemko’s hypothesis has been cited by Reuben and Eriksson in 2003.
Mitral stenosis
Mitral stenosisMitral stenosis
Mitral stenosis is a valvular heart disease characterized by the narrowing of the orifice of the mitral valve of the heart.-Signs and symptoms:Symptoms of mitral stenosis include:...
is a possible, if unlikely, cause for the artist’s complaints and was discussed by Kubba and Young in 1998. The most important argument against this hypothesis is the absence of evidence that Chopin suffered from rheumatic fever
Rheumatic fever
Rheumatic fever is an inflammatory disease that occurs following a Streptococcus pyogenes infection, such as strep throat or scarlet fever. Believed to be caused by antibody cross-reactivity that can involve the heart, joints, skin, and brain, the illness typically develops two to three weeks after...
in childhood, which is the most common cause of mitral valve stenosis.
Other diseases
Kubba and Young have pointed out a number of other conceivable, if unlikely, diagnoses, besides cystic fibrosis and alfa 1-antitripsin deficiency: Churg-Strauss syndromeChurg-Strauss syndrome
Churg–Strauss syndrome is a medium and small vessel autoimmune vasculitis, leading to necrosis. It involves mainly the blood vessels of the lungs , gastrointestinal system, and peripheral nerves, but also affects the heart, skin and kidneys. It is a rare disease that is non-inheritable and...
, allergic bronchopulmonary aspergillosis
Allergic bronchopulmonary aspergillosis
In medicine, allergic bronchopulmonary aspergillosis is a condition characterised by an exaggerated response of the immune system to the fungus Aspergillus . It occurs most often in patients with asthma or cystic fibrosis...
, hypogammaglobulinemia
Hypogammaglobulinemia
Hypogammaglobulinemia is a type of immune disorder characterized by a reduction in all types of gamma globulins.Hypogammaglobulinemia is a characteristic of common variable immunodeficiency.-Terminology:...
, idiopathic pulmonary haemosiderosis, lung abscess
Lung abscess
Lung abscess is necrosis of the pulmonary tissue and formation of cavities containing necrotic debris or fluid caused by microbial infection....
es, and pulmonary arteriovenous malformation
Arteriovenous malformation
Arteriovenous malformation or AVM is an abnormal connection between veins and arteries, usually congenital. This pathology is widely known because of its occurrence in the central nervous system, but can appear in any location. An arteriovenous malformation is a vascular anomaly. It is a...
s.
Infertility
Chopin possibly was sexually active from early adulthood, but left no descendants. Some authors consider this evidence for infertilityInfertility
Infertility primarily refers to the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term...
, which would tend to strengthen the cystic-fibrosis
Cystic fibrosis
Cystic fibrosis is a recessive genetic disease affecting most critically the lungs, and also the pancreas, liver, and intestine...
hypothesis.
Depression, etc.
Chopin's biographers have often touched on the subject of depression, but the topic has rarely been broached by psychiatrists. One of the few studies of Chopin’s mental condition is a 1920 work by Bronislaw Onuf-Onufrowicz. The author cited biographers concerning Chopin's character and psyche and pointed out some symptoms that might indicate a manic-depressive disorder (aka bipolar disorder) or dementia praecoxDementia praecox
Dementia praecox refers to a chronic, deteriorating psychotic disorder characterized by rapid cognitive disintegration, usually beginning in the late teens or early adulthood. It is a term first used in 1891 in this Latin form by Arnold Pick , a professor of psychiatry at the German branch of...
(now termed schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
), but he emphasized the absence of evidence for severe psychosis
Psychosis
Psychosis means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality"...
and the fact that single symptoms may only suggest a predisposition to such mental illnesses.