Diagnostics of Pulmonary Tuberculosis in the First Half of the 19th Century: The Case of Frederic Chopin

Abstract

The renowned Polish composer Frédéric Chopin (1810—1849) suffered from pulmonary tuberculosis for most of his life, ultimately succumbing to it at the age of 39. Throughout his life, Chopin received treatment from by prominent European physicians who possessed advanced knowledge and diagnostic methods of their time. The aim of this study was to gain an objective understanding of the capabilities of diagnosing pulmonary tuberculosis in Europe during the first half of the 19th century, based on a partial reconstruction of Chopin’s medical history. We have studied: the correspondence of Frédéric Chopin and his relatives, the memoirs of his contemporaries, the works of the most authoritative Chopin’s biographers, and treatises on the diagnosis of lung diseases by leading doctors of the first half of the 19th century.It has been established that during that time, the true nature of tuberculosis was not yet understood. Consequently, the ideas in medical science regarding the etiology and pathogenesis of the disease were far from accurate. Chopin’s doctors believed that tuberculosis was linked to a hereditary or acquired predisposition. However, in France the technique and methodology of physical examination (percussion and auscultation) had already reached a high level of refinement. Detailed descriptions of physical signs indicating bronchial obstruction, lung tissue consolidation, and damage were found in medical treatises. Due to various objective and subjective factors, many practicing physicians did not use percussion and auscultation at all, or had insufficient skills in these techniques. Meanwhile, the most advanced European physicians were capable of diagnosing the infiltrative and cavernous forms of tuberculosis, based on a complex of the specific signs revealed during the medical history taking and physical examination.