A Fateful Commission: Mozart’s Requiem and His Tragic End

In August 1791, a gaunt and ailing 35-year-old Wolfgang Amadeus Mozart received a mysterious commission to compose a Requiem Mass for an anonymous patron. Plagued by weight loss, anemia, headaches, and fainting spells, the paranoid composer became convinced he was writing his own funeral music. His erratic behavior worsened over subsequent weeks. By November, he was bedridden—ravaged by violent vomiting, diarrhea, arthritis, and swollen limbs that halted his creative output. Even the song of his beloved pet canary grated on his nerves. Convinced he’d been poisoned, Mozart succumbed to treatments that likely hastened his death: bloodletting.

Historical accounts suggest he lost at least four pints of blood in his final week. His sister-in-law Sophie Haibel recorded: “They bled him, applied cold compresses to his head… then he grew weaker and lost consciousness, never to wake again.” Buried in an unmarked grave, Mozart’s death remains shrouded in mystery—but many historians agree that bloodletting played a lethal role.

The Ancient Origins of Bloodletting

To understand why physicians drained their patients’ vitality, we must step into the minds of ancient healers. The practice dates to 1500 BCE Egypt, where bodily functions were poorly understood. Observations led to flawed conclusions: Romans believed menstruation naturally expelled toxins, while Chinese Han Dynasty (206 BCE–220 CE) texts described “stagnant” blood requiring removal.

Hippocrates’ humoral theory (400 BCE) codified these ideas. Health depended on balancing four bodily fluids: blood, phlegm, yellow bile, and black bile. Excess blood? Drain it. This logic persisted for millennia. By the 3rd century CE, Greek physician Erasistratus argued that plethora (blood overabundance) caused disease—though he preferred fasting over bleeding. His contemporary Galen, however, prescribed bloodletting for everything, even hemorrhages.

Tools of the Trade: Lancets, Leeches, and Barber Poles

Bloodletting tools evolved from primitive stones to specialized instruments:
– Lancets: Curved blades (namesake of The Lancet journal) for precise vein opening.
– Scarificators: Spring-loaded boxes with multiple blades, used with cupping to draw blood.
– Barber-surgeons’ poles: The iconic red-and-white stripes symbolized blood-soaked bandages wrapped around poles during procedures.

In medieval Europe, barbers doubled as surgeons, offering haircuts, tooth extractions, and amputations. After Pope Alexander III banned clergy from surgery in 1163, barbers inherited bloodletting duties—advertising with bloody bowls until laws required discreet disposal.

“Bleed Early, Bleed Often”: The Dark Age of Heroic Medicine

Bloodletting permeated all facets of healthcare:
– Mental illness: 18th-century doctors like Benjamin Rush bled manic patients 20–40 ounces (2.5 pints) to “calm” them. London’s infamous Bedlam asylum combined bloodletting with purges for psychosis.
– Royal tragedies: England’s Charles II died in 1685 after losing pints of blood, ingesting goat gallstones, and enduring pigeon-dung poultices.
– George Washington’s demise: In 1799, physicians drained 5–9 pints from the ex-president to treat a throat infection—hastening his death from shock.

Even love had bloody cures. French doctor Jacques Ferrand’s 1623 treatise recommended bleeding for heartbreak, especially in “plump, well-fed” patients.

The Slow Death of a Dangerous Practice

Critics like Italian scholar Ramazzini (17th century) called bloodletting “the sword of Delphi murdering the innocent.” By the 1800s, germ theory and mortality statistics discredited humoral medicine. Edinburgh’s Dr. John Hughes Bennett proved in 1855 that pneumonia deaths declined as bloodletting waned.

Yet the practice lingers. Modern phlebotomy (from Greek phlebos, “vein”) treats hemochromatosis (iron overload) and polycythemia (excess red blood cells). Meanwhile, cupping—seen on Olympian Michael Phelps—revives ancient principles without incision.

Legacy: Medicine’s Bloody Apprenticeship

For 2,000 years, bloodletting exemplified medicine’s trial-and-error journey. It killed luminaries like Mozart and Washington but also spurred anatomical curiosity. Today, its scarlet threads weave through medical symbols, language (“bleeding-edge” technology), and alternative therapies—a reminder of how far science has come, and at what cost.

As historian Roy Porter noted: “The history of medicine is the history of the slow, painful replacement of bad ideas with slightly less bad ones.” In that light, bloodletting was less a villain than a misguided stepping stone toward enlightenment.