In this readable, scholarly book, plausible answers are explored to burning questions: Was Mozart really poisoned? If not, of what did he die? And why was his grave "unmarked"? What caused Beethoven's deafness? And his longstanding abdominal pain? Did he die of drink? Can Schubert's syphilis be related to his music? Did he have a premonition that he would die at age 31?

The author is both an accomplished musician and a physician. Skilled in internal medicine, he is also sympathetic to psychoanalysis. He has carefully studied the medicine of the era and avoids judging past doctors by present standards. Nevertheless, he is opinionated about the folly of his own medical contemporaries who would apply untenable diagnoses.

Historians shun retrospective diagnosis, but physicians are irresistibly drawn to it, especially when it involves artists. The danger lies in trying to impose our own views on the past--and in the impossibility of actually answering contemporary questions from sources written in other times, for other purposes. Neumayr recognized the problem when it came to divining the motives for Schubert's musical productivity as an intimation of mortality: "such an interpretation runs the risk of using our knowledge of historical events to infer thoughts and ideas in retrospect that have nothing to do with reality" (391). But he seems less troubled by the possibility of presentist interpretation when it comes to medicine. In fairness, his medical diagnoses are well argued and mostly convincing.

The conclusion of each chapter shifts in tone from a medical biography of a brilliant musician to a "clinical pathological conference" of a deceased patient, complete with photographs of three of the composers' skulls. One irony is that the subtle, biographical work contrasts with the confidence of the medical analysis. Medicine itself is historically contingent. In the few short years since the book was published some of the medical terms and concepts have already changed: for example, the aged Haydn's hardened arteries and "arteriosclerosis" would now be called atherosclerosis or cerebrovascular disease. This is a minor concern, but it serves to remind us that retrospective diagnosis can never be complete once and for all.

The authors' broad erudition, as a trained musicologist and concert pianist with a vast repertoire, is evident in his exposition of the musical compositions: for Haydn, 22 works; Mozart, 48; Beethoven, 48; and Schubert, 60. Perhaps the most useful part of the book for readers of the database will be the possibility of relating musical masterpieces to moments of illness, pain, grief, solitude, and joy in the composer's lives. Provides an enriched appreciation of music through medical listening.