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Love and death in Wagner's Tristan und Isolde—an epic anticholinergic crisis

BMJ 2003; 327 doi: (Published 18 December 2003) Cite this as: BMJ 2003;327:1469
  1. Gunther Weitz (, internist1
  1. 1Department of Internal Medicine I, Medical University Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany

    In Wagner's opera Tristan und Isolde the main protagonists take a love potion, which has various side effects and possibly causes Isolde's death. Gunther Weitz argues that the symptoms fit with severe anticholinergic syndrome

    In the opera Tristan und Isolde Richard Wagner reports the poisoning of Tristan and Isolde by a “love potion.” Shortly after ingestion of the potion, the protagonists declare their love, and both die during the opera. The opera has been extensively interpreted by psychoanalysts13 and musicologists,46 but, although at least Isolde's death remains unexplained and might be due to the potion, the medical profession has not yet analysed the case. I present evidence to suggest that the lovers were affected by a severe anticholinergic syndrome and that this is the most likely cause of Isolde's death.

    The story of Tristan and Isolde (Iseult), who fell in immortal love after drinking a magic potion, originated in the 6th century and was told in England, Ireland, and the north of France. It first appeared in writing in the 12th century, and Wagner used as his source the poetry of Gottfried von Strassburg, from around 1210.7 Although Strassburg was familiar with alchemy,8 he did not report the side effects of the love potion. Wagner's detailed description of the symptoms suffered by the protagonists may indicate his attention to possible ingredients.

    Presentation of the case

    Tristan, nephew of King Marke and knight of the Cornish court, and Isolde, princess of Ireland and King Marke's bride, try to commit suicide together by drinking poison which, however, turns out to be a …

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