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Syphilis is a sexually transmitted infection caused by Treponema pallidum. Thisbacterium affects personality and creativity when it invades the brain. A number offamous historical personages in the nineteenth century have been alleged to have hadsyphilis. Deborah Hayden claimed that the syphilitic was often rewarded, in a kind ofFaustian bargain for enduring the pain and despair by joyous energy. The presentstudy focused on three composers likely suffering from syphilis: Smetana, Wolf, andSchubert. The influences of syphilis on their works – notable in Smetana’s string quartet “From my Life”, Wolf’s “Mörike Lieder”, and Schubert’s song “Der Doppelgänger” –ranged from hearing disorders, mild cognitive impairment, creativeeuphoria, bipolar mixed states, to epileptic autoscopy. From the perspective ofneuroscience, these compositions may be related to positive symptoms and thedisinhibition syndrome.
我相信我必須去描寫我耳聾的開端。我嘗試在終樂章以第一小提琴四次擊出 E 音來描寫,因為在我全聾之前,有數周之久,每到晚上六點至七點,總會被降 A 調大三和絃的強烈哨聲所追逐,那是在短笛最高音域的降 A、降 E、C 三個音,不間斷地持續半小時或一小時,沒有任何辦法可以逃避。這個現象每天都規律地發生,正是對未來的淒厲警告!因此我嘗試在終樂章以極高的 E 音去描寫這個我命運中的可怕災難,為此,這個 E 音必須自始至終以最強音奏出。
1881 年底,Smetana 常常抱怨作曲時注意力不易集中,此後他的作曲進度
就變得十分緩慢,因為他會忘記已經譜寫過的段落,要花許多時間重讀樂譜。
1882 年 12 月,Smetana 在信中提到,他作曲時常常要尋找之前出現過的動機,
這種記憶力衰退的現象,顯現出痴呆之前的輕度知能障礙(mild cognitiveimpairment)症狀(Dudas et al. 2005)。即使作曲變得極度吃力,Smetana 還是
不願放棄。1883 年,他著手譜寫歌劇 Viola,他告訴朋友:「我繼續作曲,只是
為了要讓世人知道,當一個音樂家的頭腦在像我這種情形之下會有什麼事發
生。」
Smetana 在譜寫歌劇 Viola 時,似乎進入了躁狂(mania)的狀態,1884 年
1 月,他在總譜上寫下「Viola!永遠享有盛名──有名地享有盛名!」等狂亂
的字句。此時他的幻覺益發嚴重,會對不存在的人做出揮手的動作,顯示出精
神分裂的症狀。值得注意的是,未完成的歌劇 Viola 儘管是在這種狂亂的精神
狀況之下所寫的,但從樂譜上卻無法看出作曲家瘋狂的痕跡(Neumayr 1997:185–186)。這個現象隱然呼應了神經科學家 Oliver Sacks 所提出的一個重要觀
點:在許多大腦受損與退化的案例中,音樂能力似乎是病人最後喪失的認知能
力之一(Sacks 2002)。
四、Hugo Wolf:躁狂與 Mörike Lieder 的創作
1. 神經梅毒與躁鬱症
躁鬱症又稱為「雙極型情感疾病」(bipolar affective disorder),症狀特點是
1 有些具絕對音感的癲癇患者服用了抗癲癇藥物 carbamazepine 之後,發現樂器的音高全部降了半音(Konno et al. 2003),此症狀會在停藥後消失。此藥物可能改變了周邊聽覺神經的活動情形,以致影響音高的知覺(Wakamoto et al. 2004)。耳梅毒所導致的音高知覺異常,可能也是周邊聽覺神經受損所致。
疾病與作曲:以 Smetana、Wolf、Schubert 的梅毒為例
97
躁狂期與憂鬱期的交替循環。患者在躁狂期會覺得人生幸福到了極點,說話快
速而風趣,靈感泉湧、過度自信,以為太陽好似專門為他而升起,甚至自認能
洞悉“萬物的感覺”。在憂鬱期則正好相反,患者覺得自己一無是處,做什麼事
都缺乏興趣與動機,眼中所見的世事與人生,意義度都異常的低。躁鬱症的病
因至今仍然不太清楚,不過神經梅毒有時候可以導致躁鬱症的症狀(Hoffman1982, Ross et al. 1990, Mahendran 2001)。
積變大的部位,包括了(1)與情緒有關的 amygdala(Altshuler et al. 1998)、anteriorcingulate、ventral prefrontal cortex(Adler et al. 2005),(2)與計畫、動作有關的
primary and supplementary motor cortex(Adler et al. 2005)、caudate(Aylward etal. 1994)。另有研究顯示,躁鬱症患者的頂葉中跨感覺整合(sensory integration)區域比一般人活躍(Adler et al. 2004, Negash et al. 2004)。假如神經梅毒可以
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