Many kidney disorders often come about over a tenure of years. it primarily takes along time for kidney complaint symptoms to erect up to the indicate where you agree to that you have kidney trouble.} but once a established amount of kidney weakening has occurred, kidney function deteriorates, and kidney disaster becomes a possibility.

Typical kidney complaint symptoms engage the following:

* urinary problems that could feel identical to a bladder infection: a terrible feeling during urination, along with the feeling that you must be urinate over and over once again and urgently, even even though really small urine is produced,

* darker than normal urine,

* there might be inflammation in tools of the body, particularly the feet,

* descend back or side pain, especially if kidney stones are present,

* fatigue, low status quo and muscle weakness,

* loss of request for food,

* mental recall problems and an insufficient of skill to think clearly.

Of course, a few kidney complaint symptoms are identical to other medical conditions, so revisit your doctor for an correct diagnosis.

A condition well known as nephrotoxicity occurs when the body is unprotected to a poison or drug that damages the kidneys. when kidney damage occurs, toxins and waste products products feature in the blood. Blood electrolytes similar to potassium and magnesium are higher, and creatinine in the blood will moreover be increased.

There are a number of future causes for kidney failure. Diabetes and hypertension are amid the many perilous. Lots of people know they have these diseases but they might not agree to that they are at a ample aloft jeopardy for kidney illness at the same time. once again, kidney damage often occurs steadily over years and in both kidneys. in perspective of the fact that there are no coherent symptoms of kidney problems in the beginning, do not even agree to it’s occurring to you..

If you already have diabetes, you can safeguard yourself from kidney illness by gripping your blood sugarine in a strong range.

Anyone with high blood pressure is moreover at a larger chance for kidney problems.. when you have high blood pressure, the kidneys do not filter fluids and toxins blood really well, so progressing sustaining blood pressure levels are needed for preventing kidney damage.

Most people do not consider kidney problems until they have one. so it’s critical to pick up to agree to kidney problems symptoms so you can take rapid action, with the help of your medical professional, if signs of kidney difficulty start to stand up.

WILLINGBORO — Marcus Randolph has a new lease on life.

And it’s thanks to his wife, Trisha, his teenage sweetheart and mother of his son Marcus Jr., 8, and 8-month-old daughter Tristen.

He now walks around with her left kidney keeping him alive.

“She gave me a good kidney, she may have even given me the better one,” he joked. “For me, it’s like I’ve got a whole new beginning. she basically gave me a new beginning; an extra life.”

He quipped he feels like a character from the Super Mario Brothers video game that just got a one of the mushrooms that gives another life.

Three years ago, the now 29-year-old visited a doctor for what he thought would be a standard check-up. It was Trisha who urged him to go. she felt since they were getting older, he should get a look over.

“Just to start the New Year off,” he said of the visit. “I was going just to go.”Within a few weeks, his life was turned upside down.

Levels on some of his blood work indicted a problem with his kidney function. He was soon diagnosed with Focal Segmental Glomerulosclerosis, a kidney disease in which scarring of the organs occurs, preventing them from filtering blood properly.

According to the University of North Carolina’s Kidney Center, those who suffer from the disease often experience no symptoms. Randolph was one of those.

An athlete who played football and baseball when he was younger, he never had any health issues. As he toured all over the United States and around the world as the drummer with Robert Randolph and the Family Band, he was always the picture of health.

The condition changed that picture.

In 2008, he started dialysis for about a month and when that seemed to stabilize his vitals, he was treated with medicine. the steroids changed his appearance, causing bloating, Trisha Randolph said.

“When I got on dialysis, it did set in,” he said. “(Dialysis) drained me. I didn’t want to be there. It just made me weak and got me down. I’m looking around like ‘Wow, what I am doing here?’ ”

All the while, his wife suffered along with him. the two, who met at age 17 and 18 at a dry cleaner bsuiness, moved to Willingboro five years ago. Both are originally from Irvington, Essex County.

“It has been the hardest time of my life,” Trisha Randolph said. “It’s like a ton of bricks hit me.”

Her husband’s condition was treated with medicine for two years. He remained on tour with his band, which he formed 10 years ago with his cousins, Robert Randolph and Danyel Morgan.

The well-established band, which he terms as “funk with a gospel rock twist,” has released a live and three studio albums. Their latest, “We Walk this Road,” released in June 2010, was produced by T-Bone Burnett.

The band has toured with such notable acts as Eric Clapton, B.B. King, the Dave Matthews Band, Santana, the Black Crowes, and Al Green.

“It’s always good to have an occupation you like and love to do,” he said. “There is no greater feeling than being able to play in front of thousands of people.”

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During a tour stop at the House of Blues in New Orleans last September, Randolph noticed he wasn’t feeling well.

“I just felt sick,” he said. “I was throwing up. I couldn’t hold food down.”

He decided to fly home and try to “sleep it off.” His wife and mother, Sylvia, were having none of it. they made him go to the hospital.

“My blood pressure was like 206 over 114. It was bad, just a crazy number,” he said.

He learned he was in full renal failure and needed to start dialysis again. He started four months of dialysis on Sept. 9 and by December, his name was put on a kidney transplant list.

“My wife was the first person to step up,” he said.

She said she had a feeling they would be a match.

“I just always had that in my mind,” she said. “I prayed a lot to be a match. He is just this great spirit. I just wanted to see him not have to worry about his illness.”

Marcus Randolph feels fate set in when they met and their “love story” began, and not just because he now carries an organ of hers in him.

“We’re definitely meant to be,” he said. “I’m so thankful and glad I met her. she is a great wife and a great mom.”

During preparations for transplant surgery on Jan. 25 at Saint Barnabas Medical Center in Livingston, Trisha Randolph was told the procedure would be harder on her.

She admits recovery has been tough and that she is just now starting to feel her normal self again. but, that is no matter.

“I am definitely relieved, it’s like a huge weight has been lifted,” she said.

Through it all, their faith sustained them, the couple said.

“We are a very spiritual family,” Trisha Randolph said. “We know God. He has strengthened me to get me through.”

The last few years were difficult on Marcus Jr., the couple said. Their father-son bond is tight and through it all, Marcus Randolph has tried to continue going to the all of the youngster’s sporting and school events.

“It’s through the grace of God that things worked out,” he said. “We’ve got to give thanks to God.”

Moving forward, he will need to make trips to the doctor twice a week for a bit longer, watch his diet closely and take medication to fight off rejection. He will need to be medicated for life.

None of that bothers him.

“Now, I’ve got a fresh kidney and no more dialysis and am just happy,” he said.

His mother and Trisha’s mom, Fay Gayle, have helped with the kids and duties around the house. Things are starting to get back to normal now. Marcus

Randolph hopes to be back on the road with the band in may, with his new outlook on life intact.

“Everything I do, I am going to go hard and make sure my family is stable,” he said. “I feel it’s over now and we can move on with our lives.”

Rose Krebs can be reached at 609-871-8064, , or twitter.com/rosekrebs.

I used to be addicted to narcotic painkillers, many of which contained acetaminophen or ibuprofen along with the narcotic. I was a drinker too. It's been about 3 years since I stopped. They always check my liver enzymes at the doctor. They were elevated, but came back down to normal shortly after I got clean. I don't think they ever checked my kidneys though. what would be some signs that I have any kidney damage?

Pain in the abdomen?

edema (swelling) in your legs and feet, decrease urine output, ask the doc to check your kidney function. there are many test they can perform

I heard that your skin starts to tint yellow when you're having kidney problems.

Hmm… dunno other than that.

I am sure they checked the kidneys too.
if the kidney to be affected by acetaminophen, it will need about 10 kg collectively & the first sign will be elevated blood urea & serum creatinin.
you will feel the symptomes only when the disease is really advanced .
i think you are OK.

newstarget.com/001523.html

nlm.nih.gov/medlineplus/ency/…

My uncle was on dialysis for kidney damage/failure (not sure which). His disease was due to alcohol abuse for many many years. I know that he had pain in his lower back (where kidneys are located). Also, infrequent urination or even discolored urine such as very dark to me would indicate some kidney problems. I'm no doctor but have to drink lots of water because of previous kidney and UT infections. Pee a lot!!

Laboratory tests are almost always aimed at: urea, creatinine, electrolytes, and urinalysis– which is frequently the key test in suggesting a diagnosis. please conduct the test for microalbuminuria while conducting test for Urine analysis. you will know about the kidney damage only at the final stage-no symptoms.

I had a kidney transplant just over a year ago. best thing is watch for swelling in the ankle area, decreased urine output. muscle weakness. discoloration of the urine. if you are worried go to your doctor and have them send you for bloodwork and a urine test

Symptoms and signs of kidney damage are usually very late, if you want to know do urine test for protein, and blood test for urea and creatinine.

Public release date: 16-Dec-2010 [ | E-mail | Share ] Contact: Steve Tokarsteve.toakr@ncire.org415-221-4810 x5202University of California – San Francisco

Cystatin C, a blood marker of kidney function, proved significantly more accurate than the standard blood marker, creatinine, in predicting serious complications of kidney disease, in a study by researchers at the San Francisco VA Medical Center and the University of California, San Francisco.

Among adults who were identified as having chronic kidney disease by high creatinine levels, the researchers found that only patients who also had abnormally high levels of cystatin C were at high risk for death, cardiovascular disease, heart failure, or kidney failure. People with high creatinine but normal cystatin C levels had risks similar to those with normal creatinine levels.

The researchers also found that a “small but important segment” of the study population was missed by creatinine but identified by cystatin C as being at significant risk of serious complications, according to lead author Carmen a. Peralta, MD, MAS, an SFVAMC researcher and an assistant professor of medicine in residence in the division of nephrology at UCSF.

The study of 11,909 participants appears online on December 16, 2010, in the “JASN Express” section of the Journal of the American Society of Nephrology. The authors analyzed patient data from two prospective studies: the Multi-Ethnic Study of Atherosclerosis and the Cardiovascular Health Study, both sponsored by the National Heart, Lung, and Blood Institute.

Principal investigator Michael G. Shlipak, MD, MPH, chief of general internal medicine at SFVAMC, said that the current study highlights a potential clinical use for cystatin C as a method for confirming a diagnosis of chronic kidney disease. Shlipak has been a leader among physicians in identifying cystatin C as an alternative, accurate, and reliable marker of kidney function.

Both cystatin C and creatinine are substances made in the body and filtered by the kidneys. High levels of the substances in the blood indicate that the kidneys are losing the ability to filter them, and thus are losing function. “However,” explained Peralta, “creatinine is a byproduct made in muscles, so it is affected by what you eat and especially by how much muscle you have.” Thus, “a bodybuilder with healthy kidneys might have an elevated creatinine level because of high muscle mass, whereas a frail elderly person might have normal or even low levels of creatinine, but in fact this person’s kidneys are not working well ? it’s just that there’s not much creatinine because there’s not much muscle.”

In contrast, cystatin C is a protein made in cells throughout the body. “In studies so far, it does not seem to be that affected by age or muscle mass or diet,” said Shlipak, who is also a professor in residence of medicine and epidemiology and biostatistics at UCSF.

Shlipak proposes that cystatin C, which can cost as little as $17 per test, be added as a method for confirming or staging chronic kidney disease in guidelines that are currently being formulated by nephrologists. “It’s vital that we have an accurate diagnostic test, because kidney disease does not show symptoms until it’s too late, when your kidneys have almost failed completely,” he said.

“Being missed by creatinine is an important limitation in our current method of diagnosing kidney disease,” said Peralta. yet, she adds, being falsely identified with kidney disease through inaccurate test results can be disastrous as well. “There is fear and psychological stress, particularly in communities of color, where people have a lot of friends and family members who are on dialysis,” she noted. “You can also be subjected to unnecessary and expensive tests and medications.”

###

Co-authors of the study are Ronit Katz, DPhil, of the University of Washington; Mark J. Sarnak, MD, MS, of the Tufts-New England Medical Center; Joachim Ix, MD, of UC San Diego; Linda F. Fried, MD, MPH, of Pittsburgh Veterans Affairs Medical Center; Ian de Boer, MD, of UW; Walter Palmas, MD, of Columbia University; David Siscovick, MD, MPH, of UW; and Andrew S. Levey, MD, of Tufts-New England Medical Center.

The research was supported by funds from the National Heart, Lung, and Blood Institute, the National Institute of Neurological Disorders and Stroke, and the National Institutes of Diabetes Digestive and Kidney Diseases. Some of the funds were administered by the Northern California Institute for Research and Education.

NCIRE – The Veterans Health Research Institute – is the largest research institute associated with a VA medical center. Its mission is to improve the health and well-being of veterans and the general public by supporting a world-class biomedical research program conducted by the UCSF faculty at SFVAMC.

SFVAMC has the largest medical research program in the national VA system, with more than 200 research scientists, all of whom are faculty members at UCSF.

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.

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The term “renal” refers to anything relating to the kidneys; essentially, they carry blood from the heart to the kidneys after branching off the aorta, or main artery coming off the heart, and lead to one kidney each. The volume of blood passing through these arteries is a very large amount—about 1 ½ liters of the 5 liters of blood pumped out from the heart. This blood passes through every single minute because blood is constantly flowing through the body. so, now we talk about renal artery stenosis. This is a condition in which the diameter of these arteries decreases, and there is less room for blood to flow. Learn more about this condition, including the definition, consequences, causes, symptoms, diagnosis, and treatment.

Renal Artery Stenosis: Background InformationAs mentioned above, renal artery stenosis is a condition in which the renal arteries become narrower, restricting blood flow through them. there are two different negative things that can result from this: impaired kidney function, known as renal failure, and high blood pressure, referred to as renovascular hypertension (RVHT). when one artery to the kidneys is narrowed, RVHT results; when both arteries are narrowed, renal failure results.

Renal Artery Stenosis: ConsequencesThe problems arising from renal artery stenosis can be very serious; in fact, a whole series of reactions come about because of it. when the amount of circulating blood to the kidneys is decreased, the normal physiological reaction of the kidneys is to unleash a sequence of hormonal responses; this is called the rennin-angiotensin-aldosterone system. This defense is activated against low blood pressure and low circulating blood volume, regardless of the cause.

First: when the kidneys sense the decrease in circulating blood volume, they increase the blood level of a hormone called angiotensin 2, which causes narrowing of the small blood vessel in the kidneys.

Second: along with angiotensin 2, another hormone level is increased, called aldosterone. together, these hormones promote salt retention by the kidneys in an effort to restore and maintain blood pressure and volume.

This response is only pathological when the decreased blood flow to the kidneys is a result of the narrowing of the renal arteries. since the kidneys think there is a decreased blood volume (even though there isn’t; it’s just the decreased flow to the kidneys due to the narrowing), they will forego this reaction, and end up unnecessarily increasing blood pressure.

Renal Artery Stenosis: CausesThere are a few different causes of renal artery stenosis, but one of them occurs most frequently. The most common cause is atherosclerosis, which is the narrowing and hardening of the blood vessel wall from the inside out. Risk factors for atherosclerosis include: high cholesterol, high blood pressure, age, cigarette smoking, and diabetes. other, but less common, causes of renal artery stenosis are fibromuscular dysplasia of the vessels (thickening of the blood vessel wall leads to narrower vessels), arteritis (inflammation of the blood vessel), and dissection, which is the tearing and dividing of the blood vessel wall.

Renal Artery Stenosis: SymptomsFor the most part, the symptoms of renal artery stenosis are inconspicuous. However, certain signs of the condition would include high blood pressure that doesn’t respond to treatment; severe high blood pressure developing before age 30 or after age 50; or an incidental finding of one kidney being smaller than the other (for example, found during a routine screening or a check-up for another condition).

Renal Artery Stenosis: DiagnosisThere are two types of tests to diagnose this condition: imaging tests and functional tests. Imaging test reveal a full picture of the blood vessel, allowing the doctor to visualize the extent of the narrowing. they include angiograms, MRI, and CT. Functional tests determine whether the narrowing is enough to cause kidney failure or high blood pressure; they include a plasma rennin activity test (activity of rennin is usually higher in this condition) and a captopril renogram (measures action of the kidneys after the injection of a radioactive dye).

Renal Artery Stenosis: Treatment

MedicationThe first treatment of renal artery stenosis is to treat the high blood pressure with regular medications. if kidney function worsens as a result of these medication, which can happen in some people, the medication should be stopped.

No TreatmentIf the stenosis is found only in a routine screening and no consequential problems are apparent, treatment may not be necessary; instead, occasional monitoring of the kidneys is recommended.

X-ray AngiographyIf an abnormality of the renal artery is found, x-ray angiography is done; a 75% or greater narrowing of the artery is deemed treatable. in other words, the stenosis is severe. At this time, a widening (or dilation) of the artery is done, which is often done with angioplasty, which is when a tiny balloon is inserted into the artery and inflated to widen it; a stent may also be placed in the artery.

Vascular SurgeryIn some cases, vascular surgery may be necessary, which is a repair of the artery.

Kidney (renal) failure occurs when the kidneys are unable to perform their functions, leading to accumulation of toxic substances in the body, and consequent harm to health.

THE kidneys are two bean-shaped organs located on either side of the spine, in the space behind the abdominal cavity, which also contains the stomach, intestines, liver, spleen, and female genital organs.

The kidneys get its blood supply from the aorta through the renal arteries, which become progressively smaller in size. The smallest blood vessels, called arterioles, form groups of microscopic vessels called capillaries, each group of which is called a glomerulus. The blood leaves each glomerulus through an arteriole, which joins a small vein. The small veins join to form a large vein, which transports blood out of the kidney.

Each kidney has about a mil-lion nephrons, which are microscopic units that filter blood, producing urine in the process. each nephron comprises a glomerulus and a tiny tubule that drains fluid from the glomerulus. The fluid becomes urine by the time it reaches a collecting duct.

when there is loss of kidney function, dialysis is required. in haemodialysis, the body?s waste products are removed by circulating blood through an artificial kidney machine.

There are numerous collecting ducts that lead to cup-like structures (calyces). each kidney has many calyces, which all drain into a single large chamber-like structure (renal pelvis) from which the urine drains into another tube-like structure (ureter).

The two ureters from both kidneys join the bladder, from which the urine leaves the body through the urethra via the vulva in females and the penis in males.

The kidneys continuously produce urine, which is composed of excess water, salts, and waste products. Urine does not usually contain organisms or substances like glucose, proteins, ketones, blood etc.

The kidneys? main function is to filter blood to get rid of waste products, toxins, and excess water and electrolytes from the body, whilst reabsorbing useful chemicals.

Many medicines are excreted by the kidneys. The kidneys help in the regulation of blood pressure and also produce hormones which help regulate the production of red blood cells, and the growth and maintenance of bones.

The kidneys enable a person to consume various food, medicines, fluids and substances without toxic by-products reaching harmful levels in the body.

The functions of both kidneys can be performed sufficiently by one kidney. that is why it is possible for a person to donate a kidney to another person.

Kidney (renal) failure occurs when the kidneys are unable to perform their functions, leading to accumulation of toxic substances in the body, and consequent harm to health.

Renal failure can be acute or chronic. The former occurs rapidly, and the latter, gradually over many years, during which the kidneys are destroyed slowly.

It is estimated that about 5% of hospitalised patients develop acute renal failure, with a higher incidence in patients in the intensive care unit.

Causes

The causes of acute renal failure are usually categorised into:

> Pre-renal: causes that affect the blood flow to the kidneys.

> Post-renal: causes that affect the flow of urine out of the kidneys.

> Renal: causes in the kidney itself that affect blood filtration and urine formation.

Pre-renal causes account for more than half of the causes of acute renal failure. The causes include dehydration, from vomiting, diarrhea, blood loss and diuretics; and reduced blood flow to the kidneys, from bleeding, severe injuries or burns, infections of the blood (septicaemia), heart attack or heart failure, blockage or narrowing of blood vessel supplying the kidneys and liver failure, which affects hormones regulating blood flow and pressure to the kidneys.

As the kidneys are not damaged by the pre-renal causes, the situation can be reversed with appropriate treatment. however, delayed or inadequate treatment can lead to permanent renal damage.

Post-renal causes are the least common causes of acute renal failure. The causes include obstruction of the ureters by stones or cancer of the urinary tract or adjacent structures; and obstruction at the bladder by stones, enlarged prostate in men, blood clots, bladder cancer and neurological conditions affecting the bladder?s ability to contract.

The situation is remedied by removal of the blockage, with the kidneys usually recovering its function within a week or two provided there is no infection. however, delayed or inadequate treatment can lead to permanent kidney damage.

Renal causes account for a quarter to half of all causes of acute renal failure. they may affect filtration, blood supply within the kidney, and the handling of salt and water. Although there are several renal conditions, the most common is acute tubular necrosis, a condition in which the tubules are damaged, leading to impairment of the kidney?s filtration function. The causes of this condition include shock, medicines, especially antibiotics, chemotherapeutic agents and poisons.

Glomerulonephritis is a condition in which the glomeruli are damaged by various causes, one of the most common being a streptococcal bacterial infection of the throat.

Acute interstitial nephritis is a condition in which there is inflammation of kidney tissue that deals with salt and water balance. The causes include medicines like antibiotics, painkillers and diuretics.

Clinical features

There may be no symptoms, especially in the early stages of acute renal failure or the symptoms may be non-specific. The symptoms include decreased passage of urine, swelling of the body, abdominal discomfort, lethargy, fatigue, poor concentration and confusion. Fits and coma may occur in severe acute renal failure.

The findings on physical examination are usually few.

A diagnosis is often made from laboratory investigations of the blood or urine. these tests may be done because the patient is generally unwell or hospitalised for another reason, or as part of screening tests.

The blood levels of urea and creatinine are raised when the causes are pre-renal. The serum electrolyte levels may be very high or low when there are filtration problems. A low haemoglobin count is present when there is severe renal failure or it is prolonged.

There may be inappropriate excretion of protein and other substances in the urine. The urine may be darkened by creatinine and other substances.

Microscopic examination of the urine may reveal blood, pus and casts, which are solid materials. The retention of urine in the bladder after passing urine is indicative of a post-renal cause, which is usually an enlarged prostate in men.

An ultrasound examination of the kidneys and bladder may reveal evidence of specific causes of the renal failure. sometimes, a kidney biopsy may be done to obtain tissue samples of the kidneys for microscopic examination.

Management

The management of acute renal failure depends on the cause and its severity. The condition is usually managed by a kidney specialist (nephrologist) or a physician, if there is no nephrologist available.

The objectives of management are to identify and remove the cause of the failure, and to determine the extent to which the body is affected by the failure.

Dehydration will be corrected with intravenous fluids. If the body?s excess fluids are not adequately removed by the kidneys, fluid intake should be limited. If the blood flow to the kidneys is reduced, measures will be taken to improve cardiac function and increase blood pressure. Electrolyte abnormalities will be corrected so that other bodily functions will not be impaired.

A review of the patient?s medicines and food intake will be made. The compounds that are harmful to the kidneys will be removed or their dosages reduced.

If there is no response to the management measures and renal function does not return to normal, renal dialysis will be carried out. there are two types of dialysis, i.e. through the blood vessels (haemodialysis) or through the abdominal cavity (peritoneal dialysis). The body?s waste products are removed by circulating the blood through an artificial kidney machine in the former, and through a catheter inserted into the abdominal cavity in the latter.

The majority of patients do not require dialysis if the cause is identified and removed or treated. This is particularly so if the cause is not due to kidney damage, when there is usually restoration of normal renal function.

However, there are instances where there may be residual kidney damage resulting in only partial restoration of function. Although such patients may not need dialysis, many have to take medicines to handle the loss of function.

Prevention

Several measures can be taken to prevent acute renal failure. Adequate fluid consumption will ensure proper functioning of the kidneys. The avoidance of medicines that can damage the kidneys would be very helpful. This is one of the reasons why doctors hold the view that self-medication should be done only with the advice of the doctor.

When one is unsure or does not know the side-effects of medicines, it is prudent to seek advice from the doctor or the pharmacist.

Annual medical examinations will provide information about the health status of the kidneys and urinary tract.

Patients at increased risk of chronic renal disease should be aware of the need for early medical attention, particularly when they have urinary symptoms or notice changes in the urine. they also have need for more frequent medical check-ups and tests of renal function.

Dr Milton Lum is a member of the board of Medical Defence Malaysia. This article is not intended to replace, dictate or define evaluation by a qualified doctor. The views expressed do not represent that of any organisation the writer is associated with.

Though Schumann, who died in 1856 at the age of 46, has received fewer diagnoses than Mozart, his case is messier, and the stakes are higher. Discussions of Mozart’s final illness are confined to the physical: infection, cardiovascular disease, kidney function and poisoning. They do not affect our view of his compositions, except for the Requiem, and then only in terms of the circumstances of its commissioning.

For Mozart the medical and the musical remain separate. In Schumann’s case the usual diagnoses have included mental illnesses. Because associations between mental state and creativity are inevitable, stigmas and stereotypes attached to psychiatric illnesses have long influenced the interpretation of Schumann’s music.

During the last two decades concerts featuring music by “bipolar” composers, including Schumann, have flourished. Prominent ensembles like the Los Angeles Philharmonic and the National Symphony have brought this concept to large audiences, and in May the Baltimore Symphony is to present “Schumann’s beautiful Mind,” a program exploring that mind, “beset by bipolar disorder yet still able to produce some of classical music’s most original and inspired work.”

In academia, by contrast, since the 1980s a host of musicological studies have tried to defend Schumann’s late works against those who find traces of pathology in them.

Concerts that promise a bipolar experience and studies that locate “health” in his scores not only refashion biography, they also affect habits of listening. Retrospective psychiatric diagnoses shape the way people listen and what they hear.

Take the 2004 DVD “Music and the Mind: The Life and Works of Robert Schumann,” a Touchstar Productions video of a lecture and performance by Richard Kogan, a Cornell University professor of psychiatry and Julliard-trained pianist. In it he contends that “Carnaval,” Schumann’s Opus 9, “could not have been written by someone who did not suffer from bipolar disorder.” It is, he adds, “practically a catalog of bipolar symptomatology.”

The way Schumann’s music flits from idea to idea in that suite of short pieces, Kogan argues, is an exteriorization of the disorganized and illogical thought processes that typify manic episodes. Linking short excerpts to depressive and manic moods, Kogan seeks to isolate the actual sounds of psychiatric disorder. It’s a lesson in medico-musical listening.

The use of Schumann’s music as diagnostic evidence has a long history. In 1906 the German psychiatrist Paul Julius Mobius, who was a proponent of the idea that mental illness was a symptom of hereditary degeneration, published a “pathographie” of the composer. “Listening to Schumann’s music,” Mobius wrote, “instructs one that Schumann was an extremely nervous person.

” It seems evident, “ he added, ” that from youth onward Schumann was mentally ill. “

His diagnosis was dementia praecox, an illness soon renamed schizophrenia.

Previously most commentators had repeated the diagnosis of Franz Richarz, Schumann’s doctor at the Endenich mental asylum, who reported that Schumann had died of progressive paralysis brought on by overwork and exhaustion. As Richarz’s diagnosis became better known, commentary citing the ” exhaustion “ present in Schumann’s late music began to surface.

And so, as the Schumann scholar John Daverio reported, prominent musical figures like the critic Eduard Hanslick and the violinist Joseph Joachim (to whom Schumann dedicated his Violin Concerto) helped popularize the notion that the late works suffered from exhaustion. so while psychiatrists listened to Schumann’s music for evidence of illness, musicians began using psychiatric diagnoses to aid their assessments of musical quality.

Mobius’ work brought about a reconceptualization of Schumann’s health history. A hereditary illness like schizophrenia or manic-depressive disorder, unlike exhaustion, could leave traces throughout a composer’s output, not just in the late works. The early popularization of these diagnoses was aided by a changing orientation in German psychiatric research toward biological models that favored the hereditary transmission of mental illness over environmental factors.

In the early decades of the 20th century scientific consensus on the inheritability of mental illness helped fuel fear over the threat posed by genetic ” degeneration. “ Combined with the belief that nervous diseases were on the rise, fear of degeneracy served to increase the authority of eugenics. Famous forensic psychiatrists like Cesare Lombroso, the Italian professor of criminal anthropology, asserted a connection between genius and mental instability.

In Germany several studies on the inheritance of musical ability followed. The most painstakingly detailed in relation to Schumann was a 1925 article that sought to delineate hereditary laws governing musical ability. almost 100 of Schumann’s relatives were evaluated as being musical or not. In Schumann’s case, studies on the transmission of musical ability containing family trees and calculations of genetic inheritance were shadowed by the question of ” pathological inheritance. “

Such inheritance remained a sinister obsession of German psychiatry during the 1930s and ’40s. Shortly after the Nazi seizure of power a law mandated sterilization for anyone diagnosed with schizophrenia or manic-depressive illness (to name just two diseases often diagnosed in Schumann). By 1945 almost 400,000 people had undergone forced sterilization. At least 70,000 had been murdered. all the while the accomplishments of German composers, including Schumann, were upheld as evidence of German biological superiority.

Schumann’s death in a mental asylum thus posed a problem for psychiatry and propaganda under the Nazis. The premiere of his late Violin Concerto in 1937 was in part an attempt by Joseph Goebbels, the propaganda minister, to introduce a replacement for the racially banned Mendelssohn’s much-loved concerto. so a 1943 medical dissertation that said Schumann had suffered from vascular dementia (small strokes brought on by hypertension) rather than schizophrenia or manic-depressive illness found ready acceptance. It absolved Schumann and his family from the taint of hereditary mental illness. Despite a dearth of evidence, the hypertension diagnosis lingered on in medical and musicological discourse until the mid-1980s. After World War II work by English-speaking scholars became more prominent. In the 1950s the British psychiatrists Eliot Slater and Alfred Meyer argued for manic-depressive illness followed by syphilis. like many before them, they turned to Schumann’s music to buttress their arguments, but they used it in a novel way, as a source of quantitative data. Schumann’s productivity (measured in opus numbers per year) fluctuated over time, they noticed. Matching those records to reports of Schumann’s mood, they correlated years of elation with high productivity and depression with meager accomplishment.

Their work has sparked the wide popularity of the bipolar hypothesis, yet it is rife with dubious assumptions. does mental state change with the calendar year? does each opus represent the same amount of work? are pieces necessarily begun and completed within the same calendar year? What about unpublished works?

The study made a seductive claim. It could transform Schumann’s music — the source of endlessly conflicting interpretations — into objective data that could be graphed or charted. such thinking captured musicological attention by way of Slater’s contribution to a 1972 collection of essays on Schumann, and it reached a wider public in part through the work of Kay Redfield Jamison, a professor of psychiatry at Johns Hopkins University.

Jamison’s popular 1993 book, ” Touched With Fire: Manic-Depressive Illness and the Artistic Temperament “ (Free Press), uses Schumann as an example of the many famous artists she says suffered from the illness. It is probably the best-known study to argue for connections between bipolar disorder and genius. Performances and marketing of ” manic-depressive music “ are largely indebted to her work.

In 1991 Schumann’s mysteriously lost medical records from the Endenich asylum resurfaced. Aribert Reimann, a Berlin composer whose grandfather’s sister had married a son of Richarz, Schumann’s doctor, inherited the records on the condition he keep them secret. Reimann eventually offered them to the Berlin Academy of the Arts.

In 2006, 150 years after Schumann’s death, the records were published in their entirety (except for a few missing pages presumed to have been lost during World War II). Many scholars believe they indicate that Schumann died of neurosyphilis. But because conclusive diagnosis of syphilis was not possible until the early 20th century, the records cannot resolve all diagnostic disagreements. Published alongside the records are analyses whose conflicting readings dispel notions that the records relay straightforward or easy truths.

The medical records are difficult to decode because descriptions and interpretations of psychiatric symptoms occur within specific historical and geographic contexts. this is as true today as it was in Schumann’s time, as a glance at different editions of the Diagnostic and Statistical Manual of Mental Disorders will readily confirm. The complex and incomplete epistolary, musical and medical texts we use to study Schumann’s life will continue to elicit diverse, even contradictory readings. As much as the diagnoses have introduced new audiences to Schumann’s life and works, we will never achieve consensus on what he really had.