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

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 psychoanalysts and musicologists, 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. Although Strassburg was familiar with alchemy, 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.