Baltimore, MD. -- Wolfgang Amadeus Mozart, the uncommonly gifted and prolific composer, died 209 years ago at age 35 of a common killer-- from natural rather than unnatural ailments. So concludes a panel of physicians and Mozart scholars convened here Friday, Feb. 11, at the sixth annual Clinical Pathological Conference (CPC) dedicated to notorious case histories.

Rheumatic fever extinguished the brilliant life force of one of the world's most beloved composers, not poisoning by composer and alleged rival Antonio Salieri, concluded CPC participants, among them Neal Zaslaw, Cornell University professor of music and renowned Mozart scholar. Rheumatic fever is an immune system disease that can result from streptococcal infection of the blood. Antibiotics have made it a rare ailment today. But Mozart's sudden illness and early death spawned speculations worthy of "The X Files."

"While conspiracy theories make good fiction, there is no historical evidence that Mozart was murdered," said Zaslaw, who spoke at Friday's conference, sponsored by the University of Maryland School of Medicine and the Veterans Affairs Maryland Health Care System in Baltimore. Since 1995, the CPC has examined the deaths of Edgar Allen Poe, Alexander the Great, Ludwig van Beethoven, General George A. Custer and Pericles.

"Mozart was vigorous and successful right up until the time he fell ill," Zaslaw said. "In the last year of his life, he composed two operas, participated in an unbelievable number of performances and maintained a busy social life."

Zaslaw reminds us that we will never know for certain what killed Mozart and that rheumatic fever has been suggested as a cause of death before. In his presentation Feb. 11, Zaslaw also debunked much of the Mozart-as-Peter-Pan myth, showing how the composer, while certainly possessed of extraordinary gifts, was an ambitious and hardworking musician who hustled to market his product on two legs like any human. The Romantic notion of

Mozart as a sublime genius borne aloft by updrafts of a divine afflatus is based on questionable testimonies and contents of a forged letter unwittingly promulgated by cultural authorities during the past 200 years, Zaslaw points out. Based on historical evidence, Zaslaw's earthbound Mozart pursued a punishing performance schedule and demanded peace and quiet and a keyboard in order to get his compositions written.

The panel's diagnosis of rheumatic fever was arrived at by Dr. Faith T. Fitzgerald, internist and professor of medicine at the University of California at Davis. Fitzgerald's medical sleuthing included analysis of the dead composer's case history as reported by Mozart's family and physicians. Fitzgerald's diagnosis may be the latest final word on Mozart's fate.

However, Zaslaw's research shows the same diagnosis being reached by 18th-century physician Eduard Guldener von Lobes. A municipal health officer in Vienna at the time of Mozart's death, Guldener von Lobes claimed (in letters written 30 years after the fact) that he consulted with Mozart's two attending physicians, who were dead by the time von Lobes wrote his letter. In it, von Lobes describes Mozart as succumbing to an epidemic of "rheumatic and inflammatory fever," dying of a "deposit on the brain," according to Zaslaw's research. In addition, eyewitness accounts by Mozart's sister-in-law, Sophie Haibel, indicate symptoms of rheumatic fever, Zaslaw said.

Premature death is a tragic theme in any era, and Mozart's death was all the more poignant for robbing the world of a ferocious talent. Nonetheless, the following morbid details should save the master from further gyrations in his grave:

On Nov. 20, 1791, Mozart is stricken with a high fever, headaches, a rash, and pain and swelling in his arms and legs. He remains alert and lucid, but is increasingly agitated and asks to have his favorite pet canary removed from his room because its singing agitates him -- irritation is a classic symptom of rheumatic fever. Week two: Mozart suffers repeated bouts of vomiting and diarrhea; his body swells so his clothes no longer fit and he cannot not sit up in bed without help. Aware he is dying, he gives instructions on how to complete the Requiem he is composing. As the illness progresses, it weakens Mozart's heart causing fluid retention and extreme swelling. Fitzgerald points out that Mozart's heart may have been compromised by bouts of rheumatic fever he suffered earlier in his life. After a fit of delirium followed by a coma, Mozart finally dies on Dec. 5, 1791, just 15 days after falling ill and seven weeks before his 36th birthday.

The diagnosis is not the stuff of Hollywood blockbusters, perhaps. But these facts may quell the historical intrigue surrounding Mozart's final hours. May the Mozart postmortems R.I.P.