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In 1879, Smetana had written to a friend, the Czech poet Jan Neruda, revealing fears of the onset of madness.
By the winter of 1882 – 83 he was experiencing depression, insomnia, and hallucinations, together with giddiness, cramp and a temporary loss of speech.
In 1883 he began writing a new symphonic suite, Prague Carnival, but could get no further than an Introduction and a Polonaise.
He started a new opera, Viola, based on the character in Shakespeare's Twelfth Night, but wrote only fragments as his mental state gradually deteriorated.
In October 1883 his behaviour at a private reception in Prague disturbed his friends ; by the middle of February 1884 he had ceased to be coherent, and was periodically violent.
On 23 April his family, unable to nurse him any longer, removed him to the Kateřinky Lunatic Asylum in Prague, where he died on 12 May 1884.

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