The poem is dedicated to Friedrich Rösch, and is scored for three flutes, two oboes, English horn, two clarinets, bass clarinet, two bassoons, double bassoon, four horns, three trumpets, three trombones, tuba, a set of three kettledrums, two harps, gong, and strings.

On the flyleaf of the score is a poem in German.

The following literal translation is by William Foster Apthorp:

“In the necessitous little room, dimly lighted by only a candle end, lies the sick man on his bed. But just now he has wrestled despairingly with Death. Now he has sunk exhausted into sleep, and one hears only the soft ticking of the clock on the wall in the room, whose awful silence gives a foreboding of the nearness of death. Over the sick man’s pale features plays a sad smile. Dreams he, on the boundary of life, of the golden time of childhood?

“But death does not long grant sleep and dreams to his victim. Cruelly he shakes him awake, and the fight begins afresh. Will to live and power of Death! What frightful wrestling! Neither bears off the victory, and all is silent once more!

“Sunk back tired of battle, sleepless, as in fever-frenzy the sick man now sees his life pass before his inner eye, trait by trait and scene by scene. First the morning red of childhood, shining bright in pure innocence! Then the youth’s saucier play—exerting and trying his strength—till he ripens to the man’s fight, and now burns with hot lust after the higher prizes of life. The one high purpose that has led him through life was to shape all he saw transfigured into a still more transfigured form. Cold and sneering, the world sets barrier upon barrier in the way of his achievement. If he thinks himself near his goal, a ‘Halt!’ thunders in his ear. ‘Make the barrier thy stirrup! Ever higher and onward go!’ And so he pushes forward, so he climbs, desists not from his sacred purpose. What he has ever sought with his heart’s deepest yearning, he still seeks in his death sweat. Seeks—alas! and finds it never. Whether he comprehends it more clearly or it grows upon him gradually, he can yet never exhaust it, cannot complete it in his spirit. Then clangs the last stroke of Death’s iron hammer, breaks the earthly body in twain, covers the eye with the night of death.

“But from the heavenly spaces sounds mightily to greet him what he yearningly sought for here: deliverance from the world, transfiguration of the world.”

The poem by Ritter is, after all, the most satisfactory explanation of the music to those that seek eagerly a clew and are not content with the title. The analysts have been busy with this tone poem as well as the others of Strauss. Wilhelm Mauke wrote a pamphlet of twenty pages with twenty-one musical illustrations, and made a delicate distinction between “Fever” theme No. 1 and “Fever” theme No. 2. Reimann and Brandes have been more moderate. Death and Transfiguration may be divided into sections, closely joined, and for each one a portion of the poem may serve as a motto.

I. Largo, C minor, D flat major, 4-4. The chief “Death” motive is a syncopated figure, pianissimo, given to the second violins and violas. A sad smile steals over the sick man’s face (wood-wind accompanied by horns and harps), and he thinks of his youth (a simple melody, the childhood motive, announced by the oboe). These three motives establish the mood of the introduction.

II. Allegro molto agitato, C minor. Death attacks the sick man. There are harsh double blows in quick succession. What Mauke characterizes as the “Fever” motive begins in the basses, and wildly dissonant chords shriek at the end of the climbing motive. There is a mighty crescendo, the chief “Death” motive is heard, the struggle begins (full orchestra, fortississimo). There is a second chromatic and feverish motive, which appears first in sixteenths, which is bound to a contrasting and ascending theme that recalls the motive of the struggle. This second feverish theme goes canonically through the instrument groups. The sick man sinks exhausted (ritenuto). Trombones, violoncellos, and violas intone even now the beginning of the “Transfiguration” theme, just as Death is about to triumph. “And again all is still!” The mysterious “Death” motive knocks.