Unusual and original works of art are rarely popular. People generally prefer the comfort of the familiar and normal to the challenge of the innovative and unusual. But this symphony is an exception, and its great and wholly justified popularity easily blinds us to its astonishing originality.

The symphony was written during the first half of 1893, when Tchaikovsky was famous, successful, and recognised internationally. Writing to his nephew, to whom the work is dedicated, Tchaikovsky said "During my stay in Paris last December I had the idea of writing a programme symphony; but to a programme that should remain an enigma to everyone but myself: let them try to guess it! For my part, I intend to call it simply 'Programme Symphony'". To his brother he wrote in February "I am now wholly occupied with the new work and it is hard for me to tear myself away from it. I believe it is being born as the best of my works". In August he was able to write to his publisher that he had finished "and I give you my word of honour that never in my life have I been so contented, so proud, so happy, in the knowledge that I have written a good piece".

The programme remained an enigma until a scribbled note by Tchaikovsky was found in the 1920s outlining the plan for a symphony based on life itself, with a first movement describing impulsive passion, confidence, a thirst for activity; a second movement referring to love; a third movement 'disappointments' and a fourth movement 'Death - result of collapse'. This is the programme Tchaikovsky was referring to for this symphony.

The symphony was first performed on 28th October 1893, with Tchaikovsky himself conducting. The reception was neither good nor bad, but puzzled and uncomprehending. The following day Tchaikovsky decided that the title 'Programme Symphony' was not good, and came up with the title 'Pathetique' instead. The modern English word 'pathetic' is unfortunate, now usually meaning 'feeble and inadequate' rather than its original meaning derived from the Greek pathos meaning suffering. Tchaikovsky's meaning includes all of 'passionate', 'emotional' and 'suffering'.

The second performance, three weeks later, was a huge success. Not only was the performance better, but the composer was suddenly in the public eye (so to speak) having died a few days before - a topical fact the audience could hardly ignore. It is usually said that he died of cholera, after drinking unboiled water, but there is another theory that he committed suicide by poison to avoid an imminent sexual scandal: it is unlikely that we will ever be completely sure.

The first movement starts slowly and quietly, the bassoon groping for a melody among the double basses and violas. The tempo soon accelerates, the violas and flute introduce the main theme which works up to an energetic climax, then subsides, and a glorious slower theme unfolds on the strings. A delicate flute counter-melody joins it, and again a rich climax works up. This dies away to a clarinet solo which becomes quieter and quieter … until a huge crash ushers in the development of the previous themes, with driving energy and frequently verging on hysteria. After a colossal climax this collapses exhausted, the slow theme is recalled, and the movement ends with a solemn brass chorale above descending scales in the basses.

The second movement is a simple and original contrast; it has the feel of a waltz, but is in five beats to the bar. [The critic Hanslick was not keen on this rhythm. He described this movement in the first London performance in 1895 as "loathsome … a disagreeable rhythm ... disturbing to listeners and players alike. It is, moreover, superfluous, since the piece could be adapted to six-eight time without damage".] The dance feeling is emphasised by the regular grouping of bars in eights, and the simple repetitions of the tune played by different instruments, though with varied accompaniments. A central section, still in five beats, comprises a descending tune above pulsating drum beats, still with the same simplicity as before.

The third movement is also unusual and original, starting like a swift intermezzo, and gradually turning into a march of terrifying insistence and power. The scurrying triplet rhythm of the opening suggests a lightness which is maintained for a while, but is gradually replaced by an insistent four-square military march. As time goes on, the persistent march rhythm, the tune which never develops and never modulates (i.e. is just repeated over and over) but just gets louder and louder all contribute to the panic which lies only just beneath the surface of this apparently joyful music.

The slow finale is the most dramatic of Tchaikovsky's innovations. The strings cry out with a desolate descending tune, shared with the woodwind, and later taken over by the bassoon. A more consoling second theme is worked up by the whole orchestra to a passionate climax, which after a dramatic pause leads back to the first theme, soon becoming even more anguished than before, and pierced by a brass scale that rises through the whole orchestra. After a short brass chorale, the second theme can manage no more than its first phrase and, above a faltering pulse in the basses, the symphony ends in the blackness whence it emerged.