Tchaikovsky requested unboiled water and drank it anyway, despite the fact that he had been warned not to do so: the next day, he started displaying symptoms of cholera. The circumstances of his death, however, gave way to a wide array of theories: while the “tainted water theory” has a robust following, Biographer Anthony Holden postulates Tchaikovsky might have contracted cholera by less-than-hygienic sexual practices he had been engaging in with male prostitutes in St. Petersburg, and that drinking unboiled water was just a means to conceal the real way he had become infected.
So it appears likely that Tchaikovsky contacted the Rock Hudson disease before Rock Hudson made it famous.
Tchaikovsky was still a musical genius with great imagination. Connecting an organ designed to discharge urine and semen with a sewage discharge pipe just isn't a very bright thing to do.
The evidence is pretty strong that he committed suicide.