What was the cause of Nietzsche’s dementia?
What caused Friedrich Nietzsche to collapse into insanity at the
age of 44, when he was at the height of his creative powers? For most of the 20th
century, the answer was: syphilis. In my paper titled “What was the cause of
Nietzsche’s dementia?” published by the Journal
of Medical Biography in 2003, I show that the diagnosis of syphilis doesn’t
fit the facts of Nietzsche’s dementia. I explain how the diagnosis of syphilis
was made, why that diagnosis persisted so long despite so much evidence to the
contrary, and I suggest a more plausible alternative diagnosis. You can read
the full text of my article at this link: http://www.leonardsax.com/Nietzsche.pdf.
I am honored that subsequent researchers have continued
on this trail. The papers cited below all agree that the medical evidence
in Nietzsche’s case makes the diagnosis of syphilis implausible, and the
authors of each of these papers all cite my 2003 article. I have listed them below
in chronological order, with a brief comment indicating the diagnosis favored
by those researchers. One group of neurosurgeons (Owen, Schaller, and Binder) concur
that a frontal meningioma is the most likely diagnosis. Other researchers argue
for other explanations. The one point on which all these researchers agree is
that the diagnosis of syphilis is contradicted by the facts of Nietzsche’s case.
M. Orth & M. R. Trimble (2006). Friedrich Nietzsche’s
mental illness – general paralysis of the insane vs. frontotemporal dementia.
Acta Psychiatrica
Scandinavica volume 114, pp. 439-444. These
neurologists argue make the case for frontotemporal dementia, rather than
syphilis.
Christopher Owen, Carlo Schaller, and Devin Binder
(2007). The madness of
Dionysus: a neurosurgical perspective on Friedrich Nietzsche. Neurosurgery volume 61, pp. 626-632.
These neurosurgeons argue for a right-sided meningioma, as I did.
D. Hemelsoet, K. Hemelsoet and D. Devreese (2008).
The neurological illness
of Friedrich Nietzsche. Acta Neurologica Belgica, volume 108,
pp. 9-16. This collaboration between a neurologist and two professors of German
yielded the diagnosis of CADASIL: Cerebral Autosomal Dominant
Arteriopathy with Subcortical Infarcts and Leukoencephalopathy.
Christiane Koszka
(2009). Friedrich
Nietzsche: A classical case of mitochondrial encephalomyopathy with lactic acidosis and stroke-like
episodes (MELAS) syndrome? Journal of
Medical Biography volume 17, pp. 161-164. This biochemist makes the case
for MELAS.
Helen
Danesh-Meyer and Julian Young (2010). Friedrich Nietzsche and the
seduction of Occam’s razor. Journal
of Clinical Neuroscience, volume 17, pp. 966 – 969. These authors attribute
Nietzsche’s dementia to underlying psychopathology.
Lampros Perogamvros
and colleagues (2013). Friedrich
Nietzsche and his illness. Journal of
the History of the Neurosciences, volume 22, pp. 174 – 182. These authors
agree with Hemelsoet, Hemelsoet
and Devreese, that the most likely etiology was CADASIL:
Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and
Leukoencephalopathy.
Leonard
Sax MD PhD