POX: Genius, Madness, and the Mysteries of Syphilis

Excerpt from Nietzsche chapter:

The Nietzsche legend as created by Elisabeth had no place for syphilis, so it is ironic that word of his disease might never have reached the public if she had not attempted to cover it up. Her first blunder was to allow access to Nietzsche’s medical records at Basel and Jena to the respected Leipzig neurologist and psychiatrist P.J. Möbius. If Elisabeth had hoped for a sympathetic portrait of the last illness from Möbius, she was sadly deceived. In 1902 he published On the Pathological in Nietzsche in which he not only revealed the diagnosis, though by innuendo rather than by name, but far worse, he suggested that the first indications of mental instability, caused by syphilis, appeared as early as 1881 with the “lightning” inspiration for Thus Spake Zarathustra.

Elisabeth probably did not know the diagnosis at the time; if she had known it, she would not have given Möbius access to the records. Dr. Wille would have had no reason on Nietzsche’s admission in Basel to tell the distressed mother the origin of her son’s illness, nor would the doctors at Jena. Once the story was out, though, Elisabeth tried all the damage control she could devise. An aggressive pathographer, Möbius warned the public against the sick philosopher. Only those that are intellectually deaf, he warned, can miss the undertones of progressive paralysis in Thus Spoke Zarathustra. “If you find pearls do not imagine that it is all one chain of pearls. Be distrustful, for this man has a diseased brain.” The creeping onset of late syphilitic disease was superimposed on Nietzsche’s already morbid mental state, declared Möbius. Elisabeth flew into a rage, calling his accusation a “disgusting calumny,” not even so much because he revealed her brother’s disease as because he suggested that he had been infected by a prostitute. Philosopher and psychologist Karl Jaspers credited Möbius with being the first to recognize the incisive transformation in Nietzsche beginning in the early eighteen eighties, but he concluded that Möbius’s insight was so encumbered with absurdity that it did not gain approval.

Möbius interviewed many of Nietzsche’s friends from student days looking, unsuccessfully, for stories of any sexual activity. He concluded rather lamely that although Nietzsche’s attraction for sex had been abnormally weak, “and he lacked the sex-urge which a healthy male needs in order to devote himself to a woman,” he must have been curious enough to try sex at least once. Biographer R. C. Hollingdale had an opposite idea: that Nietzsche was “highly sexed and inordinately attracted to women,” yet there is no record, or even hint, of his ever having gone to bed with a woman of his own class -- or with any woman, we might add. That Nietzsche was inordinately attracted to women goes against all the known evidence.

Elisabeth did not give up in her attempts to cleanse the record of the ignoble diagnosis and its probable disreputable cause. If she could not stop the gossip about syphilis, she could at least put the prostitute rumor to rest. For this task in 1923 she engaged one of Nietzsche’s doctors, Health Commission Vulpius, who had assisted Binswanger at Jena. Vulpius’s finding of an inflammation of the left iris had confirmed for him the diagnosis of progressive paralysis: “The right pupil was considerably wider open than the left one, which was extremely deformed, but both showed no reaction to light. Slight adhesions of the somewhat discolored left iris with the front lens capsule were mostly dissolved after the insertion of a grain of atropin into the corner of the eye.”

“I too was deeply moved upon meeting the shadow of a man whose writings I had studied with lively enthusiasm as a student,” Vulpius recalled. “So it is understandable that I approached my patient not only with medical but also with psychiatric interest which in turn led Frau Dr. [honorary] Förster-Nietzsche to entrust me with writing a critique of her brother's medical history and the unsavory controversy connected with it.” Vulpius’s cooperative and fanciful theory at least satisfied Elisabeth with an alternative to sexual transmission:
The causal toxin must have once entered Nietzsche's system, namely without his knowledge. The most obvious and likely occasion for this assumption was his service as a volunteer medical corpsman in the 1870 campaign, and especially perhaps the final transporting of influenza and diphtheria patients under the most unfavorable hygienic conditions. To overcome his lively disgust and probably in the belief that he was thereby enjoying some disinfecting protection, he smoked in the ambulance. How easily a transmission of the poison could have taken place if he ever set down his cigar in order to help a patient in the crowded vehicle!

As far-fetched as the cigar theory sounds, spirochetes from a mucous patch in the mouth could be transferred on a cigar. Joseph Rollet, a doctor from Lyon, demonstrated that secondary syphilis is contagious in ways other than sexual by observing a glassblower with an infectious mucous patch in his mouth who infected a coworker when he passed a glassblowing pipe. By 1864 Rollet had fifteen such case studies, thus establishing the contagiousness of secondary syphilis. But Vulpius had no reason to think Nietzsche was infected in this way (perhaps he was humoring Elisabeth), and there is one sufficient reason why he was not: Nietzsche served as a volunteer medical corpsman only in 1870, whereas Möbius claimed to have in his possession letters from two Leipzig doctors who had treated Nietzsche for syphilis in 1867. This information about the Leipzig letters was provided by psychiatrist Wilhelm Lange-Eichbaum in a monograph published in 1946. He had written “Nietzsche as a Psychiatric Problem” in 1931. In this monograph he stated that a Berlin psychiatrist had told him about the treatment by these known doctors. Walter Kaufmann included this information in his section on Nietzsche in the Encyclopedia of Philosophy. And according to Hollingdale, Richard Blunck in a study of young Nietzsche “reproduces evidence which makes it impossible to doubt that Nietzsche was treated for a syphilitic infection by two Leipzig doctors during 1867.” In the clinical records Nietzsche is reported to have said he was infected twice in 1866, so treatment the following year fits a reasonable time-line for secondary syphilis. Although the information about the Leipzig treatment is not substantiated, there is no reason to doubt Möbius’s word that he had these letters in his possession as he said.

Elisabeth noted that Nietzsche had “cholera” twice in 1867, either incident being a possibility for a secondary syphilitic fever. Another possibility is that he was infected earlier and first treated only then. There was no sharp turn toward chronic illness in 1867. In fact Nietzsche’s medical history contains suspicious conditions much earlier. Between 1861 and 1866, for example, he complained of headaches, pains in the neck, chest, and throat, hoarseness, rheumatism, and spells of coughing which has led to speculation of early meningitis following a syphilitic infection.

Elisabeth’s next ploy was to get the diagnosis discredited. In May 1905 she assigned Peter Gast, who was working for her in the archive, the job of writing to Franz Overbeck, on his deathbed, requesting him to acknowledge that the diagnosis of syphilis found in the medical records at Jena was based on a remark he had made at the time of Nietzsche’s admission. Overbeck angrily answered at once that Professor Binswanger had told him in February 1890, after swearing him to secrecy, that there was no doubt in his mind about the syphilitic origin of Nietzsche’s paralysis. “I have kept Binswanger’s confidence, except in your case, Mr. Gast.” This correspondence was another of Elisabeth’s blunders. By trying to erase the diagnosis, she unwittingly documented a confirmation. When she asked Ida Overbeck to obtain a deathbed confession, Ida refused and soon after sued Elisabeth for libel for accusing her husband of losing a manuscript of the missing part of the Will to Power in Turin. In 1922 Binswanger stated that although the origins of Nietzsche’s disease could not be known, the diagnosis of progressive paralysis could not be doubted. According to present science, Nietzsche had a syphilitic infection of the central nervous system.

Indefatigable Elisabeth also attempted to explain away Nietzsche’s paralysis as an effect of drugs. A “Javanese soporific,” thought to be liquid hashish, was given to him in the summer of 1881 by a Dutchman who told him never to take more than a few drops in a glass of water. Elisabeth tried it and it had an exhilarating effect, but she came to dislike the feeling and implored her brother to be moderate in its use. In 1885 Nietzsche admitted he had taken a few drops too many and had flung himself to the ground, exhilaration passing over into a spasmodic laughter. According to Elisabeth, Professor Wille at Basel told her that Nietzsche was experimenting with soporifics not yet tried by science. All of this was revealed only after Möbius’s book was used by Elisabeth to promote the theory that Nietzsche’s paralysis was a “hashish paralysis.” She also suggested that the sleeping medication Nietzsche took left him excited in the morning.

Despite Elisabeth’s best efforts, the diagnosis would not disappear.