Document Detail

The madness of Dionysus: a neurosurgical perspective on Friedrich Nietzsche.
MedLine Citation:
PMID:  17881977     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To examine the possibility that an intracranial mass may have been the etiology of the headaches and neurological findings of the philosopher Friedrich Nietzsche (1844-1900) and the cause of his ultimate mental collapse in 1889. METHODS: The authors conducted a comprehensive English and German language literature search on the topic of Nietzsche's health and illness, examining Nietzsche's own writings, medical notes from his physicians, contemporary medical literature, biographical texts, and past attempts at pathography. We also examined archived portraits and engravings of the philosopher from 1864 onward. An English language search in the modern literature on the topic of psychiatric presentations of intracranial mass lesions was also conducted. RESULTS: From his late 20s onward, Nietzsche experienced severe, generally right-sided headaches. He concurrently suffered a progressive loss of vision in his right eye and developed cranial nerve findings that were documented on neurological examinations in addition to a disconjugate gaze evident in photographs. His neurological findings are consistent with a right-sided frontotemporal mass. In 1889, Nietzsche also developed a new-onset mania which was followed by a dense abulia, also consistent with a large frontal tumor. CONCLUSION: A close examination of Nietzsche's symptomatic progression and neurological signs reveals a clinical course consistent with a large, slow growing, right-sided cranial base lesion, such as a medial sphenoid wing meningioma. Aspects of his presentation seem to directly contradict the diagnosis of syphilis, which has been the standard explanation of Nietzsche's madness. The meningioma hypothesis is difficult, though not impossible, to prove; imaging studies of Nietzsche's remains could reveal the bony sequelae of such a lesion.
Christopher M Owen; Carlo Schaller; Devin K Binder
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Publication Detail:
Type:  Biography; Historical Article; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurosurgery     Volume:  61     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-09-20     Completed Date:  2007-11-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  626-31; discussion 631-2     Citation Subset:  IM    
Department of Neurological Surgery, University of California, Irvine, Irvine, California, USA.
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MeSH Terms
Famous Persons*
History, 19th Century
History, 20th Century
Meningeal Neoplasms / history*
Meningioma / history*
Mental Disorders / history*
Personal Name Subject
Personal Name Subject:
Friedrich Nietzsche

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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