Opinions about the merits of the writings of Friedrich Nietzsche have varied greatly during the century following his death in the year 1900. He had already achieved cult status in Germany at the time of his death and it was possible for his devoted friend Peter Gast to end an effusive oration at Nietzsche' s gravesite by saying, "Peace be on your ashes! Holy be your name to all future generations!" The continuous outpouring of books about Nietzsche, the existence of numerous Nietzsche societies all over the world and the prevalence of his writings in bookstores indicates that, while his memory may not have reached the level of a religious icon, there remains an enduring interest in his ideas. But there is another viewpoint about Nietzsche. Anacleto Verrechia, one of his many biographers, expressed the view that excessive interest in Nietzsche is a type of sickness in itself. A London bookseller during the First World War called that disastrous conflict the Euro-Nietzschean War. The Nazi era has been regarded by many as having its intellectual origin in the ideas of Nietzsche and in 1981 an issue of Der Spiegel carried a cover page with a gun-wielding Hitler back to back with a reflective Nietzsche. The caption read, "Täter Hitler, Denker Nietzsche" (perpetrator Hitler, thinker Nietzsche).


To what can this enduring fascination with Nietzsche's ideas - his ethics one might say because most of Nietzsche's thoughts represent his own unique ethics - to what can this fascination be attributed? He has often been described as a master of German prose style but he is rarely read because of his stylistic brilliance, which besides does not translate easily into other languages. His concepts are hardly those that would command him a wide audience, for example, the will to power, the relativity of values, Christianity as the bźte noire of European civilization, his notions of the Übermensch, the ultimate political incorrectness in our day as well as his. He mocked the principal metaphysical dogma of western culture - the belief in God - and went a step beyond Heine in sarcasm by saying that God was not only made sick by his creative product man, but had died of grief over man's condition. He would have nothing to do with ideas of immortality, separateness of soul or any kind of revelatory knowledge. But he was no more entranced with scientific materialism, which he saw as the manifestation of limited and self-serving minds. Socialists and nationalists he viewed as simple-minded canaille. He thought compassion to be the principal danger to a developed mind. His comments about the female sex are best left unreported. For all these ideas, he has been regarded as the ultimate nihilist of Europe. Nihilism is rarely a point of view that attracts many adherents.


Then why, one may ask, does Nietzsche continue to attract such interest a century after his death? I submit that it is because he is the individualist par excellence  - existentialist, one might say - who was committed to the primacy of the mind in all its dimensions and demanded the development of its potential. He did not concern himself with social or political issues, his interest was focussed on the nature of the human spirit.  The noble soul, he stated, has reverence for itself. TheÜbermensch to Nietzsche is not the man of political or military might, not a scientist or a scholar, not a religious leader and certainly not a plutocrat; he is a superior personality whose superiority resides in the expansion of the self. Zarathustra was his model of the higher man. The will to power, Nietzsche thought, meant the will to self-development and the cultural traditions within which individuals are so prone to become entangled were relegated by him to the category of traps for the unwary.


One has to recognize the enormous difference in reading about Nietzsche and reading Nietzsche himself. Scholarly commentators who analyze his works give their judgements within the context of scholarly analysis. But Nietzsche reveals his inner self while still retaining an intellectual awareness. He writes with his blood to use his own phrase. Walter Kaufmann said that Nietzsche creates his own special world in the tension between analysis and existentialism. His thoughts, intuitions, dislikes and positive passions are expressed personally. The reader who experiences his Geist , his spirit - the German term is more inclusive - has made contact with a writer who has risen above the trappings of society and is communicating his own uniquely personal perspectives. Such an author is very rare. It is not surprising that he inspires both extreme positive and extreme negative feelings in his readers.


During the first week of 1889, while living in Turin, the forty-four year old Nietzsche suffered a total nervous breakdown. He had been exhibiting some signs of nervous instability in the previous months but the abruptness and severity of his breakdown surprised his family and few friends. Franz Overbeck, his faithful former colleague from his Basel days as professor of philology journeyed to Turin to provide assistance. In a fateful judgement, Overbeck decided to bring him back to Basel and arranged for his admission to a local institution for the mentally deranged. After a few days of observing Nietzsche, who was by then totally manic in his behavior, the chief psychiatrist made the diagnosis of Progressive Paralyse, general paresis in English. This diagnosis was sustained by the physicians who subsequently cared for him and has been accepted by those concerning themselves with Nietzsche' s medical history. Fourteen months after his institutionalization, he was released to the care of his mother. Gradually he sunk into a total apathy. His mind, to use a term from Emil Kraepelin, father of German psychiatry, had become a devastated field. Nietzche died ten years later.


It is necessary to say a few words about the diagnosis general paresis. It refers to the development of dementia and loss of motor functions in an otherwise well adult, usually in his middle years. Megalomania, agitation and delusions of grandeur may be associated features, symptoms that many thought fitted Nietzsche perfectly. Paresis was one of the most common diagnoses during the nineteenth century among patients admitted to mental institutions. One might compare its importance then with that of schizophrenia today. It was only late in the nineteenth century that it was recognized that individuals with general paresis usually revealed a history of syphilitic infection, although this occurred many years before the onset of the general paresis. It might be compared with the temporal relationship of AIDS to HIV infection. Now it is regarded as a late manifestation of syphilis due to spirochetal infestation of the brain. Strangely, paresis is a very rare disorder today, although the same is not true of syphilis as a disease entity.


Nietzsche's diagnosis of syphilitic brain disease was known during his life only to the few physicians involved with his care. Nothing had been said to the family. It was not until 1902, two years after his death, that a long article was published by the noted neuropsychiatrist Paul Möbius which let the cat out of thebag. It was entitled "Nietzsche's Pathology" and revealed that Nietzsche had suffered with general paresis, a disease of the brain. Möbius did not mention the word syphilis, which carried the same social stigma then as it does now. However, given the association of paresis with syphilis, Nietzsche's detractors were soon able to label him as a syphilitic.


The major part of Möbius' monograph analyzed Nietzsche's writings with the purpose of showing how they were affected by his brain disease. This method of literary analysis came to be known by the name of "pathography", an approach that was used by Möbius and others for the enlightenment of readers. He believed that all of Nietzsche works published after 1880, virtually encompassing his entire output as an independent philosopher, showed the effects of general paresis. Later, pathographic writers did not necessarily believe that Nietzsche's writing was adversely affected by spirochetes in the brain; on the contrary, it was proposed by some that a "disinhibition" was induced allowing free flow of Nietzsche's thoughts. Today, no serious student of the effects of brain damage would subscribe to this view.


Subsequent to the pronouncements of Nietzsche's psychiatrists and later ones who concurred with the diagnosis, much information has become available that casts serious doubt on the diagnosis and, in fact, makes the existence of syphilitic brain disease in Nietzsche highly unlikely. The widespread availability of blood tests for syphilis after 1913 forever altered the diagnosis of this condition. It became evident that general paresis was an over diagnosed disorder. The psychiatric manifestations once thought to be specific for paresis revealed themselves to be present in many other psychiatric disorders. With the advent of laboratory testing, the diagnosis of paresis became more and more infrequent until its virtual disappearance in current times.


Furthermore, there are a number of features in Nietzsche mental illness that contradicts a diagnosis of organic brain disease of any type. The writings of 1888, Nietzsche's last year of creative literary activity, reveal the presence of exceptional cognitive capacity at a time when spirochetes were supposed to be devouring his brain cells. The hallmark of organic brain disease is the loss of cognitive capacities. Ecce Homo, completed just before his breakdown, displays a lucid and vigorous thought content and is composed with Nietzsche's usual masterful prose style. For example:


Whoever knows how to breathe the air of my writings knows that it is an air of heights, a strong air. One must be made for it, otherwise there is no small danger to become chilled by it. The ice is near, the solitude is immense - but how calm lies everything in the light! How free one breathes! How much one feels to be below oneself. Philosophy, as I have until now understood and lived it, is the voluntary life in ice and high mountains - the seeking out of everything strange and questionable in existence, everything that up to now has been banned by morality. From long experience with such wandering in the forbidden, I discovered that the fundamental causes, which up to now has given rise to moralizing and idealizing, seem very different than might be expected: the concealed history of the philosophers, of the great names in psychology, was revealed to me. How much truth can a mind endure, how much truth can a mind dare? Increasingly for me, that has become the real measure of value. Error is not blindness, error is cowardice…every accomplishment, every step forward in knowledge follows from courage, from strength in oneself, from purity toward oneself.


Whatever one may think Nietzsche's metaphors and ideas, and the hyperbole present on virtually every page of Ecce Homo, it cannot be denied that he was in charge of his material.


There were other features of his illness that did not fit the diagnosis of general paresis. These were the extremely slow progression of his disorder beyond the experiences of the time and the absence of dysarthria and other motor losses characteristic of paresis. Nietzsche's physicians were aware of these discrepancies but preferred to believe that Nietzsche was an atypical case.


There can be little doubt of how Nietzsche would have been managed by psychiatrists of today. He would have been diagnosed with manic depressive psychosis (current terminology uses the less meaningful term bipolar disease). He would have been loaded with drugs from the armamentarium of psychotropic medications, which no doubt would have suppressed some of the more bizarre symptoms that he displayed during his fourteen months of institutionalization. If, in spite of medications, Nietzsche continued to show signs of psychosis, his diagnosis would have been changed to chronic schizophrenia, a common switch in long term manifestations of psychosis. In either case, Nietzsche's unique creative life would have come to an end, as it did in the actual course of his illness.


However, facile utilization of psychiatric jargon does not explain anything in the case of Nietzsche. One of his earliest and most sympathetic of his biographers, Charles Andler, refused to involve himself with such questions saying that “his sloughed-off remains, consumed by an interior fire, belong only to the psychiatrists.”  This has been the attitude of many scholars interested in his work. Yet the problem of what happened to Nietzsche cannot be evaded. I believe that one must look to his life, not to his brain, to understand what happened to him. Nietzsche had broken with all his professional, family and social connections. He was single, lived alone in constantly changing circumstances, had no friends in his vicinity and possessed an inadequate grasp of the languages spoken where he lived. Additionally, he had a severe visual handicap that significantly interfered with his life. His small income was increasingly precarious. Added to all these pressures was his mode of thought, which was idiosyncratic to an extreme. He had created values that set himself against the entire cultural and religious framework of his era. The ever-increasing sarcasm and hyperbole of his writings reveal the extreme tension within which he lived. Franz Overbeck, who knew him best, commented that his whole life was a preparation for madness.


Thus what is surprising is not that Nietzsche lost contact with reality but that the break took as long as it did to occur. But the fact that he could not sustain his equilibrium does not mean that his thoughts expressed prior to the breakdown can be discounted as the megalomania of one with brain disease. Nietzsche valued the creative capacities of the human mind. A key to this value system can be found in a passage in Beyond Good and Evil in the section entitled, ' What is Noble'.  "The greatest events and thoughts - but the greatest thoughts are the greatest events - are comprehended last; the generations that are contemporaneous with them do not experience such events - they live right past them." Perhaps the best commentary on Nietzsche was written by Ralph Waldo Emerson before Nietzsche was born.  "Beware when the great God lets loose a thinker on this planet. Then all things are at risk. It is as when a conflagration has broken out in a great city, and no man knows what is safe, or where it will end." Nietzsche had read Emerson and used one of his sentences as an epigraph for the first edition of The Gay Science.


One should not make an idol of Nietzsche nor did he wish to become one. He had character faults, he could be boastful, deceptive and self-pitying. Amor fati for him was a goal to be sought, not a part of his normal temper. Ultimately the discrepancy between Nietzsche's ideals and the realities of his psychic structure became so great that he collapsed into psychosis. He should not be regarded as a martyr but as a human being whose personal capacities could not keep pace with his aspirations. He is more Icarus than Satan or Jesus, his life proves that there are limits to one's capacity to create oneself in an integrated manner. But madness fascinated Nietzsche. He refers to it over and over again in his writings and regarded it as a necessary condition for spiritual progress in society. He did recognize the price to be paid. In a letter to a friend in July 1888, six months before his breakdown, Nietzsche commented:  "I have given men the deepest book they possess, my Zarathustra...however, how one must atone for that! Must pay for it! It almost ruins one's character. The cleft has become too great. Since then I really only carry on clowning (Possenreisserei) in order to keep control over an unbearable tension and vulnerability."  Perhaps he felt the state of madness was easier for him than maintaining links to an oppressive world. Like Robert Louis Stevenson’s Dr Jekyll who could no longer escape from Mr. Hyde, Nietzsche may have lost the ability to return his creative state of mind in which he had struggled so hard to maintain himself. All this is speculation but not more speculative than the medical diagnosis that has been attached to his persona.


The popularity of Nietzsche in America today may have a certain national basis not existing elsewhere. There are considerable similarities between Bismarckian Germany of his day, the “Second Reich”, and the United States at the turn of the twentieth century. Both were the national powerhouses of their time, both exerted a hegemonic influence that was founded on economic and military power. Bismarck’s Germany based its national pride on the concept of German Kultur; in the United States, it is technological mastery that is the touchstone of its self-confidence. In either case, the consequences were an enormous development of power in the societal structures within the countries and corresponding diminishment of the capacity of the individual to develop himself as a fully independent entity. Nietzsche may have been an expatriate, but he lived under the shadow of German cultural institutions. Referring to the triumph of Germany over France in the 1870 war, Nietzsche commented that the victory of the German Reich had led to the extinction of the German Geist. Some such process may be afoot today in the United States. Its economic and scientific superiority creates institutions of such power that the free spirit of the individual can hardly breathe. The materialist orientation is preeminent and dominates the life of the individual, whatever his occupation or way of life. Nietzsche’s writings support the free spirit in his efforts to be free.


Henry David Thoreau whose life and thoughts have many similarities to Nietzsche's - albeit Thoreau possessed a more integrated personality  - observed that most men live lives of quiet desperation. It is unlikely that his judgement would be different today. Perhaps this is why so many individuals resonate empathetically with Nietzsche whose desperate state is clearly manifest in his writings. The problems of Nietzsche are still the problems of today. Of course, there are not many who suffer with them as much as Nietzsche did just as there are few who possess his genius and capacity for self-expression. The focus of western societies is often on a self-serving "ethics" indiscriminately imposed on others. But in the long run according to Max Weber, founder of scientific sociology, the only really significant factor in human society is the free, value-creating initiatives of the individual personality. That is why interest in Nietzsche persists and his legacy lives on today.


Richard Schain

May 2003