Turin’s breakdown: Nietzsche’s pathographies and medical rationalities

Abstract

At age 44, after suffering a breakdown in Turin, philosopher Friedrich Nietzsche was diagnosed with neurosyphilis. There was no necropsy on his body, so this medical diagnosis has been questioned over the time. We conducted a literature review on the medical diagnosis of Nietzsche, which emphasizes three genres of pathographies that emerged successively as alternatives explanations for Nietzsche’s breakdown in Turin: (1) narratives about syphilis (“demoniac-pathological”); (2) narratives about functional psychosis (“heroic-prophetic”); (3) other narratives about organic diseases, other than syphilis (“scientific-realistic”). The latter – which correspond to our study object in this work – undertake retrospective diagnostics, attempting to retrieve the “truth” underlying the disease and elucidate “Nietzsche’s affair”. We inquire this detective-like impetus, currently taken to the extreme by “evidence-based medicine”, and we denounce its anachronism. Syphilis has become a scientific fact only after the death of Nietzsche. We conclude that the diagnosis he received is shown to be consistent with the nineteenth-century medical rationality and the syphilis status as a cultural fact at that time.