A paper just published in Acta Psychiatrica Scandinavica reconsiders the insanity and death of philosopher Friedrich Nietzsche, who is commonly thought to have died of neurosyphilis.

In contrast, the authors of the new study suggest that Nietzsche died of frontotemporal dementia – a type of dementia that specifically affects the frontal and temporal lobes.

While many people have ‘diagnosed’ historical figures in retrospect, this study is different, in that the authors reviewed Nietzsche’s actual medical notes in light of what is known about the progression of syphilis and dementia today.

More than 100 years after his death, Friedrich Nietzsche remains one of the most contentious figures in the history of philosophy. His writings contain some of the most profound philosophical statements of the 19th century, and have been exceptionally influential. However, they also express ambiguities and contradictions, which leave scholars perplexed and still arguing about their meaning and intent. Such ambiguities are reflected not only in Nietzsche’s life, but also in his terminal illness and death. Following a psychotic breakdown in 1889, at the age of 44 years, he was admitted to the Basel mental asylum and on 18 January 1889 was transferred to the Jena mental asylum. He remained in demented darkness until his death on 25 August 1900. In Basel, a diagnosis of general paralysis of the insane (GPI; tertiary cerebral syphilis) was made. This diagnosis was confirmed in Jena and is still widely accepted. However, even some of Nietzsche’s contemporaries doubted this. The lack of certainty about his primary luetic infection, the long duration of the disease and some clinical features lead us to question the diagnosis of GPI. In this study, we re-construct the anamnesis [clinical history] of Nietzsche’s illness and review the clinical presentation. We then note the natural history of GPI as it was at the turn of the 19th century, and suggest an alternative diagnosis, namely that of frontotemporal dementia (FTD) which has been characterized in detail only in the last two decades.

Link to abstract of paper.