From childhood he had poor eyesight and began wearing glasses at age four. He required stronger glasses as he aged and often experienced severe headaches, even migraines, from long hours reading and writing by poor light.
Matters worsened after be became a professor at Basel. “For the first time, he was having stomach problems on top of his other symptoms. Eyestrain, headaches, and vomiting gradually worsened. Minor illnesses such as hemorrhoids and shingles were annoyances. He felt in 1873 that ‘the machine was breaking down.’ It was during this time that he began his dabbling with a multitude of treatments for his symptoms, interspersed with consultations with various physicians. Leeches and cupping were again used as in his Pforta days. Diets, hydrotherapies, physical therapies, electrotherapies, kinds of medications, and home remedies were tried at different times. He was a voracious reader of medical and physiological texts.” (Richard Schain, page 19)
That he remained equal to the stresses and challenges of academic research and teaching indicates how obsessive Nietzsche must have been of his work. Insomnia was another of his many complaints and doubtlessly he often focused on his writing and lecture preparation far into the night. This further strained his eyesight.
Fritz defined the almost overwhelming level of illness to enter his life in his own words in 1871: “…the classroom drudgery of Basel, plunged Nietzsche into a state of deep depression, finally culminating in a nervous breakdown. On or around 21 January, after three weeks of silence, he informed his worried mother that he was suffering from stomach upsets, sleepless nights, too little exercise, severe eye-strain and ‘intolerable weather’. He was overworked, he felt at times completely fed up with the ‘whole professional business’, he was frustrated by the feeling that the best years of his life were being consumed in ‘excessive school-mastering’.” (Cate, page 122)
A combination of what he perceived as being enslaved to his professorship and his growing breach with Richard Wagner exasperated his illnesses, giving them a neurotic quality.
“What Nietzsche really desired was to withdraw into an informal private world which he was trying to construct. There was the constant dream that he could pursue his philosophical interests. When he discovered the Alps, he found he could disappear from the world through long walks in the forests, sometimes for six to eight hours. …He was tired of what he felt to be the slavery of professional life.” (Schain, page 20)
He was completely torn between the reality of his life as a professor and as a close associate of Wagner: “…we should, in this case, speak of ‘neurotic’, and a sign that Nietzsche was becoming neurotic during the mid-1870s is that his emotional inclination was all towards what he knew intellectually he should be giving up….Taking into account all we know of him at this time, we cannot doubt that the stomach trouble which drove him to Steinabad and away from Bayreuth at just this moment was psycho-somatic in origin.” (Hollingdale, pages 86-87)
“Throughout the autumn and early winter on 1873 Nietzsche was almost permanently unwell, suffering not only from acute eye-aches every time he tried to read for more than an hour or two, but also from nausea, stomach upsets and even vomiting – almost certainly due to his hyper-nervous condition at moments of difficult creativity. As his doctor friend, Professor Immerman, one day said to him, knowing in advance that it was an impossible prescription: ‘Be more stupid and you will feel better.’” (Cate, page 184)
In 1875, when he attempted to publish some early essays (to be discussed here in a future post), his publisher responded that he wanted Nietzsche to provide a new essay every nine months. One might think Fritz would have been elated at the prospect of being published on a regular basis. Instead, the deadlines mixed the pressure of creativity in with his workload and other concerns to such an extent that it had a “shattering effect on Nietzsche, unleashing a psychosomatic crisis of extreme gravity. For the next six weeks, despite the consoling presence of his sister, he suffered from acute eye-aches and headaches, and convulsive stomach upsets, some of then sp protracted that blood came up with the vomit. When other treatments failed Fritz tried massive doses of quinine. One shudders in imaging the acute abdominal spasms that this traitement de cheval must have generated in ‘attacking’ Nietzsche’s stomach ulcers. The vomiting, sometimes going on for hours on end, was often so convulsive that Nietzsche felt that his last hour had come and yearned for nothing so much as a quick, ‘easeful death’.” (Cate, page 214)
Basel granted him a leave of absence in 1876 on grounds of illness. He did not resume his teaching duties until the fall semester of 1877. But, by 1879 Nietzsche was incapable of continuing his professorship. He was forced to resign from the university. He would live off his modest pension from Basel for the rest of his life. In The Good European we find an example of how commonplace his various illnesses became: “By the end of 1879 he had experienced 118 days of severe illness – a ‘lovely statistic,’ as he wryly commented to Elizabeth on December 29.” (page 122)
Then there is the matter that, apparently, Fritz caught a sexually transmitted disease from a prostitute and was never adequately treated for it. Syphilis. Though some disagree, offering alternate theories, current scholarly consensus is that, in the end, syphilis likely led to Fritz’s ultimate mental demise.
It seems he frequented brothels, particularly in his student and soldiering years. As the theory goes he contracted the disease at this time and it went untreated all his life. The impact of Nietzsche’s possible contraction of syphilis will be discussed in a future post when we reach the point of his breakdown in Turin in January 1889.
Young suggests that the sexual disease diagnosis is unnecessary, however. "Nietzsche clearly suffered from symptoms indistinguishable from those of migraine. Nausea and vomiting, sensitivity to light, and fatigue are classical migraine symptoms, while the things that affected Nietzsche, emotional stress, bright light and loud noise are classic triggers. Nietzsche suffered intermittent stomach pain all his life, but certainly did not die of a stomach ailment. This suggests that 'irritable bowel syndrome' (IBS) is a more plausible diagnosis of the stomach-pain side of Nietzsche's complex medical condition." (page 209)
One of Nietzsche’s many primary themes in his mature philosophy is the concept of “self-overcoming.” Exactly what he meant by this term is subject to interpretation, of course. However, it is certainly plausible that Nietzsche’s own, intimate and virtually continuous, struggle to remain healthy enough to live a full of life of art and philosophy, of travel and discovery, had a profound influence on his attitude toward the nature of human strife and the need to overcome the limitations of oneself.
To that extent, being sick was (ironically) a vital part of Nietzsche’s refinement as a thinker.