Moving onto the 2nd part of my very long screed on Nietzsche and syphilis.
Now, we have seen that Nietzsche had, according to accounts, an emotional reaction, very quickly followed by a physical collapse, followed in the very next days by his writing off letters to friends, the Wahnbriefe, letters in which he is more off-planet than your average astronaut off to Alpha Centuri, and he is way off-planet with no oxygen supply, but what is interesting is what is absent. When you read the Wahnbriefe, they do not sound like the writing of a classical paranoid. There are sudden disconnects, abrupt changes, incoherence, and there are complaints from the personal ("Also, last year I was crucified by the German doctors in a very drawn-out manner"), mixed in with complaints from the impersonal, where he "commanded the German emperor to go to Rome in order to be shot and summoned the European powers to take military action against Germany".
A large part of forming some sort of a differential diagnosis is also including what is missing. It is exactly like when Sherlock Holmes speaks to Watson of the mystery of why the dog did not bark in the nighttime. Again and again, when we try to understand what happened with Nietzsche, we are going to have to look at what is absent as well as what is present.
And what is absent here is crucial. Note that his crisis starting Jan 03 1889 is sudden. No-one reports a long lead-up, though this is misleading. His friends don't say he has finally gone over the edge after a fair long period of manic build-up, instead they seem to say he's suddenly off the deep end; and he has a physical collapse, along with everything else. Now of course you can postulate the physical collapse is something seperate and coincidental; but that would start getting very implausible indeed and very silly as soon as one knows that Nietzsche suffered several symptoms very reminiscent of a stroke. So let's look for an answer that comprehensively deals with all that was reported of the incident on Jan 03 to Jan 08 or so, 1889, and afterwards till his death in 1900.
Now, first off, we can very probably wipe out bipolar syndrome out of the list of answers. The bugger went and physically collapsed, and went on to become somewhat uncommunicative, and had physical symptoms in keeping with a stroke. To postulate he was only undergoing a bipolar syndrome crisis doesn't match the full picture; and if we have an answer that would match the physical symptoms as well as the mental symptoms, then we really don't need bipolar syndrome (manic-depressiveness) as an answer.
Don't get me wrong here. It is quite possible Nietzsche was bipolar; a hell of a lot of people seem to be, more than is usually reported in the official figures of incidence. But bipolar syndrome simply does not explain the physical side of his very sudden collapse, and it becomes wholly superfluous to it all. IOW, we can conclude Nietzsche may have been bipolar, but since he never got himself locked up for it before, then if he did have bipolar it was relatively mild. Going on, since bipolar syndrome does not explain a lot of things, and answers that explain those other things can also explain the mental / emotional side that is vaguely reminiscent of bipolar, then it really is bloody superfluous and more importantly totally useless, and we can leave that one behind.
I'll post this, and go onto the 3rd part in my next post.
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