What Was Van Gogh’s Problem?

Self Portrait, 1887, oil on artist's board

Self Portrait, 1887, oil on artist’s board

Vincent van Gogh walks into a bar, and the bartender offers him a drink. “No thank you,” said Vincent, “I’ve got one ‘ere.”

Oh, and there are plenty more where that came from. Van Gogh’s ear is the butt of many jokes or side comments about craziness. In fact, I’ve had several conversations lately that revealed just how many people around me just think of Van Gogh as a crazy painter who cut off his ear, and I can’t help but worry that such an opinion has a detrimental effect on their opinions of his work. In so many ways, Van Gogh was an exceptionally intelligent human being! He was an avid reader, sometimes re-reading literature by Keats, Longfellow, Zola, Michelet, Lamartine, etc. (Letters 12, 14, 15, 19, 716). He also spoke several languages: Dutch, French (he wrote to his brother in French after 1887), reasonable English, and a little German. He was a great admirer of Japanese Prints, as was Monet. He was also a very devoted and insightful artist. Read his letters.

So, I waded through several medical studies, psychology articles, and historical papers written on the subject. I have attempted to boil down and sum up the current diagnostic outlook:

Let’s just get the ear incident out of the way. Firstly, only a portion of the ear was cut. Secondly, the story in its entirely is unknown. There are a few conspiracy theories that revolve around the idea that Gauguin was the one who made the cut. Here are a few pieces of the puzzle:
– The incident was actually reported in news on December 30, 1888. According to Le Forum Républicain “Last Sunday, at half past eleven in the evening, one Vincent van Gogh, a painter, a native of Holland, presented himself at brothel no 1, asked for one Rachel, and handed her…. his ear, telling her: ‘Keep this object carefully.’ Then he disappeared. Informed of this act, which could only be that of a poor lunatic, the police went on the following day to the home of this individual, whom they found lying in his bed, by then showing hardly any sign of life. The unfortunate was admitted to the hospital as a matter of urgency.” 5
– “Van Gogh remembered little of what happened. This is evident from a note made by Dr Peyron in the asylum at Saint-Rémy on 8 May 1889: ‘During that attack he cut off his left ear, but he has no more than a vague memory of all that, and is not aware of it.’”5
– Gauguin’s accounts of the event changes. In his first telling, Gauguin did not even witness the cutting. It was only 15 years later that the story developed into a colorful, violent attack.5

A SUMMARY OF SYMPTOMS
– Symptoms of serious debilitation appeared in his thirties.
– Episodes of mental derangement. He recovered quickly (a few days – week). These “crises” were “separated by intervals of lucidity and creativity.”1 In other words, the derangement was not constant.
– History of mental illness in his family (In fact, there’s speculation that his brother, sister and father suffered from the same illness)1
– Chronic abdominal pain
– Episodes of hallucinations, auditory and visual
– Partial seizures
– Incapacitating depression

EXACERBATED BY
– Malnutrition
– Fasting
– Overwork
– Excessive alcohol consumption (particularly absinthe)
– Ingesting “camphor to combat insomnia”1 and turpentine/oil paint during his “crises.”5

IMPROVED HEALTH WITH FOLLOWING TREATMENTS
– Better/balanced diet
– No alcohol
– Bromide therapy (helps with absinthe intoxication and porphyria)1

THE DIAGNOSIS
Acute Intermittent Porphyria. (acute refers to the rapid onset of symptoms and intermittent describes the periodic nature of the disorder). Porphyria is an inherited metabolic disorder. Those that suffer are deficient in certain enzymes and have difficulty synthesizing certain chemical compounds. The symptoms can be managed by the body in normal conditions, but when under stress (i.e. malnutrition or drugs), the body produces toxic levels of these unsynthesized compounds. “This explains the lack of symptoms for latent AIP patients and the intervening periods of normalcy for patients who have experienced periods of the sickness”1. There are several types of porphyria, but acute intermittent porphyria in particular is known for effecting the nervous system and can induce neuropsychiatric symptoms. This diagnosis fits all of Van Gogh’s symptoms and the timeline of his illness.1

A FEW REFUTED THEORIES
Epilepsy: The seizures described by Van Gogh and his doctors could point to temporal lobe epilepsy with complex partial seizures. However,”the usual duration of minutes or hours that attends the various forms of complex partial seizures does not fit the days and weeks of Vincent’s crises.”1 Temporal lobe epilepsy does not explain his abdominal pains, nor is it known to be induced by malnutrition. In addition, Vincent noted in his letters that his “fits and confusion…seem to have have been controlled in Arles by bromine…”, but this treatment does not affect recovery from complex partial seizures caused by temporal lobe epilepsy.1

Bipolar Disorder: Patients with bipolar disorder usually do not check themselves in medical facilities as Van Gogh did. In addition, “their disorders do not have acute onsets and offsets, and the time course of Van Gogh’s illness certainly does not fit that syndrome.”1

Schizophrenia: Without treatment, Van Gogh’s mental state would have deteriorated. Schizophrenic patients interpret reality differently, resulting in “some combination of hallucinations, delusions, and disordered thinking and behavior.”4 However, Van Gogh seemed to remain connected with reality and his letters continued to be “lucid and logical.”1

Lead Poisoning: The treatment for lead poisoning was unknown during Van Gogh’s lifetime. His illness would have progressed without treatment, but his crises were episodic.1

Meniere Disease: This disease produces symptoms such as tinnitus (think of it as “ringing” in the ear) and vertigo (a kind of dizziness due to a dysfunction in the vestibular system that creates a sensation of spinning). However, Van Gogh’s descriptions of his experiences “were clearly auditory and visual hallucinations, not tinnitus.”3 Furthermore, neither Van Gogh nor his doctors described an episode that could definitely be construed as a result of vertigo.

Voila. I realize I just threw a bunch of research at you, but hopefully it succeeded in convincing you that Van Gogh was not deranged. Yes, he had his moments. But his paintings were a product of serious practice and artistic development, because he was extremely sensitive, devoted, and lucid whenever he was well enough to paint. I’ll sum up with this little nugget of wisdom:

Vincent van Gogh was not a mad artist, but rather an exceptional man who suffered from an inherited disease.   He was wonderfully creative because of intelligence, talent and hard work. He was a genius in spite of his illness — not because of it.2

1 Arnold, Wilfred Niels. “The illness of Vincent van Gogh.” Journal of the history of the neurosciences 13, No. 1 2004, pp. 22-43.
2  Arnold, Wilfred Niels. 1992.  Vincent van Gogh: Chemicals, Crises, and Creativity.  Boston: Birkhauser.
3 Martin, C. “Van Gogh souffrait-il d’une maladie de Ménière?” Annales françaises d’Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 128, Issue 4, September 2011, Pages 245-249.
4 Mayo Clinic Staff. “Schizophrenia”. Mayo Foundation for Medical Education and Research. 4/3/13 <http://www.mayoclinic.com&gt;
5 Vincent Van Gogh – The Letters: The Complete Illustrated and Annotated Edition. Edited by Leo Jansen, Hans Luijten, Nienke Bakker. Van Gogh Museum in association with the Huygens Institute. 2009. 4/4/2013 <http://vangoghletters.org&gt;

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2 responses to “What Was Van Gogh’s Problem?

  1. One could like Van Gogh for the sensationalist story, but his art stands on its own, and is more impressive than the ear incident. If he’d had a little success and a ray of hope he might have lived to a ripe old age.

    • Cheers! I absolutely agree: his Art is much more impressive. It’s a shame so many people these days just consider him “that crazy ear guy”; it taints their opinion of his work, and such folks are more likely to overlook the bulk of his paintings and the intelligent/beautiful ideas in his writing.

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