In a 2004 article published by the Journal of the History of the Neurosciences, Arnold questions
the validity of Peyron’s diagnosis. Due to the fact that clinicians at the time were fully knowledgeable about the classical forms of epilepsy, Arnold wonders why van Gogh was never treated nor recommended to an epilepsy specialist during his lifetime. A diagnosis of temporal lobe epilepsy may explain van Gogh’s hallucinations, along with the episodic nature of his illness, and the interspersed periods of neurological normalcy.
However, complex partial seizures usually last a few hours at the most, so this diagnosis does not fit the days and weeks of agony that van Gogh described. More importantly, epilepsy does not accommodate the numerous gastrointestinal irritations that the struggling artist often complained about. Instead, Arnold proposes that van Gogh actually suffered from acute intermittent porphyria (AIP), a hereditary metabolic disorder.
Acute intermittent porphyria, also known as “the royal malady” (as it is believed to have had afflicted King George III and his family) is known to disrupt a patient’s ability to generate “heme,” a vital molecular compound found in blood cells that is needed for the transportation of oxygen throughout the body. The term “acute” refers to the rapid onset, and abrupt cessation, of expressed symptoms, while the term “intermittent” refers to the typical periodicity (distinct periods of normalcy which come between episodes of illness).
Arnold — along with Dr. Loretta S. Loftus of the University of Missouri-Kansas City School of Medicine — described in a later study how van Gogh’s illness and symptomatology is fully supported by AIP. This includes the gastrointestinal complaints, neurological disturbances, age of onset (between 20 to 40 years old), and jagged time course (which can be made worse due to inadequate nutrition or alcohol abuse — in van Gogh’s case, absinthe).
The hereditary nature of van Gogh’s AIP is also supported by the fact that his younger sister Willemina spent the later half of her life in a psychiatric ward while his brother Theo suffered from mental illness, severe fevers, leg pain, and acute bouts of stress and anxiety. In a letter written to Theo, Vincent comments on the similarity in character of both of their illnesses: “Our neurosis [as] a fatal inheritance.”
Even though Arnold and Loftus’ diagnosis of AIP may seem to be the most plausible explanation for van Gogh’s illness to date, many other clinicians have a different interpretation. In the journal Neurological Disorders in Famous Artists, Julien Bogousslavsky, along with others, proposed that van Gogh suffered from a bipolar disorder, affective or schizoaffective, that may have played a role in his death by suicide.
Other clinicians still support the idea, proposed in 1972 by Koichi Yasuda, that van Gogh suffered from Meniere’s disease. Some of the main symptoms used by the researchers to justify their diagnosis were van Gogh’s consistent nausea and vomiting and the severing of his own right ear, which he may have done to relieve the troublesome symptoms of tinnitus. Besides his letters, many clinicians also chose to view van Gogh’s artwork through a behavioral lens in order to diagnose his illness.
When one looks at his paintings, it becomes clear that van Gogh was infatuated by the color yellow. One of the defining elements of “The Starry Night” lies in the yellow coronas surrounding each star in the painting. Paul Wolf, clinical professor of pathology at the University of California, San Diego, addresses this in his paper, published by The Western Journal of Medicine. Wolf describes how van Gogh’s last attending physician (in the final 10 weeks of his life) may have treated Vincent’s “epilepsy” with digitalis, a drug extracted from the purple foxglove plant. People who receive large and repeated doses of this drug commonly see the world with a yellow-greenish tint, and in particular, report seeing yellow spots surrounded by coronas, much like those in “The Starry Night,” which was painted by van Gogh in June 1889. In one of van Gogh’s three portraits that he painted of Gachet, the physician holds a stem of Digitalis purpurea, the purple foxglove from which the drug is extracted, all painted in a yellowish hue.
Van Gogh’s recognizable yellow washes over many of his works, twirling around the stars that twinkled from his hotel room window in France’s Saint-Remyde-Provence, encircling the wheat fields that swayed before him, and illuminating from the faces that stared back at him. I too can see that yellow light which he spoke of in a letter to Theo, washing over him in Arles, France, as he painted the countryside: “Oh! That beautiful midsummer sun here. It beats down on one’s head, and I haven’t the slightest doubt that it makes one crazy … Many thanks for your letter, which gave me great pleasure, arriving just exactly at the moment when I was still dazed with the sun and the strain of wrestling with a rather big canvas.”
We are wrestling with the fact that van Gogh’s illness is still a mystery, even after 126 years of scientific inquiry. It is a multilayered and unique condition colored by bright hues of yellow, clouded by the insights and opinions of over 150 art and medical professionals. At the end of the day, all we have are his words and his paintings — a style and voice that emerged from the mind and body of van Gogh and which acted as an offering placed within the intersubjective space between the creator and the audience, both challenging and transforming one’s relationship with their environment forever.
This article was originally published in the Summer 2016 issue of Brain World Magazine.
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