[Height-induced vertigo and its medical interpretation: Goethe and the Strassburger Münster].Schweiz Med Wochenschr. 2000 Feb 19; 130(7):209-21.SM
An analysis combining medicine and literature challenges the methodology of both disciplines. This essay on the vertigo Goethe suffered on the tower of the Strasbourg Minster attempts to trace the vicissitudes of interpreting an emblem, like vertigo, burdened by cultural meaning and implications. Thus, Goethe's own report of this event 40 years after the fact, in his "Dichtung und Wahrheit", has to be related to another, hidden chronology of vertigo and fear in his account which, at first glance, conveys quite different implications. The first part of this paper refers to a medical interpretation of Goethe's dread of high places and his way of coping with it which, today, could be defined as a typical example of a behaviourist approach. In the second part, Goethe's vertigo is linked to psychoanalytic, literary, and historical reflections on the meanings of symptoms we connect today with medical terms like anxiety, phobia, and vertigo. Goethe's vertigo is shown as a complex problem--not only for himself but also for its interpreters: on the one hand, it tells its own story-within-a-story; on the other, it depends on the tools it was written with. Traditional approaches of medical history try to find symptoms and traces of diseases known to us today in literary texts, an approach which is as dubious as taking today's tools of medical analysis, such as psychoanalytic terms and concepts, to explain specific phenomena in literature without first carefully analysing these methods themselves, and only then subjecting the text to an analysis based on them. Nevertheless, this essay does not contest the justification of interpreting literary texts in the light of today's medical knowledge, but postulates that it should be clear which type of medical knowledge is applied. It is quite possible to read Goethe's account only as an old tale of acrophobia, but how will this help us? It seems more interesting to look at the link between the feeling of dizziness he experienced on top of the tower and the "cultural feeling" of the Sturm and Drang period, and then to trace the perception of this feeling at that time within its cultural context and in the light of prevalent medical theory.