Hard to Get
Ludwig II of Bavaria famously loved to paraphrase a line from the play “The Bride of Messina”, saying, “I wish to remain an eternal enigma to myself and others”. I can think of very few people who have achieved their life goal to such a high degree. For all of the information available about the Swan King, the truth of his interior life and of his tragic fate remain impenetrable to everyone who tries to learn about him.
The mysterious circumstances of Ludwig’s death read like the best of true crime, but the analyses of his mental state by medical historians read like the worst kind of academic controversy. When you manage to find an article about Ludwig’s sanity or lack thereof that has been translated to English (sorry Frau Duffy, but my high school German has all but deteriorated), you will read one of three arguments; Dr. Gudden’s diagnosis of schizophrenia in Ludwig was accurate; Ludwig’s eccentricities have been exaggerated to support a false diagnosis of schizophrenia; or Ludwig was not schizophrenic but indeed was suffering from a neurological disease. The real answer? Well, it depends on who you think you can trust.
Gudden for Punishment
Our very first subject at ULTC was Charles VI of France, and we detailed his struggles with schizophrenia. Charles had many of the hallmark symptoms of the disease, including positive symptoms such as delusions, hallucinations, and disorganized thoughts and speech, as well as negative symptoms like reduced emotional response, decreased speech, and depression-like symptoms. Ludwig’s brother, Otto, similarly suffered from schizophrenia, or “paranoia” as it was often called at the time. As we talked about during the Charles VI series, schizophrenia shows a complex inheritance pattern, but does have a genetic component, giving some support for the claim that Ludwig was also schizophrenic.
And some people do believe all these years later that Ludwig was diagnosed accurately and the doubters are just weaving fantastical conspiracy theories for the drama. Because I cannot get my hands on the original documents in German, I am relying primarily on secondary sources that synthesize witness accounts and historical records. The most compelling argument I found in support of the schizophrenia theory was published last year by German researchers Reinhard Steinberg and Peter Falkai. They cite sources like Cosima, the second wife of Ludwig’s friend/obsession, Richard Wagner. She remembers Ludwig having dinner with imaginary guests, something Dr. Gudden himself reported. Gudden also claimed that Ludwig refused to use doors to go in and out of his estates, instead climbing through the windows. In addition, Steinberg and Falkai cite a report from a Dr. Franz Carl Gerster who saw Ludwig for some dental problems in 1884, two years before his death. Gerster was“determined that Ludwig had an accelerated flow of ideas, flight of thoughts, alogical stringing together of thoughts, delusions, and illusory and hallucinatory phenomena. He informed the responsible authorities, who told him clearly that his strong suspicion of mental illness ‘was interpreted and branded by all as high treason.’”
These anecdotes push past the borders of eccentricity and have all the hallmarks of schizophrenia. But I could not get past what Stefanie told us last week: that Gudden’s diagnosis of paranoia, the one that stripped Ludwig of his ruling rights and left him imprisoned, was made without evaluating him in person. However, Steinberg and Falkai claim that that isn’t completely accurate. Gudden wrote the official testimony based on witness accounts, but he did do an evaluation of Ludwig the night before the pair died. Apparently, Gudden conveniently found Ludwig exactly as he had described him in the original report that cost him the throne, and found him suicidal to boot.
It all seems rather cut and dry. Ludwig was schizophrenic and took his own life, along with his doctor’s, the next day in the midst of psychosis. But questions remain about the lucid, well-written letter Ludwig wrote the very night Gudden diagnosed him as a paranoid maniac. Plus, the autopsy showed Ludwig had no water in his lungs, casting more than reasonable doubt on the theory that he drowned himself in a murder-suicide. And then there’s the fact that Gudden had political ties with people that would have been very happy to see him put the two heirs to the Bavarian throne in straightjackets so an ally could come to power. If we can trust the doctors, we have an open and shut case. But if you haven’t learned by now, it’s never that easy.
Ich Bin Ein Believer
Whether it was the product of a political conspiracy or not, the possibility remains that Ludwig’s free spirit was misinterpreted as a mental illness. I like Stefanie’s description of Ludwig as the eccentric theater kid you went to high school with. He was moody and mysterious and a little campy. In short, he was not what many expected their ruler to be, with his heart more on the stage than on the battlefield. Like some of our previous subjects who have been criticized for being seclusive, Ludwig preferred to be by himself (which some think may have exacerbated any underlying mental health issues), and that did not jive with his public position. It could simply be that his personality was incompatible with his position in life.
Critics of the schizophrenia theory also point out how much emphasis was placed on Ludwig’s sexuality. In 1886, homosexuality was considered a mental illness (and remained so until 1973!) and a massive social taboo. It’s very possible that Ludwig’s intimate relationships with other men made him a target. A gay king would have been a huge scandal for the royal family, so it is unsurprising that Ludwig’s sexuality was not mentioned in Gudden’s report. I still have to wonder how much it played into Ludwig’s diagnosis and the decision to replace him with a regent.
Defenders of the idiosyncratic king believe that Ludwig simply didn’t fit in. But instead of high school mean girls excluding him from the lunch table, he was deposed and killed, and posthumously framed for the murder of Gudden.
Leave Me a Lobe
At this point, both theories left me unconvinced. Gudden seemed fishy, but I was unsure that Ludwig was free from any psychiatric illness. Luckily, while we can’t look into Ludwig’s mind, there is someone who was able to look at his brain: Dr. Rudolph Magg, the physician who conducted the autopsy back in 1886.
The official autopsy found signs that Ludwig suffered from neurological disease. Like the subject of last month’s series, Ludwig became sick with meningitis as a baby (and interestingly, like Taisho, this was after a particularly traumatic birth). Although Ludwig recovered, the bout of illness had scarred his frontal lobes, the region of the brain responsible for executive functions like planning, self-control, and organization. This might have something to do with his fantastical architectural schemes that left him strapped for cash.
Even more alarming was the discovery that his brain had atrophied, or shrunken, in the temporal lobes, a region important for memory, as well as the frontal lobes. My first guess was that perhaps this was also an effect of his meningitis, but this seems unlikely. According to Schmidt et al, “Although MRI alterations after [bacterial meningitis] such as global atrophy (Davidson and Steiner, 1985) or focal hippocampal atrophy (Free et al., 1996) have been reported, they have not been related to cognitive disturbances.”
Much to my surprise, this frontotemporal atrophy is actually consistent with a diagnosis of schizophrenia. In the Charles VI series we talked about the synaptic pruning theory of schizophrenia, in which the normal developmental process of removing excessive connections between neurons becomes overactive. This results in altered brain connectivity, but also can lead to reduced brain volume. Want to take a guess at which regions of the brain are most affected? That’s right, the frontal and temporal lobes. In fact, in a study looking at patients at risk of developing schizophrenia, certain regions of the frontal cortex were shown to shrink faster in people who went on to be diagnosed with the disease than those who did not. Atrophy in the temporal lobe has been well-reported in schizophrenic patients, and is associated with language disturbances and hallucinations, as it contains important auditory and language areas.
This is crucial evidence supporting Gudden’s diagnosis, but there’s one piece that doesn’t fit for me. Ludwig was diagnosed with schizophrenia at 40, while disease onset in males is usually in the late teens and early 20s. Interestingly, there is one other disease characterized by frontotemporal atrophy that is often confused clinically for schizophrenia: frontotemporal dementia (FTD). FTD refers to a group of disorders that result in the neurodegeneration of the frontal and temporal lobes. The average age range of symptom onset begins at 45, much closer to Ludwig’s age than schizophrenia onset. There are two clinical subtypes of FTD depending on the primary symptom, and the behavioral variant (bvFTD) can be easily confused with schizophrenia. Patients with bvFTD have a dramatic shift in personality, with reduced inhibition, impaired social skills, increased preference for sugar and carbs, and a depressed-like mood. While FTD is more likely to be misdiagnosed as schizophrenia in younger patients today, Dr. Gudden would not have been able to make a distinction — FTD was not described until nearly a decade after his death. To me, it seems likely that Ludwig was suffering from early onset dementia. And if it’s true that Ludwig was perfectly normal at the time of his death, and the mental illness was a ploy to get him out of power, the clues his brain left behind make it clear that it was only a matter of time before he started to change.
No Body, No Crime
Of course, the reliability of my diagnosis depends upon the accuracy of the autopsy. Given that Dr. Magg noted that no water was found in Ludwig’s lungs, I am inclined to believe we can trust it; otherwise he easily could have lied and we wouldn’t be debating the murder-suicide theory all these years later. But I did stumble across some WILD articles calling the credibility of Magg’s report into question.
I have not been able to find English sources other than splashy news outlets to verify this information, but apparently, a 2018 German documentary featured a man named Willy Behl. Behl’s dad worked as a handyman on one of Ludwig’s family’s properties. In 1961, 75 years after Ludwig’s body was found in the lake, Behl’s father was allegedly asked to burn several items that belonged to Ludwig. One of those items was a coat with two big bullet holes in it.
This story seems off to me. Why would Ludwig’s murderers have kept such a damning piece of evidence for over three-quarters of a century and then suddenly ask the handyman to burn it? However, Behl’s memory ties in with infamous claims from Magg’s own daughter that when he was dying in 1921, Magg admitted that there were “terrible bullet wounds” in Ludwig’s body. The autopsy mentions no evidence of gunshot wounds. So was he telling the truth about the frontotemporal atrophy? Or is he just another shady character in the tangled web surrounding Ludwig’s final days?
Black Swan (King)
As I have been researching for this post, I keep thinking back to my visit to Neuschwanstein with Stefanie all those years ago. We walked through partially finished elegant rooms that would belong in any fairytale, and abruptly transitioned from a handsome sitting room right into a cave. The theatrical king had hired an artist to build an artificial cave, stalactites and all, right in the middle of this castle. I gnawed on this for a while at the time, oscillating between admiring his quirkiness and originality and wondering what sane person would build a grotto in the middle of their palace when they live on top of a mountain that presumably had many caves to offer. After a month spent with Ludwig, I am as torn as ever. Was he a misunderstood free spirit who was ill-suited to public life, or was he mentally ill and a danger to his country? The truth died with Ludwig in Lake Starnberg, leaving him the enigma that he always hoped to be.
References
Chung, Y., & Cannon, T. D. (2015). Brain Imaging During the Transition from Psychosis Prodrome to Schizophrenia. Journal of Nervous & Mental Disease,203(5), 336-341. doi:10.1097/nmd.0000000000000286
Crossland, D. (2018, July 13). Murder most foul: Doubts grow over ‘suicide’ of Bavaria’s fairytale king. Retrieved from https://www.handelsblatt.com/english/politics/murder-most-foul-doubts-grow-over-suicide-of-bavarias-fairytale-king/23582710.html?ticket=ST-379954-lHYT32GcMQmZKOPnu0cM-ap1
Frontotemporal dementia. (2021, January 08). Retrieved from https://www.mayoclinic.org/diseases-conditions/frontotemporal-dementia/symptoms-causes/syc-20354737
Gourzis, P., Skokou, M., Polychronopoulos, P., Soubasi, E., Triantaphyllidou, I., Aravidis, C., . . . Kosmaidou, Z. (2012). Frontotemporal Dementia, Manifested as Schizophrenia, with Decreased Heterochromatin on Chromosome 1. Case Reports in Psychiatry,2012, 1-5. doi:10.1155/2012/937518
Schmidt, H., Heimann, B., Djukic, M., Mazurek, C., Fels, C., Wallesch, C., & Nau, R. (2005). Neuropsychological sequelae of bacterial and viral meningitis. Brain,129(2), 333-345. doi:10.1093/brain/awh711Steinberg, R., & Falkai, P. (2020). Was King Ludwig II of Bavaria misdiagnosed by Gudden and his colleagues? European Archives of Psychiatry and Clinical Neuroscience. doi:10.1007/s00406-020-01161-8
Uneasy Lies the Crown 
I cannot tell you both how much I enjoy your posts. They are just fascinating and so well written and researched! THANK you!
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