The day before Christmas Eve 1888, Vincent van Gogh cut off his left ear and gave it to a woman at a brothel for safekeeping. Observers were understandably concerned, and when police arrived at the injured artist’s house in Arles, France, the following day, they had him admitted to the hospital.
Much about the night of December 23, 1888, remains unclear, with scholars disagreeing over everything from the events preceding the incident to whether the Dutch painter cut off the entirety of his ear or just a part of it. Among other theories, experts have posited that van Gogh mutilated himself after learning of his beloved brother Theo’s engagement, fighting with friend and fellow artist Paul Gauguin, or suffering from incessant hallucinations.
According to the Van Gogh Museum in Amsterdam, the artist “could later recall nothing about the event.” In a January 1889 letter to Theo, van Gogh wrote, “I’ve just had a simple artist’s bout of craziness.”
Now, a new study published in the International Journal of Bipolar Disorders outlines another explanation for the unexpected act, as well as the broader emotional turmoil experienced by van Gogh prior to his suicide in 1890.
Per a statement from the Netherlands’ University Medical Center Groningen, researchers drew on interviews with three art historians and an assessment of 902 of the artist’s letters to determine that he likely suffered from bipolar disorder and borderline personality disorder. They suggest that alcohol addiction, malnutrition and rising social tensions exacerbated these conditions, leading van Gogh to cut off his own ear. Following his hospitalization for the injury, the artist may have experienced delirium—a state of abrupt, disruptive confusion and lack of awareness—brought on by alcohol withdrawal.
Speaking with artnet News’ Sarah Cascone, a Van Gogh Museum representative cautioned against viewing the new findings as a definitive diagnosis, explaining, “The medical diagnosis of historical figures is full of pitfalls, and our Van Gogh experts are still hesitant when it comes to drawing firm conclusions.”
The authors themselves acknowledge the tenuous nature of their diagnosis. In the statement, lead author Willem A. Nolen of the University Medical Center Groningen says, “We were not able to interview the patient personally, which means that we must exercise caution in our conclusions.”
Still, he adds, the team’s “bottom-up” approach of investigating all potential symptoms through structured diagnostic interviews can probably “safely rule out some previously suggested diagnoses”—including schizophrenia, carbon monoxide poisoning and the rare metabolic disease porphyria—and identify “several illnesses that [van Gogh] suffered from” with “more or less” certainty.
Whether the artist had epilepsy remains up for debate, but the authors write that it’s possible he experienced focal epilepsy—a neurological disorder that can manifest as anxiety, delusions and hallucinations. In this instance, the condition may have been brought on by a combination of alcohol abuse, malnutrition and exhaustion.
From 1886 onward, the artist was heavily dependent on alcohol. He tried to reduce his alcohol intake but was ultimately unsuccessful. In addition to drinking wine, he also imbibed heavier spirits such as absinthe—a choice of drink reflected in his Café Table With Absinthe (1887). The foggy painting has an ominous atmosphere, and its blue-green undertones give the titular spirit a sickly, lurid quality.
After the ear incident, van Gogh suffered delirium caused by “an enforced period without alcohol,” as Daniel Boffey writes for the Guardian. Between December 1888 and May 1889, he was hospitalized in Arles on three consecutive occasions; in May 1889, he was transferred to an asylum at Saint-Rémy-de-Provence, where he reported having “absolutely no will, hardly any desires or none.” Subsequent periods of severe depression culminated in a July 27, 1890, suicide attempt. Two days after shooting himself in the chest with a revolver, the artist died at age 37.
“There have been thousands of medical papers about Van Gogh’s mental condition, but it has proved remarkably difficult to determine the cause of his problems,” says Martin Bailey, a van Gogh expert at the Art Newspaper, in an email to artnet News. “This latest paper, by some distinguished specialists, is certainly important and based on a serious study of the artist’s symptoms. But it is unlikely to be the last word on this challenging question.”