[Gudden's diagnosis on Louis II from a contemporary and current psychiatric perspective]

Was King Ludwig II of Bavaria misdiagnosed by Gudden and his colleagues?

In 1886, Bernhard von Gudden and three other expert psychiatrists diagnosed the Bavarian King Ludwig II with "paranoia (madness)," a diagnosis that the Bavarian government used to justify removing Ludwig from power. Although Ludwig was not evaluated in detail by the psychiatrists, in their opinion, sworn eyewitness accounts and general knowledge about Ludwig's behavior provided sufficient grounds for the diagnosis. Ludwig was a great admirer of the musician, Richard Wagner, and shared some of his ideas of an idealistic society. At first, he identified with Wagner's opera heroes, and he became Wagner's patron sponsor for life. However, he grew increasingly interested in an absolutist state, envisioning himself as a monarch with a role similar to that of Louis XIV. His multiple building projects, for which he incurred much debt, his conviction that he was descended from the Bourbons through baptism, his increasingly abnormal behavior, and his hallucinations together formed the basis for the psychiatrists' diagnosis. Although not mentioned in the expert opinion, Ludwig's homophilic behavior-a scandal at the time-was probably also an important reason for his removal from office. A review of the psychiatric knowledge and societal philosophy of the time indicates that the psychiatrists were correct with their diagnosis in their time.

[Bernhard von Gudden's psychiatric assessment and the deposition of King Ludwig II of Bavaria in 1886 : Comments on the article by R. Steinberg in Der Nervenarzt 01/2019]

King Ludwig II of Bavaria drowned himself in Lake Starnberg on 13 June 1886 after subduing and drowning Bernhard von Gudden, a Munich-based psychiatrist who had tried to hold him back. Commissioned by Prince Luitpold, Ludwig's successor to the throne, von Gudden had provided a psychiatric assessment on the king. Finding him to be suffering from a progressive mental illness and paranoia (madness), he declared Ludwig incapable of ruling. On the basis of this report Ludwig was unlawfully declared incapacitated, deposed, arrested and locked up in the Berg Castle under von Gudden's medical supervision. We conducted a 5-year psychiatric historical study of King Ludwig II, the most thorough of its kind ever undertaken. The main results were: the private, official and political letters the king wrote until his very last day were reasonable, well-argued and impeccable in style. Until his final days Ludwig had invariably fulfilled his administrative tasks in a prompt and proper way. His handling of political affairs was also wise and reasonable. Due to social phobia afflicting him since his youth he neglected his representative duties as a monarch. Von Gudden's report is marred by severe flaws. In his article published in Der Nervenarzt (01/2019) R. Steinberg adopts von Gudden's psychiatric diagnosis and misjudgement. Steinberg writes that the king's illness developed "in a clear crescendo". In fact, it was the behavioral anomalies associated with the king's homosexual relationships that grew increasingly prevalent at the court, whereas Ludwig's mental efficiency improved over time. Given the historical misjudgment and numerous other errors that Steinberg adopts from von Gudden, I considered it necessary to compare and contrast his conclusions with results from our own research.

[The report on Ludwig II by Gudden and his colleagues in relation to the state of knowledge at that time]

Bernhard von Gudden and his prominent co-experts Grashey, Hagen and Hubrich wrote an expert opinion on Ludwig II that was based on statements of sworn witnesses of the 41-year-old monarch's pathological behavior. With the contemporary material available today it can be understood why Gudden reached the diagnosis of "paranoia (madness)", which was in accordance with the state of psychiatric knowledge at that time. Even the official investigations initiated after the deaths of Ludwig II and Gudden did not come to a different conclusion. Gudden was a highly respected physician, researcher and clinical teacher; however, in the treatment of Ludwig he misjudged the consequences of his diagnosis and they both paid for his miscalculation with their lives. The Bavarian royal tragedy has many roots but a negligent or even deliberate misdiagnosis is not one of them.