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Epilepsy

Epilepsy has been a popular diagnosis. Van Gogh himself thought that he might be an epileptic and his doctor Felix Rey made the same general diagnosis, as did Dr Peyron at St Rémy A diagnosis of temporal lobe epilepsy was originally put forward in 1928 by Leroy and Doiteau and has received much support. Arnold states that the pattern of van Gogh's seizures, their timing and duration, does not fit well with the complex partial seizures associated with temporal lobe epilepsy.[18] Furthermore, it seems that Vincent's condition was controlled by the administration of bromide, which is effective against grand mal seizures, as well as absinthe intoxication and porphyria, but not for temporal lobe epilepsy.

Bipolar disorder

Perry in 1947 was the first to put together a serious case for a diagnosis of bipolar disorder, or "manic depression." It fits well with the well documented periods of intense activity interspersed with periods of exhaustion and possible depression. It has been suggested that not only was van Gogh bipolar, and that the crises in his last two years were brought about by the additional effect of thujone poisoning from his consumption of absinthe.

Sunstroke

The idea that van Gogh might have suffered some form of chronic sunstroke was advocated strongly by Roch Grey. Vincent described the effects of the Arles sun in a letter: "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. But as I was so to begin with, I only enjoy it." A month earlier he had mentioned the effects of the sun in passing in a letter to Theo: "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." A remark has been attributed to Dr Gachet describing a diagnosis of "turpentine poisoning and the effects of too intense sun on a Nordic brain," but attempts to confirm this attribution have failed.

Ménière's disease

The hypothesis that Vincent may have suffered from Ménière's disease — a balance disorder of the inner ear which is accompanied by nausea, vomiting, hearing loss, and vertigo — was first published in 1979 by Yasuda. This idea then reappeared in 1990 in the Journal of the American Medical Association (JAMA). Arnold refutes the hypothesis, stating that there is no case for Ménière's, and that the logic of the JAMA article was flawed in that it put forward only epilepsy as an alternative diagnosis. The Ménière's diagnosis relies on interpreting van Gogh's gastrointestinal problems as the nausea and vomiting associated with Ménière's. The JAMA artcle's suggestion that Vincent's cutting of his ear was an attempt at self-performed surgery to relieve the Ménière's symptom of tinnitis has been regarded as far-fetched.

Lead poisoning

Vincent was reported to nibble at his paints at times; this could account for various forms of metal poisoning. Of the various metals contained in paints, poisoning by lead most closely matches van Gogh's symptoms. Symptoms of lead poisoning include abdominal pain, constipation, vomiting, paralysis or paresis.

Acute intermittent porphyria

Arnold and Loftus put forward the diagnosis of Acute Intermittent Porphyria (often referred to as simply "AIP"). Arnold suggests the AIP was exacerbated by malnutrition and absinthe abuse. He cites two case histories of men in their 30's who were demonstrated to have AIP and displayed some symptoms similar to that of Van Gogh, including depression and hallucinations in one case, and complex partial seizures in the other. However, Erickson refutes this diagnosis arguing that the key symptom of urine discoloration was never noted, and that Van Gogh's "bad stomach" does not match the commonly experienced "excruciating abdominal pain" associated with AIP. Erickson and Arnold disagree as to the support offered by the family history, and in particular regarding the status of Vincent's father's health: Arnold, basing his opinion on Tralbaut, believes Theodorus to have been in not-very-good health for most of his life, whereas Erickson chooses to see him as being essentially an active man until a relatively sudden death at age 63. Arnold suggests that Theodorus' quiet and balanced life meant that he avoided several factors that precipitated symptoms and progress of the disorder in his children.