How to break the "medical addiction"? Uncovering the strange baron behind "Munchausen syndrome"

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Seeing Munchausen syndrome, it is easy to associate it with hypochondriasis, which refers to the mental pathological state of believing that one has a specific disease without clear medical basis. However, in the 2013 edition of DSM-5, the diagnosis of hypochondriasis was cancelled and replaced by illness anxiety disorder and somatic symptom disorder .

Yet efforts to map the spectrum of health anxiety fall short of clarifying the murky nature of hypochondriasis. These ostensibly helpful terms actually accomplish little. Although we understand more than ever about the illnesses and mental illnesses that afflict us, the body’s most intractable mysteries remain. Doctors and patients must confront them together. The only way to do this is to set aside any impulse to moralize and embrace uncertainty—something modern medicine is least equipped to do.

In 1951, London physician Richard Asher wrote a journal article about “a common syndrome seen by most physicians but rarely reported.”[1] He described a group of apparently ill people who had dramatic but plausible medical histories, made numerous visits to the hospital, argued with medical professionals, and discharged themselves from hospitals against their doctors’ orders.

In short, these people suffered from what is known today as Munchausen syndrome, a psychological disorder in which the sufferer pretends that he or she, or someone else (usually a child), is seriously ill.

If the disease had adopted medical naming conventions like Alois Alzheimer (German psychiatrist who first published cases of Alzheimer's disease) or Burrill Bernard Crohn (American gastroenterologist, "Crohn's disease" is named after him), it might have been called "Asher's disease."

But it wasn’t to be—for Ashe wasn’t keen on associating his good name with a pseudo-disease, which he believed was invented by “hysterics, schizophrenics, masochists, or psychopaths of some kind.” Instead, Dr. Ashe turned to literature for inspiration. He found inspiration in a now-forgotten 1785 novel by German author Rudolf Erich Raspe, Baron Munchausen’s Narrative of His Marvelous Travels and Campaigns in Russia.

Illustration of the Adventures of Baron Munchausen, 1890. © Wikimedia Commons

Originally published as an anonymous article, the novel has been remade into countless versions, much like Gulliver's Travels. In it, Munchausen is an aristocratic ex-soldier who thrills his dinner guests with his first-person tales of his bizarre adventures, which are so patently absurd that they take him across the Thames on a cannonball, wrestle a 40-foot crocodile and even travel to the moon.

The stories are accompanied by original illustrations. One illustration from the 1786 edition of the novel shows Baron Munchausen hanging from a crescent moon on a string. It was a favorite of Sarah Tindal Kareem, a literary scholar at UCLA, who chose it for the cover of her 2014 book, Eighteenth-Century Fiction and the Reinvention of Wonder.

“The 18th century was a unique period, when there were no clear copyright and libel laws, and there was no strict distinction between factual and fictional works,” Karim said. This was true of Raspe’s novel, as his Munchausen was based on a man of almost the same name who was still alive at the time.

Hieronymus Karl Friedrich von Münchhausen was a retired German officer who had fought with the Russian Legion in two campaigns against the Ottoman Empire.

In 1760, he was living an idle life in the German countryside, regularly entertaining aristocrats at his home in Hanover. Kind, generous, and lively, and known for his ability to tell dramatic stories, Munchausen was no charlatan. Both the real and fictional barons were initially well-respected figures. “In Raspe’s book, Munchausen thought his guests were talking nonsense, so he told ever more absurd and bizarre stories to tease their credulity,” says Karim. She estimates that Raspe’s novel was reprinted 100 times over the next two centuries.

Each edit and translation changed the text slightly. “However, in later versions, things changed and he was no longer the one telling the joke, but the joke itself,” Karim explained. “He became a clown, a liar and a comic figure.”

A portrait from around the 1740s believed to be of Baron Munchausen. © Wikimedia Commons

No doubt the rewrite of the fictional character was at least partly driven by the real-life Munchausen’s reaction. “It would have been nice if he had just gone with the flow,” Karim says, “but he overreacted and made it worse.” Munchausen had no sense of humor about the situation. He resented how he was portrayed and threatened to sue several times.

In addition to the ambiguity of libel law at the time, the Baron's lawsuit was hampered by an insurmountable problem: at the time, the author of the increasingly popular book remained anonymous. Munchausen attempted to sue Gottfried August Bürger, who had translated the novel into English, but was unsuccessful.

To the enraged Munchausen, he knew that someone (perhaps someone he had invited to his home) was or had been making a fortune by mocking him. As if to protect himself from a libel lawsuit, the author deliberately tweaked the spelling of the protagonist's name.

“Raspe inserted a real, identifiable historical figure into this grandiose fiction,” Karim said. For centuries, historians have been unable to figure out why Raspe based his protagonist on Munchausen.

Munchausen riding a cannonball in an 1872 illustration. © Wikimedia Commons

Baron Munchausen fighting a crocodile. © Wikimedia Commons

“We don’t even know if they met,” says Régis Olry, an anatomist at the University of Quebec and the author of a 2002 historical article on Munchausen syndrome.[2] The two may have crossed paths at the University of Göttingen in Germany, where Raspe worked as a librarian in the early 1760s to pay off his mounting debts, around the same time that Munchausen (whose uncle had played a major role in the school’s foundation) hosted a lavish dinner at his estate near his home.

Like Karim, Orrie did not think the so-called “Baron of Lies” was a fraud at all. “Munchausen was a storyteller,” he said, and if the stories were not entirely true, it was for two reasons: “Either he deliberately made them up to entertain his audience (and it worked), or they were nonsense he was not aware of.” Munchausen retired in 1760 (at the age of 39 or 40), and it is unlikely that he suffered from delusions other than megalomania.

To Munchausen, Raspe was an anonymous torturer, but what kind of man was Munchausen to Raspe? By 1785, more than 20 years had passed since the much younger Raspe (probably) met the Baron, and he must have made a deep impression on him. But Raspe’s opinion of Munchausen remains a mystery. Was he jealous of the Baron’s wealth and status because of his own humble origins? Did he admire Munchausen’s storytelling skills and take the novel as a compliment? Clues to Munchausen’s appeal can be found in Raspe’s biography.

Born in Hanover in 1737, Raspe studied law at the University of Göttingen but never became a lawyer. Raspe had an extensive resume as a writer, researcher, translator, journalist, librarian, geologist, and coin keeper—a position that brought him into contact with the alluring wealth of money. Raspe was later accused of stealing museum collections of coins and gems and fled to England in 1775. Increasingly untrustworthy, Raspe turned to money-making schemes and low-level crime. For example, one scam involved pretending to discover gold on the estate of a Scottish nobleman, convincing him to invest in mining, and then running away with the money.

Defrauding the not-so-bright upper classes seemed to be Raspe's specialty.

Meanwhile, "in his distress and humiliation, he recalled stories he had heard at Baron Munchausen's entertainments, and thinking he could make use of them, he published ... his recollections of them," the writer Samuel Austin Allibone noted in 1908, which were "undoubtedly grandiose, but in general so similar to the stories invented by Baron Munchausen for the amusement of his drinking companions that their origin is recognizable." Raspe was fluent in German, English, French, and Latin, and dabbled in various writings, in addition to poetry and research papers.

Yet if he sought fame and fortune through writing, the story of Baron Munchausen was a loss for him. The great irony is that during Raspe’s lifetime, his most successful work was not signed by him. After all, claiming ownership of the work would have meant a legal battle with the real Munchausen.

Ultimately, Baron Munchausen outlived Raspe by three years. The former died in 1797, still unaware of his rival’s identity, while the latter died in 1794. It was not until 1824 that a biography by the indicted translator Burge was published that the novel’s true author was revealed. Over the next 200 years, the word “Munchausen” became ubiquitous. According to the Oxford English Dictionary,[3] by the 1850s it was most commonly used as a verb, slang, to describe “a highly untrue pseudo-autobiographical story”.

By the 1950s, the term had become so ubiquitous that Ashe decided it was the perfect nickname for his new syndrome. “Like the famous Baron Munchausen, the people with this syndrome are known to the public, and their stories, as he told them, are both dramatic and untrue,” the doctor wrote. To this day, the condition has been called Hospital-Addiction Syndrome , Thick chart syndrome, and Hospital hopper syndrome.[4]

Its official name in the Diagnostic and Statistical Manual of Mental Disorders (DSM) is “factitious disorder imposed on self” or “factitious disorder imposed on another”[5].

Yet colloquially, people prefer to refer to the condition by the good name the baron once had. Outside of very specific literary circles, Raspey’s name is virtually unknown, while Munchausen’s is a household name. Had history unfolded differently, the two men’s status might have been completely reversed. “Raspey was a colorful, flamboyant character, but he also engaged in fraud,” Karim says.

Some lies are beloved, others are illegal, but the distinction and its aftermath are almost random. So the next time you over-extend a story at a dinner party, think about this: Three hundred years from now, people may still be talking about you, for good or ill.

By Rosemary Counter

Translated by tim

Proofreading/tamiya2

This article is based on the Creative Commons License (BY-NC) and is published by tim on Leviathan

The article only reflects the author's views and does not necessarily represent the position of Leviathan