It may well be that the change was also physical. The excitement of the festival precipitated an organic catastrophe towards which he had long been tending. His sister finds the original source of this catastrophe in the war of 1870. He desired to serve his country as a combatant, but the University would only allow him leave to attend to the wounded. The physical and emotional over-tension involved by his constant care of six young wounded men culminated in a severe illness, which led on to a never-ending train of symptoms--eye-troubles, dyspepsia, headache, insomnia--which were perhaps aggravated by the reckless use of drugs. I have already noted passages which indicate that he was himself aware of a consuming flame within, and that from time to time he made efforts to check its ravages. That it was this internal flame which largely produced the breakdown is shown by the narrative of Nietzsche’s friend, Dr. Kretzer, who was with him at Bayreuth. It was evident he was seriously ill, Kretzer tells us, utterly changed and broken down. His eye-troubles were associated, if not with actual brain disease, at all events with a high degree of neurasthenia.[2] At Bayreuth, Nietzsche was forced to realise the peril of his position as he had never realised it before. He could no longer disguise from himself that he must break with all the passionate interests of his past. It was an essential measure of hygiene, almost a surgical operation. This is indeed how he has himself put the matter. In the preface to _Der Fall Wagner_, he said that it had been to him a necessary self-discipline to take part against all that was morbid within himself, against Wagner, against Schopenhauer, against all the impassioning interests of modern life, and to view the world, so far as possible, with the philosopher’s eyes, from an immense height. And again he speaks of Wagner’s art as a beaker of ecstasy so subtle and profound that it acts like poison and leaves no remedy at last but flight from the siren’s cave. Nietzsche was henceforth in the position of a gouty subject who is forced to abandon port wine and straightway becomes an apostle of total abstinence. The remedy seems to have been fairly successful. But the disease was in his bones. Impassioning interests that were far more subtly poisonous slowly developed within him, and twelve years later flight had become impossible, even if he was still able to realise the need for fight.