What was it that caused Adolf Hitler’s physical and mental health to collapse in the closing days of World War II? He was losing the war, of course— surely that had a great deal to do with it. But for more than 60 years, historians have wondered if there was more to it than that.

THE LEADER

On April 21, 1945, an SS physician named Ernst-Günther Schenck was summoned to Adolf Hitler’s bunker in Berlin and ordered to stock it with food. By that time Germany’s war was hopelessly lost—most of the country was already in Allied hands. Soviet troops had almost completely circled Berlin and were battling their way into the center of the city. Rather than flee, Hitler had decided to make his final stand in his führerbunker in the heart of the Nazi capital. He would remain there until the end, which for him was just nine days away.

Like all Germans, Dr. Schenck had been fed a steady diet of photographs, films, and propaganda posters of Hitler since the dictator had come to power in 1933. But the man he saw in the bunker looked nothing like those images. The 56-year-old Hitler “was a living corpse, a dead soul,” Schenck remembered in a 1985 interview. “His spine was hunched, his shoulder blades protruded from his bent back, and he collapsed his shoulders like a turtle.… I was looking into the eye of death.”

OLD MAN

Even more shocking than the way Hitler looked was the way he moved about the bunker. He walked with the slow, halting shuffle of a man 30 years older, dragging his left leg behind him as he went. He couldn’t go more than a few steps without grabbing onto something for support.

Hitler’s head, arms, and entire left side trembled and jerked uncontrollably. No longer able to write his own name, he signed important documents with a rubber stamp. He had always insisted on shaving himself—this murderer of millions could not bear the thought of another man holding a razor to his throat—but his trembling hands made that impossible, too. He could not lift food to his mouth without spilling it down the front of his uniform and could not take a seat without help—after he shuffled up to a table, an aide pushed a chair behind him, and he plopped down onto it.

Hitler’s mental state had deteriorated as well. His thinking was muddled, his memory was failing, and his emotions whipsawed back and forth between long bouts of irrational euphoria (especially irrational considering how close Germany was to defeat) and fits of screaming, uncontrollable rage that lasted for hours.

DIAGNOSES

Schenck remained in Berlin until the end. On April 29, Hitler married his longtime mistress, Eva Braun, and the following day the pair committed suicide in the führerbunker. Germany surrendered unconditionally on May 7.

After the war, Schenck spent a decade in Soviet prison camps. He never forgot what he saw at the führerbunker, and after his release he spent years poring over Hitler’s medical records in an attempt to discover just what had caused the dictator’s health to decline so rapidly in the final years and months of his life.

He was not alone in this effort—in the more than 60 years since the end of the war, many historians, physicians, and World War II buffs have done the same thing. What caused Hitler’s collapse—was it Parkinson’s disease? Tertiary syphilis? Giant cell arteritis? Countless theories have been advanced to explain Hitler’s physical and mental decline, and after all this time the experts are no closer to agreeing than they were on the day he died.

THE CURE THAT ILLS

One of the most bizarre theories was advanced by some of Hitler’s own doctors in July 1944. The diagnosis came about by chance, after a visiting ear, nose, and throat specialist named Dr. Erwin Giesing happened to notice six tiny black pills—“Doctor Koester’s Anti-Gas Pills”—sitting on the Führer’s breakfast tray next to his porridge, dry bread, and orange juice. After spotting the pills, Giesing did something that Hitler’s own personal physician, an eccentric quack named Dr. Theodor Morell, had apparently never bothered to do: He examined the tin the pills came in and actually read the label to see what was in them. Giesing was stunned by what he read. Could it be? Was the Führer was being poisoned by the pills he took to control his meteorism—powerful attacks of uncontrollable farting?

GUT FEELING

Hitler had suffered from digestive problems his entire life. Since childhood he’d been prone to crippling, painful stomach cramps during times of emotional distress. By the time he reached his early 40s, the cramping had become more frequent, often accompanied by violent attacks of farting, along with alternating bouts of constipation and diarrhea.

The farting attacks are one of the reasons Hitler ostensibly became a vegetarian in the early 1930s: He didn’t trust doctors, so rather than seek professional help for his condition he tried to treat it himself by eliminating meat, rich foods, milk, and butter from his diet in favor of raw and cooked vegetables and whole grains.

STILL FARTIN’

Increasing the fiber in his diet did not improve Hitler’s condition; if anything it made him even gassier than he’d been before. (But the vegetarian diet may have made his farts less smelly, and he may have been willing to settle for that.) By the mid-1930s, Hitler was the ruler of Germany…and still farting like a horse. His attacks were most severe right after meals; during dinner parties it was common for him to suddenly leap up from the table and disappear into his private quarters, leaving stunned guests to wonder why the Führer had gone and when he might be back. On many nights he did not return at all.

In 1936 Hitler happened to meet Dr. Morell at a Christmas party. After pulling the doctor aside Hitler poured out his problems, describing his intestinal distress and his eczema: itchy, inflamed skin on his shins, so painful that he could not put on his boots. By now Hitler had given up trying to cure himself and allowed Germany’s best doctors to examine him. They put him on a diet of tea and dry toast, but all that did was leave him feeling weak and exhausted. Morell listened attentively…and then promised to cure both problems within a year. Hitler decided to give him a try.

Was der Führer felled by foolish fart pharmacology? Well, let’s first look into the man behind the medicine.

STRANGE BEDFELLOWS

By the mid-1930s, the Nazis had already begun destroying what before their rise had been one of the most advanced medical communities in the world. At the same time that they undermined the scientific underpinnings of the German medical establishment with their loony racial theories and crackpot pseudoscience, the Nazis were driving German Jews out of the profession, along with any “Aryan” Germans who opposed Nazism. And yet for all the damage the Nazis did to German medicine, there were still plenty of skilled, capable doctors from whom Hitler could choose his personal physician. So it’s all the more remarkable that he chose someone as peculiar and incompetent as Dr. Theodor Morell.

DOC MEDIOC–RITY

Morell’s resume left a lot to be desired. A onetime ship’s doctor who served as an army physician during World War I, he opened a general practice on the fashionable Kurfürstendamm street in Berlin after the war and counted a lot of society figures—politicians, actors, artists, nightclub singers—among his patients. With the exception of occasional cases of bad skin, impotence, or venereal disease, Morell shied away from treating people who were genuinely ill, referring these cases to other doctors while he built up a clientele of fashionable, big-spending patients whose largely psychosomatic illnesses responded well to his close attention, flattery, and ineffective quack treatments.

Morell’s skill at coddling his patients was masterful, but his abilities as a physician were clearly deficient, to the point of putting their health at risk. “In practice he was occasionally careless,” biographer John Toland writes in Adolf Hitler. “He was known to have wrapped a patient’s arm with a bandage he had just used to wipe a table, and to inject the same needle without sterilization into two patients.”

“MADE” IN BULGARIA

In addition to overseeing his practice, Morell served on the board of Hageda, a pharmaceutical company that manufactured a strange medication called Mutaflor, whose active ingredient was live bacteria cultured from the fecal matter of “a Bulgarian peasant of the most vigorous stock.”

Mutaflor was intended to treat digestive disorders—the theory being that digestive problems were caused when healthy bacteria, which lived in the intestinal tract and were essential to good digestion, were killed off or crowded out by unhealthy bacteria. Ingesting the cultured dung of a vigorous, clean-living Bulgarian peasant, the theory went, would reintroduce beneficial bacteria into an unhealthy digestive tract and restore proper function.

That was the theory, and because Dr. Morell had a financial interest in the company that made Mutaflor, he prescribed the pills to virtually all his patients, whether they suffered from digestive complaints or not. Hitler did suffer from digestive complaints, of course, and Morell soon had the Führer taking regular doses of Mutaflor …plus two tablets of Dr. Koester’s Anti-Gas Pills at every meal.

PRIMARY PHYSICIAN

Hitler’s intestinal ailments were intermittent and, as had been the case during his childhood, still had a considerable psychological component: He suffered from attacks of cramps and farting during times of stress, then when things calmed down his symptoms abated. After he placed himself under Morell’s care, it was just a matter of time before his condition improved, and when relief finally came a few months later—at about the same time his eczema began to clear up—Hitler naturally attributed his deliverance to Morell.

The “cure” was only temporary, but no matter—the Führer had finally found a doctor he could believe in. “Nobody has ever before told me so clearly and precisely what is wrong with me,” Hitler told his chief architect, Albert Speer. “His method of cure is so logical that I have the greatest confidence in him. I shall follow his prescription to the letter.” Morell would remain by Hitler’s side until almost the very end.

HEAVEN SCENT

Hitler took to Morell immediately, but the Führer’s inner circle despised the doctor from the start, and not just because he was an obvious quack—he was also an extremely unpleasant person to be around. The morbidly obese Morell did not bathe regularly: His skin and hair were greasy, his fingernails often filthy, and when his powerful body odor and bad breath weren’t enough to clear the room, his propensity for belching and farting in polite company usually did the trick. “He has an appetite as big as his belly and gives not only visual but audible expression of it,” Speer observed.

Even Eva Braun found Morell repulsive, but Hitler didn’t care. When she and others complained about his offensive body odor, the Führer brushed them off. “I do not employ him for his fragrance, but to look after my health,” he’d say. (Who knows? Maybe Hitler liked having another farter in the room, so that no one who “smelt it” could tell for sure who’d “dealt it.” )

TAKE THIS…AND THIS…AND THIS

In those early days, Morell’s influence on Hitler was fairly benign; the stinky doctor limited himself to giving diet tips and, of course, prescribing Mutaflor and Dr. Koester’s Anti-Gas Pills. But over time he became more controlling over what Hitler was allowed to eat, and the number and strength of the medications he prescribed increased dramatically. In the years to come he would prescribe enzymes, liver extracts, stimulants, hormones, painkillers, sedatives, tranquilizers, muscle relaxants, morphine derivatives (to induce constipation), laxatives (to relieve it), and other drugs by the dozen.

According to one estimate, by the early 1940s Hitler was taking 92 different kinds of drugs, including 63 different pills and skin lotions. Some medicines were taken only when specific complaints arose, but others were taken every day. By the summer of 1941, Hitler was popping between 120 and 150 pills a week on average. And on top of all the pills, Morell also administered injections—as many as 10 a day, sometimes more. So many, in fact, that even Herman Goering, Hitler’s heir apparent and himself a morphine addict, was startled by their frequency and took to calling Morell the “Reich Injection Master.”

Nobody knew for sure what Morell was giving Hitler. There were other physicians in the Führer’s service—two surgeons, Dr. Karl Brandt and Dr. Hans Karl von Hasselbach, traveled with Hitler in case he ever needed emergency surgery, and other specialists, such as visiting ear, nose, and throat doctor Erwin Giesing, were called on from time to time to treat specific complaints. But none knew what Morell was really up to. Any physician worth his salt would have been alarmed by all the injections Morell was administering. But whenever Brandt or anyone else asked him what was in the shots or why Hitler needed so many, he shrugged them off as vitamin or glucose (sugar) injections, or answered cryptically, “I give him what he needs.”

THE ONE-TWO PUNCH

Considering all the medications that Morell was administering to Hitler, why was it Dr. Koester’s Anti-Gas Pills that finally prompted the other physicians to act? It may have been the simple fact that they came in a tin. Most of the pills and shots that Hitler took were unidentified and mysterious, but Dr. Koester’s Anti-Gas Pills came in a little metal container (like Altoids breath mints or Sucrets throat lozenges) that identified them by name and even listed the active ingredients: gentian, belladonna, and an extract of something called nux vomica.

The gentian was harmless enough. But the presence of the other two ingredients in the pills, plus the revelation that Hitler, on top of all his other medications, was popping as many as 20 of the anti-gas pills a day, was startling. Even if Dr. Morell had read the label on the tin, he might not have known that nux vomica is a seed that contains large amounts of strychnine, commonly used as the active ingredient in rat poison. Belladonna, also known as deadly nightshade, contains atropine, a toxic substance that can cause excitement, confusion, hallucinations, coma, and death if taken in large quantities.

That’s what alarmed Dr. Giesing when he saw the six black pills sitting on Hitler’s breakfast tray that morning in July 1944: Without even realizing it, Hitler’s own personal physician had exposed him on a daily basis to significant doses of not one, but two deadly poisons.

DER GUINEA PIG

By then it was obvious to everyone around him that Hitler’s physical and mental state were deteriorating. His tremor had become quite pronounced, his memory was slipping, he was having trouble following conversations, and his mood swings were intensifying. Giesing wondered if the rat poison in the fart pills was the cause of some or all of these symptoms. He popped a few tablets himself…and when he began to experience some of the same symptoms, including irritability and abdominal cramps, he shared his theory with Hitler’s surgeons, Dr. Brandt and Dr. von Hasselbach.

THE PLOT THICKENS

Brandt and von Hasselbach had never liked Dr. Morell and had no faith in his abilities, and like Dr. Giesing they were concerned for the state of Hitler’s health. Now, they thought, they had an opportunity to get rid of Morell once and for all and give the Führer the proper medical care he clearly needed. But if they thought getting rid of Morell would be easy once his incompetence was exposed, they soon learned how mistaken they were. When Brandt told Hitler what was in the pills he was popping like candy, he not only took Morell’s side, he fired Brandt and von Hasselbach for daring to interfere with Morell, and he told the visiting Dr. Giesing that his services were no longer needed.

Even though Morell was as stunned as everyone else to learn that he’d been medicating the Führer with rat poison, Hitler himself didn’t seem to mind. “I myself always thought they were just charcoal tablets for soaking up my intestinal gases, and I always felt rather pleasant after taking them,” he explained.

And though it was Morell’s responsibility to keep track of how many of the pills Hitler was taking, Hitler himself had ignored Morell’s instruction to take only two at a time and had begun popping six or more before each meal. The dictator didn’t blame the pills for his stomach cramps, either, since those dated back to his childhood.

Now that Hitler understood that the fart pills were potentially dangerous, he stopped taking so many…but his health did not improve. His physical and mental decline not only continued, it accelerated.

So what was the true cause of his collapse?

BACK TO THE DRAWING BOARD

All doubts about the safety of Dr. Koester’s Anti-Gas Pills were resolved when some of them were sent to a lab for analysis. The fart pills were found to contain small enough doses of strychnine and atropine that Hitler would have had to have consumed 30 pills or more—all in one sitting—for them to pose a threat to his health. He never took more than 6 at a time, and never more than 20 over the course of a day. Strychnine is quickly neutralized by the human body and does not accumulate in body tissues; because of this, nonlethal doses such as those contained in Dr. Koester’s anti-gas pills can be taken for years on end with little or no ill effect. (Still, don’t try it at home!)

Neither the rat poison nor the peasant poop had done Hitler much good…but they hadn’t done him much harm, either. But the intravenous injections that Morell administered to Hitler beginning in the late 1930s were a different story. Morell was very secretive about what was in the Führer’s regular daily shots; in his surviving medical records he never suggests that they contain anything other than vitamins or glucose. Some of the injections undoubtedly did contain these relatively innocuous ingredients, but not all of them. There’s considerable evidence to suggest that many of the shots Morell administered contained something much more powerful—and that they, not the Mutaflor or Dr. Koester’s Anti-Gas Pills, were responsible for the collapse in Hitler’s health at the end of his life.

GOOOOOOOOOD MORNING!

Some of the most convincing pieces of evidence are the eyewitness accounts of how Hitler responded to the intravenous injections. In the late 1930s, the shots were administered infrequently, usually just before an important meeting or a major speech, when Hitler wanted a quick boost. But by late 1941, they were being administered every morning, before Hitler had even gotten out of bed, as part of his daily routine. Hitler’s valets, secretaries, and other close aides occasionally witnessed the shots being administered, and after the war they all described how the sleepy and at times completely exhausted Führer responded to the injections instantly, sometimes even while the needle was still in his arm: One moment he was groggy and noncommunicative, and the very next he was fully alert and sitting up in bed, contentedly chatting away with whoever was in the room. Ordinary vitamins and glucose don’t produce the instant surge of energy that Hitler experienced, even when injected directly into the veins.

THANK YOU SIR, MAY I HAVE ANOTHER

By 1943 Hitler was receiving two shots a day, more if the news from the front was especially bad. As the years progressed—and the tide of the war turned against Germany—Hitler called on Morell more and more frequently to give him the injections. By late 1944, the doctor was administering so many shots that he was having trouble finding fresh areas in Hitler’s needle-pocked arms to give new injections.

And as Morell confided to an assistant, Hitler’s tolerance for whatever was in the shots had increased so dramatically over time that Morell had had to increase the dosage from 2 cubic centimeters per injection to 4, then 10, and eventually to 16 cc—an increase of 700 percent—for the injections to have the desired effect.

As Dr. Leonard Heston and Renate Heston point out in their book The Medical Casebook of Adolf Hitler, human tolerance for vitamins and glucose does not change over time. The fact that Hitler was building up a tolerance for the injections is further evidence that they contained a drug of some kind.

THE DRUG CULTURE

When you compare this evidence to the eyewitness accounts of Hitler’s instant response to the drug, a likely candidate for which drug he was taking begins to emerge. “The effects described,” the Hestons write, “are characteristic of an injection of a stimulant drug of the amphetamine group or cocaine, and are not compatible with any other drug.” Of the two possibilities, “amphetamine …is a much more probable because its injectable form was readily available, while injectable cocaine was an illegal drug.…Also, the effects of amphetamine last two or three hours, while the action of cocaine is much more rapidly terminated. The effects on Hitler were relatively long-lasting.”

SIDE EFFECTS

Amphetamines give the user a surge in energy and an improvement in mood, just as the witnesses to Hitler’s injections described. But they are now illegal for very good reasons: They’re terribly addictive and they have numerous debilitating negative side effects that more than outweigh the handful of desirable effects.

When taken even in moderate amounts, amphetamines can cause insomnia—which Hitler suffered from—and loss of appetite. As dosages increase, so do the number and intensity of the side effects. Psychological side effects associated with amphetamine toxicity include euphoria, irritability, paranoia, impulsiveness, loss of emotional control, and rigid thinking that is often marked by an obsession with minor, unimportant details at the expense of the larger picture. Because these symptoms impair the user’s ability to perceive events and the surrounding environment rationally, decision making also suffers.

NO SURRENDER

Hitler suffered from all of these symptoms and, at least as far as his generals were concerned, his thinking did indeed become impaired, especially his ability to make intelligent, rational decisions. A number of the generals assigned to Hitler’s headquarters were convinced he was losing his mind.

One of the reasons the war in Europe ended in the spring of 1945 and not many months or even years later is that even as the tide of the war turned against Germany, Hitler irrationally demanded that his battlefield commanders hold every inch of ground they had conquered, even when their situations became hopeless. In late 1942, for example, General Friedrich von Paulus, commander of the Sixth Army, requested permission to withdraw his troops from the Russian city of Stalingrad to avoid being surrounded by a superior force of Russian troops. Hitler, who by now was receiving shots every day, responded with the lunatic reply that the Sixth Army could withdraw from Stalingrad, “provided that it could still hold Stalingrad.” Unable to think of a way to abandon a position and hang onto it at the same time, von Paulus dutifully remained in the city. Stalingrad was surrounded a few weeks later, and in January 1943, the Sixth Army surrendered. As many as 800,000 Axis troops died in the Battle of Stalingrad, and when it ended, the 90,000 soldiers who survived it were marched off to Siberia. All but 6,000 perished.

Had Hitler allowed von Paulus to withdraw to a defensive position when requested, hundreds of thousands of German soldiers would have lived to fight another day, and the war might have dragged on for years. Instead, Stalingrad marked the turning point of the war and the beginning of the end for Nazi Germany. Who knows? We may have Dr. Morell and his amphetamines to thank for the war ending when it did.

MIND…AND BODY

In addition to the psychological side effects of amphetamine abuse, there are physical side effects, among them twitching, tremors, and what are called “stereotypes”: compulsive behaviors, such as repeated picking at or biting of one’s own skin. Hitler was twitchy, his head jerked uncontrollably, and he had tremors in spades—the shaking that began in his left hand soon spread down his left leg and then to his right hand. He also exhibited at least two types of stereotypical behavior: compulsively biting the skin around the fingernails of his thumbs, index fingers, and middle fingers, and picking and scratching at the skin on the back of his neck until it became infected.

The trembling in Hitler’s left leg impaired his ability to walk normally, but there may be another explanation for the slow, foot-dragging shuffle and loss of motor function that he displayed at the end of his life. Chronic amphetamine abuse takes a terrible toll on the cardiovascular system and can cause both heart attacks and strokes. Electrocardiographs taken of Hitler’s heart in July 1941 and again in September 1943 show a deterioration in heart function between the two dates that is consistent with a heart attack. And among Dr. Morell’s surviving medical records is an article torn from a June 1943 medical journal that may provide another clue. Topic of the article: How to treat a heart attack.

Then, in February 1945, the Hestons write, “Hitler suffered at least one small stroke; but he may have had several, and, indeed, his rapid decline from this time onward suggests widespread vascular disease.” The odds of a healthy 56-year-old man suffering both a heart attack and one or more strokes are “distinctly improbable,” say the Hestons: “The most parsimonious explanation, given the lack of conclusive evidence, is to attribute both vascular events to the injection of intravenous amphetamine.” By April 1945, Hitler was so close to death that had he not killed himself, it may have been just a matter of time before he dropped dead from amphetamine-induced “natural” causes.

SO LONG

Morell remained by Hitler’s side until almost the very end…but not quite. Ironically, the cause of Hitler’s falling-out with his beloved quack was an injection: Hitler had resigned himself to remaining in Berlin and committing suicide before the city fell to the Russians. Many in the Führer’s inner circle wanted him to escape to the mountains of southern Germany, where it might have been possible for remnants of the military, led by Hitler, to hold out indefinitely. Hitler would hear none of it. He was determined to die in his capital, but he feared that his subordinates would drug him and take him out of Berlin against his will. And who better to administer the drugs than Morell? When the doctor came to Hitler on April 21 with yet another syringe filled with who-knows-what (probably just more amphetamines), the raging, paranoid Führer fired him on the spot. Not that Morell minded—by then the bombs were dropping on the führerbunker 24 hours a day, and he was desperate for an excuse to escape.

LAST GASP

Morell did make it out of Berlin, and he survived the war, but not by much. A few days after fleeing the city, he checked into a hospital complaining of heart problems. On July 17, 1945, he was arrested by the Americans and imprisoned. After investigators determined he wasn’t guilty of any war crimes, he was released. Morell’s health continued to deteriorate, and by June 1947 he was back in the hospital, where he remained bedridden until May 1948, when he died shortly after suffering a stroke.