Friedrich Nietzsche was a clear-sighted diagnostician, whose penetrating analysis encompassed the history of European culture from the archaic age of the Greeks to his own day. His analysis was guided by this central insight: that the manner by which a culture interprets suffering is an index of its spiritual health. Using this diagnostic benchmark, Nietzsche was sure that Greek tragedy (as performed during the archaic age) functioned as a showcase for the artistic genius and robust health of that ancient culture. Modern Europeans, on the other hand, do not live in a culture characterized by tragic art and, as a consequence, are not as fit as those splendid and powerful humans of the past.

Nietzsche explained the decline of the spiritual health of European culture in On the Genealogy of Morals: A Polemic. Published in 1887, On the Genealogy of Morals is simultaneously an account of the development of modern morality, as well as a detailed pathology of modern Europe's sickness. This is a very different work from The Birth of Tragedy, published over a decade and a half earlier in 1872. Nevertheless, both works highlight Nietzsche's unwavering conviction that the health of a given culture is best measured by the manner in which it gives suffering meaning.