Reading a biography of Nietzsche, and it got me thinking. We don't really know what caused Nietzsche's madness in 1889, but syphilis and brain cancer are both candidates. Let's assume it's one or the other, and that Nietzsche doesn't contract it, and remains sane. What would the consequences be? Does he still reach the fame he did IOTL without the tragic-romantic end to his story? If he does, and he doesn't have his sister "reinterpreting" his philosophy for him, how does that change the reception of his ideas?