It has also been persuasively argued that Otto's problems were the result of contracting syphilis, which would also account for his physical problems, particularly the paralysis from which he suffered from in later years.
Juga secara persuasif dikatakan bahwa masalah Otto adalah hasil dari kontak sifilis, yang juga akan memperhitungkan masalah fisiknya, terutama kelumpuhan yang dideritanya beberapa tahun kemudian.