In “Essence of Nihilism”, Emanuele Severino wrote half a century ago: “The West is a sinking ship”. That disturbing warning was taken up by Ivano Spano (2016) at the beginning of his book “The Disease of the West” and titles of the same kind are now recurrent in many analyses and denunciations, such as in Stanley Sloan’s (2018) book “Transatlantic traumas” which contains a chapter entitled “Malaise in the West”. In fact, the widespread malaise is alarming, intertwined with a crisis of political and social institutions; a malaise and crisis so contrasting with the growing well-being of the 40 years after the end of the Second World War which was accompanied by the solid functionality of the democratic organization. If it is a disease, it is necessary to consider how the clinical examination proceeds. An organism is considered very ill when a relevant part and function is seen to suffer. Its balance which has perhaps been lost is then examined; one then looks for the faults of the main mechanism, and finally the malfunctions of specific processes. Applying a clinical examination to the disease of Western countries, one can see that the middle class has been suffering for a long time, along with it the essential upward social mobility, and consequently, the legitimacy of its system of regulation; the economic-social balance has been lost, serious failures have occurred in the central mechanism of capitalist accumulation, two decisive basic processes have crumbled: motivation to work and democracy.