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It was originally titled A Psychologist's Idleness but renamed to give a greater sense of grandeur, along with the added subtitle, "How One Philosophizes With a Hammer." The hammer is a metaphor use by Nietzsche to say that he diagnoses the ill of the idols as a medecin (for exemple, a medecin beat the knee of his patient to test the reflex). But here, he heard to the resonances of the vacuity of the falses gods.
It is, in a sense, a summary of his later philosophy, which is often attacked as the ramblings of a madman by critics, but some others people disagree with this simplism judgment.