35 On most evenings: Peter D. Olch, “William S. Halsted and Local Anesthesia: Contributions and Complications,” Anesthesiology 42, no. 4 (1975): 479–86.
36 If you were wealthy and white: Francis F. Beirne, The Amiable Baltimoreans (Baltimore: Johns Hopkins University Press, 1984); and MacCallum, Halsted, pp. 62–63.
37 Baltimore did not offer: Joseph H. Pratt, A Year with Osler, 1896–1897: Notes Taken at His Clinics in the Johns Hopkins Hospital (Baltimore: Johns Hopkins University Press, 1949), pp. 191–201; Harvey Cushing, The Life of Sir William Osler, vol. 1 (Oxford: Oxford University Press, 1925), p. 378; and Jon Teaford, The Unheralded Triumph: City Government in America, 1870–1900 (Baltimore: Johns Hopkins University Press, 1984), pp. 140, 156, 219–21, 224, 246–47, 249.
38 He adorned his muscular frame: MacCallum, Halsted, p. 106.
39 Heroin addicts have an odd slang term: Random House Historical Dictionary of American Slang, ed. J. E. Lighter (New York: Random House, 1997), vol. 2, p. 313.
40 Elsewhere on the second floor: MacCallum, Halsted, pp. 58–71.
41 William could always come to him: We have excellent evidence of what William H. Welch sounded like, albeit in old age. In 1932, Welch made a short informational film to commemorate the fiftieth anniversary of the discovery of the tubercule bacillus, or Mycobacterium tuberculosis, the causative organism of tuberculosis. I was first introduced to this film in 1989, while in graduate school at the Johns Hopkins Institute for the History of Medicine, by the late professor Jerome Bylebyl. A few years ago, in 2007, Dr. Barry Silverman of Atlanta, Georgia, kindly sent me a DVD recording of the film. Thanks to the digital efforts of the Alan Mason Chesney Archives of the Johns Hopkins Medical Institutions, this film is now available for viewing at www.medicalarchives.jhmi.edu/welch/welcome.htm (accessed May 4, 2010).
42 And it was then: The vial story appears in Beckhard and Crane’s young-adult biography of Halsted, Cancer, Cocaine and Courage, pp. 155–57.
43 It is unknown how William acquired: For example, decades later, W. T. Councilman recalled experiencing a tooth abscess around this time that required Halsted to inject his mouth with cocaine before Councilman could muster the courage to seek a dentist for a painful extraction. Councilman to MacCallum, February 2, 1928, in William Stewart Halsted Papers, Series II, Notes, Box 49, Alan Mason Chesney Archives, Johns Hopkins Medical Institutions, Baltimore.
44 There he remained: Annual Report of the Trustees and Superintendents of the Butler Hospital for the Insane; Peter D. Olch, “William S. Halsted: The Antithesis of William Osler,” in The Persisting Osler, ed. J. A. Barondess, J. P. McGovern, and C. G. Roland (Baltimore: University Park Press, 1985), pp. 199–204.
Chapter 9. The Interpretation of Dreams
1 In an agate font: “Kleine Chronik,” Neue Freie Presse, April 25, 1886. A translated version appears in Peter Gay, Freud: A Life for Our Time (New York: W. W. Norton, 1998), p. 53.
2 “In the time span”: Sigmund Freud, An Autobiographical Study, trans. J. Strachey (New York: W. W. Norton, rpt. ed., 1989), p. 17.
3 Among his publications: Sigmund Freud, On Aphasia: A Critical Study, trans. E. Stengel (New York: International Universities Press, 1953, originally published in 1891); and Sigmund Freud, Infantile Cerebral Paralysis, trans. L. A. Russin (Coral Gables, Fla.: University of Miami Press, 1968; originally published in 1897). For more than ten years (1886–96), Freud worked part-time at the Vienna First Public Institute for Sick Children, or, as it came to be known, the Kassowitz Institute; he served without pay as he built his private practice. During this period, he put in many thousands of hours, examined many thousands of pediatric patients, and published nine papers and case studies on various neurological topics. See Ernest Jones, The Life and Work of Sigmund Freud, vol. 1 (New York: Basic Books, 1955), pp. 211–17. See also Andre Bolzinger, “Freud pédiatre et antipédiatre,” Le Coq-Héron 146 (1997): 61–69; Carolo Bonomi, “Why Have We Ignored Freud the ‘Paediatrician’?” Cahiers psychiatriques genèvois, special issue (1994): 55–99; J. Gicklhorn and R. Gicklhorn, Sigmund Freuds akademische Laufbahn (Vienna-Innsbruck: Urban & Schwarzenberg, 1960); C. Hochsinger, Die Geschichte des ersten öffentlichen Kinder-Kranken-Institutes in Wien während seines 150 jährigen Bestandes 1788–1938 (Vienna: Verlag des Kinder-Kranken-Institutes, 1938); P. J. Accardo, “Freud on Diplegia: Commentary and Translation,” American Journal of Diseases of Children 136, no. 5 (1982): 452–56; L. D. Longo and S. Ashwal, “William Osler, Sigmund Freud and the Evolution of Ideas Concerning Cerebral Palsy,” Journal of the History of the Neurosciences 2, no. 4 (1993): 255–82; C. W. Wallesch and C. Bartels, “Freud’s Impact on Aphasiology, Aphasiology’s Impact on Freud,” Journal of the History of the Neurosciences 5, no. 2 (1996): 117–25; and D. Galbis-Reig, “Sigmund Freud, MD: Forgotten Contributions to Neurology, Neuropathology and Anesthesia,” Internet Journal of Neurology 3, no. 1 (2004); ISSN 1531–295X; at www.ispub.com/ostia/index.php?xmlFilePath=journals/ijn/vol3n1/freud.xm (accessed February 6, 2009).
4 Specializing in the nascent arena: As time went on, Freud began to distance himself from Charcot’s (and, later, Hippolyte Bernheim’s) theories on the clinical uses of hypnotism. Beginning in the 1890s, he found that psychotherapy freed him—and his patients—from the need for this method. See Gay, Freud, pp. 50–51; and George Makari, Revolution in Mind: The Creation of Psychoanalysis (New York: Harper Perennial, 2008), pp. 27–34.
5 The flat leased for 1,600 gulden: Frederic A. Morton, A Nervous Splendor: Vienna, 1888–1889 (New York: Penguin, 1980), pp. 27–29, 87–88. Morton calls Freud “the first specialist in bourgeoisie angst.” See also Carl E. Schorske, Fin de Siècle Vienna: Politics and Culture (New York: Vintage Books, 1981), pp. 181–207. The apartment building where Sigmund and Martha Freud first lived was called the Sühnhaus, or the House of Atonement, and the rents collected were contributed to charitable causes. Maria H. Lansdale, Vienna and the Viennese (Philadelphia: Henry T. Coates, 1902), p. 41.
6 There were many days: Morton, Nervous Splendor, p. 89.
7 As the cultural historian Frederic Morton: Ibid. See also Gay, Freud, pp. 53–54.
8 In face-to-face conversations: Morton, Nervous Splendor, pp. 138–39.
9 He frequently described his mood: Gay, Freud, pp. 75–80.
10 In 1896, a year after: Ibid., pp. 59, 163; Peter Gay, “Sigmund and Minna? The Biographer as Voyeur,” New York Times, January 29, 1989, p. 44. It is also interesting to note that the letters that do exist between Martha and Freud during these years are mostly centered on the running of the household and the welfare of their children, in distinct contrast to the love letters of their engagement. Martha and Sigmund’s sexual pact may have originated as an ultimate measure of birth control. Apparently, Freud detested using condoms.
11 “She was very much bothered”: J. M. Billinksy, “Jung and Freud (the End of a Romance),” Andover Newton Quarterly 10 (1969): 39–43; quote is from p. 42.
12 “some dreams that bothered him”: Ibid., p. 42.
13 “He looked at me”: Ibid. Jung went on to tell Billinsky that it was this incident that signaled the end of his storied friendship with Freud. Jung suggested that Freud should have completed analysis and that there was evidence of significant neuroses over the situation, such as several psychosomatic problems and trouble controlling his bladder during the trip to America. “If Freud would have tried to understand consciously the triangle,” Jung explained in recollection, “he would have been much, much better off.” In subsequent years, many have asserted that it was Jung’s rejection of Freud’s theory that the libido or inner drive was singularly related to sex, in contrast to the energy or life forces espoused by Jung. But in this article, as well as his autobiography, Jung reported that Freud’s inability to be completely truthful about his affair and his need to maintain an authoritative hegemony over his student was really at the root of the relationship’s demise. See also Carl G. Jung, Memories, Dreams, Reflections (New York: Vintage Books, 1989)
, p. 149. The dating of Jung’s initial visit to Vienna differs in Jones’s biography and Jung’s autobiography, but according to the correspondence between Jung and Freud, their first in-person visit occurred in March 1907; see W. McGuire, ed., The Freud/Jung Letters: The Correspondence Between Sigmund Freud and C. G. Jung (London: Hogarth Press and Routledge and Kegan Paul, 1974), p. 24. I am indebted to Dr. James Harris, professor of psychiatry at the Johns Hopkins University School of Medicine, for helping me to sort out this complex episode in Freud’s life.
14 With the practiced duplicity: Franz Maciejewski, “Freud, His Wife, and His ‘Wife’: Freud and Minna Bernays,” American Imago 63, no. 4 (2006): 497–506; Franz Maciejewski, “Minna Bernays as ‘Mrs. Freud’: What Sort of Relationship Did Sigmund Freud Have with His Sister-in-Law?” American Imago 65, no. 1 (2008): 5–21; R. Blumenthal, “Hotel Log Hints at Illicit Desire That Dr. Freud Didn’t Repress,” New York Times, December 24, 2006; Albrecht Hirschmüller, “Freud and Minna Bernays: Evidence for a Sexual Relationship Between Sigmund Freud and Minna Bernays?” American Imago 64, no. 1 (2007): 125–29; Gay, “Sigmund and Minna?”; and Peter J. Swales, “Freud, Minna Bernays, and the Conquest of Rome,” New American Review 1 (1982): 1–23.
15 Sigmund was particularly captivated: Gay, Freud, p. 52.
16 The diagnosis of hysteria: See, for example, American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (New York: American Psychiatric Publishing, 2000). The fifth edition of the DSM is scheduled for May 2013.
17 Before the advent of modern gynecology: Rachel P. Maines, The Technology of Orgasm: “Hysteria,” the Vibrator, and Women’s Sexual Satisfaction (Baltimore: Johns Hopkins University Press, 1998); and Mark S. Micale, Hysterical Men: The Hidden History of Male Nervous Illness (Cambridge, Mass.: Harvard University Press, 2008). The Greek root hystero means “womb” or “uterus.” The suffix ectomy comes from the root ecto and means “outside” or “removal.”
18 As The Oxford Companion to Medicine succinctly notes: “Hysteria,” in J. Walton, P. B. Beeson, and R. B. Scott, eds., The Oxford Companion to Medicine, vol. 1 (New York: Oxford University Press, 1986), p. 573.
19 These poor souls: Micale, Hysterical Men, pp. 117–61; and Andrew Scull, “Prisoners of Gender,” Times Literary Supplement, January 23, 2009, p. 25.
20 “It was easy to see”: Freud, Autobiographical Study, p. 12.
21 Still, it is important to recall: “It’s always a question of the genitals … always … always … always.” See Roy Porter, The Greatest Benefit to Mankind: A Medical History of Humanity (New York: W. W. Norton, 1997), p. 515; and Eli Zaretsky, Secrets of the Soul: A Social and Cultural History of Psychoanalysis (New York: Alfred A. Knopf, 2004), p. 34.
22 Sigmund reciprocated by sharing: Freud, Autobiographical Study, p. 19.
23 In what many members of the audience: The title of Freud’s controversial paper to the Vienna Medical Society was “On Male Hysteria.” The actual lecture has been lost to posterity but has been pieced together from the society’s official minutes and medical newspaper reports of the meeting. See Anzeiger der k. k. Gesellschaft der Ärzte in Wien 25 (1886): 149–52; Allgemeine Wiener medizinische Zeitung 31 (1886): 506–07; Wiener medizinische Presse 27 (1886): 1407–09; Wiener medizinische Wochenschrift 36 (1886): 1444–47; Munchener medizinische Wochenschrift 33 (1886): 768; and Wiener medizinische Blatter 9 (1886): 1292–94. These articles have been gathered together and reprinted in Luzifer-Amor: Zeitschrift zur Geschichte der Psychoanlyse 1 (1988): 156–75. Five years later, in 1891, Theodor Meynert made a deathbed request to see Freud. At their final interview, Professor Meynert confessed that he’d fought Sigmund’s theories so hard because “I was always one of the clearest cases of male hysteria.” See Morton, Nervous Splendor, p. 315; Micale, Hysterical Men, p. 241; and Sherwin B. Nuland, “Macho Misery,” New Republic, April 15, 2009, pp. 40–43.
24 Five weeks later: Sigmund Freud, “Beobachtund einer hochgradigen Hemianästhesie bei einem hysterishen Manne,” Wiener medizinische Wochenschrift 36 (December 1886): 1633–38.
25 “Hysterics suffer for the most part”: Josef Breuer and Sigmund Freud, Studies in Hysteria, trans. N. Luckhurst (New York: Penguin Books, 2004), p. 11.
26 One of the most fascinating cases: For the case of Anna O., see Breuer and Freud, Studies in Hysteria, pp. 25–50. Bertha Pappenheim went on to a prominent career as a social worker, feminist, and Jewish activist. See Lucy Freeman, The Story of Anna O.: The Woman Who Led Freud to Psychoanalysis (New York: Jason Aronson, rpt. ed., 1994).
27 But by the summer of 1882: A. Orr-Andrawes, “The Case of Anna O.: A Neuro-Psychiatric Perspective,” Journal of the American Psychoanalytic Association 35, no. 2 (1987): 387–419; and S. de Paula Ramos, “Revisiting Anna O.: A Case of Chemical Dependence,” History of Psychology 6, no. 3 (2003): 239–50. Bertha’s complex partial seizures, for example, may well have emerged from her drug dependence on morphine or from a preexisting case of epilepsy. In later years, she was able to recover from her morphine abuse. She was readmitted to mental health facilities several times between 1882 and 1887. See also Makari, Revolution, pp. 39–41, 44.
28 He hypothesized that talking at length: Jones, Life, vol. 1, pp. 222–26; and William M. Johnston, The Austrian Mind: An Intellectual and Social History, 1848–1938 (Berkeley: University of California Press, 1972), pp. 221–37.
29 Breuer and Freud went their separate ways: The original text appeared as Sigmund Freud and Josef Breuer, Studien über Hysterie (Leipzig and Vienna: Franz Deuticke, 1895).
30 Breuer heatedly disagreed: Eventually Sigmund would revise his theories to abandon the primacy of “seduction theory” and expand the concept to include all sexual frustrations and conflicts, real or imagined, encountered by many a civilized man or woman living in late-nineteenth-century bourgeois Western culture. Paul R. McHugh, Try to Remember: Psychiatry’s Clash over Meaning, Memory and Mind (New York: Dana Press, 2008).
31 In his later years: Louis Breger, A Dream of Undying Fame: How Freud Betrayed His Mentor and Invented Psychoanalysis (New York: Basic Books, 2009); and Saul Rosenzweig, The Historic Expedition to America (1909): Freud, Jung, and Hall the King-Maker (St. Louis: Rana House, 1994), p. 108.
32 “My emotional life”: Sigmund Freud, The Interpretation of Dreams, trans. James Strachey (New York: Penguin Books, 1991), p. 622.
33 This now famous second-story apartment: Louis Breger, Freud: Darkness in the Midst of Vision (New York: John Wiley and Sons, 2000), p. 88.
34 “My letter of today”: Freud to Fliess, November 24, 1887, Jeffrey M. Masson, ed., The Complete Letters of Sigmund Freud to Wilhelm Fliess, 1887–1904 (Cambridge, Mass.: Belknap Press of Harvard University Press, 1985), p. 15.
35 As their novel notions: Peter Gay, “Freud: A Brief Life,” in Sigmund Freud, The Ego and the Id, trans. Joan Riviere, part of The Standard Edition of the Complete Psychological Works of Sigmund Freud (New York: W. W. Norton, 1989), p. xiv.
36 Careful nasal examinations: See, for example, W. Fliess, The Relationship Between the Nose and the Female Sexual Organs (Berlin: Verlag von Franz Deuticke, 1897); Sander Gilman, The Jew’s Body (London: Routledge, 1991); Sander Gilman, The Case of Sigmund Freud: Medicine and Identity at the Fin de Siècle (Baltimore: Johns Hopkins University Press, 1994); Sander Gilman, Difference and Pathology: Stereotypes of Sexuality, Race and Madness (Ithaca, N.Y.: Cornell University Press, 1985); and Janet Malcolm, In the Freud Archives (New York: New York Review Books, 1997), pp. 46–49.
37 More intriguing, they explored: Jeffrey M. Masson, “Freud and the Seduction Theory: A Challenge to the Foundations of Psychoanalysis,” Atlantic Monthly, February 1984, www.theatlantic.com/issues/84feb/masson.htm (accessed May 4, 2010); and Jeffrey M. Masson, The Assault on Truth: Freud’s Suppression of the Seduction Theory (New York: Harper Perennial, 1992).
38 In another still: Zaretsky, Secrets, p. 49; and P. Newton, “Freud’s Mid-Life Crisis,” Psychoanalytic Psych
ology 9, no. 4 (1992): 447–75. See, for example, Fliess to Freud, July 15, 1896, Complete Letters, pp. 2–4, 194–95. Zaretsky notes that while Masson translates the phrase “befruchtenden Stromes” as “stimulating current,” befruchten also means “fertilize” or “pollinate.” Freud refers to the homoerotic component of his relationship with Fliess in a letter to Ferenczi; see Ernest Jones, The Life and Work of Sigmund Freud, vol. 2, 1901–1919 (New York: Basic Books, 1955), pp. 83–84. See also Malcolm, Freud Archives, p. 47; Gay, Freud, pp. 55–58; and Zaretsky, Secrets, pp. 49–51.
39 While recuperating: A peritonsillar abscess is a collection of pus that forms in the soft tissue of the throat, next to one of the tonsils. It is the result of an infection and can cause pain, swollen tissues, and, if severe enough, actual blockage of the throat and difficulty swallowing and breathing. Freud to Fliess, May 15, 1893, Complete Letters, p. 48.
40 Freud reported feeling especially better: Freud to Fliess, May 30, 1893, Complete Letters, pp. 49–50.
41 “The last letter I was able to produce”: Freud to Fliess, November 27, 1893, Complete Letters, pp. 61–62; quote is from p. 61.
42 Incidentally, it was not the last time: See, for example, Freud to Fliess, April 20, 1895, Complete Letters, p. 126. In this letter Freud notes that he was able to pull himself out of “a miserable attack” only with cocaine but might require cauterization or galvanization to open his blocked nasal passages.
43 “Less obvious, perhaps, is the state”: Freud to Fliess, April 19, 1894, Complete Letters, pp. 67–68; quote is from p. 67.
44 Initially, Sigmund diagnosed: Freud to Fliess, April 25, 1894, and May 6, 1894, Complete Letters, pp. 69–71. “Rheumatic myocarditis” is an antiquated term referring to the inflammation of the heart that can follow a bacterial, viral, or fungal infection of the heart. The key symptoms include chest pain, discomfort, and, potentially, congestive heart failure.
45 Interestingly, in 1897: In 1897, Freud wrote Fliess: “The insight has dawned on me that masturbation is the one major habit, the ‘primary addiction,’ and it is only as a substitute and replacement for it that the other addictions—to alcohol, morphine, tobacco, etc.—come into existence.” Freud to Fliess, December 22, 1897, Complete Letters, pp. 287–89. Freud makes this point more explicitly in his 1898 essay “Sexuality in the Aetiology of the Neuroses”: “Left to himself, the masturbator is accustomed, whenever something happens that depresses him, to return to his convenient form of satisfaction.… For sexual need, when once it has been aroused and has been satisfied for any length of time, can no longer be silenced; it can only be displaced along another path.… Not everyone who has occasion to take morphia, cocaine, chloral-hydrate … acquires in this way an ‘addiction’ to them. Closer inquiry usually shows that these narcotics are meant to serve—directly or indirectly—as a substitute for a lack of sexual satisfaction.” In Sigmund Freud, Three Essays on the Theory of Sexuality (New York: Basic Books, 1962), pp. 275–76. See also Breger, Darkness, pp. 168–69.
An Anatomy of Addiction Page 31
