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Wilhelm Fliess

Wilhelm Fliess

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Wilhelm Fliess was born on 24th October 1858. He established himself as an ear, nose, and throat specialist in Berlin. Fliess was an associate of Josef Breuer and when he visited Vienna in November, 1887, he was advised by his friend to attend a lecture given by Sigmund Freud. After the lecture Breuer introduced Fliess to Freud. (1)

That night Freud wrote a letter to Fliess: "While my letter of today has a business motive. I must introduce it with the confession that I entertain the hope of continuing the relationship with you, and that you have left a deep impression on me." It was the beginning of a very close friendship. (2)

Freud had very few patients during the first few years of his married life. His first patient was suffering from depression and Freud prescribed electrical treatment. He also gave lectures to young doctors on a wide variety of topics, including clinical neurology and medical uses of electricity. Freud took a close interest in the work of Jean Martin Charcot and his "latest investigations upon hysteria... He had proved, for instance, the genuineness of hysterical phenomena and their conformity to laws... the frequent occurrence of hysteria in men, the production of hysterical paralyses and constructures by hypnotic suggestion." (3)

Freud discussed these issues with Josef Breuer. Both men began to use hypnotic suggestion to treat patients suffering from hysteria. This was a term used at the time that meant "ungovernable emotional excess" in women. This included anxiety, nervous coughs, shortness of breath, migraines, contorted facial muscles, paralyzed limbs, tics, muteness, fainting, insomnia, irritability and promiscuity. Charcot believed hysteria to be a disturbance of the nervous system and claimed both men and women could suffer from hysteria. (4)

Hypnosis is a state of human consciousness involving focused attention and reduced peripheral awareness and an enhanced capacity to respond to suggestion. Charcot's idea was you could use hypnosis not only to replicate the hysterical attack but to introduce suggestions to the hysteric that might enable a cure. Freud initially hypnotized patients by pressing his hand on their foreheads. However, Freud found, however, that he was not always able to induce hypnosis, either at all or deeply enough for his needs. (5)

In the autumn of 1892 Ilona Weiss became one of Freud's patients. To protect her identity, Freud always referred to her as "Elisabeth von R". The twenty-four year old daughter of a wealthy Hungarian family was suffering from pains in the legs and had difficulty in walking. Her doctor had examined her and could not find anything physically wrong with her legs and decided she was suffering from hysteria and she was sent to Freud. He decided to use a different method to treat her. Freud asked Elisabeth to lie down on his couch and close her eyes. Applying pressure to her forehead, he asked her to report faithfully whatever came into her mind. (6)

Elisabeth admitted that she was in love with her brother-in-law. However, she was able to suppress these feelings but did seek out his company and enjoyed long walks together. Her troubles began when her sister died and she developed the idea that he could become her husband. This "unacceptable thought" challenged everything that she believes about herself as a moral and loyal person. She resisted it and tried to force it out of her consciousness. It was because of these feelings that caused the pain in her legs. Freud believed the symptom can be traced back to the very walks that she had enjoyed with her brother-in-law before the death of her sister. Freud argues that far from being the degenerate fiends of popular myth, invariably the hysteric is too moral, punishing herself for her unacceptable desires. Elisabeth's treatment involved recovering her guilty thoughts from her unconscious and accepting it. This resulted in a full cure and in the spring of 1894 he attended "a private ball" where he saw "my former patient whirl past me in a lively dance". (7)

Sigmund Freud continued to experiment with encouraging patients to talk freely, without censorship or inhibition, about whatever ideas or memories occurred to them. Freud then used these comments to help discover the link with other events and feelings. During this process it was for the doctor to "decide what is and is not relevant: the patient must shape the discourse". This approach, "if it is to be effective, has to be understood as a partnership". (8)

In 1895 Sigmund Freud and Josef Breuer published their book, Studies on Hysteria. It consists first of a reprint of the joint paper they had written, then five case histories, a theoretical essay by Breuer, and a concluding chapter on psychotherapy by Freud. The first case history, by Breuer, is that of Anna (Bertha Pappenheim). Freud contributed the other four cases, including Ilona Weiss (Elisabeth) and Fanny Moser (Emmy).

The book received mainly hostile reviews. The best one appeared in the Neue Freie Presse, the leading daily newspaper of Vienna, by Alfred von Bergner, Professor of the History of Literature in the University of Vienna. He said he read the case histories with admiration and understanding, and then added the significant prediction: "We dimly conceive the idea that it may one day became possible to approach the innermost secret of human personality... The theory itself is in fact nothing but the kind of psychology used by poets." (9)

Havelock Ellis, a doctor working in London, and a founder member of the Fabian Society, also praised the book, and agreed with Freud's views about the sexual cause of hysteria. However, most people were shocked by the idea and it took over thirteen years to sell 626 copies of the book. It was not a very profitable exercise and the authors only received 425 gulden between them (£18 each). During the writing of the book the two men disagreed about the role that sexual impulses played in hysteria. (10)

David Stafford-Clark has pointed out: "Despite the comparative success of their joint publication, Breuer and Freud never collaborated in any further published material.... This in fact heralded not only the break with Breuer but the beginning of the independent emergence of Freud's own concept of psychoanalysis. The basic difference of opinion between the two authors, upon which Freud was later to lay considerable emphasis, concerning the part played by sexual impulses in the causation of hysteria." (11)

After the loss of Josef Breuer, Sigmund Freud formed a close relationship with Wilhelm Fliess, an ear, nose, and throat specialist. Breuer considered Fliess to be "one of the richest intellects" he had ever met. Fliess was very interested in new ideas and was very knowledgeable in the fields of the arts, mathematics and biology. Fliess acted as a sounding board for Freud's developing ideas. (12)

Ernest Jones, one of Freud's closest friends, spoke highly of Fliess. "His (Fliess) scientific interests ranged far beyond his own special field, particularly in medicine and biology. It was this extension that interested Freud and at first seemed to fit in with his own." (12a)

Their friendship grew through their frequent letters and regular meetings in Vienna and Berlin, but most of all liked to arrange two or three-day trips away from home (they called these special meetings "Congresses"). They not only exchanged their unorthodox scientific ideas but Freud provided intimate details of his own life (which he withheld from wife). In fact, it has been claimed that Freud used these letters as "self-analysis". (13) Freud became infatuated with Fliess: "Only someone who knows he is in possession of the truth writes as you do." (14)

During this period Freud's moods swung wildly from elation to depression: "Sometimes he convinced himself of the value of his discoveries; at other times he was plagued with self-doubt. In addition he was troubled with anxiety symptoms: fear of travelling by rail, dread of dying, shortness of breath and cardiac arhythmias, headaches and recurrent sinusitis... Yet out of this turmoil... some of Freud's most profound insights arose." (15)

Sigmund Freud reported in October, 1895: "I am almost certain that I have solved the riddles of hysteria and obsessional neurosis with the formulas of infantile sexual shock and sexual pleasure, and I am equally certain that both neuroses are, in general, curable - not just individual symptoms but the neurotic disposition itself. This gives me a kind of faint joy - for having lived some forty years not quite in vain - and yet no genuine satisfaction because the psychological gap in the new knowledge claims my entire interest." (16)

It was only after the death of his father in 1896, that Freud could begin to open up about how his own early sexual life had influenced his personality. "The chief patient I am preoccupied with is myself. My little hysteria, though greatly accentuated by my work, has resolved itself a bit further. The rest is still at a standstill. That is what my mood primarily depends on. The analysis is more difficult than any other. It is, in fact, what paralyzes my psychic strength for describing and communicating what I have won so far. Still, I believe it must be done and is a necessary intermediate stage in my work." (17)

Freud became convinced that most cases of neurosis can be traced back to incidents in early childhood but did not have full access to those memories that had been repressed into the unconscious. "I have not succeeded in gaining a theoretical understanding of repression and its interplay of forces. It seems once again arguable that only later experiences give the impetus to fantasies, which then hark back to childhood, and with this the factor of a hereditary disposition regains a sphere of influence from which I had made it my task to dislodge it - in the interest of illuminating neurosis." (18)

In a letter written on 15th October, 1897, Freud begins to explore what later became known as the Oedipus complex. "My self-analysis is in fact the most essential thing I have at present and promises to become of the greatest value to me if it reaches its end... Being totally honest with oneself is a good exercise. A single idea of general value dawned on me. I have found, in my own case, too, the phenomenon of being in love with my mother and jealous of my father, and now I consider it an universal event in early childhood... If this is so, we can understand the gripping power of Opedius Rex... the Greek legend seizes upon a compulsion which everyone recognizes because he senses its existence within himself. Everyone in the audience was once a budding Oedipus in fantasy and each recoils in horror from the dream fulfillment here transplanted into reality, with the full quantity of repression which separates his infantile state from his present one." (19)

Freud is referring to Oedipus Rex, an Ancient Greek drama written by Sophocles in about 429 BC. Oedipus is the son of Laius and Jocasta, the king and queen of Thebes. When his son is born, the king consults an Oracle as to his fortune. To his horror, the oracle reveals that Laius "is doomed to perish by the hand of his own son". Laius orders Jocasta to kill him. Unable to kill her own son, she gives him to a servant to carry out the task. He abandons Oedipus on a mountain top but he is rescued by a local shepherd. He presents him to the childless king Polybus, who raises Oedipus as his own son.

As he grows to manhood, Oedipus hears a rumour that he is not truly the son of Polybus. He asks an oracle who his parents really are. The Oracle seems to ignore this question, telling him instead that he is destined to "mate with his own mother, and kill his own father ". Desperate to avoid this terrible fate, Oedipus, decides to leave Corinth. On the road to Thebes, Oedipus encounters Laius and the two men quarrel over whose chariot has the right of way. The king attempts to strike Oedipus with his sceptre, but during the struggle Laius is killed.

Before arriving at Thebes, Oedipus encounters the Sphinx, a legendary beast with the head and breast of a woman, the body of a lioness, and the wings of an eagle. The Sphinx was sent to the road approaching Thebes as a punishment from the gods, and would kill any traveler who failed to answer a certain riddle:"what is the creature that walks on four legs in the morning, two legs at noon, and three in the evening?" Oedipus correctly guesses, "man", who crawls on all fours as an infant, walks upright in maturity, and leans on a stick in old age. The Sphinx throws herself from a cliff, thereby ending the curse. Oedipus' reward for freeing Thebes from the Sphinx is its kingship, and the hand of the now widowed queen, Jocasta. The couple have two daughters, Antigone and Ismene.

Many years later another oracle discloses the truth of how Oedipus has killed his own father and married his mother. Oedipus decides to cut out his mother's womb. However, before he can do this, she hangs herself. Oedipus takes her down and removes the long gold pins that held her dress together, before plunging them into his own eyes in despair. A blind Oedipus now leaves the palace and the chorus repeat the Greek maxim, that no man should be considered fortunate until he is dead.

Sigmund Freud argues that rather than see Oedipus' fate as a horrifying and individual event, he sees it as expressing "the long-forgotten desires of childhood that accompany and shape every individual's sexual development" and "between the ages of three and five, every child must struggle with what comes to be called the Oedipus complex, when, like the Greek king, they long to be rid of the parent of the same sex in order to take possession of the parent of the opposite sex". (20)

Freud later destroyed all of Wilhelm Fliess' letters, but it becomes clear that he advocated the theory that all adults were bisexual and that these repressed desires were the cause of some cases of hysteria. On 25th March, 1898, Freud wrote to Fliess: "I do not in the least underestimate bisexuality.... I expect it to provide all further enlightenment." (21) A year later he said: "Bisexuality! You are certainly right about it. I am accustoming myself to regarding every sexual act as a process which four individuals are involved." (22)

Freud told Fliess that he always needed a very close male friend and that he was disappointed by the end of his relationship with Josef Breuer: "In my life, as you know, woman has never replaced the comrade, the friend. If Breuer's male inclination were not so odd, so timid, so contradictory - like everything else in his mental and emotional makeup - it would provide a nice example of the accomplishments into which the androphilic current in men can be sublimated." (23)

Freud admitted to Fliess that the theories emerging from his self-analysis was not really science. His attempts at analyzing his personality was more the work of an artist: "I am actually not at all a man of science, not an observer, not an experimenter, not a thinker. I am by temperament nothing but a conquistador - an adventurer, if you want it translated - with all the curiosity, daring, and tenacity characteristic of a man of this sort." (24)

In January 1899, Sigmund Freud wrote to Fliess declaring he had made a break-through in understanding the human personality: "I want to reveal to you that the dream schema is capable of the most general application, that the key to hysteria as well really lies in dreams... If I wait a little longer, I shall be able to present the psychic process in dreams in such a way that it also includes the process in the formation of hysterical symptoms. So let us wait." (25)

The following month he wrote: "My last generalization has held good and seems inclined to grow to an unpredictable extent. Not only dreams are wish fulfillments, so are hysterical attacks. This is true of hysterical symptoms, but probably applies to every product of neurosis, for I recognized it long ago in acute delusional insanity. Reality - wish fulfillment - it is from these opposites that our mental life springs. I believe I now know what determines the distinction between symptoms that make their way into waking life and dreams. It is enough for the dream to be the wish fulfillment of the repressed thought, for dreams are kept at a distance from reality. But the symptom, set in the midst of life, must be something else besides: it must also be the wish fulfillment of the repressing thought." (26)

During this period Freud gradually abandoned the use of hypnotism, finding it difficult to induce and being uncertain in its effects. He now asked his patient to relax on a couch and they were asked to try and recall anything that seemed relevant to a particular symptom. At first he would press the patient's forehead with his hand and insist that some thoughts would occur. However, by 1899 he adopted a "less interventionist approach, realizing that he would learn more by allowing the patient's thoughts to evolve freely." (27)

The first edition of The Interpretation of Dreams was published in November 1899 but it did not become available to the following year. The publisher printed 600 copies. In the six weeks following publication 123 copies were sold, but only a further 228 were purchased over the next two years. According to David Stafford-Clark: "This book is now universally regarded as Freud's theory of dreams, and a confirmation of his earlier theories of unconscious mental mechanism, brilliantly exemplified. Freud himself never doubted the importance of the book and of his discoveries therein recorded, which had changed his own life." (28)

Sigmund Freud told his friend, Ernest Jones, it was his favourite book: "It seems to be my fate to discover only the obvious: that children have sexual feelings, which every nursemaid knows; and that night dreams are just as much a wish fulfillment as day dreams." However, it did not make him very much money as he only received 522.40 gulden (£41 16s.) from the publisher. (29)

The scientific journals did not bother to review The Interpretation of Dreams. A couple of newspapers did report on the book and one academic, Professor Raimann, claimed that Freud had constructed a theory "so that he can fill his pockets adequately". Another academic made a more valid point when he argued that the "imaginative thoughts of an artist had triumphed over the scientific investigator." (30)

In a letter written in August 1901, Freud admitted that Wilhelm Fliess had played an important role in the development of its ideas. "You remember my telling you years ago, when you were still a nose specialist and surgeon, that the solution lay in sexuality. Several years later you corrected me, saying that it lay in bisexuality - and I see that you are right. So perhaps I must borrow even more from you; perhaps my sense of honesty will force me to ask you to co-author the work with me; thereby the anatomical-biological part would gain in scope, the part which, if I did it alone, would be meager. I would concentrate on the psychic aspect of bisexuality and the explanation of the neurotic. That, then, is the next project for the immediate future, which I hope will quite properly unite us again in scientific matters as well." (31)

However, Freud appeared to drop the idea and Fliess became worried that he was steal his ideas and use them in his own book on the subject. After Fliess complained about this Freud stopped writing to him. He also destroyed all the letters Fliess had sent him. Fliess claimed that at their last meeting, Freud was extremely hostile and expressed the desire to kill him. (32)

In a footnote that appeared in a later book, Freud pointed out that in the summer of 1901 he did have a "lively exchange of scientific ideas" with an unnamed friend. He explained how later his friend accused him of stealing his ideas. Freud rejected this view but added that "since then I have grown a little more tolerant when, in reading medical literature, I came across one of the few ideas with which my name can be associated, and find that my name has not been mentioned." (33)

In 1903 Otto Weininger published a book entitled, Sex and Character. Wilhelm Fliess read the book the following year and was shocked that it contained ideas about bi-sexuality. Fliess discovered that Weininger was a close friend of Hermann Swoboda, a close associate of Freud and came to the conclusion that his ideas on sexuality had been passed on to the young writer. In a letter written in July 1904, Fliess wrote that he had found in Weininger's book "my ideas on bisexuality and the nature of sexual attraction that follows from it - feminine men attract masculine women and vice versa." (34)

Freud replied that Swoboda was not a pupil, but a patient to whom he had mentioned in the analysis that a bisexual constitution was universal and who had then casually made the same remark to Weininger. He then pointed out that Weininger had committed suicide after he had been accused of plagiarism by Paul Julius Möbius. "The late Weininger was a burglar with a key he had found". (35)

Wilhelm Fliess replied that he had evidence that Freud had met with Weininger while he was writing the book. Freud now admitted that he had done this and "confessed he must have been influenced by his wish to rob Fliess of his originality, a wish presumably compounded of envy and hostility." (35)

In 1906 Wilhelm Fliess published The Course of Life: Foundation of Exact Biology, which spelled out his theories of bisexuality in exhaustive detail. This was followed by a pamphlet denouncing Swoboda and Weininger as plagiarists and accusing "Freud of being the conduit through which they had secured access to Fliess's original property. What offended Freud most about this polemic was that it quoted from his private communications to Fliess." (36)

Wilhelm Fliess died on 13th October 1928. Two months later his wife wrote to Freud asking for her husband's letters. Freud replied: "My memory tells me that I destroyed the larger part of our correspondence some time after 1904." He then added: "I would certainly like to hear that my letters to your husband, my intimate friend for long years, have found a fate that would protect them from any future utilization." (37)

On 30th December, 1936, Freud received information from Marie Bonaparte that a bookseller from Berlin owned the letters that he had sent to Wilhelm Fliess. (38) Freud was appalled as when Fliess had died in October 1928, he had asked his widow to return the letters. However, she told him that she could not find them. He told Bonaparte that the letters were "the most intimate you can imagine" and that it is important that they were destroyed. "It would be most awkward" to have the letters "fall into the hands of strangers" and "I want none of them to come to the notice of so-called posterity". (39)

Freud attempted to buy the letters but the bookseller refused as he feared that he would destroy them. Marie Bonaparte agreed to buy them but refused to destroy the letters. She promised not to read them, but proposed to deposit the letters in some safe library with the stipulation that they be kept from anyone's eyes "for eighty or a hundred years after your death." She added: "You belong to history of human thought like Plato, let us say, or Goethe... Something would be lost to the history of psychoanalysis, this unique new science, your creation, which is more important than even Plato's ideas." (40)

Freud had always been highly secretive and had been destroying documents for most of his professional life. In one letter to Martha Freud he wrote: "I have destroyed all my notes and letters accumulated for 14 years, all scientific abstracts and manuscripts of my work; only some family letters have been spared. All my old friendships and relations presented themselves again and silently took the deadly blow... I cannot mature and cannot die, worrying about who will lay their hands on my old papers. The biographers should work it out somehow, we don't want to make it too easy for them." (41)

Ernest Jones made very little use of the Freud-Fliess correspondence in his book, The Life and Work of Sigmund Freud (1953). It was not until the following year that with the permission of Marie Bonaparte and Anna Freud the letters were published as The Origins of Psycho-Analysis: Letters to Wilhelm Fliess, Drafts and Notes, 1887-1902 (1954).

Your kind-heartedness is one of the reasons I love you. initially, it seemed to me that you had broken off contact because of my remarks about the mechanism of the symptoms distant from the nose, and I did not deem this improbable. Now you surprise me with a discussion that takes those ideas seriously!

You are right that I am overflowing with new ideas, theoretical ones as well. My theories on defense have made an important advance of which I shall give you an account next time. Even the psychological construction behaves as if it would come together, which gives me immense pleasure. Reporting on it now would be like sending a six-month fetus of a girl to a ball...

I need a lot of cocaine. Also, I have started smoking again, moderately, in the last two to three weeks, since the nasal conviction has become evident to me. I have not observed any ensuing disadvantage. If you again prohibit it, I must give it up again. But do consider whether you can do this if it is only intolerance and not etiology. I began it again because I constantly missed it (after fourteen months of abstinence) and because I must treat this psychic fellow well or he won't work for me. I demand a great deal of him. The torment, most of the time, is superhuman.

I am working on psychology, vigorously and in solitude; I cannot yet send you anything that is halfway finished, no matter how much I reduce my standards concerning what is finished. I believe more and more firmly in the chemical neurone theory; I started with assumptions similar to those you described, but now I am stuck after I ruined my head with it yesterday.

I feel more certain about consciousness and must now make an attempt to deal with this most difficult of all things in my lectures on hysteria. On Saturday I lectured on dream interpretation to the youths of the Jewish academic reading circle; someday you will hear about what it contained; right now I am in no mood for presentations.

I am as isolated as you would wish me to be. Word was given out to abandon me, for a void is forming all around me. So far I bear it with equanimity. I find it more troublesome that this year for the first time my consulting room is empty, that for weeks on end I see no new faces, cannot begin any new treatments, and that none of the old ones are completed. Things are so difficult and trying that it requires, on the whole, a strong constitution to deal with them.

By one of those dark pathways behind the official consciousness the old man's death (Jacob Freud) has affected me deeply. I valued him highly, understood him very well, and with his peculiar mixture of deep wisdom and fantastic lightheartedness he had a significant effect on my life. By the time he died, his life had long been over, but in my inner self the whole past has been awakened by this event. I now feel quite uprooted.

I must tell you about a nice dream I had the night after the funeral. I was in a place where I read a sign. You are requested to close the eyes.

I immediately recognized the location as the barbershop I visit every day. On the day of the funeral I was kept waiting and therefore arrived a little late at the house of mourning. At that time my family was displeased with me because I had arranged for the funeral to be quiet and simple, which they later agreed was quite justified. They were also somewhat offended by my lateness. The sentence on the sign has a double meaning: one should do one's duty to the dead (an apology as though I had not done it and were in need of leniency), and the actual duty itself. The dream thus stems from the inclination to self-reproach that regularly sets in among the survivors.

My last generalization has held good and seems inclined to grow to an unpredictable extent. Reality-wish fulfillment - it is from these opposites that our mental life springs. But the symptom, set in the midst of life, must be something else besides: it must also be the wish fulfillment of the repressing thought. A symptom arises where the repressed and the repressing thought can come together in the fulfillment of a wish. The symptom is the wish fulfillment of the repressing thought, for example, in the form of a punishment; self-punishment is the final substitute for self-gratification, which comes from masturbation.

This key opens many doors. Do you know, for instance, why X.Y. suffers from hysterical vomiting? Because in fantasy she is pregnant, because she is so insatiable that she cannot bear being deprived of having a baby by her last fantasy lover as well. But she also allows herselt to vomit, because then she will be starved and emaciated, will lose her beauty and no longer be attractive to anyone. Thus the meaning of the symptom is a contradictory pair of wish fulfillments.

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(1) Peter Gay, Freud: A Life for Our Time (1989) page 55

(2) Sigmund Freud, letter to Wilhelm Fliess (24th November, 1887)

(3) Sigmund Freud, Autobiography (1923) page 2

(4) Elisabeth Young-Bruehl, Freud on Women (2002) page 1

(5) Ernest Jones, The Life and Work of Sigmund Freud (1961) page 210

(6) Beverley Clack, Freud on the Couch: A Critical Introduction to the Father of Psychoanalysis (2013) page 38

(7) Sigmund Freud and Josef Breuer, Studies on Hysteria (1895) pages 160-161

(8) Beverley Clack, Freud on the Couch: A Critical Introduction to the Father of Psychoanalysis (2013) pages 39-40

(9) Alfred von Bergner, Neue Freie Presse (2nd December 1895)

(10) Ernest Jones, The Life and Work of Sigmund Freud (1961) page 224

(11) David Stafford-Clark, What Freud Really Said (1965) page 39

(12) Laurence Spurling (editor), Sigmund Freud: Critical Assessments (1989) page 305

(12a) Ernest Jones, The Life and Work of Sigmund Freud (1961) page 251

(13) Stephen Wilson, Sigmund Freud (1997) page 49

(14) Elisabeth Young-Bruehl, Freud on Women (2002) page 50

(15) Sigmund Freud, letter to Wilhelm Fliess (12th December, 1897)

(16) Sigmund Freud, letter to Wilhelm Fliess (16th October, 1895)

(17) Sigmund Freud, letter to Wilhelm Fliess (14th August, 1897)

(18) Sigmund Freud, letter to Wilhelm Fliess (21st September, 1897)

(19) Sigmund Freud, letter to Wilhelm Fliess (15th October, 1897)

(20) Beverley Clack, Freud on the Couch: A Critical Introduction to the Father of Psychoanalysis (2013) page 63

(21) Sigmund Freud, letter to Wilhelm Fliess (25th March 1898)

(22) Sigmund Freud, letter to Wilhelm Fliess (1st August, 1899)

(23) Sigmund Freud, letter to Wilhelm Fliess (1st August, 1899)

(24) Sigmund Freud, letter to Wilhelm Fliess (1st February, 1900)

(25) Sigmund Freud, letter to Wilhelm Fliess (3rd January, 1899)

(26) Sigmund Freud, letter to Wilhelm Fliess (19th February, 1899)

(27) Stephen Wilson, Sigmund Freud (1997) page 50

(28) David Stafford-Clark, What Freud Really Said (1965) page 67

(29) Ernest Jones, The Life and Work of Sigmund Freud (1961) page 299

(30) Ernest Jones, The Life and Work of Sigmund Freud (1961) page 307

(31) Sigmund Freud, letter to Wilhelm Fliess (7th August, 1901)

(32) Laurence Spurling (editor), Sigmund Freud: Critical Assessments (1989) page 311

(33) Sigmund Freud, The Psychopathology of Everyday Life (1904) page 143-144

(34) Wilhelm Fliess, letter to Sigmund Freud (20th July, 1904)

(34) Sigmund Freud, letter to Wilhelm Fliess (27th July, 1904)

(35) Ernest Jones, The Life and Work of Sigmund Freud (1961) pages 272-273

(36) Peter Gay, Freud: A Life for Our Time (1989) page 155

(37) Sigmund Freud, letter to Ida Fliess (17th December, 1928)

(38) Marie Bonaparte, letter to Sigmund Freud (30th December, 1936)

(39) Sigmund Freud, letter to Marie Bonaparte (3rd January, 1937)

(40) Marie Bonaparte, letter to Sigmund Freud (7th January, 1937)

(41) Sigmund Freud, letter to Martha Freud (28th April, 1885)

Freud’s Friend, Fliess BY John Riddington Young

Wilhelm Fliess, a Berlin rhinologist, was for many years Sigmund Freud’s closest friend and confidant. He was born in Poland in 1858. In 1887, he visited Vienna for postgraduate studies, and met the famous psychoanalyst, Freud [1]. They were immediate friends perhaps because of their common belief in the importance of sex in the cause of disease. Freud believed sexual repression gave rise to mental illness and Fliess had a similar idea about nasal pathology.

Fliess’s book The Flow of Life [2] had three basic theories: firstly, that the nose and sexual function are inextricable secondly, that all animal life (including humans) are bisexual and thirdly, that animals all have innate periodicity. He postulated a male 23-day ‘menstrual’ cycle, and just as the female 28-day cycle is controlled by the ovaries, he centred the male period specifically on the nasal turbinate.

Both Freud and Fliess agreed that much disease is caused by masturbation, coitus interruptus and the use of condoms, all of which prevent natural energy from leaving the body normally.

Freud asked Fliess to undertake nasal surgery on some of his psychological patients. Fliess had three important nasal treatments for this type of case. Minor problems could be dealt with by the simple expedient of painting the inferior turbinate with cocaine paste. Intermediate cases were treated by cauterisation and serious masturbators were subjected to turbinectomy [3].

Freud himself was a well-known hypochondriac and in early February 1895, he travelled from Vienna to Berlin to undergo nasal cautery by Fliess. He felt so much better, particularly with respect to his angina that he decided to send a female patient to the German capital for Fliess’s opinion.

Her exact complaints are not clearly recorded, although it has been suggested that she suffered from menstrual problems. In Freud’s copy of Fliess’ book, The Causal Connection between the Nose and the Sexual Organs, [4] there is a marked passage that reads, “Women who masturbate are generally dysmenorrhoeal. They can finally be cured by an operation on the nose, if they truly give up this bad practice.” Fliess examined her nose, spotted a suspicious area on her right inferior turbinate, performed a turbinectomy and sent Emma back to Vienna by train. Things then went disastrously wrong and she very nearly died.

Two weeks later, she developed osteomyelitis of the maxilla (swelling, foetid odour and bleeding). Freud’s Austrian pal took her to theatre, where he removed a stinking ribbon gauze pack and staunched a torrential haemorrhage. Poor Freud fainted and had to be revived with cognac. Emma was more stoical and made a jibe about the weaker sex. She survived after a long and stormy postoperative period during which ligation of the carotid was considered but had a hideous facial deformity over the right cheek. Amazingly a year later, Freud wrote to Fliess that he thought that, she bled out of longing (- for him!) [5].

This eccentric rhinologist however, is thought to have exerted a profound influence on Freud’s conception of human development, which is often undervalued [6].

1. Ferris, P. Dr Freud, A Life. London, UK Sinclair Stevenson 1997.
2. Fliess, W. Der Ablauf Des Lebens: Grundlegung Zur Exackten Biologie 2nd Edition. Leipzig and Vienna: Deuticke 1923.
3. Young, J R. Freud’s Friend, Fliess. Historia Otorhinolaryngolica 20162:107-121.
4. Fliess, W. Die Beziehungen zwischen Nase und weiblichen Geschlechtsorganen: In ihrer biologischen Bedeutung dargestelt. Leibzig and Vienna: Deuticke 1897.
5. Moussaieff, J. The Complete Letters of Sigmund Freud to Wilhelm Fliess 1887 to 1902. Belknap Press of Harvard University Press 1985:505.
6. Young, A R. Freud’s Friend, Fliess. Presentation at 7th Meeting of the British Society History of ENT 29th September, 2000. The Journal of Laryngology & Otology 2002116(12): 992-5.

Dr. Hermann Swoboda, Psychologist

. Everyone experiences days when everything he does seems to be right and, on the other hand, days when nothing he does seems to make any sense. This state of affairs is not new man has long puzzled over the range of his own actions and feelings. Even Hippocrates, the traditional physician's physician, advised his students and associates some 2,400 years ago to observe the "good" and "bad" days among the healthy and the ill, and to take these fluctuations into consideration in the treatment of patients.

Although man understood that he acted, felt, and thought differently at different times, for centuries a fundamental question went unanswered, even unasked. At the end of the nineteenth century, Dr. Hermann Swoboda, professor of psychology at the University of Vienna, was prompted by his research findings to wonder whether there might not be some regularity or rhythm to these fundamental changes in man's disposition. Swoboda apparently was impressed by John S. Beard's report of 1897 on the span of gestation and the cycle of birth, and by the publication of a scientific paper on bisexuality in man by Wilhelm Fliess. . Swoboda, in his first report, presented at the University ] of Vienna at the turn of the century, noted:

One does not need to have lived a long span of life before one comes to realize that life is subject to Consistent Changes. This realization is not a reflection on the changes in our fate or the changes which take place during various stages of life. Even if someone could live a life completely devoid of outside influences, a life during which Nothing whatever disturbs the mental or physical aspect, life would nevertheless not be the same day after day. The best of health does not prevent man from feeling unwell at times, or less cheerful than he is normally.

During his initial research between 1897 and 1902, Swoboda recorded the recurrence of pain and the swelling of tissues such as is experienced in insect bites. He discovered a periodicity in fevers, in the outbreak of an illness, and in heart attacks, a phenomenon Fliess had reported in a medical review, which led to the discovery of certain basic rhythms in man one a 23-day cycle and the other a 28-day cycle.

However, Swoboda, as a psychologist, was mainly interested in finding out whether man's feelings and actions were influenced by rhythmical fluctuations and whether these rhythms Could be precalculated. The results of his persistent research Can be summed up in his own words:

We will no longer ask why man acts one way or another, because we have learned to recognize that his action is influenced by periodic changes and that man's reaction to an impression can be foreseen, or predicted, to use a stronger term. Such a psychoanalysis could be called bionomy because, as in chemistry where the researcher Can anticipate the outcome of a formula, through bionomy the psychologist can anticipate, or predict, so to speak, the periodic changes in man.

Swoboda was an analytical thinker and a systematic recorder. His painstaking research in psychology and periodicity produced convincing evidence of rhythms in life. He showed a deep interest in the study of dreams and their origin, and noted that melodies and ideas would often repeat in one's mind after periodic intervals, generally based on a 23-day or a 28-day rhythm. In searching for the origin of these rhythms, Swoboda carefully noted the birth of infants among his patients and found that young mothers would often have anxious hours about the health of their babies during periodic days after birth. He reasoned that this phenomenon, which was often accompanied by the infant's refusal to take nourishment, was a sign of rhythmical development on these days the tempo of digestion and absorption was apparently slower. He advised the mothers not to worry, since these periodic crises could be considered part of natural development and growth. Similar rhythmical turning points were reported in asthma attacks.

Swoboda's first book was Die Perioden des Menschlichen Lebens (The Periodicity in Man's Life). This book was followed by his Studien zur Grundlegung der Psychologie (Studies of the Basis of Psychology). In order to facilitate his research and also to encourage other scientists and medical doctors in the recording of the mathematical rhythms, Swoboda designed a slide rule with which it was fairly simple to find the "critical" days in the life of any person whose birth date was known. The instruction booklet was entitled Die Kritischen Tage des Menschen (The Critical Days of Man).

His most profound work was a 576-page volume entitled Das Siebenjahr (The Year of Seven), which contains the 23-day and 28-day mathematical analysis of the rhythmical repetition of births through generations. With documentation covering hundreds of family trees, he endeavored to verify that most major events in life, such as birth, the onset of an illness, heart attacks, and death, fall on periodic days and involve family relationships.


Abraham, Karl. (1991). Six lettres in é dites à W. Fliess. A. Buffel, E. Porge. Littoral, 31-32, 247-257.

Fliess, Wilhelm. (1977). Les Relations entre le nez et les organes g é nitaux f é minins pr é sent é es selon leurs significations biologiques (P. Ach and J. Guir, Trans.). Paris: Le Seuil. (Original work published 1897)

Freud, Sigmund. (1985c). The complete letters of Sigmund Freud to Wilhelm Fliess 1887-1904. (J. M. Masson, Trans.). Cambridge, MA: Belknap/Harvard University Press.

Sulloway, Franck. (1979). Freud: The biologist of the mind. New York: Basic Books.

Freud's 'lost' dream and the schism with Wilhelm Fliess

Although there was only one specimen dream in the first draft of 'The Interpretation of Dreams' that Freud would describe as fully analysed, he removed his dream from the text on the insistence of his friend, Wilhelm Fliess. The content of this 'lost dream' has been one of the great mysteries in psychoanalytic history. In this paper the author, working from clues in Freud's letters to Fliess and elsewhere, demonstrates that Freud's submission to Fliess caused him great anguish. The author contends that rather than discarding the lost dream as it has been assumed he did, Freud dismembered, disguised and resurrected it, along with the entire dream analysis, in the essay 'Screen memories'. A reconstruction of the lost dream and Freud's analysis as it appeared in the first draft of 'The Interpretation of Dreams', is attempted. The fate of the lost dream was the catalysing element in the dissolution of Freud's relationship with Fliess, it is maintained. Along with the transferential aspects of his relationship with Fliess, Freud's personal circumstances and the realities of the historical moment in Vienna are considered as contributing to his state of mind at the time.

Availability of references in the Footnotes:

P216 Footnote 1 : Freud’s attention had for months past been directed to the study of infantile phantasy he had studied the dynamic function of phantasy and gained lasting insights into this field. See pp. 204 and 207 and Letter 62 sqq : See Letter to Wilhelm Fliess of 16th May 1897 : known as Letter 62 : Sigmund Freud or here

P216 Footnote 2 : Quote, Thirdly, there was the definite realization that there is no “indication of reality” in the unconscious. – See “Project,” p. 429 : See The Project for a Scientific Psychology: 23rd & 25th September & 5th October 1895: Sigmund Freud or here : Quote from p428 to 429 of James Strachey’s translation : There is no doubt a second biological rule, derived by abstraction from the process of expectation, to the effect that one must direct one’s attention to indications of quality (because they belong to perceptions that may lead to satisfaction)and then allow oneself to be led from the indication of quality to the perception which has emerged. In short, the mechanism of attention must owe its origin to a biological rule of this kind, which will regulate the displacement of ego-cathexes. [Footnote 1 : See the continuation of this line of thought in Freud (1911b) (Freud, Sigmund. (1911b). Formulations on the two principles of mental functioning. SE, 12: 213-226.) where attention is assigned the task of “periodically searching the external world, in order that its data may be already familiar if an urgent internal need should arise”. ]

Here it may be objected that a mechanism like this, operating by the help of indications of quality, is redundant. The ego, it will be said, might have learnt biologically to cathect the perceptual sphere in states of expectation on its own account, instead of only being led to this cathexis through the agency of indications of quality. There are, however, two points to be made in justification of the mechanism of attention. (l) The sphere of the indications of discharge from the system W (ω) is clearly a smaller one, comprises fewer neurones, than the sphere of perception-that is, of the whole pallium of ψ which is connected with the sense organs. Consequently the ego saves an extraordinarily large expenditure if it cathects the discharge instead of the perception. (2) The indications of discharge or the indications of quality are also primarily indications of reality, and are intended to serve the purpose of distinguishing the cathexes of real perceptions from the cathexes of wishes. Thus we see that we cannot do without the mechanism of attention. But it consists in every case of the ego cathecting those neurones in which a cathexis has already appeared.

The biological rule of attention, in so far as it concerns the ego, runs as follows : If an indication of reality appears, the perceptual cathexis which is simultaneously present must be hypercathected.

This is the second biological rule. The first one is that of primary defence.

p216 Footnote 3 : (This leaves open the possible explanation that sexual phantasy regularly makes use of the theme of the parents. ) [3] The next step from this was insight into the Oedipus complex.

P217 : Footnote 1 : See Ernst Kris’s Introduction p29 : 1954 : in The Origins of Psychoanalysis op. cit. and following :

Quote p29-30 : During the last few months of 1896 and the first half of 1897 Freud studied the luxuriant growth of his patients’ phantasy life not only their day-dreams, but more particularly the infantile phantasies which invariably manifest themselves in the thoughts, dreams and behaviour of adult neurotics under the conditions of psycho-analytic treatment. From these he slowly gained the first hesitant insights into the nature of infantile sexual organization, at first into what was later to be called the anal phase. Later observation was to pie on observation in what was perhaps Freud’s boldest undertaking. His observations of adult neurotics enabled him to reconstruct some of the normal stages in the child’s growth towards maturity in the half-century since Freud first discovered them the stages of development of the libido have been the subject of detailed research and systematic observation which have invariably confirmed them afresh.

In the spring of 1897, in spite of accumulating insight into the nature of infantile wish-phantasies, Freud could not make up his mind to take the decisive step demanded by his observations and abandon the idea of the traumatic role of seduction in favour of insight into the normal and necessary conditions of childish development and childish phantasy life. He reports his new impressions in his letters, but does not mention the conflict between them and the seduction hypothesis until one day, in his letter of September 21 st 1897 (Letter 69 – See Letter to Wilhelm Fliess of 21st September 1897 : known as Letter 69 : Sigmund Freud or here), he describes how he realized his error. The description of how this came about, and the consequences of the abandonment of the seduction hypothesis, tallies with that given in his published works.

“When this aetiology broke down under its own improbability and under contradiction in definitely ascertainable circumstances, the result at first was helpless bewilderment”, he states in ‘On the History of the Psycho-Analytic Movement’. “Analysis had led by the right paths back to these sexual traumas, and yet they were not true. Reality was lost from under one’s feet. At that time I would gladly have given up the whole thing. Perhaps I persevered only because I had no choice and could not then begin again at anything else.”

Nearly thirty years later, in his ‘Autobiographical Study’, Freud pointed to what seems another psychologically important explanation of his mistake. “I had in fact stumbled for the first time upon the Oedipus complex”, he wrote. We see from the letters that insight into the structure of the Oedipus complex, and thus into the central problem of psycho-analysis, was made possible by Freud’s self-analysis, which he started in the summer of 1897 during his stay at Aussee. (This is stated in Letter 75 – See Letter from Sigmund Freud to Wilhelm Fliess of 14th November 1897 : known as Letter 75 or here and contradicted in Letter 65)

P217, Footnote 1 continued : Quote : In a footnote dated 1924 to the section on “the specific aetiology of hysteria” in “Further Remarks on the Neuro-Psychoses of Defence” (1896b) Freud states : This section was written while I ws under the ascendancy of an error which I have since then repeatedly acknowledged and corrected. I had not yet found out how to distinguish between patients’ phantasies about their own childhood and real memories. I consequently ascribed to the aetiological factor of seduction an importance and general validity which it does not possess. When this error was overcome, the door was opened to an insight into the spontaneous manifestations of infantile sexuality which I described in my ‘Three Essays on the Theory of sexuality’ (1905d).Nevertheless, there is no need to reject the whole of what appears in the text above seduction still retains a certain aetiological importance, and I still consider that some of the psychological views expressed in this section meet the case.

A Biographical Interlude - Wilhelm Fliess (1858-1928)

Wilhelm Fliess (October 24, 1858 – October 13, 1928) was a German otolaryngologist, or in simpler terms an Ear, Nose and Throat surgeon or an ENT specialist who practised in Berlin. On Josef Breuer's suggestion, he sought Freud out to share his theories with him.  To us today, these theories seem wild and outlandish - perhaps even in those Victorian times they appeared somewhat so also. Fliess attended lectures given by Freud in Vienna.  He was about the same age as his mentor and came from a similar background.  Like Freud, he had a wide range of intellectual interests and, as Stephen Wilson points out "both men were uninhibited by convention." (Wilson and Zarate, Introducing The Freud Wars, Icon Books, 2002, 16).   Being both intellectuals and scholars, they became firm friends.  Indeed, for a period of ten years - between August 1890 and September 1900 -  they corresponded regularly.  They also met frequently for dialogue and discussion over weekends.  These extended dialogues, they called rather cryptically "congresses".  Fliesswas to become in Freud's opinion the "Kepler of biology" and any praise from his protégé he was to soak up as veritable "nectar and ambrosia."  Freud was then working on his general theory of psychology based on the notion of instinctual drive and its expression in psychic energy - to this he was to give the name Libido, from the Latin for "lust" or "desire."  Fliess was highly eccentric and was prone to let his speculation lead him into much wilder and stranger ideas that even Freudhad the luxury to propose.  However, Freud subscribed to many of Fliess's thoughts and proposals.  Fliess was before his time in proposing the idea of "bio-rhythms" which he thought were somehow determined by special numbers in a quasi-mystical way (shades of the ancient belief in numerology here.)

Then, he made what may be termed a very strange contention indeed, namely that the mucous membranes in the nose were connected in some way to the functioning of the genitals - this Fliess called reflex nasal neurosis.  How Freud went along with this strange idea is mystifying to say the least, but he did subscribe to it, and sent patients to Fliess for nose operations in this regard.  Indeed, he even had Fliess operate twice on his own nose. Wilson refers to Fliess'sidea as "The Genital Nose" and I have read elsewhere that his theory was described also as "The Sexual Nose." (See Wilson and Zarate, opus citatum supra, 18-23)  It is at this stage that the case of Emma Eckstein, to which I referred in the last post, comes in.  Eckstein was a young woman of 27 years who, among other complains, suffered from stomach ailments and menstrual problems.  As the Freud critic Jeffrey Masson says in his 1994 book, The Assault on Truth , these complaints would undoubtedly have been attributed by both Freud and Fliess to masturbation.   Here is what the WIKI states:

Emma Eckstein (1865-1924) had a particularly disastrous experience when Freud referred the then 27-year old patient to Fliess for surgery to remove the turbinate bone from her nose, ostensibly to cure her of premenstrual depression. Eckstein haemorrhaged profusely in the weeks following the procedure, almost to the point of death as infection set in. Freud consulted with another surgeon, who removed a piece of surgical gauze that Fliess had left behind. Eckstein was left permanently disfigured, with the left side of her face caved in. Despite this, she remained on very good terms with Freud for many years, becoming a psychoanalyst herself.  (I have left in the WIKI links.  See this link for the actual quotation Fliess )

Freud went on to ascribe total blame to the patient with respect to this bleeding or haemorrhaging by insisting that her post-operative condition was attributable to hysteria.   I shall quote a little from Freud's letter to Fliess in an effort to deflect blame from the latter:

Dearest Wilhelm,

Just received your letter and am able to answer it immediately. Fortunately I am finally seeing my way clear and am reassured about Miss Eckstein and can give you a report which will probably upset you as much as it did me, but I hope you will get over it as quickly as I did.

I wrote you that the swelling and the haemorrhages would not stop, and that suddenly a fetid odour set in, and that there was an obstacle upon irrigation. (Or is the latter new [to you]?) I arranged for Gersuny to be called in he inserted a drainage tube, hoping that things would work out once discharge was reestablished but otherwise he was rather reserved. Two days later I was awakened in the morning--profuse bleeding had started again, pain, and so on. Gersuny replied on the phone that he was unavailable till evening so I asked Rosanes to meet me. He did so at noon. There still was moderate bleeding from the nose and mouth the fetid odour was very bad. Rosanes cleaned the area surrounding the opening, removed some sticky blood clots, and suddenly pulled at something like a thread, kept on pulling. Before either of us had time to think, at least half a meter of gauze had been removed from the cavity. The next moment came a flood of blood. The patient turned white, her eyes bulged, and she had no pulse. Immediately thereafter, however, he again packed the cavity with fresh iodoform gauze and the haemorrhage stopped. It lasted about half a minute, but this was enough to make the poor creature, whom by then we had lying flat, unrecognisable. In the meantime--that is, afterward--something else happened. At the moment the foreign body came out and everything became clear to me--and I immediately afterward was confronted by the sight of the patient--I felt sick. After she had been packed, I fled to the next room, drank a bottle of water, and felt miserable. The brave Frau Doctor then brought me a small glass of cognac and I became myself again.

Now that I have thought it through, nothing remains but heartfelt compassion for my child of sorrows. I really should not have tormented you here, but I had every reason to entrust you with such a matter and more. You did it as well as one can do it. The tearing off of the iodoform gauze remains one of those accidents that happen to the most fortunate and circumspect of surgeons, as you know from the business with your little sister-in-law's broken adenotome and the anaesthesia. Gersuny said that he had had a similar experience and therefore he is using iodoform wicks instead of gauze (you will remember your own case). Of course, no one is blaming you, nor would I know why they should. And I only hope that you will arrive as quickly as I did at feeling sympathy and rest assured that it was not necessary for me to reaffirm my trust in you once again. I only want to add that for a day I shied away from letting you know about it then I began to feel ashamed, and here is the letter.  (My italicisation and bolding) See this link for Freud's letter: Eckstein Letter.

Wilson tells us that Freud's infatuation with Fliess finally came to an end in the summer of 1900, when they met for a holiday in the Austrian Tyrol by a lake called Achensee.  According to Fliess, Freud took exception when he remarked that periodic biological processes were at work in the psyche "and consequently neither sudden improvements nor sudden deteriorations in a person's mental state can be attributed to analysis alone." (Wilson, op.cit., 24) In 1906, in a published account of the quarrel between the two doctors Fliess maintained that Freud had shown "a violence towards me which was at first unintelligible to me." (ibid., 24)

Some years later Freudordered that his correspondence with Fliessbe destroyed. It is only known today because Marie Bonaparte bought their letters and refused to permit their destruction.

Above I have uploaded a caricatured photograph of Fliess. The image says it all.

[Who heals, is right!--A forgotten genius? In memory of Wilhelm Fliess on the occasion of his 150th birthday and 80th anniversary of death]

Introduction: Interdisciplinary contacts between otorhinolaryngology and gynecology are rare. We commemorate a special example of such dialogue in remembrance of the rhinolaryngologist Wilhelm Fliess on the occasion of his 150 (th) birthday and 80 (th) anniversary of death in October 2008.

Curriculum vitae and merits: Born in Arnswalde (Western Pomerania, today Poland) in 1858, after secondary school medical studies at Friedrich-Wilhelm-University in Berlin (Germany), graduated with Doctor of Medicine degree, in 1883 start of his own medical practice as a general practitioner in Berlin, in 1887 specialization as rhinolaryngologist. Close friendship with Sigmund Freud, considered as "midwife of psychoanalysis" and originator of biorhythm concepts. Main scientific research: nasogenital reflex theory, vital periodicity and idea of innate bisexuality.

Nasogenital reflex theory: The basis was Fliess' hypothesis of "nasal reflex neurosis", a "shifting of conflicts" from the genitals to the nose. He defined endonasal "genital spots" at the anterior ends of the inferior turbinates and at the tubercula septi, which were treated by cocainization, chemical etching or cauterization to eliminate dysmenorrhea, other abdominal pain and sexual disorders.

Discussion: The presented rise and fall of Fliess' therapeutic nasogenital concept demonstrates that even in established theories which have been confirmed by thousand-fold successful treatment results a critical examination should be consistently performed to question the nature of our "clinical success".


Fliess developed several idiosyncratic theories, such as "vital periodicity", forerunner of the popular concepts of biorhythms. His work never found scientific favor, but some of his thinking, such as the idea of innate bisexuality, was incorporated into Freud's theories. Fliess believed men and women went through mathematically-fixed sexual cycles of 23 and 28 days, respectively. Ώ]

Another of Fliess's ideas was the theory of "nasal reflex neurosis". This became widely known following the publication of his controversial book Neue Beitrage und Therapie der nasaelen Reflexneurose in Vienna in 1892. The theory postulated a connection between the nose and the genitals and related this to a variety of neurological and psychological symptoms Fliess devised a surgical operation intended to sever that link.

On Josef Breuer's suggestion, Fliess attended several conferences with Sigmund Freud beginning in 1887 in Vienna, and the two soon formed a strong friendship. Through their extensive correspondence and the series of personal meetings, Fliess came to play an important part in the development of psychoanalysis.

Freud, who described Fliess as "the Kepler of biology", repeatedly allowed Fliess to operate on his nose and sinuses to cure his neurosis and also experimented with anaesthetization of the nasal mucosa with cocaine. Together, Fliess and Freud developed a Project for a Scientific Psychology, which was later abandoned. Fliess wrote about his biorythmic theories in Der Ablauf des Lebens. ΐ]

Emma Eckstein (1865–1924) had a particularly disastrous experience when Freud referred the then 27-year-old patient to Fliess for surgery to remove the turbinate bone from her nose, ostensibly to cure her of premenstrual depression. Eckstein haemorrhaged profusely in the weeks following the procedure, almost to the point of death as infection set in. Freud consulted with another surgeon, who removed a piece of surgical gauze that Fliess had left behind. Α] Eckstein was left permanently disfigured, with the left side of her face caved in. Despite this, she remained on very good terms with Freud for many years, becoming a psychoanalyst herself.

Fliess also remained close friends with Freud. He even predicted Freud's death would be around the age of 51, through one of his complicated bio-numerological theories ("critical period calculations"). Their friendship, however, did not last to see that prediction out: in 1904 their friendship disintegrated due to Fliess's belief that Freud had given details of a periodicity theory Fliess was developing to a plagiarist. Freud died at 83 years of age.

Freud ordered that his correspondence with Fliess be destroyed. It is only known today because Marie Bonaparte purchased Freud's letters to Fliess and refused to permit their destruction.


  • Wilhelm Fließ: Die Beziehungen zwischen Nase und weiblichen Geschlechtsorganen (In ihrer biologischen Bedeutung dargestellt), VDM Verlag Dr. Müller, Saarbrücken 2007. (In German.)
  • Sigmund Freud: Briefe an Wilhelm Fließ 1887–1904. S. Fischer Verlag, 2. Auflage (incl. Errata und Addenda) 1999.
  • With Sigmund Freud: The Complete Letters of Sigmund Freud to Wilhelm Fliess, 1887–1904, Publisher: Belknap Press, 1986, ISBN 0-674-15421-5
  • Ernest Jones:
    • — (1953). Sigmund Freud: Life and Work. Vol 1: The Young Freud 1856–1900.
    • — (1955). Sigmund Freud: Life and Work. Vol 2: The Years of Maturity 1901–1919.
    • — (1957). Sigmund Freud: Life and Work. Vol 3: The Last Phase 1919–1939. London: Hogarth Press.
    • Psychoanalytic Series, Volume 1: Erogeneity and Libido : Addenda to the Theory of the Psychosexual Development of the Human.
    • Psychoanalytic Series, Volume 2: Ego and Body Ego: Contributions to Their Psychoanalytic Psychology
    • Psychoanalytic Series, Volume 3: Symbol, Dream and Psychosis.


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