I must hurriedly write to you about something that greatly astonishes me; otherwise I would be truly ungrateful. In the last few days I have felt quite unbelievably well, as though everything had been erased – a feeling which in spite of better times I have not known for ten months. Last time I wrote you, after a good period which immediately succeeded the reaction, that a few viciously bad days had followed during which a cocainization of the left nostril had helped me to an amazing extent. I now continue my report. The next day I kept the nose under cocaine, which one should not really do; that is, I repeatedly painted it to prevent the renewed occurrence of swelling; during this time I discharged what in my experience is a copious amount of thick pus; and since then I have felt wonderful, as though there never had been anything wrong at all. Arrhythmia is still present, but rarely and not badly; the sensitivity to external pressure is slight, the sensations being between 0 and -0. I am postponing the full expression of my gratitude and the discussion of what share the operation had in this unprecedented improvement until we see what happens next.
On the last day you were here, I suddenly discharged several scabs from the right side, the one not operated on. As early as the next day there appeared thick, old pus in large clots, at first on the right side only and soon thereafter also on the left. Since then the nose has again been flooded; only today has the purulent secretion become somewhat less dense. Light but regular symptoms: in the morning a stuffed nose, vile head, not better until large amounts have been discharged; in the interval occasionally migraine; everything by the way, not very severe. During the first of these days, I noticed with pride that I can climb stairs without dyspnea; for the last three days pain in the heart region, atactic pulse, and beautiful insufficiency.
Though not designed to make one feel at ease, this information affords some pleasure because it emphasizes once again that the condition of the heart depends upon the condition of the nose. I cannot regard the latter as a new infection; I have the impression that I really still have, as you surmised, a focal pus accumulation (right sphenoid bone), which now happens to feel inclined to produce eruptions like a private Etna, as it were.
It is a shame that both of us suffer from so much illness when we have so much ahead of us.
Yesterday Mrs. K again sent for me because of cramplike pains in her chest; generally it has been because of headaches. In her case I have invented a strange therapy of my own: I search for sensitive areas, press on them and thus provoke fits of shaking which free her. Formerly, these areas were supraorbital and ethmoid; now they are (for the breast cramps) two areas on the left chest wall, wholly identical with mine. When I press on a point in her axillar, she says she feels it along the entire arm into her fingers. She does not have these pains spontaneously, as I do.
My confession of how bad I am feeling also interfered with my mailing of the letter. Now I can report to you that since the day before yesterday I suddenly feel very good again – about the level I was on while you were here. The suppuration stopped a few days ago.
Poor Eckstein is doing less well. This was the second reason for my postponement. Ten days after the second operation, after a normal course, she suddenly had pain and swelling again, of unknown origin. The following day, a hemorrhage; she was quickly packed. At noon, when they lifted the packing to examine her, renewed hemorrhage, so that she almost died.
With regard to my own ailment, I would like you to continue to be right – that the nose may have a large share in it and the heart a small one. Only a very strict judge will take it amiss that in view of the pulse and the insufficiency I frequently believe the opposite.
Today I can write because I have more hope; I pulled myself out of a miserable attack with a cocaine application. I cannot guarantee that I shall not come for a day or two for a cauterization or galvanization, but at the moment that too is not possible.
Something strange but not unpleasant has happened to me. I put a noticeable end to the last horrible attack with cocaine, since then things have been fine and a great amount of pus is coming out. Evidently I still have an empyema of the sphenoidal bone on the left, which naturally makes me very happy. She [Emma E.] too, my tormentor and yours, now appears to be doing well.
Since the last cocainization three circumstances have continued to coincide: (1) I feel well; (2) I am discharging ample amounts of pus; (3) I am feeling very well.
Now, to my ideas about the nose. I discharged exceedingly ample amounts of pus and all the while felt splendid; now the secretion has nearly dried up and I am still feeling very well. I propose the following to you: it is neither the congestion nor the flow of pus that determines the distant symptoms.
Your kindheartedness is one of the reasons I love you.
I am feeling I to IIa. I need a lot of cocaine.
We can share quarters, live and take walks together, insofar as our noses permit it.
By this time news from you had become a necessity for me because I had already drawn the conclusion, in which I am rarely wrong, that your silence meant headaches. I began to feel more comfortable again when – after a long time – I once more held a piece of your scientific material in my hands. So far I have merely glanced at it and fear that respect for so much honest and subtle material will put my theoretical fantasies to shame.
I am putting together all sorts of things for you today – several debts, which remind me that I also owe you thanks, your case history of labor pains, and two notebooks of mine. Your notes reinforced my first impression that it would be desirable to make them into a full-fledged pamphlet on “The Nose and Female Sexuality.”
Crazy, isn’t it, my correspondence! For two weeks I was in the throes of writing fever, believed that I had found the secret, now I know that I still haven’t, and have again dropped the whole business.
Everything fine except the three-day migraine. Aside from that regret, this letter is devoted to science.
I was of course terribly pleased with your opinion about the hysteria-obsessional neurosis solution. Now listen to this. During an industrious night last week, when I was suffering from that degree of pain which brings about the optimal condition for my mental activities, the barriers suddenly lifted, the veils dropped, and every thing became transparent – from the details of the neuroses to the determinants of consciousness. Everything seemed to fall into place, the cogs meshed, I had the impression that the thing now really was a machine that shortly would function on its own. The three systems of n; the free and bound states of Qn; the primary and secondary processes; the main tendency and the compromise tendency of the nervous system; the two biological rules of attention and defense; the characteristics of quality, reality, and thought; the state of the psychosexual group; the sexual determination of repression; finally, the factors determining consciousness, as a function of perception – all that was correct and still is today! Naturally, I can scarcely manage to contain my delight.
Although I am dead tired, I feel obliged to write to you before the month is over. First, to your latest scientific reports which I also welcome as a measure of your headaches.
First impression: amazement that there exists someone who is an even greater fantasist than I am and that he should be none other than my friend Wilhelm. Conclusion: I intend to return the pages to you so they will not get lost. Meanwhile, I found the matter quite plausible and said to myself that only an expert in all fields like you could have come up with it. I was singularly impressed with the sharp glance over all the roofs. I guess I was born to be your claque.
I feel really amazingly well, as I have not since the beginning of the whole business. Moreover, I no longer have any pus, just a lot of mucous secretion. I have, by the way, never doubted the success of your minor surgical interventions, and thus have earned my well-being.