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For a writer such as is Isbister, it may well stretch his "… credulity to believe that this incident [the Emma episode] did not spring to mind when Freud was presenting his associations [to the Irma dream]." However, working with resistance and the dynamic unconscious produces daily examples of what does not come to mind in free association or dream association. Emma Eckstein's operation and complications were behind Freud and well defended when he had the specimen dream. Thus, it is not surprising that Emma did not enter Freud's associations.
Only Schur argued that the Emma episode was day residue. In support of his idiosyncratic view, Schur cited Fisher's 1954 paper. Apparently, Cohen has joined Schur in either not reading or not understanding Fisher's work.
My argument is that the Emma episode represented an acting out of infantile conflict on the part of Freud and that Freud's (1914) words apply: "… the patient does not remember anything of what he has forgotten and repressed, but acts it out. He reproduces it not as a memory but as an action; he repeats it, without, of course, knowing that he is repeating it" (S.E., 12, p. 150). Only after beginning self-analysis in 1897, did Freud understand the Emma episode and the nature of his relationship with Fliess.
Freud's letters to Fliess during Emma's recovery (March-April, 1895) sought to reassure Fliess about leaving gauze in the wound. Leaving aside the many inconsistencies in Schur's 1966, 1969 and 1972 works, the quotations he used in support of his thesis of exculpation do begin on April 26, 1896, while Freud was blaming Emma for her bleeding rather than Fliess (and himself). These