You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Budapest, December 7, 1912
VII., Erzsébet-körút 54
Dear Professor,
My long silence was due to illness; I didn't want to disturb you with it. Now I am much better again, so I want to report to you in detail about it, at least after the fact. The case history has gone through many developments and complications; in retrospect it can now be presented as follows:
The local symptoms (infection of the Cowper's glands and infiltration of the regional lymph glands (especially in the right inguinal and retroperitoneal))1 made me and also a specialist think it was syphilis. Thereupon deep depression, several sleepless nights with heart palpitations (tachycardia), weight loss, muscle weakness. The syphilis anxiety later proved to be groundless, but the aftereffects remained. A few days of bed rest brought improvement; but then a new symptom appeared: every time I fell asleep, my breathing became shallow, my pulse got bad, and after three to four hours' sleep I awoke (without anxiety) with a strange breathing, reminiscent of Cheyne-Stokes,2 which lasted for a time beyond my waking state. My first thought was nephritis. Repeated examinations proved, however, that I am only suffering from orthostatic albuminuria. Then new symptoms were added: hoarseness and general muscle weakness, which could be interpreted as a kind of “myasthenia.”3 Finally, a few days ago I was able to determine that I am breathing badly while lying and sleeping because my breathing through the nose is insufficient. It has already been that way for a long time, but it manifested itself now because of the partly psychically determined muscle weakness and weight loss. The nose specialist—Zwillinger!4 —in fact diagnosed a relative stenosis5 of both nasal meati and applied cocaine and menthol, whereupon breathing became easier and I had my first good night after weeks of sleeplessness. The rhinologist advised an operation (removal of a part of the nasal septum).
That's the way things now stand. The period of serious d