Letter from Freud to Fliess, February 4, 1888

Vienna, February 4, 1888

Esteemed friend and colleague:

Would you kindly predate the receipt of this letter; I should have written it long ago, but did not get to it what with work, fatigue, and playing with my daughter. First, I should give you some news about Mrs. A., whose sister is with you at present. The case turned out to be quite simple, an ordinary cerebral neurasthenia, which the sages call chronic cranial hyperemia. This was becoming clearer and clearer, and there was steady improvement with galvanization and demi-bain [hydrotherapy] treatment; I thought I could cure her completely with muscular exercises — but then something unexpected happened: she missed her period, became worse soon thereafter; at the time of her next period she missed treatment. Her condition, though presently not very good, allows a great deal of hope. For my part I would have liked to continue the treatment, but do not feel sufficiently certain of its success to take a stand in the face of the anxiety of the woman and her entire family, and against Chrobak's1 opinion; so I have associated myself with the prophesy that all will be well by the fourth month quite on its own and I am keeping secret my strong doubts about this. Have you had any experience with the influence of pregnancy on such neurasthenias?

It may be that I am in part responsible for this new citizen. I once spoke very strongly and not unintentionally in the patient's presence about the harmfulness of coitus reservatus. Perhaps I am mistaken in the matter.

Of other things, esteemed friend, there is not much. My little Mathilde is thriving and gives us much pleasure and fun. My practice, which, as you know, is not very considerable, has recently increased somewhat by virtue of Charcot's2 name. The carriage is expensive, and visiting and talking people into or out of things — which is what my occupation consists in — robs me of the best time