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Vienna, April 19, 1894
Dearest friend,
Your kind letter puts an end to my reserve and my wish to spare you. I feel justified in writing to you about my state of health. The scientific and personal news will then follow at the end.
Since everyone needs the suggestive influence of someone else in order to obtain a respite from his own criticism, I have in fact not had anything warm between my lips since then (today it has been three weeks); and today I can already watch others smoke without envying them and even again imagine life and work without this support. It has not been long since I reached this point; moreover, the misery of abstinence has been far greater than I ever imagined — but that, of course, is obvious.
Less obvious, perhaps, is the state of my health in other respects. Soon after the withdrawal, there were some tolerable days and I began to write down the state of the neurosis problem for you; then suddenly there came a severe cardiac misery, greater than I ever had while smoking. The most violent arrhythmia, constant tension, pressure, burning in the heart region; shooting pains down my left arm; some dyspnea, all of it essentially in attacks extending continuously over two-thirds of the day; the dyspnea is so moderate that one suspects something organic; and with it a feeling of depression, which took the form of visions of death and departure in place of the usual frenzy of activity. The organic discomforts have lessened during the past two days; the lypemanic mood1 persists, having the courtesy, though, to let up suddenly (as it did last night and at noon today) and leave behind a human being who looks forward with confidence again to a long life and undiminished pleasure in resuming the battle.
It is too distressing for a medical man who spends every hour of the day struggling to gain an understanding of the neuroses not to know whether he is suffering from a logical or a hypochondriacal mild depression. He has to be helped with this. So I actually tu