Letter from Freud to Fliess, April 11, 1895

Vienna, April 11, 1895

Dearest Wilhelm,

Gloomy times, unbelievably gloomy. Above all, this Eckstein affair, which is rapidly moving toward a bad ending. Last time I reported to you that Gussenbauer inspected the cavity under anesthesia, palpated it, and declared it to be satisfactory. We had high hopes, and the patient was gradually recovering. Eight days later1

she began to bleed, with the packing in place, something that had not been the case previously. She was immediately packed again; the bleeding was minimal. Two days later renewed bleeding, again with the packing in place, and by then overabundantly. New packing, renewed perplexity. Yesterday Rosanes wanted to examine the cavity again; by chance, a new hypothesis about the source of the bleeding during the first operation (yours) was suggested by Weil. As soon as the packing was partly removed, there was a new, life-threatening hemorrhage which I witnessed. It did not spurt, it surged. Something like a [fluid] level rising extraordinarily rapidly, and then overflowing everything. It must have been a large vessel, but which one and from where? Of course, nothing could be seen and it was a relief to have the packing back in again. Add to this the pain, the morphine, the demoralization caused by the obvious medical helplessness, and the tinge of danger, and you will be able to picture the state the poor girl is in. We do not know what to do. Rosanes is opposed to the ligation of the carotid that was recommended. The danger that she will run a fever also is not far off. I am really very shaken to think that such a mishap could have arisen from an operation that was purported to be harmless.

I do not know whether I should hold this depressing business exclusively responsible for the fact that the condition of my heart remains so much below par for this year of illness. After an interruption of several months, I started to take strophantus2 again so as to have a less disgraceful pulse, something that so far has fail