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28 January 1909
Vienna IX, Berggasse 19
4F
Prof. Dr. Freud
Dear Dr. Binswanger,
Though he is only 23, Herr J. v. T. is already considered to be one of Vienna's most prominent personalities. Because of his pronounced interest in music, ethics and philosophy, and his exceptionally generous donations to cultural causes, he is much liked and respected in intellectual circles.
His father, originally of a refined and kindly disposition, although intellectually undistinguished, contracted syphilis following an unhappy marriage, and then suffered an unending alternation of melancholic and manic episodes, finally dying in December 1908 after a great deal of pain and suffering. His mother, who will be calling on you, is exceptionally unfeminine and has contributed considerably to the aetiology of her son's illness. The brother, Dr. G. v. T., who will be escorting them, is as able as he is intelligent, having successfully surmounted the influences to which he was exposed during his youth.
The underlying causes of J.'s condition are not known to his mother; G. has had to hear about them from me without the patient's knowledge. The patient must not be told about this breach of confidence. He is a homosexual with the usual aetiology, namely flight from libidinous fixation to the mother, which was plainly provoked