by URTE LAUKAITYTE
A bizarre theory (and a gory surgery) in fin-de-siècle Vienna help us get a grip on how science and medicine actually work
In Vienna, in late February 1895, a 30-year-old woman, Emma Eckstein, is about to undergo an operation. She has recently complained of a few health problems – mostly stomach pain and discomfort, some sadness, especially around her period. Luckily, a young Berlin doctor by the name of Wilhelm Fliess is there to help. He comes highly recommended by a long-time trusted family friend, himself a reputable physician, Sigmund Freud. They agree that Eckstein’s menstrual stomach issues can be addressed through a simple surgery on an altogether different body part – Fliess removes a bit of bone from inside her nose.
The late 19th century saw a flowering of interest in the nasogenital reflex – the idea that there is a strong physiological link between the nose and the genitals. The nasogenital concept could allegedly explain all manner of trouble, not just in the reproductive system but across the board. The nose provided a clinical shortcut of sorts, a kind of map of the body. For mild illness, treatment could involve stimulating the problem areas of the nasal mucosa with cocaine. If the situation was a bit more serious, it may further be necessary to cauterise – with acid or electricity – the implicated ‘genital spots’ in the nose. In the most stubborn cases, however, the only course of action left to the well-meaning healer was to surgically cut out sections of the inferior turbinate bone. Also known as nasal conchae, these are thin shell-shaped structures crucial for warming, humidifying and filtering air – nothing to sneeze at.
The nasogenital reflex strikes most people today as a wacky brainchild of an obvious charlatan – the so-called nose-and-throat specialist Wilhelm Fliess. The famously no-nonsense science writer Martin Gardner christened him as ‘one of the giants of German crackpottery’. Recent scholarly literature on Fliess revolves around his close relationship with and profound influence on Freud. In retrospect, some try to minimise the affinity between them, whereas others use it to stain the reputation of Freud who had, after all, dubbed Fliess ‘the Kepler of biology’. While at the University of Vienna, Freud lectured on Fliess’s ‘enthralling material’, as he called it. In some of the nearly 300 letters he wrote to Fliess, they discussed co-authoring a book to review the two men’s breakthroughs – weaving together anxiety and nasal reflex neuroses. Freud very much hoped the phenomenon would be termed ‘Fliess’s disease’ to honour his friend’s discovery. In the meantime, he intended to name one of his two youngest children after Fliess. ‘Fortunately,’ a biographer of Freud’s remarked, ‘they were both girls.’
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