Psykopatologia.munfoorumi.com

Freud suspected, in addition to hysteria, a "nasal reflex neurosis", a condition popularized by his friend and collaborator Wilhelm Fliess, an ear, nose, and throat specialist. Fliess had been treating "nasal reflex neurosis" by cauterizing the inside of the nose under local anesthesia with cocaine used as the anesthetic. Fliess found that the treatment yielded positive results, in that his patients became less depressed. Fliess conjectured that if temporary cauterization was temporarily useful, perhaps surgery would yield more permanent results. He began operating on the noses of patients he diagnosed with the disorder, including Eckstein and even Freud himself.
Eckstein's surgery was a disaster. She suffered from terrible infections for some time, and profuse bleeding. Freud called in a specialist, his old school friend, Dr Ignaz Rosanes,[13] who removed a mass of surgical gauze that Fliess had not removed. Eckstein's nasal passages were so damaged that she was left permanently disfigured. Freud initially attributed this damage to the surgery, but later, as an attempt to reassure his friend that he shouldn't blame himself, Freud reiterated his belief that the initial nasal symptoms had been due to hysteria.
Guilt over the episode has been identified as contributing to the dream of Irma's injection in The Interpretation of Dreams: 'Max Schur grasped right away the significance of the episode to the "Irma" dream...in his paper on the specimen dream'.[14]

In 1893 Fleiss published his monograph on ‘The Nasal Reflex Neurosis’, in which he claimed that back pain, chest tightness, digestive disturbances, insomnia and ‘anxious dreams’ could all be attributed to nasal pathology. He also claimed that temporary relief of these symptoms was possible with the topical application of cocaine,4 of which Freud had published the first account of local anaesthetic properties.5
Gradually the list of conditions grew to include migraine, vertigo, asthma and then gynaecological conditions such as dysmenorrhoea and repeated miscarriages. All these could be diagnosed by careful inspection of the nasal mucosa. Fleiss later concluded that there was a ‘special’ connection between the nose and the sexual organs.
It is interesting that recent and more orthodox research techniques have confirmed a link of sorts and possibly a subliminal reflex between the nose, its olfactory function and choice of sexual partners. A limited degree of posthumous credibility might now distinguish Fleiss and his once-discredited nasal-reflex theory.