But even at the time I thought it improbable, since she is extremely reserved. She resists, as the dream shows. Another explanation might be that she does not need it; in fact, until now she has shown herself strong enough to master her condition without outside help. Now only a few features remain, which I can assign neither to Irma nor to her friend; pale, puffy, false teeth. The false teeth led me to the governess; I now feel inclined to be satisfied with bad teeth. Here another person, to whom these features may allude, occurs to me. She is not my patient, and I do not wish her to be my patient, for I have noticed that she is not at her ease with me, and I do not consider her a docile patient. She is generally pale, and once, when she had not felt particularly well, she was puffy. * I have thus compared my patient Irma with two others, who would likewise resist treatment. What is the meaning of the fact that I have exchanged her for her friend in the dream? Perhaps that I wish to exchange her; either her friend arouses in me stronger sympathies, or I have a higher regard for her intelligence. For I consider Irma foolish because she does not accept my solution. The other woman would be more sensible, and would thus be more likely to yield. The mouth then opens readily; she would tell more than Irma. *(2)

* The complaint of pains in the abdomen, as yet unexplained, may also be referred to this third person. It is my own wife, of course, who is in question; the abdominal pains remind me of one of the occasions on which her shyness became evident to me. I must admit that I do not treat Irma and my wife very gallantly in this dream, but let it be said, in my defence, that I am measuring both of them against the ideal of the courageous and docile female patient.

*(2) I suspect that the interpretation of this portion has not been carried far enough to follow every hidden meaning. If I were to continue the comparison of the three women, I should go far afield. Every dream has at least one point at which it is unfathomable: a central point, as it were, connecting it with the unknown.

What I see in the throat: a white spot and scabby turbinal bones. The white spot recalls diphtheria, and thus Irma's friend, but it also recalls the grave illness of my eldest daughter two years earlier, and all the anxiety of that unhappy time. The scab on the turbinal bones reminds me of my anxiety concerning my own health. At that time I frequently used cocaine in order to suppress distressing swellings in the nose, and I had heard a few days previously that a lady patient who did likewise had contracted an extensive necrosis of the nasal mucous membrane. In 1885 it was I who had recommended the use of cocaine, and I had been gravely reproached in consequence. A dear friend, who had died before the date of this dream, had hastened his end by the misuse of this remedy.

I quickly call Dr. M, who repeats the examination. This would simply correspond to the position which M occupied among us. But the word quickly is striking enough to demand a special examination. It reminds me of a sad medical experience. By continually prescribing a drug (sulphonal), which at that time was still considered harmless, I was once responsible for a condition of acute poisoning in the case of a woman patient, and hastily turned for assistance to my older and more experienced colleague. The fact that I really had this case in mind is confirmed by a subsidiary circumstance. The patient, who succumbed to the toxic effects of the drug, bore the same name as my eldest daughter. I had never thought of this until now; but now it seems to me almost like a retribution of fate- as though the substitution of persons had to be continued in another sense: this Matilda for that Matilda; an eye for an eye, a tooth for a tooth. It is as though I were seeking every opportunity to reproach myself for a lack of medical conscientiousness.

Dr. M is pale; his chin is shaven, and he limps. Of this so much is correct, that his unhealthy appearance often arouses the concern of his friends. The other two characteristics must belong to another person. An elder brother living abroad occurs to me, for he, too, shaves his chin, and if I remember him rightly, the M of the dream bears on the whole a certain resemblance to him. And some days previously the news arrived that he was limping on account of an arthritic affection of the hip. There must be some reason why I fuse the two persons into one in my dream. I remember that, in fact, I was on bad terms with both of them for similar reasons. Both had rejected a certain proposal which I had recently made them.