Fleiss,Freud and the nose

The review by Mahmood Bhutta (JRSM 2007;100:268–274) concludes that, even in humans, the humble nose maybe responsible for far-reaching consequences if it cunningly influences one's choice of partner. ¹ Grand claims have previously been made for this appendage. Wilhelm Fleiss (1858–1928), a nose and throat specialist in Berlin, developed a unique and curious theory that illnesses are caused by disturbances in the nasal mucous membranes. ²

Fleiss attended a course of lectures given by Sigmund Freud in Vienna and they later became close and influential friends; ³ indeed, Fleiss twice operated on Freud's nose. 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.

Competing interests None declared.