Leopold. It is a comparison similar to the one above between the disobedient patient Irma and her friend who is thought to be more sensible. I now become aware of one of the tracks along which the thought association of the dream progresses; from the sick child to the children's asylum. The dulness to the left, below, recalls a certain case corresponding to it, in every detail in which Leopold astonished me by his thoroughness. Besides this, I have a notion of something like a metastatic affection, but it might rather be a reference to the lady patient whom I should like to have instead of Irma. For this lady, as far as I can gather, resembles a woman suffering from tuberculosis.
An infiltrated portion of skin on the left shoulder.
I see at once that this is my own rheumatism of the shoulder, which I always feel when I have remained awake until late at night. The turn of phrase in the dream also sounds ambiguous; something which I feel... in spite of the dress. "Feel on my own body" is intended. Moreover, I am struck with the unusual sound of the term "infiltrated portion of skin." "An infiltration behind on the upper left" is what we are accustomed to; this would refer to the lung, and thus again to tuberculosis patients.
In spite of the dress.
This, to be sure, is only an interpolation. We, of course, examine the children in the clinic undressed; it is some sort of contradiction to the manner in which grown-up female patients must be examined. The story used to be told of a prominent clinician that he always examined his patients physically only through the clothes. The rest is obscure to me; I have, frankly, no inclination to follow the matter further.
Dr. M. says: "It is an infection, but it does not matter. Dysentery will develop, and the poison will be excreted.
This at first seems ridiculous to me; still it must be carefully analysed like everything else. Observed more closely, it seems, however, to have a kind of meaning. What I had found in the patient was local diphtheritis. I remember the discussion about diphtheritis and diphtheria at the time of my daughter's illness. The latter is the general infection which proceeds from local diphtheritis. Leopold proves the
