07 December, 1896
A large hall - numerous guests, whom we were receiving. - Among them was Irma. I at once took her to one side, as though to answer her letter and to reproach her for not having accepted my 'solution' yet. I said to her: 'If you still get pains, it's really only your fault.' She replies: 'If you only knew what pains I've got now in my throat and stomach and abdomen - it's choking me.' - I was alarmed and looked at her. She looked pale and puffy. I thought to myself that after all I must be missing some organic trouble. I took her to the window and looked down her throat, and she showed signs of recalcitrance, like women with artificial dentures. I thought to myself that there was really no need for her to do that. - She then opened her mouth properly and on the right I found a big white patch; at another place I saw extensive whitish grey scabs upon some remarkable curly structures which were evidently modelled on the turbinal bones of the nose. - I at once called in Dr M, and he repeated the examination and confirmed it ... Dr M looked quite different from usual; he was very pale, he walked with a limp and his chin was clean-shaven ... My friend Otto was now standing beside her as well, and my friend Leopold was percussing her through her bodice and saying: 'She has a dull area low down on the left.' He also indicated that a portion of the skin on her left shoulder was infiltrated. (I noticed this, just as he did, in spite of her dress.) ... M said: 'There's no doubt it's an infection, but no matter; dysentery will supervene and the toxin will be eliminated. ... We were directly aware, too, of the origin of the infection. Not long before, when she was feeling unwell, my friend Otto had given her an injection of a preparation of propyl, propyls ... propionic acid ... trimethylamin (and I saw before me the formula for this printed in heavy type) ... Injections of this sort ought not to be given so thoughtlessly ... And probably the syringe had not been clean.