Freud's Free Clinics

1918–1922: SOCIETY AWAKES
He began the essay as a diplomatic colleague would, suggesting that Wagner-
Jauregg was a man of principle who had acted against his better psychiatric
judgement because of civic commitment to the interests of the state. While
both men agreed on the symptomology underlying war neurosis, they disagreed
on the treatment. But Freud ended with a withering critique of war and
traditional military psychiatry. Conscription was not the patriotic duty of the
state, he said, but the opposite, the “immediate cause of all war neurosis,
[forming] rebellion against the ruthless suppression of [the soldier’s] own personality
by his superiors.” Wagner-Jauregg’s willingness to act in concert with
the corporate state, by implicitly supporting governmental use of violence, dishonored
the physician’s humanitarian concern for the individual. 49 Freud had
told Ferenczi that he would ”naturally treat [Wagner-Jauregg] with the most
distinct benevolence,” adding that the events had “to do with war neurosis.” 50
He had only wanted to show the court how their clinical and theoretical approaches
differed without attacking his colleague personally. Just then the Viennese
psychoanalytic society was formulating plans for its own free clinic, and
Freud knew that the project would require at least nominal diplomacy toward
his conservative rival. Wagner-Jauregg was eventually exonerated, but he continued
to represent for Freud Vienna’s old-time medical establishment and the
dominance of a reactionary punitive stance in psychiatry.
All too soon, however, Freud found his courtesy to Vienna’s institutional
psychiatry and Wagner-Jauregg outmaneuvered. Hostile functionaries and a
lethargic medical bureaucracy blocked Hitschmann’s proposal for the Ambulatorium
at each turn over the next two years. Since the license to open the
clinic remained in the hands of the medical community’s conservative opponents
of psychoanalysis, Hitschmann enlisted the backing of his physician
colleague Guido Holzknecht. Highly respected as a leading radiologist of the
time, assistant in Hermann Nothnagel’s clinic, and connected with the governing
Society of Physicians of the Allgemeines Hospital, Holzknecht had
also been since 1910 a member of the Viennese psychoanalytic society. 51
Holzknecht, Freud, and Hitschmann were friends and partners, jointly convinced
that investigation of the unconscious mind and the interior body have
equivalent aims. Holzknecht’s genius in discovering tumors was the physiological
counterpart to Freud’s detection of the neuroses. Holzknecht and
Freud also found themselves associated as reciprocal doctors and patients:
Holzknecht, a former analysand, was the radiologist who treated Freud’s cancer
in 1924, and in 1929 Freud visited Holzknecht, who was dying of cancer
from his own experiments, his right arm already amputated. Freud said,
“You are to be admired for the way you bear your fate,” and Holzknecht
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