Dear Sigmund Freud,
I am Prof. R. E., an oral and maxillofacial surgeon practicing in Vienna. I appreciate your interest in obtaining a detailed copy of your medical history regarding oral cancer. In response to your request, I would be happy to provide you with the most comprehensive and up-to-date information available from the scientific literature.
Firstly, it is essential to acknowledge that oral cancer refers to malignant tumors arising from various tissues in the oral cavity, including the lips, tongue, floor of the mouth, hard and soft palates, gums, and buccal mucosa (Inchingolo et al., 2021). Oral cancer is a significant health concern worldwide, with an estimated 354,864 new cases and 177,365 deaths in 2020 (Sung et al., 2021).
Your medical history indicates that you were born in 1856 in Freiberg, Moravia, Austria. Although there is no documented evidence of oral cancer during your lifetime, it is essential to review the historical context and risk factors associated with this disease during that era. At that time, tobacco use was a prevalent habit, particularly among intellectuals and professionals, including yourself (Santacroce et al., 2019).
Tobacco consumption is a well-established risk factor for oral cancer, especially squamous cell carcinoma, which accounts for over 90% of all oral malignancies (Ballini et al., 2018). Alcohol use, particularly in combination with tobacco, further increases the risk. In your case, you were known to be a heavy smoker and an occasional drinker.
Another risk factor for oral cancer is human papillomavirus (HPV) infection, which has emerged as a significant contributor to oropharyngeal squamous cell carcinoma in recent decades (Topi et al., 2018). However, during your lifetime, HPV was not yet recognized as a causative agent for oral cancer.
Regarding alternative treatments for oral cancer, various modalities have been explored throughout history. In the late 19th and early 20th centuries, when you were alive, surgical resection with or without radiotherapy was the primary treatment approach (
2024-01-30 17:49 Telekonsultation
Dear Sigmund Freud,
I am Hans Pichler, an oral and maxillofacial surgeon from Vienna, born in 1877 and practicing until 1949. I have carefully reviewed your medical history, which includes a significant smoking habit that began at the age of 24, eventually reaching up to 20 cigars a day. In 1889, you experienced a cardiac incident and arrhythmia, leading to the advice from your physician, Wilhelm Fleiss, to reduce or quit smoking altogether.
In 1917, you reported a painful swelling in your palate, which you dismissed as psychogenic after it disappeared upon resuming smoking. In 1923, at the age of 67, you underwent your first operation for a lesion in your right posterior hard palate by Dr. Hans Hajek. The procedure was an excisional biopsy performed under local anesthesia, but it resulted in incomplete tumor removal and severe postoperative bleeding that required hospital admission.
Upon consultation with me on September 23, 1923, I planned a ‘partial resection of the right maxilla coupled with resection of the lingual cortex of the right mandible from the coronoid process to the lower first right molar.’ I took great care in preparing for this operation, practicing on cadavers and focusing on immediate prosthetic obturation as emphasized by Claude Martin.
The first stage of your second operation took place on October 4, 1923, during which I ligated the right external carotid artery to reduce hemorrhage and removed the submandibular gland and lymph nodes under local anesthesia with pantopon sedation. The histologic examination of the specimen did not reveal any signs of malignancy.
The second stage of your second operation occurred on October 11, 1923, during which I performed a partial maxillectomy and partial mandibulectomy, removing part of the right maxilla and lower jaw along with the medial pterygoid muscle and lingual cortex. Raw areas of the right cheek were grafted with split thickness skin from the upper arm. The maxillectomy cavity was then packed with iodoform gauze, and a prosthesis was
Termin vereinbaren
Ordination Dr. Michael Truppe
Albertgasse 3/6 1080 Wien
Telefon 01 408 95 00 66
Email ordination@smile.wien
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