European Archives of Oto-Rhino-Laryngology

, Volume 276, Issue 1, pp 263–265 | Cite as

The disease of Sigmund Freud: oral cancer or cocaine-induced lesion?

  • Matteo TrimarchiEmail author
  • Giacomo Bertazzoni
  • Mario Bussi
Short Communication



Sigmund Freud, the father of modern psychoanalysis, suffered from what was considered to be a malignant tumour spreading from the back of his palate. He underwent numerous surgical interventions and radiation therapy over the course of 16 years. Such a long survival casts a shadow of doubt on the diagnosis of oral cancer that was given to Freud.


The book “Freud: Living and Dying”, in which the personal physician of Freud described in detail his patient’s fight with oral cancer, was reviewed. Current and past evidence, as well as epidemiological data, on oral cancer and cocaine-induced midline destructive lesions were also reviewed.


Tobacco and cocaine are both responsible for oral lesions and Freud was a dedicated cigar smoker as well as a user and defender of cocaine. Freud’s medical records indicate that the main cause of Freud’s oral disease was excessive smoking. On the other hand, the diagnosis of oral cancer does not seem to be entirely consistent with the 16-year-long survival of Freud. Freud used cocaine regularly in the 1890s, as reported by his personal physician, and it is possible that he continued taking it beyond that time period without feeling the need to inform his doctor.


It is possible that the lesion that progressively and very slowly eroded the splanchnocranial structures of Freud was not a bona-fide cancerous malignancy, but rather, the necrotizing effect of cocaine use that has been previously reported to be responsible for some massive facial destructive lesions.


Oral cancer Cocaine-induced midline destructive lesions Sigmund Freud Oral cancer survival 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of OtorhinolaryngologyVita-Salute San Raffaele University, San Raffaele Scientific InstituteMilanItaly
  2. 2.Department of OtorhinolaryngologyUniversity of BresciaBresciaItaly

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