ABSTRACT
In 1895, Sigmund Freud concluded Studies on Hysteria with his vivid, uncomfortable analogy between “cathartic psychotherapy” and surgery. Freud’s radical intervention in the emerging field of psychoanalysis during the 1880s is often contrasted with that of his Philadelphia contemporary Weir Mitchell. But in the wake of recent, and especially, post-Kleinian developments, the surgical analogy has lost some of its edge. The purgative effects of pity and fear have well-known literary antecedents; Freud was writing in the wake of influential nineteenth-century theories of tragedy. In its modern form, it entered medical practice at exactly the same moment, during the late 1880s and early 1890s. Surgical intervention only came to offer a real prospect of cure for breast cancer when wholesale excision—the so-called radical mastectomy—emerged at the cutting edge of treatment for malignant breast tumors.
