Character Analysis
Mathilde was the name of Freud's eldest daughter, but it was also the name of a patient who appears—in disguised form—in the Dream of Irma's Injection.
As Freud explains in his interpretation of the dream, his patient Mathilde represented a painful memory for him, because she was a reminder of a "tragic event" in his medical career (2.1.25). At an earlier point in his practice, Freud had accidentally produced "a severe toxic state" in the woman by prescribing a harmful medication. His repeated prescriptions resulted in her death.
As Freud realizes, many elements in the Dream of Irma's Injection come together to remind him of his failures and anxieties as a medical practitioner. Along with its references to Freud's unfortunate friend and colleague Ernst Fleischl von Marxow, the dream's disguised allusions to Mathilde really add fuel to the fire of Freud's fears concerning his "lack of medical conscientiousness" (2.1.25).