A new biography demolishes whatever was left of the Viennese con man's reputation.

Writing to his close friend and collaborator Wilhelm Fliess in 1890, Sigmund Freud explained that he couldn't pay a visit because, in a struggling psychiatric practice that suckered rich society women in Vienna, "My most important client is just now going through a kind of nervous crisis and might get well in my absence."

No, Freud wasn't being ironic: He depended on grandes dames to stay in business. On another occasion, referring to a cartoon in which a yawning lion grumbles, "Twelve o'clock and no negroes," he wrote, "The worries begin again whether some negroes will turn up at the right time to still the lion's appetite." That appetite, as Frederick Crews makes clear in his exhaustive, reputation-pulverizing book Freud: The Making of an Illusion, was from an early age for fame and riches, which Freud relentlessly pursued by championing one faddish quack remedy after another, backing away when justified criticism made his position untenable, covering his tracks with misleading or even completely false claims about what he'd been up to, then bustling on to the next gold mine.

In 1884, for instance, in the giddy throes of a fondness for cocaine that Freud would indulge on and off for some 15 years, he had the marvelous idea of treating a brilliant young scientist, Ernst Fleischl von Marxow, for a mild morphine addiction (resulting from surgery) by putting the patient on cocaine. Instead, Fleischl became hugely addicted to both morphine and cocaine - sleepless nights, strung-out dozy days - and wasted away into a scarecrow while Freud, writing about the patient under a pseudonym, bragged in a paper about the tremendous success of his experiment. Meanwhile, a colleague of Freud was discovering an actual useful application of cocaine, as a topical anesthetic that opened the door to new kinds of surgery (such as on the eye). This was a truly revolutionary breakthrough and Freud had nothing to do with it. Later he would suggest that he had been on the brink of making the discovery but had been distracted by his fiancée, Martha.

The case for Freud's misogyny is ludicrously easy to make. After his cocaine frenzy, Freud headed to Paris to study with Jean-Martin Charcot, who oversaw an insane asylum full of women upon whom he freely experimented and operated under the assumption that they were suffering from "hysteria," an almost exclusively feminine phenomenon in which sex organs supposedly caused otherwise unexplained behavior and bodily disorders. Freud would carry the concept of hysteria to breathtaking extremes in his private practice: Leg pain? Morphine addiction? Asthma? Freud treated patients with these disorders under the working theory that they were suffering from hysteria, which among his mostly female clientele morphed into an assumption that the origin story of all neurosis was a childhood sexual trauma, which he called the "seduction theory" and which Crews relabels "molestation theory," since a small child who has suffered a sexual assault is not actually a seducer.

If the patient couldn't remember any childhood sexual trauma, Freud would "reconstruct" it by coaching her to devise one. Despite claiming in a typically grandiose but evidence-free 1896 lecture that his psychoanalysis had helped unveil and repair childhood sexual trauma in 18 patients - the speech was so devoid of clinical standards that a senior scientist, Richard von Krafft-Ebing, said, "It sounds like a scientific fairy tale" - Freud later revealed in a letter to Fliess that he hadn't cured even one person.

In one of the many horror stories Crews documents at length, Fliess, with Freud's eager encouragement, nearly killed a patient whose symptoms suggest she was a hemophiliac who had an ovarian cyst by operating on her nose and removing a chunk of bone, on the crackpot theory he called "nasal reflex neurosis" that the genital-based hysteria natural to women was traceable to cartilage in the nose. As the suffering woman, Emma Eckstein, nearly bled to death while Freud bungled her recovery, he blanched and nearly vomited, regaining his poise only with the aid of a glass of brandy. "So, this is the strong sex?" asked Eckstein. Freud continued to insist that "she bled out of longing" (emphasis his) and when a (female) surgeon noticed Eckstein had an abscess treatable by a single incision, she recalled that Freud "asked me with biting scorn whether I believed that hysterical pain could be cured by the knife." Later Freud observed that Eckstein for some reason reacted badly to being called unattractive after half her face had been caved in by the surgery.

Freud's Studies in Hysteria, in which he played a heroic mind-detective who dug up the patient's hidden actual troubles, simply adapted the fad for Sherlock Holmes stories (of which he was a fan) into a medical realm, adding a dollop of erotic titillation dressed up in clinical detachment. "The principal point is that I should guess the secret and tell it to the patient straight out," he wrote. Diagnosis first, then make the facts fit. When they didn't, Freud felt no compunction about using the techniques of fiction writing to play up his own prowess. As Crews shows, the idea of therapeutically talking through problems didn't originate with Freud, and though psychoanalytic theory has little to no value, what Freud brought to it was mainly borrowed from Fliess - ideas about sexual latency, bisexuality, repression, and the sublimation of sexual desire. A huge slice of Freud's work is simply plagiarism.

Today Freud barely exists in scientific literature, which has rejected his dodgy claims and outlandish boasts. In his more honest moments, he admitted his work did little to advance the cause of his supposed métier. "I am actually not at all a man of science, not an observer, not an experimenter, not a thinker," he wrote Fliess. "I am by temperament nothing but a conquistador - an adventurer, if you want it translated - with all the curiosity, daring and tenacity characteristic of a man of this sort." If Sigmund Freud had a genius for anything, it was for chutzpah. That, and public relations.