The scene opens on Dr. Hirschfeldt. He is being connected to a local baron through a series of overly courteous operators and takes a moment to reflect on the nature of Vienna during this period. It is an artistic and scientific hub, home to Freud and Mahler and Klimt, and yet he is disgusted by the way decades of imperialism have given way to stuffy traditions, calling the city, “the imperial capital with an excess of its own grandeur” (109).

Dr. Hirschfeldt is a Jewish doctor treating venereal diseases. He is known for his discretion and says that though his clients “would not have a Jew defile their drawing room [...] they were only too pleased to entrust to him the care of their private parts” (110). Hirschfeldt treats his brother, who comes in with a wound from a duel, and learns about a document called the Waidhofen Manifesto, which claims Jews are subhuman. Later, Hirschfeldt treats a bookbinder named Mittl, who has late-stage syphilis and is losing his mind. Mittl cries when he can’t pay for experimental treatment, making Hirschfeldt uncomfortable. That night Hirschfeldt discovers his own wife is having an affair, and he frantically visits his current mistress Rosalind, who rejects him for not bringing her gifts in over a month.