The author pleads for a greater interest on the part of psycho-analysts in the psycho-physical borderland, and claims that the skin is a territory favourable for the exploration of physical changes related to emotional conflict. The clinical material that he cites in proof of such a relationship chiefly consists of cases of chronic eczema.

Some attempt is made to deal with the theory of skin changes in hysteria, along the following lines: … If one seeks the cause of repression one at last always comes across the outer world which is hostile to instinct. The skin, an organ that lies on the periphery of the body, forms a boundary between it and this frustrating and therefore hostile outer world. Aggression which is directed against this outer world and which can find no discharge, appears as an inwardly directed destructive instinct. We see it in the pathological-anatomical changes which we can in very many cases speak of as an expression of the destructive urge. Perhaps we are generally right in seeing in the skin a primitive, archaic organ of expression. …