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While psychiatric interest in the problem of peptic ulcer has continued at a high level (9, 4 for example) relatively few detailed psycho-analytic studies of ulcer patients have been reported (13)(11) since the work of the Chicago group (19).
In this field, recent physiological studies, often combined with psychiatric examinations and anamneses (15)(20)(21)(22), have contributed impressively to a knowledge of the rôle of emotion in normal and pathological gastric function, and thus toward belief in the emotional etiology of peptic ulcer. Nevertheless the study of this disease as of other fields of 'psychosomatic' research continues to demand detailed scrutiny of material, toward the increasingly certain establishment of the very fact or estimated proportion of psycho-genesis in the illness. The accumulation of further psychological detail would certainly seem desirable before general formulations regarding the psycho-genesis of peptic ulcer be securely established.
For these reasons, it is felt that the following case merits special report. This is executed with apology for the difficulty of finding a meaningful path between the convenient conciseness of a sound but inevitably influential interpretative system and the mass of unorganized biographical and psycho-analytic detail that would result, were an interpretative system to be ignored entirely. In this connection, emphasis on the phenomenon of obstinate transference sleep during analytic hours may provide an axial basis for communication, aside from its special place as an objectively observed clinical phenomenon.
The account is based on the detailed review of 776 analytic hours with a married business man of about forty when work was begun. The patient (Mr. Roland S.) was seen in three separate periods of analysis, successively shorter, the first constituting most of the total at five hours a week, the last only thirty-six hours at three hours a week. the patient resumed analysis on each occasion after an in