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This valuable work summarizes the former findings and theories of Dr. Garma about the psycho-genesis and treatment of peptic ulcer patients (in this Journal: 31, 1950, 53, and 34, 1953, 102) completed by the presentation of seventeen highly instructive cases. Gastrectomy and vagotomy do not seem to eliminate the troubles of such patients. Either the complains persist or arterial hypertension ensues instead, or else their potency suffers by the traumatic effect of the operation. Dr. Garma's contention is that it is not the latent femininity of the patient (Draper), or his tendencies to passivity (Alexander), or his masochism (Bergler) which are primarily responsible for this illness, but that peptic ulcers represent inner aggressions expressed in the digestive tract, being the remorse caused by an unjust and severe superego. They are (re)activated by actual external aggressions (mainly genital frustrations) caused on the part of the patient's environment on which the patient is dependent. The internalized bad mother acts as harmful food. The orally regressed patient displaces his conflict to the digestive tract, where his hostility and anxiety struggle to meet the bad mother. This is usually exacerbated by the patient's indulging in a too strenuous activity which does not allow for an adequate emotional discharge. The future ulcer patients are usually children whose mothers, while good milk suppliers, held back their babies too long from eating meat; moreover, having spurred them to activity, spurned their oedipal desires.
An (oedipal) prohibition of digesting certain foods (e.g. meat) is present, besides the desire for the same in order to prove the capability to 'digest' the bad mother. The digestive tract of these patients expresses both their aggressive wishes to bite and the punishment for it. Their behaviour in love life is usually brusque, and they seek 'digestive orgasm' instead of genital. Also they seek 'dangerous' food on which to put their ma