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This case is of special interest for two reasons. It belongs to the diarrhoea group as well as to the gastric group, and at the same time manifests a compulsive type of character and compulsive symptoms. Secondly, it demonstrates a variety of "giving" reactions in response to strong receptive urges which have dominated the picture from the beginning of the analysis.
The patient was a twenty-seven year old man of Scotch-Irish descent, a teacher of mathematics, who came for analysis because of recurrent exacerbations of a chronic diarrhoea, nausea, and vomiting. He had had three or four bowel movements a day for the previous ten years and an almost daily mild nausea and vomiting. In addition, he had various compulsions; such as, for example, that of spelling out words while reading. Repeated medical examinations had revealed a low basal metabolic rate and an intestinal hypermotility, shown fluoroscopically. Thyroid, ephedrine, and whole adrenal gland therapy raised the metabolic rate, but left the patient's condition essentially unchanged. Medicinal, mechanical and dietetic therapy for the gastro-intestinal complaints were of little value.
Superficially, the man's outstanding trait was his impulse to give of himself to others. He seemed not to want to spend money on himself, preferring to spend freely on others, being especially open-handed with his mother and a brother who was three years older than himself. He had the reputation of being an excellent teacher of mathematics, a reputation based on his enjoyment of the giving of explanations. He was regarded as being "nice", gentle and kind in his superficial everyday relationships. He emphasized the fact that he had little "property-sense", i.e., that he had apparently little regard