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The following case illustrates the relationship between psychogenic factors and organic disease and, in this particular case, death. I saw the patient only twenty-six times during the last five weeks before she died; therefore, while the psychoanalytic material which I am able to present is incomplete, it is nevertheless significant for the topic in question.
The patient, fifty-one years old, of German descent, the wife of a well-to-do manager of art exhibitions, had suffered for two months from a dysentery-like colitis. It was not a true dysentery. Bacteriological and x-ray examinations were completely negative. The clinical picture was unusual and did not conform to that of serious organic disease but seemed to be more in the nature of a psychogenic disorder. The family doctor who had called me was not at all in favor of the psychological point of view nor of psychotherapy but in this case he called in the psychoanalyst as a last resort.
Several years before her last illness the patient had had gonorrhoea of the rectum as a consequence of an infection from her husband. Her present symptoms were continuous fever, frequent bloody mucoid stools, painful tenesmus, nausea, vomiting, insomnia, and severe loss of strength and weight. She was given a transfusion of her husband's blood. Immediately after the transfusion she developed a state of great excitement resembling an agitated depression. She sang patriotic and religious hymns which she knew from her childhood and insisted upon leaving the hospital. She had to be taken home where she was treated with diet and narcotics. She