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The patient whose analysis provided the material to be presented here was a woman in her middle twenties. There is little doubt that her severe obsessional neurosis had definitely been conditioned by a congenital talipes equinus which deformed her left leg and foot, as well as by unusually marked deprivations and frustrations during her early life. A detailed study of the interrelation of the reality situation and the ego and symptom formation might prove extremely interesting, but does not lie within the scope of this paper which deals only with the utilization of certain specific trends and the manner in which the patient acted them out according to her libidinal organization of the time. Suffice it to state that her daily emotional satisfactions were almost entirely derived from rituals of thought and action which, by their very nature, reduced her reality gratifications to the barest minimum.
One year after a competent gynecologist had pronounced her cured of a gonorrhoeal infection, the patient finally sought analytic treatment because of a persistent fear that she might still have gonorrhoea, despite repeated negative tests. She had had intercourse without untoward consequences, but she was afraid of infecting men during the sexual act, particularly if she happened to be menstruating, and of being reinfected by them. The patient claimed that since her gonorrhoeal infection she could not menstruate unless she took liver extract by mouth.1 Except under special circumstances she could not ingest milk, coffee or meat without suffering from gastro-intestinal