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After a short review of the literature, going back to 1694, a clinical picture of anorexia nervosa is given, centering around the symptoms: reaction to food,
constipation, and amenorrhoea. In these cases the act of eating is symbolically equated with sexuality, particularly with fantasies of impregnation. The complete rejection of eating is understandable only in terms of its symbolic significance and not of its original biological function. Gratification of the pregnancy fantasy may be expressed by overeating. Two excellent case histories are given as illustrations. The symbolism of eating as impregnation is clear and unambiguous. The wish to be impregnated by mouth results in compulsive eating or in guilt and consequently in rejection of food, constipation and amenorrhoea. The amenorrhoea may also be part of the direct denial of genital sexuality. Overeating preceded anorexia in each case. The syndrome of anorexia nervosa involves not a physiological system, but rather a functionally coördinated unit. It is not the system, but the function in terms of the patient's fantasies that is of importance.