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Eidelberg presents the sadistic and masochistic pathological masturbation fantasies of four analytic patients and then gives the unconscious structure of each of them from the material which appeared in their analyses. In a subsequent discussion the author compares the structure of these fantasies to those in normal masturbation and those in a phobic fantasy. He also attempts to answer two questions: why the material of these fantasies is conscious while similar material in other patients remains unconscious, and why the fantasies are accepted by the total personality and not treated as 'a foreign body' and rejected as are other fantasies which constitute defense mechanisms. He finds (in essence) that 'these fantasies are the result of an unconscious defense by the ego and the superego against an infantile wish from the id'; that they represent 'a denial of an infantile narcissistic mortification suffered in infancy'; and that these unconscious satisfactions lead to conscious genital stimulation ending in orgasm. This masturbation produces a feeling of independence of external objects and of control. They are accepted because they differ in several important points from the structure of a phobic fantasy and 'because patients who accept them belong to the narcissistic type'. Finally, he says, 'They resemble the acts of perverts in being ego-syntonic, but differ from them in respect of their independence of an external object'.