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Stone records in some detail his analysis of a forty-year-old man suffering from duodenal ulcer and various other neurotic symptoms such as marked disturbances in his sexual functioning, periods of depression and anxiety, compulsive character traits and constipation. He compares his psychodynamic findings with those of Alexander and his colleagues, Carel van der Heide, and Garma in their studies of ulcer patients. In addition to many etiological factors which Stone's patient had in common with those of the other workers, he indicated a deeper, more primitive one in a symptom which consisted in falling into a deep sleep on the analytic couch whenever the analyst made an interpretation. Stone says, 'The biphasic problem of sleep strongly suggests that the Anlage of this patient's psychophysiological disease lay in the sadomasochistic and libidinal borderland between the intra-uterine type of sleep and the need to establish normal sleep through the sucking of a breast. Such a depth consideration would be of importance in relation to Alexander's statement that the ulcer has no symbolic significance: … It could legitimately be argued that the ulcer might achieve psychological meaning