After a brief review of the literature, Schwartz reports the analysis of a thirty-seven-year-old dentist suffering from cardiospasm. The illness was precipitated by a conflict between active masculine drives and passive, feminine, dependent, masochistic tendencies. The spasm enabled the patient to 'push out' (reject 'taking in')—his defense against oral, incorporative homosexual wishes. At the same time, by 'holding', he himself became castrative toward his hated and aggressive phallic mother and sister and his threatening elder brothers. The cardiospasm represented the two phases of his conflict, i.e., the active, expulsive, contractive phase and the retentive, passive, dilated phase.