Six male patients with exacerbations of chronic duodenal ulcer were studied exhaustively by psychoanalysis and psychoanalytic therapy in an effort to detect psychological factors concomitant with the disease. 'Ulcer symptoms recurred most often when the threat of depletion exceeded the promise of replenishment and the resulting angry protest was restrained. The ulcer exacerbation was associated with no single factor operating alone but required the integrated presence of the nuclear conflict, basic fear, special ego defenses, and ambivalent interpersonal relationships.' Specificity and its meaning are discussed.