The genesis of peptic ulcer is re-examined. Garma believes that actual (external) conflicts reactivate a basic underlying problem, the oral-digestive internal aggressions of the representations of the bad internalized mother. He rejects Alexander's theory that ulcer depends on a repressed elemental wish toward the mother, a regressive expression of the repressed wish to be loved by and dependent on her. The internalized bad mother expresses her aggressions in the prohibition of 'good food', the forcing of 'bad food' on the patient, excessive tonic and peristaltic contractions, and other corroding and damaging consequences.