Following an earlier paper by A. Garma, the author regards peptic ulcer as the psychosomatic consequence of an unconscious conflict with the bad internalized mother. This imago obliges the unconscious ego to injure the self through perforation of the stomach or duodenum. The evil image originates in the first months of life and is a talion of the child's own developing sadistic orality. Fixation is afforded by traumatic experiences to which the ego may later regress as a defense against Oedipal or genital problems. The analysis of a four-year-old boy with anorexia and vomiting, but no ulcer, is described. (The author's speculations would have been more convincing had he had an ulcer.)