Page:The International Journal of Psycho-Analysis II 1921 3-4.djvu/12

 266 MICHAEL JOSEPH EISLER

further evidence. At first he suddenly feU in the middle of his trip a painful desire to defaecate, and had rapidly to forsake his car. Moreover it always troubled him uselessly, for he could never obtain a motion. Medical treatment was adju.sted to the many and changeable complaints and symptoms of the patient, and they tried pretty well everything that one does in the case of bowel disturbance which is not clearly diagnosed. Even a chemical examination of stomach contents was undertaken. The patient's description of this, and a dream following upon it, led at last to the solution of the hitherto unintelligible transient symptomatic acts produced at the beginning of the analysis. In the patient's phantasy, the stomach tube had attained perverse secondary signi- ficance (as object of fellatio). His extraordinary behaviour, which quite corresponded to that at a stomach test, the protruded throat, anxiously dilated eyes, etc., was as it were the unconscious consent to a' homosexual perversion. This feminine attitude to the doctor was the key to all the symptomatic acts that occurred later too in the course of the cure. From the manifold symptoms of the disease, there crystallised gradually a very obstinate spastic constipation, which we recognise as a hysterical manifestation in Freud's sense. After several months, the continuance of this trouble was endangering the patient's position, and the condition slowly terminated. An extremely effective measure had been suppositories, which, on doctor's orders, were introduced into the rectum. The patient was at the time very satisfied with this treatment. The connection of this spontaneously evaporated mono- symptomatic hysteria with the conditions of his life at the time brings out the state of affairs still more clearly. Things happened at work, particularly that he occasionally had run over pedestrians on the streets (among them a boy who fortunately had got caught up in the safety arrangement) ;i these greatly worried him, where- fore he was already thinking of another change of occupation. The circumstances of his marriage contributed very important motives for illness. As I have already recorded, they had not united without disturbances. For not long previously he had heard by accident that there was an illegitimate child. The

in response to which the sense of pity is aroused. To recover from his fright, by the way, the patient thrashed the boy like a mother punishing him, after he had brought him forth.
 * A veritable birth-saving phantasy. A sadistic trait too is unmistakable,