need stitching, those to the forearm and side being but skin abrasions. No sort of internal injury was supposed to exist at that time. During his stay at the hospital, the doctor in charge of his treatment also had the injured parts X-rayed with negative results. Three weeks after admission, he left hospital cured. He again took up his work and after a short time felt quite fit. Some weeks later pains set in beneath the first rib on the affected side occurring at first rarely, but soon more frequently, until they partook of the character of regular attacks. They took place at short intervals, about fortnightly, lasted fourteen to sixteen hours, and passed off again. During an attack he felt a boring pain in the left side 'as if a solid object was trying to emerge', afterwards he was exhausted and required rest. However the intervals between attacks passed without the appearance of any particular phenomena, excepting a slight stitch in the side which occurred along with any considerable excitement. In time the condition became more and more obstinate and intolerable. He had often to neglect work, and sought out all the various hospitals, where they were eventually baffled by his complaints. Toward the end of the second year of his illness, he had lost consciousness in three consecutive acute attacks, and they sent him on to the neurological department. On the strength of the negative findings of surgeons and physicians, a diagnosis of Traumatic Hysteria was made. As such, the case was submitted to psycho-analytic treatment.
At the outset of the course, before the history of the case could be written down in any detail, all the signs of a stormy transference set in and engaged my whole attention; it was only later shown that the explanation lay in his many years of previous treatment and experiences with other doctors. I must confess that I found the behaviour of the patient at this time very strange, and the possibility of a mistaken diagnosis just passed through my mind. At the very beginning of analysis, he performed two peculiar actions, of which the first was relatively intelligible, but the second seemed completely nonsensical. Soon after the beginning of the first hour he stood up without any particular occasion, and said he had felt exactly as if the couch had rolled off with him. Obviously it was an attempt to escape from his unaccustomed situation and the presence of the physician. When at length I had persuaded him to lie down again, he was incapable of producing coherent ideas. At the close of the hour, on my departure, he
