Patients suffering from this disorder (ulcerative colitis) more frequently than usual refer its onset and relapses to “worry”, and frequently appear mentally abnormal even to the casual observer.

It is well known that gross impairment of nutrition is a not infrequent finding in the newly-admitted psychotic patient. Some of these cases present a state of mental confusion which is directly attributable to a condition of semi-starvation brought about by personal neglect and refusal of food. Obvious clinical signs of malnutrition are present, such as anorexia, emaciation, coated tongue, constipation, and ketonuria. Rapid mental improvement frequently occurs as a result of a liberal diet and relief of gastro-intestinal stasis. But it is equally important to recognize the mild and less obvious forms of malnutrition.

The age of maturity may be regarded as having begun when the individual has finally chosen his mate, and is satisfactorily and happily married. The problems of the unmarried and the homosexual are somewhat different, but have analogous solutions.

Home-sickness springs from the conflict between family ties and herd or group feelings, and among immigrants, such as those Austrian and German domestic servants working in London, the nostalgic reaction may lead to certifiable mental disorder. The present study concerns forty cases of this kind who, between 1931 and 1937, came under my care at Friern Hospital.

This paper deals with the problem of neurotic anxiety, that is of anxiety which is not justified by external circumstances. Such anxiety is explained as a reaction to an internal danger situation created by emotional conflict in early life. An attempt is made to reconstruct the nature of this conflict in the light of evidence based on the psycho-analysis of patients suffering from anxiety symptoms, and the primitive defences called out by this danger are discussed. The conclusion drawn is that these defences, though temporarily successful, are in the long run ineffective, and actually set up a vicious circle which perpetuates the very danger it aims at averting.

The fact that in the course of many neuroses there occur associated feelings of inferiority of a bodily nature, as well as the fact that there are neuroses originating in disturbances of bodily functioning—organ neuroses—compels us to scrutinize our hitherto accepted ideas of the nature and meaning, both of the somatic and of the psychic analysis of the latter. This need is based not merely on speculative grounds and on clinically or experimentally determined facts of recent medical research, but also in reference to the conceptions of modern physics and the views due to advances in zoology and biology. The accurate observations of these scientific disciplines and the inferences drawn from them no longer allow us to consider the somatic as merely secondarily informed by the psyche or as though inspired by a psychic act of projection. Just as the “wave “of the physicist is as much the carrier of the same primeval essence as is the “atom”, so also the world of organic forms has not been constructed secondarily by the conscious thinking spirit; on the contrary—apart from the aberrant (?) adaptations—we must recognize a prototypical pattern (?) also throughout the plant-animal kingdom. We have to recognize an aesthetic controlling principle that belongs to the somatic as such and is innate with it. The great creative artists have always sought for this essential pattern.

The problem of puberty can be regarded as the problem of functional psycho-somatic disharmony. The solution cannot lie exclusively in the field of mind or of body, because we are dealing not solely with psychic structures which are undergoing reshaping in their own right, but with the processes of maturation in the somatic field. The vector of normal growth lies somewhere within the parallelogram of these two forces. On this analogy, the presence of negative agencies must be stressed when we consider the repressive forces of the mind, and the return to primitive physiological responses as in schizophrenic reactions.