280 MICHAEL JOSEPH EISLER
symbols), but in part too they show that an incredibly generalised anal erotism has transformed the oral zone to a secondary cloaca.^ It was only after all these things had been made clear that I arrived at a final explanation of a communication made by the patient long before. He had told how in the early months of his recent illness he had decided, without much consideration, to have his upper incisors extracted one by one, because he could no longer tolerate their foul smell. But during the process he fainted with pain. I vaguely guessed that these faints were causally related to the repeated losses of consciousness following the pain in the loin, but I could at first not find my way about the muddle of complaints, memories, interpretations, and so on. Here again the dominant pregnancy phantasy was a decisive factor. Tooth- extraction, which counts as a well-known symbol of parturition in women's dreams, must have the same significance in this case ; and the forceps delivery observed as a child contributed an inter- mediate idea.2 At the beginning of his hysteria, therefore, the patient attempted to rid himself of his diseased fancies by a sacrifice in the oral direction. The tooth extraction moreover was to be a substitute for the operation unavailingly anticipated at the X-ray performance, and to effect an outlet for the concomitant damming back of libido. Nevertheless the neurosis was the stronger, and found here another motive for its establishment. It is of interest to note the direction it took in that it first achieved transient expression in primordial form. Thus the archaic con- ception of oral birth is most impressively represented in the biblical story of Jonah, where the hero is spat forth by a whale. In describing the introductory phase of the treatment I called attention to one of the patient's character traits, which I could not then explain. I take this opportunity of interpolating the explana- tion at a point at which the trait became intelligible to me. The resistance which sooner or later appears in every analysis, as an inevitable consequence of treatment, is of course rooted in diflfer- ent sources from case to case, and must therefore be resolved independently each time. The factor of resistance that arises from the nature of the disease is often sufficiently equalised by the
' Cf. Ernest Jones, ' Einige Falle von Zwangsneurose ', Jahrbuch der Psa. Bd. IV, S. 596.
' To this may be added the grandmother's collectioQ of her teeth, and the injury to the little girl with the catapult.
