Emphasizing the high position presently reached by psychosomatic medicine, the author studies especially the cases in which the psychopathoiogic action works indirectly, i. e., from the patient's behavior there results some damage. After reviewing similar cases of literature, the author quotes Marbe, who clearly established, by statistical procedures, that there are people more liable to injuries than others. The author believes that, according to their origin, the accidents may be: 1 - strictly casual; 2 - dependent upon disability or neurologic disorders; 3 - true "failed acts", comparable to memory or speech lapsuses, and caused by an intrapsychic conflict of conscious and unconscious tendencies. When the injuries are very numerous, the accidents of the last type are real neurotic symptoms and will be removed only by means of psychotherapy. The author reports a case of a workman who, in the course of a little more than a year of observation, underwent 17 injuries, generally not severe. The tendency to hurt himself was shown since youth. The mental examination evidenced definite neurotic signs: irritability, doubts, envy, ansiety, phobias. The Rorschach test confirmed the patient was a neurotic; particulary, every answer is determined by the form, the type of vivency being O:O there are 91 per cent of F+; the perception type is G:(D): Dd; the sequence is rigid; the colors schock is evident on the plate II. Trying to give a psychoanalytic explanation for the case, and taking on account familial and former individual data, the author believes that the injuries point to: 1 - on a deeper level, pre-oedypian introjected aggressivity against the mother; 2 - more superficially, autocastra-tion to punish himself for the wishes repressed in the Oedypus complex and to avoid their actualization; 3 - still more superficially, it must be taken on account the secondary profit of the symptoms, of little significance.
