The communication presents an approach to the psychiatric treatment of neuroses simulating or associated with somatic diseases, using common manifestations of the gastro-intestinal tract as a basis for discussion. Although essentially clinical, the first section outlines a dynamic grouping consisting of: (1) arcissistic; (2) transference neurotic, and (3) physio or actual neurotic reactions.The use of such formulations in handling clinical material is illustrated by cases taken from the Columbia Medical Center, New York City. The importance, for treatment purposes, of determining the narcissistic and transference elements is emphasized.The presentation, though intended for psychiatrists, indicates the importance of the problem for the general medical man, and the need for making the psychiatrist's experience available to him. This is particularly true when manifest physical disease is combined with a neurosis, a combination which present day research is finding more and more common.Abstract Teaser