_P. H._ The patient was said always to have been somewhat seclusive, mingling little with other people; this tendency was so strong that she would leave the room when visitors came. She always slept a great deal. It was stated that she was able to do heavy housework quite well, but never learned cooking. At 16 she hired out as a servant for a year and a half, and then did laundry work. When 18 she had an illegitimate child by a co-worker. _History of Psychosis:_ About a year before admission the patient’s sister was burned to death. When the patient heard of this she said that something had come up in her throat. Henceforth she often complained of a lump in her throat, and often bit her nails. Two months before admission she suddenly left the laundry, again spoke of the lump in her throat, and claimed to have seen the dead sister. Two weeks later when the family had an anniversary mass for the sister the patient appeared sad, but the following day laughed, said she had seen her “sister beckoning her to come.” She also thought she saw her picture “and Heaven was behind it.” She also talked of “dead relatives and friends.” A reaction of levity in connection with a sister’s death is highly suggestive of a malignant psychosis. Two weeks before admission her mother found her in a stupor, immovable, with her eyes closed. In 24 hours she woke up, began to sing “Rest for the Weary,” prayed, then was stuporous again for six hours. When she came out of this, she said she was “going to die,” God had told her so and talked of her own funeral arrangements. She again went into a stupor, in which she was sent to the Observation Pavilion. At the _Observation Pavilion_ she was described as happy, laughing, singing, saying she felt happy, but adding, “I like to be sad too, I am going to Heaven Easter Sunday.” She claimed that her sister frequently stood in front of her, and that she knew she wanted her to go with her.