After such an operation most people have a slight, nervous reaction, and then everything becomes more difficult to bear. This was, as a matter of fact, just the moment when the catastrophe did occur, in her terror lest her fiancé should break with her when he heard of her previous life. That was the first anxiety-attack. Just as the patient had not acknowledged her secret in all these years, so she now sought to guard it, and shifted the fear in her guilty conscience on to the extraction of the teeth; she thus followed a method well known to us, for when we dare not acknowledge some great sin we deplore some small sin with the greater emphasis. The problem seemed insoluble to the weak and sensitive mind of the patient, hence the affect became insurmountably great; this is the mental desire as presented from the psychological side. The series of apparently meaningless events, the so-called madness, have now a meaning; a significance appertains to the delusions, making the patient more human to us. Here is a person like ourselves, beset by universal human problems, no longer merely a cerebral machine thrown out of gear. Hitherto we thought that the insane patient revealed nothing to us by symptoms, save the senseless products of his disordered cerebral cells, but that was academic wisdom reeking of the study. When we penetrate into the human secrets of our patients, we recognise mental disease to be an unusual reaction to emotional problems which are in no wise foreign to ourselves, and the delusion discloses the psychological system upon which it is based. The light which shines forth from this conception seems to us so enormously powerful because it forces us into the innermost depths of that tremendous disorder which is most common in our asylums, and hitherto least understood; by reason of the craziness of the symptoms it is the type that strikes the public as madness _in excelsis_.