The first patient presented by Delbruck was an Austrian maid-servant who in her wanderings through Austria and Switzerland had played at various times the roles of Roumanian princess, Spaniard of royal lineage, a poor medical student, and the rich friend of a bishop. Her lying revealed a mixture of imagination, boastfulness, deception, delusion, and dissimulation. She romanced wonderfully about her royal birth and wrote letters purporting to be from a cardinal to herself. She fled disguised as a man from an educational institution to Switzerland where her sex was discovered. It appeared that she was subject to contrary sex feelings and thought of herself as a man. She was under the observation of Krafft-Ebing at one time. He considered it at least as a case of paranoia. Others had determined the girl to be a psychopath who indulged in simulations and lies. Delbruck denominated it a case of direct lying with a tendency to phantasies, delusions, and dissimulations. Delbruck from this case argues that a mixture of lies and delusions is possible, comparing such a state with dreaming and with the hypnotic condition in which one follows the suggestion of the hypnotizer and is still aware of the fact. It was evident at times that this girl half believed her own stories, then again that she had forgotten her former lies. In her, Delbruck considers perverted sex feeling and hysteria revealed a brain organization abnormal from birth. There was the instinctive tendency to lie.