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A case of severe paranoia, a young man of twenty, who nevertheless retained powers of ordered intelligence and ready co-operation gave Dr. Reich the possibility of an analysis in which the regression of the ego and the libido to deepest archaic levels found direct verbal expression. This fact together with the memories of impressions, thoughts and phantasies dating from the second year obviated the need of doubtful reconstruction, and of interpretation from children's games and phantasies which the author sees as a difficulty in the child analysis of the English school. The material confirmed the work of Freud, Abraham, Tausk, Ophuijsen, Stärcke and Bibring on paranoia, a particular feature of the case being the way in which the external persecutors took on the actual form of the skybalum. The illness broke out after a dog-bite, while the patient waited with others for inoculation against rabies: the dreaded change became an immediate psychical actuality, the figures of the other patients assuming strange and threatening forms. Thenceforth, until its solution by analysis, his central symptom consisted in these crazy transformations. All libidinal excitation in relation to an object brought about the change of the object into a monster, a 'stool person', with a corresponding change in himself, to be followed by strenuous efforts to bring about and maintain an overestimation of himself and of the object equal to the previous degradation of the two. The connection of the various changes with processes of introjection and projection on an oral-anal-sadistic level was particularly clearly given in the patient's own account of the process; the introjected object being eaten and chewed, but 'making a hubbub in his body', 'threatening him inside', 'infecting him with its own defects', so that he took on its form. Freedom from this painful situation was sought by the ejection of the object, now an ugly, evil-smelling, chewed mass, seeking revenge on him, therefore to