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1. The literature on the Schreber case is briefly reviewed. Freud's conclusions have stood unquestioned. No new material from the Memoirs has been studied, and no new interpretations have been advanced. 2. Weaknesses and discrepancies in Freud's study are pointed out with emphasis on the lack of distinction between neurosis and psychosis. Hypochondriacal delusions (somatic symptoms) are neglected by Freud and generally in psychoanalytic theory and practice. 3. In this light the literature on pregnancy fantasies is critically
reviewed. Overemphasis on genital, homosexual, and neurotic aspects has led to neglect of psychotic mechanisms, i.e., the irruption of archaic, pregenital, asexual procreation fantasies. 4. Re-examination of Schreber's material shows his psychosis to be a reactivation of archaic asexual procreation fantasies with concomitant loss of sex differentiation. He was as much male as female, both and neither. Libidinal homosexual conflict explains only the genital aspect of the change of sex, leaving out of account the fundamental psychotic procreative aspect of the transformation into a reproductive woman. 5. Schreber's absolute ambisexuality represents the 'balanced imbalance' of sex regularly, if not invariably, found in schizophrenics. 6. Freud's analysis is reviewed in the light of these findings. 7. Although much of Schreber's material can be interpreted from schizophrenic expression, the clue to his psychosis lies in the hypochondriacal delusions which are and express the deepest and most disruptive layer of his procreation fantasies. 8. The psychotic mechanism underlying hypochondria and its relation to psychosis is discussed; its nosological position and bearing on psychosomatic symptom-formation are pointed out.