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Knapp reports four acute asthmatic episodes in the course of the analysis of a thirty-year-old male patient. Particular attention was paid to the role played by fantasies involved and emotions evoked at the onset of each attack. Both were important, though largely unconscious, and were expressed through the respiratory apparatus. The fantasies were principally those of dangerous interaction with the outer world, especially reflecting ideas of devouring, being filled with some dangerous substance (at times connected with pregnancy), or of expulsion. In these episodes strong emotions were aroused which were 'radically altered into sadness and longing and subjected to generalized inhibition similar to that seen in states of depression'. The author offers a schema which includes the following conditions necessary for the production of acute bronchial asthma: a sensitized pathway of respiratory vulnerability, the activation of intake-expulsion process by either physical or psychodynamic factors, respiratory arousal by forbidden fantasy impulse, and respiratory restraint by transformation and inhibition of excitement.