Levitan hypothecates that the individual manic episode is precipitated by the need to control the memory of pain. Three sources of data are used to support the hypothesis: certain dreams preceding mania; clinical pain-mania sequences; and the regular step-by-step action of narcotic drugs. In dreams, the painful experience is revived, followed by the sudden abrogation of the pain and then the emergence of the archaic pleasure ego which characterizes the ensuing mania. That the pain does not awaken the dreamer seems pivotal, for the dreamer does not restore his or her awake ego functions, including reality testing. In the pain-mania sequences the memory of actual tissue damage is extinguished at the outset of the manic episode, thus supporting the idea that pain is the conscious component of the depressive phase of manic-depressive disease. Narcotics, which in small doses result in the relief of pain, can create ecstasy in larger doses.