Hartmann's theories have experienced a remarkable rise and fall in popularity over the past fifty years. In this paper, an effort is made to arrive at a balanced view. The genetic and economic aspects of Hartmann's ego psychology are found to be problematic, but the dynamic aspect led to a sophisticated psychoanalytic concept of health as yet unsurpassed. Hartmann always called for the clinical application of his ideas. In this spirit, a vignette is offered from a clinical area in which questions of "health" and "illness" are particularly vexing at present.