I greatly appreciate the interesting, stimulating remarks of the discussants. Dr. White's point regarding coronary insufficiency is most relevant. In reply to Dr. Kaufman's question: the young woman did have a history of previous attacks of asthma, a few times a year and quite mild. In response to Dr. Wahl's comment: there is no disagreement, as I did not mean to imply that sudden death can have only a single cause, or can occur only at impasse. My note reports on one, single setting which seemed connected with its occurrence. It may occur in other settings as well. The whole story would lead, as Dr. Solomon suggests, to an enormous study; but I think he will agree that the history of medicine shows that suggestive clinical observations have stimulated our observation and increased our knowledge, and may still do so. Dynamic psychiatry today, while drawing on every relevant field, is still rooted in the daily clinical observations of the physician.