I have seen a number of cases of this disease. As is well known to all physicians the ulnar nerves control sensation and motion to a certain extent on the side of the hand next to and including the little finger. When this nerve becomes inflamed, when the condition of neu-10 ritisexists, the patient suffers intensely from the pain and numbness. This disease in a patient of mine completely broke down his self-control and made a weakling of a man who, when well, was powerful, both intellectually and physically. Dr. Bemheim Bays, "These examples relate to actual observations. However singular they may appear they are nevertheless facts." He says, "In these cases, sometimes the pain persists, or is simply diminished; it may gradually disappear after two or more treatments. In other cases it may be diminished when the subject awakes, and may continue growing less until it disappears without a new hypnotization. If not, a new suggestion may succeed, especially if a deeper sleep be induced. The pain taken away for the moment may return in several hours or later, and may only yield definitely after a variable number of hypnotizations. Finally, only certain troubles among those complained of may be effaced. The others resist the attempt.

We can understand that the effect obtained is subordinate both to the subject's suggestibility and to the psychical cause which determines the symptoms. Muscular pains, the painful points in phthisis, certain dynamic contractures, even though bound up with organic affections of the nervous centre, certain movements which remain after chorea, incontinence of urine, which children suffer from at night, etc., often disappear as if by enchantment after a single suggestion or after several."

He also says, "The mode of suggestion should be varied and adapted to the special suggestibility of the subject. A simple word does not always suffice in impressing the idea upon the mind. It is sometimes necessary to reason, to prove, to convince; in some cases to affirm decidedly; in others to insinuate gently; form the condition of sleep, just as in the waking condition, the moral individuality of each subject persists according to his character, his inclinations, his special impressionability, etc. Hypnosis does not run all subjects into a uniform mould, and make pure and simple automatons out of them, moved solely by the will of the hypnotist; it increases the cerebral docility; it makes the automatic activity preponderate over the will. But the latter persists to a certain degree, the subject thinks, reasons, discusses, accepts more readily than in the waking condition, but does not always accept, especially in the light degrees of sleep. In these cases we must know the patient's character, his particular psychical condition, in order to make an impression upon him."

Another case reported by the same author was that of a hysterical woman, who went easily into somnambulism (this term is used synonymously with hypnotism or rather denotes a particular stage of hypnotism), but in this condition she often complained of discomfort, pain, and oppression; then sometimes an attack of hysterical sleep, in which the patient ceased to be in relationship with the operator, replaced the hypnotic sleep. Affirmation alone did not succeed in dissipating this uncomfortable precursor of a crisis. He succeeded by means of a musical diversion; he made her hear a wonderful suggestive orchestra. (In the hypnotic state the patient will hear any sound suggested by the operator, the sound existing, of course, only in the imagination of the patieut.) As she adored music, her face became radiant, she beat time with her hand and all discomfort vanished.

As there was no music save in the mind of the patient it would have been of interest had Dr. Bernheim noted what rhythm she indicated with her hand.

I cannot but feel impressed in reading carefully the work of Dr. Bernheim, which I have quoted, that he is sometimes led away from accurate scientific observation by his enthusiasm, and is unwittingly deceived as to his results. Too much care cannot be enjoined upon those investigating the phenomena of hypnotism not to bo deceived by hysterical states of the subjects, who, I have found, frequently simulate that which they do not feel.

Dr. Bernheim is in accord with me in questioning the infallibility of therapeutic suggestion. He writes, "Therapeutic suggestion is not infallible, though it gives good results in a large number of cases. It may even fail when it is intelligently and persistently managed. The cause of failure is inherent sometimes in the disease, sometimes in the subject."

The following cases of hysterical persons Dr. Bernheim has found not to be benefited by hypnotism. They are cases of melancholia, some cases of hypochondria, and certain neuropathic cases.

Hypochondriacs simulating as they do diseased conditions, it seems rather singular that hypnotism should prove of so little value in many such cases. The following case will illustrate the condition well.

"I recently had to treat a young woman who was hypochondriacal. Among other troubles she had a violent pain in the epigastrium which she believed to be connected with uterine cancer, although she had been repeatedly told that there was no lesion there. I succeeded in hypnotizing her enough, and sometimes even in obtaining a profound sleep. I hypnotized her for ten days, and by energetic suggestion succeeded in quieting the pain.

But she hastened to add that the pain would return, and in fact it did come back, involuntarily evoked by her diseased imagination."

It is my belief that the pain complained of in Dr. Bernheim's case just quoted, is a sensory hallucination, probably provoked in the same way that hallucinations of sight, hearing, etc., are provoked.