The final question of the clinical physician, and the medical practitioner is the practical demand for the definition of the position of hypnotism in its relation to therapeutics. I may, I think, take it as proved beyond all reasonable doubt that the hypnotic condition is a real and admitted clinical fact. Setting aside all the impostures, follies, and errors which have gathered around it, brushing away the fantastic halo of clairvoyance, telepathic and visional communication, transference of thought or sensation across space, or by contact and externalisation of sensation, as pure fallacies, fancies, or frauds, we have still the solid basis of the subjective condition of artificially induced sleep and heightened suggestibility. What use then, if any, can be made of the power of suggestion under these circumstances as a curative agent? In reply to this question I will adduce chiefly the evidence of Dr. Luys, Dr. Charcot, Dr. Babinski, and M. Ballet, analysing the results of long years of clinical experiment on a vast number of subjects in Paris and in Nancy. M. Babinski discusses the subject very carefully in a lecture which he gave, at the Salpdtriere on June 23, 1891.1 He opens his lecture very frankly with the following statement: - 'At the Salpetriere, without at all objecting to hypnotism as a weapon of the therapeutic arsenal, it is considered that its indications are limited, and that this mode of cure can hardly be applied with success except in hysteria.' 'In any case it may,' he considers, 'be affirmed (p 23) that the greater part of the symptoms which have been cured by this method arise from and belong to that neurosis.' 'Hypnotism,' he further says,' may, it must be admitted, serve in the treatment of hysterical manifestations, but it must also be acknowledged that even in affections of this class, hypnotic practice does not give brilliant results.'

1 Hypnotisme et Hysterie: du Role de l'Hypnotisme en Therapeu-tique. Lecon faite a la Salpetriere le 23 Join, 1891, par J. Babinski, m6deoin des hopitaux, ancien chef de clinique des maladies ner-veoses a la Faculte. Paris: G. Masson, 1891.

From the therapeutic point of view he groups hysterics into two distinct classes. To the first belong the great number of hysterical persons who are not capable of being hypnotised, however much trouble is taken with them. Some of these patients are no doubt subject to the very old-fashioned influence of suggestion in the waking state. Such people have always been susceptible to cure by bread pills and distilled water and by the 'rapid' influence of electrotherapy, hydrotherapy, etc. In the second class are the hysterics, persons who can be hypnotised, and these present numerous varieties. Some of them, especially those subject to hysterical neuralgia and cutaneous hyperesthesia, are very rebellious to suggestion, and in others only a partial and very inadequate result can be obtained. In some cases of hysterical contraction of the limbs suggestion gives relief, but it has to be renewed from day to day, sometimes five or six times a day, and the patient is very liable to relapse. In a very few cases a gradual and definite amelioration is obtained, as in one case of hysterical muscular contraction and coxalgia which Dr. Babinski is able to quote. 'Finally,' he asks himself after many years of study and experience as chef de clmiqus des maladies nerveuses and as an hospital physician, who has constantly observed the cases at the Salpetriere, 'does the field of action of hypnotism pass beyond the domain of hysteria?' His final conclusion, which he italicises at the dose of his address, is that it is justifiable to say, and he is authorised to conclude that outside of hysteria there does not exist a single affection capable of being notably modified by hypnotism, or at least that the contrary is not proved, for the cases published with that object are far from being demonstrative.

Of course the opposite thesis is maintained by M. Bemheim, but after the close analysis to which Dr. Babinaki subjects the cases published by Dr. Bernheim in his two books on psychotherapy and suggestion, there remains very little which can be accepted as substantial.

In addition to bodily diseases some alienist physicians have alleged that mental maladies may be cured by hypnotism. Here again we may take the results of competent French alienists who have given a practical trial to this method. M. Magnan authorises the statement that experiments made on the treatment of insanity by hypnotism at the Bureau de l'Admission during three years have given no appreciable result, while M. Bernheim himself recognises that the domain of mental alienation is the most rebellious to suggestion. Dr. Forel, of Zurich, is not less positive in his conclusions. He says l :-' Insane ideas have never been modified in any patient. Even those whom I succeeded in hypno-tising, in rendering ansasthesic and amnesic, whom I made realise post-hypnotic suggestions, refused to accept any suggestion opposed to their insane ideas. I never succeeded in influencing the course of true melancholia (I do not speak of hysteric melancholia) by suggestion; at most I was able sometimes to produce sleep, and in one case to hasten convalescence.' M. Briand, Chief Physician of the Asile of Villejuif, said on the same occasion: - ' I have many times attempted to send to sleep the insane and delirious who presented no hysteric taint, but I was never fortunate enough to obtain any result.' If this is so in France, the results are likely to be at least as negative in Great Britain, where the population is undoubtedly much less susceptible to suggeation.

1 Premier Congres International de l'Hypnotisme, p. 155. Paris: Octave Doin, Editeur, 1890.