Reality of Hypnotic Phenomena. - Simulation Tests. - Practical Directions for Medical Hypnotism. - Excessive Nervous Tension. - Warmth by Suggestion. - Vital Reaction. - Absence of Personal Element in the Nancy Treatment. - Method of Fascination. - Some Diseased Conditions benefited by Hypnotism. - Medical Education essential for its Successful Practice. - Racial Susceptibility. - Wetterstrand's Methods. - Table of Diseases treated by the Author. - Farez and Suggestion Somnique. - Mental Diseases and Insanity as affected by Hypnotism. - Voisin's Success in Lunacy. - Researches of Italian Alienists and Neurologists. - Forel's Opinion of the Treatment. - Treatment of Epilepsy by Hypnotism and by Prolonged Hypnosis. - Hypnotism in Organic Disease. - Treatment of Stammering, Rheumatism, Neuralgia, Sea-sickness, Neurasthenia, Asthma, Chronic Alcoholism. - Statistics of Results and Remarks. - Formation of Medical Society for the Study of Hypnotism in England. - Aids to Hypnotism.

To the believer in the scientific certainty and therapeutic value of hypnotic suggestion, it is somewhat trying to be told, as he sometimes is, that the whole thing rests upon a foundation of error or misrepresentation. Sceptics, we find, divide themselves naturally into two classes: those who entirely deny the existence of the hypnotic state, or affirm that its production is so rare as to be hardly worth taking into account; and those who, while they acknowledge the reality of the psychical condition, refuse to believe in its utility as a remedial agent.

The former are a diminishing quantity, and must soon succumb under the accumulating evidence adduced by such scientific observers as Charcot, Richet, Hack Tuke, Moll, Heidenhain, Krafft-Ebing, Preyer, Beaunis, Tam-burini, Lornbroso, Bramwell, Myers, McDougall, Mitchell, etc.

The attitude of the latter class is comprehensible and, indeed, natural. It is right that the guardians of the public health should exercise a healthy scepticism and demand convincing evidence before approving a treatment of this kind, or admitting it into their practice.

The work of such practical observers and clinicians as Bernheim and Liebeault of Nancy, Voisin, Berillon, Farez, Dumontpallier of Paris, Von Schrenk-Notzing of Munich, Van Renterghem and Van Eeden of Amsterdam, Albert Moll of Berlin, Wetterstrand of Stockholm, Cruise of Dublin, Bramwell, Wingfield, and Woods of London, George Kerr and Murray Lyon of Edinburgh, Betts Taplin of Liverpool, Bryan of Leicester, and many others, will soon supply the necessary therapeutic testimony - if, indeed, it has not already done so - and we shall see hypnotic suggestion take its place in the armamentarium of the medical practitioner in spite of the difficulties thrown in its way by charlatanism and impostors past and present.

The argumentum ad hominem is, as Richet * tells us undoubtedly the best to use; and as medical men are often excellent subjects, it has sometimes been my good fortune to convince a friend, and at the same time benefit a patient, by putting a member of our profession into one or other stage of the hypnotic state.

That simulation and imposture are frequently practised at public ' entertainments,' I am not concerned to deny, though it is easier to procure a genuinely susceptible subject than to take the trouble of training a confederate. Public performers are generally careful to have with them some subjects whom they have frequently hypnotized, so as to be prepared for contingencies.

One must admit that the desire to please and to appear interesting will, especially among hospital patients, lead to a good deal of simulation, intentional or unintentional. But in private practice and among intelligent patients, simulation is a bugbear of which we need take little

* ' L'Homme et l'lntelligence.' account. With experience, too, comes the ability to detect deception, and the practised hypnotist is on the watch for it, * and is very acute in perceiving its slightest tokens. And, in fact, the patient is, as a rule, more rather than less influenced than he supposes. He will frequently say that he has in no way lost control over his thoughts and actions, and will be surprised to find that he cannot open his eyes, or that his arm has become immovable at the operator's bidding. The very way in which he tries to open his eyes is characteristic of an altered condition. Instead of using the levator palpebrarum, he wrinkles his brows and energetically employs the frontalis. If at last he succeeds, it is only after great exertion, and the eyelid opens in a peculiarly slow and heavy manner. In the same way, if, after being a little more influenced, he is told that he cannot bend or otherwise move his arm, he will make violent efforts to do so with the wrong set of muscles, and will perhaps at last, with difficulty, effect a partial and jerky movement in the desired direction.

It is but fair to ask one's self, Why should a patient make pretence about hypnotism any more than about other medical procedures? If we give a prescription to remove neuralgia or rheumatic pains, we do not accuse our patient of simulation when he returns and tells us that the mistura ferri or sodii salicylas has relieved or cured him, but rather attribute this good result to our remedy, and congratulate ourselves on its success. The therapeutic test is a perfectly fair and correct one, and as it is neither necessary nor desirable to produce the physiological action of drugs when we give them as curative agents, so it is needless to evoke or expect the phenomena of le grand hypnotisme in cases where we use suggestion as a remedy. A knowledge of the physiological action of a

* Charcot has devised an ingenious instrument, by means of which the tracings given by the involuntary movements of the arm in simulated catalepsy can be compared with the very regular and even tracing made on a revolving cylinder when the subject is in the genuine hypnotic state. This contrivance may prove useful in the detection of fraud. (Vide ' Diseases of the Nervous System,' vol. iii.) drug is necessary, as without such knowledge we should be using it empirically; and a familiarity with the phenomena of advanced hypnotism furnishes us with a key to the action of suggestion, as in the phenomena of poisons we find one to the action of drugs.