After the patient has been thoroughly accustomed to the treatment, it is often possible to hypnotize even while he is suffering great pain, as I have seen in cases of acute rheumatism and neuralgia. But even when the patient is a good subject pain may render the process of no avail. Under such circumstances I again have recourse to an anodyne, and when the severity of the pain is subdued there is rarely any further difficulty in inducing the usual degree of hypnosis.

As an example of this, I may refer to the case of a gentleman who came to me to be hypnotized for locomotor ataxy. After the second sitting he experienced no more pain for nearly three months. Then he was caught in a storm, and sat for some time in his wet clothes. A violent attack of pain came on the night following, and he got to my house with much difficulty the next day.

The lightning pains in his thighs were so severe that they made him scream out, and they were almost continuous. He was only susceptible to the first degree, and it would have been useless to have tried hypnotism under the circumstances. After the injection of half a grain of morphia, in divided doses, he at last became quiet and free from pain, and I then hypnotized him with success, and he remained free from pain for a long time. He, however, returned regularly for treatment every two weeks, and I find that repetition of the operation at about that interval is necessary in these cases. Dr. Van Eeden told me, and I have fully confirmed his observation, that when natural sleep is induced instead of the hypnotic state, the subject is not in touch with the operator, and is therefore insusceptible to suggestion, and no benefit then results from the operation. I have seen natural sleep instead of hypnosis induced by suggestion several times. I have found hypnotic suggestion very successful in many cases of peripheral neuritis, especially when of the alcoholic variety.

Relief of pain and restoration of function in some of these cases is so immediate that it has to be seen to be believed.

Forel has stated that it is very inadvisable to hypnotize insane and weak-minded persons in company, as they are very apt to be acted upon by suggestions meant for other patients. I have always found that the more private and serious the procedure is made, the better is the result - at any rate, with English patients. Dr. Crichton Miller, however, has adopted the Continental method, and claims much success from collective hypnotism.

I have failed to get any improvement in a case of paralysis of the right arm dependent on spinal sclerosis; nor have I been more successful with an old-standing right hemiplegia, with late rigidity, in a young man of twenty-one, dating from an attack of infantile convulsions, and dependent on cerebral lesion. * I gave up a case of congenital chorea, as it was impossible to tell if the patient - a boy aged eight, of weak intelligence, but great cunning - were really influenced, or was only pretending. I am unable to say much of its use in epilepsy. In some cases the fits have diminished in number and intensity at first, but they have generally reasserted themselves. Several times, however, I have persuaded the patient to leave off taking bromides, and have generally found that hypnotic suggestion, as long as it is used, will enable the sufferer to dispense with drugs. In cases of bromism this is by no means a small gain.

In the Zoist and other mesmeric publications of the last century one frequently comes across references to the successful treatment of epilepsy by mesmerism, but there is generally a want of scientific accuracy in the accounts of such cases which very much weakens their value.

* The improvement I have seen result from suggestion in several cases of locomotor ataxy would encourage me to try the treatment in organic cerebro-spinal diseases. Drs. Fontan and Segard, Professors at the Medical School of Toulon, have published in their ' Elments de Medecine Suggestive ' clinical notes of a case of disseminated sclerosis of the cord. The patient improved so much under hypnotic treatment that doubts were thrown on the accuracy of the diagnosis; but the man returned to the hospital the following year and died there of acute tuberculosis. A careful necropsy was made, which revealed very extensive patches of sclerosis, chiefly in the left lateral column, and rendered the improvement somewhat extraordinary. As Bern-heim says, there is, no doubt, a great deal of sympathetic and functional disturbance of the neighbouring centres and structures in many forms of cerebro-spinal disease, and it is this element which can be reached by suggestion.

On a priori grounds hypnotism might be expected to exert a powerful influence in epilepsy, and I confess that the rarity with which it has effected cures is a matter of much disappointment to me.

Hypnotism undoubtedly affects the cortical cells, as does epilepsy, and its action on them should be regular and orderly, instead of explosive and destructive. In fact, it might be expected to act as a physiological corrective by controlling irregular nervous discharges, breaking the morbid nerve habit, and conserving the energy which epilepsy dissipates. No doubt hypnotism does act in this manner in most cases of hysterical origin, and in some where no hysteria is present. In long-standing cases, when the disease is hereditary, or when it has atraumatic origin, I should hardly expect, from my experience, to find hypnotism of much value; and, of course, where the disease is traceable to a reflex irritation - e.g., unerupted wisdom-tooth, elongated foreskin, visual defects - this should be put right. It is, however, always justifiable to make a careful trial of hypnotism in cases of epilepsy, for there are many cures now recorded on the best authority. I have cured one case of true epilepsy, of recent development in a youth of sixteen, and I have frequently seen it useful in modifying the number and violence of the attacks.