I tried six or seven times to hypnotize her, but was unsuccessful. I then advised her to put herself under Dr. Auguste Voisin, of Paris. He endeavoured to hypnotize her on thirty-five occasions, but failed, though he employed chloroform as an auxiliary. On her return to England I again made some futile attempts, and then sent her to Dr. Milne Bramwell, who at that time lived at Goole. He and his partner tried about 150 times, and at length succeeded in inducing partial catalepsy and sensation of numbness in one arm. But the patient could always open the eyes, and the pain was little, if at all, relieved. She writes to me that she has now been operated upon about 210 times, and expresses her intention of continuing the treatment, as it seems to offer more chance of relief than anything else she has tried. The lady is remarkably bright and intelligent, and one can only suppose that the intense and long-continued pain has made it impossible for her to attain the necessary abstraction of thought.*

Another patient, a hospital nurse, was sent to me in 1904 by a throat specialist for functional aphonia. The young lady had come all the way from New Zealand for treatment, and several specialists had tried various treatments, without any result. She was anxious to be hypnotized, and there seemed nothing against success, yet our attempts were futile. She had to return home, so I advised her to stop at Sydney and consult Dr. Creed, whose success is remarkable, and to let me know the result. She wrote to me some months afterwards, telling me she continued much the same, and that, though

* Dr. Bramwell in his book expresses the opinion that I am wrong in being so easily discouraged. Prolonged experience, however, confirms me in my practice. I do not, of course, mean that I expect to get the full effect of hypnotic suggestion in three or four sittings in a difficult case, but only that I look for some effect. Vain repetition of attempts to hypnotize become most irksome to both doctor and patient, and the money question is apt to arise. The patient may object to paying fees without any result, and the doctor cannot afford to sacrifice his time and energy without even the satisfaction of assured ultimate success. So, except under special circumstances, 1 think it is better to either send intractable patients to a colleague, to see what he can do, or to tell them to try again later on.

One never can tell, as Forel says, what is at the back of the patient's mind. Very often it is some erroneous preconception which argument, time, or change of operator may remove; but as long as it persists it is useless to expect results.

I shall never forget my experience with two patients in my early and enthusiastic days. The first was a medical man with delusions of persecution, sent to me by the late Sir J. Russell Reynolds. I spent an hour a day on that man for a month without the slightest result, and I now know that he was absolutely unhypnotizable. About the same time a lady asked me to try what I could do for her brother, who had disseminated spinal sclerosis. This patient was a retired officer, and he used to come to me with military punctuality daily, lie down on the couch with resignation, receive my ministrations with apparent acquiescence, and ask me at the end of twenty minutes if I were finished and he might go. He simply came to satisfy his relatives, and resolutely opposed my efforts.

Forel emphasizes the fact that much depends upon first impressions in hypnotic treatment, and compares this to warfare, in which the result of the campaign often turns on the first engagement. Fortunately we all find good results reward our efforts even in chronic cases when the apparent hypnotic effect is very slight, and both patient and doctor are therefore encouraged to persevere.

Dr. Creed had been most persevering, and had tried twelve times, the effect on her was absolutely nil. I tried to hypnotize her ten times before giving it up, and I am sure a hundred attempts would have seen us no nearer the goal.

Bramwell mentions one case in which he was successful in hypnotizing a patient after having failed to influence her in sixty-five previous attempts. The patience of both parties was rewarded by the lady being very soon cured by hypnotic suggestion of pruritis vulvas, which had defied treatment for several years.*

One frequently finds the degree of hypnotic effect varies.

For instance, I hypnotized Mr. R------in November, 1888, and noticed that he fell into the fourth stage. He was suffering from chronic bronchitis, and was in a low, depressed state of vitality generally. Subsequently I could never induce more than the second degree, for as his health improved he became less susceptible.

As regards personal qualification, I should say that tact and confidence are the only requirements. Different patients require to be approached in different ways, and the somewhat imperious tone which is necessary in some cases would arouse fatal antagonism in others.

The personal equation is, we must admit, a very powerful factor in all medical practice, and it becomes, perhaps more prominent in suggestive therapeutics. For instance, some years ago a small tradesman came to me for obstinate lumbago, and I put him under hypnotic treatment. He was a good subject, and improved so rapidly that I expected soon to have him quite well. Then suddenly he ceased to make progress, and, in fact, rather went back. Finally we sent him to Droitwich, and the brine baths there completed his cure.

On his return he came to report himself, and then told me why he had suddenly ceased to improve under my treatment. It appears he was an ardent teetotaler, and among the many high qualities with which his imagination endowed me was that of sharing his horror of alcohol. His ideal was shattered one day by my coming in to hypnotize him from a luncheon party, at which I had drunk a glass of sherry. My breath betrayed me; he felt I was a poor, weak sinner, weaker than himself, and my suggestions never again had their former power over him. The education and training of a medical man naturally tend to the development of the necessary qualities, and from my experience I believe that any medical man can, with a little practice, succeed in hypnotizing the majority of patients. Anyone can hypnotize some people, and there are others whom, practically, no one can influence. Between these extremes lies a third and comparatively small class, with whom it requires experience and practice to succeed, and it is the management of these cases which requires most time and patience.

Doctors who have known nothing of hypnotism, except that they have seen me hynotize two or three patients, have frequently gone home and at once been able to hypnotize their wives, children, and servants, and have only been stopped in their run of success by meeting a case altogether insusceptible or requiring very careful management. Bernheim, in his hospital clinique, claims over go per cent, of successes, and four-fifths of the patients fall into profound sleep or somnambulism, whereas in his private practice this ratio is altered in a remarkable degree, for though nearly the same percentage are influenced, only one-fifth or one-sixth fall into profound sleep without recollection on waking. The French seem slightly more susceptible than other nationalities, but Forel at Zurich, Ladame at Geneva, Von Shrenk-Notzing at Munich, Moll at Berlin, Van Eeden and Van Renterghem at Amsterdam, Wetter-strand at Stockholm, Tokarsky at Moscow, Hamilton Osgood in Boston, U.S.A., Creed at Sydney, N.S.W.,and other practitioners all over the world, obtain nearly as good results. *

* British Medical Journal, February 28, 1891.

* Cory says ('Hypnotism and Mesmerism,' Boston, 1888) that he has never succeeded in hypnotizing a Chinese, though he has experimerited on several. The Orientals I have treated have mostly been good subjects.