It would have been wiser to have passed by this confused work without taking any notice of it, were it not for the fact that it reflects accurately the confusion existing in so many minds. Babinski remonstrates against the term "suggestion" because it contains something which is ominous. Then he desires to replace the word hysteria by troubles pithiatiques (disturbances which are curable by persuasion). In this he confounds the curing of symptoms with the curing of a constitutional psychopathy, for hysteria is this, and be continues to muddle up hysteria and suggestion. He has not yet understood the difference between normal suggestibility and the pathological hypnosis of the hysterical, even after these twelve years.

We know from the manifold phenomena of psychopathology that the conceptions in this science are for the most part only dependent on pathological strengthening, weakening, or qualitative alterations of psychological or psychophysiological ideas. Nothing is easier than to explain hysteria also as a pathologically increased suggestibility, as Moebius has done. He pointed out correctly that the symptoms in the hysterical are apt to arise from conceptions. I myself have accentuated the pathological autosuggestibility, because the majority of hysterica and the worst eases are more autosuggestible than suggestible.

Ringier 1 was right when he distinguished two relative categories of hysterical persons; the first included those who possess a very high degree of autosuggestibility, and are but little influenced by foreign suggestion, and the second included those who are more easily influenced by foreign suggestion. I shall return to these categories, which Ringier introduced on the basis of suggestive therapy, because they are reflected in other conditions.

There have always been some paradoxical practitioners who say that all women are more or less hysterical. We can deduce from this, as well as from Charcot's identification of hypnosis with a portion of the picture of hysteria, that it has always been difficult to differentiate the idea of hysteria from that of the normal condition.

1 Ringier, "Results of Hypnotism in Country Practice." (Munchen: Lehmann, 1891.)

But it is not easy, either, to differentiate this idea from that of severe psychoses. This is well shown by the mixed terms of "hystero-epilepsy," "hysterical madness," "hysterical mania," etc. However, Charcot, Brener, Freund, Vogt, and also several authors who have reported single cases, have proved that apparently severe phenomena, which are extremely like severe neuroses, epilepsy, or severe psychoses, can be produced by conceptions, and can be again removed by conceptions. I myself have observed a number of striking cases of this kind. Such cases may even last for years, or almost for a lifetime, and yet finally be cured, as if it were by a miracle. I have seen such a case of severe paraplegia in Wetterstrand's practice.

Still, we must not allow ourselves to be blinded by appearances. These cases belong really to true hysteria, whether they affect men or women. But it is quite different in the case of the true mixed forms. These belong chiefly to Ringier'a first-mentioned category. If we study such individuals carefully, we find that they harbor in themselves elements of severe constitutional psychopathic anomalies or psychoses, such as ethical defects, erethic conditions of mood, irritable weakness, rudiments or elements of ideas of exaltation or delusions of persecution with partial lucidity which take up a position halfway toward psychoses, impulsion, abnormalities of the sexual sphere, morbid amorousness, pathological giddiness, constitutional quarrelsomeness or melancholia, hypochondriasis, etc. In brief, we are floating from the region of hysteria into that of other constitutional psychopathic conditions, or maybe we are already in it before we know what has happened. The phenomenon of pathological autosuggestibility is undoubtedly more deeply pathological than that of pathological suggestibility. But one cannot draw a definite line of demarcation. Not only can other psychopathical persons show exquisitely hysterical phenomena, but if we fix our attention on the latter of Ringier's categories, we find that these people, if they are markedly hysterical and are not to be considered normal, really belong to the constitutional psychopaths, even if it be to the relatively milder ones.

We have built up a transition series from the severe psychopathical conditions to relatively pure hysteria, and thence to the normal condition, by means of these cases.

However, lines and planes are not to be found in this subject. Many constitutional psychoses show transitions to the normal condition which do not reveal anything hysterical at all in them.

But more than that As is well known, a formerly healthy person may acquire an hysteria. Attempts have been made to deny this, but not with justification. Just as the cardinal symptoms of paranoia, or of melancholia, or perverse sexual appetite, etc., exist both constitutionally as disorders of the character and acqniredly as acute or chronic psychoses, so is this the case with the symptoms of hysteria, and even with the disposition toward hysteria. I have experienced several exquisitely acquired cases of perverse sexual appetite, which have been produced by autosuggestion, occurring in highly ethical and educated persons. Some of these I have been able to cure by suggestion.