The two last cases I shall give are not examples of brilliant cures, but illustrate the importance of not promising too much from the treatment.

2. Miss H------has been a chronic invalid almost since childhood.

She is forty years of age, and has anchylosis of the right hip-joint, following hip-joint disease and lateral curvature of the spine. She is of hysterical and melancholy temperament, and her mental powers seem to have atrophied pari passu with her disused muscles. A year's perseverance in the treatment has enabled her to find some enjoyment in life; she is able to walk over a mile without much fatigue, and to play the violin for nearly an hour at a time. Previously for some months she had been barely able to move about the house, and it is years since she was able to walk a quarter of a mile. Neither had she been able for a long period to play, partly because of invincible hebetude, and partly from the fatigue attendant on the slightest effort.

3. Miss E------was sent to me suffering from hysterical right hemiplegia of a year's standing. It came on suddenly after her mothers death, and she had had repeated relapses after apparent improvement. She fell sometimes into the third and sometimes the fourth degree of hypnosis, and in this condition friction was applied to the paretic side, and suggestions made. She improved but slowly, and after twelve operations suffered from a relapse, and was confined to her bed completely helpless for a week. On her return to me I found the right arm and leg much colder than the left, and the reflexes on that side increased. Perseverance in the treatment for three months has produced a decided improvement: the right leg is nearly as warm and strong as the left, and her general health has greatly improved. One would almost have felt justified in expecting more rapidly curative results in this case, and the relapse whilst undergoing treatment was disappointing. It illustrates the point I have so frequently alluded to, that pronouncedly hysterical persons are by no means the best subjects for this treatment.

My appreciation of the efficacy of drugs has been increased since studying hypnotic suggestion; for I have seen on several occasions a properly-selected remedy remove a symptom which suggestion had left untouched. Van Eeden has shown how the beneficial effects of massage and Swedish gymnastics are increased in certain cases by being combined with Liebeault's system.

Curative suggestion, of course, takes many forms. Forel insists upon the importance of keeping nervous and hypochondriacal patients well occupied. As we know, such people lack initiative and are unable to map out their own time to advantage. It is the recognition of this fact that makes the success of many Continental ' cures.' Forel considers the curative effect of much electrical and other treatment as due to suggestion, but he nevertheless urges their importance. Farez (Revue de l'Hypnotisme) relates a case of hysterical contraction of the hand in a girl. Though she was a good hypnotic subject, suggestion alone failed to remove the contraction, but taking sparks from the back of her hand through a static battery cured her, for she said she felt the electrical flames loosening the joints, and the hand gradually opened.

There was a discussion in the British Medical Journal in 1906 as to the morality of a surgeon performing a sham operation to satisfy a patient, and the old story was quoted of the lady who thought she had swallowed a green frog, which lived in her stomach and waxed fat by robbing her of her nourishment. I think Trousseau first told the story, and how, after seeing many doctors, she called in one who understood her case. He provided himself with a green frog, which he slipped into the basin required by the emetic he administered. The patient, like so many hypochondriacs, hugged her delusion and hated to part with it; so she replied, when the doctor, pointing to the reptile, said, ' You were right, madam; and there is the cause of your trouble,' ' Ah ! you have only got rid of one; but it has bred in my stomach and left its young there.' ' Impossible,' said the doctor, gravely examining the frog, ' for it is a male.' Dr. Mercier quoted this story to support his contention that it is useless as well as wrong to deceive a patient, even for his own good, for the obsessent idea removed is almost certainly replaced by a new, and perhaps more dangerous, one.

But he left out the second half of the story, and, I think, missed the moral, which is, I take it, that the doctor using suggestion should be a man of resource and able to follow the intricate windings of a nervous patient's mind.

That hypnotic suggestion is destined to play henceforth an important part in the treatment of disease and the alleviation of human suffering is evident, and enlarged observation will show what it can and what it cannot do.

Its future in this country depends on the attitude the medical profession assumes towards it during the next few years. If the attitude is a wise one, and the utility of hypnotism in treating certain diseases is recognized, and its practice given an honourable position, we shall see benefit conferred on humanity. Hypnotism affords special scope for quackery, and if its legitimate possessors refuse to use it, we shall probably see a class of undesirable practitioners arise whose interests in it will not coincide with those of their patients or the profession.*

* In giving evidence recently (1913) before a mixed committee of eminent doctors and clergymen, presided over by the Dean of Westminster, instituted to investigate the claims of mental and spiritual healing, I expressed earnestly the opinion that both professions should study normal and abnormal psychology - i.e., human nature. The young practitioner knows all about disease and drugs, but is ignorant of human nature; the quack knows nothing of medicine, but makes an intimate study of human nature, and waxes fat to the detriment of the profession and the public.

I cannot think this necessary instruction will be long delayed. Its need was forcibly brought home to me a short time ago. Dr.

X------came to see me, and asked me to show him some hypnotic practice. He was in practice in New Zealand, and had come home to take his M.D. at Cambridge and to take up post-graduate work at the hospitals. He wished to return to his practice fully informed as to the latest things in medicine and surgery, and expressed great indignation that no reference should have been made by his teachers to psycho-therapy. I think instruction in hypnotic theory and practice should be given in general hospitals and medical schools as a part of the ordinary student's curriculum. Nothing could be more adapted to impress the young practitioner with a sense of his responsibility. In after-life he could use hypnotism himself in a few suitable cases, and would at any rate be able to advise patients what to do. We don't all do the operation for appendicitis, but it is a poor doctor who fails to recognize its needfulness. I have known people die from such ignorance, and I have seen patients condemned to suffer for years when psycho-therapy would have speedily cured them.