Bernheim, in his book on "Suggestive Therapeutics," page 116, says, "The use of hypnotism for the production of surgical anaesthesia is by no means a new thing. Dr. Char-pignon reviewed the following facts, relative to operations practised during hypnotic anaesthesia, in the Gazette des Hopitaux in 1829. The removal of a breast by Jules Cloquet in 1845; in 1846, the amputation of a leg, and the extirpation of a gland, painlessly performed by Dr. Loysel of Cherbourg; in 1845, a double thigh amputation by Drs. Fanton and Towsel of London; in 1845, the amputation of an arm, by Dr. Joly of London; in 1847, the removal of a tumor of the jaw by Drs. Ribaud and Kiaro, dentists of Poitiers.

"In spite of these fortunate trials, surgeons soon showed that hypnotism only rarely succeeds as an anaesthetic, that absolute insensibility is the exception among hypnotizable subjects, and that the hypnotizing itself generally fails in persons disturbed by the expectation of an operation."

It is my experience that a larger number of persons can be made insensible to pain than the eminent author. Dr. Bernheim, and his colleagues believe to be true. All of the anaesthetics now in use, each in their turn, have met with very great enthusiastic admiration on the one side, and profound distrust on the other. I agree with Dr. Bernheim that hypnotism can never wholly supplant the use of ether, chloroform and gas as an anaesthetic for surgical purposes.

Many of the failures, however, to produce by hypnotism the insensibility to pain, were due to the subjects not having been properly prepared. I am also willing to admit that my own experience in the surgical use of hypnotism is limited when compared with European hypnotists; but I shall give it, and trust that it may add a little to what has been so ably written by physicians, both in Europe and in America.

I have hypnotized forty-two persons for minor and major surgical operations. Six obstetrical cases are to he added to the list, making a total of forty-eight. Every one of these patients was hypnotized more than once before a surgical operation was attempted. Six of them were major or capital operations, exclusive of the obstetrical cases. This leaves thirty-six of my cases which were only minor operations. Four of these thirty-six oases, while there was no danger in the operation performed upon them, would have suffered severely had it not been for the deep hypnotic trance.

The most difficult operation performed under hypnosis which ever came within my experience will now be related, and a few of the others will be casually mentioned.

The patient now to be described was a young man, suffering with tubercular disease of the bladder. His sufferings had been for over a year something terrible to witness. Opiates had been used, practically in vain, as he soon established a tolerance for each and all of them, and could take astonishingly large amounts of them without either stupefying him, or in the least mitigating his misery. The terrible suffering so wore upon him that his whole nervous system was shattered.

It was necessary, of course, to treat the bladder locally. Under hypnosis this could be accomplished without pain. Finally an exploration of the bladder became necessary, with a view of removing inflammatory material, which it was supposed had collected upon its walls, and interfered with the expulsion of its contents. As there had been other surgical procedures in the case, the patient was so worn by 7 these various attempts to relieve him, that we feared the sight of a strange surgeon might prove too much of a shock to his enfeebled nervous system.

At my request an eminent Boston surgeon was called and arrangements made to administer an anaesthetic. The mans condition was so feeble that we all feared that chloroform, ether, or gas, would prematurely end his life. I stated to the surgeon that I believed he could be hypnotized to such an extent that he would never know what had occurred.

Now, as every tissue about the bladder of the patient was, owing to its diseased state, as sensitive, possibly, as the human eye, every one familiar with bladder surgery will realize the depth of anaesthesia that must have been induced to obtain the following results.

The patient was thrown by suggestion, and by looking at a bright object, into a deep hyp-notice trance. Let me say, in passing, that his temperature was 103.8 at this time.

After he had been thoroughly entranced a pre-arranged signal was given, and the surgeon entered the room. He explored the bladder thoroughly through a supra-pubic opening, investigated every part of it, and determined its size, and this by means of the sense of touch. Proper apparatus were adjusted for drainage, and the wound dressed. The surgeon left the room, and when the young man was brought out of the hypnotic trance he did not know that any one had been in the room, and insisted that the hypnotism simply had made him feel a great deal better.

It is far from my purpose to appeal to the love of the marvellous inherent in the race, but, in the words of the surgeon who operated, the degree of ansesthesia obtained seemed to him "absolutely uncanny." That the patient did not pretend anaesthesia will be apparent, when I state that every surgeon who ever made such an operation, will testify that it would be, without an anaesthetic, one of the most painful in the whole category of major surgical operations. To illustrate the highly sensitive condition of the bladder, I shall state that from one-half to one ounce of warm water very slowly introduced through a syringe and catheter had previously caused the patient to shriek and have spasms of the whole body from the instense pain he suffered.

Hypnotism was used on this young man twice or three times a day, for a period of nearly four months, and the amount of pain saved is a little short of miraculous.

I have hypnotized, as previously stated, six women in childbirth. In one, instrumental interference became necessary by means of forceps. She claimed to be wholly unconscious of what was done. One patient died, as was after-mrdfl proved, from organic disease of the heart during labor, while in the hypnotic state. The death, however, was not due in any way to hypnotism.

Of my other four patients, three claimed to be wholly unconscious, and free from pain during the birth of their children, while the other one knew what was passing, but claimed that she experienced no pain.

Now while it is true that only a certain number of persons susceptible to hypnotization can be hypnotized sufficiently to be rendered insensible to pain, the fact that some such do, is an earnest plea of itself for its use whenever feasible.

It is my belief, from experiments, that this number can be made very much larger than hypnotists generally believe, by hypnotizing a numl>er of times, prior to the operation, the person to be operated upon, so that the system will become accustomed to the deep trance. What percentage can be hypnotized to this extent I do not as yet know, but for that percentage, for that unknown quantity, I ask a fair hearing before the great bar over which scientific thought presides as a judge.

It is my purpose in this book to make it largely elementary, and I deeply regret that the limited space forbids my quoting more extensively from the writings of Bernheim, Moll, Liegeois, Luys, King, Forel, and others. There is quite an extensive literature at the present time bearing on this subject, and upon kindred branches of hypnotism. Most of it is unfortunately too technical to permit of casual reading by the every-day busy man, and yet it is to the masses that hypnotism is of value, if it has any value. The judgment of it will not be left to any set of men, no matter how learned. Therefore, if I can in a measure make the ordinary phenomena of hypnotism clear, and enhance the appreciation of its uses, and give a fair understanding of its dangers, my labors will not have been in vain.

With reference to the department of surgery hypnotism has its place. It does not fill that place at the present time, owing either to the scepticism or the ignorance of those to whom it would be of the most value. I think a large amount of dentistry might be safely and painlessly done if hypnotism were used as an anses-thetic.

It is claimed that persons partially under the influence of chloroform can he hypnotized more readily and more deeply, than is ordinarily the case with a normal individual. Most persons when they begin to take ether imagine that the stupor produced by the drug is identical with that of sleep, and I have seen a person go to sleep when he imagined he was taking ether, when only a sponge scented with a substance resembling it in smell was placed over the face, although the substance placed upon the sponge was practically inert.

The whole subject of the application of hypnotism in surgery is, then, notwithstanding the many attempts which have been made in Europe and America to solve it, as yet sub judice, and I earnestly hope that a widespread effort on the part of the surgeons, both in Europe and America, will bring about a more intelligent application of it and ameliorate much suffering which now goes unrelieved.

I cannot see the necessity of entering into the details of a larger number of cases in which hypnotism has been used as a surgical anaesthetic either by myself or by others. Any one wishing to further study the subject will find a very good description of it in Dr. Bern-heim's book, "Suggestive Therapeutics."

One thing should be noted, however. In certain classes of diseases there is a great deal of pain following surgical operations. Persors are either left to bear this pain, or morphine is used for its relief. In every such case hypnotism should be tried thoroughly before resorting to the use of opiates.