It is very interesting to observe how often the would-be discoverer of some particular, method thinks he can put aside the possibility of suggestive influence without producing even a trace of proof for his assumption. Thus Fleury, on the ground of theoretical considerations, regards the infusion of salt as the specific agent in the treatment of neurasthenia, and thinks that in so doing he excludes the influence of suggestion. When Nageli, who treats neuralgia and neurosis by a process of manipulation, concluded a lecture with the words " suggestion is excluded," Forel very properly pointed out how little is proved by such assertions. In fact, any experimenter of experience in the domain of suggestion must often be astonished at the unthinking manner in which suggestion is assumed to be excluded. As Forel has rightly pointed out, Brown-Sequard's testicular injections must be considered from the same point of view. Massolongo regards their operation as purely suggestive, and Martinet is convinced, on the ground of numerous experiments, that it is a matter of indifference whether testicular fluid or distilled water is injected. Save the peripheral stimulus imparted by the injection, there is no other essential moment worth minding but the operation of suggestion.

Of course this is no reason for denying animal substances all somato-therapeutic action. I would only point out that the results obtained by these and other similar therapeutic measures can be completely explained by suggestion.

At all events, there are numerous cases in which this explanation is much more satisfactory than any of the complicated and pseudo-scientific attempts at explanation that are so frequently made. A striking example of this fact is supplied by balneo-therapeutics. Formerly the efficacy of such treatment was ascribed to salts in the springs visited, and the enormous influence which leaving home and all business troubles must have on a patient who visits a watering-place was ignored. But in order to attribute a thoroughly specific action to springs, special value has recently been laid on radio-active substances. And yet an unbiassed investigator will often find a perfectly adequate explanation in spontaneous improvement, and in numerous other cases in the influence of suggestion - an explanation which makes him feel those "scientific" interpretations mere triflings which remind one of the wood that cannot be seen for the trees.

Even in the case of operations we must always be on the watch for mental influence. I call to mind the discussion that ensued on the introduction of castration for hysteria and mental affections, and I cannot do better than quote the excellent remarks made by Julius Friedemann in his thesis for the degree of Doctor of Medicine: - " Only to think of the number of women who have, in reality, been mutilated since clitoridectomy was introduced as a cure for neuroses and psychoses! But neither in hysteria, nor in epilepsy, nor in onanism, nor in any psychosis connected with sexual processes will any good result from removing a healthy clitoris. It is now said that the arcanum has been discovered in the ovaries which are to blame for all the lamentable symptoms which characterize those diseases." Even at that period Friedmann, Israel, and Landau opposed the views held by Hegar and Tauffer, and rightly drew attention to the mental influence of such operations. Unfortunately, a general appreciation of mental influence was impossible in those days; but time has wrought a change in that respect.

OF course, there are many questions in this connection still unsolved, and even now we are at times unable to decide whether some particular therapeutic action should be ascribed to suggestion or to somatic influence. But undoubted proof of the exclusion of suggestion should always be given when its influence is denied in any particular case. To assert apodic-tically "suggestion is excluded" does not furnish such proof.

On the other hand, we must beware of tracing everything to suggestion after the manner of people who delight in catchwords. Since the influence of suggestion was underrated at first, it easily came to be occasionally exaggerated later on; for example, the chemical and physical action of remedies was denied, and results were traced to suggestion. How far we may be led astray in this manner is shown by the reception which was given to Schleich's method of inducing local analgesia. The fact that local analgesia could be induced by suggestion - Barth, for instance, had induced a sufficient degree of anaesthesia for minor operations on the throat by persuading the patient that the solution of common salt with which his throat was painted was cocaine and therefore rendered the mucous membrane insensitive - led to the erroneous conclusion that Schleich's method was suggestive, though Schleich had shown that the injection of water produced such swelling of the tissues that a surgical operation might be painlessly performed.

In the case of internal remedies, also, the action of suggestion has occasionally been assumed in the wrong place, not only in respect to chemical or physical action, but where the action of a drug has been simulated by a spontaneous cure or spontaneous improvement I have already discussed the latter point in detail on page 297. Here I will only call attention to a point that shows how careful we should be in the use of catchwords a la suggestion. In recent times homoeopathy has come to be looked upon as a form of suggestive therapeutics; but when we consider that homoeopathy also plays a great part in veterinary medicine, and that it is impossible to understand how an animal so very low down in the intellectual scale as a horse should be influenced by suggestion, it follows that there are other sources of error to be considered in the case of homoeopathy. I think that both in veterinary and medical practice many a really spontaneous cure is put down to homoeopathic treatment. Of course, such real exponents of homoeopathy as Roth, Sperling, Lorbacher, Pfander, and Julius Fuchs distinguish between the efficacy of homoeopathy and suggestion and spontaneous restoration to health.