Although there are many points on which we must still remain in doubt, hypnotism has put a check on exaggerated notions of morbid anatomy as a cause of disease and given freer scope to the neglected study of diseases of functional and mental origin. We must certainly take up the position that there is no disease and no subjective trouble without an anatomical substratum. But we must not forget that the latter is in many cases so fine and so unstable, that not only are we unable to detect it post-mortem, even with the help of the microscope, but also it is impossible for us to form even the slightest notion of the nature of the abnormality without getting lost in a maze of fruitless hypotheses. We must bear this firmly in mind if we wish to understand what hypnosis has done for us. It has taught us to diagnose functional disease in cases where there was formerly a tendency to assume the presence of stable morbid anatomical changes. We now know that, where formerly organic disease of the heart or stomach was suspected, such disturbances are often enough of a functional nature, and very frequently of mental origin.

Hypnotism has therefore greatly improved diagnostics.

We have seen what a source of error the action of suggestion has proved in medical investigations. This fact brings us to the importance hypnotism has acquired in the study of the history of medicine. How are we to explain the fact that so few of the remedies that played so great a part in old books on by mental means. Hypnotism has shown us that in other cases besides those ordinarily termed hysterical, symptomatic improvement may be obtained by mental action, and that this occurs even when progressive organic diseases are concerned. Recognition of this fact has thrown a new light on charlatanism. But it is particularly on the question of curative magnetism, a branch of charlatanism, that hypnotism has enlightened us. By presenting the scientific doctor with psycho-therapeutics, and thereby rendering it possible for him to be successful in cases in which patients formerly had recourse to the charlatan, hypnotism has made the fight against quackery easier. This fact must not be underestimated. First and foremost, hypnotism has given what O. Binswenger calls psychological guidance to medical thought.

There was formerly far too great a tendency to search for a material focus of disease for every disorder, and when that was not found to put the trouble down as unimportant or exaggerated or even to lying. And the patient who knows his doctor doubts him feels injured by his mistrust, " he turns his back on him and seeks help elsewhere, only too often to become the prey of unscrupulous adventurers who make the most they can out of the weakness and helplessness of the sick and their need of practical assistance." The more doctors learn to think psychologically the less likely will they be to fall into this error, and they will thereby be rendering a great service to their patients. For although the mental influence of a charlatan may sometimes benefit a patient, that is nothing compared to the dangers of quackery. The possibility of a person's health being improved by psycho-therapeutic means cannot make up for neglect of the diagnosis (Lobedank) and omission of the necessary physical methods of treatment; and this is what almost invariably happens where charlatanism is concerned.

Hypnotism has also shed light on many a superstition in the same way that it has on quackery. When we find that in some parts of Germany the superstition obtains that insomnia can be prevented by placing one's shoes with the toes towards the bed, or by leaving two pots turned upside-down on the table (Wuttke), we can well conceive that this may act just in the same way as suggestion does. The study of the action of suggestion has also thrown fresh light on medicine as practised by uncivilized peoples. It enables us to understand the effect produced by the medicine-man, and the study of hypnotism has become of importance to the student of ethnological psychology, as Bastian, Stoll, and other ethnologists long ago surmised it would.

Those miraculous cures which so often occur without the intervention of a scientifically trained doctor or a professional charlatan belong here, such, for instance, as the cures observed at Lourdes and similar places. Medical men usually object that such cures only affect hysteria, and it must be admitted that the vast majority of the cases that terminate successfully are hysterical, but not all. When we read reports from Lourdes impartially, such, for instance, as those contained in Boissarie's book, Great Cures at Lourdes, we find a large number of cases that we have no right to put down to hysteria. That book recounts miraculous cures at Lourdes of lung troubles, of tuberculous inflammation of the joints, of wounds, of gastric ulcers, of eye-diseases, of cases of deafness and deaf-mutism, as well as of all kinds of paralyses, internal inflammatory processes and nervous diseases. In going through these cases I have become more and more convinced that many were real instances of severe organic disease in which the patient's condition was improved by psycho-therapeutics. I must here refer the reader to the remarks I made on this question on page 314 et sea.

Believers in Lourdes certainly assert that otherwise incurable diseases, such as cancer, are cured there; but what I have read of the medical history of such cases has given me no scientific ground for accepting the diagnosis as accurate. On the contrary, the superficial manner in which the diagnosis is often arrived at is very striking to the critical reader. Charcot admitted that organic lesions had been cured at Lourdes, but he thought that this was only so in the case of organic changes of hysterical origin, the cure of which by psychic means can be explained. He mentioned, amiong others, Fowler, who reduced tumours of the breast by mental influence, but he considered such tumours merely trophical disturbances of hysterical origin. The supposed miracles of Lourdes can be easily understood without giving so wide a meaning to hysteria as Charcot did. In many cases it will be found that the remarks I made on quack-diagnosis on page 319 hold good.