Finally, I must mention religion as the most effective psycho-therapeutic remedy we possess. I do not mean those forms of religion that involve superstitious practices, because they may prove injurious by causing the necessary somato-therapeutic to be neglected, although they do at times have a therapeutic effect; what I really mean is the religion that enables a patient to face even the most terrible situations with equanimity. There must always be cases in which the disease is either incurable or to an extent stationary or progressive, where the patient can no longer be buoyed up by any influence his doctor can bring to bear. In these cases religious belief is the best medicine for the patient. When a patient says, "The Lord our God must indeed love me, or he would not inflict such suffering on me," a doctor cannot but reflect, as Lcewenfeld rightly insists, that he can never provide a patient with such consolation from any other source.

I have intentionally abstained from going any farther into the indications for the employment of psycho-therapeutics. The examples I have already given show that it is as well-calculated to satisfy the indicatio causa/is as it is to fulfil the indicatio morbi and the indicatio symptomatica. But we must be very careful in our delineation of these indications. It is frequently assumed that in cases of functional disease all that is requisite is to satisfy the indicatio causalis or even the indicatio morbi.

It is generally admitted in the present day that the use of psycho-therapeutics is more frequently indicated than was the case twenty years ago, when it was thought desirable to limit its application entirely to hysteria. There is hardly any disease in which it does not play a part. This applies as much to functional diseases as to organic ones, to curable as well as to incurable, or to stationary or progressive, acute or chronic maladies. The way in which psycho-therapeutics has come to be looked on in the present as an important factor in the treatment of exactly the severest diseases, proceeds from the recognition that the care of the sick now enjoys, the influence of which on a patient's mind is of the greatest importance. Even in surgical cases in which a superficial judge would consider psycho-therapeutics superfluous, it really plays a great part. Klaussner has called attention to this in a small pamphlet. A very essential point is how a surgeon makes his preparations for an operation; whether he selects his instrument in the presence of the patient, or whether the latter hears the cries of pain emitted by others or even sees the blood of those who have just been operated on. All these matters come within the scope of psycho-therapeutics and have been much too long neglected.

Of course, the object for which a doctor employs psycho-therapeutic remedies will be different in each particular case. Sometimes psycho-therapeutics, for example, praxi-therapeutics, will be employed to prevent the patient being conscious of his disease, sometimes to cure the disease itself! The form of mental influence to be used must be so chosen as to suit not only the nature of the disease but the patient's individuality as well. Age and sex, financial conditions and social position, nationality, temperament, character and degree of culture, religious belief, and many other facts are all determinants in the selection of the kind of influence to be employed. A simple talking-to by the doctor without any other accessory suffices in the case of a child (Comby), but it may be much more difficult to make an impression on a grown-up person. With weak-minded persons we shall have to pursue a different course to that we should take with the intelligent; but no doctor has ever any right to neglect psycho-therapeutics. From the age at which a human being becomes susceptible to mental influence down to the hour when he is lying unconscious in the death-agony, psycho-therapeutics has to be taken into account.

Indeed, in respect to the latter point, I must draw special attention to the fact that a dying person is in most urgent need of the psycho-therapeutic influence of the doctor and of those at the bedside, and that those somatic influences - injections of camphor, for instance, and all the other tortures to which the dying are so often subjected - are, in numerous cases, quite opposed to the fundamental principles of psycho-therapeutics and humanity. I also take this opportunity of giving a word of warning against assuming that the death-agony is accompanied by unconsciousness in cases in which the patient may possibly still be susceptible to the influence of those around him. Solicitude for the dying person's peaceful passing (euthanasia) opens up a wide field to psycho-therapeutics. I have discussed this point in great detail in my work Arztliche Ethik.

It follows from the foregoing explanations that the use of psycho-therapeutic influence is not limited solely to specialists. I must here refer the reader to what I said about medical specialists for hypnotic treatment on page 326 et seq. But there are certainly many cases in which a doctor who has made a speciality of psycho-therapeutics is better suited to carry out the treatment than another, but every other doctor, whether he is engaged in general practice or in some special branch of medicine, is bound to have many opportunities for employing psycho-therapeutic influence. In many cases certain quite definite factors also play a part. Thus there are cases in which a doctor who is almost a stranger is able to exert a greater influence than one who is a friend of the patient. It is an old story that when a doctor is on intimate terms with his patient, his influence on the latter is frequently lessened, though it sometimes happens that old acquaintanceship increases the influence. Take the case of a family doctor who has attended the same family for twenty years, seen its members in happiness and in suffering, watched the children grow up, been consulted on all serious matters of health, and without whose knowledge no other doctor has ever been called in.