We can well understand that such a family doctor is often able to exert the very strongest influence on such patients. On the other hand, a doctor who is a family doctor in name only, but who in reality occupies the degraded position of advertising agent to specialists, hydropathic establishments and sanatoria, can never under any circumstances be calculated to exercise such influence. It often happens that a doctor, whose reputation for special skill has preceded him and whose extensive practice forbids the devotion of sufficient time to each patient, obtains the best results; his every word seems a revelation to the patient. There are many other cases in which it is much better for a patient - a neurasthenic with all kinds of hypochondriacal troubles, for instance - to seek the advice of a doctor who can devote sufficient time to his case to go into all his complaints, and who can also direct him to some occupation and activity. But this will generally have to be a doctor who is not very busily employed.

Of course, a doctor should not bide by a mere schematic use of the psycho-therapeutic remedies that have been described, or even think that he has only to use one of them at a time. It has only been my intention to give a general sketch of the question, and I have consequently omitted many details. As a rule, a doctor will not merely combine mental with psychic treatment, but will employ several mentally curative factors simultaneously. I have already repeatedly touched on this question. When a doctor intends, for instance, to use volitional therapeutics or praxi-therapeutics he ought, almost invariably, to explain to the patient the importance of such methods in the treatment of his disease - i.e.., instructional therapeutics should precede volitional therapeutics. It often happens that hypnotic treatment cannot be employed until its character has been explained to the patient. Also we are not always able to separate the action of the emotions, more especially that of expectant attention, from the action of suggestion. For this the numerous holy shrines visited by so many pilgrims, and of which Lourdes is the most famous in Europe, afford an admirable field of observation.

It was at La Bonne Sainte Anne in Quebec, where sick people have resorted for more than two hundred and fifty years, and which is even now visited yearly by several thousand Catholic pilgrims, that I was able to obtain the clearest insight into the manifold nature of the influences at work. For a long time beforehand the patients are prepared for the journey and filled with hopes of its results. Intercourse with the other patients, the influence of religious exercises, especially of prayer and the impressive services of the Church, each of these produces its effect Patients may be seen praying fervently before the numerous ex voto crutches offered by their lame and spectacles by their blind predecessors.

Similarly, we shall often find it necessary in scientific medicine to combine mental remedies with others.

In many cases it will be found necessary to use psychotherapeutics for preventive purposes in the form of psycho-hygiene. O. Binswanger rightly advises that children who are disposed to hysteria should early be subjected to a process of mental hardening. We should begin as early as possible to combat their timidity and nervous fears, and carefully avoid any but class-instruction, since it is constant emulation with companions of their own age which will best combat their morbid egoism and self-will and reduce their hyper-sensitiveness to a normal degree. Much modern agitation against over-pressure in schools may easily lead to very serious results. I have already alluded to this in my work on Der Einfluss des grosstadtiseken Lebens und des Verkehrs auf das Nerven-system (The Influence of Public Life and Business on the Nervous System). Perpetual public discussion of the so-called over-pressure in schools must in the end enervate the pupils and diminish their powers of resistance. There are cases known to me in which children have excused their laziness under the pretext of over-pressure, the dangers of which they knew had been recognized by medical men! Without entering into the question of the injury done to education by thus undermining the respect in which the scholars should hold their school, I for my part consider that the published accounts of such discussions, which young people only too readily read, do them on the one hand more harm by debilitating them, than they can on the other ever repair.

Instead of considering external stimulus a danger and exaggerating its importance, it is a far better plan to endeavour to render children, and adults too, capable of offering resistance by accustoming them to the action of certain stimuli.

I must here point out the dangers to psycho-hygiene that generally arise from modern hygiene. It frequently happens that the good hygiene was going to do results in evil, and for this many a bacillus-hunter is to blame. Eschle reminds us that Rosen bach gave warning of this danger fifteen years ago. Every opportunity seems to be taken of harassing the public with the fear of infection; now it is books from the lending library, now combs, or knives and forks that the hygienists denounce as dangerous. But apart from the fact that these dangers are often exaggerated and frequently unavoidable, since human beings must do business with one another and each of us cannot shut himself up in his own isolation-hut, this creation of scares is very reprehensible from a psycho-hygienic point of view. It has brought about such a dread of infection as to amount to a veritable mental epidemic Of course we ought not to ignore the teachings of hygiene, but we should never press them so far as to make it impossible for a man to touch anything or transact any business without nervously inquiring "What danger am I running into?" The care of the mind is as much the purport of a true system of hygiene as that of the body, and that is a point which our hygienists should take into consideration.