As Max Dessoir has shown, perversion appears in the earliest days of puberty and often leads to "perverse" tendencies, but tine latter disappear altogether when taken in time and properly treated. It is of the greatest importance that such young people should be warned against wretches who would lead them astray and endeavour to make them believe that their perverse tendencies are incurable. For this purpose it is sometimes necessary to explain how sexual perversion comes about and all that appertains to it, if the victim is to be rendered amenable to medical advice. A similar method of procedure is necessary in some other cases; Oppenheim, for instance, was only able to make a sufferer from akinesia algera follow his instructions after he had explained the origin of the disease and the nature of the underlying mental factor. Sometimes it is as well to convince the person who comes for advice that he has nothing the matter with him. There are patients who imagine they are impotent merely because their powers are not the same as others. It is beneficial to let such people know that men boast of powers they do not possess.

Similarly, sensitive young men who have never tried their prowess on ladies of easy virtue should be taught that that is no reason why in married life they should prove impotent in the arms of a modest woman.

In other cases it may be essential to prove that the disease from which the patient thinks he is suffering - cancer, softening of the brain, spinal disease, kidney disease, etc. - does not exist There are times in which such fears are epidemic; this is especially the case when a disease is the subject of much discussion in the papers because some public person is suffer-ing from it, or that medical investigations or some other circumstance have led to its discussion. When the Emperor Frederic was suffering from cancer, thousands of people went to their doctor to know if they were not developing cancer of the larynx. Many of them were, of course, suffering from some organic affection of the larynx, such as catarrh, but very many others had not even that trouble. The same thing is observed when an epidemic like cholera is raging; people take a harmless diarrhoea for the severe disease cholera. We must also include here people who think they are suffering from a disease because they have misunderstood the description given of it. This fear of disease frequently arises from reading nasty popular works on medicine, but it also happens to young medical students when they first hear diseases minutely described.

The best method of quieting and curing such patients is to submit them to a searching examination; that will generally satisfy them that their fears are groundless. This method does not, of course, succeed in serious cases; it is then necessary to leave it to the ingenuity of the doctor to devise some means of satisfying the patient. A doctor once took severe measures with a patient who would not believe that he was not suffering from hydrophobia; the doctor kissed the patient on the lips as a proof that he had no fear of infection.

It must be explained to patients who occasionally suffer from headache or loss of appetite that such things happen to the healthiest people and are of no importance. Special care must be taken to do this with patients who have at one time suffered from a severe disease and who dread its return every time any trouble reminds them of it. A patient who has suffered from ulceration of the stomach will generally be very frightened when he has a slight pain in the region of that organ. He should then be told that such pains are not as a rule the result of organic changes.

In many cases explanation should be directed to prognosis and therapeusis. A patient who is suffering from a chronic disease should be told that it is seldom cured spontaneously, and that there may even be exacerbations of the malady while the curative process is gradually going on. It is often as well to point out these matters beforehand, so that the patient may be prevented from being frightened by anything that may occur and from drawing unfavourable conclusions therefrom. It is sometimes advisable to give the patient a proof that the treatment is doing him good - to show a diabetic, for instance, that the analysis of his urine points to a diminution in the excretion of sugar. This is calculated to make him more inclined to follow his doctor's advice in the future. It will also sometimes be necessary to point out to patients that the remedies they have proposed are useless, perhaps injurious. For example, people who suffer from insomnia should be told that the constant use of hypnotics is injurious and may set up a condition even worse than the loss of sleep.

Of course, doctors who practise psycho-therapeutics must be as careful to avoid overdoing it as when using any other method of treatment. It is just this explanatory system of treatment that so easily gives rise to such errors. Many a doctor thinks he is making matters clear to a patient when he is doing nothing of the kind. For this reason I will point out an error that was formerly very common, though it does not occur so frequently nowadays. It should never be drummed into a patient that he is not ill because he has no organic lesion and that his malady is consequently imaginary. Folks frequently make such remarks; but a psychologically trained doctor should scrupulously avoid anything of the kind at all times. He should know that the expression "imaginary pain "is false. Such "imaginary pains" have been excellently compared with hallucinations. Now, we can say that the hallucinatory object is imaginary; but it is false to say the perception is imaginary; it has a central cause, whether the object is imaginary or not. Similarly, a pain that is felt is the result of a definite central process. It is a matter of indifference whether the central process is caused by a peripheral one such as a prick, or by suggestion by a spontaneous mental act.