Case 18. Ischuria of mental origin

X., at. 25, of a generally nervous disposition, but free from any organic disease, had long experienced difficulty in passing water. He found it difficult to make water voluntarily even when his bladder was full. The trouble particularly affected him in public conveniences. Even when alone he could only pass water after exposing himself for some time. The trouble, which had lasted many years, was all the more painful as he felt the desire to make water but could not do so. I found it easy to induce deep hypnosis, and a few sittings sufficed to effect a cure, and when I saw him some months later there had been no recurrence of the trouble.

I have already mentioned that great improvement can be obtained in the symptoms of organic disease, and I now append a few cases.

Case 19. Multiple sclerosis

Mrs. X., at. 34, had for years suffered from increasing tremors, which only occurred when she attempted to carry out some voluntary movement. Although her head was not quite free, the tremors were particularly noticeable in the arms and legs. Movement of the lower limbs obviously weakened; gait uncertain and spastic in character. Her speech was scanning, there was evident nystagmus, and she sometimes suffered from retention of urine. Sensory disturbances were not very great but easily demonstrable, the skin in particular being less sensitive to temperature and touch. Hypnotic treatment was directed essentially to the tremors in the arms, and to the urinary troubles. There was very considerable improvement in the former directly after the first application of hypnotic suggestion. This could not be considered an accidental coincidence; for although the patient had previously been unable to lift a glass or a spoon to her lips, she re-acquired the power of so doing for at least some considerable time, as a direct result of suggestion. There was also a noticeable decrease of the urinary trouble.

When the necessary hypnotic suggestion had been made, the patient was invariably able to pass water comfortably, and the improvement sometimes lasted a few days, occasionally even longer - as much as three weeks. After that it became necessary to repeat the suggestion. Of course a cure was neither expected nor obtained. On the contrary, the symptoms of the progressive nature of the disease were evident after a time.

Case 20. Deformative polyarticular rheumatism

The patient, aged 49, had suffered from severe articular rheumatism for eight years. There were large bony protuberances in the finger-joints and also in the knee-joints, rendering movements of most of the affected joints very limited, or quite impossible. The pains were indescribable, making it impossible for the patient to sleep at night or rest during the day; he therefore desired hypnotic treatment so as to obtain relief from some of his pains. It was found that deep hypnosis could be induced and the patient thereby almost invariably relieved from pain for a certain time. The patient's ability to move gradually returned, and he was finally able to walk a little, even to go downstairs. The treatment lasted four weeks, and when I saw the patient subsequently I found that the improvement had been maintained, except for occasional attacks of pain which always speedily gave way to suggestion. As a rule the loss of pain was so marked after suggestion that there could be no doubt as to its cause.

Of course there can be no question of curing osseous and cartilaginous deformities, but it is always possible to modify a whole series of morbid symptoms in such cases as the above.

Among other diseases accompanied by organic injury, I have seen a very painful eczema of the ear, in a child of eight, made completely painless by post-hypnotic suggestion, I observed this case in the company of my friend and colleague Friede-mann, then of Kopenick but now of Berlin, whom I have to thank for a number of interesting experiences in hypnotism. The child in question had so painful an eczema that he could not bear the slightest touch. An order given in his first hypnosis had such an effect that he could afterwards endure even strong pressure on the affected spot.

We have now to consider how hypnotic therapeutics can best be installed as a practical method of treatment, and this at once brings up the question: To whom shall hypnotic treatment be entrusted ? There can be but one answer: solely to the scientifically trained medical man. He alone is in a position to establish a diagnosis and thereby determine the indications and contra-indications in any case; he must watch the effect of the treatment on the patient and decide whether or not the hypnotic method should be continued. He alone can decide on diagnostic grounds whether hypnosis should be supplemented by other methods of treatment or be stopped. I do not deny that there are laymen who are well acquainted with the technique of hypnosis, perhaps even better so than the average medical man. Delbceuf was one of them; but we need not take such exceptional cases into account when discussing the practice of hypnosis. But apart from that, such an investigator, even if possessed of the requisite knowledge of the technique of hypnosis, would be unable to determine what was indicated by the diagnosis in any particular case; and it is even more important to oppose the therapeutic use of hypnosis by ignorant laymen, such as charlatans.

For this reason Warda has entered a protest against Lcewenfeld's proposal that attendants should at times be allowed to hypnotize patients for the purpose of alleviating certain symptoms. Warda certainly thinks that a therapeutic hypnosis should never be entrusted to any one who is not a medical man, otherwise we should be encouraging quackery.

On the other hand, I do not think that every medical man is fit to undertake the hypnotic treatment of patients. Just as in other special branches special knowledge and experience are requisite, I am also convinced that the experimenter in hypnotism must have a special faculty for hypnotizing and suggesting, and to avoid any misunderstanding I may add that I do not lay any claim to the possession of this special faculty. Frank regrets that suggestive therapeutics have been so greatly neglected by doctors, and traces this to the fact, among others, that everybody does not possess the necessary ingenuity, as it were, for employing the method successfully* Just as many imponderabilia play a part in hypnotic treatment as in mental therapeutics in general; and this prevents the majority of experimenters from obtaining the best results. The gift of individualizing, which we so often hear of in medicine, is given to few as far as hypnotic treatment is concerned. But this power is all the more necessary because men are no more alike mentally than they are physically. Since each of us does not possess this gift, we have no right to deny the successes of others because of our own failures.