An eminent Swedish alienist - Oedmann - says that he recognizes the good effects of suggestion in alcoholism, but that as he is unable to produce them he sends such patients to Wetterstrand (Corval).

In any case, it is a mistake for doctors, who have no aptitude for mental therapeutics and who moreover lack experience, to deny the successes of others.

But even if every one is not a hypnotic therapeutist by nature, it does not follow that specialists alone have a right to practise hypnotic treatment. In simple cases it is not always necessary to call in a specialist; and in addition to specialists there will, very properly, always be some medical men who occasionally practise hypnotic treatment. It is much the same here as with other special branches. A country doctor, or one in a small town, often treats cases or employs methods, which in a large town would be left entirely to a specialist. But even in large towns we can hardly desire that all hypnotic treatment should be carried out exclusively by specialists. Sometimes no advantage whatever would be gained by the patient leaving the doctor who had been treating him and seeking the services of a specialist for the purpose of some hypnotic sitting or other. The patient's circumstances have also to be considered in such a case. In short, it is quite wrong to assume that only a medical specialist should hypnotize.

Of course a patient has a right to expect that a doctor who undertakes to treat him hypnotically has had a certain amount of training in the practice.

But I do not think it right that when a patient places himself in the hands of a specialist for hypnosis the latter should confine his treatment exclusively to hypnosis. Specialism is not without its dangers. The specialist who only treats particular diseases, like the specialist who only employs certain methods, has a tendency to become biassed. The mere fact that we cannot dispense with these two forms of specialism is no reason why we should shut our eyes to their dangers. Specialization, especially as regards methods of treatment, should be carried no farther than is absolutely necessary. For this reason I do not think it right to consider hypnotic treatment an exclusive speciality. The man who devotes himself to hypnotic treatment must cultivate psycho-therapeutics in general as well. There are so many details and so many combinations to be considered, that it would be irrational to separate hypnotic treatment from the rest of psycho-therapeutics. I will give an example. The assertion that alcoholism can only be cured in an institute is a fairy-tale; many alcoholists can be made abstainers by proper mental measures outside an institute. In some cases hypnosis renders the task easier, but alone it seldom leads to a cure.

Wherever drinking is a social custom, the patient is always liable to be led astray by his companions. It is consequently necessary, especially in the earlier stages of the treatment, to modify the patient's surroundings so as to keep him out of temptation. The beneficial effects of temperance societies and of doctors who are abstainers depends on this. Bonne lays special weight on the doctor being an abstainer, because his example and the conviction it brings are most effective methods of suggestion. Without wishing to exaggerate its importance, I must certainly point out the necessity of giving some advice to the patient's entourage. In many cases it happens that a patient who is convinced he can do without alcohol thinks he can also resist temptation; but at first he requires protection, which the doctor must endeavour to provide him with. It would be foolish for the doctor to leave this to a colleague, and merely confine his own attention to the hypnotic treatment. Legrain reports that a number of dispensaries have been established in Russia, at the instigation of the Government, which are visited by numbers of alcoholic subjects in search of free treatment. Here hypnosis is the chief, but not the only, remedy employed. And such is the only right way.

It is almost invariably necessary to bring a number of other mental influences into play simultaneously with hypnosis. Mental treatment is not quite such a simple matter that "every tailor, cobbler, and shepherd-boy" can carry it out, as Ewald thought. I go still farther on the question of specialism in hypnosis. Psychology teaches the physician the unity of man's being, and that should be taken into consideration in the treatment of a patient. For a doctor who is treating an emaciated neuropathic patient for sleeplessness to consider himself so much a specialist in hypnotism that he cannot attend to the patient's diet himself, but must call in a specialist in dietetics every day, is not only ludicrous but injurious as well. It is just from the psychological standpoint that uniformity of treatment is so necessary. For this reason I agree with Forel that, as far as possible, only one doctor should treat the patient by methodical suggestion. I do not mean by this that a medical hypnotist should not occasionally call in a colleague such as a specialist in diseases of nutrition, or that he should not busy himself specially with hypnosis, but he should not do the latter exclusively.

I may here remark that apart from the patient's interests, it is not to As I have already mentioned, the employment of hypnotic suggestion should not preclude the use of other remedies, when their application is indicated; and I have also called attention to the fact that other mental influences besides suggestion may be operative during hypnosis. The action of suggestion may, for example, be supported in a case of hysterical vomiting, by telling the patient during hypnosis that she is not suffering from any organic disease of the stomach. In cases of stammering, in which the patient's mental state of course plays a great part, we shall sometimes have to supplement suggestion by exercises in talking. In a case of aphonia following laryn-gotomy, published by Hilger and Sanger, the action of hypnosis was supplemented by systematic exercises of that kind. And it is also just as necessary to avoid anything that might spoil the prognosis or render suggestion ineffectual as it sometimes is to employ other remedies in conjunction with hypnosis. It is, therefore, sometimes as well to explain to those present that they should not make heedless remarks or put stupid question's that might counteract the suggestions made to the patient.