According to Charcot, the motor regions of the cerebral cortex can be stimulated through the cranium by means of the galvanic current, so that the muscles in connection with them contract. 3. The somnambulic stage. In some persons it arises primarily by means of fixed attention; it can be induced in all by friction of the crown of the head during the lethargic or cataleptic stages. The eyes are closed or half closed. By means of gentle stimulation of the skin the underlying muscles can be put into rigid contraction, but not, however, by stimulation of the muscles, nerves, or tendons, as in the lethargic stage. Also, the contracture does not disappear on stimulation of the antagonistic muscles as in that stage. The posture of the limbs produced by contracture in somnambulism cannot also be so easily altered as in catalepsy; a certain resistance appears as in flexibilitas cerea; Charcot calls it the cataleptoid state. The same stimulation of the skin which induced the contractures is employed to resolve them.

In somnambulism many external influences are possible by means of suggestion, of which I shall speak later on in their proper connection.

With regard to these stages of Charcot, most investigators think that they are only an artificial product, the result of an unintentional training process. It is certainly striking that since the Nancy school pointed out the many sources of error that should be avoided, the stages of Charcot are less and less frequently observed. Wetterstrand never found them at all among 3,589 different persons (Pauly). I also have never been able to find them, even in hystero-epileptics, in spite of Richer's opinion that every one who experiments on such persons will obtain results identical with those of Charcot.

Even those authors, who on the whole accept Charcot's stages, admit there are many exceptions. For instance, Dumontpallier and Magnin consider that the increase of neuromuscular excitability is by no means confined to the lethargic stage, but appears in all of them. They have likewise described certain conditions in which the symptoms, partly of the lethargic and partly of the cataleptic stages, show themselves. Jules Janet, also, has produced a fourth stage in Wit, - one of the best-known of Charcot's subjects - which is distinguished from the three others, both physically and mentally. Gilles de la Tourette describes a lithargie Iucide, in which there was no loss of consciousness. In any case, the idea of the stages has become more and more confused as attempts have been made to include everything possible within them. Every one looked for the stages, and when he could not find them exactly as Charcot did, he believed himself obliged to add certain new characteristics to them.

It is perfectly certain that we cannot recognize Charcot's three stages as a general principle on which to base a classification of the various conditions met with in hypnosis. Even granted that the stages do exist, it must be admitted that they are confined to a few cases of severe hysteria. Opinions also differ as to whether, in such cases, the stages may not be an artificial product. Certainly Raymond maintains that all three stages were described by Despine as far back as 1840, under the names catalepsy, somnambulisme mort, and somnambulisme vivant, and that it is therefore improbable that the conditions observed by Charcot in his investigations were merely artificial products. Recently, too, - for example, at the second International Congress of Hypnotists, 1900, - several investigators have admitted, with more or less reserve, the possibility of Charcot's stages presenting themselves in some cases of hysteria; and Micheline Stefanowska has gone so far as to .express the opinion, based on numerous experiments, that the grande hyptose as understood by the Salpetriere investigators can be induced in frogs, in whose case there can be no question of suggestion.

In particular, M. Stefanowska thinks she has clearly established both the lethargic and cataleptic stages.

But even supposing we hold the opinion that Charcot's three stages were solely produced by artificial means, there still remains the question whether in hypnosis the muscles are responsive to a physical (not suggested) stimulus, which would produce no effect in the non-hypnotic state. Heidenhain stated the same thing much earlier; he believed that a gentle stimulation causes the underlying muscles to contract, and that the contracture produced spreads in proportion to the strength of the stimulation. In this manner Heidenhain considers the rigidity which is seen in hypnosis, to be a reflex. Like Born and others, Heidenhain believed he had discovered new reflexes in the course of his experiments.

Without wishing to maintain that specific physical reflexes do not occur during hypnosis, I certainly think that no definite proof of their existence has been brought forward. For instance, Lehmann reports that Dr. Hiitten, who has submitted more than 6000 persons to hypnotic treatment, has never observed anything comparable to hyper-excitability, unless he had suggested that phenomenon. Nowadays, when we know that these phenomena can all be brought about by suggestion, the latter must first of all be excluded. The best way of accomplishing this end is to establish a very strict supervision of the first experiment performed on a subject; for it cannot be avoided, that when the same experiments are repeated many times certain intimations - some remark or motion made by the experimenter - should be given, from which the subject draws conclusions as to what he is expected to do. We have to take into account the quick perception which a hypnotic possesses and his desire to carry out every suggestion made by the experimenter. Certainly, Charcot's pupil, Richer, maintained that in their experiments, which were varied a thousandfold, the results were always identical, and that imitation was excluded.