I should wish to place those disturbances of the body which are usually performed unconsciously, the results of which alone are conceived by us, but which come under the influence of the central nervous system, first among the therapeutic objects of suggestion. These functional disturbances, and the functions themselves as well, form, in my opinion, the most thankful field of suggestive therapy, whether they be produced sensorily - i.e., psychopetally or psychocentrally - or whether they be produced as motor, vasomotor, or secretory processes - i.e., psychofugally. One can include these disturbances among the neuroses; no real objection can be raised to this. But to avoid imparting the false idea that they represent diseases of the peripheral nerves, it would perhaps be better to call them cerebral neuroses or en-cephaloses.

1 Reprinted from the Zetischrift wur Hypnotismus, 1883.

I have chosen habitual constipation as my example. No doubt certain cases exist in which local intestinal affections can produce constipation. But these are really very rare. Ordinary common habitual constipation is nothing more or less than a chronic "cerebral neurosis." Since the cure of this condition by suggestion has become recognized, this has been repeatedly admitted.1 Let us first look at the facts of the ease.

Apart from fermentative diarrhoea, catarrh, stricture of the gut, typhoid fever, and the like, we find first of all that both the frequency and the consistency of the motion vary enormously in healthy persons. Sometimes it is soft, sometimes it is formed and " normal," and sometimes it is hard. We may regard a daily formed stool as the normal condition.

Turning our attention first to the case of a normal, formed stool, passed once every day, we find that, although one can voluntarily hasten or retard the stool by means of abdominal pressing and of the action of the sphincters, this is only possible within certain limits, and that, as a rule, it is apt to be passed at a definite time of the day. This time of day varies in different persons, and in different epochs in the same person. However, we notice in general that when a person has accustomed himself to evacuate his bowels at a certain time of the day, the necessity of doing so is apt to make itself felt at this time. Perceptible peristaltic movements of the intestines, rumblings and the like, often precede this, and herald the desire to go to stool at the given time punctually. But one can frequently make another observation. If one voluntarily or compulsorily postpones the evacuation beyond the usual time, the desire to pass the motion mostly passes off after a relatively short time, provided that the faecal accumulation is not too large. Not infrequently the desire is postponed till the same time on the following day in such cases. When this takes place the faeces will have become inspissated and harder in the meanwhile, and the motion can only be passed by heavy exertion of the abdominal pressure, sometimes accompanied by pain. In short, con-stipation is present.

1 See also Dr. Th. Dunin, "On Habitual Constipation." (Berliner Klinik, 1891, vol. xxxiv.)

These facts are more important than one would imagine at first. They prove that normal defecation is subjected to the influence of central automatisms, and the latter in their turn are dependent on certain conceptions of time, generally remaining unconceived. They further prove that the longer one waits, the more difficult will be the work for the bowel and abdominal muscles. It is hardly necessary to point out that, apart from this, the accumulated faecal masses act as stimuli, and thus produce the desire to pass a stool reflexly. Still, it should suffice for the present to mention that other factors take part in the action.

If we now consider the conditions other than those which we regard as strictly normal, we also find several important phenomena. Constipation is a very common symptom in certain psychoses, especially in melancholia. The same applies to hysteria, hypochondriasis, and other so-called "nervous diseases," which one does not usually classify among the psychoses for reasons of politeness and other considerations of this kind, but which are one and all, none the less, functional encephaloses. The inhibitory action of the innervation of the brain can also not be overlooked in these conditions. On the other hand, certain emotions, especially fear and expectation, notoriously act as stimuli in such a way that this has become proverbial. One also knows that the desire to go to stool does not infrequently present itself at times when one fears that it may (under certain awkward circumstances - e.g., in former times, when there were no w.c's in trains), and passes off as soon as the "danger" is over, and one could satisfy the desire in peace and comfort.

Certain foods have the reputation of constipating, and others of rendering the motion easier or more fluid. I certainly must acknowledge that there is something in this, and that fruit, for example, generally produces a softer motion. However, if one takes the trouble to inquire more closely into the matter, one meets with inexplicable contradictions, as is well known. The food which constipates one person purges another. The same articles of diet often enjoy opposite reputations with different sets of people. The same foodstuffs can produce opposite actions even in the same individual at different periods of his existence - e.g., milk, coffee, etc. - and the person who is habitually constipated will not be helped, as a rule, by foods.

Practically the same may be said of the mode of life. Speaking generally, one says that & sedentary mode of life leads to constipation. But this is often produced on the other hand, by exercise and mountain climbing.