Mental disease is not characterized by the psychological form of a symptom or of a symptom complex, hut by a disease of the brain itself. The cause of the disease (apart from general paralysis of the insane and other so-called organic psychoses, as well as those which depend on intoxications) is obscure, but nevertheless is undoubtedly concealed behind the psychical contents of the symptoms. It is not the phenomenon of the hallucination which is in itself morbid, 1 but it is the concealed pathological irritation which produces the continued repetition of certain hallucinations. A rapid jabbering of fleeting ideas is not in itself morbid, for every one may exhibit the phenomena of a brief flight of ideas during the moment of adequate incita-tion or excitability. But the cause, which is still unknown, of the pathological storm of irritation which boils in the brain of the maniac, and which produces, besides, the general psychomotor excitement, euphoria, etc., is morbid. The contents of delusions are not in themselves morbid, for every normal person can think or dream nonsense. But the incapability of correcting the delusions logically, and the impulse by means of which they keep on recurring, is the morbid thing. Both are obviously based on peculiar conditions or irritation and disturbances of coordination in the process of thinking; these are perhaps localized in a definite manner, and, at all events, are combined in a more or less regular manner in every so-called form of disease, and so on.

1 One need not construct one's mind, one's whole edifice of conception, on an hallucinatory foundation for this reason (Janet., Dessoir). Without wishing to dispute the sharpness and depth of such views, I may be permitted to state that in the philogenetic development of the engrams the capability of primary differentiation between impressions of memory conjured up (ecphorized) and actual perception of reality forms a biological postulate of the self-preservation of the individual and of the kind. The animal must be able to distinguish the renewed complex of stimuli coming from without from the ecphorized engram complex of former stimuli which lies latent in the brain (internal conceptions} in order to find his way about in the outer world.

The doctrine of suggestion throws light on psychology in this way, and offers important hints to it, which are partly confirmations of views that clear-minded psychiatric observers have held for a long time. It is of particular importance for the doctrine of hallucinations. It has led to the discovery of negative hallucinations in the insane, and proves clearly to us that the hallucination is not the morbid symptom in itself, but becomes this through its pathological cause.

It is indisputable that certain forms of insanity of a mild or little generalized type can be occasionally improved or even cured by suggestion, if the patient possesses a very suggestible brain, and if the operator is very skillful. Wetterstrand has even cured several cases of epilepsy solely by suggestion; 1 he has also done the same in mild melancholia and hypochondriasis. Professor von Speyr, of Berne, and others, including myself, have observed a few surprisingly favorable results of this treatment. The chief difficulty lies in the inattention and inaccessibleness of the patient, and in the intensity of the pathological stimuli and inclinations. The difference between the insane and normal hypnotized persons if recognized only too markedly even when the type of symptoms appears to be the same. I have often compared the waxlike flexibility of the katatonic patient with suggestive catalepsy: in the one case one has the meaningless stare and the inaccessibility for all suggestions, and in the other one has automatic obedience. The two are absolutely different. In the former there is in all probability pathological (edema of the brain, and in the latter only a transient functional anaemia of the brain (see O. Vogt, p. 147).

I have said, " The brain of the hypnotized person is our curing apparatus with which we work, I might almost say our dynamo machine. If the machine gets out of order, it becomes difficult or impossible to work with it."

1 I have always been doubtful whether be was not really dealing partly with gross forms of hysteria.

This requires a certain amount of explanation. Firstly, it is self-evident that a living machine is not a machine in the ordinary sense of the term. The living organism is a self-developing and self-supporting machine, which works automatically. It seeks the conditions of its movements (motor) in the shape of food and water for itself, and it can, besides, adapt itself. Next, it goes through a progressive evolution of life. However, if we allow for all these differences, the comparison may be of use as a comparison by analogy.

The more I hypnotize, the more clearly do I learn to recognize the reasons of failure in healthy minded persons. First of all there are the emotions, such as inward excitement, anger, exaggerated lively exaltation, fear, mistrust, sadness and despair, etc., which limit the result, or may actually destroy it entirely, even in very suggestible people who have often been hypnotized. As soon as I notice that a person remains uninfluenced or does not obey well any longer, I ask him, "What is it that is exciting you ? Why don't you tell me what you have got on your mind ?" And this question, asked in a friendly but definite tone, rarely fails to elicit a positive reply. The patient notices that I have recognized the cause of the failure at once, and almost always confesses it. I can generally reassure him thereby, and, in consequence, attain what I am aiming at.

But it is not only emotions which disturb. Every other brain activity as well, which holds the attention in a condition of tension, disturbs hypnosis, sometimes to a greater and sometimes to a less, extent - preoccupation, awakening of the interest, reasoning, impulses, etc.