Brown-Sequard's empiricisms on spermalotherapy also were admitted into scientific medicine, possibly because they originated from a scientist Naturally, curative results were obtained by this means, for a powerful suggestive factor must act in this case. One hears of results which have taken place without the patient knowing anything of the procedure, but how can one carry out an injection without the knowledge of the patient? The organotherapy developed in response to a comparison with injections of other substances. According to this last-named, the physiological action of an organ can be more or less transferred to the body by the eating of the organ. Luckily, one does not hear much about these new panaceas now, although there certainly seems to be something in it as far as the thyroid gland is concerned.

Homoeopathy, the new-fangled "natural methods," Kneipp's methods, and the like, owe their results to suggestion in connection with a healthy dietary. Apart from this, they further owe their power to the avoidance of a haphazard application of active remedies. In this way the most consummate ignorance, the most idiotic superstition, often in conjunction with the most contemptible advertising swindle, may succeed in competing successfully with sound medical science. But why should one damn the whole treatment by suggestion, even if the suggestive action of our drugs and methods is not satisfactory? The actual justification of the homoeopathic method, for example, cannot, of course, be admitted as long as we have no proof that homoeopathically diluted drugs act by themselves, without the assistance of the credulity of the patient.

Should we go to the other extreme, and only see suggestive action indiscriminately in everything? Those who interpret us like this, or who pretend to, either do not or will not understand us. In medicine one must distinguish serious investigation, clear and indisputable facts, and also those facts which are explained in their causal connections from the therapeutic drivel, as I have described it above. The laity is inclined naturally to confuse things, and may refuse medical science on account of the medical shortcomings.

One comes across cases and methods of treatment frequently enough which demonstrate quite clearly that when one compares the results of alternating exhibition of the method and those of pure suggestion carefully and without bias the results may be referred one and all to suggestion. This becomes clearer the longer one continues these observations. The experiment must be carried out without the patient being aware of it, and should be tried in a number of patients. One can substitute an absolutely inert drug for the drug which one is testing, but the name should not he altered. The theories of specific actions of certain drugs can also be disproved by removing the essential conditions for the specific action without letting the patient know of it. One obtains just as good results, if not better ones, in this way if one carries out the suggestions skillfully and intently. But one may not have a personal faith in the drug one's self. Bernheim is undoubtedly right in referring the action of suspension for tabes dorsalis, the results of metallotherapy, and at all events the greater part of the results of electrotherapy, to pure suggestion. I would add to these the greater part of balneotherapy (the supposed specific action of certain natural springs), of hydrotherapy, and many other new and old-fashioned methods of treatment, without hesitation. In these the whole type of the results shows clearly that they belong under the same heading.

One should not forget that the suggestive action of numerous methods of treatment is particularly powerful, and the results are often better than those of simple verbal suggestion for this reason. To wit, the mystic nature of the remedy (electricity, metallotherapy), the peculiar local sensation (electricity) or pain (blisters), erotic sensations (Brown-Sequard's sperrnato-therapy), powerful shock (suspension, cold douches), the religious belief (laying on of hands), the high price or altered surroundings and the improved conditions of life (treatment in watering-places, etc.). One is not justified in contending that the action of any method does not depend on suggestion because the method succeeds when simple hypnotizing fails. For this reason one must continue to use these methods, and to continue them with verbal suggestion.

However, the most instructive cases are those in which the suggestive action is combined with an ascertained specific action of a drug. Bernheim has proved conclusively that chloroform often acts suggestively, especially in those cases in which the patient falls fast asleep after having scarcely taken a couple of breaths. In these cases one can calmly sprinkle something else on the chloroform mask on the next occasion; the anesthesia will set in just as well. Roth 1 described a case of this kind. One can observe the intermingling of suggestion and the action of the drug still more clearly in the breaking off of the morphine habit. The patients often go to sleep in response to an injection of pure water at the end of the treatment, but cannot sleep without an injection. We are not going to dispute the narcotic actions of morphine and chloroform, for they are absolutely clear, certain, and powerful. The following may be taken to represent the scientific moral of the story:

1 Roth, Correspondenzblalt fur Schweizer Aerzte, vol. xix, 1, p. 29, 1889.

Suggestion insinuates itself insidiously into all the actions of our lives, and combines with the therapeutic attempts of all kinds in a very complicated manner. At times it acts by accelerating and at times by inhibiting. It either adds to or subtracts from the action of the drug. But in a large number of cases it actually forms the only therapeutic agent. Both doctors and patients have been deceived, about the specific action of numerous drugs from the earliest times, and the scientific development of therapeutics has suffered considerably in consequence. I do not deny that the more "enlightened" formerly realized the matter more or less, and recognized that "fancy" played an important part in cures. Still, the most enlightened did not have the faintest idea of the real importance of suggestion, of the actual objective intensity of its action, and of its identity with the phenomena of animal magnetism, which they themselves felt obliged to regard as mysterious. Animal magnetism used to be called cures by miracles or by witchcraft.