Dr. Francis, the well-known specialist, has published the following notes: †

'My mother, aged eighty-one years, has suffered for more than thirty years from obstinate constipation. During the last fifteen years she has had glycosuria, and has kept strictly to a diabetic diet. Of late years she has suffered from time to time from a severe paroxysmal cough. During the last few years the constipation had become so serious that it was a grave menace. Almost every conceivable form of treatment was tried, and the most drastic remedies were of but little avail. The glycosuria began as more or less typical diabetes (thirst, wasting, pruritus, carbuncles, etc.), and in spite of a strict diet the amount of sugar remained persistently very high.

* British Medical Journal, December, 1908.

† The relief of constipation in such cases as this by suggestion is of great importance in every way, and should always be aimed at. It inspires the patient with hope and confidence, and makes an excellent start for psychic treatment. I always endeavour to ascertain the cause - i.e., deficiency of secretion, want of power in the muscles of the abdominal wall or intestines, deficient nervous impulse, or a combination of these - and I make corrective suggestions accordingly. The response, as seen and felt on the salivary glands, and as may be inferred from the result on the intestinal secretions, is very marked, as is the evocation of healthy inclination for stool after months, or perhaps years, of inertness.

' Last October she consulted Dr. Lloyd Tuckey for the constipation, and he treated her by hypnotic suggestion. After the second visit she had a natural motion for the first time for many years. Since then, during the last nine months, the bowels have acted regularly and well, although she has not taken any purgative except a little senna-tea, which she takes at bedtime and was told would be sufficient.

' In November Dr. Tuckey treated her in a similar manner for the cough, which at that time was very distressing, resembling whooping-cough in the violence of the paroxysms. After one treatment the cough entirely disappeared.

' Having met with such success, it was proposed that the glycosuria should be similarly attacked, particularly as the patient suffered from double cataract, and an operation was not considered advisable, on account of the large amount of sugar in the urine.

' In order to test more correctly the value of the treatment, ten quantitative analyses were made by an independent chemist.

' The following are the results; the first analysis was made before the first treatment for the glycosuria, and may be taken as representing the average antecedent condition. The subsequent analyses were made of urine passed on the second day after each treatment. The patient remained on the same diabetic diet throughout:

' On July 9 iridectomy was performed by Mr. L. V. Cargill. Healing took place rapidly and without any complication, and the coloboma gives greatly improved vision.'

At the Berlin International Medical Congress Dr. Berillon was twitted with having only published his successful cases, and he was able to retort that if that was an offence he sinned in good company. The practitioner undoubtedly learns much from his own failures, but I cannot think that they convey much to others. In hypnotism, as in all other treatments, we meet sometimes with failure and disappointment where success seemed assured. Such a case is the following: A lady, aged thirty-eight, consulted me in November, 1890, for partial hemiplegia of apparently functional origin. Though it had lasted for six years, and all kinds of treatment had been tried in vain, I felt justified in hoping for a good result from hypnotism, especially as the lady was very susceptible and speedily became somnambulic. Suggestions were made with great caution, and she was told that she would become stronger and better daily, and on the seventh day would be able to get out of bed and walk without a stick. Though the suggestion was repeated daily, and the circumstances seemed most favourable, nothing critical happened on the expected day, and the patient still remains partially hemiplegic.

Her general health has, however, improved; she has lost her headaches and feels ' more alive.' Her intelligence, which was in the same condition somewhat as her limbs, has greatly benefited, and she has lost a habit she had of letting things fall that she tried to hold.

Probably in this case the disorder has lasted so long that it has become a part of the patient's individuality, and therefore cannot be cured unless something occurs to completely change that; or possibly the case may turn out to be one of those referred to by Dr. Buzzard, when the earlier stages of disseminated spinal sclerosis are masked by hysterical symptoms.*

Though she frequently becomes somnambulic, she does not completely lose touch with the external world, and though anaesthetic and irresponsive to any voice but that of the operator, she will be seen to smile if something very amusing is said in her presence. She does not, therefore, fall into the profound state attained by Dr. Dumontpallier's patient, in which suggestion is all-powerful, and there is always a degree of unconscious resistance which prevents the suggestions being accepted by the mind and transformed automatically into actions.