But it is unnecessary to multiply instances showing the influence of the mental states over bodily functions, as everyone must have numberless examples of it in his own person. Mental discouragement and depression have as their accompaniments disinclination for exertion and very frequently a sense of bodily fatigue. Who has not felt such a combination of symptoms after disappointment and worry, and does not know that the removal of the cause is followed by immediate removal of the effect? A letter saying that the friend we mourned as about to die has recovered, or that the investment we thought hopelessly bad has turned out a brilliant success, not only removes the mental symptoms, but also seems to put new energy into our actions. The sense of fatigue vanishes, the muscles become braced up, and there is an immediate demand for an outlet of energy which has been liberated by the removal of the inhibitory effects of despair. The counterpart is equally apparent, for we know and have experienced the effect on the depressed and wearied mind of a game of tennis or billiards, or any form of effort which acts as a derivative by calling off nervous energy from overworked and enfeebled centres into other channels and fresh combinations.

The philosopher is indifferent to privation and suffering because he is able to direct his thoughts into channels which are not affected by the ups and downs of ordinary life, and his philosophy is practically the outcome of the development of his power of inhibition.

* Hypnotism greatly increases the ideo-motor association, as is shown by Professor Pitres, of Bordeaux. He hypnotized a young woman named Celestine, and she at once passed into a condition of profound trance, in which she lay motionless and expressionless. He asked what she was thinking of, and she replied, ' Nothing,' and her face showed no sign of intelligence She was then placed in a kneeling position, with her hands clasped, and immediately her fare, previously so dull and apathetic, lighted up, and assumed an aspect of devotion resembling that seen in religious ecstasy, while her lips were seen to move. ' What are you doing?' asked Dr. Pities. ' Saying my prayers,' answered the girl. When asked what she saw, she replied, 'The Virgin,' and proceeded to describe her dress and appearance. The attitude suggested the idea, and the thought produced the hallucination. - Pitres, op. cit., p. 155.

The lesson the study of mental suggestion teaches is not that disease is imaginary, but that the imagination has a powerful influence over its manifestations, which should be recognized and made use of. Here come in the training and skill of the physician, and it is the want of these which cause the amateur and quack to come to grief. When an army surgeon is quite sure that a soldier is malingering, he has no hesitation in punishing him and returning him to duty; but he must make sure of his ground. A few years ago I read of a man falling dead on parade at Aldershot. He had reported himself sick, but the surgeon, after a perfunctory examination, passed him as fit for duty. The man was really ill, as the event proved. The soldier died, and the surgeon was requested to send in his papers. So in treating an organ or function, let us first make sure of our diagnosis, and then we can safely employ our remedies - material, mental, or both.

Hypnotism in some cases enables us to do for our patients what the philosopher can do for himself. ' It seems the only kind of therapeutic power that can penetrate a certain obscure province of pathology at all.

When the senses practise strange tyrannies over the emotions and the will, or when the imaginative and intellectual powers maltreat the body with suppressed treacheries and revolts, suggestion alone seems able to interpose in the confusion of consequent suffering. The dualism of the remedy matches the dualism of the treated malady.' * The case of Mrs. E------, quoted on p. 326, is an example of this.

I have recently seen a lady whose condition is in some ways a typical example of the connection between mental states and bodily functions. She is a woman of thirty-five, and is married and has children. She has no organic disease as far as can be ascertained, and spends more than half her time happily and naturally. But she s subject to attacks of melancholia, and these generally come on every three or four weeks, and last about a week. She goes to bed eeling well, but awakes utterly dejected and miserable after a disturbed sleep of two or three hours. Her whole appearance undergoes a change; she looks much older, her complexion becomes muddy and sallow, and her skin dry and harsh, her eyes dull and heavy, her attitude and gait stooping and slow. The timbre of her voice alters, and her speech becomes slow. At the same time the bowels become obstinately confined, and the water high-coloured, thick, and scanty. She also suffers at these times from constant frontal headache and loss of memory. During the attacks she suffers from insomnia, and when she does sleep, she has disturbed dreams, and is restless and agitated. It is interesting to note that she is naturally of an unusually bright and energetic temperament, and systematically overworks and strains herself.

She comes of a neurotic family, and was scrofulous as a child. The attacks are often preceded by a period of unusual excitement and mental activity. In this brief sketch of a not unusual condition one sees the close connection between mental states and bodily functions, and it is not easy to say whether mind or body is the primary seat of disturbance. I am disposed to think that the symptoms depend on exhaustion of nervous energy in the highest centres of the cortical area, and that this exhaustion affects not only memory and sleep, but also nutritive and secretory processes.

Dr. T. W. Mitchell relates how a patient of his had, as alternating states, mental depression with terrifying dreams and functional hemiplegia. †

* Wingfield, op. cit., p. 170.

† Soc. Psych. Research, Medical Number, November, 1912.