There is one class of cases for which hypnotic treatment offers particularly good prospects of relief. The exhausted brain-worker, whose nervous system is in a painful state of erethism, will here find exactly the remedy which is physiologically indicated. He is suffering from functional derangement of the highest centres, and the action of hypnotism on those is their reduction to a condition of physiological rest. The overwrought and overanxious victim of modern economical and social conditions can be soothed and refreshed, by hypnotic suggestion, to an extent quite unattainable through drugs or physical treatment of any kind. But hypnotization of these subjects is a process requiring much tact and patience - for the condition of the brain is such as to render the necessary mental quiet and confidence difficult of attainment. Perseverance will, however, generally be rewarded by success, and success here often means new life to the sufferer.

I attended a case of this kind in 1899. The patient, a professional man aged thirty-seven, had separated from his wife from incompatibility of temper, and had lost nearly all his money. He got attacks of rage almost amounting to mania on the least contradiction or provocation, and at other times was intensely depressed, and often suicidal. It did not seem a very hopeful case, as suggestion could not bring back his money, nor render him and his wife suitable partners. But I tried it, and it succeeded in making him take a philosophical view of the situation. He now leads a rational life, works hard, and succeeds in forgetting his troubles. There is no doubt but that hypnotism has saved this gentleman from madness or suicide.

* ' Lectures on Neurasthenia,' 3rd edition, p. 19.

A somewhat similar case came under treatment about the same time. This patient is an accountant who had broken down from overwork and business worry. He had been a good deal to blame, and was tortured by exaggerated remorse. He had been sent a voyage round the world, but Caelum, non animum, mutant, qui trans mare currunt, and he returned no better. Resumption of work was followed by a very bad nervous breakdown, and he was induced to try hypnotism. Though but slightly susceptible, suggestion soon told upon him. He has lost his morbid fancies, regained his power of work, and has been actively engaged in his business ever since. Loss of sleep is the first symptom of breakdown in these cases, and it is one of the first to be corrected by suggestion.

'When one of these hypochondriacs,' writes Binet and Fere, 'whom we are apt to call maladcs imaginaires, comes to seek the help of medicine, complaining of subjective pains and uneasiness, what do we often reply? "It is nothing; it is merely fancy; try not to think about it"; and he is sent away with some anodyne or simple remedy. This invalid, who has suggested to himself his disease, and who really suffers from it, becomes convinced that it is not understood, and that nothing can be done for him. * The more he trusts his physician, the deeper is this conviction; and he who came with merely a trifling complaint may go away with one which is practically incurable.' * This is an appropriate place for once more urging medical men to try hypnotism and suggestion in the early stages of disease, and not to wait until the patients' bodily strength and mental receptivity have been exhausted by experiments in other fields of therapeutics.

* Dr. Savill, in his ' Lectures on Neurasthenia' (1906) devotes a most instructive chapter to differentiating hypochondriasis, hysteria, and neurasthenia. He considers the first as generally incurable, and the last as generally curable if properly treated, and hysteria as semi-curable.

The disease induced by morbid auto-suggestion may be controlled and cured by healthy suggestion from without, given when the brain is in a state peculiarly receptive of outer influence. The mind of a nervous, hysterical, hypochondriacal person is usually shut against all outward influence, except such as corresponds with and feeds its morbid state. The patient when awake rejects cheerful and hopeful suggestions almost as if they were insults, but in the hypnotic sleep, his morbid self-influence being temporarily in abeyance, his mind will admit and act upon suggestions of bodily and consequent mental cure.

Dr. Russell Sturges, of Boston, U.S.A., has reported an interesting series of cases which he has treated by hypnotic suggestion, and a somewhat singular part of his work is that he has gained success without putting his patient into the deeper stages of hypnosis. On the contrary, he contends that deep hypnosis is unnecessary, and sometimes even harmful. Dubois is very insistent on this point, and his book † deals with the subject in an admirable manner. He says he cures by appealing to the patients' reason. But surely that has been done already ad nauseam by everyone in the entourage, and something more is looked for from the physician. Moreover, most of these professional invalids have ceased to be reasonable. Dubois may succeed in many cases owing to his strong personality, but most doctors need all the help they can get. ' Chinese ' Gordon went through his wars armed only with a walking cane, but ordinary soldiers find it necessary to carry swords and firearms. When I am asked if I can remove a morbid idea, I reply that it depends upon the patient's susceptibility to hypnotism.

But, as Professor Pitres of Bordeaux points out, some people are more suggestible when awake than others when profoundly hypnotized.

* Physicians practising hypnotism see a great many of these cases, and they are most difficult to cure, for every failure on the part of a previous doctor acts as a strong counter-suggestion to success. The hospital physician who recently told a young friend of mine before the patient that he might try hypnotism if he liked, but that he was sure an operation would be necessary, seriously handicapped the treatment, for such a statement coming from one in authority tended to fix the morbid idea and its attendant symptoms.

† 'The Psychic Treatment of Disease,' English translation, 1910.