Milne Bramwell says his results in epilepsy have been encouraging, but not convincing. Out of ten cases five were markedly improved, but none recovered completely. †

The question of the curability of organic disease by any method of treatment is one of much interest, and does not affect hypnotism alone, but all therapeutic methods equally. The answer depends in a great measure on what we mean by cure. If we mean only removal of symptoms and arrest of active disease, it is certain that the question is answered in the affirmative every day, for we see patients with obvious signs of phthisis pulmonalis, for example, frequently restored to what may pass for sound health by many forms of treatment. But if we mean restoration of structurally degenerated and altered tissue, I think no physician will have the temerity to maintain that destroyed lung tissue can be restored, or that liver cells spoilt by cirrhosis can be replaced. But there are stages in a disease short of the stage of dissolution of tissue, in which, if healthy action can be set up, we may hope for restitutio ad integrum - for example, in the early period of fatty degeneration of the heart, before the muscular fibres have completely lost their character; in the first oncoming of Bright's disease after scarlet fever, before the excreting structure is serious compromised.

* Op. cit., p. 144. † Op. cit., p. 257.

Even when structural alteration has gone so far that restoration of the tissue to its normal quality is impossible, we can often prevent the extension of degenerative changes, and can favour a compensative increase of functional activity in the healthy tissue which remains - e.g., compensative hypertrophy in valvular disease, hypertrophy of the healthy kidney when the other is destroyed. We can also afford relief by removing symptoms and reducing them to their anatomical expression (de Watteville), as we endeavour to do in incurable diseases, such as cancer and tabes dorsalis.

There is a great choice of treatment for the attainment of these various indications, and no sensible medical man feels bound to any one of them, or maintains that it is the only method which can afford relief. Sometimes no treatment is required, and the only indications are to place the patient under the most fovourable conditions for the vis medicatrix natures to act. In other cases a course of hydropathy or massage favours the curative processes, and in others, again, drugs exert a specific effect. Take, for instance, a case of locomotor ataxy. Sometimes the gait may be improved and the pains relieved by suspension or by re-educational exercises; by drugs, especially strychnia and antipyrin; and by hypnotic suggestion. From the way many persons criticize hypnotism and hypnotics, one would suppose that we employed this agent as a panacea in every case. This is exactly the position we want to avoid and intend to keep out of. But we feel that it is a very great point to have at our disposal a method of treatment to which we can have recourse when other remedies have failed.

The late Mr. Ernest Hart was strongly opposed to the use of hypnotism. He said it was not wanted, for we had other more reliable remedies for every curable disease. One can only envy Mr. Hart the good fortune which must have attended him in his practice. Most of us find it otherwise, and an additional weapon in our armamentarium is not to be despised.

The saying 'Nature is a good physician but a bad surgeon,' is on the whole, true, for the tendency, fortunately, in most acute diseases is restoration towards normal health if the conditions are favourable. Hence we meet medical men in large and successful practice, whose experience lies chiefly with acute illness, perfectly satisfied with things as they are. But even they will find hypnotism useful in relieving symptoms and promoting convalescence.*

When we come to chronic disease it is otherwise, and a vicious circle once entered upon is apt to grow wider in extent and permanent in duration unless broken by appropriate treatment.

In treating it the conscientious practitioner is often reduced to his wits' end to know what to do for his patient's good, and he will be well advised to try hypnotic suggestion, either himself or through the agency of a medical friend.

* It has been said that out of a hundred patients under the care of an ordinary practitioner, 80 per cent, will get well with ordinary routine treatment, 10 per cent, will require special treatment, and 5 per cent, will prove incurable to any treatment. The residual 5 per cent, is almost a negligible quantity to the busy practitioner, and is the source from which the clientele of specialists, orthodox and unorthodox, is drawn. A large proportion of the two latter classes could be benefited or cured by hypnotism.

I would again urge medical men to try hypnotism first and not last. Over thirty years ago, when I first began to use hypnotism, I was asked to address an audience of medical men in North London on the subject. Discussion was invited, and I was considerably heckled. I remember one gentleman was very outspoken. He asked if I advised him to hypnotize the next patient who came to his surgery with stomach-ache, and ended his harangue by betting me five pounds that I couldn't hypnotize him ! So much has professional feeling altered in the last few years that I doubt if any medical man to-day would display such ignorance.

I have tried hypnotism in about fifty cases of stammering, and in half of these I have found it useful. In two cases, those of schoolboys, complete cure resulted, and in six others there is so much improvement that little inconvenience remains. One of the patients is a barrister, who was debarred from pleading in court by his infirmity. He was only slightly susceptible to hypnotism, but he improved rapidly, and he has recently written to tell me that he has been appointed Recorder of a large town, and fills that important post with satisfacton.