Herrero, Von Schrenk-Notzing, Wetterstrand, and other authorities have made considerable use of chloroform for the purpose of quieting nervous excitement and breaking off the life of relation, and so favouring the induction of hypnosis. They express themselves as well pleased with their results. Dr. Van Velsen, of Brussels, tells me that he succeeded in hypnotizing a friend after giving him 10 grains of chloral whom he never could influence before, though he had made many attempts; subsequently the patient was susceptible without chloral, and became a somnambulist.

Dr. Barwise says: ' I have had no difficulty in hypnotizing patients taking bromide of potassium or chloral hydrate, and from some observations I made a year or two ago upon the action of cannabis indica in the treatment of sick headache, I was led to the conclusion that this drug predisposed to hypnosis, and a recent experience has removed all doubt of it' (op. cit., p. 7). Dr. Farez has recently substituted somnoform for chloroform, as being equally efficacious and less dangerous. Dr. Crichton Miller uses what is called the combined method, preparing the patient for hypnosis by large doses of bromide and other drugs.

I should here like to add a word of caution against regarding hypnotism as a panacea in every case of drunkenness. I am thoroughly convinced of the value of hypnotic suggestion as an aid to moral reform, and look forward to a time when it will be used in all retreats for inebriates and other reformative institutions; but I recognize its limits, and I know that its indiscriminate employment will only bring disappointment to the patients and discredit to the system.*

When we consider that hypnotism simply intensifies to a notable extent the influence of suggestion on the bodily functions and mental characteristics, we see how its curative scope is necessarily limited by pathological and other conditions, and how illogical it is to expect miracles in the way of moral reformation from it alone. Granted the patient has preserved come degree of self-control, and has a strong desire to be cured, it is possible that success may result from the use of hypnotic suggestion even when the surroundings continue unsatisfactory. Under such circumstances I know that publicans have been cured without leaving their business, and soldiers without quitting their regiment; but I regard these cases as exceptional, and in long-standing or inherited dipsomania removal from temptation is an essential condition of success.

It is important to bear in mind how drunkenness varies in degree and kind. Between the man who drinks to excess when occasion offers, and who cannot resist the solicitations of friends, and the dipsomaniac, there is a great difference. Though the ordinary drunkard may become dipsomaniac, this is not usually the case. The drunkard is mad because he drinks; the dipsomaniac drinks because he is mad. Dipsomania is a form of impulsive insanity, which is nearly always inherited, and which manifests itself by uncontrollable fits, during which the patient is obviously insane. Dr. Ball, speaking of this disease, says: ' The prognosis is absolutely hopeless, especially when it depends on heredity, and is not due to acquired habit. Such patients are never cured, though the methods of treatment are as varied as they are numerous. ... If there is any chance of safety for them, it lies only in their being placed under restraint for a prolonged period - I may say for an indefinitely prolonged period' (op. cii., p. 797).

* Canon Barnett told me years ago a propos of a drunken woman he was interested in, that he thought I should reap disappointment unless I could bring about a change of heart in these patients. A change of outlook is at any rate necessary. Hypnotic suggestion undoubtedly very often enables us to effect the latter if not the former change. One of my patients tells me he abstains altogether from alcohol now because he finds the amount he can take without causing illness and disgrace is so small as to be not worth while.

I have treated during the last twenty-five years over 300 cases of chronic alcoholism, and have found hypnotic suggestion has proved completely curative in about a third of these. This is a good result, considering that in no case was the patient confined in a retreat or kept away from his home or business for longer than a month. I only stipulated that for a specified time he must be under responsible supervision, and must lead a healthy and rational life. One generally found self-control was rapidly regained, and it became safe to gradually give him more liberty. The immense gain of this treatment in suitable cases over that of confining patients in a retreat for twelve months - the least time the advocates of this system recommend - is apparent. Not only does the patient keep in touch with his family and business, but he is saved the demoralizing effects of a loafing and idle life. I know inebriate retreats are necessary, and many of them are admirably managed, but association with other drunkards cannot be beneficial, and it is difficult to find rational employment for all the inmates of a retreat for the better classes." * I should like to see every drunkard

* The Dalrymple Home, Rickmansworth, is one of the best-known and best - managed retreats in the country. Its report for 1899 states that, of the 518 men who had passed through it since it was opened, 169 are doing well. This proportion and mine may appear small alongside of systems which 'never' fail, or which claim to cure over 90 per cent. The explanation lies in the fact that our reports give a more accurate account of what happens. It is easy enough to coax a drunkard into sobriety for a few weeks, and then to claim him as a cure. In one well-known instance twelve drunkards were treated by a vaunted specific, and it was reported in three months, with great given the chance of speedy and pleasant cure by hypnotic suggestion under favourable conditions. * If it failed, I should consign him to an agricultural colony for inebriates, conducted on somewhat similar lines to those adopted at the excellent institution for epileptics at Chalfont. Work, discipline, and hygienic surroundings are the remedies for chronic alcoholism, as idleness, laxity of aim and principle, and unhealthy surroundings, are its principal causes. An unfortunate denizen of the slums once said that a bottle of whisky was the shortest way out of Sheffield. † flourish of trumpets, that they had all been cured.

Alas ! I am informed that after twelve months every one of them had relapsed. Inebriates are generally emotional, and easily acted upon by their environment. Well fed, petted, flattered, the excitement of their new situation sufficed to keep them sober for a few weeks. But the object achieved by the advertisers, their attentions to the patients ceased, they were thrown on their own resources, and speedily resumed their old habits. It will be noticed in the accompanying table how many of my patients relapsed after three months, and I look on that as a somewhat critical period.

* Dr. Astley Cooper uses hypnotism and psycho-therapy in conjunction with all the other latest forms of treatment, re-educational and moral, in his excellent institution near Cockermouth, and he gives an interesting account of his experience in his recent book ('Pathological Inebriety,' 1913, with an Introduction by Sir David Ferrier, F.R.S.).