The failure of ordinary retreat treatment was commented on recently by Mr. Mead, Metropolitan magistrate at Marlborough Street Police Court, who said: ' Our experience of these homes is unfortunate, because we have not had a single successful case of reform of persons sent to them. So far as this court is concerned, the Act is an absolute failure' (Times, January 31, 1913).

So much for rate-supported institutions. Well-to-do patients go from one institution to another, and I have met several who have been in five or six. Some of those who have gone in with one vice have come out with half a dozen. The greatest care should be taken in choosing a home for an inebriate. Rational direction and occupation are at least as important as deprivation of drink.

+ Increased experience confirms these ideas, and they are shared by my confreres who use hypnotism in all parts of the world. It is gratifying to find they are held by Dr. Creed, and that he has expressed them strongly in a report he was asked to draw up for the New South Wales Government. His position will perhaps enable him to put his theories into practical application.

The advertised cures for drunkenness largely depend for their success upon the careful use of suggestion, supplemented by drugs which seem to satisfy to some extent the craving for alcohol - e.g.,

I have embodied my views on this subject in a paper I read at the annual meeting of the British Medical Association at Nottingham in 1891, which is published in enlarged form by Messrs. Churchill; and I herewith (p. 246) reproduce a table from a paper I read at the International Congress on Psychology, held at Munich in 1896. * strychnine and atropine. It is difficult to keep au courant with the new nostrums, generally hailing from America, and always having two things in common - costliness and infallibility. The first arrival, the Keeley cure, still holds its own. I have known a few successes and many failures follow its use. Then, there are two other secret systems, highly recommended by two distinguished and disinterested philanthropists - Lady Henry Somerset and the Rev. Hugh Chapman - the Oppenheimer cure and the Normyl treatment.

I have seen only a few cases treated by these, and there have been more failures than successes. Mr. Chapman states in his recent report (1906) of the Normyl treatment that, out of over 1,000 cases treated, the number of failures known to the association working it is only 8 per cent. I fear there is a rude awakening in store for him. Dr. Mary Gordon has recently read a most instructive and interesting paper before the Society for the Study of Inebriety {The British Journal of Inebriety, January, 1907). She criticizes the report of the first year's working of the best of these drug treatments carried out by scientific English medical men at the Norwood Sanatorium. Out of 80 cases treated in a year 22 are reported as having abstained for over six months, 8 are reported as improved, and of 24 no information is given. I fear, from sad experience, most of those stated to be improved will ultimately swell the list of known failures (at present 16), and the same may be predicted of those who have failed to give information; 22 are reported as having abstained for less than six months, and are, therefore, not to be considered.

Miss Gordon is, therefore, in my opinion, justified in condemning the short treatment system by drugs, and in preferring the system of prolonged detention in well-managed retreats. The only fault I have to find with her excellent paper is that it ignores the value of hypnotism in treating dipsomania and drunkenness.

* It is of practical interest to trace the subsequent life-history of some of these alcoholic patients:

Case 1 (1906) continues well, and has been for many years a moderate drinker. This is, of course, quite exceptional, and, in the main, I agree with Forel that it is ' utterly idiotic and harmful to attempt to convert a soaker into a moderate drinker.' Total abstinence is the only course, he says.

Case 2, when last heard of, in 1901, was reported as keeping well.

Case 4 emigrated to the colonics, where he led an adventurous and most trying life, surrounded by temptations. He got cancer and came home to die in 1897, having had no relapse.

Case 25: This patient has had a few relapses, but none of a serious nature. His younger brother, treated in 1896, seems really and permanently cured, though his case appeared even more serious.

Among the successful cases are certainly ten of real dipsomania. In nearly all cases I have seen partial or temporary success, and in many instances where there was relapse cure would, I think, have resulted had circumstances been more favourable. I have never seen hypnotism weaken the character where it has been properly used; but, on the contrary, it is interesting to note the almost invariable improvement in disposition which takes place under the influence of moral suggestions. It is my practice to make the suggestions in the direction of evoking the patient's own powers; and it would be manifestly wrong to introduce a personal element into the treatment, or to make the patient sober in order that he may please the hypnotist! But in many quarters that seems to be the idea of treatment, and in cases so treated I can well understand that when the personal influence of the hypnotist is removed the patient may relapse. I suggest: First, abhorrence of drink and its results; secondly, absence of craving for it; and, thirdly, increased self-control, so that if temptation does arise there may be power to resist it.

If the patient is only slightly influenced, or if it is only necessary to slightly supplement the power