I find a good method of testing susceptibility to hypnotism is the following: The patient is directed to stand with his back to me and his arms extended, so that his fingers lightly touch the chimneypiece. I tell him to stand easily and with relaxed muscles, to put his heels together, his chin in the air, and to close his eyes. He will then be in a state of rather unstable equilibrium, and it does not take much to shake him. I then make ' passes ' down the back from the occiput to the sacrum, my fingers just touching him. If he is very susceptible, he will almost at once begin to sway backwards, and will fall unless supported. If less susceptible, it will only be when he is told to drop his hands to the side that he will sway or fall; whilst if he feels nothing and makes no movement, I know that I have a difficult subject to deal with. This little experiment is very easily made, and it is interesting to note the number of persons among one's friends who respond to it - at least seven out of ten.

Sometimes the body becomes cataleptic, and sometimes drowsiness is felt; at other times, though the swaying is very apparent, the subject says he feel nothing.

* Livingstone has recorded his sensations when in the clutches of the lion which lacerated his arm and was very near killing him. He says he felt no pain and was conscious of no fear while his eyes were riveted on those of the enraged animal. In fact, the emotional centres were inhibited, and he was practically hypnotized.

Hypnotism, as I have already said, is merely a psychical preparation or vehicle for suggestion, and this condition being induced, it remains for the treatment to be applied. The suggestions vary, of course, with the nature of the malady to be treated. If headache is the chief symptom, the head is gently rubbed, while the disappearance of the pain and its non-reappearance are suggested. If sciatica, the course of the sciatic nerve is rubbed, and the substitution of warmth for pain is suggested. If insomnia, the patient is told to feel sleepy at a certain time, and to sleep steadily through the night. If constipation, a motion is suggested at a specified hour - for instance, after breakfast. In treating rheumatic affections, the parts are well rubbed and the joints and muscles exercised by movements. In neurasthenia and spinal irritation, the spine is rubbed and kneaded. In cases of amenorrhoea, the advent of the period is suggested at the time when, by inquiry, it is found to be due.

In moral cases, such as dipsomania, a dislike of stimulants and a freedom from craving or discomfort is suggested, as also are self-control and a desire for cure. The training and tact of the physician find full scope in the application of suitable suggestions, and also in the recognition of the amenability of a case to this treatment.

The results are often more pronounced and more rapid than in most lines of treatment, and a patient may awake relieved or cured of a long-standing pain or loss of function; but it is well that neither patient nor physician should expect too much, and marvellous cures are apt to be short-lived. There should, however, be a steady improvement from day to day, and if, after a few trials, no change is observable, I generally give up the case, as being unsuited for the treatment. Liebeault allowed only a few minutes for each case, but in many instances it seems to me desirable to let the patient rest for twenty minutes or longer, for we may well suppose that during that period suggestions are working under a favourable condition of the nervous system.* The treatment should be repeated at intervals of not more than two or three days; otherwise incipient improvement may be checked by a fresh relapse.

I find improvement progressive, and cure permanent when once achieved. But in many patients there is a tendency to give up when a certain amount of progress has been made; and this tendency should be strenuously combated. In moral cases, it is absolutely necessary to have the patient under trustworthy observation, so as to guard against deception and relapse. I now refuse to treat such cases unless the friends are able to give proper supervision; and even after the cure appears complete, the patient, so I consider, should be told to report himself at regular intervals for at least a year, for repetition and reinforcement of the suggestion.

My practice is to make three or four attempts to hypnotize, and if absolutely no effect is produced I feel that the subject is not susceptible. In this respect I confess I lack the confidence and perseverance of Dr. Moll, who seems to think that every one can be hypnotized, by one method or another, in course of time. He relates how he tried one patient forty times ! Dr. Milne Bram-well reports cases in which he has succeeded in inducing somnambulism after the patient has proved absolutely insusceptible fifty, sixty, and even seventy times - an experience which speaks equally for the faith and pertinacity of patient and physician. I have occasionally, in special cases, made five or six attempts, but so far I have almost invariably found that if no effect is produced at the third sitting, it is useless making further efforts - at least, for some time to come. In such cases I console myself now with the dictum of a clever American woman doctor, who told me that some patients are on the spiritual, others on the mental, and others on the pill plane, and that it is useless trying to treat the third class with anything but crude drugs. It is quite probable that circumstances may change, and subsequent attempts be successful.

I know one lady who has suffered intolerable pain from occipital neuralgia for six years, and who consulted me about two years ago with a view to trying hypnotism.

* Professor Wood, of Philadelphia, writing to the Lance/, January 11, 1890, on hypnotic suggestion, which he had recently studied in Paris, and has introduced into his hospital practice, seems to consider that the hypnotic sleep alone is frequently sufficient to promote cure, and to think that Bernheim is wrong in attributing everything to ' suggestion.' I entirely agree with Dr. Wood that in certain cases of hysteria and nervous exhaustion and irritability the physiological rest enjoyed during hypnosis is a powerful and, perhaps, sufficient factor in the cure; but it is impossible, even in these cases, to eliminate curative suggestion, for where it is not expressed by the physician it is understood and supplied by auto-suggestion by the patient. Dr. Wood's remark that the atmosphere of the Nancy and Paris hospitals is ' heavy with faith ' applies, fortunately, to all institutions where cure-work is carried on. In London, at present, we have not the advantage of this meteorological condition, but the results are sufficiently satisfactory in suitable cases.

Dr. Bramwell relates how much more easy he found it to hypnotize his patients at Goole, where he carried on a general practice for many years, than afterwards in London, because of the greater simplicity and faith of the people there.