529 A. Alcoholism, as the vice which least easily escapes notice, is that which medical practitioners have most frequently endeavoured to combat. The list of specifics alleged to cure drunkenness is inexhaustible. It is probable that the temporary success of those which have met with any success at all is due to the suggestive action of a convinced physician upon a patient anxious to be rid of his curse. At any rate, it is the vice which suggestion, intentionally and consciously used as a therapeutic method, has been (with varying success) most universally employed to eradicate. Lists of cures of alcoholism by suggestion have been published by practitioners in every country ever since the first impulse given to psycho-therapeutics by the Nancy School.

See Otto Wetterstrand, Der Hypnotismus und seine Anwendung in der praktischen Median; Georg Ringier, Erfolge des therapeutischen Hypnotismus in der Landpraxis; Van Renterghem and Van Eeden, Psycho-Therapie; Auguste Forel, Einige therapeutische Versuche mit dent Hypnotismus bei Geisteskranken; Lloyd Tuckey, Revue de l'Hypnotisme, January 1897, p. 207; Ladame, Revue de l'Hypnotisme, November 1887, p. 131, and December 1887, p. 165; A. Voisin, Revue de l'Hypnotisme, vol. ii. (1888), p. 69, and vol. iii. (1889), p. 353; Vlavianos, Revue de l'Hypnotisme, June 1899, p. 361; Neilson, Revue de l'Hypnotisme, vol. vi. (1892), p. 17. See also the works of Liébeault, Bernheim, and Milne Bramwell.

The impulse to drink, like the impulse to steal, can be traced through a variety of stages; from the most elementary, when the impulse is allowed to follow its course because the satisfaction of it is pleasurable, through the diminishing degrees of the power of inhibition, and the progressive mechanisation of the process, until the impulse becomes irresistible, and is felt as a curse, which the will is powerless to oppose. The complete evolution of the process is to be found in those cases where the impulse and its associated states of consciousness have become entirely separated from the normal stream of thought, and the dipsomaniac presents alternating personalities.

The case of one of Pierre Janet's patients, Maria (see Névroses et Idées Fixes, vol. i. p. 222), illustrates the final stage. She had a hysterical brother and an insane sister. Her father and grandfather were drunkards. She, however, abhorred this vice so thoroughly that she always drank water in her normal state. Moreover, she had no taste for alcohol nor desire to drink it. From time to time, however, she had a feeling of distress which drove her out of the house into the streets. This was the beginning of a dipsomaniacal attack. She drank ether, alcohol, anything she could get. After a few days of such conduct she used to be found by the police lying intoxicated in the street, and would after some time awaken to find herself in a police station or hospital. In her then normal condition she could remember nothing of the attack after the initial feeling of distress that had led to it.

529 B. A case recorded by Dr. Milne Bramwell in a paper entitled "Dipsomania and its Treatment by Suggestion " in the Proceedings of the Society for the Study of Inebriety, June 1900.

Mrs. C, aged forty-four, November 23rd, 1894. Family history of alcoholism. At the age of twenty the patient began to have frequent hysterical attacks, and for these stimulants were prescribed in rather large quantities. Two years later she began to take stimulants in excess, but did not do so frequently, and rarely became intoxicated. From thirty-two to thirty-six she was an abstainer; then commenced taking stimulants again, and attacks of genuine dipsomania soon appeared. The patient suffered from an almost constant craving for alcohol. She was, however, a woman of culture, refinement, and high principle, devoted to her husband and children, and the idea of giving way to drink was in every way abhorrent to her. She therefore struggled with all her might against the temptation; resisted it successfully for a week or two, then the craving became irresistible, and a drinking bout followed. I hypnotised Mrs. C. thirty times, from November 23rd, 1894, to February 14th, 1895. From the very beginning of the treatment she abstained from stimulants, but the craving, although much diminished, did not entirely disappear for some months.

Up to the present date there has been absolutely no relapse.

Other successful cases, and a general discussion of dipsomania and the conditions favourable to its successful treatment, are given in this paper.

529 C. Nicotinism has also been successfully treated by suggestion. The following is a typical instance, recorded by Auguste Voisin, Revue de l'Hypnotistne, vol. ix. (1895), p. 245.

Mr. X., forty-five years old, hypochondriacal, memory and moral power considerably diminished. For the last fifteen years has smoked between forty and sixty cigarettes a day. Pains at the level of the first dorsal vertebra; constant sensation of fatigue; emaciated. Heart-beats very feeble; patient coughs frequently. Nothing abnormal in the senses of sight, hearing, and smell. Taste alone somewhat impaired. Speech clear. Hardly any appetite. Hypnosis was only attained after two attempts by the method of fixation of the eyes or of the fingers. The degree obtained was one of semi-lethargy. Patient cannot open his eyes; although he asserts afterwards that he was not entirely asleep. The suggestion given was, first, that he should dislike tobacco, and not smoke more than three cigarettes a day; later, that he should detest tobacco. Suggestions perfectly carried out. Cure complete and final.

See also Dr. Hugenschraidt, Revue de I'Hypnotisme, vol. ix. (1895), p. 217; and Wetterstrand, Ringier, Van Renterghem and Van Eeden, loc. cit.