eyes and put himself in a passive state. He should be assured that suggestibility is well-nigh universal in healthy individuals, but that his coöperation is absolutely essential.

As soon as catalepsy has been secured one should say with some emphasis: "No one shall ever be able to hypnotize you against your will, or except for your good, or no one but your physician." This suggestion is very reassuring. This cataleptic stage is sufficient for giving many therapeutic suggestions, indeed when we treat of this, we shall see that a-hypnotic suggestions are made by many therapeutists, many claiming that the passive state is all that is required. It is surprising how easily analgesia to a pin-prick may be secured. Anesthesia or complete insensibility to contact is not secured short of somnambulism.

One would hardly like to depend on the analgesia for surgical purposes short of the somnambulic stage.

In treating a stricture of the tear duct in a child of twelve years, the probing was so painful that very little progress was made in several visits. Catalepsy with analgesia to the prick of a needle was easily secured. The writer then suggested that the probing would not be painful, at the same time massaging over the region of the duct. The child was perfectly conscious, and in response to the question said it did not hurt when the probe was forced thru a tough stricture, opening the duct to the nose. Nevertheless

altho she maintained it did not hurt, there was evident considerable muscular reaction.

It will be remembered that Esdaile's use of hypnotism was almost entirely as an analgesic in surgery. He devoted half an hour to the hypnosis as a routine measure, and there can be little doubt that somnambulism was secured.

Bramwell hypnotizes on several successive days before attempting any very painful operations. He has secured complete anesthesia in only about ten per cent. This uncertainty evidently lessens its value as a general anesthetic, but where it is effective it is devoid of danger, which cannot be said of chloroform and ether. Not only does the patient suffer no pain, but the reflexes are abolished. This is certainly objective proof of anesthesia.

Analgesia in surgery has been demonstrated over and over again before representative medical societies. At the Boston Homeopathic Medical Society a few years ago Prof. George H. Earl reported a dispensary confinement case, where it became necessary to use forceps with no ether at hand. The patient was hypnotized and the delivery was practically painless. This naturally leads us to inquire why normal childbirth cannot thus be made painless, and Bramwell quotes numerous instances of its successful employment.

I have seen no reference to its use preliminary to giving an anesthetic. It would seem that it might here be of greatest value, in reassuring the patient

and controlling the after vomiting. The value of hypnotism in medicine will be considered under Suggestive Therapeutics."

The hypnotic control of the pulse has been frequently secured by the author. As an example a recent experience may be mentioned. When the subject, a medical student, had reached the somnambulic stage another physician was asked to take his pulse, but not to mention the result. It was then suggested that in ten minutes the rate would be increased ten beats per minute. The patient was left quietly reclining in an easy chair, no suggestions of an exciting or emotional nature being made. second count showed the exact increase suggested. It was then suggested that in ten minutes the rate would be ten beats less than at first. The same physician announced the result as seven less.

A

Doctor Sidis and others have shown by sphygmo-. graphic tracings a marked change in the character of the curve under hypnosis. More interesting perhaps are the results of pneumographic tracings. The increased sensitivity of the hypnotic state is graphically shown by the great variations from the normal tracing caused by stimuli of various kinds. Thus laboratory results confirm the observations that suggestibility is greatly increased. The therapeutic bearing of this fact will be discussed under "Suggestive Therapeutics."

The transition to the alert stage seems somewhat contradictory. This has always impressed the au

thor when telling a subject who has been put into a sound sleep that he can open his eyes and still remain asleep.

That something of the kind occurs to the subject is often evident from the slight hesitation which he shows. I have frequently said to a patient, "Your sleep is not quite like ordinary sleep because you can open your eyes. You can hear me speak to you, can you not?" His reply will often show considerable effort and the word "yes may be whispered. This has been observed so often that one should be suspicious that he is being deceived if the subject should respond in a loud voice at first.

Hallucinations will now be accepted. These may be either positive or negative. That is, the subject may be told that he is looking at a beautiful landscape; this would be a positive hallucination. Or he may be told that the chair which stood in front of him has vanished, that there is no one present in the room; these are negative hallucinations.

This brings us to the subject of rapport. Before any suggestion of the kind is made the patient appears perfectly oblivious to the presence of all save the operator, and appears not to hear when the operator speaks to others than himself.

This rapport seems to be a phenomenon of hypnosis entirely independent of the suggestion. The operator can, however, introduce an observer either under his true name or fictitiously.

The deductive nature of the hypnotic state is universally recognized. For example, the subject is told that he is John L. Sullivan, and he immediately assumes his idea of the pugilist.

On one occasion in a public hall the writer saw a washerwoman taken on the stage and told that she was Susan B. Anthony, and informed that she was to address the audience on "Women's Suffrage." In the normal state probably no amount of persuasion would have induced the woman to say a word in public, and yet she bowed to the audience and made a very good speech. She believed herself to be the person named, and given this premise, deduced a logical sequence.

Suggestions should be made direct, emphatic, and oft repeated. Sidis has shown this to be in strong contrast to the normal state, in which suggestions are effective in proportion to their indirectness. For example, if you want your friend to whistle a tune, he would probably refuse your command, but if he be somewhat preoccupied, you pretend yourself the same, but carelessly whistle the tune, and the chances are that your friend will change his tune and whistle yours.

In like manner the mental processes differ. The conscious self reasons inductively. He builds up a conclusion by putting together separated and unrelated experiences. For example, Newton watching the apple fall conceives that there is a mutual attraction between the earth and the apple, then between