R K 921 R6 /Biology B 3 646 7M^ \ '■K THE PHYSIOLOGICAL EFFECTS ARTIFICIAL SLEEP WITH SOME NOTES ON THE TREATMENT BY SUGGESTION Dr. MATHIAS ROTH. BAILLIEEE, TINDALL & COX, ' 20, King Willi a.m Street, Stra>T), W.C. 1887. INTRODUCTION. About 52 3'ears ago, while a medical student in Vienna, I caught cold and had the misfortune of being treated according to the fashion of the day by bleedmg, and besides the venesection as many leeches as could be placed on my arm were applied. My two very kind and Kcellent teachers of anatomy, Professor Berres and his ssistant, Dr. Hyrtl, who had afterwards a world-wide fame as a professor of anatomy, were my medical attend- ants. Their heroic treatment had a baneful effect on my constitution for years ; thus I was induced to study various other, at that time, prevalent modes of treatment, amongst these animal magnetism. In the whiter of 1839-40 I was present at the magnetic demonstration of Baron Dupotet at the Athenseum m Paris. A few years later Baron Eeichenbach published his first experiments on odism. At the same time I had an idiopathic som- nambuhst patient under treatment who for some time after the attack suffered from periodical catalepsy. On this patient I had occasion to verify many of the experiments made by Eeichenbach. My interest in the study of animal magnetism was kept up by reading amenorrhoea, of from three to six months' duration. Each patient was placed in a state of somnambulism, and during this condition it was suggested to them that the period should commence at a certain hour, and in each it did so punctuall}'. In two instances neuralgia was associated with the uterine fault, and this too was cured. Dr. Voisin said that he restricted himself simply to detail the facts, leaving the explanation to future physiological enquiry, adding that previous observa- tions by Liebault, Beaunis, Focachon, Dumontpallier, Bourru, Bourrot and Mabille had proved the possible in- fluence of hypnotic suggestions on the vaso-motor system. These various instances of the therapeutic use of suggestions, made during the hypnotic state, will, I trust, be sufficient to excite your interest in this subject, and induce you to study some of the many works regarding it which have lately appeared. By so doing you will be able to cure many neuro-pathic and other disorders which you probably now find difficulty in dealing with successfully. Many cures effected by mesmerisers owe their successful result to various modes of inducing artificial sleep and by post hypnotic suggestions ; certain nervous attacks accompanied by the so-called aura, the hysterical globe in the throat, or by the hysterical nail ofi the top of the head were cured merely l)y the affirmation and sugges- tion in persuading the jiatitrnt that there will not be another attack. Gesne)- (the priest) used to exorcise people by reading and quoting to them certain parts from the Bible. 19 Suggestive therapeutics cure even at the present time many nervopathic complaints, while bread pills and coloured water are believed to have produced excellent curative effects in hypochondriac patients and such as suffer from imaginary disorders, it is desirable rather to confirm them in their morbid notions than to try to counteract them. If they are hypnotised their individu- ality might be changed and post-hypnotic suggestions made which will induce them to change their fixed ideas or to act in a manner differently from the promptings of their imaginary state. In the service of Dr. Luys in the Salpetriere was a girl of sixteen years of age who could not be hypnotised. She suffered from a complete hysterical paralysis with anaesthesia and had been confined to bed for fifteen months ; the muscles of the legs were considerably atrophied ; neither the bromide of potassium, douches, static and faradaic electricity, nor any other treatment caused improvement. On the 23rd January a draught was ordered which was called fulminant e (fulminating) and consisted of common water coloured with some harmless substance, the patient was told that it was a very powerful poison. On the 24th, in the morning, she complained of having passed a completely sleepless night, her face was much congested, she was tormented by constant palpitation of the heart and her left arm was quite paralysed for a few hours, but without anaesthesia. The result of the imaginary poison was more violent than was expected ; it was desirable that the moral causes destined to influence the brain should calm down like medicinal influences. The patient was left quiet for several days in order that she might be well prepared for the experiment. On the 30th her diet was reduced, and on the 1st February three pills (bread) of the size of a pin's head were ordered, and she was told that they contained some of the strongest poison which had ever been known ; the doctors affirming at the same time that she would be very ill, but that it w^as certam she would be cured ; the patient was so tery much afraid that it required some force to make Her swallow the pills. Two hours after havmg taken them she had a kind of syncope, her skm got very pale, her heart palpitated, there was constant vomiting with very violent colic ; these symptoms lasted almost twelve hours ; afterwards creeping and pricking 20 sensations in the arms and in the paralysed legs ■were felt and the next day some movements could be observed in the legs. During the following few days the power of movement increased to such an extent that she was al)le to walk, first with the assistance of two persons and, later, on crutches ; finally on the fifteenth day, movements and sensation were perfectly recovered in the previously paralysed limbs ; she pretended that even at that time the little pills still continued to act on her nerves. Many similar cures are known where influences acting upon the imagination have caused such a revulsion in imaginary and neuropathic diseases ; it is well known that Boerhavc, in the case of schoolgirls suftering from chorea, caused by imitation, stopped the further progress of the epidemic liy thi:eatenmg to apply the actual cautery. In a pamphlet on " Fear and Fright," published many years ago, I have collected numerous cases of complaints produced by the effect of the mental influence caused by fear and fright, and also many cases in which they had a curative effect. If suggestions, affirmations and threats can produce such effects in persons who cannot be and are not hypnotised, it will be easily understood and admitted how much more powerful the influence of suggestions will act therapeutically on those in the hy]")notised state. Dr. Voism, of the Salpetriere, was able to cure by the help of the hypnotic sleep a patient suffering from hallucination and a furious frenzy. He caused her to fall into a prolonged sleep and suggested the exact hour for awakening. Dr. Voisin has also modified the char- acter of some patients mentally affected by the suggestive method ; thus some who were very rude became equally polite, others who were idle began to work with much zeal. It was enough to suggest to them, while in a state of somnambulism, the idea of working at dressmaking as soon as they awoke. After a few seances of h^'pnotisation accompanied with suitable suggestions, the good hal)its continued and the whole being of the patients became absolutely changed. Voisin believes that there is reason for hoping that post-h,ypnotic suggestions will be able to suppress or diminish evil instincts. Dr. Lic'l^ault, who made use of these suggestions, was able by hypnotising a lazy child to render it industrious to such an extent that he became the first in his class. 21 These fits of industry lasted for some time, when the child fell back into his lazy state and afterwards objected to be again hypnotised. I have not mentioned the importance of the medico- legal aspect of h}73notism, but it is easily understood that there might occur numerous cases m which persons previously hypnotised will be irresistibly induced to commit any misdemeanour or crime which has been suggested to them. Such persons will have no recollec- tion of the actions they have committed, and they cannot be made responsible for any committed in a state of unconsciousness. Therefore it is desh-able that the attention of the legal profession, as well as of judges and juries should be directed to the importance of this subject.* In catalepsy, phenomena consequent on different suggestions will be produced in one half of the body ; m somnambulism illusions of different kinds will occur in different places. Dr. Magnm has frequently relieved contractions followmg hystero-epileptic attacks by the aid of hjq^no- tism. Dr. Dumontpaillier has caused supplementary haemorrhage by suggestion. From a therapeutic point of view it is remarkable that similar hgemorrhages can be stopped by suggestion . Hitherto the various explanations of the effects of hypnotism on the nervous centres which have been proposed have not been considered satisfactory, and it is still left to future experimenters to find out the real scientific explanation. Mental Disease treated by Dr. Voisin. " The first lunatic I have treated m this manner was one named Jeanne Sch. . . aged 22 years, who was attacked by maniacal paroxysms which succeeded hysterical attacks, hallucinations of hearmg and absolute inco- herence in her speech and actions. One day she was seized by a most violent agitation for three hours. When I came to the hospital I had heard her cries at least 300 metres off. I found her in a straight jacket, held sitting on a sofa. I tried to hyp- notise her, and I succeeded, notwithstandmg the difficulty of making her fix her attention on my forefinger held * Gilles de la Tonresse, L'Hypnotisme et les Mats Analogues av, point de vue medico-legal. Paris, 1886. 22 above the bridge of the nose. She fell into a deep sleep, and quiet succeeded immediately to the most violent agi- tation any one could imagine. The first sleep lasted three hours and a half. I repeated the treatment, and I succeeded every day, but not with- out difficulty, for it was necessary to take sometimes two or three hours to induce sleep. This treatment was continued without interruption ; sleep lasted ten to twelve hours at least, in every 24, by means of the method of suggestion, that is to say, by enjoining the sleeper to wake at such an hour. I am deeply astonished to l)e able to state that the patient gradually calmed, and that the hallucinations diminished, then ceased. Several times I came without l^eing expected, and I have found the patient iii a paroxysm as furious and frightful as can be imagined, and hypnotism has caused it immediately to subside. It is a most touchmg sight to see the patient fall into a most calm sleej), and into absolute insensibility, who a minute previously gesticu- lated, struck and vociferated. This power of hypnotism impressed me to a high degree. But Schaff. . . remained unsubdued as soon as she awoke, and her language and bearing were then very bad. The idea occurred to me to suggest to her during her hypnotic sleep, ideas of obedience, of submission and good behaviour with the nurses and with us, and to enjoin her not to speak again in language improper and low, not to get into a passion, and to execute such or such work at a given time. My injunctions, as well as those of M. Gomet, my house surgeon, have been punctually executed, and I succeeded so far as to make her sew for an hour or two of a day in the work-room of my quiet patients. She often answered us during her sleep that she would not obey, but on insisting, we obtained her promise of executing the suggestion, and she did so with astonishing punctuality and precision. She has become obedient and submissive to rule. She does not use improper language, she keeps her person clean, and even with a certain degree of niceness. Having obtained such results, I suggested that she should learn some passages from a moral book and recite them to me two or three days after at an hour indicated. She has done it, and has shown in reciting S3 these passages a retentive memory more remarkable because the pages were composed of a series of detached sentences, and this girl had not read a line for several years. I have suggested to her to come and recite some chapters of morals before my pupils. She has executed my injunction. I thought after this I would try and revive her senti- ments of affection, which were absolutely extinct. She had spoken to me with hatred of her sisters. She had threatened to kill them, and had refused to see them. I have enjoined her during one of her sleeps to write me a letter, in which she will promise me to behave as a honest girl just like her sisters, and to Avelcome them. She has written the letter at the hour named, and on the follow- ing morning she had received her sisters with affection. Her demeanour towards them has not altered since. So as Braid has observed, my patient had no know- ledge of what passed in her hypnotic sleep, thus she cannot tell me why she did such and such acts, nor why she recited to me whole pages ; she said she did it of her own accord, having no consciousness that she had done it by suggestion. This woman was totally cured, and what is more, her whole bearing became so good that she could be admitted as attendant in one of the Paris hospitals, where her conduct is irreproachable. Hypnotism in this case has been a means of curing madness and a moralising agent." Hysteeio- Epilepsy, Convulsive Attacks, Hallucina- tions OF Sight and Hearing. Furious Delirium, Maniacal Agitations. "A woman, G — , 25 years old, had a grandmother, on her mother's side, who was epileptic. She began to be ill five years ago when she had convulsive attacks, which were soon complicated by hallucination and delirium. When first hypnotised she had fearful hallucinations of sight and hearing, and the delirium was as furious as possible ; she spat into the doctor's face, tried to bite and injure him. She said that " the man who is up there does not permit me to be put to sleep." She said "I am intoxicated, he does not wish me to drink or eat. I am ill-treated, and one of the students after having passed the night with me wheeled me about and put my bed into the water ; during the night I have ^4 seen serpents of various colours creep on my bed, but specially one red serpent." She told the doctor that he was a thief, a murderer, and accompanied these words with menaces ; her looks were very wild. This i^atient has, since she entered the hospital, attacks of mania lasting 8 to 15 hours, She was hypno- tised during her period in November 1884. Afterwards this was continued after her periods as a preventive means. The first trials were very difficult and most fatiguing. The patient was kept by live or six nurses while the doctor tried to fix her ej'es on a magnesium lamp or on his own e3'es, and was obliged to keep her eyelids open either with his fingers or with an instrument, and many seances have lasted one hpur or one hour and-a-half and even three hours, especially in the beginning. The transition from agitation to sleep has always been very rapid, and as soon as she was asleep her voice had a sweet sound and amiable tone. The insensibility and her collapse was complete ; after- wards it was suggested that she should sleep till the next morning till 8 o'clock, that is during twenty-three hours, and at that time cither the lady superintendent or the doctor would place a hand on her forehead. If no convulsion occurred, the suggestion succeeded, l)ut it often happened that an attack awoke the patient. Then a student replaced her into sleep. She awakes as after a natural sleep, opens her eyes, sits up ; the face is animated and coloured, sometimes it is even purple, which contrasts very much with the discoloured or pale yellow tmt which she had, like all hypnotised persons, during sleep. During the hypnotic sleep, and according to the sugges- tion given, she takes her meals and medicines which are l)rought to her, the same which she has refused while awake. She leaves her bed to satisfy her bodily wants. During the periods of agitation the patient is not per- mitted to be awake more than half an hour in twenty-four hours. During this half-hour she remains usually very calm, l)ut if a longer time passes she begins agam to be agitated and to be a maniac. After a certain period of treatment the agitation has ceased, although some attacks returned ; it is necessary to watch that the agitaiion should not reappear, and to l)reveni the maniacal habitude to establish itself. Thus 25 during seven daj-s the patient has several times remamed asleep except during seven half hours. The patient eats the hospital diet and takes bromide of jwtassiam dnving the sleep which she refuses when awake. The refusal of eating and taking medicines is still due to the hallucination of the man who is high up, who does not permit her to take nourishment. While the maniacal state was decreasing she was only eighteen hours hypnotised in the twenty-four. During this period she is now also quiet, hut if she is permitted during the maniacal period to be more than half an hour awake, the agitation returns with the accompanying bad behaviour and words. After four months treatment the patient had no further maniacal periods, and at present fifteen months have passed since her cure, and the attacks have ceased. The patient is now polite, sociable, and even amiable. She is grateful for my attendance, and has neither halluci- nation nor delirious conceptions, and she no longer believes me to be the assassin or the murderer of her father. She is employed in the Salpetriere as linen-room keeper" (Voisin). Therapeutic Application of Hypnotism (Azam). It is impossible to know beforehand to what extent the study of Braidism will contribute to relieve and cure many complaints. Braid quotes 65 observations of cures of various diseases. The thoughtful medical man will no doubt ascribe much to the enthusiasm of the inventor of hypnotism. A method which causes at our will anaesthesia hyj)er- aesthesia, the most absolute immovability of one or another part of the body, which retards or increases as required the circulation, which can produce a calm sleep and arrests, as M. Peul and Azam have seen, spontaneous catalepsy, kc. Such a method must have a certain therapeutic future as soon as it is studied without prejudice and merely with the desire to find out the truth. An important question must 1)6 asked. Is there any danger in hypnotism ? The abuse of its application might fatigue the nervous system and cause hysterical attacks. It is not j)rudent to employ it in epileptic patients nor on those who suffer from heart disease. Neither Braid or Azam have ever observed that life is 2(? endangered by lij'pnotisni, and the latter has never observed even fainting. Only medical men should make use of it as the}' alone can judge whether there are any counter indications, and will l)e able to relieve nervous accidents. The whole future of surgical anaesthesia produced by hypnotism depends on patient and well- made experiments ; the operations which have been already made prove sufficiently that insensibility to pain can be realised. Surgical Application of Hypnotism. It is only necessary to substitute for the sponge or the compress impregnated by etlicr or chloroform, a very bright, shiny object, for the purpose of putting a patient to sleep. The principal condition is to lix the attention of the person, to have the mind calm, there must be no noise and therefore it is desirable that the patient should be several times hypnotised before any operation is performed, in order to be sure that he can be put to sleep and that the period of the anaesthesia is sufficiently long. But surgeons in general object and find that chloroform is much easier to use, but as we practise surgery not for ourselves but for the sake of our patients, it is desirable to have some perseverance to avoid any movement in the shining object and to prevent any noise, because some patients are sometimes quickly excited by anything which affects their hearing. A medical man who was hypnotised by M. Yerneul, and who is able to give a good account of the first period before he fell asleep, affirms that the slightest movement of the shiny object kept before his eyes or even a very slight noise retarded and prevented him from falling asleep. Medical Precepts regarding the Application of Suggestion. By Prof. Bernheim. " Shall we prescribe something which might be useful although its al)usc might be injurious ? Thus should we not prescribe wine, alcoliol, opium, quinine, because the immoderate use and unsuitable use of these substances might produce accidents ; there is no doubt that sugges- tion applied by dishonest and unskilful people is a dangerous practice. The law can and must interfere to prevent abuse. Suggestion applied for curative purposes and used with prudence and intelligence can- only be beneficial. 27 It is the task of the medical man to apply its useful effect for the relief of his patients. If I think that suggestive therapeutics has some chance of success I believe I deserve some reproach if, as a medical man, I would not propose it to my patient, and if I would not insist upon inducing him to try it. But before I apply it, I consider it my duty to adhere to some rules which every medical man should strictly follow to preserve his conscience and his professional honour, 1. — Never to put to sleep any person without his formal consent or the consent of those who have the charge of the patient. 2, — Never to cause sleep except in the presence of a third authorised person, relative, husband, father, &c., who guarantees both the hypnotiser and the hypnotised. Thus every disagreeable supposition or future accusation will be prevented, as well as every suspicion of any experiment the aim of which is not for the good of the patient, 3. — Never to make to the hypnotised person without his consent any other suggestions than those required for his cure. The professional man has no other powers than those which are confided to him by the patient. He must limit himself to merely therapeutic suggestion, not make, even if it is in the interest of science, any experiment except after previous formal consent of the patient. Further, the medical man must not make use of his influence upon the patient for obtaining this consent, when he thinks that the experiment which he intends to make might be in any way inconvenient. As a physician and clinical professor it was my duty specially to study suggestion aj^plied for curative purposes. I have the right to affirm, supported by numerous facts, that curative suggestion exists, without wishing to say that it is alwaj'^s applicable or always efficacious. But this is often the case. It is not because I am indolent nor is it that I wish merely to satisfy a vain superficial scientific curiosity that I began this study about five years ago, which I have pursued vigorously, notwithstanding many obstacles and notwithstanding the ridicule to which I was exposed " (Bernheim). 28 APPENDIX I. Cures by Miracles and Imagination.* The stones attached to the girdles of the Hebrew pontiffs and of the priests of Cj'bele, the stones under the form of a beetle, of a hand, of a circle which were worn round the neck of Orientals, of the Greeks and Bomans, and even the cameos worn at the present time by ladies have been considered by the Ancients as magic talismans of mysterious power. Paracelsus, who has observed the cause of the effects produced by amulets and similar objects, says: "Whether the object of your belief is real or false, you will always obtam the same effect ; thus, if I believe in a statue of St. Peter, just as if I believe in St. Peter himself, I shall obtain the same effects as if I would have believed in St. Peter himself; but this is a superstition. It is the belief which produces these miracles and whether the belief is true or false it will always produce the same wonders. Peter Pomponazzi, an author of the 16th Century, says : — "We can easily understand the marvellous effects pro- duced by confidence and imagmation, especially when they are mutual between the patient and the person who acts upon them. The cures attributed to certain relics are the effects of this imagination and of this confidence. The wicked and philosophers know that if 3'ou place the bones of any skeleton in the place of the bones of a samt, the patients will still recover their health as long as they believe themselves to be near the real relics of a saint. Cures by Mineral Magnetism. The loadstone which was used by the Egj^ptians in the fabrication of their prophylactic amulets has in all times cured gouty pains, headache, toothache and hysterical complaints. During the last century Father Hell, the well-known Viennese astronomer, has jirepared artificial magnets which cured spasms, convulsions and paralytic affections. The magnetic contrivances, constantly and habitually applied by the Abbe Lenoble have also been very efficacious in severe nervous' affections. *From Prof. Bernheim. 29 The treatment by magnets and by metals according to Dr. Burcq have been the real precursors of the hypnotic treatment. Mineral magnetism preceded Mesmer's animal magnetism, and the modern magneto-thera- peutics preceded the curative suggestion. In 1777 the Paris Eoyal Medical Society examined the effect of Lenoble's more perfect artificial magnets which had such a power as had never been before obtained. Drs. Audry and Thuret have been commissioned by the Society to repeat Lenoble's experiments, and after having made forty-eight observations they confirmed the state- ment that these magnets relieved or cured toothache, nervous headache, rheumatic pains, facial neuralgia, tic- douloureax, stomach pains, convulsive hiccuj), palpita- tions, different kinds of trembling, convulsions, hystero- epilepsy, etc., etc. Amongst the observed cases a large number were relieved shortly after the application of the magnet ; strong neuralgia and facial pains have been relieved each time by contact with the magnet. Spasmodic and convulsive symptoms disappeared rapidly after the magnet has been applied, a nervous cough was calmed instantly and did not occur again. One case of convulsive movements of the arm and of its contractions which prevented the use of the hand was relieved considerably in the course of the day. Eheumatic pains were soothed, and if they returned after the dis- placement of the magnetic contrivances they disaf)peared again as soon as the magnet was replaced. In toothache the relief was sometimes immecliate, sometimes the magnet did not produce any relief while similar pains in other patients ceased by the contact with the magnet ; it sufficed to prolong the application of the magnet or to apply a stronger one when relief was brought on. Sometimes the magnet increased the pains or appeared to produce sensations which had not been felt before. In one case the magnetic band caused fever and head- aches which ceased on the removal of the apparatus. An epileptic patient felt slight and continual fainting which ceased when the magnet was removed, and the epileptic fits appeared to be more intense. Another patient suffering from nervous paralysis, suffered from similar faintings from the use of the magnet. 80 Various sensations have been observed when the con- trivances were changed or their appHcation interrupted, as for instance, sensation of heat in the diseased parts, giddiness, nausea, palpitation, headaches, itching, etc. The Commissioners of the Eoyal Medical Society declared that these mineral magnets had a real effective power in soothing or curing nervous affections of various kinds, but they did not relieve organic diseases. Many other observers have confirmed the truth of Audry and Thuret's observations. Trousseau mentioned in 1883 that he has sometimes made use of the magnet, and that he can affirm that it has a curative effect on the parts with which it is in contact, and that it has an inffuence which it is impossible to ascribe merely to the imagination of the patient ; he has seen neuralgic pains relieved and fits of nervous dyspepsia suddenl}- arrested. Larnee praises the effect of magnets in angina of the chest, and Trousseau confirms the soothing effects in various maladies ; it is incontestable that temporary cures have been made in rheumatism and the case is mentioned of a French marshal whose rheumatic pains could not be relieved in any way except by the application of magnets. Notwithstanding Trousseau's assertions these magnetic cures have been almost entirely forgotten, and a similar disbelief in animal magnetism and Mesmer's manipula- tion has also prevailed for a long time. Cures by Metals. (Burcqism.) "When Dr. Burcq published his doctrine of metallo- therapie he was also disbelieved, and he had to wait till the physicians in the Salpetriere l)egan again to make experiments with his treatment by metals, and then only the belief in the curative effect both of metals and magnets was revived. I myself had occasion during Dr. Burcq's visit to London, about thirty years ago, to assist at his experi- ments in the mesmeric hospital, which was established at that time, especially by Drs. Elliotson and Ashbourne. Dr. Elliotson has published at that time and at my suggestion a long report on metallo-therapeutics in the Zoist. I have also made use of the various metals in form of bracelets, armlets and bands, which have been applied to the thighs, calves and arms. ai For the purpose of finding out which metal would reproduce sensation in an anaesthetic part, small metallic stripes of about an inch in width and three or four inches in length, have been placed on each finger of a hand which had lost sensation, on each finger a different metal was applied, and after about ten minutes the little metallic bands were removed and it was found that under the influence of one of these metals, the sensation had returned ; if of the five different metals none was ffisthesiogen, other five metals were chosen in order to find out which would be the suitable one in the given case. At that time Burcq had no indication for choosing the suitable metal except by applying the various metals experimentally. Long needles of gold, silver and steel have been used for the purposes of testing the sensibility of the patient. As there was usuall.y a diminution of muscular power connected with anassthesia, Burcq had a small dynamometer for testing the degree of pressure produced by the grasp of the hand. The small metallic bands, the needles, and the dynamometer were neatly placed together in a little box 3 inches square, which could be carried in the pocket. As soon as it was ascertained which metal produced the sensation, it was chosen for the larger metallic application on the forearm, upper arm, and the lower extremities ; patients suffering from neuropathic com- plaints, loss of sensation and of power in various parts, were soon relieved if the suitable metal was found, but frequently the pains returned after the removal of the metal. As I have not pursued my studies and obser- vations on this subject, I am unable to speak of the present state of metallo-therapeutics, which during the last few years has been used successfully in cases of anaesthesia, but since Dr. Liebault has made known his suggestive method of treating nervous complaints, sugges- tions have been used instead of mineral magnetism and metals. The invocations of Egyptian priests for the purpose of obtaining the cure of limbs submitted to the influence of the various deities using the magic formula, teaching the use of simple remedies ; the sympathic powder of Paracelsus, Perkins' metallic tractors, and the pseudo metallic, that is, wooden tractors of l)rs. Hoggarth and Palconer, and at present the so-called electro homoeo- 32 pathic medicines of Count Mattel, the king's touch, the celebrated cures made at the tomb of the diacre Pares and those of Knock in Ireland, as well as those at Lourdes in France, arc proofs of cures performed by imagination or suggestion. Many healers and curers, believed themselves possessed of supernatural powers, have no doubt cured many people without knowing it by mere suggestion ; thus the Irish- man, Grcatrakes, the German priest, Gesner, the Prince Abbot of Hohenlohe, Father Matthew, a peasant in the neighbourhood of Saumur, the Zouave Jacob, are quoted b}' Bernlieim amongst those who have cured by sugges- tion. Dr. Hack-Tuke mentions Dr. John Tanner as an enthusiastic advocate of the treatment of hysterical aphonia by electro- magnetism applied only to the tongue; among fifty cases not one was unsuccessful, and he men- tions that in one case the return of the voice showed itself l)y a great cry, in another case the voice returned immediatel}', in a third, although the voice returned it disappeared again, but returned again after a second application of the electro-magnetism, in a fourth case there was also an instantaneous return of the voice ; but Dr. Tanner insists on the great importance persuading the patient that electro-magnetism will cure him, and it is pi'obable that if he is not persuaded that there will be a failure. The treatment by suggestion is not new, it is its methodical application and its definitive adoption in the ordinary practice which is new. Dr. S. Obernheim mentions a medical man who attended a patient suffering from paralysis of the tongue w^ho had been unsuccessfully treated by various methods. The medical man had invented an instrument from which he expected excellent results, and he hi tended to try it, but wishing to know the patient's temperature he placed a thermometer into the mouth, the patient fancied that this is the wonderful instrument which would cure him, and in the course of a few minutes, he called out with great joy that he can freely move his tongue. A similar case is related by Bernhcim, under whose care a young girl was placed in the hospital who, during the last four weeks, suffered from a complete nervous aphonia, after the professor had made his diagnosis, he told the students that this disease is sometimes mstau- 33 taneously cured by electricity, but which can act through his suggestion. The instrument was sent for, but before making use of it the professor wished to try simply a suggestion by affirmation ; he placed his hand on the larynx, and while moving this organ, he said " Now you can speak very loudly." In an instant he ordered her to say A B, afterwards Mary, and thus she continued to speak distinctly. The aphonia had disappeared. Another effect of imagination during sleep on the peristaltic action of the intestines is mentioned in " La Bibliotheque chosie de Medicine." The daughter of the Consul of Hanover, 18 years old, was ordered to take an aperient, viz., rhubarb, towards which she had the greatest antipath}'. She dreams that she has taken the abhorred medicine. Influenced by this imaginary rhubarb she awoke, and the bowels acted several times. A similar result is mentioned by Demangeon, a monk ordered to take medicine the next morning, dreamt that he had done so, and when he awoke the dream acted as if he had really taken the medicine. Amongst the moral causes appealing to the imagination and influencing the cerebral mechanism of possible cure, none is so efficacious as religious belief, to which are due many well authenticated cases. The Princess of Schwartzenberg was affected for eight years by paraplegia, the most celebrated German and French doctors have been consulted; in 1821, Prince Hohenlohe, who was a priest, brought a peasant to the princess, who had convinced the young priest of the power of prayer in the treatment of diseases. The Princess was stripped of all mechanical apparatus which Dr. Heine had applied a few months before, to prevent the contraction of the limbs. The priest asked the patient to join her belief to his and to that of the peasant and to pray. After a short time the Prmcess was addressed in this way. " Do yon believe that you are relieved?" "Oh yes, I believe it most sincerely!" Then the priest said, " Piise now and walk." At these words the Princess rose, made a few turns in the room, tried to go up and down stairs. Next day she went to church and from that moment she retained the use of her limbs (related by Charpignon), 84 APPENDIX II. Hypnoscope. This is an instrument invented by Dr. Ochorovicz who asserts that all persons who are influenced by the magnet can be hypnotised in proportion to their sensitiveness to the magnet. The hypnoscope is a tubular magnet of three or four centimetres in diameter and five to six centimetres in length, in which an opening is left of two centimetres. The weight of the whole is about 1G9 grammes. Steel of Allevard is used for its construction, and the instrument has the power of suj^porting 25 times its own weight. The folio wmg is the way it is used ; after the armature (closing piece) is removed the index (first finger) is placed inside the tube so that it touches both poles the finger bemg with the palmar surface upwards, and the instru- ment hanging on it ; after two mmutes the finger is taken out, and the modifications produced in it are examined. Ochorovicz, who has been making experiments since 1880, has never observed any new sensation, and he does not believe that a magnetic sense exists, but this does not prevent 25 per cent, of men being influenced by an average powerful magnet, who feel certain very distinct sensations. Twenty in 100 persons have sensations of formication and disagreeable pricking, sometimes like sparks and needles j^ricking the skin. Seventeen in 100 have a sensation of a cold breath or sensation of warmth and dryness. These two impressions can exist together, the one in the right arm the other in the left arm. It is known that a magnet placed under the sole of the foot of some paralysed persons can warm the patients, while a good fire had not such an efiect. The sensation of the cold breath is very much like that felt when near an electro static machine. Eight in 100 have i^ainful sensations, pains in the joints. They say that they had a feeling of broken bones. Five m 100 have sensations of swelling of the skin, swelling which may be real, because it is sometimes difii- cult to withdraw the finger of the subject from between the poles of the hypnoscope. 85 Two in 100 have sensations of heaviness in the finger or the whole arm. A person otherwise in good health was asleep, the eyes shut, the pupils turned upwards, the head com- pletely enveloped in a thick veil, at each approach of the magnet, a distance of 15 centimetres, the hand was drawn quickly towards himself, and followed all his movements until the moment when it became rigid and insensible. Then it was necessary to restore sensibility or rather hyperaesthesia to recommence the experiment, I must add that the same phenomenon was reproduced although perhaps more feebly, by a metal, a glass, or some other body being placed in contact. The person questioned in his sleep said that he had felt attracted in a given direc- tion without knowing why. Symptoms Produced by the Hypnoscope. The objective modifications are more important for the diagnosis. They belong to one of the four following categories. a. Involuntary movement (very rare). h. Insensibility (analgesia or anaesthesia complete). c. Paralysis (impossibility to move the finger). d. Contraction (rigidity of the muscles) . The symptoms disappeared after a few minutes under the influence of a slight massage, and without this they can last several minutes and even several hours. The persons to whom the hypnoscope causes insensi- bility, paralysis or contraction, can be hypnotised at the first sitting, in others the experiment must be repeated. There is no doubt that the magnet has a certain influence on the nervous system of persons who are predisposed. But whether this magnetic action is really incontes- tible, this can be only partially admitted because 1. The importance of the influence is not in direct proportion to the power of the magnet, but rather m proportion to the degree of the hypnotic sensibility of the person on whom the experiment is made. 2. The north i^ole has not a difterent influence from the south pole, which would not be the case if it were a purely magnetic effect. Is it perhaps a metaloscopic influence as Mr. Pellat has suspected ? To this question, which was asked by Dr. Brown- Sequard, on the day SG when Dr. Ochorovicz made his first communication, the answer is 1. That the number of persons who were sensiljle to metals is smaller than of those who are influenced by the magnet, and still smaller than of persons who are influenced specially by steel. '2. There are persons influenced by metals, for instance by copper, but not influenced by the magnet, and there- fore not influenced by hypnotism. But is this mysterious action perhaps only imaginary or suggestive as it is at present called ? This is not the case. (1) Because it sometimes though rarely influenced persons without their knowledge, also persons who are asleep and also animals. It is easy to distinguish the sensations produced merely by an emotion or by an "expectant attention" from those which are produced by the hypnoscope itself ; the imaginary sensations change their character or disappear at a new trial, while the real sensations repeat themselves, preserve their character, and get more and more distinct. The imaginary sensibility disappears, while the real sensibility increases by force of habit. Gessmann, in Vienna, has invented a Hypnoscope, in which four magnets are arranged in such a manner as to leave in the centre a space through which the index is introduced, and thus is placed in contact with all the poles of the four magnets. 3? TABLE OF CONTENTS. PAGE Few Historical Notes ... ... ... ••■ ••• *■ Methods of inducing- Hypnotism ... ... ... ••• 4 Stages of Hyiniotism ... ... ... ... ••• ^ Lethargy ... ... ... ••• ... ••• ••• ^ Catalepsy ... ... ... ... ••• ••• ••• ^ Suggestions during Catalepsy ... ... ••• ••• 7 Somnambulism with Closed Eyes ... ... ... ■•• 'J Somnambulism with Eyes Open ... ... ... ••• ^ Fascination ... ... ... ••• ••• ■•• 1^ Artificial Sleep as a Curative Measure ... ... ... 15 Change of Personality ... ... ••• ••• ••• 1^ Hallucination Cured ... ... ••. ••• ••• 17 Eepugnance to Tobacco and Alcohol induced by suggestion ... 17 Epistaxis and Stigmata caused by suggestion ... ... ... 18 Case of Hysterical Paralysis... ... ... ••. ••• 1^ Fear and Fright ... ... ... ••• ••• ••• 20 Hallucination and Furious Frenzy Cured by Artificial Sleep ... 20 Suggestion changes Laziness into Industry ... ... ... 20 Medico-Legal Aspect of Hypnotism ... ... ... ... 21 Mental Disease treated by Voisin ... ... ... ... 21 Hysterical Epilepsy treated by Hypnotism ... ... ... 23 Therapeutic Application of Hypnotism ... ... ... 25 Surgical Application of Hypnotism ... ... ... ... 20 Medical Precepts by Professor Bernheim ... ... ... 20 Cures by Miracles and Imagination ... ... ... ... 28 Burcqism ... ... ... ... ... ... ••. 30 Cure of the Princess of Schwartzenberg ... ... ... 33 The Hypnoscope and its use ... ... ... ... ... 34 38 ANALYTICAL INDEX. Page Page Amenorrhoea 18 Convulsive Attacks . ... 23 Antemia i> Cybele ... 23 Anesthesia ... 0, 11, ID, ;il, 3.") Ashbourne 1, 30 Demangeon ... ... 33 Audry 29 Douches ... 19 Attacks, Nervous 18 Duchenne ... 8 Azam 9, 25 Dumontpallier 18, 21 Dupotet 1, 15 Durand de Gros ... 17 Beaunis 18 Dynamometer... 9, 31 Berger ... 9 Berillon 17 Electro-Biologists ... 13 Berres 1 EUiotson 1, 30 Bernheim ... 1. 10, 27, 32 Ennemoser ... 1 Boerhave 1!) Epistaxis ... 18 Bottey ... .3, It, 11, 12, 17, 18 Esmarch 5 Bourrot 18 Ether 2() Bourru 18 Esdaile ... 2 Braid :'), 10, 23 Bremaud ... 3, 5, 11 U Falconer ... 31 Brissot... ') Faradaic Electricity . ... 19 Bromide of Potassium 11), 2.") Faria 1, 3 Brown-Sequard 35 Fascination ... 5 Burcq 2, 21), 30 Fear and Fright ... 20 Focachon ... 18 Catalepsy 5, fi, 15 Folic Musculairc ... ic. Charcot 5 Fulminante ... ... 19 Charpignon 33 Furious Delirium ... 23 Chloroform 10, 20 Contraction 35 Gesuer 18, 32 39 Page P age Gomet 22 Obernheim 1, 32 Greatrakes ... 32 Ochorovicz .. 3, 34, 36 Opium ... 10, 26 Hack-Tuke ... 32 Hallucination ... 23 Paracelsus 28, 31 Haschish ... 10 Paralysis 35 Heidenheim 3, 13 Pellat 35 Heine ... 33 Perkins 31 Hell ... 28 Philipps 17 Hoggarth ... 31 Pomponazzi ... 28 H3rpera3sthesia 9, 11 Pope 10 Hysterio-Epilepsy ... 23 Princess of Schwartzenberg 33 Hypnoscope ... 3i Hyrtl ... 1 Reichenbach . . . 1 Kinesi-Therapeutic . 2 Richer Roth .. 3, 5, 10 16 Knock ... 32 Russell Reynolds 16 Ladame Lafontaine Larnee Lazy Child ... 9 ... 15 ... 30 ... 20 Somnambulism Surgical Application notism 5, 9, 11, of HjT- 18 26 Lenoble Lethargy Liebault Liegois Longpretz Lourdes 28, 29 . 3, 15, 18 5 ... 15 ... 16 Tanner Therapeutic Application of Hypnotism Trousseau Thuret 32 25 30 29 Luys 17, 19 Verneul 26 Mabille 18 Voisin ..17, 18, 19 Magnin Maniacal Agitation . 21 23 Wine 26 Mattel 32 Matthew ... 32 Zoist 30 Mesmer 3, 29 Zouave, Jacob... 32 WORKS BY De. roth. Prize Medals have been awarded at the International Exhibitions of London 1862, and Paris 1867, for Dr. Roth's Works on Physical Education, Models, &c., also a Gold Medal at the Health Exhibition 1884. ON THE MOVEMENT CURE. 1. A Short Sketch of Kational Medical Gymnastics, or, the MOVEMENT CUEE. With Thirty-eiglit Engravings. Is. 2. The PEEVENTION and CUEE of Many Chronic DISEASES BY MOVEMENTS. With Ninety Engi-avings. 10s. 3. The HANDBOOK of the MOVEMENT CUEE. With One Hundred and Fifty-five Original Engravings. 10s. 8b. Brand's Treatment of Female Diseases by the MOVEMENT CUEE. Translated by Dr. Eoth. 5s. ON PARALYSIS. 4. Contribution to the Hygienic Treatment of PAEALYSIS, and of PAEALYTIC DEFOEMITIES. With Thirty-eight Engravings. Illustrated by Numerous Cases. 3s. 6d. 5. ON PAEALYSIS IN INFANCY, CHILDHOOD, and YOUTH, and on the Pre^tention and Treatment of Paralytic Deformities. With Forty-five Engravings. 3s. 6d. 6. Contributions to the Treatment of Facial Paralysis. 6d. 6b. 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