Causation and Treatment of Psychopathic Diseases

THE CAUSATION AND TREATMENT OF PSYCHOPATHIC DISEASES

Boris Sidis, Ph.D., M.D.
Boston: R. Badger, 1916

MR. M. G. Irish. Age thirty-eight. Married. Occupation, liquor dealer. Father, living, well. Mother died of pneumonia when at the age of forty. Brother and sister died of some obscure form of “heart trouble.” Physical condition is good. Patient has no appetite, worries, has no confidence in himself, is full of indecision and fear of anything “new;” he is extremely methodical, things must be arranged in a certain order, otherwise he feels uneasy and quite unhappy. Has no headaches, suffers from insomnia. Does not drink, but smokes excessively. Sexual life normal. Has been sensitive and nervous from his very childhood. He broods much over his incapacity of spelling. Has been lately working very hard on a new business entrusted to his care. He doubts his business capacities, and fears to ruin the business. He became greatly depressed, had to give up his work and go to the country, but with no beneficial results.

The patient was brought to me in a state of deep despondency, close on the brink of suicide. He could not be hypnotized. I put him into a slight hypnoidal state, and kept him in a state of relaxation for fifteen minutes to half an hour. When he came out of it he felt “a little better, but not much.” After two weeks’ treatment the patient felt so far improved that I advised him to return to his work while his treatment was being continued. Gradually his despondency gave way; his fears, worries, and doubts disappeared, while confidence in himself became strengthened. Patient declared he felt well,—“never felt so well” before. The treatment covered a period of three months. It is now more than seven years since the completion of the cure, the patient continues to stay well and carries on his business with far more energy than before.

II. Miss P. R. Age twenty-three. American. Mother is nervous, “hysterical.” Sister high strung. Patient was “sensitive” when young, but was well otherwise. Her present trouble began some three years ago. She suffers from constipation, nausea vomiting, dizziness, dysmenorrhea. Eyes ache occasionally and are relieved by glasses. Suffers from numbness in extremities and great fatigue. Attention is good, but her mental state is one of indecision and fear.

At first the hypnoidal state was brief in duration, the patient being restless, but as I persisted, the hypnoidal state became prolonged, with gradually increasing beneficial effects.

III. B. P. Seventeen years of age. Family history is good. Up to the age of twelve was well. After that he changed in character, became irascible, deceptive in his dealings with people, careless in his social relations, contradicted and even abused occasionally his relatives and treated his mother with disrespect. All power of concentration of attention seemed to have gone,—at least he claimed so. “My head begins to whirl and my eyes darken when I get hold of a book and try to think long.” The boy probably exaggerated his condition, but he was tested in various ways by different physicians and educators, and his attention was found to be wandering. The boy was otherwise quite intelligent. He became associated with idle boys, learned to smoke and acquired other bad habits. About the age of fourteen, he met with an accident from a cannon cracker, which knocked him down unconscious and nearly destroyed his eyesight.

The treatment of the case is quite complicated and would take too much space to elucidate it here. I can only say that the hypnoidal state has been utilized in this case with great advantage. Besides the therapeutic power of the hypnoidal state, the subconscious reserve nervous energy comes into play, while many of the other psychotherapeutic methods become enhanced in their efficiency when utilized in the subwaking hypnoidal condition.

IV. Mrs. F. T. Age twenty-seven. American. Family history good. Patient is emaciated, pale and anemic; pulse is irregular; there is accentuation of second aortic; otherwise heart is in good condition. Menstruation is normal, occasionally painful and scanty. She was well when a child, but was delicate and frail. She studied hard in one of the local academies and got a fair education. In the provincial town where she lived things were quiet, and patient’s life was rather uneventful up to the time of her marriage, about the age of twenty-two. She was then suddenly transferred from a quiet environment right into the turmoil and whirl of life. The young couple had a hard struggle for the bare necessities of life; at the same time the family responsibilities and social duties were heavy, exacting, and distasteful. This told on the patient and she began to brood, became gloomy, depressed, lost her appetite, began to suffer from restless sleep accompanied with bad dreams and nightmares; complained of anorexia, indigestion, nausea, retching, headaches, and dysmenorrhea. Darkness began to gather around her and she began to feel, as if she were hemmed in by dark shadows which haunted her day and night. Her dreams were full of the same “indefinable shadows which have gotten a grip on her life and sucked out the essence of her soul.” She used to wake with those shadows, crowding on her from all sides. The patient, in short, was obsessed by a fear of shadows. She was tired at the least exertion, could not concentrate her mind, had no self-control, no will-power to decide anything, life was a burden.

Patient was treated by hypnoidization. The physical and mental conditions began to improve rapidly. All the gloom and shadows fled. The fatigue, the headaches, the digestive and menstrual disturbances were gone, and at the end of four months she recovered her health and cheerfulness, and gained twenty-three pounds in weight. It is now more than ten years since the treatment is completed; patient continues in excellent condition.

V. Miss E. F. Age twenty-five. American of Irish descent. Family history is good. Physical condition is good; menstruation normal. She was well up to the age of seventeen, when during the winter she had a severe attack of the grippe. She suffered from insomnia. It happened that a lady, a neighbor of theirs, became insane. The idea then came to the patient’s mind that she too might become insane. Filthy words enter her mind, and she feels as if she “is getting crazy.” Another source of worry is her nose which seems to her not to be shapely enough. She feels greatly depressed and life is a burden to her. She has frightful nightmares, dreams of dead people, especially of the insane woman. At day time she keeps on thinking of the insane woman.

A prolonged stay in the: hypnoidal state made the patient feel happy immediately after the first treatment. The effect wore off after a day. A few more treatments made patient feel well and comfortable.

VI. J. R. Male. American. Age twenty-eight. Family history as far as it could be ascertained is good. Occupation, artist. He has strong homosexual tendencies. The sexual instinct for women is completely absent. A big man with immense hips is his ideal of sexual desire. His mind is full of images of males in various lascivious postures. The images disturb him much, so that he cannot carry on his work. When he comes in contact with men of the same inclinations he becomes excited. In his dreams he sees men who excite him and respond to his sexual passions. His mental and physical conditions are otherwise quite good, and he is doing work which is regarded to be of high grade.

In the hypnoidal state it came to light that at the age of fifteen he carried on a love affair with a room mate of his with whom he slept in the same bed. He always liked to play with boys, and, if possible, sleep with them in the same room. This he succeeded in accomplishing a number of times. Far, far away back in his childhood perhaps at the age of six, he was influenced by a big coachman who induced him to carry out homosexual practices. It was the aspect of that coachman that became with the patient the main object of his sexual passions. This incident was always hovering in his mind, although he did not remember it so distinctly as in the hypnoidal state.

A series of treatments by means of the hypnoidal state relieved the patient of his homosexual passions. The patient was not long enough under treatment to cultivate his degenerated or rather rudimentary normal sexual instinct. This gave rise to some unpleasant complications into which I cannot enter here. The patient was, however, entirely freed from his homosexuality.

VII. H. R. Male. Age twenty-six. Occupation, engineer. Father suffers from heart trouble; mother died of some tubercular affection. Patient was operated for hydrocele and tubercular testicle some five years ago. He feels physically and mentally well, but is possessed by homosexuality. He can trace the homosexuality to his fourteenth year. It is not, however, the homosexual desires that trouble him, because they are weak; it is rather the absence of the heterosexuality that worries him, he wants to get married and have a good family life. He loves children and wishes to have some of his own. Any attempt on the part of the patient to cultivate heterosexuality meets with complete failure. He has no desire for women; in fact, he even experiences a dislike for them. He masturbates occasionally. The images which fill his imagination during the act of masturbation are entirely of a homosexual character.

The treatment was of rather short duration, about a few weeks in all, and the hypnoidal state could not be prolonged sufficiently to enable me to penetrate into the patient’s subconscious life and trace the origin and development of the homosexuality. The hypnoidal state, however, enabled me to free him fro his homosexuality and to arouse in him an interest for the other sex.

VIII. Mrs. T. D. Age forty-five. American. Married. Father well. Mother died of some unknown disease at the age of twenty-five. One sister nervous, the other died of tuberculosis. Patient was a precocious child and extremely nervous. About the age of fourteen had typhoid fever; began to menstruate about the age of thirteen. At the age of sixteen entered a millinery store and at twenty became a modiste. She was then strong, healthy, vivacious, and enjoyed life. She had many admirers and finally got married at the age of twenty-five. After a few years of married life she became nervous, restless, suffered from headache, backache, constipation and loss of appetite. She lost flesh, from one hundred and forty-five she went down to one hundred and twenty pounds. Menopause set in at the age of forty-two. She has been for some time under the care of a physician and has improved a little. She did not come to me, however, for her physical troubles, as she found that they really were of little consequence. “The whole trouble is mental. If you could only help me, I would make a clean breast of it. It has come now to a point that I need help.”

She has no children, no responsibilities, selfish, full of fears about self; she is disappointed in her husband. Sexual relations have been normal. Recently she met a young married man with whom she fell in love as a distraction and stimulation in a life of dull, monotonous selfishness and fear. She is conscious that the whole thing is foolish, sentimental; moreover, the man is unworthy. She needs help to get rid of that obsession. “Life is not worth living.” The patient is deeply depressed.

Patient was quieted by a little talk and then put into the relaxation characteristic of the hypnoidal state. At first she was restless and fidgety, but she gradually became quiet and relaxed. When she came out of the hypnoidal state she was quiet, composed and felt more self-control. After a few treatments, the patient felt considerably better, the fixed idea or insistent emotion lost its grip and she regained her self-possession.

IX. Mrs. B. F. Age thirty-eight. American. Occupation, physician. Patient comes of neuropathic stock. Both parents were highly neurotic. One of the brothers committed suicide. As a child, patient was sensitive and nervous, suffered from various fears. At the age of eight she had a bad fall, with unconsciousness. As a young girl she worked hard, but felt well. The first period after marriage was happy, but then had a miscarriage which brought her down in health. Her nervous condition became aggravated by the suicide of her brother. Patient occasionally experiences illusions and hallucinations of memory and of recognition, a condition which she thinks she has inherited from her mother who has gone through similar experiences.

When I first saw the patient she was in great emotional excitement. She cannot eat, cannot sleep and is in agony. Wants to commit suicide. The mother-in-law tortures her, alienates her husband’s love, intends to separate him from her. The evil eye of the mother-in-law “hypnotizes” her; patient “becomes transfixed and paralyzed by that gaze.” Her will power is gone, her personality is fast disappearing under the baneful eye of the mother-in-law. Nothing but death is left to her.

The patient was quieted and then put into hypnoidal state with its characteristic relaxation. After the first treatment, patient felt somewhat relieved of that in tense strain in which she was. After a few treatments by hypnoidization, she felt much better, “felt perfectly normal,” “was herself again,” was ready to meet the exigencies of life no matter how unpleasant they might prove to be. At the close of the treatment, patient regards her insistent desire to talk of herself as foolish and ridiculous; she realizes that she has magnified trifles, that she has misconstrued the relations of her husband to herself, that he really loves and is devoted to her as much as ever. Her emotional tone now is one of peace and repose; she has a good appetite, sleeps well, has no dreams, and has gained six pounds.

X. Mrs. S. D. Age thirty-two. American. Married. Family history shows neurosis. Masturbated early and for a number of years. She is very religious, is depressed on account of her sins. Suffers from insomnia, lassitude, great fatigue, crying spells, gastralgia, loss of appetite, vomiting, heartburn. She is suggestible, capricious, irritable, sensitive, suspicious, suffers from morbid introspection, indecision and doubts. Likes routine; anything new frightens her. Always dissatisfied with life, becomes easily depressed and complains of all kinds of pain.

Treated by the hypnoidal state the patient improved considerably. No cure, however, could be effected as the patient’s psychopathic condition was unfortunately kept up by the complicated, unfavorable family life.

XI. Miss D. M. Age forty-three. Family history good. Patient was well until a year ago, when menstruation became irregular and menopause set in. Patient suffers from backache, occasionally from intense pain around the sacral and coccygeal region and the back of pelvis. The pain shoots up the back of right and left sides; patient faints from dizziness. Some physician told her it was due to hemorrhage into the kidneys. She is nervous, restless, has lost her appetite, suffers from indigestion and from insomnia. A few months ago she happened to fall down from a car and since then she is afraid to board a car or to walk upstairs.

The patient was but a short time under treatment so that there was no time to follow the case closely, but she improved rapidly under the treatment by hypnoidization.

XII. Mrs. C. K. Age forty-five. Family history good. Children are all well. A year ago, at the oncome of climacteric period, patient became nervous, sleepless, lost her appetite, had flushes and flashes of light, suffered from headaches and worried a good deal. She is very religious, and is mortified by her unholy thoughts, she curses and blasphemes the Creator in her mind, and all kinds of filthy ideas trouble her, especially when she prays. She is in agony of fear; feels she is a lost soul. “God will not pardon such obscene, outrageous blasphemies on His holy name.” Patient is despondent, feels greatly depressed and is unable to do anything, cannot do her housework and has lost interest in her family. She is indifferent to her friends and refuses all social intercourse. She keeps on brooding and is full of despair.

It took me some time to gain her confidence. It was at first difficult to keep her quiet and have her relaxed. After a few treatments by hypnoidization, improvement set in rapidly and she is now in excellent condition.

XIII. Miss A. W. Age thirty-five. Irish; housekeeper. Patient is well nourished. Physical condition is good; menstruation is normal and painless. Occasionally she suffers from headache, but on the whole headaches do not trouble her. She suffers much from auditory hallucinations and thinks she is possessed by demons. From her ninth years she suffers from hearing “spirit-voices” which sometimes tell her unpleasant things. Along with the hallucinations she also has attacks of automatic speech. Occasionally the automatic speech becomes uncontrollable. It appears to the patient, as if some other being forces her to tell what she thinks. It is on that account that she shuns society. Her family in Ireland, being aware of her trouble, thought it was demoniacal possession. Occasionally she has visual hallucinations of angels and saints.

It would take too much space to give a full account of this interesting case; we can only refer to it in its main outlines, as our object here is not so much the psychopathological as the psychotherapeutic aspect of the cases.

The patient could not be hypnotized, but she went easily into the hypnoidal state. At first the improvement was rather slight. In fact, now and then the hallucinations and the automatic speech became even more frequent and more annoying than before. After a couple of months of treatment, the outlook began to be somewhat brighter, the auditory and visual hallucinations began to give way, the automatic speech considerably diminished and became more controllable. After a few months’ treatment byhypnoidization, all the symptoms completely disappeared.

XIV. Mrs. M. R. Age thirty-eight. American. Married. Family history good, children well. Patient is pale, looks worried, nervous, has little appetite and suffers from insomnia. Suffers from headaches, pneumatosis, pyrosis, eructations, has attacks of vomiting. Menstruation is scanty, irregular, and painful. When about the age of nine, she met with an accident,—she fell out of a carriage and was unconscious; about the age of twelve, she had an accident with a runaway horse. Since that time she has the greatest terror to ride in a carriage, but enjoys much automobiling. She also has an uncontrollable fear of dogs. When a child, she was attacked by a dog and then heard and read a good deal about hydrophobia. In fact, after she was bitten by the dog, the sensations she experienced in the throat seemed to her to be hydrophobia. The fear of dogs occasionally sets in as an attack and comes to the surface of her consciousness during states of extreme fatigue. She especially suffered from it during pregnancy. Many of the details of the accidents were revealed in the hypnoidal state, although she had a general knowledge of them during her ordinary condition and was painfully conscious of them during many of the attacks. A number of details became subconscious and were disclosed during the hypnoidal state.

A series of treatments by hypnoidization greatly relieved the distressing symptoms, but the treatment was not continued long enough to obtain permanent results.

XV. Mr. C. B. Age thirty-nine. Single. Russian. Builder. Father died of apoplexy at the age of seventy-two. Mother is seventy-seven years old, but has always been nervous. Brothers and sisters are all well. Patient is rather undersized, about five feet, two and one-half inches, and weighs about ninety-seven pounds. He looks emaciated, anemic, cachectic. Has no appetite; suffers from indigestion, nausea, gastralgia. Anything unpleasant makes him feel nauseated. Detailed inquiry of early sexual life discloses no abnormalities. All those symptoms set on about twelve years ago when patient had an attack of gonorrhea of which he was greatly frightened and kept on worrying about its consequences. He suffered then a good deal from nausea, which afterwards persisted. The feeling of nausea became exacerbated with his father’s death. Patient is extremely introspective and suggestible in regard to sickness. If any of his family happen to have some trouble, he is sure to be sick with the same symptoms. Thus, about two months ago, the patient’s mother fell and broke her left arm. Patient began to feel pain in the left arm and had to be treated for it. He tells me that every new moon he experience irritation in rectum and around the anus. This he kept up from his boyhood and is due to the fact that about the time of the new moon his mother, in her old-fashioned superstitious way, used to administer to him a purgative.

Put in the hypnoidal state, patient felt much relieved. The beneficial results of the hypnoidal treatment became manifest at the end of a few weeks.

XVI. Mr. J. R. Age twenty-eight. American. College education. Family neurotic. Patient is greatly emaciated. Appetite is poor. Bowels are costive. Sleep is disturbed by dreams and is usually restless. He is emotional, impulsive and has periods of feeling of well-being alternating with periods of depression. In the periods of depression he is apt to become taciturn, gloomy, retiring and brooding over his health and mental troubles. For a couple of years in succession he somewhat lost in flesh, caught colds and coughed. The fear of consumption seized on him and he went to Arizona for his health. He was possessed by the fear of tuberculosis, although the best specialists assured him that his trouble was largely of nervous origin. In Arizona, the patient lived a regular, normal life in the open air, regained his physical health, and got rid of his fear of tuberculosis and colds. This, however, did not last long. A couple of years later, when he happened to catch a cold, the fear of tuberculosis reappeared. Any irritation in the trachea, any little cough due to some dust, any little congestion in the pharynx, meant a cold with its underlying fear of “consumption.” This fear was further emphasized by a near relative who happened to suffer from colds. The patient was also obsessed by other insistent ideas. When he saw numbers, such as the date of the year, for instance, he added them, and liked that certain numbers, such as twenty-five or thirty-five, should come out. If the results did not come out, he kept inserting figures or subtracting until the desirable result was obtained. When he saw words, he looked at the letters and wanted that a certain number of “i’s” and “r’s” should be there. If the number of letters did not suit him, he inserted “i’s” and “r’s” to suit himself. The insistent ideas of this kind, however, were not accompanied by any emotional disturbances.

The treatment of the case covered a period of about two years. The condition was obstinate, difficult to control. The symptoms kept on recurring with great insistency. Persistent treatment, however, during the hypnoidal state, finally reduced the fears and the insistent ideas. The patient lost his fear of consumption, did not catch so many colds; he cared little, if he did catch any. His brooding disposition left him, and he devoted himself to his work.

XVII. Mrs. J. F. Age twenty-eight. American. Married. Family history good. For many years has been suffering from headache, backache, general fatigue, weakness in the eyes, which occasionally becomes very painful. The headaches were sometimes intense, so that the patient was in agonies, the pains extended all over the head, shooting down the back. There were present sore spots in the back of the head, the pressure on which made the patient feel more relieved. During menstruation the headaches became more severe than usual. She also complained of various pains in the right iliac region. Patient’s appetite was irregular, nothing tasted well to her, nutrition was poor, constipation present. She suffered occasionally from bulimia. The muscular condition was rather flabby. Heart in good condition, though somewhat irregular, due to the patient's nervousness. No albumen in the urine. A gynecologist diagnosed salpingitis and advised an operation on account of adhesions formed. The patient, however, refused to be operated. Patient gets a headache as soon as she reads a few pages in a book. This suggested the oculist, who measured her with a pair of glasses, but the eyes were as weak as before, the headaches were as easily induced and as persistent and severe as ever.

When under my care, after trying the gynecologist with his tampons and pessaries, and then again the oculist with his glasses, I was forced regretfully to abandon the advice of both professions and turn to my hypnoidization. The patient was glad to find that she did not need all those complicated professional outfits, and after a year's treatment felt, as she put it, “younger than ever.” The dysmenorrhea disappeared, the headache was gone, the eyes without spectacles felt far stronger and did not ache; she gained in flesh, and in strength, and is now in good health. A child born to patient a couple of years later helped the cure, regulating and moderating the impulse of self and instinct of fear.

XVIII. Miss G. A. American. Age fifty-five. Father died of pneumonia. Mother died of fatty degeneration of the heart. Three brothers died of various forms of cardiac lesions. One of the sisters had acromegaly and died of heart trouble. In the collateral branches of the family there are histories of tuberculosis. Patient looks poorly nourished; her appetite is completely gone. Menstruation stopped some ten years ago. Patient suffers from insomnia, headaches, backache, general diffused pains all over the body, complains of lassitude and loss of interest in what goes on about her. She feels despondent and has acute crying spells. She is afraid of losing her mind. When a child, used to suffer from night terrors. When about the age of twelve, she took a long, fatiguing journey with her parents. She was so exhausted that on her return she was aphasic and paraplegic, and was confined to bed for six months. The present condition set on a few years ago; she has lost the sense of smell and of taste, and is much depressed.

I must confess that when I undertook the case I did not expect any favorable results. It was an old, chronic, insidious case. The age of the patient as well as the family history were by no means encouraging. The first couple of months the treatment dragged along indifferently, all I could then say was that the patient did not get worse under the treatment. The hypnoidal state, however, gradually admitted me into the patient’s early history and I obtained important clues to her symptoms. Here comes in the value of the knowledge of the course and development of the malady and the consequent help in the treatment of the dissociated systems. With a better insight into the abnormal psychology of the case the hypnoidal state could be used to better advantage. The patient began to improve rapidly and at the end of the fourth month of treatment by hypnoidization completely recovered. It is now more than twelve years since the end of the treatment, and I may say that the patient has not had a single relapse, she continues to stay well, she has become an energetic social worker, greatly valued for her indomitable energy as well as cheerfulness of mind. People who know her say that “wherever she goes she brings sunshine with her.” A new life was awakened in her. The subconscious reserve energy which has remained dormant in her for so many years has become unlocked and utilized in her ordinary daily life.

In the control of alcoholism the treatment by hypnoidization has yielded extremely satisfying results. The principle of subconscious reserve neuron-energy stands out clear and distinct in such cases. A few cases will, perhaps, best illustrate my meaning.

XIX. Mr. G. S. American. Single. Age thirty-seven. Family history is good, except that one maternal uncle was a victim of the drink habit. Patient is physically well developed. A physical examination showed an irregular heart due to drink and excessive smoking. Liver enlarged and cirrhotic. The patient was brought just after a debauch, was weak, nervous and shaky, with quite an extensive tremor of the hands. He began to drink when in school as a matter of boon companionship, and since then became addicted to the drink habit. He kept on drinking regularly, and at times actually soaking in alcoholic beverages. He has gone through a series of treatments in various establishments for the cure of alcoholics, but with no appreciable results. As soon as he got out of the sanitarium, he immediately went off on a debauch. A number of times he suffered from severe attacks of delirium tremens. The family despaired of his condition, and he himself proposed to give up business and devote himself to his obsession.

Under a rigorous treatment by the hypnoidal state, the patient began to improve steadily. His physical and mental conditions grew in strength. After a few months’ treatment he went back to his business. The man has become completely reformed in his habits of life. He is now manifesting an extraordinary activity, devotion to and steadiness in his work. No one suspected in him before such capacities of business management, such foresight and energy in carrying on his business. New stores of subconscious reserve energy have welled up from the depths of his being. He has become another man at whom his own brothers are surprised on account of the extraordinary change produced.

XX. J. L. Irish. Protestant. Age fifty-seven. Family history good, except for the fact that his brother is also addicted to drink and has been under my care for a few weeks, with the result of leaving off drink for two years and, after having had two relapses, has completely recovered. Patient is a printer by trade and has been drinking for over thirty years. While he is usually kind natured, when under the influence of drinks he is violent, abusive, offensive, and even brutal to his wife and eight children who are afraid of him. From his sister and from his wife I have the information that periodically patient goes off on a long spree and spends all his money, neglecting his wife and children, and when he comes home he brutally abuses everybody in the house. “It is not a home, it is a hell,” as his sister puts it. In his better moments the patient himself admits he is a brute, that drink has the best of him. He must keep away from drink completely, because the mere taste of it sets him going. An examination reveals the presence of arteriosclerosis.

I found the hypnoidal state would meet with no resistance. Hypnoidization then was the order of the day. The patient began to improve, was less nervous, slept better, and, what was more important, stopped drinking and did not crave for liquor. After three weeks of treatment, by means of hypnoidization, the patient was discharged. He did not drink for a whole year, but, coming in contact with other workmen in the union, he was invited to drink, could not refuse, and once more was started on his old career. He came back to me and this time I worked at him for a month with more perseverance. Throughout the treatment, the hypnoidal state was used. The patient has given up his drink habit, has no craving for liquor, works regularly at his job and no longer associates with companions who are given to drink. His sister and his wife keep me regularly informed of his condition and the report for the last two years has been: “John is very good, he is a gentleman, treats the children well.” He has become a model father and a good husband.

XXI. C. T. Age thirty-two. American. Single. Family history bad, father drank, was off on sprees, and was drowned while in a state of intoxication. A maternal as well as paternal uncle were confirmed drunkards, and there was drunkenness in the collateral branches of the family. The patient learned to drink when very young. His mother, who volunteered the information, told me that she suspected that the patient learned to drink at the age of seven. Since that time the drink habit grew on him, and finally he took to liquor and became a habitual drunkard at the age of twenty. The physical condition of the patient is good. The patient is of a mild disposition, but it seems as if the alcohol has soaked all the good out of him. He has no ambition, and is not fit to do anything, he is constantly under the influence of drink. He has no will, no responsibility and nothing of any importance can be intrusted to him. Socially, he is ostracized by his relatives, but he seems to mind it little.

The family and the personal history, as well as the condition of the patient, greatly discouraged me. I felt there was no chance for him, no use of trying even. The family insisted on treatment, even if there was only one chance in a thousand that the patient could be saved. The mother was anxious to put him under my treatment, he was her only son. The treatment of the patient lasted for about a year, and was carried out by means of the hypnoidal state. To my great surprise, and contrary to my expectation, the patient has completely given up his drink. In fact, he changed so much that his own mother wondered at the transformation. He became ambitious, manifested a self-control which none who knew him had ever suspected in him. He became methodical, systematic, and conscientious in his work, and showed an unusual ability in management. From being weak and unreliable in character, he became firm and trustworthy. His abilities were soon noticed and appreciated, and he has since become a manager of a large concern. I may add that the only traits that remained to him from his former life were his kindheartedness and effusiveness. Nowhere have I seen such limitations, moral weakness, and lack of capacity changed to strength of will and purpose combined with ability to guard and guide complicated interests of a large business. After a case like that with so little hope I am more guarded as to the possible outcome in treatment of apparently the most hopeless alcoholic case. There is more efficacy in the treatment by the hypnoidal state than I have dared to think of.