oners often amounts to great sums, and I would have to write a good deal if I wanted to relate all the facts of this sort known to me. I will only say that Chruleff himself, the chief of the prison department, who, as is known, tried to prove at the Congress in Washington that the prisoners are almost in a happy condition in the Russian prisons, this same Chruleff, after looking over the prison budget last year in the Duma, tried to enlarge the means given to the prisoners, as he acknowledged that they were insufficient and unsatisfactory. Tired out from a hard day's work, half starved, often suffering from unjustly inflicted punishments, the unhappy convicts return at night to their cells, and make themselves at home the best they can, some of them in the berths, others on the floor. In the majority of prisons the government does not allow for any covering, and the prisoners are forced to sleep in the same dirty clothes they wear in the daytime. The suffocating, unhealthy atmosphere keeps the half-alive skeleton called "convict" from falling asleep in spite of his fatigue. But at last fatigue conquers everything-the ill smell, the hunger, the hard bed. The The unhappy one falls asleep. But it is not a healthy sleep which strengthens one. A great majority of the prisoners are exceedingly restless in their sleep; they talk, yell, cry, jump, toss around. This makes a terrible impression upon a new person when he comes into the cell and witnesses this one general nightmare. The cause of these disturbing nightmares, in addition to bad health and abnormal psychical conditions, are multitudes of parasites of all shades and sizes, which cover the victim as soon as he closes his eyes. A person who is not familiar with such surroundings as a Russian prison cannot have even a remote idea of the terrible scourge which these parasites are to the exhausted prisoners. I have not mentioned all the antihygienic conditions which exist in our prisons. For instance, I have said. nothing about the insufficient quantity of light and of the absolute absence of the sun's rays in the prison cells. But even from what I have said one can have a fair idea how these conditions influence the health of the prisoners. Even the prison officials confess that the number of sick prisoners is very great, sometimes reaching 30 or 40 per cent. In reality it is often twice as much. The principal sicknesses are stomach, lung, eye and skin diseases and scurvy. Very often epidemics, such as typhoid fever, spread thruout the prison, and finding a favorable soil often carry off the great majority of the prisoners. Russian statistics are not reliable, so that we cannot know exactly how many get sick and die in the prisons. Many prisons have hospitals or dispensaries. But as far as sanitary conditions go they are not much better than the prisons themselves: the same crowded rooms, filth, ill smell and parasites as in the prison cells, only the food is somewhat better. Besides the great number of really sick people, there are in these hospitals many people who only pretend to be sick; they want to take a rest from the severe prison régime, to enjoy somewhat better surroundings and food. To get into the hospitals the prisoners often purposely mutilate some part of the body, or in some other way harm their health. It is, therefore, not surprising that hospitals built for a small number of patients become so terribly overcrowded with sick people of different categories. Is it possible to be isolated in such conditions? Therefore the typhoid fever patients are found side by side with consumptives, syphilitics, etc. The physicians and the hospital authorities tell us that sometimes the most heartbreaking scenes, which cause the blood to cool and the hair to stand up, take place in the hospitals. I mentioned already that during the last five or six years a few thousand convicts were executed in the prisons and many more were subjected to corporal punishments. But besides this many prisons after the proclamation of a constitution began to practice real tortures. This is certainly done secretly, and not many of these cases get into print, but even what becomes known gives us a picture of something incredible. For instance, in the Ekaterinoslav prison "they burned the prisoners' fingers and hit their feet with iron rods; they spilled some kerosene on one prisoner's back and set fire to it." In In Lodz "one prisoner was beaten for several days to such a degree that pieces of flesh would fall off his body," or "the inquisitors would stand upon chairs and jump upon the unhappy victim," "they would twist the heads of the prisoners, tear out their hair, knock out their teeth, prick out their eyes, press their heads in filth." In Riga one young prisoner had every hair torn out of his head and beard, several ribs broken, his head and face mutilated. I would have to write many pages if I wanted to record only those cases spoken about in the Duma. It is easy to imagine what sufferings the tortured ones have to go thru, how the hospital, personnel and the patients feel when a person crippled by tortures is brought into their midst. Many of the prisoners, being unable to live thru these horrible conditions, commit suicide. Some of them do it in a most frightful way. They knock their heads against the wall, drown themselves selves in the excrements, swallow pieces of tin, and burn themselves. Mass suicides are also common. In the Pskov prison, only a few weeks. ago, about two hundred prisoners refused to take any food for fifteen days, expecting in this way to put an end to their lives. As an illustration let me quote the following letter which appeared in the St. Petersburg newspaper, Speech: "The Alexandrovsk prison, near Irkutsk, Eastern Siberia, is not remarkable for any excesses in the lives of its prisoners; there are neither mass massacres, nor terrible corporal punishments, nor other specially invented means of modern tortures; on the other hand there are not any tragedies to speak of, such as mass suicides and famines; and still the prisoners there die before their time the same as in any other Russian prison. The causes of the high death rate among the prisoners are the systematic, day after day innutrition, and the life in a terrible atmosphere filled with microbes. Towards evening some of the prisoners cannot bear the hunger, therefore they go to the garbage cans which stand by the side of the parasha, and from there they gather pieces of bread left from the dinner, absolutely unfit to be eaten, clean them and eat them. On account of this many of them suffer from anemia, and later tuberculosis develops in great numbers. Here are some fig ures: In the fall of 1910 a physician, after examining all the prisoners in a prison of a few hundred people, segregated 150 consumptives and put them into a separate building. Half a year later, in the spring of 1911, he again found 25 per cent. ill with tuberculosis. According to his statement, in one year the whole prison will be infected with consumption. As the reader has seen, the Alexandrovsk prison is not one of the worst in sanitary and other conditions, but on the contrary, according to the prisons in Russia. The great majority of the Russian prisons at present are graves in which are buried hundreds of thousands of human beings, crippled and mutilated. MEDICAL PSYCHOLOGY UNDER CHARGE OF J. VICTOR HABERMAN, M.D., INSTRUCTOR IN PSYCHOPATHOLOGY AND THERAPY, COLLEGE OF PHYSICIANS AND SURGEONS, COLUMBIA UNIVERSITY, AND ASSISTANT NEUROLOGIST, VANDERBILT CLINIC, N. Y. The Power and Therapeutic Importance of Hypnosis. Very slowly but surely the revived interest in psychic therapy among us is invading the environs of conservative science and is beginning, even if but timidly, to be fostered in the schools. The day is not far distant when a physician will deem it humiliating to be lacking in psychological training and will look with discountenance upon the colleague who calls neurotic symptoms "imagination," and advises his patient to take up “Christian Science" or other new-science cult as a means of relief. Philistinism without doubt, however, still holds sway, and it will necessitate a deal of trephining yet before the facts of psychotherapeutic potentialities are accepted by the minds of the profession as a whole. The renaissance of psychic therapy -for it is nothing new, having in fact been the very earliest form in which the healing art was practiced-is due to the work done in Hypnotism by the early Nancy school and the continued. enthusiasm of the students of this tradition. Controversies along the line, especially with the students of the Salpêtrière, and the masterful work of Charcot himself in sheafing the symptoms and vagaries of the hysterical disposition into our modern conception and establishing the "clinic" of this neurosis, did much to sharpen diagnosis and elaborate etiological theories yet actual therapy-where it was not in the hands of layman healers and charlatans-was undisputably nurtured and stimulated by the work in Hypnosis. For a time the "psycho-analytic" mania raised a din that made aught else inaudible. Slowly the catharsis of criticism is having its effect and the absurd absolutism, exaggeration, and forced artificialities will gradually be eliminated, so that maybe, by and by, the theories of Freud will come to leaven and the truths they contain become part and parcel of our knowledge and actual practice. In the meantime suggestive and persuasive therapy have held their own, and the interest in Hypnosis itself, for a moment on the wane, is again brought to the fore. This was apparent in the papers and discussion at the Congress of the International Association for Medical Psychology and Psychotherapy held at Munich last September. In the same number of the Zeit. f. Psychotherapie und Med. Psychologie (No. 5 and 6, Vol. III) containing the "Sitzungsberichtë of the congress, is an interesting article on Hypnosis as a therapeutic agent in the psychoneuroses by Emanuel of Geijerstam. He gives the report of a series of difficult cases (evidencing symptoms of Neurasthenia, Hysteria and the obsessions) which he treated with hypnosis for shorter or longer sessions, which were either materially benefited or cured, the permanence of the results being verified by long periods of observation (three to nine. years having now elapsed in some since treatment was given). In the course of comment on these cases Geijerstam points out certain facts which deserve especial attention. He found that in several cases hypnotic treatment treatment only started the process of amelioration and that after termination of treatment and dismissal of the patient the improvement steadily continued until a cure had been affected. This is as if a psychic process had been urged into action, which once begun, went on spontaneously to consummation. Here is a matter of much interest, for it is so often stated that individuals under hypnotic treatment are only influenced by the physician himself, and thru the induced hyper-suggestibility and their "besoin de direction" become constantly more dependent upon him and less and less self-reliant. This Geijerstam expressly shows is not the case. The fact isn't anything new, only it is very difficult to have it generally accepted; and here it becomes evident thru the history of sundry cases. This subjugation and supposed weakening of will under hypnosis is the bug-bear frightening both layman and practitioner. It stampedes whatever other ideas he may entertain regarding its salutary effects. In Curschmann's "Lehrbuch der Nervenkrankheiten," certainly one of the most thoro and authoritative of modern compilations, Aschaffenburg also emphasize the fallacy of this and said, "The fable that hypnosis paralyzes the energy of the patient still more, can only be seriously held by one who has never tested hypnosis. I am assured that many people on whom all methods of treatment were tried without effect finally and only regained their vitality (lebensenergie) thru hypnosis." 1 Another noteworthy point that G. brings up is the indication of this therapy in neurasthenia. Many have thought that hypnosis was contraindicated in this condition. This cannot for a moment," writes G., "be entertained." One has focussed far too little upon the quieting effect of hypnotherapy, its inherent calming 1 H. Cutschmann's Lehrbuch ch. p. 796 (chapter on Die Konstitutionelle neurasthine). Elsewhere p. 816, A. writes, “Bei der Opposition, die sich immer noch gegen diese Behandlungsmethode wendet, halte ich es für notwendig zu betonen, das mittels der Hypnose schon manches kranke mit Zwangsvorstellungen, der Jahrelang von Sanatorium zu Sanatorium. vom Arzt zu Arzt gereist ist, wieder zu einem branchbaren Menschen gemacht worden ist." In this connection let me also refer to a recent lecture of Prof. L. Edinger, Jahreskurse für Arztliche Fortbildung, Mai 1911, p. 6 and 12. At the Jahresvers annunlung der geselschaft Deutsche nerverärzte, Frankfort, Okl., 1911, Friedlander also took up this theme and said: 'Den wert der Hypnose sehe ich nicht allein in dem sinnfälligen erfolgen, sondern mindestens ebenso in der durch sie ernöglichten danernden Beeinflussung des Seelenlebens, in der Selbsterziehung, Eigen kontrolle, Konzentrations führ ghirs, Willensstärkung nach dem der Arzt vom Schauplatze abgetretan ist." potency. And this is just what the neurasthenic needs, for it is a recognized fact that above all he cannot get the proper rest out of sleep. He is always fatigued but worse in the morning and forenoon. "I have heard such patients say," continues G., "that they felt more rested after one hour's superficial hypnosis than after six hours' sleep at night." This of course is also nothing new, only it is not generally well enough known. Wetterstrand emphasized it quite some time ago, and Löwenfeld and the present writer in more recent publications. Nor is a high degree of suggestibility nor deep hypnosis necessary. Often the mere state of quiescence and passivity induced in order to achieve hypnosis is sufficient. Indeed, often we cannot even tell if the subject has slipped into somnambulism. Interesting are also the cases of Fear-neurosis in which one could assume a sexual etiological mechanism in Freud's sense. Without changing the life-routine, however, that is without obviating the sexual suppression, etc., Geijerstam thru hypnosis relieves these patients of their symptoms. He points out how contrary this is to Freud's assumption and how it therefore refutes, in some measure, Freud's theories. He also states that he cannot quite rid himself of the conjecture, held by others, too, that there are many and deeper accordances between the psycho-analysis of Freud and hypnosis. To recount to one's physician in a passive condition what happens at the moment to come into mind and 2 Dornblüth, in his "Die Psychoneurosen," just published, also states this fact. "Wenn die Hypnose weiter nicht lerstet, als die in den Sitzungen regelmässg erzielt liefe Beruhigung, so wür de sie damit shon einen Vorsprung vor der uberzengenden. Dialektik des Arztes haben ch. p. 627. accept as true the explanation of the connection of this with the pathological symptoms-without which acceptance as correct the therapeutic effect is not obtained. "This," writes G., “appears to have a great resemblance to a suggestive procedure." But even if the action of Freud's psycho-analysis is not thru suggestion, it isn't quite so certain that the difference between both therapies is as fundamental as one believes for, even should we grant that Freud's theories are correct, can we exclude the possibility that thru hypnosis, in this modified conscious condition of the patient, those very activities are set going, the smoothing out of the patient's unconscious conflicts, etc., which Freud purposes to bring about thru psycho-analysis? It is quite possible that eventually both therapies will prove to be analogous (just gous (just as it has been shown that the breach between suggestion and persuasion scarcely exists), for suggestion in therapy, be it remembered, is not the bold forcing of an idea upon the mind as is so often believed, but in reality the generating of normal psychic activities, and indeed by the very means of mental analysis and synthesis for the most part, even tho one employs artful insinuation and adroit persuasion and induces an artificial somniference in order the more aptly to produce the conviction of effect in such a mind. That such mental surgery is not simple, may even be detrimental in unskilled hands, should scarcely cause the procedure to be looked upon with any more suspicion and misgiving than any other powerful remedial agent or measure of consequence. In most of the modern authoritative books dealing with therapy, hyp |