to be, as it is now, and always has been if not the most unconsciously applied of therapeutic means as it is at present, certainly the most potent factor for good which it is our privilege to administer.

In the scope of this paper it will be sought to so investigate the principles of the origin and practice of psychotherapy and to so demonstrate its primordial nature as a therapeutic measure, that its essentially elemental and fundamental nature will be recognized and its influence in each and every disorder, medical, surgical, or otherwise adınittted.

Psychotherapy may be defined as the application of psychic force to the restoration of health, and psychic force as an attribute or product of neuronic activity somewhat trophic in character, and somewhat emotional in nature. If one can conceive of certain neuronic vibrations emanating from the cerebrum and exercising some such stimulating or inhibitory action on all the bodily structures as the trophic nerve cells in the cord exercise over muscular tissue, one will have formed a working conception of the nature of its action. That there is such a subjective force which makes powerfully for the well or the ill being of humanity is evidenced by the observations which originated such pungent remarks as that a certain grief or anxiety "has made him ten years older," or that a certain pleasure or success has added ten years to his life."

We have said that this psychic force is an essentially elementary and fundamental requisite of health and therefore of therapeutics. Psychic force, however, implies cerebration or brain function, and this necessitates the existence of a cerebrum. Before the advent of a cerebrum, however, organisms were born and experienced a healthy development. What had psychic force to do with them?

The most simple of monocellular organisms absorb nourishmenthave alternating periods of quiescence and activity-reproduce their kind and die. They have, that is, in the life of the universe, somewhat the same function to perform as has the most highly developed organism. Like the complex organism, also, the monocellular, as a necessary qualifi cation to life, is endowed with a power of selection, or Selective Activity, which enables it to be discriminative in its choice of food. This Selective Activity, of cell life which permits cells to take or refuse to take into their substance nourishment conducive to their welfare, develops in time into the parent sense of touch, and ultimately through mryiads of gradations into sentiency and cerebration.

For when the ultimate is said Cerebration is nothing more or less than Selective Activity directed in the highest as in the lowest organisms to the preservation of the species. The greatest effort of a Demosthenes, the most profound deduction of a Spencer, or in other words, the highest type of cerebration of which mankind is capable is to Nature selective activity to the end that organisms may live and propagate. As organisms develop and become more complex, they come into more varied correspondence with the outside world, and their power of selection undergoing elaboration and specialization is delegated to a special group of cells; which cell group for specialized selection develops ultimately into a nervous system. (The process of elaboration of selective activity does not stop here, however, because the nervous system divides into two connected and co-operative parts known as the sympathetic and the cerebral spinal

system; which systems are directly analogous to the departments for internal and external affairs respectively of certain foreign governments, and though seemingly separate, are one in action). Because cells unite, however, to form complex bodies, and because they undergo differentiation and specialization of functions, they must not be accused of having sacrificed any of their individual powers. Each individual cell uses food, rests, reproduces its kind, and is discriminative in its selection of food. That part of its activity, however, which has to do with the outside world, is delegated to the Cerebro-spinal system which acts as the foreign relations department of the commonwealth. The cerebro-spinal system develops functions which are very widely removed from those that gave it origin, but vast as is its power of volition, of emotion, and of intellect, it has no power which is not a direct outgrowth of that cellular activity from which it came; nor can it have any function whatsoever which is not of direct interest and importance to the welfare of the individual cells which gave it birth.

That certain parts of the commonwealth have been found to be without nervous connection lends confirmation to the views here expressed. Nature in her beautiful economy refrains from putting a telephone bill in houses where the nuisance of false alarms from central exchange would more than offset any advantage which the remote citizens who produce Secretin would derive from them; aud particularly as these citizens have only to step over to a neighbor's telephone to send in any complaint they may have to make.

If it be admitted, then, that cellular Selective Activity and Cerebration are essentially one and the same thing in effect, that though they differ greatly in degree they are one in result; we can proceed further to study that attribute of cerebration which we have called pscyhic force, and which we described as being trophic in nature.

It is a matter of common and universal observation that in health, when the various cells specialized, or otherwise, in the organism, or or ganic commonwealth are functionating properly, there is produced a subconscious state of satisfaction, of well-being; which state of well-being prompts its possessor to tell his neighbor to kick its legs about and crow for every joy of life. What this state is, if it is not the agreeable hum of neuronic vibrations, interchanging the glad tidings of healthful activity, directly or by proxy, between the cerebral cells on the one hand, and the somatic cells on the other, it will be hard to say, but certain it is that it exists; and that it is an attribute of Cerebration, and of that primitive form of Cerebration, Selective Activity, is equally certain. If, then, there be any truth in the theory of evolution, and if there be any truth in the development of the nervous system, as here portrayed, it would be inconceivable that there should not remain an avenue of communication and a sympathetic interaction between the selectively active somatic cell and the selectively active or cerebrating cerebrum.

Such then is the influence which we have designated psychic force, and which one experiences who feels the thrill of success which results from skillful work accomplished, entailing successful cerebration--who sees the gyrations of children upon promise of a picnic or who, in health, takes a plunge and rub down, and becomes conscious of increased power

of body and mind, because at such a time each infinitesimal somatic cell seems to vibrate or tingle with life.

From our study of its origin and development, we would be led to expect that psychic force would exercise a powerful or dominant influence for good or for ill, in health and in disease. What are the facts?

We find, on reflection, our own experiences and the literature alike replete with illustrations, showing the loss or impairment of the sense of sight, hearing, of smell, of taste or of touch; or of loss or impairment of the functions of circulation, of respiration, of digestion, of elimination, and of reproduction, proceeding directly, as a result of the influence of the mind over the body.

This loss or impairment of function of sense or vital organ may manifest itself in such minor disturbances as blushing from a feeling of shame-salivation at thought of food-perspiration through fear, or inhi bition of gastric secretion through disgust; as witness the busy practitioner who has had no time for lunch, and who goes into a restuarant in anticipation of a broiled sirloin; a negligent waiter, however, permits a nimble cockroach to wend his lithesome way over the juicy expanse, when immediately our unfortunate brother's appetite becomes satiated. Or witness again the diarrhea from which so many surgeons suffer as a result of the responsibility incident to a major operation.

If psychic force in such small and individual doses can produce such powerful results, it cannot be considered strange that when successively administered, or when administered in excessive doses that it should produce such serious results as loss of consciousness-loss of reason, or loss of life itself. That such unfortunate and often fatal results can be ascribed to mental processes needs little emphasis; Syncope can result from sympathy, from expectation, from grief or from joy. The case reports of our many institutions for the care of the insane will be a witness to the frequency with which Fright, Grief and Worry in loss of Reason. Instances of loss of Life due to Excitement, to Expectation, to Fright, to Joy and to Passion are detailed by Dr. Tuke, in his work on Mind and Body, and these can be supplemented ad infinitum by your own individual and collective experiences.

With the mention of this wer Ith of proof, however, the story is only begun. To it must be added all those phenomena ascribed to the workings of Suggestion and Auto-suggestion. Möbius defines hysteria as "a state in which ideas control the body and produce morbid changes in its functions." Stokes asserted that there is no single symptom of disease which may not be simulated in hysteria. A case which I examined in Professor Neusser's wards in Vienna last year removed whatever doubt I may have entertained as to the truth of Stokes' dictum. The patient, a girl of 19, suffered from aphonia, had night sweats, cough and expectoration. Examination of the chest revealed dullness on percussion and the presence of rales. Ever so many experienced physicians pronounced the inevitable diagnosis; repeated examinations of the chest, however, discovered the fact that the physical signs were not constant. The dullness shifted about from day to day, and finally the use of the laryngoscope and the finding of a normal larynx suggested hysteria, which diagnosis was later confirmed.

Whether or not, however, one accepts the definition of Möbius or the dictum of Stokes, one will readily admit that practically all the phenomena of hysteria-all the symptoms resulting from primary neurastheniaand all of those disorders apart from neurasthenia which result from worry or from intemperate cerebration must all be laid upon the altar of mental influences over bodily functions.

If, then, the dominant influences of psychic force which we were led to expect from a theoretical standpoint are more than fulfilled in practice -if for example, Death, itself, which has been held in abeyance for weeks at a time, despite the onslaughts of countless hosts of virulent bacteria can result instantaneously through operation of psychic force, as exhibited in the form of extreme grief or extreme joy-is it not at least possible, I ask you, that when engendered and directed intelligently and scientifically by men skilled in its use, is it not probable that its influence should be just as beneficial in disease as we have seen it to be baneful in health, when ignorantly and unconsciously used?

With such a statement of the case for our premises, then, it will be admittedly worth while to devote our attention to the principles of psychic practice, and as a preface to this investigation, I should like to quote a statement of Johannes Müller that had been previously practically affirmed by John Hunter;-"It may be stated as a general fact," says Müller, that any state of the body which is conceived to be approaching, and which is expected with certain confidence and certainty of its occurrence, will be very prone to ensue as the mere result of that idea, if it do not lie beyond the bounds of possibility,"

As a further preface, I should like to be premitted to draw an analogy between the human commonwealth and our Republic of Confederated States.

The Somatic cells are the Citizens cf a Democracy in which cell groups or glands are counties and organs are states. The cerebrum is the Federal Government, having its spinal and sympathetic divisions for the conduct of external and internal affairs, respectively. The Federal Government is the direct outgrowth of the union of citizens to form a commonwealth, and has powers manifestly greater than, but a direct outgrowth of those belonging to each citizen. The citizens-countiesstates-and Federation are autonomies: they have rights which may not be transgressed with impunity, and they have as a motto, the words: "E. Pluribus Unum." To each is accorded, therefore, a maximum of authority consistent with liberty of function. If one interferes with the prerogatives of the other, there is trouble or preverted function. Each cell, gland, organ, or cerebrum must tend strictly to its own special business, if there is to be healthful functioning of each and all; and States rights must be rigidly respected by the cerebral gov. ernment. So long as health obtains, the Cerebrum is unconscious that it has a heart or a stomach within its jurisdiction. The moment it becomes introspectivve, however, or becomes upset by emotional or other distur bances, its perversion of function is necessarily reflected and is translated into palpation and gastric neuroses: in the same manner that rumors of war in Japan or elsewhere will upset economic conditions in a Confederation.

To proceed now to the principles of psychic practice. Psychologists tell us that pleasure and pain are those states of consciousness which accompany functions which are respectively beneficial or injur jous to the race. We all know from every day experience the beneficial or injurious effects on organic functions of certain psychic states of a pleasant or unpleasant nature. The lay expression "tingles with joy" evidences an exuberance, an overflow of joyful or tonic cerebral neuronic vibrations which are transmitted to extremest organs and are in moderation as beneficial to all bodily functions and to life as extreme grief or severe fright is prejudicial; causing, as it probably does, a retraction of the neuronic substances, and an inhibition of that sympathetic interaction of psychic force which we have seen reason to believe takes place normally between somatic cell and cerebral neuron, and which shows itself in anorexia and lassitude-or when the inhibition is extreme, in loss of consciousness or death.

We will be justified, therefore, in defining those states of consciousness such as Confidence, Hope, Trustfulness and Gladness, which are beneficial to the race, as being physiologic; and in designating those of an opposite nature, such as Pain, Anxiety, Distrust, Fearsomeness or Worry, as pathologic.

Disease makes itself known to consciousness by means of psychic states of a pathologic character. We know inductively and by actual experience that of, through introspection or other intemperate cerebration the cerebrum interferes with organic disease, it is aggravated, and a vicious circle established. It follows, therefore, that the practice of psychotherapy must resolve itself into an effort to eliminate pathologic mental states and to cultivate and direct states of consciousness which are physiologic; it is, in other words, an effort to establish a physiologic equillibrium, and in its broadest sense covers the whole range of therapeutics: medical, surgical, and otherwise. It necessitates attention to each of the fundamentals of health, Nourishment, Rest and Psychio Force. Nourishment must be provided in the from of food, air and sunlight. Rest must be secured by the removal by surgery or medicine of all sources of extraneous irritation-by the establishment of a proper hygiene and the provision of physical and mental quiet, or both, and thirdly, the Selective Activity of cells must be enhanced by the cultivation of those physiologic mental states which produce the trophic action. of the cerebral neuron on the somatic cells.

How is one to cultivate physiological processes? The answer to this question forms the crux of the whole subject, and will be stated in general terms and in detail.

All those measures, and they are legion, which will divert the attention of the patient from himself and his ailments-which will stimulate confidence in the physician and in the means of relief-and which will also inculcate a hope of recovery--all those measures will tend to produce a physiologic mental condition. These measures include the personal equation of the physician himself, surgery, drugs, placebos, hydrotherapy, mechano-therapy, electricity and what not?

The means of engendering physiologic mental processes by means of psychotherapy in its restricted meaning, and without any aids, whatso