Historical: Elliotson and Esdaile: How they were Treated; Braid; Liébeault—Hypnotic Theories: The Subliminal Consciousness Hypothesis: its Advantages and Defects—Methods—Suggestion as a Substitute for Anaesthetics—Suggestion in Medicine and in Quackery—Dangers of Christian Science.
The most important thing to remember, in reference to the so-called hypnotic state, is that the condition is invariably a conscious one. Volition is unimpaired, intelligence is intact, and the patient has acquired an increased control of his own organism.
Historical.—Looking back on the revival of mesmerism, and on the origin and earlier development of hypnotism, one must admit that these movements were almost entirely due to Elliotson and Esdaile, Braid and Liebeault, all of whom were more or less martyrs to what they believed to be the truth.
Elliotson’s researches cost him official position, reputation, fortune and friends, and he was the constant subject of rancorous abuse in the medical press and elsewhere. He was described as a charlatan, not only on account of his mesmeric work, but because he was the first to use the stethoscope in England. The stethoscope, as well as the facts of percussion and auscultation, as described by Avenbrugger, were condemned as fallacies by the foremost teachers of medicine in London, while, even at a much later date, they were treated at St. Thomas’s with indignation or silent contempt. At the College of Physicians, a senior Fellow, in a Croonian Lecture, denounced the folly of carrying a piece of wood into a sick-room. Another condemned the stethoscope as worse than nonsense, and said, “Oh! it’s just the thing for Elliotson to rave about.” While a third, on seeing one on Elliotson’s table, said, “Ah! Do you use that hocus-pocus?” On Elliotson replying that it was highly important, he added, “You will learn nothing by it, and, if you do, you cannot treat disease the better.”
Esdaile’s earlier mesmeric work was ignored by the medical authorities, while his later efforts were bitterly opposed. In his case, however, opposition only acted as a stimulus. It impelled him to do more than he ever intended, and thus brought about his appeal to the Government, which resulted in the establishment of the official mesmeric hospital at Calcutta.
Esdaile was more a surgeon than a man of science, and could not understand why Professor Bennett supported “hypnotism” at the very time “mesmerism” was so fiercely attacked. Esdaile had evidently failed to grasp the importance of Braid’s views as to the subjectivenature of hypnotic phenomena, and said he would willingly have called his operations “hypnotic “if he had known that a change of title was all that was necessary in order to ensure their recognition.
Esdaile’s later days were certainly saddened by the treatment he received, and he naturally asked what he had done to deserve it. He pointed out that he had remained poor for the sake of mesmerism, and had also saved thousands of human beings the pain which, until then, had invariably been associated with surgical operations. This, in itself, surely did not justify his being considered as an outcast from his profession.
After Esdaile returned to England, Sir James Simpson, of Edinburgh, wrote to him to the effect that he owed it to himself and his profession to let his proceedings be known in England. In response to this, Esdaile sent to an English medical journal an account of 161 scrotal tumours painlessly removed during mesmeric trance. The history of what followed, and Esdaile’s opinion of the treatment he received, I give in his own words:—
“My article was not published, and I then sent a more general paper containing a resume of my surgical work. This was rejected for its unpractical character. I have heard that it is given as a reason for not printing my paper that, though no one now denies my facts, these apply to the natives of India only. But, as far as I know, no medical journal has admitted the reality of painless mesmeric operations, even for India, or inserted one of the numerous European cases reported from London, Paris, Cherbourg, etc. They will not admit, or permit you even to hear of, such indisputable facts, through fear of the consequences. But, supposing the natives of India were alone concerned, is it of no interest to the surgeon, the physician, the physiologist, and the natural philosopher, to know that the hundred and twenty millions of our Eastern, subjects (one would suppose they were monkeys) are so susceptible to mesmeric influence that painless surgical operations, and other medical benefits from mesmerism, are their natural birthright? You have been told all along by your journals that your medical brethren engaged in studying mesmerism are either fools or quacks. But how men like myself, who neither want nor will receive private practice, can be reduced to the category of quacks I do not well see. If we are fools we ought to be encouraged to write ourselves down as such, as the speediest and most effectual way of exposing us. I am convinced that you (i.e. the profession in general) and I are agreed on one point, namely, in liking to be allowed to judge for ourselves, and that you will not submit to be hoodwinked or led by the nose by persons we pay to keep us well informed of new facts, and the progress made in our profession all over the world. To pretend that there is a free medical press in Great Britain is a mockery and a delusion. And the proof of this is that medical men, who pledge their unblemished private and professional reputation for the truth of their statements, are not allowed to be heard by you in your professional organs, if what they advance is contrary to the prejudices and foregone conclusions of the editors.”
Braid, who was essentially open minded, and inspired with the truest scientific spirit, eagerly seized upon all fresh facts, and altered his theories in accordance with them. He not only invented the terminology we still use, but even, at a later date, rejected it as misleading.
Although Braid believed that hypnotic suggestion was a valuable remedy in functional nervous disorders, he did not regard it as a rival to other forms of treatment, nor wish in any way to separate its practice from that of medicine in general. He held that whoever talked of a “universal remedy” was either a fool or a knave: similar diseases often arose from opposite pathological conditions, and their treatment ought to be varied accordingly. He objected to being called a hypnotist; he was, he said, no more a “hypnotic” than a “castor-oil” doctor.
Braid frequently referred to the almost incredible opposition he had to encounter, at the hands both of the orthodox medical practitioner and of the mesmerist. His explanation of this I give in his own words:—“Like the originators of all new views, however, hypnotism has subjected me to much contention; for the sceptics, from not perceiving the difference between my method and that of the mesmerists, and the limited extent of my own pretensions, were equally hostile to hypnotism as they had been to mesmerism; and the mesmerists, thinking their craft was in danger—that their mystical idol was threatened to be shorn of some of its glory by the advent of a new rival—buckled on their armour, and soon proved that the odium mesmericum was as inveterate as the odium theologicum.”
Liébeault was rather neglected than abused. Although Elliotson had many followers and Braid obtained a certain amount of scientific recognition, Liébeault, like Esdaile, worked alone. If he were mentioned at all, a thing which rarely happened, it was only as a fanatic or madman. From the day he settled in Nancy, in 1864, until Bernheim— some twenty years later—was the means of bringing him into notice, Lidbeault devoted himself entirely to the poor, and refused to accept a fee, lest he should be regarded as attempting to make money by unrecognised methods. Even in his later days fortune never came to him, nor did he seek it. And his services—services which he himself, with true modesty, described as the contribution of a single brick to the edifice many were trying to build—only began to be appreciated when old age compelled him to retire from active work. Though his researches have been recognised, it is certain that they have not been estimated at their true value, and that members of a younger generation have reaped the reward which his devotion of a lifetime failed to obtain.
Hypnotic theories.—The views of the mesmerists and those of the Salpetriere School have ceased to interest scientific men. All theories which attempt to find a general explanation of hypnotic phenomena in a physiological or psychological inhibition, or in a combination of the two, will doubtless suffer a similar fate. The increased volition and intelligence, which are frequently observed in so-called hypnosis; can be explained neither by arrested action of the higher nerve centres nor by a hypothetical automatism. Further, subjects can be taught to induce the state and its phenomena at will. In such cases it is absolutely impossible for the phenomena to be due to the suspension of the subject’s volition, or for the operator’s supposed power of controlling him
If the subliminal consciousness theory does not satisfactorily explain all the problems of so-called hypnosis, we are at all events indebted to it for a clearer conception, not only of the condition a whole, but also of many of its component parts. The following points in this theory seem most worthy of note
The essential characteristic of the so-called hypnotic state is the subject’s far-reaching power over his own organism.
Volition is increased, and the moral standard raised.
The phenomena arise from, or at all events are ultimately connected with, voluntary alterations in the association and dissociation of ideas.
Subliminal or subconscious states are more clearly defined.
While the phenomena of hypnosis show that consciousness can be split into two or more well-defined parts, this does not justify us in concluding that distinct personalitiesmay exist in the same human being. To the physiologist, at all events, something more is necessary than evidence of alternating groups of memories and changes of character. To put the matter crudely, the phenomena we term mental are dependent on the life and activity ofthe organ which we call the brain. All the physical part of the mechanism, is enclosed in one skull, and the varying psychical manifestations are associated with the changes that take place therein. It is doubtless true that an individual may receive impressions which do not arouse consciousness at the time, and that these may be the starting-point of mental processes of which he only afterwards becomes conscious through the results. In so-called hypnosis, too, he may be conscious of mental work done in that condition, but of which he knows nothing in the normal state: Through accident or disease, he may become amnesic, or aphasic, or both; he may revive memories long lost to his normal consciousness. All these varying psychical conditions, however, have their physical correlative; they correspond to changes which have taken place in that particular individual’s brain. However great the alterations in consciousness, however marked the changes in character, we cannot get away from the fact that these are dependent on the one brain the individual was born with, and the changes that one brain has undergone in subsequent life. “John Smith” does not cease to be “John Smith” when he is hypnotised, nor when he becomes insane.
If Braid and Myers have done much towards giving us a clearer idea of the so-called hypnotic state, they have also added to the difficulties of explaining it. A conception of hypnosis which limited its manifestations to simple automatic movements was comparatively easy to understand. The subject who, while he has not lost the physical and mental powers of ordinary life, has acquired new and far-reaching ones, presents a very different problem. But normal life contains many problems, both physiological and psychological, which are yet unsolved, and some—such as the causal connection between mental and physical states—which are apparently insoluble; and while this is so, it would be unreasonable to expect a complete explanation of that still more complex state which is styled hypnosis. Further observation, however, is always giving us clearer insight, if not into the central problem itself, at all events into the phenomena which characterise it.
The subliminal consciousness theory, while marking a distinct advance on all those that have preceded it, possesses defects of its own. The explanation of the origin of so-called secondary and multiple personalities is entirely inadequate, both as to the states themselves and as to their phenomena. So far, no reasonable answer has been given to the question, “What is the connection between hypnotic methods and the production of so-called hypnotic phenomena?” Personally, I see no logical connection between the acts of fixed gazing, concentration of attention, suggested ideas of drowsy states, and the varied manifestations of so-called hypnosis. The phenomena do not appear spontaneously, but I cannot conceive that the methods explain them. To my mind, the main value of the subliminal consciousness theory is not so much the views contained in it as the facts upon which its conclusions are based. As William James truly says, these manifestations of the “hidden self” are immensely complex and fluctuating things, which we have hardly begun to understand, and concerning which sweeping generalisation is sure to be premature. Meanwhile, he adds, a comparative study of subconscious states is of the most urgent importance for the comprehension of our nature.
While I have raised objections to all the theories referred to—theories which are discussed much more fully in my larger work—I have, unfortunately, no theory of my own to bring forward in substitution for them.
Methods.—I have tried to give as clearly as possible such a description of methods as may be of service to those who may be disposed to try treatment by suggestion in their practice. The important thing to remember is that, though a certain proportion of the patients pass into a drowsy or lethargic condition, consciousness is never lost; and that the condition which has been termed hypnotic does not really involve any actual sleep, even in the states which are looked upon as the most profound. Further, suggestion frequently yields brilliant results, even in cases where it is impossible to obtain either mental or physical repose, until the patient has been cured.
Surgical cases.—The principal point of interest in all these cases is the fact that insensibility to pain was produced by suggestion. The chief objection to this form of anaesthesia is the difficulty and uncertainty in producing it. It is true that Esdaile invariably succeeded with his native patients in India, and that painless operations were daily performed in his hospitals, years before chloroform and ether were heard of. A medical man, who recently returned from India, told me he had seen Esdaile’s casebook, which was still preserved in his old hospital. There, the induction of mesmeric anaesthesia before operation was recorded as regularly as the administration of an ordinary anaesthetic would be at the present day.
With suggestion as the sole anaesthetic, formidable operations are occasionally performed from time to time. The following, performed by Dr. Schmeltz, of Nice, is a typical example:—“M---, aged 20. Enormous sarcomatous tumour of the breast. Hypnosis was induced on several occasions before the operation, which was performed in the presence of a number of medical men. The tumour was removed, the axilla thoroughly explored, five drainage-tubes introduced, and the enormous wound closed with thirty-two wire sutures. The operation lasted about an hour. Dr. Schmeltz operated slowly, and quite at his ease. The patient was very merry, chatting brightly and laughing heartily from time to time. She placed herself in different positions as requested, without the aid of an assistant, etc. She suffered pain neither during nor after the operation, and slept well the following night. Recovery was rapid, and the wound was only dressed once after the operation. The drainage-tubes were removed on the third day, and the stitches on the fifteenth day, when union was complete. The tumour weighed over 4 lbs., and microscopic examination confirmed the diagnosis.”
Despite all the successful cases cited, unless grave reasons existed for the non-employment of other anaesthetics, it would be waste of time to attempt to induce insensibility to pain by suggestion. It is possible that improvement in the method of inducing this form of anaesthesia may arise; but, until then, its usefulness in surgery will ever remainextremely restricted. The phenomena of suggested analgesia and anaesthesia are, however, so interesting that one cannot help wondering at their being received with opposition or ignored. Deep-seated prejudice alone can explain their treatment in the days of Elliotson and Esdaile. Of this an example may be given:—At the Royal Medical and Chirurgical Society, in 1842, when Mr. Ward, surgeon, reported a case in which he had painlessly amputated a thigh during mesmeric trance, Dr. Copland proposed that no account of such a paper having been read before the Society should be entered in its minutes. He asserted that, if the history of the man experiencing no agony during the operation were true, the fact was unworthy of their consideration, because pain was a wise provision of nature, and patients ought to suffer pain while their surgeons wereoperating; they were all the better for it, and recovered better.”
At the present day, when wehave reliable anaesthetics, one can understand little practical importance being attached to the induction of anaesthesia and analgesia by suggestion. One would have expected, however, to find both physiologists and psychologists keenly interested in suggested analgesia from a scientific point of view. As I have pointed out, it is a thing apart, and by no means an ordinary narcotic—not a fresh example of the methods for preventing pain by checking all conscious cerebration. It has been left to a layman, Frederic Myers, to point out the extraordinary nature of the phenomenon and the complicated intellectual, processes by which it was obtained.
Suggestion in medicine.—As Braid truly said, suggestion is not a universal remedy; it is simply an additional weapon, by means of which medical men can combat disease.
Suggestion is sometimes useful in organic maladies, especially as a substitute for narcotics in the relief of pain. Its most brilliant results, however, are obtained in purely functional nervous disorders; a class of disease in which drugs are often of little or no avail. Further, I have followed the after-history of many of my patients, and have found that relapse has been rare.
In estimating the results obtained by suggestion, it must not be forgotten that the majority of cases treated by me were extremely unfavourable ones. The patients had generally been ill for years, and had become hopeless, as the result of the failure of other methods. Thus, it is not the specialist, like myself, with a practice almost entirely confined to unfavourable cases, who is likely to get the best results; it is the general practitioner, who can choose suitable cases fromamongst his own patients—patientswhose confidence he has already gained. As the value of treatment by suggestion and its freedom from danger become more fully recognised, it will doubtless be employed in earlier stages of disease. When that day comes the results will be still more striking.
Above all else, I must again insist that the object of all treatment by suggestion is the development of the patient’s will-power, of his control of his own organism. To associate the idea of danger with such a process is absurd. During the twenty years I have practised suggestion, I have not seen a single instance in which ill effects, even of the most trivial description, have followed its use, despite the unstable mental conaition of many of my patients. My experience is shared by others. Thus, Forel asserted that he, as well as Liébeault, Bernheim, Wetterstrand, van Eeden, de Jong, Moll, and the other followers of the Nancy School, had never seen a single instance in which mental or physical harm had been caused by the use of suggestion as a therapeutic agent. No complete record of their cases has been published, but the number certainly exceeds fifty thousand.
Experimental cases.—These have been selected to illustrate the alternations of memory and other phenomena which occur in certain so-called hypnotic conditions. They also show that volition and intelligence are not impaired, and that the condition is invariably a conscious one.
Suggestion in ordinary medicine and in quackery.—Much is lost at the present day through ignorance of what has been done by earlier workers. By means of suggestion, Braid scientifically explained the origin of the phenomena attributed to odylic force, magnets, drugs in sealed tubes, and even the varying powers of the same remedy prescribed sometimes doubtfully, at others confidently. All this was forgotten, and we find the old fallacies cropping up again in experiments at the Salpetrière, Benedikt’s magnets, electropathic belts, “coloured water” prescriptions, and the like.
Telepathy, which Braid investigated with negative results, and for the existence of which I have been unable to find the slightest proof, is now claimed to be at the service of every Christian Scientist, and to form the basis of their “absence treatment.”
Christian Science, the most dangerous of all forms of modern quackery, is not only widely spread throughout America, but is also making rapid progress in this country. The difference between its pretensions and its performances is striking. Thus, on Friday, April 23rd, 1909, Francis J. Fluno, M.D., C.S.D., a Christian Scientist, gave a lecture at the Queen’s Hall, London. Amongst other things, he claimed for Christian Science that it is scientific, for it admits of no error either in premise or conclusion. Further, “because it is science it is demonstrable, and is being demonstrated to every nation of the civilised world. . . . Nothing can stand before it. Christian Science is the eternal truth, whose convincing and converting powers nothing can daunt, and whose onward march no foe can cope with. . . . Christian Scientists are finding more and more that food does not sustain life. . . . Christian Science sounds the tocsin, There is no death.”
On April 24th, 1909, the General Practitioner reported an inquest on the body of a lady who had died of consumption whilst under treatment by Christian Scientists. A doctor had been called in at the last moment, in the hope that he would give a, death certificate, but this was naturally refused. The jury declared: “We are of opinion that had the lady received proper medical advice, instead of trusting to Christian Science treatment, her life might have been considerably prolonged.”
Suggestion ought to be a subject of keen interest to the physiologist, the psychologist, and the medical practitioner. As William James has said: “A comparative study of subconscious states is of the most urgent importance for the comprehension of our nature.” Certainly, at the present day, medical men can neither afford to ignore a legitimate and valuable form of treatment, nor to allow it to fall into the hands of unscrupulous and dangerous quacks.
My newsletter brings you insights, information and practical tools you can use to create more happiness and inner peace in your life. Sign up to the newsletter here.