Fig. 15.
Motor paralysis by means of suggestion forms one of the most interesting and most carefully observed branches of hypnotism. We must first devote a few words to the history of this form of paralysis, of which the discovery is due to clinical science, and not to hypnotism.
It was in 1869 that Russell Reynolds first noted the existence of motor and sensory disturbances, developed under the influence of an idea.* The motor disturbance sometimes consists in spasms, in ataxic or inco-ordinated movements, and more frequently in paralysis which affects the upper limbs. Erb gives to these symptoms the name of imaginative paraplegia.+
The type of this paraplegia is afforded by Reynolds's first observation, which concerned a young woman who was affected by paraplegia under the following circumstances. She lived alone with her father, who had undergone a reverse of fortune, and who became paralytic in consequence of protracted anxiety. She sup-
ported the household by giving lessons, which involved long walks about the town. Influenced by the fatigue caused by so much walking, it occurred to her that she might herself become paralysed and that their situation would then be terrible. Haunted by this idea, she felt a growing weakness in her limbs, and after a while was quite unable to walk. The pathology of the affection was understood by Reynolds, who prescribed a purely moral treatment. He finally convinced his patient that she was able to walk, and in fact she resumed the practice.
Reynolds reports another remarkable case in which, although there was no real want of motor power, there was such a failure of motor co-ordination that walking became impossible. It was a case of this kind which led Charcot to study psychical paralysis, and he applied himself to show that the interpretation given by the English writer was legitimate. On this occasion Charcot again demonstrated the advantage to be derived from hypnotism in the experimental study of the phenomena which are spontaneously displayed, both in health and disease.
If the idea is impressed on a somnambulist that her right arm is paralysed, we see that this limb does in fact lose its motor power, and if the suggestion is made with that intent, the paralysis is maintained on awaking. Charcot has shown that this form of paralysis often displays objective characters which approximate to those of organic paralysis.
Moreover, as Bernheim has observed, many subjects who have been previously hypnotized may, without being hypnotized anew, display in the waking state an
aptitude for the same suggestive phenomena; that is, paralysis by suggestion may be produced in some subjects, sensitive to hypnotism, when in the waking state.* Nor is this all. Bottey has confirmed Bernheim's researches by showing that in the case of some subjects who have never been hypnotized, paralysis may be produced by strongly impressing on them the idea that they are going to be paralyzed.+ We thus come back by experiment to Reynolds's psychical paralysis. Charcot, after repeating these various experiments, has shown that there is no breach between the somnambulist, and the subject liable to suggestion, but only a gradual transition, which enables us to understand psychical paralysis, and which demonstrates its reality. The experimenters of the Salpêtrière have aimed more especially at throwing into relief, according to the experimental method indicated above, the clinical characters of the paralysed limb. It is the more important to recognize these clinical characters, since they serve as a proof of the genuineness of the experiment, and make the nature of this paralysis by an idea in some degree intelligible.
We will now give an account of a case in which one of our subjects was paralysed by suggestion, taking care to insist on the material phenomena of which we have just spoken. The subject was first thrown into a lethargy by ocular pressure, and then into somnambulism by friction of the scalp. She was then told that her right arm was completely paralysed. It was necessary to insist on this assertion in a determined manner, since the
subject offered resistance; she shook her head, moved her arm so as to show that she was able to do so, and replied to the experimenter, "I tell you I am not paralysed." The experimenter rejoined with unwearied repetition, "Your arm is paralysed: it is heavy; you cannot hold it up, it falls slackly to your side." In proportion to the repetition of these words, the subject moved her arm with increasing difficulty. Finally the paralysis was absolute, and the subject was altogether incapable of moving it.
This being the case, we said to her: "This paralysis will continue when you awake." We then awoke her by lightly breathing on her eyes. She was much surprised to find that her arm was paralysed, since her mind had retained no recollection of the suggestion made during somnambulism. She took up the pendent, paralysed arm with the other hand, and placed it on her lap.
It may seem surprising that when subjects awake in this manner to find themselves affected by a serious or revolting complaint, they show hardly any uneasiness. Unless a sensation of pain has also been suggested, they are rarely troubled by their condition, and they seem to be quite easy as to the issue of this affection. But it must be remembered that we have to do with hysterical patients, who endure with the greatest indifference all the sufferings which are the spontaneous result of their disease. For instance, they display no impatience if their limbs remain contracted for months together, and they do not deplore their lot as patients would do who are similarly affected in consequence of some organic lesion. This is a well-known feature, peculiar to hysteria.
When we examine the phenomena which are dis
played by the paralysed limb, we shall first be struck by the complete destruction of motor power. The subject is incapable of performing the slightest movement. When desired to move her arm, she makes futile efforts and ineffectual contortions. It sometimes happens that when attempting to move the paralysed right arm, the subject performs involuntary and unconscious movements with the left arm. Besides being unable to raise the arm, the subject cannot hold it up, when it is raised by the hand of another; as soon as the arm is left to itself, it falls back like an inert mass. Its flaccidity is complete. This motor paralysis is generally accompanied by insensibility of the skin, an insensibility which may be profound, even if the subject was not anaesthetic before the experiment began. The arm may be pricked or pinched with impunity, and without producing the slightest reaction. If this proof is considered insufficient, recourse may be had to electricity, and intense currents may be sent through the paralysed arm without inducing the subject to complain; she remains perfectly passive.
With respect to the distribution of the anaesthesia, Charcot has recently ascertained that in some subjects anaesthesia is exactly coextensive with the paralysed region. If only the shoulder joint and its movement are paralysed, that region alone is affected by insensibility; the arm, the forearm, the wrist and fingers retain their normal sensibility. If the articulation of the shoulder and that of the elbow are paralysed, the anesthesia goes lower, advancing as far as the middle of the forearm; if the wrist is also paralysed, the anaesthesia extends still further, and it finally affects the extremities when the fingers have also been paralysed;
Muscular sensibility is destroyed, as well as the sensibility to touch and to suffering; that is, the subject is unaware of the position occupied by the paralysed limb, and of the passive movements communicated to it. When the subject's eyes are closed, she is incapable of finding the hand of her paralysed arm with her sound hand; in order to do so, she must have recourse to the expedient of feeling for her shoulder, and passing her hand thence all along the arm to its extremity. When not allowed to use this means, the search occupies much time, and may even be indefinitely prolonged by withdrawing the paralysed hand from the sound hand which is seeking for it.
Conversely, if instead of suggesting the loss of motor power, the subject is told that throughout the limb there is a loss of cutaneous and subcutaneous sensibility, that her skin is insensible to contact, to pricks, etc., the association of symptoms produces more or less disorder in the motor functions. In some subjects a complete paralysis is produced; in others the effect is more superficial, and yet still more curious. The subject whose right arm is affected by anaesthesia, is unable, when her eyes are closed, to use this arm; when told to put her right hand on her forehead, she executes the gesture in question with her left hand. Sight is required in order to rectify this confusion between the two hands, and the subject makes no mistake when her eyes are open, and fixed upon the limb. We need not say more of this peculiarity, which is known to pathologists in other connections.
All the foregoing phenomena are purely subjective; there are others which are displayed by external signs.
The paralysed limb is cold, and the sensation of cold experienced by the subject may sometimes be verified by thermometrical observation. The motor signs must also be noted. Motor paralysis is accompanied by an exaggeration of the tendon reflex, which can be demonstrated by a very simple process of investigation. Striking on the tendons at the back of the neck, or of the wrist, suffices to produce shocks in the arm which do not occur in the normal state. This exaggerated reflex action is still more readily displayed in the leg, in which percussion of the patellar ligament produces a considerable shock (Charcot). This character connects paralysis by suggestion with organic paralysis. But, like the spontaneous paralysis of hysteria, paralysis by suggestion may present some variations in its symptomatic forms.
Richer and Gilles de la Tourette performed some interesting experiments with respect to the form of the muscular shock, by means of Marey's graphic method. They ascertained that during the period of paralysis the shock increases, and that it diminishes with the return of voluntary movement. In some cases, in addition to the increase in the height of the shock, they observed the broken and prolonged line of descent, which resembled an imperfect tetanisation. We know that when a contracture is produced during lethargy by the excitement of a nerve branch, or by kneading of the muscles, this lethargic contracture presents the curious property that it is relaxed and completely destroyed, when the excitement is applied to the muscles which are antagonistic to the contractured muscles. The contractures and paralysis produced during somnambulism or in the waking state do not display the same
characteristic. If the subject is thrown into a lethargy, she maintains the contracture or paralysis which is given to her, and the excitement of the antagonist muscles produces no effect on this phenomenon. In order to make it disappear, recourse must be had to suggestion, by which it was produced.
So far, our study has been confined to the paralysed limb, but when a limb is paralysed by suggestion, an interesting fact takes place in the limb on the opposite side; its strength is increased so as to compensate to a certain extent for the paralysis of the other limb. In his normal state one of our subjects was requested to grasp a dynamometer, with the following result: —
With the right hand ... ... ... 39
With the left hand ... ... ... 27
He was then hypnotized, and his right arm was paralysed by suggestion. The pressure of the dynamometer afforded the following results: —
With the right hand ... ... ... ... 0
With the left hand ... ... ... ... 37
This result may be explained by saying that the inhibition effected on the right side by suggestion produced dynamogeny on the left. The simultaneous production of inhibition and of dynamogeny in symmetrical points has been repeatedly noted by Brown-Sequard in his experiments in vivisection. He writes as follows: — "The diminution and augmentation of the power and activity of the nervous system generally, if not always, co-exist. The same excitement of a point in the nervous system which diffuses itself so as to produce the inhibition of a property or activity in certain parts
of the nervous centres, in certain nerves and muscles of one half of the body, also produces dynamogeny in the corresponding parts of the other half. This occurs when the exciting lesion is unilateral. For instance, the division of the sciatic nerves generally increases the excitability of the motor centres of the cerebral surface of the corresponding side, while it diminishes the excitability of the corresponding parts of the opposite side. Analogous, and generally stronger effects are observed after the transverse division of a lateral half of the spinal cord, and especially of the medulla oblongata, or of the pons varolii." *
These phenomena seem to show that the artificial modification; produced in one hemisphere tends to produce a modification in the opposite direction in the other. There must therefore exist between the two hemispheres, or, as it has been said, between the two brains, not only a functional independence, but also, under conditions which are not yet ascertained, a compensating power of supply. It may be remembered that we met with similar facts during our study of hallucinations.
In the foregoing cases we have only spoken of the total paralysis which takes possession of the whole limb. By a different mode of suggestion the paralysis may be restricted to a group of muscles which are habitually associated in one movement. The subject may be told that she is unable to bend one finger. In this ease the paralysis is not total but partial, and it is accompanied by some interesting facts which do not occur in total paralysis, of which the following is an instance.
We suggested to a subject that she would be unable to bend her thumb in a way which was indicated to her. After a moment, when time had been given for effecting the suggested paralysis, we awoke the subject, who remembered nothing and had no suspicion of the paralysis. We desired her to make a great effort to bend her thumb, which she attempted to do, but the converse of what was ordered and intended took place, and instead of bending the thumb towards the palm of the hand, it was forcibly extended. The experiment was carried on by herself, and the thumb was contractured in its extended position J by degrees the index finger lost the power of bending, and this was also the case with the middle and third fingers, which were gradually extended, and slightly contractured in their extension. Thus it appears that when the subject desired to bend her thumb, she could only extend it, and the importance of this species of motor quid proquo is entitled to a passing notice. The experiment may be connected with that of systematic anaesthesia. We have seen that when the vision of a red square has been destroyed by suggestion, the fixed gaze at this square enables the subject to see the green complementary image. In the experiment we are now considering, the paralysis of a group of movements produced, when the subject wished to execute these movements, those which were antagonistic to them. Such a movement may be compared to the after-image, and the same relation may be said to exist between the antagonistic movements as between the complementary colours.
Of this we can cite another proof. It will be remembered that the application of the magnet, as well
as suggestion, produces sensory paralysis, but with characteristic differences. Thus, under the influence of the magnet, the vision of a red cross is changed into the vision of a blank cross on a green ground. Suggestion, on the other hand, when it destroys the conscious vision of a red cross, enables the subject to see a green cross. The motor paralysis produced by the magnet differs in an analogous way from the motor paralysis produced by suggestion. If the subject is told that she can bend her thumb, and the flexion movement is then paralysed by the application of the magnet, it will be seen that the subject is also unable to extend her thumb: she can do nothing with it at all. If, on the contrary, suggestion has paralysed the flexion, the movement of extension is retained. We may say that paralysis by the magnet, which includes the two antagonistic movements, is comparable with the blank cross, in which paralysis of the two complementary colours occurs, and that paralysis by suggestion, which does not affect the antagonistic movement of extension, is comparable with the green cross, which preserves the complementary colour intact.
Secondary Symptoms. Aphasia. — The course of this brief description has enabled us to see that suggestion does not merely produce an isolated symptom in a subject, but a complete disease. It is, indeed, a remarkable fact, that when the suggested symptom is one of a nexus of symptoms, the subject of experiment shows a tendency to display the whole nexus. For instance, we impressed upon one of our hypnotized subjects the idea that when she awoke her right arm would be paralysed. We were much surprised to find that when she awoke, not only her right arm was paralysed, but she was
unable to utter a word. Her intelligence was not affected, and she perfectly understood what was said, but the extremity of her tongue was drawn to the left side, and moved with difficulty. It was impossible for the subject to divine that this coincidence, interesting in more than one particular, could occur. This association is explained by the vicinity of the motor centres of the right arm, and of those for the muscles concerned with the production of articulate speech in the cortex of the left hemisphere of the cerebrum.*
So far we have been only concerned with the flaccid forms of paralysis. Contractured paralysis may be produced by the same process, since it is subject to the same laws as flaccid paralysis, and likewise causes an augmentation of muscular power in the corresponding limb. The special feature of suggested contractures consists in the possibility of impressing upon them the character of systematization which belongs to lethargic contractures. We have already observed that during lethargy the excitement of a nerve produces the contracture of the muscles in connection with it; the excitement of the ulnar nerve, where it passes behind the internal condyle, produces the well-known ulnar contracture. What is effected by mechanical excitement may also be effected by suggestion; when the idea is suggested to the subject of a pressure exerted at a level with her elbow, an ulnar contracture is produced which cannot be distinguished from that of lethargy. This experiment may be varied by describing a small circle on the lethargic subject's forearm, and by pressing the centre of this circle with the finger; a certain number of the muscles become contrac-
tured. The subject is then caused to pass from lethargy into somnambulism, and is told that on awaking she will feel a strong pressure on the centre of the small circle which has been described on her forearm. When she awakes, the subject complains of pain, seated in the spot indicated by the suggestion, and her hand soon becomes contractured, and reproduces precisely the attitude it had assumed during lethargy. This experiment shows that the suggested idea of an excitement, the image of a cutaneous excitement, may produce effects as intense and as precisely localized as an actual excitement.
This does not imply that lethargic contracture is a contracture produced by suggestion. Suggestion and the physical impression constitute two parallel methods, and it would be very illogical to refer the method by excitement to the method by suggestion, because the latter is really derived from the former.
When once produced, paralysis by suggestion may be indefinitely prolonged. We have seen a case in which it was maintained for twenty-four hours, and was unmodified by natural sleep. The attempt to put an end to it provoked more resistance than if the paralysis had been recent, and there can be no doubt that without such intervention, it would have become more intense, and more difficult to cure. The usual mode of destroying physical paralysis is to suggest the opposite idea of motor power; a simple assertion will not suffice, and it is necessary to insist, and to return to the charge, repeatedly telling the subject that she can move the limb if she chooses to do so. Under the exciting influence of this suggestion, the subject attempts to raise the stiffened arm, the power of movement gradually returns to it, and the
nervous circulation is restored, but some of the objective signs of paralysis, such as the exaggeration of the tendon reflex, remain for a little while longer. Another mode of curing motor paralysis is often quicker and more efficacious than suggestion; namely, to represent movement to the subject, either by actually performing such movements before him, or by impressing passive movements on the paralysed limb. The influence of such operations is well shown by the fact that, in the case of a healthy subject, the representation of a movement produced by one of the methods just indicated is calculated to increase the motor power.* It is a still more effectual process to induce the subject to move his sound limb, and then attempt to imitate these movements with the paralysed limb. In this way the subject carries on his motor education, at once by the muscular sense and by the sense of sight.
In concluding this clinical study of paralysis by suggestion, it should be added that the physical characters described above are not absolutely constant, and have not occurred in the subjects of several experiments. But their inconstancy does not affect their value and importance. All the foregoing experiments were performed on typical subjects, that is, on the hystero-epileptic subjects who display all the characters of profound hypnotism. These subjects have the advantage of displaying, with considerable exaggeration, symptoms which are rudimentary or altogether absent in normal subjects. From this point of view it may be said that the subjects of profound hypnotism constitute analytic cases which are eminently adapted for nosographical study.
Systematic paralysis differs from total paralysis in its more complex character. It consists in the loss of special and adapted movements. The subject affected by it does not completely lose the use of his limb, but he is incapable of using it to perform a given act, and that act only. Thus, the subject may be deprived of the power of performing the movements necessary in the action of sewing, drawing, writing, smoking, singing, playing on the piano, etc., while other movements are not affected. The authoritative assertion that the subject will, on awaking, be unable to write will, if repeated often enough, produce, by a mechanism which we do not yet understand, a paralysis of the power of writing, which is termed agraphia.
It is for the experimenter to choose the form which the systematic paralysis is to take; it may be varied indefinitely, just as the form of hallucinations may be indefinitely varied. Suggestion can reproduce all physiological phenomena, and the old magnetizers often took advantage of this fact. They said to their subjects: "You cannot leave the circle I have drawn round you," and the subject remained glued to the spot, in spite of all his efforts to leave the circle. Or: "You cannot pronounce your own name," and the subject vainly opened his mouth, without being able to utter a syllable of his name. Dr. Phillips, who in 1860 held public séances in hypnotism in Paris, on one occasion suggested to a person present, who was called Laverdant, that he would be unable to pronounce or write the two a's in his name.
The subject tried in vain to write his name, and he traced the characters given in the accompanying facsimile (Fig. 15).
At first sight, systematic paralysis appears to have nothing in common with total paralysis. When a subject
Fig. 15.
has received the suggestion that she will on awaking be unable to write, no visible modification occurs in her arm. The paralysis remains in some sense latent, and is only revealed to the subject's consciousness at the decisive moment when she takes up a pen and tries to write. Up to that time her right arm appeared to be as perfectly free as the left, and displayed nothing in common with the flaccidity of total paralysis. Yet these two forms of paralysis only differ in degree. Total paralysis involves the loss of all kinds of movement, extension, flexion, rotation, abduction and adduction, etc., while in systematic paralysis, the loss does not apply to all movements, but only to those which are necessary for the performance of a given act.
To speak more precisely, when the subject is deprived of the power of performing a certain act, all the movements which have to do with that act are paralysed by suggestion. This is the plain fact. Suppose that suggestion has destroyed an act in which the movement of extending the index finger occurs. It may be asked whether the subject, who cannot perform the act as a
whole, is incapable of extending the index in an isolated movement. In other words, is the systematic paralysis a loss of movement, or a loss of the power of co-ordinating certain movements with a view to an act?
Experiment alone can reply to this question. Give to a subject a suggestion of agraphia, and when she awakes, examine her right hand. It is easily ascertained that the power of bending and extending the fingers remains, although these movements are largely employed in the act of writing, so that the individual movement is not lost, but the possibility of co-ordinating these movements so as to accomplish a given act. Another instance throws a still stronger light on this fact. Deprive a hypnotized subject of the power of writing the word not, and she will still be able to write at your request many other words, even those which contain the letters n, o, t, which proves that she has not lost the power of writing each of these letters separately, but only the power of combining them. Systematic paralysis therefore consists in a disturbance of motor co-ordination; it does not affect movements, but the association of movements; it disassociates the movements which were originally associated.
A useful comparison may be made between systematic paralysis and systematic anaesthesia, of which we have given a slight sketch above. There is a correspondence between these two phenomena, since one is in the series of facts of motor power, the other in the series of facts of sensation. There is paralysis in both cases, and in both the paralysis has a systematic character. The total paralysis of a limb corresponds with the total blindness of an eye, and the incapacity to perform a given act, and
that act only, corresponds with the incapacity to perceive a given object, and that object only. We therefore decline to apply to systematic anaesthesia the name of negative hallucination, which appears to us to be singularly inappropriate, since we are not at all concerned with hallucination. To call systematic anaesthesia a negative hallucination is much the same as it would be to call systematic paralysis a negative motor impulse. We must set aside a vicious terminology which only serves to confuse our ideas.
The comparison we have just indicated might be carried further if our space permitted it. We can only point out one conclusion which may be deduced from it; that systematic anaesthesia, since it resembles paralysis, consists in great measure in a disturbance of the co-ordinating faculty.
We return to the study of systematic paralysis after this short digression. One character connects it with total paralysis: it is generally accompanied by a weakening of the motor power. If we turn to the former example, which is the simplest, we find that the subject whom we have caused to be affected by agraphia generally complains that his right hand feels somewhat heavy and inert. These subjective sensations are confirmed by direct examination. If the subject of agraphia is requested to grasp the dynamometer with his right hand, it is generally found that he exerts less than the normal pressure. This slight paresia has been pointed out by Pitres in a minute clinical observation, whence it appears that the artificial agraphia produced by suggestion presents this characteristic in common with spontaneous agraphia.
We have noted a second physical sign, which we also think important. Systematic paralysis, as well as total paralysis, produces a manifestation of dynamogeny in the symmetrical limb. When the right hand is affected by agraphia, the left hand becomes capable of registering on the dynamometer a higher degree than before. The loss on the one side is compensated by a gain on the other. This experiment may be carried further. The systematic paralysis of one limb may not only produce in the other an increase of intensity in the muscular contraction, but also greater accuracy and perfection of movement. When a subject's right hand had been rendered agraphic by suggestion, she was on awaking requested to set down figures with the left hand. She consented, and the figures, which were reversed, as in a mirror, were almost irreproachable as far as the writing was concerned. The figures were all set down with one movement, and continuously, nor did the subject pause to consider. On another occasion we observed this subject's normal writing with the left hand, when the right hand was not agraphic. She then wrote with great difficulty; each figure cost her at least a half-minute's reflection, and moreover the result was somewhat defective.
The agraphia of the right arm consequently increases the co-ordinating power of moving the left arm in writing. This experiment may be explained by saying that, owing to the suggested agraphia, the faculty of writing, acquired by the right hand in consequence of a long apprenticeship, is transferred to the left hand.
These facts will remind the reader of the experiments in transference by the magnet which we have given
above. We saw that when the magnet was applied to a subject who had received the suggestion of writing with the right hand, the impulse was transferred from the right to the left hand; the subject wrote backwards, as in a mirror, with the left hand, and at the same time the right hand became agraphic. The direct suggestion of agraphia produces an analogous result, and this is explained by the fact that, whatever be the nature of the excitement, whether suggestion or the application of the magnet, the brain remains the same, and always re-acts in accordance with the laws which govern it. This reason also explains why Brown-Sequard produced the same effects in dogs and guinea-pigs, by a twofold organic lesion, which are produced in hysterical subjects by transference.
We must in conclusion point out one more characteristic of systematic paralysis, which is also found in total paralysis. The following observation was made by Richer, who was not aware of its importance, although he recorded it with the scrupulous conscientiousness of an observer, and this makes it the more significant.*
"When X— was in the somnambulant state, we told her that she was unable to write.... As soon as she awoke, we requested her to write her name. She took up a pen with eagerness, but it had hardly touched the paper, when she found it impossible to write a stroke, however anxious she was to do so. It was interesting to observe her gestures. At every effort which she made to bend her fingers, they assumed movements of extension.
Her wrist was also extended, and her hand was raised. She tried to keep her right hand resting on the table with the aid of the left hand, but she was unable to restrain and regulate the contradictory movements which ensued from each attempt to write."
As we have already observed, the occurrence of antagonistic movements which accompanies the paralysis of certain movements, seems to us to resemble the production of the complementary colour which is observed in suggested achromatopsia. In both cases the paralysis of one function causes an exaggeration of the other, and it may be said that the same relation exists between the antagonistic movements as between the complementary colours.
When speaking of suggestions of acts, we insisted on the varied forms which the suggestion may assume. Suggestions of paralysis are susceptible of similar variations. Sometimes the subject is simply told that his arm is paralysed; sometimes it is suggested to him that he has forgotten how to move it, or again that he wishes not to move his arm, or the idea of an inability to move it is impressed upon him.
Most observers make use of several of these suggestions at once, cumulatively and without distinction, and it is noteworthy that such different processes afford identical results. From the psychological point of view there is a. wide difference between the subject who does not move his arm because he is unable to do so, and the subject who does not move his arm because he does not wish to do so. But the clinical observation of these two kinds of paralysis shows that they present the same characteristics; it is, therefore, probable that in all these cases
suggestion produces the same modification in the motor centres of the arm, in spite of its diverse forms.
We thus come to the conclusion that paralysis of the motor centre is the fundamental fact. This fact may be interpreted by the agent in different ways, and may be ascribed either to an incapacity to act, or to a determination not to act; but such interpretations are secondary, accessory, superadded phenomena, which do not form an integral part of the occurrence. The whole history of the will is comprised in two words, impulse and paralysis.
It may be asked what are the normal facts which may be compared with psychical paralysis by means of suggestion. Total paralysis, with its complete flaccidity, and its other strongly marked features, does not appear to correspond with anything in normal psychology; but this is not the case with systematic paralysis, since phenomena of inhibition occur in a sound person whenever his will effects an arrest of movement. Heidenhain observes that inhibition takes place when a man lowers his raised arm, and this is also the case when he refrains from the manifestation of violent anger or of fear. Ribot justly regards the will as at once a power of impulse and a power of restraint. As energetic a will is displayed in remaining impassive as in giving free vent to passion.
The action of aesthesiogens on paralysis by suggestion, merits examination. It is a remarkable fact that the transference which takes place in unilateral paralysis only occurs after "a great convulsive discharge in the limb to which the paralysis is transferred, resembling a partial attack of epilepsy. When a bilateral paralysis is subjected to aesthesiogenic action, the corresponding impulse is substituted for it. The follow-
ing example will suffice. When X— was in a state of somnambulism, we suggested to her that she could no longer twirl her thumbs. She resisted the suggestion, saying that she could twirl them, and she did twirl them, but when the suggestion was repeated she stopped short. She was then awakened, and requested to make the movement in question; she tried to cross her hands, and was unable to do so. A small magnet was then placed at the back of her head, on the left side, without her being aware of it. After it had been there a few moments, she crossed her hands and twirled her thumbs. Presently she desisted, saying that she did not know how to do it, then resumed the movement, and continued it for five minutes without interruption, twirling her thumbs now in one direction, now in another. Meanwhile she talked of her friends among the patients, without thinking of what her fingers were about. We have already observed that the inverse effect is obtained by applying magnetic excitement to a subject who has received the suggestion of a motor impulse; in this case the movement is paralysed.
It should also be mentioned that in the case of many subjects a simple peripheral excitement, such as the compression of a limb, produces a similar inversion of the physiological state; the corresponding paralysis is substituted for the impulse, or the impulse for the paralysis. It is therefore probable that the magnet only acts as an unconscious peripheral excitement, of which the efficacy depends on the subject's physical condition.
What we have said of hallucinations, suggestions of acts, the paralysis of the senses, etc., also applies to motor paralysis. These comparatively simple and objective
phenomena should serve as an introduction to the study of those which are more delicate and complex. We think that motor paralysis, the first order of systematic paralysis, naturally leads the observer to the study of the paralysis of the will, which has been termed aboulia. In order to make the meaning of this word intelligible, we may mention one of Bennett's patients, who was thirsty and requested the servant to bring a glass of water. When the glass was presented to her on a tray, the patient could not make up her mind to take it, although she wished to drink and her arm was not paralysed.
One of the present writers * has observed that when aboulia is produced by suggestion, it may become the source of delirious impressions which tend to become general. A subject who has been rendered incapable of seizing a given object will go on to say that it is not worth having, and will reject all the objects which resemble it.
We must now point out the analogy between aboulia and systematic paralysis; these two phenomena cannot be distinguished by any objective character. It can only be said that aboulia is an attenuated form of paralysis, but that it is at its maximum intensity equivalent to paralysis. Suppose that a subject affected by aboulia has at first experienced a certain reluctance to take up a pen and write, and gradually becomes incapable of doing so. At this point, his incapacity cannot be distinguished from a psychical paralysis of the movements employed in writing.
It may also be said that aboulia is a more complex
state than systematic paralysis. To take, again, a case of agraphia, a subject affected by aboulia may be able to write anything except his signature, as was the case with a notary observed by Billod, while a subject affected by normal agraphia is unable to write anything at all. This difference is not, however, opposed to the fact that aboulia consists in a functional paralysis of one order of movements while all others are retained; it is in some sense an agraphia, but of a more systematic kind.
Whether, therefore, we have to do with total paralysis, with systematic paralysis, or with aboulia, the motor disturbance in correspondence with it is fundamentally the same, and we must recognize a cause which is analogous both in its nature and site. The analogy between these three phenomena can be illustrated by experiments in suggestion, performed on hypnotic subjects. We have seen that total paralysis and systematic paralysis produce in some cases an augmentation of force in the opposite limb. This is also the case in aboulia.
Suppose that it is suggested to a subject that he will be unable, however much he wishes it, to open a table drawer with his right hand, in order to take out something which is there; if, after having produced this unilateral aboulia, a dynamometer is placed in the subject's hands, it will be ascertained that the muscular force of the right arm has diminished, while that of the left arm has increased.
We can judge from this example of the value of a method which takes phenomena in a series. Aboulia is a complex pathological fact which cannot be grasped at once, and without preparation; we might as well
begin geometry with the study of curves. Aboulia can only be understood after we have studied the simpler phenomena, which are more easy to observe and analyse. We consider that paralysis by suggestion presents the elementary phenomena which should serve as a basis and introduction to the study of aboulia.
In short, the great psychological conclusion which may be drawn from all the disturbances of motor power, is that these disturbances are directly caused by functional modifications of the motor centres: these are the true causes of motor paralysis, whether total, systematic, or phenomena of aboulia. It may even be said that in a case of total paralysis by suggestion, the effects observed are the same as when a knife has destroyed the motor centre in correspondence with the paralysed limb. The mode in which the subject interprets the motor disturbance by which he is affected is an altogether secondary matter. It is unimportant whether the motive assigned by the subject for his impotence is that he cannot, or that he will not, or again — as it is said by some subjects affected by aboulia — that he is not able to exert his will, or that he does not understand. If these assertions were taken literally, we might be inclined to regard these disturbances of the motor power as distinct phenomena, instead of recognizing the fact that they are included in the same order. When the subject says that he cannot move his limb, we shall see in this inability a simple motor paralysis. When the subject asserts that he really desires and yet is unable to resolve on passing through a door, a lesion of the will may be diagnosed. Finally, when the subject says he has forgotten how to make the movements employed in writing, such agraphia must
be ascribed to a lesion of the motor memory. The logical consequence of this method would be to ignore the fundamental unity of these three motor facts, which are, as we must repeat, only variations of the same state, that of motor paralysis.
Our object in this study of the facts of suggestion is to show the importance of hypnotism as a psychological study. Its importance was advocated many years ago, but the cause of animal magnetism was so much compromised by erroneous methods, that people were afraid of entering upon such questions. After Braid had demonstrated the reality of a nervous state, produced by looking fixedly at a brilliant object, together with the possibility of producing, by verbal suggestion, many psychical phenomena in the hypnotized subject, it might have been supposed that psychologists would at length have begun to study these facts, in which they were so directly interested. This was, however, by no means the case. With the exception of a few isolated attempts, these fruitful studies were for the most part neglected, doubtless from the dread of compromising the inquirer. It is a matter of regret that the English psychologists of the associationist school — Stuart Mill, Bain, and Spencer — who, although not experimenters, strictly so called, yet have always evinced the greatest respect for experiment, never thought of availing themselves of the precious documents contained in the writings of their fellow-countrymen. It is strange that they did not understand that these afforded the finest illustrations of the general law of the association of ideas which justly appeared to them to be so important.
The indifference displayed by psychologists towards
hypnotism was such a well-known and established fact, that it was supposed to have nothing to do with psychology, and in 1871 Mathias Duval expressed the current opinion, when he wrote the remarkable article on hypnotism in which he asked, not without irony,
"Where are the discoveries of hypnotism? Where are its analyses? Where are the results of this new experimental philosophy? "
A revolution has taken place since that epoch. Profound hypnotism, studied with so much precision by Charcot, has triumphed over the general indifference which stifles inquiry. It is now generally admitted that hypnotism constitutes one method of psychological research, which offers the twofold advantage of enlarging and isolating the states of consciousness.
It is the more important to insist on this fact, since we think that hypnotism is adapted to fill up a breach. It is some years since a certain set of writers endeavoured to establish an experimental psychology in France, in opposition to the classic psychology which is still supreme in all the universities. But up to this time we have been unable to note any marked distinction between the new and old schools. In reply to the inquiry into its characteristics, we are told in the first place of a dislike to metaphysics. But this is only a name, and it is hard to say where metaphysics begin, and positive science ends. Again, it has been said that the new psychology is experimental. But in order to be experimental it is_ necessary to perform experiments, and we must ask where these are to be found. They are few in number, and chiefly consist of observations relative to the measure of sensations, the time of reaction, etc. It
seems to us that hypnotism, in association with the clinical observation of mental and nervous diseases, would afford to the new school the method of which it is in search, and would furnish conclusions founded on experiment.