having special knowledge; he is hopeful of a good result and is prepared to act upon the advice proffered. In a multitude of cases such factors seem to constitute the essentials of the cure, while the subsequent particularity of method is but of secondary importance; and however much analysis may scorn suggestion, and it does so quite ostensibly, it, like other methods, can hardly hope to escape such vitiations of its pure practice. In analysis the patient must necessarily feel a more than ordinary degree of confidence in one to whom, through a species of psychic vivisection undergone by himself, he is prepared to reveal such facts about himself as the penitent reveals only under the safeguards of the seal of confession, and indeed possibly to go further and reveal much more that is revolting and that is not present in consciousness. Such confidence in itself implies a faith which would move mountains and a mental state singularly receptive of suggestion. From deductions based upon their experience some analysts regard an examination as incomplete until and unless a sexual complex has been discovered. This probably accounts, at least in part, for the fact that the time occupied runs sometimes into years, and that even then the results are not wholly illuminating and satisfactory: while it almost certainly does account for an unfortunate persistence of thought along sexual lines which sometimes develops in patients treated by this method. It is, however, in the detailed elaboration of investigation and in the consequent establishment of unsuspected relationships between ideas and trends of thought and action that the undisputed merit of later psychological methods is to be found. Hitherto psychological examination of the normal mind has for the most part been by the subject of the subject, that is, the subject has been artificially objectified by itself; while examination of the abnormal mind has mostly been confined to the conscious superficies. Analysis has made examination both of the normal and of the abnormal a definite study of objective mental phenomena.
Many diseases in general and many functional nervous disorders and mental affections in particular get better or well by a natural process of cure, and it is difficult to distinguish among the antecedents of the process of betterment those which especially have a causal relationship with it. Some such are artificial and have been devised on various grounds,—religious, magical, philosophical and scientific,—for therapeutic purposes; but the essential difficulties in therapeutics are to determine the efficacy of such artificially introduced antecedents and whether the desired result might have been attained without them. Hence the remarkable discrepancies of opinion as to the value of modes of treatment, even when they have been originated and practised by those trained in scientific method and of ample knowledge. The frequent apparent absence of adequate physical factors in the causation of many functional nervous and mental diseases, the dualism which distinguishes between the spheres of action of mind and body, and the apparent potency of the psychic activities of one person directed upon the mental state of another, combine to justify the practice of psychotherapeutics. Nevertheless, even with a proper respect for most recent developments, it is still difficult to be sure as to which is the most successful method, or whether a combination of physico- and psychotherapeutics may not be better than either alone. It is strange to note how exceedingly exclusive the methods of therapy are apt to be. Those who perform miracles or heal by processes such as those of Christian Science claim no technical skill in medical diagnosis or any regard for it, but variation in treatment according to variation in diagnosis or at least according to the various aetiological factors discovered might be expected from the scientifically trained. Nevertheless too frequently the persuasionist, the hypnotist or the analyst apply their methods, much in the way that their precursors of long ago applied their nostra, with entire lack of discrimination. Perhaps lying behind their particular methods there is a common factor, one of personal influence, in which certain outstanding practitioners excel and which the remainder conspicuously lack. That there is such a factor is apparent when an ignorant practitioner is seen to be highly successful and one who is learned to be unsuccessful. In truth, however, the nature of this influence, like so many of the antecedents of improvement in cases of functional nervous and mental disorders, is at present unknown. There must be a very considerable advance before we obtain accurate knowledge of the relative value of the many therapeutic factors that are perhaps concerned. At present treatment is largely haphazard, and improvement is ascribed to the treatment, if any, immediately preceding it; treatment which, maybe, has nothing whatever to do with the improvement that occurs.
Literature.—The most important works on psycho-analysis are four by S. Freud, the most prominent investigator of the subject, translated for English readers by Brill: Collected Papers on Hysteria (1912), The Interpretation of Dreams (1913), The Psychopathology of Everyday Life (1914) and Three Contributions to the Theory of Sex (1918). Brill has given a good account of these in his Psycho-analysis. Jung's deviation from Freud's position is set forth in Collected Papers on Analytical Psychology, edited by Constance E. Long (1917). Dream Psychology by M. Nicoll (1920) expounds an interpretation of dreams of a less sexual character than that given by Freud. P. Janet criticised the methods and findings of psycho-analysis in his report to the 17th International Congress of Medicine (Proceedings of the Congress, Sect. 12, pt. 1, p. 13). This criticism is somewhat elaborated in Janet's Les Médications Psychologiques (1919). On hypnotism the following works are good and ample: J. M. Bramwell, Hypnotism (1913); A. Forel, Hypnotisme (tr. by H. W. Armit 1906); C. Lloyd Tuckey, Treatment by Hypnotism and Suggestion (7th ed. 1921). On persuasion the following may be commended: Paul Dubois, De l'Influence de l'Esprit sur le Corps (Engl. tr. 1910) and L'Education de Soi-même (Eng. tr. 1911); J. Camus and P. Pagniez, Isolement et Psychothérapie (1904); J. Déjerine and E. Gauckler, Psychonévroses (1911). A book from a distinctively Christian point of view is the Spiritual Director and Physician by Rev. V. Raymond, tr. by Dom Aloysius Smith (1914). (E. D. M.)
PUBLIC ASSISTANCE. A marked feature in the social-economic history of the 20th century, and one which became even more marked in its second decade, has been the growth in public expenditure in relief of private wants. “Public Assistance” is of two kinds, direct and indirect. Direct public assistance is the receipt of any benefit in money or in kind at the expense of the rates or taxes which is wholly or partly unpaid for by the recipient. Direct public assistance includes objects like old-age pensions, unemployed benefit, children's meals and medical assistance. Indirect public assistance includes cheap baths and wash-houses, main drainage, cheap railway tickets, sanitary inspection and regulation generally, the control and maintenance of water supply and roads. It is with direct public assistance only that this article deals.
In the form of general doles, public assistance has always exercised a most disastrous influence on the countries where it prevailed. In the ancient world the State was founded on slavery and the citizens were a minority. In Athens the payment of citizens for attendance at the public assemblies and religious ceremonies known as the theoric fund, exercised a corrupting influence on the democracy from the time of Pericles, and Aristotle lays down the general proposition: “Demagogues distribute surplus revenue to the poor. These receive them and are again in want. For such help to the poor is like ‘the cask with holes in it.’ ” The free distribution of corn at Rome had the same results. At first it was sold cheap to the poor in 121 B.C.; then in 58 B.C. it was made free. At first only one-eighth of the citizens took part in the distribution, but within little more than a decade the proportion had increased six-fold, and the number reached 320,000. Cæsar reduced the number to 150,000, but in Augustus' time it rose again, and the rise continued till as Gibbon relates “in the age which preceded the fall of the Republic only 2,000 citizens were possessed of an independent substance.” When the imperial granaries, namely Sicily and Carthage, were lost, the wretched people, by this time quite destitute of self-help and self-reliance, were thrown back upon voluntary charity and the Church.
Great Britain.—In modern times England has been the “classic land” for State-regulated public assistance. The system dates from 1601, the 43rd year of the reign of Elizabeth. During the Middle Ages the poorer classes depended on the feudal chiefs and the Church. As the feudal system decayed the poor fell back on the ecclesiastical foundations, and in the oft-quoted
