diagnosis, I sought an interview with this lady and explained my views to her. In plain language I told her that she was holding the arm down by direct though unconscious volition, and that all she had to do was to let go her mental hold on the muscles controlling the movements of the affected shoulder. At first she was a little startled, but I told her to think of it overnight and tell me in the morning if, with the aid of my explanations and the facts of her own and other cases which I related to her, she would not arrive at the same conclusion. She returned the next day, saying that she was convinced that I was right; that she was sure that, through dread of the pain which she anticipated, if she allowed the shoulder-joint to move, she was holding it by main force. She knew and believed all this, but still she had not the power to relax her mental hold on the muscles of the shoulder. To assist her in this I adopted the following plan: I caused her to recline in an easy position, while I stood behind her and took both her hands, the arms bending at the elbows. I made not the least traction on the hands, but simply held them for the purpose of directing and controlling her attention. My requirement was to raise both arms into the upright position, that is, to extend the arms over the head, but not to raise the right, which was free, any faster than she did the left, which she was holding down in close contact with the body. The object was to cause her to give her attention to and absorb her thoughts and interest in the right and unaffected arm, so as to enable her to relax her hold on the left and affected shoulder. The expedient was successful. She did let go her arm, and within a week she had entirely relaxed the muscles about the left shoulder, and regained complete use and control of the previously rigid joint.
I have seen every joint in the body relaxed or stiffened by mental influence, often disastrously so when no aid came to them—sometimes relaxed and stiffened by turns; but I introduce illustrations from cases where these peculiar manifestations have happened at the shoulder, first because they are typical cases, and secondly because I fancy they might be more likely to escape the possible suggestion that, after all, there might have been some organic lesion involved in the cases. We certainly do have the same mental influences complicating organic diseases of the joints. But my object, at this time, is to exclude such cases as can justly be subject to such an imputation. Of course, after once understanding the true condition of things, it is easy to see that the only influence of the respective operations of force brisée, in these cases, was on the patient's mind. In the first case, while she was lying weak and prostrate from the effects of the anæsthetic, she forgot her shoulder and simply let go of it. That was all. In the next operation, three years afterward, on the other shoulder, there was less novelty calculated to engage and keep her attention, and the rupturing of the adhesions which had sprung up in consequence of prolonged loss of motion was sufficient to maintain her interest in the joint, so that her attention failed to be
