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The conditions giving rise to hypertrophy are the reverse of those described as producing Atrophy (q.v.). They are concisely stated by Sir James Paget as being chiefly or only three, namely: (1) the increased exercise of a part in its healthy functions; (2) an increased accumulation in the blood of the particular materials which a part appropriates to its nutrition or in secretion; and (3) an increased afiflux of healthy blood.

Illustrations are furnished of the first of these conditions by the high development of muscular tissue under habitual active exercise; of the second in the case of obesity, which is an hypertrophy of the fatty tissues, the elements of which are furnished by the blood; and of the third in the occasional overgrowth of hair in the neighbourhood of parts which are the seat of inflammation. Obviously therefore, in many instances, hypertrophy cannot be regarded as a deviation from health, but rather on the contrary as indicative of a high degree of nutrition and physical power. Even in those cases where it is found associated with disease, it is often produced as a salutary effort of nature to compensate for obstructions or other difficulties which have arisen in the system, and thus to ward off evil consequences. No better example of this can be seen than in the case of certain forms of heart disease, where from defect at some of the natural orifices of that organ the onward flow of the blood is interfered with, and would soon give rise to serious embarrassment to the circulation, were it not that behind the seat of obstruction the heart gradually becomes hypertrophied, and thus acquires greater propelling power to overcome the resistance in front. Again, it has been noticed, in the case of certain double organs such as the kidneys, that when one has been destroyed by disease the other has become hypertrophied to such a degree as enables it to discharge the functions of both.

Hypertrophy may, however, in certain circumstances constitute a disease, as in goitre and elephantiasis (q.v.), and also in the case of certain tumours and growths (such as cutaneous excrescences, fatty tumours, mucous polypi, &c.), which are simply enlargements of normal textures. Hypertrophy does not in all cases involve an increase in bulk; for, just as in atrophy there may be no diminution in the size of the affected organ, so in hypertrophy there may be no increase. This is apt to be the case where certain only of the elements of an organ undergo increase, while the others remain unaffected or are actually atrophied by the pressure of the hypertrophied tissue, as is seen in the disease known as cirrhosis of the liver.

A spurious hypertrophy is observed in the rare disease to which G. B. Duchenne applied the name of pseudo-hypertrophic paralysis. This ailment, which appears to be confined to children, consists essentially of a progressive loss of power accompanied with a remarkable enlargement of certain muscles or groups of muscles, more rarely of the whole muscular system. This increase of bulk is, however, not a true hypertrophy, but rather an excessive development of connective tissue in the substance of the muscles, the proper texture of which tends in consequence to undergo atrophy or degeneration. The appearance presented by a child suffering from this disease is striking. The attitude and gait are remarkably altered, the child standing with shoulders thrown back, small of the back deeply curved inwards, and legs wide apart, while walking is accompanied with a peculiar swinging or rocking movement. The calves of the legs, the buttocks, the muscles of the back, and occasionally other muscles, are seen to be unduly enlarged, and contrast strangely with the general feebleness. The progress of the disease is marked by increasing failure of locomotory power, and ultimately by complete paralysis of the limbs. The malady is little amenable to treatment, and, although often prolonged for years, generally proves fatal before the period of maturity.

HYPNOTISM, a term now in general use as covering all that pertains to the art of inducing the hypnotic state, or hypnosis, and to the study of that state, its conditions, peculiarities and effects. Hypnosis is a condition, allied to normal sleep (Gr. ihrvos), which can be induced in a large majority of normal persons. Its most characteristic and constant symptom is the increased suggestibility of the subject (see SUGGESTION). Other symptoms are very varied and differ widely in different subjects and in the same subject at different times. There can be no doubt that the increased suggestibility and all the other symptoms of hypnosis imply some abnormal condition of the brain of a temporary and harmless nature. It would seem that in all ages and in almost all countries individuals have occasionally fallen into abnormal states of mind more or less closely resembling the hypnotic state, and have thereby excited the superstitious wonder of their fellows. In some cases the state has been deliberately induced, in others it has appeared spontaneously, generally under the influence of some emotional excitement. The most familiar of these allied states is the somnambulism or sleep-walking to which some persons seem to be hereditarily disposed. Of a rather different type are the states of ecstasy into which religious enthusiasts have occasionally fallen and which were especially frequent among the peoples of Europe during the middle ages. While in this condition individuals have appeared to be insensitive to all impressions made on their sense-organs, even to such as would excite acute pain in normal persons, have been capable of maintaining rigid postures for long periods of time, have experienced vivid hallucinations, and have produced, through the power of the imagination, extraordinary organic changes in the body, such as the bloody stigmata on the hands and feet in several Well attested instances. It has been proved in, recent years that effects of all these kinds may be produced by hypnotic suggestion. Different again, but closely paralleled by some subjects in hypnosis, is the state of latah into which a certain proportion of persons of the Malay race are liable to fall. These persons, if their attention is suddenly and forcibly drawn to any other person, will begin to imitate his every action and attitude, and may do so in spite of their best efforts to restrain their imitative movements. Among the half-bred French-Canadians of the forest regions of Canada occur individuals, known as “ jumpers, ” who are liable to fall suddenly into a similar state of abject imitativeness, and the same peculiar behaviour has been observed among some of the remote tribes of Siberia.

The deliberate induction of states identical with, or closely allied to, hypnosis is practised by many barbarous and savage peoples, generally for ceremonial purposes. Thus, certain dervishes of Algiers are said to induce in themselves, by the aid of the sound of drums, monotonous songs and movements, a state in which they are insensitive to pain, and a similar practice of religious devotees is reported from Tibet. Perhaps the most marvellous achievement among well-attested cases of this sort is that of certain yogis of Hindustan; by long training and practice they seem to acquire the power of arresting almost completely all their vital functions. An intense effort of abstraction from the impressions of the outer world, a prolonged nxation of the eyes upon the nose or in some other strained position and a power of greatly slowing the respiration, these seem to be important features of their procedure for the attainment of their abnormal states.

In spite of the Wide distribution in time and space, and the not very infrequent occurrence, of these instances of states identical with or allied to hypnosis, some three centuries of enthusiastic investigation and of bitter controversy were required to establish the occurrence of the hypnotic state among the facts accepted by the world of European science. Scientific interest in them may be traced back at least as far as the end of the 16th century. Paracelsus had founded the “ sympathetic system ” of medicine, according to which the stars and other bodies, especially magnets, influence men by means of a subtle emanation

or fluid that pervades all space. J. B. van Helmont, a distinguished man of science of the latter part of the 16th century, extended this doctrine by teaching that a similar magnetic fluid radiates from men, and that it can be guided by their wills to influence directly the minds and bodies of others. In the middle of the 17th century there appeared in England several persons who claimed to have the power of curing diseases by stroking with the hand. Notable amongst these was Valentine Greatrakes, of Affane, in the county of Waterford, Ireland, who was born in