Page:Popular Science Monthly Volume 48.djvu/886

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I SHALL deal in this paper with abnormal states of several types, all of which, in my opinion, may be grouped under the one concept of disordination. The normal consciousness is in all apparently destroyed or displaced, and very often memory of the abnormal states is lacking. Hence we are often compelled to rely upon ambiguous external indications for our knowledge of the patient's condition during the abnormal state, and any attempt to explain it from the psychological point of view is attended with difficulty and open to attack.

In the first place, I must clear away a prolific source of confusion. All the states which I now have occasion to examine are akin to sleep, and many have in addition a superficial resemblance to sleep: the eyes are closed, the countenance is placid, the breathing regular. In others it is less marked: the eyes may be open, fixed, and staring, the body may be rigid and contorted, the face may express intense emotion, movements may occur, and so on. This distinction is purely accidental, and is of no importance from the theoretical point of view. Yet it has become set in our nomenclature, and we can not well get rid of it. For the first group I shall therefore use the generic word "hypnotic," which means simply "sleeplike." The chief characteristics of hypnotic states are: (1) the closed eyes, expressionless face, and relaxed muscles—in general, absence of any spontaneous sign of mental life; (2) the presence of heightened suggestibility. The chief characteristics of the trance states are: (1) spontaneous evidences of mental life, afforded in talking, writing, emotional expression movements of other kinds, or by memory after the state is over (2) the absence of suggestibility. But it is needless to say that many states are found which can not be put into either of these classes.

There are many ways of inducing hypnotic states, but all agree in involving an arrest of the flight of thought, concentration of attention upon one element, restriction of the conscious field. In some very susceptible patients any sudden arrest of attention, such as that produced by an intense and unexpected stimulus, may induce a hypnotic state or some other form of disordination. A sudden flash of light, or the clang of a loud gong, has been known to produce this effect. But generally the concentration of attention must last some time, and it is usually necessary that the patient should voluntarily co-operate with the hypnotizer. One of the easiest methods of getting him to do this is to tell him to go to sleep, for we all, in trying to go to sleep, do precisely what