without being conscious of it, as he was not conscious of restraining it at and after the second injury.
In this, as in all such cases, accepting by the patient of the opinion that the power exists, is not sufficient to restore the member to use. It is very important to secure the intelligent coöperation of the patient, and instructing him by careful explanations goes far in assisting to arrange the circumstances which tend to restore the normal condition. But simply to know and understand the mental nature of the case is not enough to establish control, because it is not the intelligence principally which is at fault, but there is a modification of what may be called mental timbre, coloring the thoughts and all mental operations, which, in my estimation, is the quality with which we have to deal in this class of phenomena. Dr. Elsberg has used the word timbre to indicate the quality of a compound sound, and I use the word in an analogous manner to indicate a certain quality of the mind as a whole, as distinguished from separate mental attributes. Further illustrations will make this quality of the mind perfectly clear, as well as show that it is through this timbre that the mind makes its potent impressions on the organism.
A young lady was brought to me six years ago for what was supposed to be paralysis of the left lower extremity. She had lost the use of that limb eighteen months before, and, since that time, she had got about entirely on crutches. I immediately recognized the mental character of the affection, and adopted the following plan in order to differentiate between the conscious and the unconscious volitions: After a preliminary examination the day before, I called at her room while she was lying on the bed. Requesting her to remain lying, I engaged her in conversation with the intention of absorbing her entire interest. In this I so far succeeded that when I put my hand below her right foot and began to force it upward, she only remarked that that was the wrong limb, and immediately returned her attention to the story I was telling. When I had pressed it upward enough to bend the knee, I asked her to stretch it down again, which she did, repeating the movement several times without paying any particular attention to what I was doing. After making several pretty vigorous efforts to straighten the limb against some resistance from my hand below the foot, I quietly seized the foot of the affected side, and thus both feet were carried upward together, coming down together also. After several such movements, I began to feel distinct muscular action in the affected member, and, after it had become somewhat vigorous, I quietly let go my hold on the well foot, after which she continued to draw up and push down the affected limb as vigorously as she had just before done with the well one. I was successful in holding her attention to my story, so that she had at most but a dim consciousness, if any at all, of what I was doing. I then recalled her attention to her lower extremities, and requested her to push the left foot down, after I had pushed it up, but she could not make the slightest motion with it.
