dazing it and reducing it to extreme impressionability. Then follow the suggestions. Verbal from the hypnotist, to the hypnotized victim of the casualty they come from the circumstances of the accident, or what follows it, or from the victim's mind itself, as it reflects on injuries he has seen or heard of resulting from similar disasters. Thus is determined the symptomatic type. Little by little the symptoms spread and deepen—they rarely reach their full development at once—until at last, the patient, sound in wind and limb, may become as inert a mass as ever wheel-chair carried.
As important as the accident itself, or even more so, are the circumstances which follow it. Injudicious sympathy from friends, fears felt by physicians not wise enough to keep them to themselves, the solicitous exaggeration by attorneys and the patient's perception of the financial possibilities of his wrongs, all give new tentacles to the morbid ideas, which burrow deeper among the roots of rational conduct. Left to a physician versed in psychic medicine and rich of conscience, with damage claim thrown out the window, there are few cases of traumatic hysteria, taken at the outset, which a month of vigorous treatment would not cure. But, with the demands of legal procedure ever imminent, such a course is never possible. In Germany and other countries which maintain parental protection of the injured, conditions are even more unfavorable. In these countries, the injured workman is placed on an allowance of money, graded in accordance with his earning, which continues to be paid as long as he is incapacitated. This robs the patient of his spur to effort and tends to prolong the mental instability. As a result, in these countries, or at least in Germany, traumatic hysteria is more protracted and rebellious than it is with us. With us, sooner or later, the case is finished. It may be years before the final card is played; but some day the game is over and the hands are on the table. And then, for the first time since the accident, the injured person has a chance to regain his health. Before there was no chance. For, with the persistence of symptom-inducing suggestions, inseparable from litigation, it is practically unheard of, if not impossible, for a plaintiff to improve in any essential particular before the release is signed or the court-room doors have closed upon him for the last time. This helps to make hysteria the most difficult disease of any found at law of satisfactory settlement out of court.
At the outset, the surgeon for the company, thinking the case is one of temporary shock, reports favorably and the claim agent makes offers of small sums. These are rejected; the plaintiff's physician has seen such symptoms aggravate with time. The attorney feels a conscientious duty toward his client and must know the way things are going before settlement is thought of. While they all thus solicitously wait, the gloomiest fears are realized. Paralysis sets in. By this time the dangerous character of the case dawns on the defendant. Head sur-
