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. ὕπνος), 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 fixation 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 February 1628, and who attracted great attention in England by his supposed power of curing the king’s evil, or scrofula. Many of the most distinguished scientific and theological men of the day, such as Robert Boyle and R. Cudworth, witnessed and attested the cures supposed to be effected by Greatrakes, and thousands of sufferers crowded to him from all parts of the kingdom. About the middle of the 18th century John Joseph Gassner, a Roman Catholic priest in Swabia, took up the notion that the majority of diseases arose from demoniacal possession, and could only be cured by exorcism. His method was undoubtedly similar to that afterwards followed by Mesmer and others, and he had an extraordinary influence over the nervous systems of his patients. Gassner, however, believed his power to be altogether supernatural.
But it was not until the latter part of the 18th century that the doctrine of a magnetic fluid excited great popular interest and became the subject of fierce controversy in the scientific world. F. A. Mesmer (q.v.), a physician of Vienna, was largely instrumental in bringing the doctrine into prominence. He developed it by postulating a specialized variety of magnetic fluid which he called animal magnetism; and he claimed to be able to cure many diseases by means of this animal magnetism, teaching, also, that it may be imparted to and stored up in inert objects, which are thereby rendered potent to cure disease.
It would seem that Mesmer himself was not acquainted with the artificial somnambulism which for nearly a century was called mesmeric or magnetic sleep, and which is now familiar as hypnosis of a well-marked degree. It was observed and described about the year 1780 by the marquis de Puységur, a disciple of Mesmer, who showed that, while subjects were in this state, not only could some of their diseases be cured, but also their movements could be controlled by the “magnetizer,” and that they usually remembered nothing of the events of the period of sleep when restored to normal consciousness. These are three of the most important features of hypnosis, and the modern study of hypnotism may therefore be said to have been initiated at this date by Puységur. For, though it is probable that this state had often been induced by the earlier magnetists, they had not recognized that the peculiar behaviour of their patients resulted from their being plunged into this artificial sleep, but had attributed all the symptoms they observed to the direct physical action of external agents upon the patients.
The success of Mesmer and his disciples, especially great in the fashionable world, led to the appointment in Paris of a royal commission for the investigation of their claims. The commission, which included men of great eminence, notably A. L. Lavoisier and Benjamin Franklin, reported in the year 1784 that it could not accept the evidence for the existence of the magnetic fluid; but it did not express an opinion as to the reality of the cures said to be effected by its means, nor as to the nature of the magnetic sleep. This report and the social upheavals of the following years seem to have abolished the public interest in “animal magnetism” for the space of one generation; after which Alexandre Bertrand, a Parisian physician, revived it by his acute investigations and interpretations of the phenomena. Bertrand was the first to give an explanation of the facts of the kind that is now generally accepted. He exhibited the affinity of the “magnetic sleep” to ordinary somnambulism, and he taught that the peculiar effects are to be regarded as due to the suggestions of the operator working themselves out in the mind and body of the “magnetized” subject, i.e. he regarded the influence of the magnetizer as exerted in the first instance on the mind of the subject and only indirectly through the mind upon the body. Shortly after this revival of public interest, namely in the year 1831, a committee of the Academy of Medicine of Paris reported favourably upon “magnetism” as a therapeutic agency, and before many years had elapsed it was extensively practised by the physicians of all European countries, with few exceptions, of which England was the most notable. Most of the practitioners of this period adhered to the doctrine of the magnetic fluid emanating from the operator to his patient, and the acceptance of this doctrine was commonly combined with belief in phrenology, astrology and the influence of metals and magnets, externally applied, in curing disease and in producing a variety of strange sensations and other affections of the mind. These beliefs, claiming to rest upon carefully observed facts, were given a new elaboration and a more imposing claim to be scientifically established by the doctrine of odylic force propounded by Baron Karl von Reichenbach. In this mass of ill-based assertion and belief the valuable truths of “animal magnetism” and the psychological explanations of them given by Bertrand were swamped and well-nigh lost sight of. For it was this seemingly inseparable association between the facts of hypnotism and these bizarre practices and baseless beliefs that blinded the larger and more sober part of the scientific world, and led them persistently to assert that all this group of alleged phenomena was a mass of quackery, fraud and superstition. And the fact that magnetism was practised for pecuniary gain, often in a shameless manner, by exponents who claimed to cure by its means every conceivable ill, rendered this attitude on the part of the medical profession inevitable and perhaps excusable, though not justifiable. It was owing to this baleful association that John Elliotson, one of the leading London physicians of that time, who became an ardent advocate of “magnetism” and who founded and edited the Zoist in the interests of the subject, was driven out of the profession. This association may perhaps be held, also, to excuse the hostile attitude of the medical profession towards James Esdaile, a surgeon, who, practising in a government hospital in Calcutta among the natives of India, performed many major operations, such as the amputation of limbs, painlessly and with the most excellent results by aid of the “magnetic” sleep. For both Elliotson and Esdaile, though honourable practitioners, accepted the doctrine of the “magnetic” fluid and many of the erroneous beliefs that commonly were bound up with it.
In 1841 James Braid, a surgeon of Manchester, rediscovered independently Bertrand’s physiological and psychological explanations of the facts, carried them further, and placed “hypnotism,” as he named the study, on a sound basis. Braid showed that subjects in “magnetic” sleep, far from being in a profoundly insensitive condition, are often abnormally susceptible to impressions on the senses, and showed that many of the peculiarities of their behaviour were due to suggestions, made verbally or otherwise, but unintentionally, by the operator or by onlookers.