Undoubtedly,  cure  would  be  possible  in  the  majority  of
these  cases  in  the  psychic  way  alone.  A  case  recently  pub-
lished by  Grasset  is  typical  in  this  connection.  It  concerns  a
traumatic  hysteroneurasthenic  cured  in  a  single  day  because
he  had  dreamed  the  night  before  that  he  was  cured!

But  as  the  question  here  concerns  the  mentality  of  the
subject,  it  is  impossible  always  to  give  rise  to  this  conviction
of  cure  and  to  develop  it.  The  patient,  in  a  lawsuit  with  his
employers,  is  not  in  a  state  of  mind  that  is  favorable  to  this
kind  suggestion;  he  is  defiant,  and  the  difficulties  over  which
he  is  arguing  often  contribute  through  the  course  of  years  to
aggravate  his  mental  condition.
Thus  one  sees  the  hysterical  manifestation  hanging  on  for-
ever, and  resulting  finally  in  a  permanency  which  seems  to
indicate  organic  changes,  or  the  trouble  proceeds  toward  a
confirmed  psychosis.
The  unfavorable  prognosis  of  these  traumatic  psychoneu-
roses  may  perhaps  also  be  due  to  the  fact  that  they  are  born
under  the  influence  of  a  violent  emotion  in  people  who  were
formerly  normal.  The  provoking  agent  acts  with  sufficient
power,  as  there  may  be  no  reason  to  admit  a  very  marked
predisposition  or  a  latent  condition  of  hysteria.  The  moral
"  fracture  "  is  made  abruptly,  and  it  is  with  all  sincerity  that
the  patient  believes  that  he  recognizes  in  the  accident — that
is  to  say,  in  an  influence  which  seems  purely  physical — the  sole
cause  of  his  diseased  condition.  He  is  not  at  all  disposed  to


OF  NERVOUS   DISORDERS         359

accept  advice  from  the  moral  standpoint  and  to  aid  the  phy-
sician in  his  attempts  at  psychic  treatment.
