in others like paresis or paranoia
reduced to an almost insignificant factor. Where it can help and where
not we recognize as a mere question of experience. Certainly the
severity of the symptoms alone does not decide it. As the treatment is
entirely empirical, no one can foresee whether or not the situation may
change to-morrow. We may find psychotherapeutic schemes by which
epilepsy or maniacal depressive insanity or traumatic neuroses may
become accessible. We simply do not know why we may remove stammering or
synthesize a dissociated personality or overcome an inborn sexual
perversity, while we are unable to remove the depression of the
melancholic. Certainly the symptoms of the circulatory insanity
disappear completely in the free intervals; there is no reason to give
up hope that psychotherapy might find the way to hasten the appearance
of such a normal period.

But we have emphasized from the start that the psychotherapeutic work
has not only to set in when the disturbance itself lies in the
psychophysical system. We may utilize the influence which the
mind-brain system has for the whole body and thus may apply the
psychical tool to work on the disturbances in the bodily apparatus. We
may discriminate a direct and an indirect influence in the psychical
treatment of bodily diseases. Transition from the foregoing group of
psychical disturbances offers itself perhaps most easily through the
state of insomnia.

The causes of sleeplessness may still lie in the psychophysical sphere;
restless thoughts may inhibit the idea of sleep. The effect of sleep is
again in the sphere of the mind, the annihilation of conscious contents.
But the center which regulates and creates the sleep, probably by
contracting the blood-vessels, lies outside of the psychophysical system
in the lower centers of the brain. The real disturbance thus lies in the
inactivity of this purely bodily apparatus and mental influence which is
to create sleep has therefore to work downwards from the mind to a
bodily organ. In the same way many other non-psychical centers of the
brain may be brought to efficiency through psychophysical regulation.

But the therapeutic effect is certainly not confined to the central
nervous system. Whithersoever the centrifugal nerves lead there the
mind-brain system may have its curative influence. In the most startling
way that is true for the digestive apparatus. The secretions of the
stomach, the activity of the intes