BODILY CONDITIONS MENTAL STATES. 43 



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 cooperation 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 enougli to establish control, because it is not the intelligence prin- 

 cipally 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 distin- 

 guished 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 sup- 

 posed 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 char- 

 acter of the affection, and adopted the following plan in order to differ- 

 entiate 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 w r as 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 move- 

 ment 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 up- 

 ward together, coming down together also. After several such move- 

 ments, 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. 



