the speech movements through all degrees of stammering and severe impairment. Up to a certain degree, though not often completely, they too yield easily to psychotherapeutic influence. We enter now that region of constitutional disturbances in which psychotherapy is of small help. It leads from epilepsy to the periodic diseases, especially the maniacal depressive insanity, the paranoia which develops late, and finally to states of idiocy which cover the whole life. We are far from claiming that psychical influences are entirely powerless, the more as we insisted that psychotherapy goes much beyond mere suggestions and appeals. No psychiatrist will work without psychological tools when he deals with the exultations of the maniac and the depressions of the melancholic, with the hallucinations of persecution or the erotic insanities of the paranoiac. Still more the whole register of psychology has to be used, when we are to educate the idiot and the imbecile. But the disappearance of the disease or of the chief symptoms through the mental agencies is in all these cases out of the question. Only in incipient cases, especially of melancholia and mania, the psychotherapeutic work seems not entirely hopeless; and for epilepsy some distinct successes cannot be denied. We have reviewed the whole field of psychophysical disturbances, those produced through external conditions in the normal brain and those resulting from abnormal brain constitution. We have seen that the work of the psychotherapist is of very unequal value in different parts of the field; in some, as in neurasthenia, in psychasthenia, in hysteria and similar regions most effective, 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.