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This is a new edition of the lectures given by the author at Harvard Medical School in 1906. The lectures are reprinted, but the author in a very interesting introduction to this second edition discusses the development in his thought touching hysteria since that time.
The author refers to his previous works in which he emphasized the importance of fixed ideas in hysteria; the symptoms are but an expression of a conviction that the patient has in his mind, or to put it in the words of Bernheim “the hysteric patient realizes her accident as she conceives it.” This view has much to commend it, as too has the later and more developed aspect of this theory which goes under the name of pithiatism. Pithiatism distinctly attributes the symyptoms to suggestion. Janet, however, very properly points out that this is an incomplete and inadequate explanation, as the normal mind does not react to suggestion as does the hysteric. He makes a similar criticism, and with as much justness, of the theory that the “driving back” of the idea is sufficient to account for the symptoms. Such a theory does not take into account the fact that the normal mind does not develop hysterical symptoms solely because of disagreeable ideas.
Janet reverts to his theory, which he has frequently expressed elsewhere, of the hierarchy of the mental functions, in which, following the analogy of fatigue, the higher functions are exhausted and the lower type are then free to manifest themselves. Janet sees in reflection the evidence of the activity of the higher functions, and in the absence of reflection the indication of their exhaustion and the sign of the activity of the lower functions, which the reviewer takes is but another way of saying that reflex and automatic acts are not accompanied by consciousness or at least not a highly organized consciousness, whereas acts which involve judgment, choice, and where there are many motives engaged result in that delay between preception and action which is filled