hich shows at least
the maximum distance treatment by mail, from Boston to Seattle. This
particular case presented no difficulty in getting hold of the starting
point as my correspondent, whom I have never seen, himself at once
pointed to the original source of his obsessing idea.

The patient who lived with his family in Seattle wrote to me the
following: "----I shall undertake to describe in a few words a
condition which the writer has fought against for about eight years
and which has subjected him to untold mental anguish.----I was
backward in a social way but altogether happy. After working in a
bank about a year, was discovered one evening by the cashier
smoking a cigar in the basement, was unable to look him in the face
at the time. Went home that night and thought very little about it,
but on the following morning during the regular course of business,
I stepped up to him to ask some question, and as usual,
unconsciously looked him in the face. His glance was questioning
and suspicious, and that was the beginning of a life of anguish for
me. At first I could not look him in the eyes, then when looking at
some other person, I happened to think of it and so on, until in
two or three days it was impossible to look at anyone who came to
my window. The cashier did everything he could for me. No use: I
quit my position, lost most of my friends, had to leave a happy
home and came to Seattle to work for an old school friend. In the
first year, owing to new environments, I managed to conceal my
mental condition to a certain degree. All of a sudden, I was again
plunged into the depths of black despair. It took me about two
years to (partially) forget it, when the same thing occurred again,
and I lost my grip. The last time about eighteen months ago was
almost more than I could stand. These three or four instances I
speak of were cases of extreme despondency, but my usual mental
condition is extremely unhappy. If occasions arise where I have to
sit and talk to anyone for ten minutes, controlling myself is such
an effort that it leaves me with a case of the blues.... I shall
come and see you as the relief would give me a new lease on life."

This letter was written on the twenty-third of January, 1908. I
replied to him at once that he certainly ought not to come from the