What asylum physician is there, who, in prescribing drugs for his patients, has any approach to a feeling of certainty that these drugs will have the effect he anticipates? I refer more particularly to sedative drugs. Is there any such physician who will lay down a rule by which it may be known whether opium, hyoscyamus, Indian hemp, or bromide of potassium is the best medicine to be given in a particular case? We have the statements of individual authors in regard to the right mode of giving some of these drugs, but after all those are merely opinions founded on most limited observations, and lack the exactitude of research, and the numerical basis on which alone scientific truth is founded. It is no wonder that many of our specialty are sceptics in regard to medical treatment in insanity, when we generally find that the advocates of particular medicines, or of special modes of administering them, merely give us “selected” cases. To anyone who has read something of the history of medicine, it seems a mere waste of words to advocate any new treatment of a disease, except it is clearly shown that the spirit of fairness and scientific impartiality has regulated the observations on which the would-be conclusions are founded. And as for discussing and quarrelling over the general question of the good effects of medical treatment versus moral treatment, surely the energy and acuteness so expended would be employed to far more purpose in observing and recording facts, so that we might have something certain on which to base an argument on the one side or the other. And by observing facts, I do not mean vaguely noticing the course of certain random cases subjected to unsystematic and desultory treatment, and accepting the confused impression of the result left on the mind as scientific truth, on which an argument may be founded or a boon to humanity conferred. It is surely possible for the physicians of asylums to combine their opportunities for observing the treatment of disease in one vast and systematic effort, all working on the same plans, and all adopting the same conditions. What accuracy might we not acquire in our notions as to the effects of morphia given in melancholia, if the drug was tried in the case of every melancholic patient in all our asylums for a year, and an accurate record of the results drawn up? The idea may seem in many respects chimerical and absurd, but it seems questionable if much accuracy in therapeutics will ever be attained until something of the kind is done. There is no single man who has opportunity sufficient to solve such a problem, except by careful experiments extending over years, and we know how difficult it is for a physician to continue careful experiments over long periods. And surely this exact, scientific, and statistical age will not allow the present state of utter doubt to continue much longer without making at least an effort to dispel it. We require to know the full and true result of giving drugs in every case, and not merely in a few favourable cases which may be natural recoveries.