In none of the more practical aspects of insanity, with the exception perhaps of that of pathology, does the alienist stand at so much disadvantage with the other members of the medical profession as in the matter of prognosis. In diagnosis we have, as a rule, an easy task, though now and then cases arise in which it requires much thought to come to a determination whether some unhappy event is due to insanity or to crime. Again, in treatment we fairly hold our own, taking into consideration the complex nature of the organs and functions that are affected, coupled with the impossibility of direct examination and treatment of them. But in prognosis we are distinctly less sure of our footing, and it is unfortunate that this uncertainty is accompanied by a most pressing demand for accurate forecasts from the relatives of those who are placed under our charge. This pressure, no doubt, arises in chief from the necessity in nearly every case for modifying, either temporarily or for good, those circumstances, domestic, official, and pecuniary, from which the patient has been removed; but there is this further difficulty, that while in cases of general disease, other than insanity, the friends have some sort of knowledge and opinion of their own as to the probable result, gained from insight into similar cases, in insanity such clinical experience is denied them by the necessity for withdrawing patients from the observation of the public. They are thus almost entirely without guides of their own, and in consequence they come to lean more heavily on the doctor. The strain and responsibility for error thus cast on us would be intolerable were there only the two eventualities of absolute recovery and absolute loss of mind; but, fortunately, there are many stages to fill up the huge gap between these two extremes, stages of partial recovery which allow of the restoration of the patient to various degrees of liberty and usefulness in the world. It is not too much to say that the problem of the future of the patient has to be faced never less often, generally more frequently, than that of treatment.