DR. GOODALL, the Medical Superintendent of the Joint Counties Asylum, Carmarthen, draws attention, in his annual report, to the fact that the prevalent view amongst the community at large is that insanity is an incurable state, and that whilst people who have suffered from many bodily diseases - such as gout, rheumatic fever, or disorders of the air passages - will, as a rule, take precautionary measures to avoid a recurrence of the malady, their pessimistic views regarding insanity (and, we may add, the too-frequent idea that insanity is in the nature of a miraculous visitation, unconditioned by the ordinary environment of the sufferers) militate disastrously in many cases against prophylaxis as regards mental relapses. He relates the case of one patient who had had an attack of acute mania and returned to her home from the asylum to nurse four or five young children in scarlet fever, and at the same time had to attend to her ordinary household duties, whilst none too well fed. The result was what might have been foreseen. He describes three other cases from this year's readmissions in which the risk of relapse might and should have been avoided. Now, amongst the better-informed and educated classes of society, the risks of relapse are doubtless reduced to a minimum; but with regard to the insane poor, almost nothing is attempted by way of educating the patients or their guardians as to the conditions likely to bring about these unfortunate results. We remember visiting a private asylum, in North Germany, whose medical director limited the number of his patients to twenty-five. These took up, he said, the whole of his time, as he had not only to study their individual characters and to discover the appropriate treatment of their individual mental or emotional idiosyncrasies, but before their discharge as convalescent he had to visit their homes, to study their mode of family life and to prescribe to the patient's relatives rules to guide them in their conduct towards the returning member of their family. This ideal is of course impossible of attainment in the case of any but small private establishments, but what might be done, in the case of the insane poor, is the formation of charitable societies with branches all over the country, to do all that is possible, by way of publications and otherwise, to enlighten returned patients and their families as to the nature of insanity, and, without anything in the nature of meddlesome interference, by personal visitation and instruction to remedy any bad condition which seems likely to cause a return of the affection in predisposed persons. There are already societies for the after-care of friendless patients; their extension in the new direction indicated would undoubtedly be of immense benefit to both the patients and the general community.