These unfortunate suicides are happening every day. They are the saddest possible blow to a family. Only the most careful watchfulness will prevent their occurrence. Clergymen should add the weight of their authority to that of the medical attendant in insisting, when such patients are kept at home, that they shall be guarded every moment. As a rule melancholic patients should be treated in an institution. Their chances of ultimate complete recovery, and, more important still, of speedier recovery than at home are much better under the routine of institution life and the care of trained attendants. Nearly three-fourths of the patients who suffer from melancholia will recover from a first attack under proper care. Subsequent attacks make the prognosis much more unfavourable. Not more than one-half will recover from a second attack, and, although melancholia is often spoken of as a mild form of intellectual disturbance, recurring attacks give a proportionately worse and worse outlook for the patient. If the general condition of the patient, that is, the physical health, is very much run down when the mental disturbance commences, then the outlook is much better than if the mental disturbance should occur when the patient is enjoying ordinarily good health. Thin, anaemic patients, contrary to what might be expected, usually recover and often their recovery is permanent. The first favourable sign in the case is an improvement in physical health. This is very shortly followed by an almost corresponding improvement in the mental condition. When the patient has reached the normal physical condition, the mental disturbance has usually disappeared. It is an extremely unfavourable sign, however, to have run-down patients gradually improve in physical health {221} without commensurate improvement in their mental condition. This is nearly always a positive index that the mental disturbance will continue for a long while, may not be recovered from completely, or may degenerate into a condition of dementia with more or less complete loss of mental faculties.