There are undoubtedly institutions, many of them not widely known, in which is available skillful, humane, intelligent and successful handling of this disease. From personal observation and experience in institutional work, and from analysis and investigation of many histories, it is my opinion that the results of institutional treatment depend more upon the quality of its medical and nursing staff than upon any other consideration. That the mere fact that addiction-disease is handled in an institution is a very minor consideration in comparison with the intelligence of that handling, is amply attested to in the testimony of the Whitney Hearings and by the experience of many addicts. Unquestionably, unknown and large numbers of narcotic addicts have been relieved of their addiction in reputable sanitaria conducted by skillful and competent medical men. Also unquestionably, large numbers of addicts have been relieved of their addiction through the honest efforts of practitioners of medicine, in private practice. Unfortunately these efforts and their results have received entirely too little recognition. The average physician may be inexpert and not as completely educated in the appreciation, understanding and clinical handling of narcotic drug addiction-disease as he is in other diseases. The common-sense remedy for this situation, however, is not to drive the addict out of his hands, but to make him as competent in that addict’s handling as he is in any other clinical condition. It is only a matter of time and education before the competent practitioner of internal medicine can be brought to a comprehension of and ability to intelligently handle addiction-disease. It is largely a matter of securing general appreciation of and ability to clinically recognize, and interpret physical symptomatology, and to meet the indications of individual disease manifestations. The ultimate solution of the problem of handling the narcotic addict lies largely in the education of medical men, both in institutions and in private practice, and through them securing lay appreciation of disease facts. Any legal or administrative restrictions which drive the care of the honest addict out of the hands of the honest medical man simply postpone the day when this ideal may be consummated.