In the last number of the Journal of Mental Science Dr Savage discusses this question, and begins by protesting against the acceptance of what is a too widely spread notion – viz., that nearly all insanity is the outcome of direct neurotic inheritance. The influence of heredity is not denied or minimised, but the great importance of environment is insisted upon. To quote the words of the author: “We are what we are in mind and body to a great extent as organic results of our forefathers, but that we are no longer naked savages is some evidence that progress and development in the individual and the race may take place as the result of changing surroundings” There can be no two opinions as to the encouragement to be got from such a view. A too great insistence upon heredity as the determining cause of insanity must land us in a hopeless pessimism as regards treatment, whereas a recognition of the influence of surroundings is the first step towards the construction of a reasonable and efficacious system of therapeutics. The author also cites many examples of hallucinations and delusions which are suggested by surroundings; and whilst all will not be inclined to accept his dictum that disorder of function may lead to disease of tissue, there will be few who will not share his opinion as to the efficacy of restful, pleasant surroundings in the treatment of mental disorder as compared with the virtues of “medicine out of a bottle”.