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”.

The first scientist to confront society with the central role of sex in human development was Freud. His method, the detailed and in depth analysis of the childhood experiences of a handful of upper class Viennese women, may be suspect by today's standard of scientific inquiry. It was, however, the first systematic attempt to study an area of human behaviour which was wrapped in mystery, prejudice and fear. His crucial and most controversial book, Three Essays on the Sexual Theory, was published in 1905 and branded at the time as an obscene book. A disclaimer from the publisher was attached to the English translation of this book which read: “The sale of this book is limited to Members of the Medical, Scholastic, Legal and Clerical professions”. If read together with Freud's earlier book, The Interpretation of Dreams (1899), these two books give the distinct impression that Freud did discover the problem of sexual abuse.