=In Insanity.--=When it comes to insanity I strongly suspect that those who have the selection of the examining board will have difficulty in finding an alienist who is willing to take the responsibility of deciding on just which insane individuals shall be operated on and which not. For among the insane there are so many kinds and degrees of mental unsoundness, and these are of such varying and as yet unknown eugenical significance, that a positive decision is frequently out of the question. Of the twenty-seven or more recognized forms of insanity who knows with any considerable degree of certainty which are heritable, which not? Shall we treat all manic-depressives alike? Shall we treat them as, for instance, we would those suffering from dementia precox? Who will take the responsibility of answering positively? Again, what shall we do in cases of paresis, or general paralysis of the insane, an affliction which probably invariably has syphilis as its antecedent? Yet it constitutes one of the commonest forms of insanity found in asylums. Doctor George H. Kirby, director of Clinical Psychiatry, Manhattan State Hospital, says that with one exception there are more admissions of paretics to Manhattan State Hospital than sufferers from any other form of mental disorder. He continues, "We find that when either the father or the mother suffers from paresis that many other members of the family may be infected with syphilis, and furthermore, we find that a surprisingly large number of children in these families are feeble-minded, nervous, or in other ways abnormal." But here, it is clear, the patient has done the damage before he reached the hospital, nor was it paresis as such that did the harm but the syphilitic infection of which paresis itself was but the outcome. Certainly the one fact which stands out conspicuously when we face most concrete cases, is that at present we need more urgently than sterilization laws for the insane, exhaustive studies of the inheritability of specific mental infirmities that we may know with some degree of certainty which warrant sterilization. Yet on the other hand one of the most disquieting facts that confronts us to-day is the large number of patients who are on parole from our hospitals for the insane, subject to recall. What shall we do with them? Shall we submit them to the tremendous hardship of still remaining under custodial care although to all intents and purposes sane, or shall we make their release contingent upon their submission to vasectomy or salpingectomy?