The author during a long tropical service has seen a distressing number of cases of tropical neurasthenia including a number that ended in suicide. The condition is common in Malaya of which he is writing. In a group of rubber plantations with an average staff of 75 (presumably Europeans) in the past two years, one has committed suicide, eight have been repatriated for nervous breakdown, and two have been sent on home leave for the same reason. In a series of 33 invalidings analysed by SQUIRES [no reference given] 45 per cent. [15] were for psychological reasons. Neurasthenia in the tropics differs from that seen in practice in temperate countries by the predominance of cerebral over spinal symptoms. The mild cases show increased irritability with occasional outbursts of uncon rolled rages, restlessness, and moderate amnesia. In the intermediate cases these symptoms are worse and periods of worry and depression occur, often amounting to delusions of persecution with insomnia. In the severe cases, the depression is predominant; to this is added procrastination and indecision, loss of confidence, fear of insanity and of loss of employment, which constitute a vicious cycle that may end in suicide. The author classes the causes as personal and environmental, the former being the more important; the prominence of the personal factor is due to the tendency for social misfits and others who are dissatisfied with home conditions to seek employment in the tropics where they hope to find life easier. The environmental factors are (i) Exile from one's own country and loss of firm roots in a place that one calls home, (ii) The excessive stimuli of the tropics; under this heading the author includes the direct effects of the climate and discusses the sexual factor, (iii) Overwork and excessive responsibility, (iv) Isolation and monotony; under this last heading [the sequence of thought is obscure to the reviewer] he includes a suggestion that the recent increased rate of breakdown in Malaya may be due to years of war strain and present economic and political difficulties. The preventive measures he advocates include more careful selection of candidates for service in the tropics and the suggestion that a psychiatric assessment as well as a physical examination should be made; more frequent home leave; annual local leave to a hill station; shorter office hours; more security of tenure of appointments in commercial undertakings; and freedom to marry early in his service. Finally, the author suggests that, since this problem is an admittedly serious one, the Malayan branch of the British Medical Association should make a study of its aetiology and prevention, and convey their conclusions to the Government and to commercial and industrial associations. L. E. Napier.