Before proceeding with the subject of this paper, it is my very great privilege to extend to the distinguished members of the Royal Medico-Psychological Association the cordial greetings of my own Chief of Service, Dr. W. Parsons, the Commissioner of the New York State Department of Mental Hygiene, who has long held in high respect his European acquaintances in the field of psychiatry; in particular, those residing in the British Isles. For purpose of clarity it should be explained that the Department of Mental Hygiene is a branch of the State Government, and the Commissioner is charged with the execution of the laws relating to the custody, care and treatment of the insane, mental defectives and epileptics in all public and private licensed institutions.