The responsibility of the hospital for the future of the patient begins with his arrival at the institution and the ultimate outcome of the case often depends entirely upon the developments of the first few weeks of his residence in the wards. A complete understanding of the patient's mental condition, the prospects of an ultimate recovery and the line of treatment to be followed can only be determined by a thorough and accurate examination on admission. This constitutes the basis for all further procedure. If satisfactory results are to be obtained this task should be delegated to a medical officer who has had an extended psychiatric experience. For purposes of completeness, as well as uniformity, a definite plan should be followed. The form used in writing the initial history and in recording the results of the routine mental and physical examinations at the Boston State Hospital are described in full in the "Medical Staff Manual" which is furnished to all assistant physicians entering the service. This has been found to be of great assistance in the training of new men along proper lines and insures a uniformity of hospital records which is indispensable. In a general way the form of examination employed by Meyer and Kirby[31] for some years has been followed. As this scheme is fairly representative of the method of procedure used by hospitals for mental diseases throughout the country it has been thought worth while to reproduce it in full. HISTORY _Name of Physician_: _Date_: _Name of Informant, Address, Relation to Patient_: It is often desirable to make a note on the intelligence and apparent reliability of the informant. _Residence and Citizenship of Patient_: Birthplace? Date of birth? Time in Massachusetts? If foreign born, date of arrival in U. S.? Naturalized or alien? _Family History_: It is not sufficient to ask simply the general question: Has any member of the family been insane or nervous? A great many persons will answer in the negative, whereas a detailed inquiry will often bring out a number of instances of nervous or mental troubles. Specific inquiry must be made concerning the persons of the direct ancestral lines as follows: (a) Paternal grandparents—nervous or mental disease? (b) Maternal grandparents—nervous or mental disease? (c) Father: Age, nervous or mental disease, alcoholism? If dead, age at death and cause of death? (d) Mother: Age, nervous or mental disease, alcoholism? If dead, age at death and cause of death? (e) Number of children in family (brothers and sisters of patient). Nervous or mental trouble in any of these besides patient? Psychopathic personality, alcoholism, criminality, etc.? (f) Collateral branches: mention any known cases of insanity or nervous diseases in uncles, aunts or cousins. PERSONAL HISTORY OF PATIENT 1. _Early Development_: