When the Act came into force there were no State Institutions, and the accommodation in Certified Institutions was totally inadequate to meet the needs of the situation. A State Institution was secured towards the end of 1914, but was almost immediately handed over to the War Office. Little, or nothing, could be done in the way of provision of further accommodation, State or otherwise, during the continuance of the Great War, and, as a result, very few criminal defectives could be dealt with. Since the termination of hostilities, a State Institution for male and female defectives has been established, and further institutional accommodation provided, and it is hoped that in the near future full provision will be made for dealing with all defectives, guilty of criminal offences, who are certifiable under the Act. From 1st April 1914 to 31st March 1919, 871 cases were certified under the Act, the total receptions into local prisons for this period being 376,000, _i.e._, 2·3 per 1,000 receptions. The prisoners certified in prison do not comprise the whole number of cases of criminal defectives dealt with, as Courts have power under the Act to send such defectives direct to Institutions, instead of to prison, and, as the working of the Act becomes more stabilised, advantage is taken of this power to an increasing extent. But even so, there is a considerable discrepancy between the defectives dealt with under the Act and the official ante-Act estimate, which was considerably greater, and this is mainly due to the strict requirement of the Act that the defect must have existed from birth or from early age. Here at once a large number of prisoners regarded as mentally defective, forming 30 per cent. of the whole, were excluded from the operation of the Act owing to the fact that the mental defect from which they were suffering, _e.g._, senility, alcoholism, arose from causes operating later in life. Again, of the number of prisoners whose mental defect was regarded as of congenital origin, 77 per cent. were over 25 years of age, thus making it difficult to obtain proof of the existence of the defect from early age, without which a certificate cannot be given. But the Mental Deficiency Act, limited as it is in its scope, and disappointing in its results, is a pioneer piece of legislation of considerable importance. Many Voluntary Associations and other bodies in this country interested in its administration are advocating an extension of its provisions, and I think we can anticipate with every confidence the time, to which the prison reformer has so long looked forward, when those unhappy persons, who through mental affliction drift inevitably into criminal courses, are removed from prison surroundings to the more appropriate atmosphere of institutions where they can remain under proper care and control.