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number of the American J01brnal of Medical Soienoes byWilson and MacCarty gives very definite facts supportingthis view. All the specimens of stomach disease removed bythe brothers Mayo for some years past were subjected tothorough pathological investigation. Of these 153 wereundoubted carcinoma, and out of this number 109 (71 percent.) showed definite evidence of previous ulcer. Therewere in addition 5 cases of ulcer presenting early doubtfulmalignancy and 11 cases of cancer with doubtful evidence ofpreceding ulcer. These statements are made very convincingby the large number of illustrations which accompany them,and they fully bear out the modern surgical view that cancerof the stomach is the result of chronic ulceration in the greatmaioritv of cases.-I am. Sir. vours faithfullv.

ERNEST W. HEY GROVES.University of Bristol, Feb. 21st, 1910. ITHE CONTROL OF INFECTIOUS DISEASES

IN ISOLATION HOSPITALS.To the Editor of THE LANCET.

SIR,-While thanking you for your very fair and impartialcriticism of my paper on the control of scarlet fever, may Ibeg space to mention what I did not perhaps make quiteclear-namely, that the method described grew simply out ofan attempt to make the best of the conditions which notinfrequently arise in growing districts when the populationincreases more rapidly than the hospital accommodation ? ‘!

I am, Sir, yours faithfully,Mortlake, S.W., Feb. 18th, 1910. F. G. CROOKSHANK.

THE PSYCHOLOGY OF POLITICS.To the Editor of THE LANCET.

SIR,-As the science of medicine expands it comes toembrace the psychological aspect of human events in theirnormal and abnormal varieties. The mental sides of thoughtand action become, as Munsterberg shows, a recognition ofthe "causal" and "purposive" ways of looking on the

standpoint from which man is to be considered. The balanceof opinion is determined partly by arguments applied to theone side or the other, but there are basic mental trends ortemperaments which so affect an adjustment of the scalesthat it becomes a medical duty to examine the conditions ofthe psychological causes at work without the least bias onone side or the other. And that this is a medical questionarises from the fact that sanitation, eugenics, overcrowding,feeding problems, &c., have an influence on the tempera-ment, whilst the consideration of these influences must helpus to arrive at a proper estimate of things as they are,preparatory to undertaking measures which may alter theessential nature of mental states often too hastily criticisedbecause they are not understood.What makes a man a Tory or a Liberal ? Many will

think that it is merely a question of environment. They saythat a man is Tory because Toryism is his family creed ;there is a causal connexion between the two, just as anotherman is Liberal because Liberalism is the tradition of hisstock. But there is more in it than explanation by heredity.Many a man "rats" in turn from one party to theother, and this he may do from conviction that the old linesare too narrow and cramped or that they are too faradvanced and destructive. These are the fluctuatingmembers who cause much trouble and heart-burning inthe constituencies. Young men are notably inclined to

Liberalism; it suits their self-esteem, their pulsatingegotism, their urging to be free from the slow methodsof old-fogeyism ; it seems to offer a life more fullof possibilities with greater hope of realisation ; andat this period of growth and impulsive enthusiasm it

appears to offer the attractions which, though theydimly discern, they eagerly anticipate. What makesLiberalism so attractive to the young is that it connotes dis-content with the existing order of things, finding its bestexposition in the topsy-turvydom so agreeable to theexpectant and dissatisfied mind, a condition often seen inthe younger sons of high families, whom the accident ofbirth has placed at a disadvantage. It matters not thatthe tenets of the two great sections are changed in

"content" ; as long as they are opposed he is on the side

which by its undefined promises coincides with the limitlesshorizon of his own aspirations. Beyond and beside all thisthere is yet some trend which-supposing that the opposingfactions are clear and breed true to their tenets and proposi-tions-influences a man to ally himself to one side or theother, and that trend, we venture to think, works throughwhat is known as Temperament, the source of many of themost striking mental differences between individuals andraces. Temperament is a complex result determined partlyby the influence of the bodily organs upon the mentalprocess and partly by general functional peculiarities ofthe nervous system, and is not only born in the man butis little alterable by any effort he may make, differing in thisrespect from Character, which is largely made by his ownefforts.How is it that Scotland and Wales are Liberal, and

probably always will be ? The Scotch temperament is

phlegmatic ; the people pride themselves on being dour,"they call themselves " independent," and think that they areas good as anybody. Even at the time when there were kingsin Scotland this non-truckle element was prominent andseething. Now the Tory spirit is essentially that of the oldaristocratic families-a weight-carrying influence, powerfulin the counties, where it has lasted for ages, and it carrieswith it a large number of people who like to assimilatethemselves as much as they can to the upper classes. Thisis truly a causal relationship, whilst the Liberal policy hasmore of the purposive character-i.e., the adaptation ofmeans to an end, whether involving consciousness or not.A man who is in a state of action-i. e., of doing something-must always have an end in view, and to select such anend is "purposive." The Conservative mind is satisfiedwith things as they are ; it is what it is becausecertain things (mostly of an agreeable tone) have com-bined to make it so ; it is therefore causal in essenceand is content to dwell in the present, resenting the pushingforce of others who would drive it to a state of thingsperhaps unpleasant to itself and always obscure anddoubtful. Liberalism, on the other hand, is of the pushfultrend, it traverses the regions of pain rather than of

pleasure, and as the progress of purposive action is chieflyconnected with the effects of pain it must necessarily appealmost strongly to those whose life is carried on where thecircumstances are to a large extent painful in their nature,ambitious perhaps, but downtrodden by old and vestedinterests ; and hence the lower classes and those who havegrievances, those whose spirit is aroused against their con-dition of stagnation and their fancied oppression by theclasses which seem to them to be no better than they them-selves are, come perforce to be Liberal, they keep beforethemselves an end to be attained and their conduct is

strictly purposive ; moreover, it has been so for years,it has become a tradition, and is handed down totheir children. The Welsh Liberalism may be tracedto the obstinacy engendered by Nonconformist principlesagainst the influence exerted by the Church, whichwas always associated with the Tory party, aided bythe trend of the Celtic temperament. The Church has beenconnected with the State for a long time ; it is supposed tohave enjoyed special patronage and facilities, and thiscombination has had its direct influence upon minds of adifferent purpose, prompting an opposition to the politicalparty with which the Church has been prominently associated.Now and then a new principle is started by one side or theother of so striking a kind as to counterbalance the force oftemperament, and if this is done through the agency of agreat leader it may spread through constituencies with allthe force of a hypnotic suggestion ; but, even so, if the" suggestion" is brought forward by the party from whichchange and progress are not as a rule expected the antagonismto its reception may cause its failure to succeed owing to thestolid temperaments with which it has to contend, and inany case its acceptance must be a slow and a begrudged one.The change in the representation of constituencies from

time to time is to be explained partly by the shifting of popula-tion. People drift into towns from the country, carrying withthem their temperaments and ideas which they spread amongtheir fresh surroundings ; on the other hand, the populationof towns tends to live in the outskirts and in the country,so that both town and county representations change andfluctuate in the most surprising way-the resurrection of newindustries bringing along a population of the purposive order