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learn his views upon the present aspect of University politics.I received replies from both candidates to my queries. Thatfrom Sir Philip Magnus I forwarded to you last week, butyou very justly held over its publication " until Dr. Bristowehad had time to come to a decision with regard to hisreply," which dealt very fully with the questions I had putto him. Dr. Bristowe now writes to me that he has come tothe conclusion to "withhold his assent to its publication ;for the reason mainly that if it were to be publishedwithout comment or explanation, it would almost certainlymislead many of those who might read it, with respect tohis present attitude towards the University and his viewson educational questions." This decision is the more to beregretted as his published utterances on which voters willnaturally fall back assert the University to be a "failure,"its results "paltry," the matriculation "outrageouslysevere," the preliminary scientific examination to be of"exceeding difficulty," &c.At the present crisis Convocation sadly needs to elect a

representative man, one familiar with and in harmony withits wishes (as by resolution expressed), and with its longefforts after reforms which, if listened to by the Senate,might have avoided the present complication. Dr. Bristowe,if we only knew what his views really are, might be anacceptable man to medical graduates. It has been toomuch the fashion in the past to elect a Fellow merelybecause he is a respected author or teacher. The resulthas been to add to the Senate men of eminence, no doubt,but with a lack of administrative ability, out of touch withConvocation, and sometimes, alas ! with merely a vigilantregard to the movements of the "jumping cat." I appendmy letters to the two candidates, and Sir Philip Magnus’sreply. I am, Sirs, your obedient servant,

W. J. COLLINS, M.S., M.D., B.Sc.Albert-terrace, Gloucester-gate, June 8th, 1890.

Albert-terrace, Regent’s-park, N.W., May 25th, 1890.DEAR SIR PHILIP,-With reference to the election of Fellow at the

University, may I take it that you would now endorse the view ex-pressed in a letter to me of May 14th, 1885, when you were a candidateat a similar election-" I am quite with you as to maintaining thestandard of the examinations for medical degrees " ? Other graduates,as well as myself, are anxious to be reassured on this point.

Yours sincerely,Sir Philip Magnus, B.Sc., B.A. w J. CoLLixs.

Fontainebleau, May, 28th, 1890.MY DEAR COLLINS,-As you know, I have not changed my opinion

about our medical and other degrees. I think the standard should bemaintained, but that greater facilities .should be afforded to candidatesfor passing them. The institution of two Preliminary Scientific Examina-tions in the year was a step in the right direction.

Yours very tmly.Dr. Collins. PHILIP MAGNUS.

Albert-terrace, Regent’s-park, May 25th, 1890.DEAR DR. BRISTOWE,-I have received a paper requesting me to add

my name to the list of your supporters in your candidature for theFellowship of the University of London. In common with othergraduates I feel that at the present juncture it is most important toelect a graduate familiar with, and in harmony with, the wishes of Con-vocation as expressed in resolution in the matter of the reconstitutionof the University and the maintenance of the standard of the medicaldegrees. May I ask, therefore, whether you hold now the views whichyou are reported to have given utterance to in 1885? The reportappeared in the British Aledical Journal of -.Nlarch 14th in that year,and was subsequently reprinted and circulated. You are there reportedto have said-(1) That in your opinion the University of London was afailure, grounding this opinion upon the fact tliit it did not dispense itsdegrees with the same facility and liberality as the Scotch and IrishUniversities ; further, that you could find no evidence of it increasing inpopularity, whereas I find that the candidates for the matriculation were,in the year 18851900, as against 1056 in 1875 and 616 in 1865. (2) That" thePreliminary Scientific Examination includes subjects of very great diffi-culty, and that you do not believe any one of them is necessary for amedical man." May I ask, do you seriously consider a knowledge ofphysics, chemistry, electricity, and biology entirely superfluous to aproperacquaintance with the theory and practice of medicine? (3) That menwho have been in practice twenty years should be allowed to obtain adegree on simply passing the professional examination. May I ask, doyou recognise no academical requirements or distinction in a medicalUniversity degree, but merely regard it as a stamp of professional ex-perience ? (4) You apparently suggest that the matriculation examina-tion should be so modified as to make io available as the entranceexamination for all licensing bodies in London. To effect this would itnot require to be reduced to the level of the preliminary examinationof the College of Preceptors or Apothecaries’ Hall, and cease to be,what at the present time it is largely recognised as, a high class leavingschool examination? Or would you reduce its severity only for thoseseeking graduation in the medical faculty’!Trusting you will favour me with an early reply to the above queries,

put in no captious spirit, but prompted by loyalty to the traditions cfthe University and the wishes of Convocation, and anxious that yourinfluence, if elected, would not operate in a, direction which some of usthink would be detrimental alike to the University and to education,

.

Yours very trnlv,J. S. Bristowe, Esq., M.D. W. J. COLLINS.

W. J. COLLINS, M.S., M.D., B.Sc.

PHILIP MAGNUS.

LONDON AND EDINBURGH DEGREES.To the Editors of THE LANCET.

SIRS,-Dr. Bryan Charles Waller’s respectful allusion tothe "dreaded sphinx of Burlington-gardens" is refreshingtestimony to the fact that even he can look with a certainadmiration, not unmingled with awe, on something outsideof Edinburgh. Now this is as much as to say that Dr.Waller has this kind of regard for the London M.B. degree.If Dr. Waller will now kindly turn to THE LANCET ofMarch 1st he will find it stated on page 477 that a SpecialCommittee of the Royal College of Physicians recommend"that the second and third professional examinations ofthe Conjoint Board-i.e., the second and final for L.R.C.P.,M.R.C.S.-be accepted, instead of the intermediate andfinal M.B. examinations" of the University of London.Whether this suggestion be acted upon or not, it is quitesufficient to show the opinion which the gentlemen makingit hold of the professional abilities of those who have passedthe difficult examinations of the London Colleges of Phy..sicians and Surgeons. Than those gentlemen none couldbe more admirable judges of the fitness of such a suggestion,for the most of them are examiners both for the M.B.degree and for the L. R. C. P. Lond. and M. R. C. S. Thefact that about two-thirds of them are themselvesgraduates of London is sufficient guarantee against theirwishing to give away its unique degrees too lightly. I fearthat Dr. Waller will not approve of this; perhaps it maycomfort him if I assure him that he has altogether mistaken.the calibre, not of the old " London average student," butof the London L. P,. C. P., M. R C. S. That Dr. Waller has anyintimate acquaintance with the latter in the lecture-room hemust pardon my doubting. He does not go to Edinburghto be taught ; why should he ? He has unrivalled facilities.for clinical work, and teachers of world-wide renown allaround him. No; the "average student" whom Dr. Wallerhas probably met is one not unknown to us in London.Failing to pass at the London, he goes to the EdinburghColleges. I know a dozen such cases. But these do notrepresent the London student. With regard to Dr. Waller’--comparison between the London L.R.C.P., M R.C.S , andthe M.B. of Edinburgh, I may just say that the curriculumfor each is strikingly similar, as anyone can ascertain)readily from the books. The Preliminary Examination inArts is practically identical ; the professional course isnominally about four years, but more frequently five. Ineach case the student is permitted to qualify when twenty--one years of age, but rarely if ever does so ; andin each course there is a first, a second, and a thirdprofessional examination. I suppose that it is thisgreat similarity which induces frequent comparisons be-tween the two. Respecting Dr. Waller’s remarks con-

cerning the markedly practical nature of the Edinburghman’s work, I may just remark that while the LondonM.B. and the L.R.C.P., M.R.C.S. must conduct twentycases of labour before the final examination, the EdinburghM.B. need attend only six. But it is no part of my purposeto underrate the Edinburgh graduate. When, however.Dr. Waller presents him to us as a black swan, he provokesus to remind him that the Edinburgh M.B. is not unknownin the land-the degree is possessed, and abundantlypossessed, by our brothers, our young cousins, and ourfriends. It multiplies exceedingly, and bids fair to replenishthe earth, if not to overpopulate it. Perhaps we shall tryto venerate its possessors a little more in future, especiallyas Dr. Waller kindly dreads the sphinx of Burlington.-gardens ; but those whom I know (and they are not a few}are good, jolly young fellows with no shoppy vanity aboutthem. For their sakes, permit me simply to subscribemyself, Sirs, yours faithfully,June 10th, 1890. ONE WHO MEANS TO PASS THE SPHINX.

URINE TESTING IN PREGNANCY.To the Editors of THE LANCET.

SIRS,-I can assure Dr. Ha1fe that I had not the leastintention of being di!scourteous in any way, but I have notseen THE LANCET for a fortnight, as I have been away,,and hence I could hardly have written to him.The words used in Dr. Herman’s paper are very definite.

They are-"In accordance with the instructions of mycolleague, Dr. Ralfe, the urine was tested by heating," &e.

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In view of such a statement I venture to think thatDr. Ralfe M responsible for the methods employed ; at

least, if he is not, I fail to see who is, for it is not to be

supposed that his instructions would be inaccurately carriedout. The error, it is true, is the printer’s; but it is an

exceedingly bad one, and, as such, on so important a sub-ject, merits a public refutation. I was quoting from ascientific journal, whose reports one would naturally pre-sume to be correct. I can but take things as I find them,and, surely, if Dr. Ralfe lends the weight of his name toany statement, it is his business to see that that statementis correctly reported, and it is hardly with me that heshould find fault if it is not.

I am perfectly aware that the method of saturating urinein the cold with magnesium sulphate, in order to precipi-tate paraglobulin, is not Dr. Ralfe’s, but I have yet to learnthat Hammarsten "heated his solution, as the statementread in Dr. Herman’s paper before the error was corrected.With regard to the substitution of the word "treat" for"heat," I doubt if the description of the method employedgains much in accuracy. " Treat" may mean anything,and the word really gives but little clue as to the chemicalmethods to be followed out. That I should have annoyedDr. Ralfe is a matter of much regret to me, but, with alldue deference to him, I think I was perfectly justified in- writing as I did.vriting as I I am, Sirs, yours truly,

W. KINGTON FYFFE, M.B. Cantab.St. George’s Hospital, June 9th, 1890.

ARE LEPROSY AND SYPHILIS IDENTICAL?To the Editors of THE LANCET.

SIRS,-Sir W. Moore, in his able and learned article inTHE LANCET of May 17th, endeavours to establish etio-logical identity between leprosy and syphilis. So far as I- can judge, after a careful perusal of his article, I thinkthat he has altogether failed in the attempt. He mainlyrelies upon the similarity of appearances for arguments insupport of his theory. If we were to try to trace pathologicalidentity in "vivid resemblances," we should be drifting intoa hopeless condition of scientific embarrassment from whichthere could be no rescue. Is it necessary at this stage ofmedical science to remind Sir W. Moore that such attemptsin the past have resulted in nothing but pathologicalchaos ? It is at best an artificial system of classificationand useful only for clinical purposes, being absolutelyuseless for throwing any light on etiological mystery.As such it has played an important part in the history ofscience, but now it had better remain a landmark in itsevolution.He says: Like syphilis, leprosy frequently develops as an

acute febrile eruption develops." Therefore he argues thatsyphilis and leprosy must be identical diseases. The argu-ment simply requires to be mentioned to carry its ownrefutation. Why can we not say that all diseases whichdevelop with acute febrile eruptions are identical ?He lays great stress on " vivid resemblances " be-tween secondary eruptions of syphilis and leprouspatches. I have spoken at some length on this point. Ihave pointed out the unscientific position in which we areplaced by depending too much on "vivid resemblances."Polymorphism is the most characteristic feature of syphi-litic eruptions. Papillary, vesicular, pustular, and variousother intermediate forms, are found side by side indiscri-minately in one and the same crop of eruptions. Does notsyphilis mimic various non-specific forms of skin eruptions?Are these diseases pathologically identical because there are" vivid resemblances" ? Are there not diseases etiologicallyidentical and yet morphologically divergent one from theother as white is from black ? Is not cancer hard and soft, nowa fungating mass, then an extensive ulcer, and again a hard,firm cartilaginous nodule ? There are diseases morpho-logically similar which are etiologically different. By mor-phological, I mean "in appearance." Syphilitic, lupus, androdent ulcers on the face are very difficult to diagnose, butwe know that they are all etiologically distinct one fromthe other. He says : "Hoarseness and nasal voice are

symptoms of leprosy as of venereal." Do we ever findhoarseness and nasal voice as symptoms in any othermalady which human ílesh is heir to? I leave it toSir W. Moore to answer this question. He goes onto observe: "Palate and nasal bones are sometimes

destroyed in syphilis and leprosy." Have cancer androdent ever played any mischief with the self-same bones ?Is it rare to find leprosy attacking fingers and toes?Are these the favourite places of selection by syphilis? Igrant that sometimes the tubercles of leprosy and the de-posits of syphilis are very similar in appearance, but so islupus, the tuberculosis of skin. Tuberculosis, togetherwith the aforesaid two, forms the pathological group, whichgoes by the name of "infective granulomata." " I shouldlike to know if Sir W. Moore believes in the evolutiontheory of diseases. If so, he can assert a common parentagefor all the three diseases, which, distinct to-day, wereidentical once. It is not for me to enter into a scientificspeculation on etiology of diseases. For all practicalpurposes it is enough for me to know that tubercle, leprosy,and syphilis are distinct in their causation and in theirnatural history. Ilickets and scrofula were considered asoffsprings of syphilis, but regarded from the more modernpoint of view they are both independent of venereal. If SirW. Moore wants to prove his theory to the medical pro-fession, then it is incumbent upon him to prove that onemerges imperceptibly into the other. He has not instancedone single case where a subject of inherited or acquiredsyphilis subsequently developed into a leper. I have neverseen one such case, neither has any member of the wholemedical profession of the world. Perhaps he has observedsuch cases. He must show us the reason why leprosy ispractically unknown in this country, while syphilis, mildand severe, acquired and inherited, is as common as canbe. We should like to know why syphilis (for all prac-tical purposes) is amenable to treatment, while leprosyis not.

Sir W. Moore further remarks: " Improvement of treat-ment and improvement of sanitary surroundings, whichinclude lodging, food, &c , may have eradicated one form ofheredity." May I ask why not the other if etiologicallythe same? Cannot the same argument be, with greaterforce and plausibility, used by those who maintain thatsyphilis and leprosy were distinct in their origin and course.They may argue thus: it is precisely because both thediseases are distinct in their nature that one has disappearedwhile the other has remained unchecked. Environments,which are unfavourable to leprosy, do not seem to beunfavourable to syphilis. Has the withdrawal of the Con-tagious Diseases Act from Bombay in any way influencedleprosy as it has done syphilis? Perhaps the time is tooshort to pass any opinion.

I am. Sir, yours faithfullv,A. D. COOPER, L.R.C.P. Lond., M.R.C.S.

Montague-place, Russell-square, W.C., May 28th, 1890.

THE STAMPING-OUT SYSTEM AS A SUB-STITUTE FOR VACCINATION.

To the Editors of THE LANCET.SIRS,-I beg to observe that Dr. Crookshank has not

answered my question. His letter, published in your lastissue, gives some interesting facts to show the value ofisolation in dealing with an epidemic of small-pox; but hedoes not tell us what we all want to know-how he proposesto prevent the disease spreading from an isolated patient tothose around him in the distant future, and after the generalabandonment of vaccination. The cases cited by him asinstances of the success of isolation in limiting the spread ofsmall-pox are not on all fours with the case I propoundedto him of a community consisting exclusively of un-

vaccinated people. In Leicester, as well as in our Australiancolonies, the immense majority of the adult population areprotected by vaccination, and it is they who furnish thecontingent of officials needed for carrying out the system ofisolation. To suppose with Dr. Crookshank that improvedsanitation will ever modify the virus of small-pox, or renderthe human subject insusceptible to it, is to betray a wantof familiarity with a disease whose infective power transcendsthat of all others in its activity and wide diffusibility. Noone in these days, not even the most zealous advocate ofvaccination, would venture to underrate the importance ofisolation and sanitation in controlling the spread of small-pox, although the action of local sanitary authorities maylag behind scientific opinion in providing the requisitemachinery. But we may rest assured that isolation withoutvaccination, even when backed by all the resources ofsanitary science, will utterly fail to stamp out small-pox,