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In the first attempt at a compilation of so voluminous afeature as the street list, the best and finally to be adoptedarrangement can scarcely be expected; but this we may say,that, for the future, the title of M.D. will be appended tothose names entitled to it, and the title of phys. to thosewho practise as such. So it was intended in the present list,but the compilation having been intrusted to two individuals,one of them only observed the regulation; the other appendedphys. indiscriminately, and thus the apparent inconsistency isaccounted for.We apprehend, that in the instances quoted by "I-Ax,"

the profession (by whom alone the street list will be referredto) all know as well as he does that the gentlemen he hasnamed practise as physicians; and thus, although the omis-sion is to be regretted on the score of uniformity, no harm isreally done.As to " Scrutator," we believe we may enlighten him by

stating, that although all M.D.’s are physicians, all physiciansare not necessarily M.D.’s; the latter distinction being deriv-able only from an university.We think that when fault is found, and our accuracy ques-

tioned, great care should be taken by the critic to cite ex-amples in proof thereof. " Scrutator" has, singularly enough,done the very reverse. He has quoted Drs. Holland andTweedie as examples of error, whereas, it so happens, that inthese particular cases we are strictly correct. Dr. Tweediebeing an M.D. is so represented-Dr. Holland not being anM.D., although a fellow of the Royal College of Physicians,and physician extraordinary to the queen, is designated phys.But were it otherwise, as we have already said, whoever

might wish to know more of these, or of any other gentlemen,would naturally turn to the alphabetical list, where not onlythe name and address, but the qualifications, medical appoint-ments, and literary publications of every practitioner are fullyset forth.The gratuitous assumption of "Scrutator," that the omis-

sion of the proper designation is some significant mark of the,editors, is too absurd to require comment.Does he suppose that we should in any case be so unmindful

of our best interests as to endanger the success of our laboursby allowing personal feeling, even if such existed, to influenceus in the compilation of the Directory?What earthly reason can we have (as editors of such a

work) to set a mark on the many physicians whom it isasserted we have deprived of their just titles, the greatmajority of whom, too, are our subscribers! We expect" Scrutator" to make the amende for such a ridiculous in-sinuation, and he cannot do better than by pointing out to usthe other anomalies with which, according to his 1pse dixit,the work abounds.As to the criticisms of "I-Ax," they are directed against

the returns of individuals rather than against the work, thegood or bad taste of which criticisms we will not stop to dis-cuss; but we must protest against palpable errata of the press- such as serg. for surg., in Mr. Clayton’s case, and lecturer forlectures, in Mr. Whiteman’s-being held up as fair examplesofinaccuracy.

Again, if a highly respectable physician like Dr. RisdonBennett chooses to return himself Fell. Roy. Coll. Phys. byelection, is there any valid reason why it should not be so in-serted ? We see nothing ridiculous in it. In Dr. RobertRowe’s case, we happen to know, that the only reason thisgentleman does not go up for his intra-urbem licence is, fromthe reasonable expectation existing of some reform in the col-lege, which may render such a step, and consequent expendi-ture of money, unnecessary. But the malicious feeling whichpervades these criticisms is so apparent that we shall forbearfurther notice of them.We may conclude by saying, that a book is kept at the

office of the Directory for the correction of existing errors,and any notice of them, from whatever quarter, will at alltimes receive the best attention of

Sir, your very obedient servants,THE EDITORS OF THE "MEDICAL DIRECTORY."

Beaufort-buildings, Strand, Feb. 1849.

THE SERPENTINE.[NOTE FROM MR. SAVORY. ]

To the Editor of THE LANCET.SIR,—In the analyses of the water and mud of the Serpentine,

published in last Saturday’s LANCET, are a few typographicalerrors, which I think it would be advisable to correct.

In the analysis of No. 1 specimen of the water, the decimalpoints before the first three substances found have been omitted,

and in that of the mud also ; in the organic matter, the decimal

points are omitted, and 440 printed instead of .44 grains. I in-close You a copv of "how it is. and how it ought to be," and

THOMAS H. SAVORY.remain, dear Sir, yours truly,

THE PROPOSED INCORPORATION OF THE GREATBODY OF THE MEDICAL PROFESSION WITHTHE UNIVERSITY OF LONDON.

To t7te El clitor of THE LANCET.

SIR,-In THE LANCET of the 25th of December last, I per-ceive what the writer probably contemplates as a triumphantanswer to my former communication. I imagined that I hadshown that an university degree is simply an honorary testi-monial of a certain amount of knowledge, and that, such beingthe case, it is morally impracticable that the senate of theUniversity of London could confer the degree on persons whohad not been subjected to a proper and searching examina-tion. It has, it is true, been customary among certain Britishuniversities, to admit members of the one to an ad eundemdegree in the other; but in the present suggestion or claimfor general practitioners (i.e., members of the College of Sur-geons, and licentiates of the Apothecaries’ Company) to beadmitted to the University of London degree, no ad cundemcould be granted, because they are not members of any otheruniversity. Those who desire that general practitionersshould be admitted without examination, must not at leastspeak of an ad eundem admission." A General Practitioner" has chosen to fall foul of me,

because I have, as he supposes, represented that "the gra-duates of the university are, it seems, in his opinion, at oneextreme of the profession, and the general practitioners atthe other." This, I think, Sir, is an inference not at alljustified by any expressions in my first letter. I am wellaware, from personal experience, that there exist among themass of general practitioners a large number of men equal inacquirements to the best informed of the profession; but Iam equally aware that there are others profoundly ignorant,not only on theoretical, but also on practical matters. If wehad any means of sifting the wheat from the chaff otherwisethan by a stringent examination, it is quite clear that thesenate of the University of London would be justified in thedesired admission. But I contend that an indiscriminatecreation of M.B.’s, such as that advocated by " A GeneralPractitioner," would bring disgrace on the university, andmaterially lessen the value of its, degrees. The " GeneralPractitioner" well knows that the most idle and dissolutestudent can be crammed or ground for the examination ateither the Hall or College in six or eight months, withoutany enormous amount of application on his part. Is such aman to be admitted to university honours on such a title? Inorder to make good his case, the " General Practitioner"speaks most positively of the practical nature of the examina.tions at the Apothecaries’ Hall, and the theoretical characterof those of the University of London,and appeals to the examina-

! tion papers in support of his assertions. Let us compare the two.The examination at the Hall occupies from forty minutes toan hour and a half, sometimes, when an ignorant candidatepresents himself, being extended to two hours, for the purposeof giving him every chance of scraping through. In this timethe Company profess to inquire into the amount of knowledgepossessed by the candidate of five or six sciences, and hencebut a few minutes can be devoted to each. When I pre-sented myself at the Hall, some years before the Universitywas founded, the examinations were anything but what theyought to have been; and I confess that I retired from the

, room, after having satisfied the examiners, with a feeling of1 contempt for the examination I had undergone.

" The examinations at the University," says the " General1 Practitioner," "are theoretical; those of the Hall practical.", In what, I may inquire, are the examinations at the Hall

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more practical than those of the University ? Is it in che-mistry ? Experiments and substances are placed before thecandidate at the University, who is required to explain theformer and name the latter; at the Hall, a few pharmaceutical lpreparations are required to be named. Is it in anatomy ?At the University, a dissected limb is shown to the candidate,a.nd he is required to demonstrate the parts exhibited in the- dissection; at the Hall, a few questions are propounded tohim. Is it in materia medica ? Substances and plants arerequired to be named, both at the Hall and the University.Is it in botany ? The examination is confessedly more strictat the University than at the Hall. In medicine, in surgery,

,in midwifery, in forensic medicine ? Surely the examinationsare as practical as any that I have heard of at the Hall. Itis true that a cursory reading of the examination paperswould seem to favour the notion that the questions are of atheoretical character, for this simple reason, that they aregeneral rather than particular questions; that they each em-brace a wide field in which the candidate can expatiate Ifreely, and show what is in him; and there is this in the Inature of a written examination, that the candidate mustshow the real amount of his knowledge, whether it be theo-retical or practical; and an acute examiner can easily detect ’,whether the information conveyed in the answers be theresult of mere reading or clinical experience.The first principle, on which the senate of the University

seems to have acted, and on which I hope to see it continue toact, is to admit none to its degrees who have not a competentknowledge of the whole range of medical sciences-sciencesso closely interwoven as to be essentially necessary to anaccomplished practitioner. All that the senate has donehitherto would fall dead, were the proposal now made to becarried into effect.The " General Practitioner" has commenced his note with

an allegation which must be refuted before I close the presentcommunication. He has accused me of " extreme vanity;"he has stigmatized my letter as " insane and inapt." The latterpart of the accusation, the insanity and inaptitude, I shall leaveto yourself and your readers to judge; but I must defend my-self from the imputation of extreme vanity. It has been saidof old time, " that he who beareth testimony of himself, histestimony is not true." I must therefore appeal to the judg-ment of others, who, I suppose, may be admitted by a " Gene-ral Practitioner" as competent judges-I mean the College ofPhysicians. This body, some years since, issued a manifesto,which appeared in all the medical journals, in which it wasstated that the college was ready to grant its licence tothe graduates of the University of London without furtherexamination, on the simple condition that the censors of thecollege should be permitted to be present at the examination;and the college proffered the same boon to the graduates ofother universities so soon as the examinations in theseuniversities should come up to the standard required bythe college, but not until then. The college, moreover, statedin this manifesto, that the University of London had come;up to the required standard. I quote this from memory, butif I am mistaken, the error can be easily rectified. Now, Sir,if the College of Physicians be a body capable of judging cor-rectly of the nature of an examination, I think that the mem-bers of the university cannot be charged with "extremevanity" for asserting that the degree possesses a high cha-racter of which they may justly feel proud, and I confess thatI cannot perceive either the insanity or the inaptitude of the- remarks I made in my first communication-perhaps a "Gene-ral Practitioner" will be so obliging as to point out how theinsanity and inaptitude are to be ascertained.

I do not deny that the examinations at the University ofLondon are capable of improvement ; indeed, I firmlybelieve that they might be rendered more efficient and morepractical than they now are ; but I take leave to denymost emphatically that they are one whit less practicalthan those of any other institution, either in Britain or onthe continent. There is one great deficiency in all our exami-nations-a deficiency, Sir, that you have often indicated inthe pages of your journal,-it is the absence of examinationof actual cases of disease at the bedside of the patient, bywhich the man of books would be readily distinguished fromthe man of experience; and I hope to see the day when the.candidates for the degrees in the University of London willbe brought to the bedside of patients selected for the purpose,.and called upon to write commentaries or histories of the dis-eases which he has himself diagnosed. As I feel convinced,that whatever clamour may be raised for the admission ofmembers of the college and hall to university honours, willnot be successful in inducing the senate of the University of

London to relax its requirements, I imagine that I shall notagain need to trespass upon your columns, which might beoccupied with more useful matter; but I could not permit theassertions of a " General Practitioner" to pass without somenotice. I am, Sir, your obedient servant,Nov. 28, 1843.

__________________

P. X.

Medical News.

I ROYAL COLLEGE OF SURGEONS.—The following gentlemenhaving undergone the necessary examinations for the diploma,were admitted members of the college at the meeting of theCourt of Examiners on the 2nd inst.:—

BROWN, JOHN HENRY, Gorton, near Manchester.CHATFIELD, GEORGE, London.DOBELL, HORACE BENGE, Cheltenham.HUNTER, WILLIAM GuvER, London.HUTCHINSON, JoHN, East Indies.AIILLAR, SAMUEL SMITH, Enfield.TROlTSDALE, THOMAS, West-Butterwick, Lincolnshire.WELBYKING, FRANCIS TURNER, Melton-Mowbray.WILLING, GEORGE FREDERICK BRUTTON, Hampstead.

MIDDLESEX HOSPITAL.—At the annual meeting of the gover-nors of this institution on Thursday last, the salary of theapothecary was increased to X200 per annum, and that of theassistant-apothecary to X70 per annum. At the same meeting, itwas stated that the income of the hospital, during the past year,had reached .624,328 2s. lId., but the ordinary receipts amountedto X5306 16s. 4d., and the expenditure to X9006 14s. lld., leavinga deficiency of X3699 18s. 7d. The treasurer reported the re-ceipt of £ 500 from the Rev. Deacon Morrell, and a similar sumfrom Mr. C. Dixon, of Stanstead-park. A reversion of £100, be-queathed forty years ago by Mr. Appleton, had just come intopossession of the institution.HEALTH OFFICER OF THE CITY OF LONDON.—The salary of

Mr. Simon was, on Tuesday last, fixed, at a court of the citycommission of sewers, at X500 a year, by a majority of twenty-seven to twelve votes.NAVAL SURGEONS.-At the last meeting of the Court of Exa-

miners of the Royal College of Surgeons, Messrs. James Wade,Johnston Thomas Mosgrove, and John Turner Caddy, passedtheir examinations for naval surgeons : these gentleman had pre-viously been admitted members of the college, their diplomasbearing date respectively, Oct. 28, 1842, April 26, 1844, andMay, 27, 1844.THE SERPENTINE AND THE BOARD OF HEALTH.-A deputa-

tion, lately appointed at a public meeting in Chelsea, and consist-ing of the Rev. R. Burgess, (rector of Upper Chelsea, Drs. Copland,J. A. Wilson, Lankester, and Tilt, Mr.Woolley, and Mr. J. Lilwall,had an interview with the Commissioners of Woods and Forests on

January 26th, at their office in Whitehall, on the subject of theimpurity of the Serpentine. Lord Carlisle regretted not havingat his disposal the sum necessary for the complete removal ofthe nuisance. He said that he had caused to be effected suchimprovements in the sewerage of Bayswater as will prevent thefuture contamination of the Serpentine ; that the Commissionersof the Woods and Forests had ordered the immediate cleansing ofthe upper portion of the long water, and had taken measures toinsure a better supply of water for the future. We rejoice to findthe medical staff of the neighbouring hospital, well representedby Dr. James A. Wilson, (senior physician to St. George’s,) hasprotested against the toleration of such a nuisance, and we dotrust that, as in legendary times, St. George will vanquish theSerpent. But we cannot rest satisfied with so small an instalmentof sanitary improvement. We refer our readers to the interestingletter of Dr. Tilt, in the last number of THE LANCET.JUVENILE PAUPER ESTABLISHMENTS.—We have learned that

the Board of Health has given directions for medical visits to bepaid to all pauper institutions where children are brought up,with a view of ascertaining their exact condition, and thereby ofcoming at their general treatment. This proceeding, if carriedout, will be of incalculable advantage to the destitute portion ofthe community and the public generally.MORTALITY OF THE METROPOLIS.—Deaths registered from

all causes in the week ending January 27th, 1208; showing anincrease of 39 on the average of five winters, but giving a morefavourable result than was obtained in the two previous weeks,when they were respectively 1448 and 1345. Deaths from dis-eases affecting the respiratory organs were 245, almost the same asthe average; having declined from 325 and 300, the numbers ofthe two former weeks ; while the mean daily temperature ranged

from 24° 6, on the 2nd day of this month to 49°6 on the 25th: