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of pharmacy law this provision appears inadequate to securethat the dispensing of medicines for insurance patientsshould be done by pharmacists. Dispensing does not

necessarily entail a sale, and under the Pharmacy Acts it

is the sale of a poison by an unqualified person and not the

dispensing of it which constitutes an offence. There is there-

fore nothing in the Bill which would prevent societies from

making arrangements for the dispensing of medicines by-unqualified persons, and such dispensers need not be

under the supervision of registered medical practitionersor pharmacists. It is perhaps improbable that societies

would make such slipshod or irregular arrangements, butthe experience of pharmacists of the effects of looselyworded measures of legislation has been so unfortunate inthe past that they are doubly anxious to be safeguarded froma similar experience in the future. Let it be assumed, how-

ever, that some clear amendment will be made for the dis-

pensing to be done by qualified persons: this would not

necessarily mean that pharmacists in business would be

employed for that purpose, for friendly society officials

have already indicated that they are considering the

question of establishing a central drug depot and branch

dispensaries for the supply of medicines to insur-

ance patients. If this project is carried out it will

be disastrous to a large proportion of pharmacistsnow in business, especially those in working-classdistricts.

The practical difficulty of separating prescribing from

dispensing is not settled either because their divorce of

functions is considered scientifically sound or because

the decree has been pronounced in the Bill. Manypractitioners would much prefer to do their own dis-

pensing ; many patients will find the new arrangements,whatever they are, irksome ; and in many forms of practicethe loss of the dispensing for club patients will make dis-

pensing for private patients more difficult. The fact that

in other countries the work of the dispensing chemist

is never done by the medical practitioner is of

great significance, but we cannot help thinking that theawkwardness of defining what is dispensing must have madeitself felt before now in those countries. If, for example,a surgical emergency requires splints and bandages, who

provides them under the Bill ? Consideration of such a

point as this brings us face to face with the fact that a closedefinition is required of what is a medical benefit under thenew legislative proposals. We take it that in the actual con-

tracts such matters as the treatment of accidents and of com-

plicated midwifery cases, night calls, and long journeys willbe made the subject of schedules, and upon the proposals forthese payments medical opinion ought to be heard. Would

it not be well if our great medical corporations and ourdegree-granting universities made an attempt, late in the dayas it may be, to cooperate upon some general principles, toascertain the views of their Members, Licentiates, and

Graduates, and to present to public view the position in

which the medical profession believes that it should be

placed ? With some such idea a unanimous resolution of the

Royal College of Surgeons of Edinburgh has resolved to

petition the Government for a reasonable delay in the passage of the Bill.

The Reconstruction of theUniversity of London.1

THE thanks of all those interested in the higher educationof London are due to Sir WILLIAM ALLCHIN for the work he

has done in presenting a full and accurate account of thereconstruction of the University of London. The first partappeared some time ago and brought the story up to theappointment of the first Royal Commission on the Universityin the year 1888; the second part details the negotiationsthat took place with regard to that appointment, anddescribes the progress of events up to the rejection by Con-vocation of the scheme brought forward by the Senate in1891. Although the time comprised within this volume is

therefore hardly more than three years, it was a time of

activity, when much work was done in the investigationof the conditions then existing and in the bringing forwardof many and widely varying proposals for their ameliora-tion. Large as this volume is, it was needed for the

adequate description of all that took place. In May, 1888,in response to the demand for a teaching university in

London, a Royal Commission was appointed to investigatethe existing conditions and to make recommendations ; it

contained seven members, one of whom, however, the

Hon. G. C. BRODRICK, attended only one meeting, and there-fore took no real part in the matter. The names of the

commissioners are sufficient to show that care had been

shown in their selection, for they were the Earl of SELBORNE,a Lord Chancellor, the Right Hon. J. T. BALL, a LordChancellor of Ireland, Sir JAMES HANNEN, Sir WILLIAM

THOMSON, afterwards Lord KELVIN, Sir GEORGE STOKES,and Dean WELLDON, then headmaster of Harrow, and later

Bishop of Calcutta. It will thus be seen that half of the

working members of the commission were eminent membersof the legal profession, while the other three were activelyengaged as teachers. It will be noticed, however, that not a

single representative of the medical profession was called toserve on the commission, whether connected with the Univer-

sity or not, although the question of the granting of medical

degrees to London students was one of the more importantmatters which had given rise to the existence of the com-mission.

The problem of the granting of medical degrees in Londonis of such intricacy that it is hardly possible for anyone not

thoroughly conversant with the facts to attempt to solveit merely from the evidence supplied to this or any RoyalCommission. Representatives from many bodies gave

evidence before the commission, and especially may bementioned the witnesses from University College and

King’s College, who advocated the establishment of a

teaching university in London. We refer our readers

to the admirable summaries of the evidence submitted

by Sir WILLIAM ALLCHIN, reminding them that the

essential question at issue was whether or not there

should be established in London a second university,where academic training, in certain metropolitan collegesand schools providing teaching and university life, was

1 An Account of the Reconstruction of the University of London,compiled by Sir W. H. Allchin, M.D. Lond., F.R.C.P. Part II., Fromthe Appointment of the First Royal Commission to the Rejection of theScheme of the Senate by Convocation, 1888-1891. Price 5s.

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a necessary precedent to examination for degrees, while

the examinations were to be conducted by the teachersin the recognised colleges, together with external examiners,representatives from the Royal Colleges of Physiciansof London and Surgeons of England being placed on the

governing body. It is true that there was also a petitionof the Royal Colleges for the power of granting the degreeof M.D. in order to meet the demand of the London medical

students for a medical degree on terms similar to those

granted to students by other universities in the kingdom,but this petition occupied only a secondary place in the

proceedings. The report of the commission was presentedabout a year after its appointment. It was a lengthydocument, but it mdy be summarised as rejecting almost

unceremoniously the petition of the Royal Colleges, while

it recommended that the existing University should within areasonable time endeavour to make such alterations in its

procedure and constitution as would meet the main pointscontended for both by the Royal Colleges and by those whodesired the establishment of a teaching university. Duringthe next year the University of London endeavoured to cometo terms with University College and King’s College, and theSenate drew up a scheme which was provisionally acceptedby those colleges and by the Royal Colleges of Physiciansand Surgeons. A little later University College and King’sCollege withdrew their adhesion to the new scheme, but itwas finally and utterly damned when the draft supple-mental charter was presented to the Convocation of the

University of London and was rejected by 447 votes to 197.Thus an attempt made with the best intention on the

recommendation of a Royal Commission to solve a problemof the higher education of London failed miserably. The

Senate of the University, with an anxious endeavour to

please all parties concerned, had devised a scheme thatsatisfied none. It endeavoured to unite incompatibles, and

necessarily it failed; but the primary cause of the failurewas to be found in the constitution of the Commission. The

medical profession was unrepresented, and sufficient attentionwas not paid to the needs of London medical students.The difficulties which existed at that time remain with us

at present. Now, as then, it is not possible for the averagemedical student with average ability and average diligenceto attain the degree of M.D. in London, and this is clearlydemonstrated by the large number of London students who

go elsewhere for their degrees. Into the merits of the scheme

formerly advocated by the Royal Colleges we need not nowenter, for that scheme is no longer put forward by those

Colleges ; but the fact remains that, in spite of the changesmade in the University, in spite of the softening of thematriculation and the alleged weakening of its other

examinations, the conditions imposed are still too hard forthe average medical student. Nor are we attempting todiscuss the difficult question whether the candidate at anexamination should be examined by his own teacher or by a

stranger. But the true basis of the agitation for the estab-lishment of a teaching university in the metropolis has beenthe need felt by teachers that they should have the controlof examinations. The evil which was then flagrant was thatteachers of the highest rank were compelled to instruct theirstudents according to schedules drawn up by others, often

much less acquainted with the needs of the student, and theresult was to embarrass considerably those who had to teach.Something has been done to remedy this grievance, but weare by no means convinced that anything like the presentarrangement in London can endure. Modifications are

demanded both by teachers and by students, and the

medical profession is not alone in awaiting with interest

and anxiety the findings of the Royal Commission at presentinvestigating the question of the higher teaching in London.To all concerned in this matter, whether commissioners or

witnesses, it is essential that they should know what hasbeen done in the past, and nowhere else can be found so

satisfactory an account as that put forward by Sir WILLIAMALLCHIN.

Physiological Albuminuria.THE recent discussion at the Medical Section of the Royat

Society of Medicine, reports of which we published in ourcolumns on April 29th (p. 1134) and on May 6bh (p. 1205),has once more drawn attention to the vexed question of"physiological albuminuria." The late Sir WILLIAM

ROBERTS was one of the first observers to use this term,

It naturally implies that the appearance of the albumin ?not indicative of any morbid condition, but it givesno suggestion as to the precise condition of the pheno-menon. As is well known, the albumin is found under

varying circumstances. It is, as a rule, not constant ; it

may only be present on first rising in the morning, aftera cold bath, after meals, or after severe exercise. Hence, as.

alternatives to the word "physiological, the terms inter-mittent, dietetic, postural, cyclic, orthostatic, and functionalhave been employed. The expression ’ hæmatogenous albuminuria " has been adopted by some observers, based uponthe researches of Sir A. E. WRIGHT and Dr. E. A. Ross, who,

maintain that the albuminuria is due to a condition of the

blood, in which the power of coagulation of that fluid is

lowered, or in which there is some change in the albumins,of the serum, or in the acidity which influences the

coagulability.’ Some authorities were at one time of the opinion thatalbuminuria was always pathological, but the remarks of thevarious speakers in the discussion to which we have alluded

clearly show that" physiological albuminuria " is now anaccepted fact. The expression "albuminuria occurring’in.adolescence " was generally adopted rather than one of theterms we have mentioned, as it is rather in this period of life-that the condition is usually met with. Dr. J. F. GOODHART,who opened the discussion at the Medical Section of the

Royal Society of Medicine, gave an account of the after-

histories of a large number of cases of "adolescent albu-

minuria " which had come under his notice. In addi-

tion to the causal factors that have been already-mentioned, he suggested wounding of the passages by the-transit of oxalates, uric acid, and phosphates. He also

believes that rapid and inordinate growth of young peoplemay have a determining influence. Food-bolting, in his

opinion, may also be responsible for some of the cases. He

expressed the opinion that albuminuria of the adolescent hadno sinister effect upon health or upon the duration of life.