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the right axilla was occupied by a tubercu.lar tumour presenting two ovoid ulcersplaced one above the other, the inferior ad-vancing rather to the front of the chest.These two ulcers had existed since the pa-tient was nine years old. Those of the faceand neck were but of four months’ duration,nd the indolent clavicular abscess hadcommenced but two months before the pa-tient’s admission into the Hopital SaintLouis. The symptoms underwent an an-nual exacerbation in June, and the suppti-ration was then much increased.

The abdominal parietes, the lower part ofthe left side of the chest, the neck and limbs,presented numerous scars of the worst cha-racter.

Macaire had passed almost his whole lifein different hospitals and asylums. Havingexhausted all the resources of the first esta-blishment he was received into, he passedfive months in the Civil Hospital of Lisle,without the slightest advantage. The orga-nic lesions, already so numerous and so

severe, and which had produced great debi-lity and emaciation, were but too effectuallyassisted by the deep moral dejection of thisunhappy young man, who since his birthhad only experienced the most perfect stateof disease, pain, misery, and destitution.May 12, 1830. Ioduretted treatment. The

sub-clavicular abscess was punctured, andthere escaped a quantity of pus, or ratherof softened tubercular matter, readily re-

cognisable by its purulent and cheesy as-pect. A solution of iodine was injectedinto the cyst and allowed to remain thereinsome minutes. The ulcers were dressedwith charpie, strongly charged with the

proto-ioduret of mercury. He was placedalso on the use of the ioduretted mineralwater, and he was ordered three sulphureousbaths weeklv.

26. Parietes of the abscess adherent;generally improved.June 15. Ulcers of the face and neck

cicatrised. The only remaining sore wasthat corresponding to the middle region ofthe sterno-mastoid muscle. The thoracicand axillary ulcers were replaced by well-conditioned scars. For three weeks he hadrecovered the free movements of his headand jaws, of which latter circumstance heavailed himself with much pleasure.

July 10. Respiration embarrassed, cough,diminished appetite, sterno-mastoid ulcer

suppurates pretty well. I had retardedthe ctire of this ulcer for some time, re-garding it as a natural and beneficial issue.The analogy of these symptoms to thosewitnessed in the case of Jarry, decided meto use the same treatment, and it was at-tended with equal success, In this casealso the touching of the ulcers, in the secondfortnight of their treatment, with the con-

centrated solution of iodine, was attendedwith such striking local improvement, thatit was perfectly visible from day to day, sothat I was obliged to restrain it very soon,lest the sudden suppression of the ulcersshould give rise to any dangerous effects.

25. Appetite good, sleeps well, and feelshappy. His only remaining ulcer was drpss-ed once daily with the ointment of the

proto-ioduret of mercury ; his daily doseof iodine in solution was three-quarters of.a grain. The cicatrices were touched twicea week with the rubefacient solution, or

caustic iodine, in order to diminish theirredness, smoothness, and prominence.

October 25. In every respect as well aspossible. The cicatrices were excellent,and no longer could convey any notion ofthe disease from which they resulted. Upto this time the local and internal treat-ment had been persisted in. The last ulcerwas now healed, or very nearly so, its reo

opening being encouraged from time to

time for reasons already specified.Dec. 31. Local treatment neglected for

two months. The mineral water was con-tinued in order to coufirm the cure. Norelapse has since taken place, and everything seems to promise permanent goodhealth.

THE PER-CENTAGE SYSTEM.

To the Editor of THE LANCET.SIR,—I am a constant reader of your in-

valuable publication, being convinced thatit is a channel through which medical know-ledge flows in profusion, through whichmedical men are stimulated to the highestattainments of their profession, and throughwhich all attempts at quackery, monopolv,and imposition, are seized, dissected, anddemonstrated by an instrument well calcu-lated for the occasion. Having lately pe-rused No. 389 of your work, I was gratifiedon observing the able mannerin which yourcorrespondent "Amicus Justitiæ " has ex-

posed the trafficking system which existsbetween physicians and chemists, and feel-ing persuaded that publishing the names ofthe offending parties is the only chance of°’ striking terror to their hearts." 1 shailfollow the laudable example of your corre.spondent, and relate a circumstance whichoccurred to myself a few days ago.A respectable female, with a prescription

in her hind, entered the surgery where I amresiding, remarking at the same time shebad been to consult Dr. Marshal Hail,who lives in Manchester Square, and whohad written a prescription, and had beenvery particular in desiring her to get

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it prepared at a certain place, and beinga stranger to London she wished to knowif she had come to the right house. Theanswer she received was, that I was con-

standy in the habit of preparing prescrip-tions for medical gentlemen, but I could notpretend to say if Dr. Hall had directed herto bring it to our house. After she hadhesitated a few moments, and again repeat-ing her anxiety to have it prepared at theplace Dr. Hall had taken so much pains todirect her, she consented to my dispensingit for her, and took a seat with the intentionof waiting until it was finished, but judge ofmy surprise, Mr. Editor, when I arrived at

the second line, to find a formula which isneither contained in the London, Edin burgh,nor Dublin pharmacopoeias, and the know.ledge of which, 1 presume, is only worthyof being known by the head of him whoprescribed it, and the hands of him who wasdestined to dispense it. I need scarcelysay at that moment I was convinced that thepatient had made a mistake in the house,and I likewise as soon accounted for thetrouble which the doctor had taken in in-structing her where to go. I immediatelybegan asking her if she could not rememberthe name of any of.the streets the doctor hadmentioned, and whilst I was in conversa-tion with her my thumb and finger happen-ed to unroll one of the corners of the pre-scription which had been previously curledup, when my eyes were instantly struckwith the womls, "4, Thayer Street." Think-ing possibly that might be the patient’sresidence, I inquired if Dr. Hall mentionedthe name of Thayer Street to her ? She

immediately jumped up, and exclaimed" That was the street, Sir ! " Is this not it?I answered no, returned her the prescrip-tion, and directed her the nearest way tofind it. You will not be surprised, Sir,when I inform you that on the first oppor-tunity I made a point of walking into ThayerStreet to ascertain who resided at No. 4, andfound a person of the name of Howlett, whocalls himself a chemist, occupying g that house.Here, Sir, my curiosity ceased, feelingassured the patient could not have failed tohave found out Mr. Howlett’s after the uti-rections 1 gave her for proceeding to ThayerStreet. I happened to relate the eircum-stance to a friend the following day, who ashort time ago was living in the neighbour-l.ood of Manchester Square, who immedi-ately replied, " I perfectly recollect oncehearing Mr. Howlett express his delight atthe prospect of having all Dr. MarshallHall’s prescriptions to prepare."Now, Mr. Editor, having given you a full

detail of the case, allow me to ask, Is thisconduct proper on the part of Dr. M. Hall ?for it appears he is not contented with poc-keting his fees; he is not contented with

I recommending his patients to get his pre-scriptions prepared at a certain house, buthe literally, it would appear, compels his pa-tients to go whither he thinks proper, or in

a word, if they do not think proper to gowhither he directs, they must go withoutmedicine, for I flatter myself that no medi-cal man would attempt to prepare a pre-scription which may be legible but not com-prehensible. It remains for me now, Sir, toapologise for having obtruded so much onyour valuable pages ; and allow me to say ityou think the length of my communicationtoo great for the importance of the subject,you are perfectly at liberty to curtail it in

any way you may think proper-my onlydesire being to shame the offenders, and tocrush the vile system of the percentage-mongers. I am, Sir, your very obedientservant,

S.R.London, 1831.

LONDON COLLEGE OF MEDICINE.

OBJECTIONS TO THE UNIVERSAL TITLE OF" DOCTOR."

To the Editor Of THE LANCET.

SIR,—Living, as we do, in the age ofmedical reform, it would be well for us torecollect, that it is less difficult to be con-vinced of the necessity of reform, than todefine the nature of that change which wouldbeneficially and permanently influence thewhole medical community. Salutary reformdoes not, in my opinion, consist in removingevery impediment for the purpose of esta-blishing perfect equality ; nor is the level-ling system carried to a fearful extent, at allcompatible with the best interests of the

profession. The physician, by lording itover the general practitioner, has broughtretaliation on himself, by driving the latterto trample under foot the barrier which hasso long and so unjustly separated them.This, in all likelihood, would not have beenconsummated thus early, had not a largenumber of the physicians of this kingdompractised as such by virtue of the Scotchdiploma, an instrument which confers a

superior degree, whilst the person who holdsit is nominally elevated above the class of

general practitioners to which he had hi-therto belonged, without his elevatiou beingcharacterisfd by a single iota of talent or

acquirement to which others of his class

might not lay claim. Thus a degree ofjealousy has been engendered; the manwho was formerly an equal (and is still

equal, if not inferior in point of knowledge),all at once arrogates to himself the right tosuperiority of judgment, as well as lays