of doing business directly with the persons taking quack remedies is in great, and apparently growing, favour with makers of such things. The letters with which the sufferer is inundated are, as a rule at any rate, printed in imitation of typewritten letters or reproduced by some manifolding process, and the recipient, unless he be something of an expert, is likely to suppose that he is receiving letters composed for his personal benefit, an illusion that is sedulously maintained by a profession of “special interest in your case,” or some equivalent fiction. The majority of the preparations described in this chapter contain substances commonly employed for the relief of piles, such as hamamelis (witch hazel), lead acetate, zinc oxide, calomel, or others, if possible, still more old-fashioned; some, like the “Muco-Food Cones, containing concentrated glutinous nourishment,” consist of flour and cocoa butter, and are innocent of medicinal ingredients. Advertisers, of course, indulge in the usual impudent reflexions on the work of the medical profession; one, for instance, hazards the statement that “for centuries piles have been treated in a careless, listless, manner by physicians, who, through ignorance or indifference, were unfit to be entrusted with such cases.” These same advertisers remark: “The people do not like to be humbugged”—a statement, perhaps, as far from the truth as some other assertions in the advertisements and letters. One company—two of whose “cures” have been shown in previous chapters to consist of sugar only, and whose ointment for piles is about equally active—invites those who are not cured by it to detail their symptoms to “our medical correspondence department”; it is easy to believe that “you will receive the same thorough attention from our medical staff as if you were examined personally,” but how much attention that would be is wisely not stated. The majority of the articles are of American origin, some of them being marked “Made in U.S.A.,” and others being now prepared in this country, but having originally come from across the Atlantic. Whether English or foreign, however, the usual disproportion is to be found between the prime cost and the price charged. If in the present series the highest price is charged—and the greatest pertinacity in extracting the sufferer’s money is shown—by a transatlantic concern, in other chapters English quacks have been shown well to the fore as regards both price and methods. BUER’S PILES CURE. On purchasing from an address in one of the Home Counties Buer’s “Piles Cure” for 1s. 1½d., it proved to consist of a box of Buer’s Mul’la, and a single sample powder of Buer’s Pile Powders, which cost a further 1s. 1½d. for a box. Several circulars were enclosed in the package. The trade mark was a picture of a donkey; a few extracts will suffice as specimens of the statements made: