It is a well-known fact that rheumatism or rheumatic neuralgia, so called, is often aggravated by the administration of acids. It is barely possible that in this case, the drug being kept in a solution, probably with syrup, partial decomposition may have taken place, and through the large amount of chloral taken, a sufficient amount of hydrochloric acid has been ingested to produce the aggravation of pain. I offer this simply as a suggestion. Many chloral-takers, especially the English, use the drug in the form of the officinal syrup chloralis (B. P.), or in a syrupy solution, expose it to the air and light, and do not keep it in warm places. When a large amount of the drug is used, and decomposition has taken place, an appreciable amount of acid might be taken. Pains in the limbs, face, chest, eyes, and about the heart are not uncommon, but in some cases never occur, although the person is taking large amounts (100 to 200 grains). Flushing of the face and ears, and congestion of the eyes, the latter apparently bloodshot, is often seen, and is intensified by the use of a small amount of any alcoholic stimulant. A physician in the South, an habituè for years, writes me that his face became so very scarlet, and his eyes so bloodshot after drinking a glass of liquor, that people in the street would turn around and stare at him in amazement. It is of the same character, though less intense than that flushing of the face produced in some people, not chloral-takers, by the use of coffee. It is due to a more or less complete paralysis of the vaso-motor nerves. It is usually accompanied by dyspnœa and palpitation of the heart. It sometimes occurs on taking stimulants a week or ten days after the habit has been broken. Nervous chills are also often found, and following them is sometimes felt numbness of one leg or arm, or the sensation of insects crawling on the skin of the trunk, less often of the limbs. Paralysis sometimes occurs, and is usually confined to the legs. Dr. W. R. Upham, of Yonkers, N. Y., reports the following:— “Had one case of a lady afflicted with cancer of the breast, who had taken about twenty-five to thirty grains, for one year. Soon after this she became partially paralyzed in the lower extremities; and, becoming very much frightened, she discontinued the use of the drug at once, and without much trouble. She afterwards took up the use of morphine, and has recently died from the original disease. She was of a very nervous temperament.” Here is a similar case by Dr. William Kirkpatrick Murphy[72]:— “Young man, twenty-nine years of age. Muscular athlete. Took chloral for insomnia. Amount taken not known, as it was taken loosely, without measure. Once nearly died from an overdose. Awoke one morning to find the power of his lower limbs completely gone. This was transient, but caused him to abandon the use of the drug. POINTS OF INTEREST.