Upon the kidneys the effect of the long continued use of chloral is to produce congestion, dilatation of the vessels, and albuminuria. There is no positive evidence that chloral produces any organic change in these organs. Albumen is present in the urine, often in large amount, but its presence there is readily accounted for by the vaso-motor paralysis, and the impoverished condition of the blood, which is still further aggravated by this, its symptom. Casts are often found, but are usually small and medium sized light granular, and hyaline. Epithelial and fatty casts occasionally occur, but it is probable that, in these cases, renal disease had commenced before the chloral was used to excess. Hemorrhage from the kidneys and, indeed, from the whole urinary tract, is sometimes found. It is but a part of a general condition, usually, purpuric spots being found on the skin, and bleeding occurring from the mucous membrane of the throat, stomach, nose, or bowels. Both before the albuminuria appears, and during its continuance, dropsy is not uncommon. Puffiness of the face and eyelids, dropsy of the feet and legs, and ascites occur in certain cases, not from suppression of urine, but from the condition of the vascular system and blood. The albuminuria, unlike that of opium patients, is usually persistent. Diabetes is found in some cases where large amounts of the drug have been used for a long time. In acute poisoning by this drug sugar has been found in the urine of man, by Bouchut[75] and Levenstein[76]. Labbée[77] failed to find it in the urine of chloralized rabbits and frogs, but Feltz and Ritter[78] found it in the urine of dogs into whose veins they had injected chloral. They proved its presence by both the fermentation and reduction tests. They also claim to have found an organic body, which was present in such small quantity that a determinative analysis was impossible. The same substance was probably found by Von Mering and Musculus, who named it _uro-chloralic acid_. They found that it reduced the copper and bismuth tests, and turned the polarization apparatus to the _left_. This from small doses, while large doses gave sugar, turning the polarization apparatus to the _right_. Dr. John B. Roberts and Morris J. Lewis[79] found that the urine of patients taking chloral, and urine to which chloral had been added, gave a yellow precipitate, with Fehling’s test solution. It is probable that in the urine of patients habitually using small doses of chloral, the reaction with the copper solution is due to the presence of uro-chloralic acid, while that of those taking large doses is due to both uro-chloralic acid and sugar; the preponderance of the latter masking or overcoming the reaction of the former, especially with the polarization test.