“I shall now relate a case observed by myself, which is yet more striking, from the multiplicity of its phenomena, which are of a kind, perhaps, to give us some clearer understanding of their origin. The case was observed by me at a time when the evil effects of chloral hydrate were not yet known; the medicine was, therefore, continued, in spite of the most multiplied symptoms, because chloral was not for a long time recognized as their cause; the affection was, therefore, followed up further than we should dare to do now, that our increased knowledge would oblige us to stop at an earlier stage. [Here follows a detailed report of the case, which need not be given]. If we may sum up the weightier symptoms of this case, we find a young, strong, personally healthy person suffering from uncomplicated mania, in whom, on the ninth day of chloral treatment, a rash appeared in the form of groups of red spots, which soon became confluent. On the twentieth day the temperature and pulse rapidly rose to a febrile pitch; three days later the temperature had reached 106.7°; large and repeated doses of quinine were given without result, and baths had only a temporary effect. Œdematous swelling of the face, cheeks, eyelids and ears now set in. During the whole course of the disease the skin, so far from returning to its natural appearance, was the seat, now of impetiginous, now of moist, now of scaly eczema and ichthyoses, so that the process of desquamation, instead of being short, as in the acute exanthemata, occupied many weeks, during which great sheaths of epidermis were cast off from all parts of the body. “The profound lesions of the skin nutrition were evidenced in the later stages by a remarkable shedding of the hair, and a gradual falling off of all the nails of the hands and feet. The affection of the skin was accompanied by a similar one of the mucous membranes, first of the intestines, which kept up watery diarrhœa in spite of medicine, and then by a similar affection of the conjunctiva and the bronchi. From the sixth week of the disease onward a series of large abscesses formed on both arms, over the shoulders and armpits, which secreted a considerable quantity of pus. While these phenomena were occurring there had been for eight weeks a continuous fever, occasionally remitting, and then again running up to a temperature beyond 104°.