“Every remedy had failed, and the patient seemed on the brink of the grave. The physician, therefore, recommended the discontinuance of a daily dose of forty-five grains of chloral which had been given as an hypnotic, whereupon all these highly alarming symptoms vanished, in an almost magical way; the cerebral disturbance ceased, and the respiration quickly resumed its normal type. The dyspnœa may be anatomically explained by analogy with the effects of chloral upon the skin and mucous membrane, by hyperæmia of the lungs, which is produced through the channel of the vaso-motor nerves. “We find here a further confirmation of the assumption that chloral operates upon the vaso-motor centre and the medulla oblongata, and that its paralyzing influence extends thence to the peripheral branches of the affected nerves. This might also lead to a practical contra-indication of chloral in all morbid conditions where there is a tendency to congestions or stases of blood in the lungs.” In non-habituès it has been found by Fothergill[92] to produce dyspnœa where there is cardiac disease:— “A patient was taken into the West London Hospital, with emphysema and aortic stenosis. In spite of rest, digitalis and ammonia, he was liable to attacks of dyspnœa, which had come on _since_ his admission into the hospital. On searching for an explanation, it was found that the house-surgeon had benevolently prescribed chloral for the sleeplessness complained of. This was at once stopped, and the attacks of dyspnœa never returned, though the man gradually sank.” Dyspnœa is reported by thirteen of my correspondents as a symptom of the continued use of chloral. On the throat and larynx the effect is one of decided irritation, attended by congestion and sometimes ulceration. The uvula is congested and œdematous, the epiglottis red and swollen, and the vocal cords sometimes congested also. Cases of this kind are reported by Kirn[93] and Chapman[94]. THE EYES. Upon the eyes the continued use of chloral produces a very decided and characteristic effect. Some persons not addicted to the use of chloral manifest a peculiar idiosyncrasy with reference to it. A single dose sometimes, more often a few doses, will produce severe conjunctivitis, occasionally accompanied by œdema of the subjacent parts, as also of the face. Photophobia is often marked. Abundant testimony as to this effect of chloral on the eyes may be found in my article upon that subject in the N. Y. _Medical Record_ for 1881. Conjunctivitis from the continued use of chloral is reported by forty-one of my correspondents, œdema by thirteen, and photophobia by thirteen.