The practice employed by some physicians, of “tapering off” chloral eaters on small doses of opium or morphine, I consider unnecessary, and extremely dangerous, for these patients, as is well established, are prone to go from one habit to another, and the use of these drugs is placing needless temptation in their way. PROGNOSIS. Cure may be assured if proper control of the patient is had. As much depends on proper after treatment of these cases as in that of the morphine habit. Relapses less often occur in these than in opium habituès. Finally, then, the prolonged use of chloral is not so likely to form a habit; is not so thoroughly enslaving when formed; is less prone to endanger life in small, more prone to destroy mind and body in large doses, and is easier broken, than the opium and morphine habits. DANGERS. There is a certain peculiar danger attending the use of chloral that is comparatively rare among opium habituès, viz: that of death from an overdose; death, also, from a dose that has previously been taken with safety.[101] Medical literature is filled with records of such cases, and instances where death almost occurred, the patient only being saved through the exertions of the physician called. In some instances an overdose was accidentally taken; in others the person is found dead, it being probable that he took no more than his customary dose, which, however, acted with unusual strength upon a system surcharged with the drug. Here, for instance, is, supposably, one of these cases. It is sent me by Dr. P. C. Remondino, of San Francisco, Cal.:— “Isaac H., barrister, aged fifty-six; about four years ago began taking chloral for sleeplessness, due, he was told, to cerebral anæmia; was then a portly gentleman; hair and beard dark; beard slightly tinged with gray; feeling the need of stimulus, began to drink quite freely, and also to take morphia; then soon followed the habitual use of chloral. He now takes as much as one hundred and eighty grains per day, in three to four doses. Sometimes takes ten grains of morphia _with one of the doses_; is more than usually nervous; now is greatly emaciated; hair and beard a bleached white; skin itches and has a hard, dry feel; has small brownish spots, about the size of this ◯, that cast off a small scab of skin; suffers with pain in wrists and knees; also elbows and ankles, but not so severely as in the wrists and knees; insomnia and loss of appetite. Bowels regular; mental faculties are active; of course nothing like those he formerly possessed, as his physical debility makes him childish, but still he can use his mind and will, to a certain extent; acts perfectly gentlemanly, although he is as stated. His physical state is that of the debility and tottering of a man of ninety.”