“Seven years before was ordered chloral and bromide of potassium, for relief of spasmodic retention of urine. Of these he took about one drachm each, daily, for six years regularly, and during that time neither he nor his friends noticed any ill effects on either mind or body. “At the end of this time he had an attack of bronchitis, for the dyspnœa attending which he was given chloral, without bromide. Recovery from bronchitis was rapid. Death in his family and other troubles, however, led him to the continued use of the chloral. Commencing with sixty grains daily, he came to use one hundred and eighty grains daily. This in ten-grain doses, often repeated. Effect not hypnotic, but calmative and soothing. “No headache or vertigo were complained of, but there was lassitude, nervous debility and exhaustion; irritability of temper and peevishness. Anorexia, acidity, nausea and vomiting appeared. Piles became troublesome and the fæces white and hard. “Intellectual enfeeblement and perversion of affective life and character. He became untruthful and deceitful, and manifested a dislike for home and family. Even threatened violence to his wife. Three weeks before admission he discontinued using chloral, and kept himself in a chronic state of muddle and confusion, by means of whiskey. In a day or two he became restless, excited and quite unmanageable. Diarrhœa set in, with great discharge of blood from the bowels. A state resembling delirium tremens came on. Imaginary voices mocked him; he saw loathsome animals, snakes, etc. What little sleep he had was broken by terrible dreams. This terminated in three severe and unmistakable epileptiform convulsions, at intervals of four hours. This was followed by stupor, and that by excitement. ON ADMISSION. “Man of average height and development, but seems to be prematurely old and broken down. Very weak and anæmic, can speak only in an undertone, and can hardly walk. “Expression blank and vacant. Eyes dull and meaningless. Great enfeeblement of mind. Silly, childish, and almost imbecile. No excitement, but, rather, slight depression of mind. Would laugh and cry without adequate cause. No interest in surroundings. Replies to questions rambling, incoherent and disconnected, being unable to carry on a consecutive line of thought. Memory almost obliterated. Could not tell his age or where he came from. Had vague, fleeting delusions on various subjects.