“Persistent muscular tremulousness of upper and lower extremities, requiring assistance in walking, while the finer acts of coördinative power, as writing and whistling, could not be performed at all. Tongue furred in the centre, tremulous and with fibrillary twitching at the edges, and pointed markedly to the right side. Articulation thick and indistinct. Pupils equal, dilated, irregular at margins, and insensible to light. Right side of face partially paralyzed. Reflex action of cord much impaired. Common sensation acute, verging on hyperæsthesia. Complained of sleeplessness and exhaustion, but had no headache nor neuralgic pains. “No cutaneous eruption. Muscles poor and flabby. Conjunctivæ yellow. Respiratory and circulatory system normal. Pulse 67, weak and thready. Temperature 97°. Urine, specific gravity, 1.005. Neither albumen, sugar, bile nor tube casts. Could only make water at night, when it was passed in large quantities, was clear and limpid, resembling that of hysteria. Bowels confined, fæces hard and of a white color. “Neither narcotics nor alcoholic stimulants were used. Tonic mixture, containing strychnia, prescribed. Improvement in all the symptoms marked and rapid. Discharged, well, physically and mentally, in three months’ time.” This case illustrates, also, the fact that the majority of those who become habituated to chloral, and in whom it works the most serious injury, are of the neurasthenic type, and manifest a morbid craving for some stimulus or narcotic. Of the cases where I have been able to obtain information upon this point, I find the temperaments given as follows:— Nervous, 63 Sanguine, 1 Nervo-sanguine, 8 Melancholic, 21 -- 93 In forty-one cases there is a history of either nervousness, nervous disease, insanity, alcoholism or opium addiction in the ancestors. In many of these patients there is a “mixed” habit, as opium and chloral, alcohol and chloral, alcohol, chloral and morphine, chloral and chlorodyne, etc. It is largely used[60] by the intemperate as a substitute for alcohol. On this point the testimony is abundant and positive. As an example of hereditary tendency, etc., the following, sent me by Dr. N. Jasper Jones, of Blairstown, Iowa, is very interesting:— “Alcoholism prevalent in the family, also the opium habit, but no insanity, although the mother, at times, under mental worry, becomes somewhat unreasonable, as though she might become insane. Father died of heart trouble while sitting at breakfast. The entire family are of the most intense nervous type, on the mother’s side, all the children taking after the mother; but the father was unusually reserved and cautious, probably because he had schooled himself to be so, on account of his wife’s and children’s excitable natures.”