resembles nettle rasli, and at others, measles ; and as a rule it is accom-
panied by severe itching. This liyperaemic condition is extraordinarily
intensified immediately after the ingestion of the smallest quantity of
wine, beer, or spirits (Murphy). The drug has not often been puslied
beyond the stage of intense erythema, with multiple oedemae, the
minute cutaneous blood-vessels being visibly dilated ; but in a few cases
conditions, evidently purpuric in nature, have been noted, and the
ultimate action of the drug in this direction has thus been shown.
1. The pernicious effects which Chloral may, under certain conditions,
exert, do not seem to be limited to vaso-motor paralysis, or a transient
skin neurosis. Two cases wnich have occurred have seemed to demon-
strate that they may also involve the constitution of the blood and the
nutrition of the tissues, and may thus imperil life. In these two cases,
Chloral administered in the presence of organic disease of the brain,
induced what can only be designated acute puqjura — a condition in
which, with marked constitutional disturbance, there was alteration in
the capillaries of the cutaneous and mucous surfaces, with subcuticular
hemorrlmge and ecchymoses.
M. A., female, set, (59, who had been an inmate of this asylum for
many years, and who was subject to periodical attacks of mania, occurring
every six months, and ushered in by convulsions and coma, entered
upon one of her wonted paroxysms on the 1st of March, 1870, and was
ordered twenty grains of Chloral hydrate three times a day. This
produced sleep and cutaneous anesthesia, and on the 4rth of March a
very unexpected result, in the form of a bright red blush, erythematous
in aspect, but permanent unaer pressure, over the chest and shoulders.
