Although no post-mortem examination could be obtained, the pauses were, I think, the result of some lesion which not only affected the medulla oblongata, but also other parts of the nervous centres, as evidenced by the loss of voice and the difficulty of deglutition. The patient suffered most probably from fatty degeneration of the heart; and the fainting fit, which seemed to have ushered in his fatal illness, may have been one of the cerebral attacks sometimes seen in fatty disease of the

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... . When I saw the patient soon after the fit I thought it might have been caused by embolism, and the subsequent symptoms lend some weight to that hasty opinion. It has been said that hydrate of chloral is a very useful remedy in Cheyne-Stokes respiration. It so happened this patient had been taking hydrate of chloral when the respiratory pauses came on, and it was fully tried, but without any good result. The patient was ordered plenty of nutriment, and medicines of various kinds were prescribed; but the medicine from which he derived the greatest benefit was dilute nitric acid in a bitter infusion. This mixture sustained his strength, freed him from the troublesome throat mucus, and quite subdued the cough, thus rendering him