There may be a history of a drinking bout and the odor of alcohol may be detected in the breath but the possibility of illness or injury occurring to a patient ego has taken a harmless amount of alcohol must be considered or the alcohol may have been administered after the onset of illness. The patient is often stupor us with flushed skin full pulse deep respiration and dilated pupils which react sluggishly to light. In severe alcoholic poisoning there may be deep coma with respiratory depression. The pupils then become very small but if the patient is hake nth pupils dilate though he cannot be roused and again constrict what he is left at rest. This sign is highly characteristic of alcoholic coma. It is sometimes seen in narcotic poisoning but never after head injury or apoplexy.