During the past few years we have had an opportunity to observe an unusual form of spontaneous hypoglycemia which, as far as we are aware, has not been previously reported. The patients concerned have all been chronically addicted to alcohol and have been drinkers of denatured alcohol in a form known locally as "smoke." This so-called smoke has been prepared by the addition of a variety of denatured alcohols (varnish and paint removers, antifreeze, "canned heat") to water; the milky or "smoky" appearance of the resultant mixture has been the basis for its name. Samples of typical denatured alcohols used have always given strongly positive tests for methyl alcohol. Not one of the patients, however, has complained of diminution of vision. Although we have gathered little information concerning the exact nature and cause of this hypoglycemic reaction, we are reporting our clinical observations on 6 patients in the hope that