Nothing can be done, indeed nothing is needed, but regulation of the posture, when coma is established. The head is to be supported on a firm pillow, or bolster, and slightly raised, but not so much as to increase the tendency to slide downwards in the bed. Whatever position of the body is found to lessen the stertor, and ease the breathing should be maintained. In the earlier stages of the process above described--in the condition which precedes and passes into coma--a carefully adjusted posture of the patient, in which he is propped up at an angle of not less than forty-five degrees, and often at one of much more, and due support is given to the trunk of the body by pillows--will do more than anything else in relief of embarrassed and laboured breathing. “The object is to support with the pillows, the back _below_ the breathing apparatus, to allow the shoulders room to fall back, and to support the head, without throwing it forward.”[75] The suffering of dying patients, says Miss Nightingale, is immensely increased by neglect of these points. If secretions have accumulated in the air passages, ammonia or turpentine may be administered. Should the breathing be gasping and spasmodic, ether, with or without opium, should be tried. When duskiness and lividity of the face have come on, we can do but little--when deep coma and stertorous breathing, nothing--but adjust the posture of the patient to the more pressing requirements of the case. When the heart or great vessels of the chest are the seat of the disease, and the circulation through the lungs is becoming seriously embarrassed by it, there are often paroxysms of great suffering. The patient is agonized by a sense of instant suffocation, and sits in or out of bed, with the head bent forward, resting on a table or other support, and expecting dissolution every moment. Here ether and opium is our best resource; or the nitrite of amyl, the cautious inhalation of which has in some instances given marked relief. When death, commencing at the brain, destroys life through the lung, and in the way of coma, as it usually does, the treatment is the same as in the coma that occurs late in the series of events which mark death by asphyxia. When, on the other hand, death, beginning at the brain, destroys life through the heart and by way of exhaustion, the treatment is the same as above described for those dying primarily from the heart and in the way of asthenia. * * * * * When the face of the dying person is flushed, the head hot, and the carotid arteries beating forcibly, the head is to be raised and supported on firm pillows, and ice or a cold spirit lotion applied to it. * * * * *