CASE I. Baln R. M., aged fifty-five, thin, emaciated and irritable temperament, has been suffering from hereditary asthma for the last twenty-five years. For the last six or seven years he suffered from asthmatic fits almost nightly and a troublesome cough with a good deal of frothy expectoration. He said he had not known what sleep was for the last six or seven years, in fact, he could not lie down in bed, as that would immediately bring on a violent fit of coughing which would not cease until he sat up, so the recumbent posture for him was almost impracticable, and he used to sit up during the night and doze on a pile of pillows. He passed his days comparatively better, but the approach of the night was a horror to him, his struggle, commencing at 9 or 10 P.M., would last till the morning. He was the father of many children and was well taken care of, but his suffering was so great that he had no ambition to live any longer. He tried almost all systems of medicine without much good. For the last ten years he took opium, which afforded him slight relief at the beginning, using as high as forty-eight grains of opium in twenty-four hours. Owing to the constant sitting posture he became stooped, and the back of his neck stiff and painful. In April, 1889, he was suddenly taken ill with fever. The fever became protracted. After an illness of over a month his condition became so bad that all hope of his recovery was given up. During this illness he was treated by an old school physician of some repute, but his condition daily grew worse, the asthmatic attacks became very violent and almost incessant, and the difficulty of breathing very great. He became so feeble that he had not strength enough to enable him to bring up the expectoration; his chest was full of it; fever was less; there was general anasarca. He was sitting with head bent forward, almost touching the bed, as that was the only position possible to him day and night. He had become almost speechless, when I was sent for, at about 3 P.M. on the 23d of May, 1889. When I was entering the patient's room a medical man came out and hinted that there was no use of my going in as the patient was just expiring. I found the patient breathing hard; unconscious; jaws were locked and saliva dribbling from the corners of his mouth; body cold; cold, clammy perspiration on forehead; eyes partially opened; in fact, to all appearance, he looked as if he were dead, except for the respiratory movements. I felt his pulse and found it was not so bad as the patient was looking. I examined the back of his chest, as that was the only portion easily accessible, and noticed that the bronchial spasms were going on with loud mucous râle. From the character of his pulse I thought that the present state of the patient was _probably_ due to the continued violent struggle and not deep coma, and that he had become so exhausted that he was motionless, speechless and completely unconscious.