At the examination of the body, the cartilages of the ribs were found to be ossified. The heart and lungs were perfectly healthy, but the lungs were in a congested condition. There was an extravasation of blood in the spinal muscles, and a little blood in the spinal canal, in what part or between what structures is not stated.[111] _Case 40_ occurred in the Lock Hospital, London, in May 1854. Walter Hollis, a tailor, aged eighteen, had been under treatment for sores within the prepuce, and these having healed, he was about to undergo the operation for congenital phymosis. He had been of dissolute habits, and exhibited a pale cachectic appearance. “The inhaler used was a simple mouth-piece by which the nostrils are left uncovered. About two drachms of the fluid were poured into the instrument. After about six minutes inhalation, insensibility seemed to be coming on, and at this moment the pulse was ascertained to be of good volume. Nothing whatever had occurred to indicate the impending danger, when, after a few more inhalations, the pulse suddenly failed, became quite imperceptible, and the countenance assumed a pale and leaden hue. The inhalation was immediately stopped, and attempts to resuscitate, by means of striking the chest sharply with a wet towel, applying ammonia to the nostrils, and by artificial respiration, were at once commenced. These were employed for three or four minutes before any signs of life were perceived; but, subsequently, the pulse was again to be felt, and spontaneous respiration was renewed. Artificial respiration was desisted from on the occurrence of these signs of returning life, and for upwards of ten minutes the chest continued to fill regularly, and the pulse beat at a rate of from 40 to 50 in the minute; the countenance of the patient also much improved, and even assumed a slight flush. After the expiration of, perhaps, a little more than ten minutes, however, these indications of returning vitality again disappeared, the pulse and respiratory efforts simultaneously ceased, and the countenance became deathlike. Artificial respiration and the other means were again adopted, but this time without the slightest success.... Post-mortem examination on the next day shewed great venous congestion within the cranium; the lungs were also somewhat congested. The heart was slightly enlarged, and the ventricular parietes were thinned; in the muscular fibres the microscope detected decided fatty degeneration. The blood was universally fluid.”[112]