“ A characteristic change in the respiration, known as Cheyne-Stokes breathing occurs prior to death in some cases; it indicates that the respiratory centre in the medulla is becoming exhausted, and is stimulated to action only when the venosity of the blood has increased sufficiently to excite it. The breathing consequently loses its natural rhythm, and each successive breath becomes deeper until a maximum is reached ”

“ Secondary coma may arise as a complication in the following diseases:—diabetes, uraemia, general paralysis, meningitis, cerebral tumour and acute yellow atrophy of the liver; in such diseases it is anticipated, for it is a frequent cause of the fatal termination. The depth of insensibility to stimulus is a measure of the gravity of the symptom; thus the conjunctival reflex and even the spinal reflexes may be abolished, the only sign of life being the respiration and heart-beat, the muscles of the limbs being sometimes perfectly flaccid. ”