SOME APPLICATIONS OF PHYSIOLOGY TO MEDICINE

Sudden and Unexpected Death durinig Rcst. THE difficulty of explanation of such deaths has lonig been felt, in the absence of recognized conditions (effort and excitement) tending to make an extra call on the heart and of such powerful afferent excitation as might be assumed to be provocative of reflex inhibition of intensity and dura tioni sufficient to be fatal. Recourse has colnstantly been had to the verdict of " failure of the heart's action," though the sudden collapse in cardiac efficienicy remains unaccounted for, post-mortem examination ofteln affording lno explana tioni of the abrupt ending of life. Sir Clifford Allbutt,27 while suggesting vagus inlibition as a mode of death durinig anginal attacks, writes with regard to the class of deaths n1ow under consideration-during conditions of rest, apart from anginal attacks, and where no exciting cause is apparent: "But the riddle, which I have done s0 little to read, is the frequent suddenness of death in one who, having scarcely known illness, expires under no extraordinary effort; or In the peace of his own bed or chair passes silently away. The reading of this riddle is not yet."