d produces
venous congestion and oedema, and sometimes pneumonia. Dyspnoea, with
cyanosis, a persistent cough and frothy or blood-stained sputum, a
feeble pulse and low temperature, are the chief symptoms.

When the fat lodges in the capillaries of the brain, the pulse becomes
small, rapid, and irregular, delirium followed by coma ensues, and the
condition is usually rapidly fatal.

Fat is usually to be detected in the urine, even in mild cases.

The _treatment_ consists in tiding the patient over the acute stage of
his illness, until the fat is eliminated from the blood vessels.

TRAUMATIC ASPHYXIA OR TRAUMATIC CYANOSIS.--This term has been
applied to a condition which results when the thorax is so forcibly
compressed that respiration is mechanically arrested for several
minutes. It has occurred from being crushed in a struggling crowd, or
under a fall of masonry, and in machinery accidents. When the patient is
released, the face and the neck as low down as the level of the
clavicles present an intense coloration, varying from deep purple to
blue-black. The affected area is sharply defined, and on close
inspection the appearance is found to be due to the presence of
countless minute reddish-blue or black spots, with small areas or
streaks of normal skin between them. The punctate nature of the
coloration is best recognised towards the periphery of the affected
area--at the junction of the brow with the hairy scalp, and where the
dark patch meets the normal skin of the chest (Beach and Cobb). Pressure
over the skin does not cause the colour to disappear as in ordinary
cyanosis. It has been shown by Wright of Boston, that the coloration is
due to stasis from mechanical over-distension of the veins and
capillaries; actual extravasation into the tissues is exceptional. The
sharply defined distribution of the coloration is attributed to the
absence of functionating valves in the veins of the head and neck, so
that when the increased intra-thoracic pressure is transmitted to these
veins they become engorged. Under the conjunctivae there are
extravasations of bright red blood; and sublingual haematoma has been
observed (Beatson).

The discoloration begins to fade within a few hours, and after the
second or third day it disappears, without showing any of the chromatic
changes which characterise a bruise. The sub-conjunctival ecchymosis,
however, persists for several weeks and disappears like other
extravasations. Apart f