SummaryThe most proeminent anatomic lesion of mortal asthma is acute pulmonary emphysem due to bronchial and bronchialar plugging by mucous casts. These are due to an anormal glandular secretion, really«holocrine».It is mostly said that these patients die of acute anoxia. However, it is impossible, in pathology as well as in physiology, to dissociate sharply respiration from circulation. Marked symptoms of circulatory impairment are regularly recorded during oppressive paroxyms of bronchial asthma : severe cutaneous vaso-constriction, tachycardia, weak pulse, arterial hypotension with reduction of differential tension. The most caracteristic sign, and the most constant, is Küssmaul’s paradoxal pulse : marked weakening or, even, disappearance of the pulse during inspiration. The end of asthmatic paroxyms is always accompanied by the disappearance of Küssmaul’s pulse.These circulatory symptoms were a marked feature of the case here reported. Our patient died suddenly during the last of a series of three asthmatic paroxyms; one cannot really speak here of status asthmaticus.Some therapeutic views are briefly discussed.