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To the Editor:— Once upon a time I had the opportunity to participate in the care of a disreputable patient who had been stabbed in the chest. The patient's injury was thought to be minor, but he was admitted to the hospital for observation. After about 12 hours his responses to questions became inappropriate, and he had at least one grand mal seizure. In the absence of immediate evidence that these changes stemmed from the injury, neurologic consultation was sought and plans were made for possible transfer to the neurologic service the next day. However, early that evening the patient became orthopneic and hypotensive (one examiner was unable to obtain the blood pressure and another obtained a pressure of 70/ 50 mm Hg). The patient proved to have cardiac tamponade secondary to a laceration of the aorta. After the laceration had been repaired and the patient had been returned to