In this chapter, Tolstoy introduces the central metaphor of the work, that of the sack. He explains that Ilyich, in his "stupefied misery," felt he was being pushed through a "narrow, deep, black sack." This must be some kind of vision he receives in a dream, for only after he falls through the sack does he regain his consciousness. Only after he's broken through does he begin to speak to God directly, and he begins to realize that he hasn't lived his life has he ought.
He says to himself, regarding his life's decisions, "I was going up in public opinion, but to the same extent life was ebbing away from me. And now it is all done and there is only death."
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