The piece takes its title from a verse in Hebrews: “In your struggle against sin, you have not yet resisted to the point of shedding your blood.” (Hebrews 12:4) This very graphic image reminds us how basic the battle is between right and wrong.  The piece is basically a rondo form, alternating fast, punching sections (an ‘outward’ struggle) with more reflective, calm sections (a kind of introspective struggle).