RESUSCITATION A committee of the Royal Medical and Chirurgical Society has been endeavouring to formulate a new system of resuscita tion, or to report on the methods now in vogue, but the long promised report is not yet forthcoming.
The system which is at the present time most generally recommended is the Silvester, so called because it was sug gested by Mr. H. R. Silvester, M.D., who in 1883 received the Fothergill Medal from the Royal Humane Society for his scientific researches. The Marshall Hall and Howard methods are also constantly practised. The forerunner of these systems was a means of inducing artificial respiration by insert ing the pipe of a pair of bellows into one nostril and closing the other. Air was forced into the lungs and then expelled by pressing the chest, thus imitating respiration. Dr. Hawes, the founder of the Royal Humane Society, at the end of the eighteenth century used a kind of cradle in which the subject was placed and then raised over a furnace. Bleeding, holding up by the heels, rolling on casks, &c., were at various times re commended, but all were gradually discarded for the Silvester, Marshall Hall, or Howard method. Simple means are even now often resorted to in localities where the work of the Humane Societies is little known. A typical case occurred in New Zealand in 1891, when a person received an award from the Australasian Society for Rescue and Resuscitation, the latter being accomplished by holding the subject over a smoky fire, which is the native method of restoring life.
Persons have of course been revived by many other means than what may be termed the official systems. A case occurred at a riverside town a few years back, in which a man was restored after the Silvester method had been tried without success. The operator (who may possibly have acted unskil fully) was thrust aside by a spectator, who placed his hand kerchief across the mouth of the patient, and then alternately blew into and drew air out of the lungs of the apparently dead man, until natural breathing was restored. But in view of the vast amount of success which has attended the adoption of the official systems, it is, perhaps, best to study them exclusively until some other method is generally advocated by the leading Humane Societies, who all have the advantage of advice and assistance from eminent medical men, ever ready to serve the cause of suffering humanity.
Before proceeding to describe the various methods of resus citation it is as well, in order that the principles regulating them may be fully understood, to give a general description of the organs which are primarily affected by continued immersion beneath the surface. The lungs have allotted to them the
important duty of purifying the blood. They take from it the carbonic acid gas which it accumulates in its circulation through the body, and in exchange supply it with oxygen, so that it may be purified before it re-enters the heart. Therefore, if the lungs be deprived of a supply of oxygen, the accumulated carbonic acid increases largely in volume, and the whole body is quickly poisoned.
The lungs are two large membranous bodies which, with the heart, fill the cavity of the thorax, or chest. The only entrande to them is through the trachea, or windpipe, which runs down the front of the neck. When felt through the skin, it will be noticed that this is strengthened by a series of cartilaginous hoops. At the top of the trachea is a chamber termed the larynx, the opening to which, termed the glottis, is protected by the epiglottis. The trachea passes downward into the thorax, and then is divided into two branches, one going to the right and the other to the left lung. These are termed the bronchi. As soon as these enter the lungs they subdivide into numerous branches, termed the bronchial tubes. The larger bronchial tubes are supplied with cartilage, but as the tubes get smaller and smaller the cartilage disappears, and the tubes can almost be closed by muscular movement. At the termination of these minute tubes are the air cells, a series of little sacs opening into a cavity. According to Professor Huxley, their average diameter is but of an inch. Each lung is made up of these cells. The partitions between them are composed of very delicate tissue, and through them are carried the blood capil laries, separated only from the air cells by a most delicate lining. The lungs, which are both highly elastic, are each enveloped in a double membranous bag known as the pleura, the outer bag lining the cavity of the chest and the inner protecting the lung. In an ordinary being these two bags are in close contact. Below the lungs is the great arched muscle known as the diaphragm, which separates the body into two distinct divisions, the thorax and the abdomen. Through the diaphragm the large blood-vessels supplying the lower portion of the body are carried. The cavity of the thorax is surrounded and protected by the ribs, which are attached to the spine, and are supplied with muscles capable of raising or depressing them at will.