RESPIRATION, ARTIFICIAL, is required in all cases of suspended animation, from drowning, noxious gases, chloroform, etc. It may be performed either by forcing air into the lungs by means of a pipe passed through the mouth or the nostril into the glottis, or (which is usually preferable) by imitating the natural expansion of the chest by muscular effort, as by the methods invented by the late Dr. Marshall Hall and by Dr. Sylvester.
The best mode of forcing air into the lungs is by the use of a small pair of bellows, with the nozzle inserted in one of the patient's nostrils. The air should be driven into the lungs with extreme gentleness, the larynx being pressed backward against the spine, so that the air may not go into the esophagus and stomach. Gentle but firm pressure must be then applied to the chest to expel the introduced air, and fresh air again driven in; and this process of introducing and expelling the air alternately must be continued until either natural respiratory efforts appear, or the case becomes hopeless.
In the article ASPIIMA., It is stated that one of the best methods of filling the lungs of an asphyxiated person with fresh air, is that of Dr. Marshall Hall. Dr. Sylvester's method (The True Physiological ..ifet1wd of Restoring Persons apparently Drowned or Dead, and of Resuscitating Still-born Children; London, 1859) is, however, generally regarded as decidedly preferable to that of Dr. Marshall Hall, although the same in principle. The following are Dr. Sylvester's rules, as slightly modified by a committee, whose investiga tions will be presently noticed. The patient is laid on his back on a plane, inclined a little from the feet upward; the shoulders are gently raised by a firm cushion being placed under them; the tongue is brought forward, so as to project a little from the side of the mouth. The operator then grasps the patient's arms just above the elbows, and raises them till they nearly meet above the head. This action imitates inspiration. The patient's arms arc then turned down, and firmly pressed for a moment against the sides of the chest. A deep expiration is thus imitated; and these two sets of movements should be perseveringly continued at the rate of about 15 times in a minute.
Special reference must be made to two important documents among the publications on this subject. The first of these is the Reports of the Scientific Committee on ,Suspended Animation, presented to the royal medical and chirurgical society of London in July, 1869: and when it is stated that this report was signed by "C. J. B. Williams, chairman, W. S. Kirkes, George Harley, J. B. Sanderson, C. E. Brown-Scquard. H. Hy-de Salter, E. H. Sieveking, and W. S. Savory, honorary secretary," its scientific claims to our attention are undeniable. The following are their suggestions in relation to treatment: 1. That all
obstruction to the passage of air to and from the lungs be at once, so far as is practicable, removed; that the mouth and nostrils, e.g., be elthinsed from all foreign matters or adher ent mucus, 2. That in the absence of nattiral• respiration, artificial respiration by Dr. Sylvester's method (as already described) should be employed. 3. That if no natural respiratory efforts supervene, a dash of hot Water (120° F.) or cold water be employed, for the purpose of exciting respiratory efforts. 4. That the temperature of the body be maintained by friction, warm blankets, the warm bath, etc. [whether the warm bath is serviceable or positively hurtful is, however, still an open question]; and 5. That in the case of drowning, in addition to the foregoing suggestions, the following plan may, in the first instance, be practiced: Place the body with the face downward, and hanging a lisle over the edge of a table, shutter, or board, raised at an angle of about ;30', so that the head may be lower than the feet. Open the month, and draw the tongue forward. Keep the body in this posture for a few seconds, or a little longer if fluid escapes. The escape of fluid may be assisted by pressing once or twice upon the back.
The other document to which we referred is entitled instructions for the Restoration of the apparently Dead from Drowning, and was issued in 1864 by "The National Life-boat Institution." In these instructions (a copy of which should be in the possession of every family), it is recommended, that if breathing cannot be excited by the application of stimulants to the nostrils, or by dashing water on the face, Marshall Hall's method should be tried; and that if this do not prove successful in from two to five minutes, Dr. Sylvester's method should be resorted to.
In conclusion, a reference must also be made to the Reports of the Scientific Committee [of the membe•s.of the royal medical and chirurgical on the Uses and Effects of Chloroform. The committee decide that the most certain means of restoring life after. poisoning with anwsthetics is by artificial respiration. "By this means, resuscitating may generally be accomplished after natural respiration has ceased, provided the heart continue to act; and it May sometimes he effected even.after the cessation cf the heart's action. Galvanism resuscitates within the same limits as artificialrespiration ; it is, how ever, far less to be relied on in equal cases. Galvanism may be used in addition to arti ficial respiration; but the latter is on no account to be delayed or suspended, in order that galvanism may be tried."—Proceedings of the Royal Medical and Chirurgical Society, vol. iv. 1864.