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Artificial

fig, pressure, held and respiration

ARTIFICIAL RESPIRATION.—Respiration produced by mechanical means. To perform artificial respiration the tongue should be grasped ‘vith a handkerchief or towel, held between the thumb and index-finger, and pulled out beyond the line of the teeth. With the other hand pressure is made over the abdomen in the notch between the ribs, toward the dia phragm, at regular intervals, about 25-3o times to the minute. By means of this alternating compression and relaxation, the lungs are made to con tract or expand. If an assistant is present, he should be directed to extend both the patient's arms fully over the head and then to bring them down along the chest and press them tightly the body (see Figs. 75, 76, 77).

The elevation must correspond in time with the relaxation of the pressure on the abdomen, and the depression of the arms with the com pression on the latter (Sylvester's method).

Howard's method is especially valuable in apparent death from drown ing. The body of the subject is bared to the waist and the clothes rolled up into a tight bundle which is placed under the stomach of the patient who is stretched out prone on the ground (see Fig. 78). The person may also be placed over the knee and the head held Nvith the hand as shown in Fig. 79. The tongue thus drops forward and pressure on the back favours the outflow of the water through the mouth and nose. The

subject is then placed on his back and the tongue drawn out at the angle of the mouth, preferably on the right side, and held there by an assistant who may grasp it with a towel held between his index-finger and thumb. The bundle of clothes remains under the back so that the region of the stomach is directly elevated. The operator then kneels down alongside the patient, or assumes a straddling position over the hips (Fig. So), placing both hands on the chest so that the thumbs are directed toward the intercostal notch and the palms extend around the lower part of the thorax (Fig. Sr). In this position the operator exerts on the subject's chest a steady pressure which may be aided by leaning over and resting the Nveigh t of the body on the hands (Fig, Si). The operator counts to three, then releases the pres sure suddenly ; again counts to two. and renews the pressure. This must be continued until the person breathes xvithout artificial aid.

Artificial respiration is useful in the treatment of many poisoning accidents, as by opium, morphine, alcohol, coal-tar products (headache- and menstruation-powders), etc. It is imperative in the treatment of drowning. See ASPHYXIA DROWNING. Consult also the paragraph on RESPIRATION in INTRODUCTORY CHAPTERS (pp. 144-145).