THE ALUMNI JOURNAL, 



77 



patient as if he had an apopletic fit, or 

 compression of the brain, as you can do 

 no harm in that way. If the case is one 

 of unmistakable drunkenness it is a good 

 plan to administer an emetic — say a table- 

 spoonful of mustard or a drachm of 

 powdered ipecac in a tumbler of warm 

 water. After vomiting, 25 or 30 grains 

 of bromide of potassium may be given, 

 followed by a tumbler of liquid citrate of 

 magnesia. If there are indications of 

 collapse — cold, clammy skin and feeble 

 pulse, heat must be applied as in a case 

 of shock. Don't forget that death has 

 been due to alcoholic intoxication. 



Asphyxiation from Illuininating Gas. — 

 These cases are generally easily recogniz- 

 ed as we have the immediate history of 

 the case to guide us. The patient is in 

 a more or less profound stupor depending 

 upon the amount of gas inhaled. The 

 ej^es are suffused and the pulse slow and 

 full, and there is a perceptible odor of 

 gas in the breath in cases where respira- 

 tion has not ceased. Treatment: Loosen 

 the clothing and give the patient plenty 

 of air. If he can swallow, administer a 

 little brandy and milk, extend the arms 

 far above the head, and if the respirations 

 lag, make firm and gradual, but gentle 

 pressure with both hands downward over 

 either side of the chest, corresponding to 

 the expirations or breathing out. Then 

 relax your pressure during the inspira- 

 tion and press down again during ex- 

 piration. This is one form of artificial 

 respiration and will often suffice. Con- 

 tinue it for a few minutes, at the same 

 time dash cold water in the face and hold 

 ammonia to the nostrils. If these meas- 

 ures fail and the respiration has almost 

 or entirely ceased, the Sylvester method 

 of artificial respiration should be resorted 

 to, and to properly carry out this method 

 you will require an assistant. Place the 

 patient on his back with the shoulders 

 resting on a folded blanket or roll of 



clothing. Then examine the patient's 

 mouth. If the tip of the tongue shows 

 just, within the teeth it requires no at- 

 tention, but if it has dropped back it 

 must be at once brought forward as the 

 patient may be smothered by the organ 

 closing the air passage. It can generally 

 be brought forward and secured by a dry 

 handkerchief or cloth held between the 

 fingers. If necessary, however, do not 

 hesitate to pass a threaded needle 

 through t-he tip of the tongue and hold- 

 ing it by the thread. Physicians generally 

 employ a sharp-pointed, hook-like in- 

 strument called a tenaculum for this pur- 

 pose. Having satisfied your mind about 

 the tongue kneel behind the patient's 

 head, then grasp him by the fore-arms 

 half-way between the elbows and wrists 

 and draw his arms up and over his head 

 rather quickly, but steadily until the 

 hands touch the ground or floor behind 

 the head and hold them in that position 

 two seconds. This motion draws the 

 ribs up, thus expanding the chest, and 

 air enters. The arms are held back two 

 seconds to allow the air, time to com- 

 pletely fill the lungs. Now reverse the 

 movement, that is^ carry the arms back 

 until they rest against the sides of the 

 chest, the forearms a little on top Press 

 the forearms firmly downward and in- 

 ward against the chest for one second. 

 This pressure depresses the ribs, con- 

 tracts the chest and forces the air out. 

 These back and forth movements should 

 be repeated persistently at the rate of r6 

 or iS per minute (rate of normal breath- 

 ing) until some effort is made by the 

 patient to breathe. This process should 

 continue for at least an hour and a half 

 if necessary, or until life is declared ex- 

 tinct by a phj'sician. As soon as respira- 

 tion is fairly established put the patient 

 in a warm bed and place hot bottles to 

 his feet and along the sides of his legs 

 and body. Continue to use all kinds of 



