631 



DROWNING. 



DRUGS; DRUGGISTS. 



632 



maintained so long unless the individual had breathed at intervals 

 during the time ; and as none can tell what circumstances may have 

 occurred favourable to the inspiration of air, it is an imperative duty 

 in all cases to resort to the proper means for restoring animation with 

 all the promptitude and energy possible. 



When a person who has been drowned, who was previously in a 

 state of sound health, is taken out of the water, the appearances pre- 

 sented by the body are the following : 



The whole of the external surface is cold ; the colour of the skin is 

 pallid, excepting in the parts where it is livid rather than pallid, as in 

 the face, which is always either entirely pale or slightly livid. The 

 eyes are half open, and the pupils much dilated. The mouth and the 

 nostrils contain a great deal of frothy fluid. A large quantity of the 

 game kind of fluid is contained in the trachea, the bronchial tubes, 

 and the ah- vesicles of the lungs. The tongue is protruded between 

 the teeth, and approaches to the under edge of the lips. The 

 whole head is sometimes much swollen, and the features occasionally 

 present the appearance of those of a person who has died from 

 apoplexy ; and this is said to be particularly the case with those who 

 have fallen into the water in a state of intoxication. It is usually 

 considered as a sign that a person has been drowned while living, and 

 that the body has not been thrown into the water after death, that the 

 if the fingers are excoriated, and that there is a collection of dirt 

 or sand under the nails, appearances resulting from the efforts which 

 the drowning person has made to avert his impending fate ; but if the 

 water be deep, no appearance of this kind is present, because the power 

 of struggling is over before the body touches the ground, and a person 

 in the state of intoxication, who falls into deep water may expire 

 without the power to make a single effort to save himself. 



With regard to the internal organs, the heart and its great blood- 

 vessels are always found preternaturally loaded with dark-coloured 

 blood, sometimes to such an extent that the heart seems completely 

 to fill the bag of the pericardium. This accumulation of black blood 

 is always on the right side'of the heart, which usually contains some- 

 what more than double the quantity contained in the left cavities. 



The lungs are invariably very much reduced in volume, and are 

 exceedingly loaded with black blood. Both the pulmonary arteries 

 and veins are likewise distended with black blood. 



The substance of the brain is of a darker colour than natural, and 

 its vessels are commonly turgid with black blood ; but sometimes the 

 turgescence of the cerebral blood-vessels is not in proportion to the 

 accumulation of blood in the other organs. 



There is always a quantity of water mixed with frothy matter in 

 the trachea and bronchi. Occasionally this frothy matter is mixed 

 with blood. The quantity varies a good deal in different cases, but it 

 is never very great. At one time it was thought to be so great as to 

 be the cause of death in drowning. It was conceived that the water 

 flows into the lungs by the trachea in such abundance as to occasion 

 asphyxia. The controversy which was long agitated on this point is 

 now set at rest by numerous and accurate experiments, which demon- 

 strate that only a very inconsiderable quantity of water enters the 

 trachea, and never sufficient to occasion death. 



A similar controversy prevailed on the question whether water 

 enters the stomach, which ia now equally decided in the negative. It 

 is proved beyond all doubt that no water passes into the stomach, or 

 at least that no quantity enters it capable of contributing in the 

 slightest degree to the fatal event. The establishment of this point is 

 important, because the contrary notion had led to the adoption of 

 moat pernicious practices. With a view of evacuating the water sup- 

 posed to be accumulated in the lungs and stomach, the bodies of the 

 drowned, when taken out of the water, were held up by the heels, 

 rolled on barrels, and subjected to other practices calculated rapidly to 

 extinguish any remaining spark of life ; and though the notion which 

 led to these absurd practices is exploded, the practices themselves 

 continue. 



The proper remedies for the recovery of the drowned are few and 

 wimple. The body, placed on a bed-chair, should be removed to the 

 receiving-house or any place where the conveniences required may be 

 most easily obtained. The wet clothes should be stripped off as 

 rapidly as possible, the body well dried and surrounded by warm air, 

 if it can be readily procured, by the portable warm-air bath, of which 

 there ought to be one at every receiving-house. At first the heated 

 air should only be a few degrees above the temperature of the body, 

 and the heat, which ought always to be ascertained by a thermometer, 

 should be subsequently increased with caution. The body being thus 

 surrounded with warm air, artificial respiration should be performed 

 without the delay of a moment, and this should be assisted by elec- 

 tricity applied at first in the form of very gentle shocks. 



By the application of heat the capillary blood-vessels are stimulated" 



to action, the determination of blood towards the external surface of 



the body is favoured, and the internal organs are thus relieved of their 



-Hive load. By artificial respiration the cavity of the chest is 



'.d, the collapsed state of the lungs is removed, and atmospheric 



air, Uie great agent needed for the decarbonisation of the blood, and 



on the want of which all the dangerous phenomena of drowning depend, 



is transmitted to the lungs and brought into contact with the venalised 



blood. By electricity the organs which carry on the mechanical part 



of respiration, that is, those which alternately enlarge and diminish 



the capacity of the thorax, are roused and excited to resume their 

 natural action. There are some few other useful auxiliaries, but so 

 important and efficacious are these three powerful agents, when judi- 

 ciously and perseveringly employed, that they may be considered as 

 the only remedies worth regarding. But unfortunately they are as 

 potent for evil as for good. A slight mismanagement of any of them 

 may utterly destroy that life which the delicate and skilful use of it 

 would have reanimated. 



A plan of treatment of the drowned was proposed by the late 

 Dr. Marshall Hall to the Royal Humane Society in 1856. Many 

 instances have been recorded of the benefit of this plan, in cases of 

 suffocation and drowning, even after the heart had entirely ceased to 

 beat. We give this plan in Dr. Marshall Hall's own words : 



1. Treat the patient instantly on the spot, in the open air, except 

 in the severe weather, freely exposing the face, neck, and chest to the 

 breeze. 



2. Send with all speed for medical aid, and for articles of clothing, 

 blankets, &c. 



3. Place the patient gently on the face, with one arm under the fore- 

 head, so that any fluids may flow from the throat and mouth, and 

 without loss of time 



I. To excite Respiration. 



4. Turn the pitient on his side, and 



a. Apply snuff or other irritant to the nostrils. 



6. Dash cold water on the face, previously rubbed briskly until 



it is warm. 

 If there be no sucoess, again lose no time ; but, 



II. To imitate Respiration, 



5. Replace the patient on his face (when the tongue then will fall 

 forward, and leave the entrance into the windpipe free) ; then 



6. Turn the body gently, but completely on the side and a little 

 beyond (when inspiration will occur), and then on the face, making 

 gentle pressure along the back (when expiration will take place), alter- 

 nately ; these measures must be repeated deliberately, efficiently, and 

 perseveringly, fifteen times in the minute only. Meanwhile, 



III. To induce circulation and warmth, 



continuing these measures, 



7. Rub the limbs upwards, with firm pressure and with energy, 

 using handkerchiefs, &c., for towels. 



8. Replace the patient's wet clothing by such other covering as can 

 be instantly procured, each bystander supplying a coat, waistcoat. &c. 



" These rules," says Dr. Hall, " are founded on physiology, and whilst 

 they comprise all that can be done immediately for the patient, exclude 

 all apparatus, galvanism, the warm bath, &c., as useless, not to say inju- 

 rious, especially the last of these, and all loss of time in removal, &c. , 

 as fatal." 



DRUGS; DRUGGISTS. The difference between drugs and che- 

 micals is vague and indeterminate ; and the professions of the chemist 

 and druggist and apothecary are in like manner generally mixed up 

 together in popular estimation. The rules established by the medical 

 corporations, such as the College of Physicians, the College of Surgeons, 

 and the Apothecaries' Company, have had much to do in producing this 

 uncertainty. The acids, alkalies, salts, and oxides used in largest 

 quantity, are made on a scale which requires complete manufacturing 

 arrangements, with large furnaces, stills, and other apparatus. Such 

 is the case in relation to sulphuric and nitric acids, chlorides of lime 

 and of sodium, alum, &c. ; such articles are made by manufacturing 

 chemists, at the vast chemical works which are met with at Glasgow, 

 Liverpool, Newcastle, Hull, and Bristol,} and to some extent in the 

 metropolis. A retail shopkeeper who calls himself a chemist and 

 druggist is a chemist in so far as he retails, and understands the general 

 character of, the chemicals made on a large scale by others ; while he 

 may be regarded as a druggist to the extent that he understands, and 

 sells by retail, the substances used in medicine. If he can himself 

 prepare, on a small scale, a considerable number of -the substances 

 which he sells, it is now customary to term him a pharmaceutist or 

 pharmaceutical chemist. 



Dr. Normandy has published a work on drugs and chemicals, under 

 the name of ' The Commercial Handbook of Chemical Analysis,' 

 especially designed to afford aid in the detection of fraud in the manu- 

 facture of food, drugs, and chemicals. The list of articles of which 

 the processes of adulteration, and the means of detection, are given, 

 is very comprehensive ; including not only ordinary viands and beve- 

 rages, as bread, porter, tea, coffee, chocolate, cocoa, spirits, liqueurs, 

 and wines, but the drugs used in medicine, and a great variety of mis- 

 cellaneous substances. They are alphabetically arranged, for con- 

 venience of reference. " Country druggists," it has been remarked, 

 " form a class of persons to whom this book would be very serviceable ; 

 for, although there are of course highly creditable exceptions, par- 

 ticularly in great provincial towns, the bulk of them are not distin- 

 guished for chemical or even pharmaceutical knowledge. Few are 

 capable of conducting an analysis or organic research, and they are 

 frequently imposed upon by wholesale dealers, who send them damaged 

 or spurious drugs, which, if administered in dangerous maladies, might 

 induce aggravation of disease, and very probably cause death." 



