;24 



ACCIDENTS AND INJURIES. 



and shoulders on a small firm cushion, as 

 a folded coat, placed under the shoulder 

 blades. Keep the tongue still projecting 

 as before directed ; then let an operator 

 stand at the patient's head, grasp the 

 arms just above the elbows, and draw the 

 arms gently and steadily upwards until 

 they meet above the patient's head (this 

 is for the purpose of drawing air into the 

 lungs), and keep the arms in this position 

 for two seconds. Then turn down the pa- 

 tient's arms, and press them gently and 

 firmly for two seconds against the sides 

 of the chest ; repeat these measures alter- 

 nately, deliberately and perseveringly, 

 about fifteen times a minute, until a natu- 

 ral effort to breathe is perceived, when 

 you may immediately cease and proceed 

 at once to induce warmth and circulation. 

 Commence rubbing the limbs upwards, 

 with a firm, grasping pressure and ener- 

 gy, using handkerchiefs, flannels, etc. 

 Continue the friction under the blankets, 

 or even over the dry clothing, if that has 

 been put on. Promote the warmth of the 

 body with hot flannels or hot bricks, or 

 bottles filled with hot water and placed 

 under the arm-pits, between the thighs, 

 and at the soles of the feet. Be careful 

 not to expose the patient to any draught, 

 but let the room be well ventilated. On 

 restoration to life, a teaspoonful of warm 

 water should be given, and when power 

 of swallowing has returned, small quanti- 

 ties of wine, warm spirits and water, or 

 coffee should be administered. Keep the 

 patient in bed, and any disposition to 

 sleep should be encouraged. In carry- 

 ing out the above treatment, avoid rough 

 usage, be careful to keep the tongue out, 

 and do not desist in your treatment until 

 all hope and chance are gone, for persons 

 have been restored by the above treat- 

 ment after many hours' perseverance. 



The following are the rules for .the re- 

 storation of persons apparently dead 

 from drowing, given by Dr. Benjamin 

 Howard, of New York city, and sanc- 

 tioned by the Metropolitan Board of 

 Health, of the city of New York: 



i. Unless in danger of freezing, never 

 move the patient from the spot where 

 first rescued, nor allow bystanders to 

 screen off the fresh air, but instantly wipe 

 clean the mouth and nostrils, rip and re- 

 move all clothing to a little below the 

 waist, rapidly rub and dry the exposed 



part, and give two quick, smarting slaps; 

 on the stomach with your open hand. 

 If this does not succeed immediately,, 

 proceed according to the following rules 

 to perform artificial breathing: 



2. Turn the patient on his face, a 

 large bundle of tightly-rolled clothing 

 being placed beneath his stomach, and 

 press heavily over it upon the spine for 

 half a minute. 



3. Turn the patient quickly again on 

 his back ; the roll of clothing being so 

 placed beneath it as to make the short- 

 ribs bulge prominently forward, and raise 

 them a little higher than the level of the 

 mouth. Let some bystanders hold the 

 tip of the tongue out of one corner of 

 the mouth with a dry handkerchief, and 

 hold both hands of the patient together, 

 the arms being stretched forcibly back 

 above the head. 



4. Kneel astride the patient's hips, and 

 with your hands resting on his stomach, 

 spread out your fingers so that you can 

 grasp the waist about the short-ribs. 

 Now throw all your weight steadily for- 

 ward upon your hands, while you at the 

 same time squeeze the ribs deeply, as if 

 you wished to force everything in the 

 chest upwards out of the mouth. Con- 

 tinue this while you can slowly count — 

 one — two — three ; then suddenly let go,, 

 with a final push, which springs you back 

 to your first kneeling position. Remain 

 erect upon your knees while you can 

 count — one — two ; then throwyour weight 

 forward again as before, repeating the en- 

 tire motions — at first about four or five 

 times a minutes, increasing the rate grad- 

 ually to about fifteen times a minute, and 

 continuing with the same regularity of 

 time and motion as is observed in the 

 natural breathing which you are imitat- 

 ing. 



5. Continue this treatment, though ap- 

 parently unsuccessful, for two hours, or 

 until the patient begins to breathe ; and 

 for a while after this, help him by well- 

 timed pressure to deepen his first gasps, 

 into full, deep breaths ; while the friction 

 of the limbs, which should, if possible, 

 have been kept up during the entire pro- 

 cess, is now further increased. 



6. As soon as the breathing has be- 

 come perfectly natural, strip the patient 

 rapidly and completely. Wrap him in 

 blankets only. Put him in bed in a. 



