326 



NATURE 



[August 6, 1903 



with the thoroughness and success with which it has 

 reformed and revivified every branch of higher 

 education. Cloudesley Brereton, 



Principal works consulted :— " Ministfere de I'lnstruc- 

 tion Publique et des Beaux Arts; (i) Statistique de 

 I'Enseignement Sup^rieur; (2} Introduction k la 

 Statistique de I'Enseignement Sup^rieur, par M. L. 

 Liard, Directeur de I'Enseignement Superieur. (Paris : 

 Imprimerie Nationale, MDCCCC.) (3) " Legislation 

 et Jurisprudence de I'lnstruction Publique. Extrait du 

 Repertoire du Droit administratif." Premiere partie, 

 Historique et Organisation g^n^rale ; Deuxieme partie, 

 Enseignement Superieur; Sixieme partie, Ecoles ne 

 relevant du Ministere de I'lnstruction Publique. (Paris : 

 P. Dupont, 1903.) 



THE RESUSCITATION OF THE APPARENTLY 



DROWNED. 

 T N 1862 a committee, which included several eminent 

 •"■ medical men and physiologists— amongst the latter 

 Dr., now Sir, John Burdon Sanderson — was appointed 

 by the Royal Medical and Chirurgical Society to investi- 

 gate the phenomena attendant upon drowning, and the 

 methods which had been recommended for the recovery 

 of apparently drowned persons. That committee made 

 a number of experiments in man upon the dead sub- 

 ject, and upon animals during life, and the results 

 they obtained were duly published in the Transactions 

 of the society. But it appeared important to renew 

 the inquiry with modern methods, and a second com- 

 mittee for the investigation of this important subject 

 was accordingly appointed a few years ago, with Prof. 

 Schafer as chairman. This second committee 

 attempted, in the first instance, to pursue the inquiry 

 as to the best means of carrying on artificial respira- 

 tion, in the same manner as the 1862 committee, i.e. 

 upon the cadaver, but met with grave difficulties from 

 the outset in the enormous resistance which the con- 

 dition of rigor mortis sets up to effecting changes of 

 volume of the chest, a difficulty which had been also 

 met by the earlier committee, and very imperfectly 

 surrnounted. The new committee accordingly decided 

 to discard the cadaver, and to endeavour to determine 

 in the living human subject how great an amount of 

 air could be moved into and out of the lungs by move- 

 ments imparted to the thorax by the agency of external 

 force. This force was applied either by intermittent 

 traction upon the arms, or by intermittent pressure 

 upon the thorax, the subject being either in the supine 

 or prone position, and remaining perfectly passive 

 during the short period of the experiment. The 

 amount of air taken in and given out was measured 

 in a graduated vessel, or by means of an ordinary 

 gasometer. 



The results showed that by all methods which have 

 been suggested for the performance of artificial re- 

 spiration, viz. the Silvester traction method, the Mar- 

 shall Hall rolling method plus compression of thorax, 

 the Howard method of compression of thorax in the 

 supine position, and also a similar method of pressure 

 upon the thorax with the subject in the prone or semi- 

 prone position, an amount of air can be drawn into 

 and driven out of the thorax which is at least as great 

 as the amount of air exchanged in the ordinary tidal 

 respirations of the individual. This being so, it is 

 evident that, in selecting a method of artficial respira- 

 tion for restoring the drowned, one should be guided 

 less by the actual amount of air which any given 

 method is capable of exchanging than by other con- 

 siderations, such as the facility offered for the escape 

 of water and mucus from the air passages, and the 

 preventing of the tongue from falling back and block- 

 ing the fauces, both of which objects are better 

 NO. 1762, VOL. 68] 



attained by the lateral and prone than by the supine 

 position. It was further clear that it is more easy 

 to effect artificial respiration by exerting intermittent 

 pressure upon the thorax than by arm traction, and 

 although the committee do not give instructions for 

 the restoration of the apparently drowned in their re- 

 port, it is obvious that their conclusions point to the 

 adoption of the prone or semi-prone position of the 

 subject, and to rhythmically intermitted pressure upon 

 the thorax, as the methods which are likely, in the 

 circumstances of drowning, to yield the best results. 



The experiments upon animals (which were per- 

 formed almost entirely upon anaesthetised dogs) are, it 

 is believed, the first in which all the phenomena con- 

 nected with the circulation and respiration have been 

 graphically recorded during the process of drowning 

 and subsequent resuscitation by artificial respiration. 

 The chief points which they illustrate are the very 

 large amount of water which can be taken into the 

 lungs and become entirely absorbed into the system 

 within a few minutes, without producing any but quite 

 temporary symptoms, the great amount' of vagal 

 stimulation which is produced during drowning, and 

 which is, in some instances, sufficient to arrest the 

 heart's action almost entirely, and the extreme varia- 

 bility in the power of resistance to drowning in different 

 individuals of the same species, so that, while a sub- 

 mersion of two minutes is fatal to some individuals, 

 one of seven or eight minutes, or even more, can be 

 borne by others with a fair chance of recovery as the 

 result of the application of artificial respiration. The 

 experiments all point to the supreme importance of 

 commencing artificial respiration at the earliest possible 

 moment, and are, therefore, condemnatory of all 

 instructions for the recovery of the apparently drowned 

 which direct that, before proceeding to apply artificial 

 respiration, the patient should be divested of clothing, 

 hartshorn should be applied to the nostrils, and various 

 other remedies attempted — all of which merely serve 

 to waste time, every second of which is invaluable for 

 combatting the actual condition which is threatening 

 life, viz. the lack of oxygenation of the blood. Inci- 

 dentally it was found in the course of these experiments 

 that, without sufficient aeration of the blood, even the 

 most powerful cardiac and vascular stimulant — such, 

 for example, as the extract of suprarenal capsule — is 

 entirely unable to assist recovery. 



The experiments upon the cadaver were chiefly per- 

 formed by Mr. Pickering Pick, Mr. Henry Power, and 

 Dr. J. S. Bolton, in London; those upon the living 

 subject by Prof. Schafer and Dr. P. T. Herring in 

 the physiological laboratory of the University of Edin- 

 burgh. The report of the committee was read by 

 Prof. Schafer at a largely attended meeting, held on 

 May 26 last, at the rooms of the society in Hanover 

 Square. 



NOTES. 



We regret to learn that on Saturday, July 25, M. Prosper 

 Henry, of the Paris Observatory, was found lying dead 

 in the La Valoise Valley near Pomogen at an altitude of 

 1600 metres, in the French Alps. His death appears to 

 have been due to congestion caused by extreme cold. M. 

 Henry was buried at Nancy, his birthplace, on August i. 

 A number of astronomers was present at the sad ceremony, 

 among them being M. Callandreau, of the Paris Academy 

 of Sciences ; MM. Borchart and Fraissinet, of the Paris 

 Observatory ; and M. Tripled, director of the Algiers 

 Observatory. M. Prosper Henry and his brother, M. Paul 

 Henry, were attached to the Paris Observatory in 1865, 

 and their work is well known in the astronomical world. 

 Between 1872 and 1882 they discovered fourteen asteroids, 



