ARTIFICIAL RESPIRATION. 855 



KULES OF THE KOYAL HUMANE SOCIETY. 



Treatment to Restore Natural Breathing. 



RULE 1. To maintain a Free Entrance of Air into the Windpipe. Cleanse the 

 mouth and nostrils ; open the mouth ; draw forward the patient's tongue, 

 and keep it forward : an elastic band over the tongue and under the chin 

 will answer this purpose. Remove all tight clothing from about the neck 

 and chest. 



RULE 2. To adjust the Patienfs Position. Place the patient on his back on 

 a flat surface, inclined a little from the feet upwards ; raise and support the 

 head and shoulders on a small firm cushion or folded article of dress placed 

 under the shoulder-blades. 



RULE 3. To imitate the Movements of Breathing. Grasp the patient's arms 

 just above the elbows, and draw the arms gently and steadily upwards, un- 

 til they meet above the head (this is for the purpose of drawing air into the 

 lungs) ; and keep the arms in that position for two seconds. Then turn 

 down the patient's arms, and press them gently and firmly for two seconds 

 against the sides of the chest (this is with the object of pressing air out of 

 the lungs. Pressure on the breast-bone will aid this). (The Silvester 

 method. ) 



Repeat these measures alternately, deliberately, and perseveringly, fifteen 

 times in a minute, until a spontaneous effort to respire is perceived, imme- 

 diately upon which cease to imitate the movements of breathing, and pro- 

 ceed to INDUCE CIRCULATION AND WARMTH. 



Should a warm bath be procurable, the body may be placed in it up to the 

 neck, continuing to imitate the movements of breathing. Raise the body in 

 twenty seconds in a sitting position, and dash cold water against the chest 

 and face, and pass ammonia under the nose. The Patient should not be 

 kept in the warm bath longer than five or six minutes. 



RULE 4. To excite Inspiration. During the employment of the above method, 

 excite the nostrils with snuff or smelling-salts, or tickle the throat with a 

 feather. Rub the chest and face briskly, and dash cold and hot water alter- 

 nately on them. 



Treatment after Natural Breathing has been Restored. 



RULE 5. To induce Circulation and Warmth. "Wrap the patient in dry 

 blankets, and commence rubbing the limbs upwards, firmly and energeti- 

 cally. The friction must be continued under the blankets, or over the dry 

 clothing. 



Promote the warmth of the body by the application of hot flannels, bottles or 

 bladders of hot water, heated bricks, &c., to the pit of the stomach, the 

 armpits, between the thighs, and to the soles of the feet. Warm clothing 

 may generally be obtained from by-standers. 



On the restoration of life, when the power of swallowing has returned, a tea- 

 spoonful of warm water, small quantities of wine, warm brandy and water, 

 or coffee should be given. The patient should be kept in bed, and a disposi- 

 tion to sleep encouraged . During reaction, large mustard plasters to the 

 chest and below the shoulders will greatly relieve the distressed breathing. 



In the recovery from drowning, or from other forms of asphyxia, 

 the various phenomena which characterize the production of that state 

 are, as it were, reversed or undone, beginning at the re-establishment 

 of the flow of blood through the pulmonary capillaries. On the in- 

 troduction of air into the lungs, by the artificial imitation of the re- 

 spiratory movements, oxygen is once more absorbed by, and carbonic 



