RESPIRATION. 37* 



During the third stage the pulsations of the heart become feebler 

 and stop. After the respiratory movements have ceased the heart con- 

 tinues its action for a few seconds. 



In slow asphyxia, as in death by membranous croup, there is a 

 feeling of painful constriction around the larynx and sternum, yawns, 

 gapings, and vain efforts to breathe, with dimness of sight, buzzing in 

 ears, and vertigo, soon followed by loss of consciousness. The face 

 and lips are tumefied and livid; the eyes watery and projecting; the 

 conjunctiva injected; the jugular veins distended with blood; the 

 nose, ears, hands, and feet have a violet color; the whole skin pre- 

 sents spots like bruises; the heart movements are uneven and inter- 

 mittent, and grow weaker and weaker ; finally the respiratory, move- 

 ments become less and less frequent, soon cease altogether, and almost 

 at once the heart stops and the body is motionless in death. 



As regards mammals, the age particularly affects the rapidity of 

 death from suffocation. In fact, the newborn of this class of animals 

 resist the suppression of respiration very much longer than adults. 

 This accords with the instances of newborn infants which, having 

 been found in pools of water, or even in water-closets, have been pre- 

 served alive, although the time passed since their immersion permitted 

 but little hope of saving them. An adult cannot be submerged more 

 than four minutes, and live. 



ARTIFICIAL RESPIRATION IN ASPHYXIA. In cases of suspended 

 animation artificial respiration must be performed. Care should be 

 taken first to remove any foreign bodies or froth from the mouth and 

 nose. Draw forward the patient's tongue and keep it projecting 

 beyond the teeth, Eemove all tight clothing from about the neck and 

 chest. For relieving asphyxia by dilating and compressing the chest 

 so as to cause an exchange of gases there are several methods. Chief 

 among these are Sylvester's, Marshall Hall's and Schaefer's. 



In the Sylvester method the tongue is pulled forward to prevent 

 any hindrance to the entrance of the air into the windpipe. Expan- 

 sion of the chest is produced by drawing the arms from the sides of 

 the body and then upward until they almost meet over the head. 

 Bringing the arms down to the sides again, causing the elbows 

 almost to meet over the pit of the stomach, produces contraction of 

 the chest. The rate of elevation and depression of the arms should 

 be about sixteen times per minute. 



In the Marshall Hall method the person is placed flat upon his 



I face, gentle intermittent pressure being made upon the-back with one's 

 hands. The body is then turned on the side and a little beyond, then 



