57« 



NATURE 



[August 7, 19 13 



which, on the whole, is a closer representation 

 of the facts of nature than a collection of more 

 accurate scraps of knowledge not properly assimi- 

 lated one to the other can possibly be. Those 

 biologists who find it a matter of the utmost 

 difficulty to keep abreast of the growth of know- 

 ledge in one small corner of the vast field of 

 comparative anatomy can alone appreciate the 

 magnitude of the task Prof. Biitschli has accom- 

 plished in these volumes. For a man who has 

 built up a deservedly great reputation by original 

 investigation in the domain of protozoology to 

 write the best comparative anatomy of the 

 Vertebrates is surely an achievement that is not 

 likely to he repeated. G. E. S. 



RESUSCITATION. 

 Resuscitation from Electric Shock, Traumatic 

 Shock, Drowning, Asphyxiation from any cause 

 by means of Artificial Respiration by the 

 Prone Pressure (Schaefer) Method. By Dr. 

 C. A. Lauffer. Pp. v + 47. (New York: John 

 Wiley and Sons ; London : Chapman and Hall, 

 Ltd., 191 3.) Price 2S. net. 



IN this little book of forty-seven pages Dr. 

 Lauffer, the medical director of the Westing- 

 house Electric and Manufacturing Company, East 

 Pittsburg, deals with the subject of artificial re- 

 spiration as applied to resuscitation in electric 

 shock. Dr. Lauffer is an enthusiastic advocate of 

 the prone pressure (Schaefer) method of resuscita- 

 tion, and his enthusiasm appears to be based upon 

 considerable experience. He narrates several 

 cases which have come under his immediate notice 

 in which it has been successfully employed : one 

 of concussion of the brain, with unconsciousness 

 and failure both of heart and respiration, requir- 

 ing an hour's application of the method: two 

 severe cases of electric shock ; one of suffocation 

 from smoke, in which life appeared to be extinct ; 

 one of an injury to the head, in which respiration 

 was completely arrested and the patient would 

 have died but for the prompt assistance of artificial 

 respiration on the part of one of the men whom he 

 had instructed who happened to be present ; and 

 one of drowning. In addition to these cases, he 

 states that he knows a man who has resuscitated 

 six victims of electric shock, all of which cases 

 would have been fatal but for his prompt and 

 efficient efforts at artificial respiration. The author 

 adds, " This man is an enthusiastic advocate of 

 the prone pressure method." 



Dr. Lauffer does not, it will be seen, confine 

 himself to those cases in which he is more imme- 

 diately interested, but has carried on his observa- 

 NO. 2284, VOL. 91] 



tions on cases of asphyxia from whatever cause. 

 He points out the various circumstances in 

 which artificial respiration may be necessary, in- 

 cluding asphyxia arising from poisoning from 

 carbon monoxide, ammonia fumes, gasoline fumes, 

 sewer gas, suffocation by smoke, inhalation of 

 confined air, inhalations of chloroform and ether, 

 overdoses of laudanum, shock from a heavy blow 

 on the abdomen, and apparent death from drown- 

 ing. He explains the process of respiration, and 

 gives a clear account of the manner in which 

 artificial respiration should be performed. He 

 especially emphasises the fact that by the prone 

 pressure method resuscitation can easily be carried 

 out by a single individual and without the aid of 

 any extraneous apparatus; even if the operator 

 be a mere boy and the victim an adult, the boy 

 can utilise more than 80 per cent, of his weight 

 by raising his knees from the ground and sup- 

 porting himself entirely on his toes and the heels 

 of his hands, the latter being properly placed over 

 the floating ribs of the patient. He might perhaps 

 have added that if the boy were to kneel directly 

 upon the back of the patient, an even larger pro- 

 portion of the operator's weight might be utilised. 



Dr. Lauffer has never seen a case of fracture 

 of the ribs or any damage to internal organs arise 

 from the prone pressure method. He considers 

 that the teaching of the subject should be made a 

 part of every gymnastic course, especially in col- 

 lege and Y.M.C.A. gymnasiums and in Boy Scout 

 organisations (which we believe is already the case 

 in this country) ; he states that it is employed in 

 the United States Army as part of the setting-up 

 exercises. 



The author further deals with the question of 

 supplementary assistance which might be ren- 

 dered if there is any second person to assist, but 

 rightly points out that nothing must be allowed to 

 interfere with the immediate application of arti- 

 ficial respiration, nor should this be desisted from 

 nor the patient permitted to get up until his 

 breathing has become regular. Dealing with the 

 question of mechanical assistance, whilst not 

 averse to the employment of any such assistance 

 if it is immediately available, he points out that 

 extravagant claims are made for various 

 mechanical devices, and that, since such devices 

 may be too remote, or when procured may be out 

 of order, he concludes that there is nothing so 

 dependable as the hands of a man's friends, and 

 that no reliance can be placed on any outfit that 

 cannot be carried with every electrical workman 

 and which is not instantly available. 



We commend Dr. Lauffer's little book to all 

 who are interested in the subject. 



