420 REPORT — 1869. 



Respecting the means of recovery from the intoxication by the slowly acting 

 narcotics, the rnles are extremely few and simjjle : they are two only, and they 

 include all ; they are («) exposiu-e of the animal to warm air, and (6) in 

 extremity the steady and efficient maintenance of artificial respiration. 

 When these rules are rigorously followed, death from the profoundest intoxi- 

 cation is rare. This remark applies even to those extreme examples where 

 there are tremors of muscles and all the signs of instant dissolution. The 

 temperature of the air should be, as a rule, about ten degrees below that of 

 the natural temperature of the animal. But in intervals of great depression 

 the temperature may be raised to ten and even twenty degrees above the 

 degree of temperature natural to the animal. 



In regard to recover}' from the extreme and sudden effects of the second 

 class of substances, moderate warmth of air is again an advantage ; but 

 sudden extreme warmth is often fatal, from the expansion of gaseous matter 

 in the lungs. From G0° to 65° Fahr. is the best temperature for recovery 

 from the more volatile agents. 



In both classes of cases artificial respiration is often all essential ; but it 

 may be used to kill as well as to save, imless it always be used with a perfect 

 knowledge of what it is to do. 



And this I find to be a rule having no exception, that it is always bad 

 practice to excite artificial respiration so long as there is anything like a 

 natural respiration. If the subject be breathing once in ten or even fifteen 

 seconds, it is best to let well alone. The reason for this rule is simple, and 

 rests on the fact that the balance of circulatory and respiratory power must 

 be sustained. In health there is a nicely adjusted balance of pressure be- 

 tween the blood brought by the action of the right side of the heart to the 

 lungs to be aei'ated, and the air brought by the muscles of respiration to eifcct 

 aeration. To resort to any violent means to enforce respiratory movement is 

 to destroy this delicate balance, to cause rupture of the air-vesicle, and infil- 

 tration of air into the surrounding tissue — emphysema. In brief, when the 

 current of blood passing from the right to the left side of the heart is 

 reduced, as it is in the cases we are treating of, to the extreme of debility, 

 the i)oiut of practice is to bring back the respiration and the circulation toge- 

 ther. NVe must treat the body, in a word, as we would a candle or lamp, the 

 active flame of which is extinguished, but the wiek of which is still burning 

 without flame. It is also important, in performing this act, not to disturb 

 the body by any sudden movement, for the least motion, when the circulation 

 is ebbing, is often sufficient to stop the enfeebled and hesitating heart. 



To meet these refinements in the method of restoring animation, I have 

 invented the simple pocket-bellows which I place before you ; they arc made 

 of india-rubber, and the bellows part consists of two round balls, which can 

 be grasped by one hand. "When the bellows are compressed, the ball on the 

 right-hand side yields the air it contains to the long exit-tube, while the 

 ball on the left hand yields the air it contains directly to the outer atmo- 

 sphere. When the bellows are allowed to till with air, the right ball fills 

 directly from the pure air, the left from the long exit-tube. AVhen, then, 

 the long exit-tube is inserted in the nostril, and the beUows are worked 

 together, one bcUows fills the lungs, during compression, with pure air, the 

 other empties the lung, during expansion, of impure air. Thus the natural 

 conditions for breathing are carefully imitated, and the manipulation is 

 simple to the last degree. In using the bellows I commonly leave one nostril 

 quite open, putting the tiibe of the bellows firmly into the other. Then I 

 commence gentle inflation, and continue until such time as the action of 



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