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ROYAL NATIONAL LIFE BOAT INSTITUTION.

DIRECTIONS FOR RESTORING THE APPARENTLY DROWNED.

The leading principles of the following Instructions are those of thelate Dr. MARSHALL HALL, for the Restoration nf tite apparently Deadfrom Drowning, and are the results of the latest discoveries:-

Send immediately for medical assistance, blankets, and dry clothin!?; but proceed totreat the patient instrantly on the spot, in the open air, whether ou shore or afloat.The points to be aimed at are, first and immediately, the restoration of breathing and

the prevention of any further diminution of the warmth of the body; and secondly,after breathing- is restored, the promotion of warmth and circulation.The efforts to restore breathing’, and to prevent any further diminution of the warmth

of the body. must lre commenced immedi,,itelv and energetically, and must be perseveredin for several hours, or until a medicat man has pronounced that life is extinct. Effortsto promote warmth and circulation must be deferred until natural breathing has beenrestored.

TO RESTORE BREATHING.TO CLEAR THE THROAT-

1. Place the patient on the floor or ground, with hisface downwards, and onp of his arms under the forehead.in which position all nnids will escape by the month, andthe tongue itself will fall forward, leaving the entranceinto the windnipe free. Assist this operation by wipingand cleansing thp month.

2. If satisfactory breathirg commences, adopt thetreatment described on the next page to promote warmthand natural breathing. If there be only slight breathing,or no breathing, or if it fail, then-

TO EXCITE BREATHING-

3. Turn the patient well and instantly on the sideand-

4. Excite the nosh-ilo with snuff, hartshorn, and smell-ing salts, or tiekif thp throat with a feather, &c., if theyare at hand. Rub the chest and face warm, and dashcold water on it.

5. If there be no success, lose not a moment, but in-stantly TO IMITATE BREATHING-

6. Replace the patient on the face, raising and sup-porting the chest well on a folded coat or other article ofdress.

7. Turn the bodv very gently on the side and a littlebeyond, and then brisklv on the face. back again; re-peating these measures deliberately, efficiently, and per-severingly about fifteen times in the minute. or oneeevery four seconds, occasionally varying the side: [Byplacing the patient on the chest, the weight of the bodyforcfs the air out; wben turned on the side, this pres-sure is removed, and air enters the chest.]

8. On each occasion that the body is replaced on theface, make uniform but emcient pressure, with briskmovement, on the back between and below the shoulder-blades or bones on each side. removing the pressure im-mediately before turning the body on the side: [Thefirst measure increoses the expiration, the second com-mences inspiration.]

*** The result is respiration or natural breathing; andif not too late, life.

CAUTIONS.

1. Be particularly careful to prevent persons crowdinground the body.

2. Avoid all rough usage and turning the body on theback.

3. Under no circumstances hold the body up by thefeet.

TO PREVENT ANY FUR-THER DIMINUTIONOF WARMTH.

, N.B.-The.,e efforts mustbe made very cautiously, andmust not be such as to pro-mcte wllrmfh and circulation

rapidly ; for if circulation isinduced before breathing hasL been restored, the life of thepatient will be endangered.No other e1T’eet, therefore,should he sought from themthan the prevention of eva-poration, and its result, thediminution of the warmth ofthe body.

1. Expose the face, neck,and chest, except in severeweather (such as heavy rain,frost, or snow).

2. Dry the face, neck, andchest as soon as possible withhandkerchiefs or anything athand; and then dry the handsand feet.

3. As soon as a blanket orother covering can be ob-tained, strip the body; butif no covering can be iiytm,--diately procured, take dryclothing from the bystanders,dry and re-clotht, the body,taking care not to interferewith the efforts to restorebreathing.

CAUTIONS.

1. Do not roll the body oncasks.

2. Do not rub the bodywith salt or spirits.

3. Do not inject tobafeo-smoke or infusion of tobacco.

4. Do not place the patientin a warm bath.

N.B.-The directions are printed in parallel columns to avoid confusion, snd to ensurethat the efforts to obtain both objects shall be carried on at the same time.

TREATMENT AFTER NATURAL BREATHING HAS BEEN RESTORED.

TO PROMOTE WARMTH AND CIRCULATION.

1. Commence rubbing the limbs unwards, with firm grasping’ pressure and energy’using handkerchiefs, Rennets &e : [’By this measure the blood is propelled along theveins towarrls the heart.] The friction must be continued under the blanket or overthe dry clothing.

2. Promote the warmth of the body by the application of hot Bannel*’, bottles, orbladders of hot water, heated hricks, &e., tr, the pit of the stomach, the armpits,between the thighs, and to the soles of the feet.

3. If the patient has been carried to a house after respiration has been restcred, becareful to let the air play freely about the room.

4. On the restoration of life, a teaspoonful of warm water should be given ; and then,if the power of swallowing have returned, small quantities of wine, warm brandy-and-water, or coffee, should be arlministered. The patient should be kept in bed, and a dis-position to sleep encouraged.

GENERAL OBSERVATIONS.The above treatment should he persevered in for several hours, as it is an erroneous

opinion that persons are irreeoverable because li’e does not soon make its appearance,cases having been successfully treated after persevering for many hours.

APPEARANCES WHICH GENERALLY ACCOMPANY DEATH.

Breathing and the heart’s action cease entirely; the eyelids are generally half-closed;the pupil- dilated; the jaws clenched; the fing-ers semi-eontracted; the tongue ap-proaches to the under edees of the lips, and these, as well as the nostrils, are coveredwith a frothy mucus. Coldness and pallor of surface increase.

ROYAL HUMANE SOCIETY’S INSTRUCTIONS

DIRECTIONS FOR RESTORING THE APPARENTLY

DEAD.

I.-IF FROM DROWNING OR OTHEB SUFFOCATION, OR NARCOTICPOISONING.-Send immediately for medical assistance, blankets, anddry clothing ; but proceed to treat the patient instantly, securing asmuch fresh air as possible.

The points to be aimed at are, first and immediately, the restorationof breathing ; and secondly, after breathing is restored, the promotionof warmth and circulation.

The efforts to restore life must be persevered in until the arrival ofmedical assistance, or until the pulse and breathing have ceased, forat least an hour.

TREATMENT TO RESTORE NATURAL BREATHING.

RULE 1.—To MAINTAIN A FREE ENTRANCE OF AIR INTO THEWINDPIPE.-Cleanse the mouth and nostrils; open the mouth; drawforward the patient’s tongue, and keep it forward : an elastic bandover the tongue and under the chin will answer this purpose. Removeall tight clothing from about tbe neck and chest.

RULE 2.-To ADJUST THE PATIENT’S POSITION.-Place the patienton his back on a flat surface, inchned a little from the feet upwards;raise and support the head and shoulders on a small firm cushion orfolded article of dress placed under the shoulder-blades.

RULE 3.-To IMITATE THE MOVEMENTS OF BREATHING_-Graspthe patient’s arms just above the elbows, and draw the arms gentlyand steadily upwards until they meet above the head (this is for thepurpose of drawing air into the lungs), and keep the arms in thatposition for two seconds. Then turn down the p1tient’s arms, andpress them gently and firmly for two seconds again-t thl’ sides of thechest (this is with the object of pre-sing air out of the lungs. Pres-sure on the breast-bone will aid this).

Repeat these measures alternately, deliberately, and perseveringly,fifteen timds in a minute, until a spontaneous effort to respire isperceived, immediately upon which cease to imitate the move-ments of breathing, and proceed to induce circulation andwarmth (as below).

Should a warm bath be procurable, the body may be placed in itup to the neck, continuing to imitate the movements of breath-ing. Raise the body in twenty seconds in a sittuig position,and dash cold water against the chest and face, and passammonia under the nose. The patient shou d not be keptin the warm bath longer than five or six minutes.

RULE 4.-To ExcITE INSPIRATION.—During the employment of theabove method, excite the nostrils with snuff or smelling salts, ortickle the throat with a feather. Rub the chest and face briskly, anddash cold and hot water alternately on them.

*** The above directions are chiefly Dr. H. R. SILVESTER’S methodof restoring the apparently dead or drowned, and have been approvedby the Royal Medical and Chirurgical Society.

TREATMENT AFTER NATURAL BREATHING HAS BEEN

RESTORED.

RULE 5.-To INDUCE CIRCULATION AND WARMTH. - Wrap thepatient in dry blankets, and commence rubbing the limbs upwards,firmly and energetically. The friction must be continued under theblankets or over the dry clothing.

Promote the warmth of the body by the application of hot flan-nels, bottles or bladders of hot water, heated bricks, &c., to thepit of the stomach, the armpits, between the thiglls, and to thesoles of the feet. Warm c;othing may generally be obtainedfrom the bystanders.

On the restoration of life, when the power of swallowing has re-turned, a teaspoonful of warm water, small quantit’es of wine,warm brandy-anft-water, or coffee, should be given. Thepatient should be kept in bed, ann a disposition to sleep en-couraged. During reacti n, large musta d plastt-rs to the chestand below the shoulders will greatly relieve the distressedbreathing.

II.-IF FROM INTENSE COLD.-Rub the body with snow. ice, orcold water. Restore warmth by slow degrees. In these accidents itis highly dangerous to apply heat too early.

III.-IF FROM INTOXICATION.-Lav the individual on his side on abed, with his head raised. The patient should be induced to vomit.Stimulants should be avoided.

IV.-IF FROM APOPLFXY OR SUN-STROKE.-Cold should be appliedto the head. which should be kept well raised. Tight clothing shouldbe removed from the neck and chest.

APPEARANCES WHICH GENERALLY INDICATE

DEATH.

There is no breathing or heart’s action ; the eyelids are generallyhalt-closed; the pupils dilated; the jaws clenuhed; the fimers semi-contraeted ; the tongue appearing between the teeth ; and the mouthand nostrils are covered with a frothy mucus. Coldness and pallor ofsurface increase.