1774: The birth of the Royal Humane Society

Figure 1 - This is one of two popular engravings
published and sold by the the Royal Humane Society.
This one depicts "a young man taken out of the water
apparently dead, in sight of his disconsolate parents."
(12, page v, xiii)

A primitive mother and her 8-year-old son are walking along the Nile when all of a sudden the child falls into the water.

A bystander pulls the boy out, but the boy appears to be dead: he's cold, pale-blue, and not breathing.  In other words: he is no longer animated.

Using her maternal instincts, the mother kneels over the boy and covers his mouth with her own in a panicked attempt to reanimate him.  As she exhales into his airway she observes her son's chest rise.  She does this for quite a while.  Yet despite her rash efforts her son does not survive.

Similar events must have occurred from time to time since the beginning of mankind. Since people did not understand the physiology of death and dying, their efforts would have been varied and the results mostly futile.

The most common response to such a situation would probably have been to idly stand by in a state of shock. This was described by the authors of a 1920 booklet by the Lungmotor company:

That drowning was probably a most frequent cause of accidental death in the primitive days of man, when like other animals he sought the drinking place and the swimming hole, is most probable, and is supported by Ethnological observations. That the awe and horror, which caused the early man to stand inactive beside his drowned dead is in a great measure still existent in the heart of modern man, is proven by every day observation; because where they are not definitely instructed, those measures of resuscitation which are taught by the experience of Life Saving Crews, are neglected by the general public. (1, page 3)

Figure 2 -- This engraving shows
the "subsequent resuscitation"
of the boy in figure 1.
Such engravings as these
show the 'great benevolence"
created by the efforts
of the Royal Humane Society
12, pages viii,xiii)

Indeed, there must have been a few precious moments when such a child was pulled from the water, awkward versions of mouth to mouth breathing performed, and the child survived. Perhaps a rescuer thumped on a child's chest or abdomen and the child survived. Or, perhaps he tickled the child's nose with a feather, and the child survived.

Such successes, although rare, would have brought great joy and celebration, thus encouraging the rescuers to share these stories. As later generations experienced similar situations, their response may have been similar to that of the characters in the stories.

There were random, almost vague, descriptions of artificial breathing in ancient writings, although these were generally hints of it being done, as opposed to descriptions of a specific life saving procedure.  A perfect example is the hint to mouth to mouth breathing in the Second Book of Kings where Elisha is depicted as resuscitating the child of a Shunamite woman.

When Elisha came into the house, he saw the child lying dead on his bed. 33 So he went in and shut the door behind the two of them and prayed to the Lord. 34 Then he went up and lay on the child, putting his mouth on his mouth, his eyes on his eyes, and his hands on his hands. And as he stretched himself upon him, the flesh of the child became warm.35 Then he got up again and walked once back and forth in the house, and went up and stretched himself upon him. The child sneezed seven times, and the child opened his eyes. (2 Kings 4: 33-36

However, according to an 1823 Annual Report of the Royal Humane Society:

"The art of resuscitating the apparently dead does not appear to have been known to the ancients." (12, page v)

Chances are the report is correct, and the procedure, or efforts to reannimate, were rarely performed in the ancient world.  When they were, they were rarely successful.  When they were successful, chances are the child would have lived irregardless of the technique used.

When a child who had been submerged in water survived, chances are he was breathing shallow, and had skin of a purplish color, and was cool to the touch, similar to a cadaver. He was alive, but not conscious. Eventually, whether efforts were made or not, he would take in a deep breath, open his eyes, and spit out water from his mouth.

He was, as Dr James Curry explained in 1792, in a state of "Apparent Death" but not yet in a state of "Absolute Death." Curry said: (14, page 1)

The important difference between the two states is this,—that in absolute death, the Vital Principle is completely extinguished, whilst in apparent death, it only lies dormant, and may again be roused into action, and the person thereby completely restored to life and health. (14, page 1)

By the 18th century the state of "apparent death" was often referred to as "suspended animation." Attempts at reviving, or at resuscitation, were referred to as "reanimation attempts." A person who was "brought back to life" was thought to have been "reanimated."

And regardless of the truth, credit was always given to the rescuer, or more likely God.  Her brave efforts were the reason the child was brought back to life, but her actions were guided by the almighty God.  This was the case of the Shunamite child, where the works of Elisha were proof that God existed.

The 1823 report suggested that the first official report of "recovery from drowning and hanging" did not occur until 1650. The report further notes that "it does not seem, however, that these instances did not excite any public interest, or that any serious investigation of the subject of SUSPENDED ANIMATION took place until the middle of the last century (about 1750)." (12, page v)

The first official report of artificial respiration was made in 1773, and this ultimately lead to a group of men gathering together to discuss how they might be able to help save the lives of those in need.  They would ultimately form an organization, the Royal Humane Society.

Men victims on the mind of these men were those who were pulled from water. However, there were other reasons a person might might suddenly lack animation, such as hangings or other such methods of suicide attempts.  A medical reason might be appoplexy, which is an old term used to describe what we would now refer to as a stroke.  (12, page 32)

Yet the most common reason for an unexpected death was drowning.  There were simply too many young men and children who were falling into unprotected waters only to meet their maker.

The first known evidence of mouth to mouth breathing was

Such was noted by the Lungmotor Company:

The first reliable history of a resuscitation from drowning was that performed by M. Reamer in Switzerland. This was reported to the French Academy of Sciences and translated into English by Dr. Crogan in 1773. About this time Dr. J. Fothergill published his "Physical Dissertation on Drowning," which was read before the Royal Society in England. In 1773, the first society for the rescue of those apparently drowned was instituted at Amsterdam, Holland (in 1767). In 1774, Dr. Crogan's translation of Reamer's paper, together with Crogan's success in resuscitating those apparently drowned, enlisted the sympathy of Dr. Hawes and these two gentlemen, with thirty-two of their friends, organized the Royal Humane Society which appointed Dr. John Mullwood as their first physician, and proceeded to establish stations throughout the empire to save the lives of those in a state of suspended animation due to apparent drowning. (1, page 3)(also see 12, pages v-vii)(the date 1767 comes from reference 14, page iii and 15, page 1)

Now it is well documented that the first time mouth to mouth resuscitation was recommended was by the Paris Academy of Sciences in 1740. It was essentially recommended for the reanimation of a near drowning victims.

Dr. J. Fothergill noted a variety of methods used in saving drowned victims, and in his report to the Royal Society noted "the possibility of saving many lives without risking anything." (12, page vi)

While his report went relatively ignored initially, it did ultimately lead, as noted above, to the formation of a society in Amsterdam called The Life Saving Society of Amsterdam, or The Life Saving Society of the Apparently Drowned.

A report noted:

Finding that a strong and general prejudice existed against the practicability of Resuscitation, and that the idea was even ridiculed as hopeless and chimerical, he determined to demonstrate it. With this view he publicly offered rewards to persons who, between London and Westminster Bridges, should, within a certain period from the occurrence of an accident, rescue drowned persons, and bring them to places appointed on shore for their reception. At these places he and his friends restored several lives. During a whole year Dr. (William) Hawes continued to pay these rewards himself. At the end of this period Dr. Cogan represented to him the injury his private fortune must sustain by such continued expenses, and kindly offered to unite with him for the formation of the HUMANE SOCIETY, which at first consisted of 32 individuals, their respective private friends. (12, vi-vii)

Perhaps responsible for the formation of the Royal Humane Society, and its success, was due to the fact there were physicians in England at that time (many of them of notable fame).  Dr. Hawes is responsible for forming the Humane Society, and Dr. John Hunter was the first director.  His brother Dr. William Hunter, along with Dr. Cullen, Dr. Monro Secundus, and Fothergill were also members. (15, page 1)

Another reason for the success of the organization is that...

...from the start start kept records of all cases of attempted resuscitation which came to its knowledge. At various intervals it formulated and published rules, in conformity with the views which prevailed, at the time, and stimulated individuals to and formed committees for special investigations with the object of discovering reliable methods to be employed. (15, page 1)

The keeping of data made it possible to review cases, and determine what methods worked and what methods did not work. Methods that worked would continue to be recommended as the rules and recommendations were updated. Methods that did not work, or that caused excessive trauma to the body that made caring for the reanimated patient difficult, were noted as high risk or no longer recommended.

The committees made it possible to research for better wisdom and newer methods of resuscitation. The committees also made it possible for the Humane Society to adjust to changes in society, as when new emergent situations emerged, new safety and rescue recommendations were made.

For example, along with rescuing drowned victims, the society ultimately learned how to save people from hangings, electrocutions, intoxication, gas poisoning, drug overdoses, fainting, exposure to cold, suffocation, still born births, etc.

In other words, the members of the Royal Humane Society did the best they could with the data they presently had, and as they learned better they did better.

*For example, in 1786 the Humane Society of Massachusettes was formed. (13, page 3) In 1824 the Royal National Lifeboat Association was formed.  (9, page 171), 

References: 

1. "Drowning: Historical-Statistical Methods of Resuscitation," no author nor editor listed, Published by Lungmotor Company, Boston, Massachusetts, 1920
2. "Pulmotor advertises gas company," Gas Age, volume 29, 1922, New York, Robbins Publishing Company Inc. 
3. Cannon, Walter Bradford, George Washington Crile, Joseph Erlanger, Yandell Henderson, "Report of the Committee on Resuscitation from Mine Gases," Technical paper number 77, Department of Interior, Bureau of Mines, Joseph A. Holmes, Director, 1914, Washington, Government Printing Office
4. "Schaefer Method of Resuscitation," The Colliery Engineer, August, 1913, Volume XXXIV, August 1913 to July 1914, Scranton, PA, International Textbook Co., page 53 (no author or editor listed)
5. Hughes, Martin, Roland Black, "Advanced Respiratory Critical Care,"  2011, New York, Oxford University Press; material from section 3.1: "Invasive Ventilation Basics: Development of Invasive Ventilation (history)."
6. Agasti, T.K. "Textbook of Anesthesia for Postgraduates," 2011, New Delhi, Jaypee Brothers Medical Publishers, page 590
7. Safar, Peter, "Exhaled air ventilation and cardiopulmonary resuscitation," published in the following: Gordon, Archer S, "Cardiopulmonary Resuscitation: Conference Proceedings," May 23, 1966, Washington D.C., National Research Council
8. Donahue, Mary, "History of Lifesaving," DeAnza Collegge, http://faculty.deanza.edu/donahuemary/Historyoflifesaving, accessed 8/10/13
9. "Resuscitation of the apparently drowned," The Dominion Illustrated Monthly, February, 1893, Montreal and Toronto, Vol. II, NO. 1, pages 171- 175
10. Eisenberg, Mickey S., "Life in the Balance: Emergency Methods and the Quest to Reverse Sudden Death," 1997, New York, Oxford University Press
11. Knott, Arthur Reynolds, "Lie Saving and Artificial Respiration," 2nd edition, 1915, no city or publisher noted in book
12. "The Forty Ninth Annual Report of the Royal Humane Society, For the Recovery of  Persons Apparently Drowned or Dead," 1823, London, 
13. "History of the Humane Society of Massachusetts," 1845, Boston, Samuel N. Dickinson, Printer
14. Curry, James, "Observations on Apparent Death from drowning, hanging, suffocation by noxious vapours, fainting-fits, intoxication, lightning, exposure to cold, & etc., and an account of the means to be employed for recovery. To which are added the treatment proper in cases of poison, with caution and suggestions respecting various circumstances of sudden danger," 2nd edition, 1815, London (the 1st edition was published in 1792)
15. Meltzer, S. J., "History and analysis of the methods of resuscitation," Medical Record: A Weekly Journal of Medicine and Surgery, July 7, 1917, Volume 92, Number 1, New York, 
16. Meltzer, ibid, page2; the reference alluded here is to an article by Arthur Keith, Lancet, 1909, 1, page 745, 825, 895,
17. Rush, Benjamin, "Medical inquiries and observations," volume 1, 2nd edition, 1805, Philadelphia, chapter one: "An inquiry into the natural history of medicine among the Indians of North America, and a comparative view of their diseases and remedies with those of civilized nations, read before the American Philosophical Society, held at Philadelphia, on the 4th of February, 1774," pages 1-68

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