Wednesday, March 16, 2016

1774: Humane Society: Recommended methods for reanimation

This is a depiction of the barrel-roll.  It was used to both remove water
from the victim's lungs, and as a means of providing artificial breaths.
As you might imagine, this method had the potential to be quite
hazardous for the victim, and this was probably the reason it was
ultimately rejected by the Royal Humane Society. 
During the 18th century there were various methods used to reannimate the bodies of the recently dead. The Royal Humane Society essentially settled on two.  The first involved warming the victim, and the second involved breathing for the victim.

Yet even before getting to that point, the first duty of the rescuer was to remove the victim from danger, which most of the time was water. That task accomplished, the next duty was to warm the victim in order to restore the victim's natural heat. (12, page 4)

Perhaps this was an idea initiated by primitive men and women, as they figured the victim to be dead, and cadavers are generally cold.  So given this way of thinking, warming the body would have been quite rational.  (12, page 4)

In 1792, James Curry explained this more clearly:
As a certain degree of Warmth is uniformly present while the living functions continue perfect; and as experience has shewn, that these functions are suspended or destroyed by any thing that greatly diminishes this Warmth,—it was very naturally concluded, that to restore Warmth to the body, was one of the most necessary, and, therefore, ought to be one of the first steps taken, in every case of Suspended Animation. (14, pages 35-36)
This is a depiction of the horse trot method of providing artificial breaths.
The trotting of the horse would provide the breaths, and by the patient
hanging off the side water could flow out of the lungs. 
The following were some methods of warming the victim, most of which were dependent on the materials available near the vicinity of the accident. (12, page 4)(also see 14, page 53-56)
  1. Sunshine, if it is strong at the time
  2. Drying the victim
  3. Wrap victim in warm blankets (may be heated with hot water)
  4. Lying the victim near the warm fire
  5. Filling bottles with hot water and placing them at the bottom of the feet, near joints of knees, and under armpits
  6. Placing a warming pan, heated bricks or rocks, wrapped in cloth, in the direction of the spine
  7. Filling a large bladders with hot water, wrapped in flannel, applied to region of the heart and stomach
  8. Covering the person in grass (if victim near grass house)
  9. Covering the person in bags of grain (if victim near grainery)
  10. Covering victim with warm ashes
  11. Covering victim with embers
  12. Covering the victim with warm sand
  13. Placing the victim in a warm bath
  14. A kindly person lying by the side of the victim (particularly useful for children) (12, page 4-5)
  15. Applying friction, which supplies heat and also assists with circulation of the blood during prolonged efforts at breathing for a victim. (12, page 3, 4, 8 &12)
  16. Instilling some strong stimulant, such as liquor, into the stomach.  This is done by inserting a flexible tube into the esophagus, filling the syringe with the solution, and then after connecting the syringe to the tubing, injecting the solution.  This should stimulate the heart and brain. (12, page 4)(14, page 60-61)
  17. Bleeding to relieve congestion of blood in vessels (a cause of death among drowning victims).  Extracting some of the blood from the external jugular vein may relieve the brain and contribute to the restoration of life. Other than drowning, a sign that this is indicated is turgid neck veins. (8)(12, page 18)(12, page 9-10)(14, pages 42-43, and 62-63)
  18. Bleeding by using cupping glasses on the neck. This is particularly necessary when the vessels of the neck are bulging or turgid, indicating congestion of the blood.  Such efforts were ultimately believed to release some blood from the brain, thus stimulating it. (14, page 71)
  19. Bleeding by placing leaches on the head (particularly useful for hangings, which increases congestion in the brain) (14, page 71)
  20. Applying heat by hot coals or heated excrement (necessary to replace natural heat) (8)(12, page 3)
  21. Rubbing (friction) coarse salt over the patient's skin (8)(14, page 57-58)
  22. Rubbing (friction) spirits of hartshorn, strong mustard, aromatic spirit of vinegar, etc. (14, page 57-58)
  23. Infusion of tobacco up the rectum (may use a syringe and catheter)(15, page 1)
  24. Many other methods were trialed
Meanwhile, over in America, the Native Americans have come up 
with a method of their own to reanimate those who have drowned.
According to Dr. Benjamin Rush, in his 1774 document called
North America:   "Their practice of attempting to recover Drownd
 People, is irrational and unsuccessful. It consists in suspending the
 patient by the heels, in order that the water may flow from his mouth.
 This practice is founded on a belief that the patient dies from 
swallowing an excessive quantity of water. But modern 
observations teach us that drowned people die from another cause.
 This discovery has suggested a method of cure, directly opposite 
to that in use among the Indians; and has shown us that the
 practice of suspending by the heels is hurtful."  (17, page 25)
Second, along with applying heat, some type of effort to breathe for the patient must be attempted. Ideally, such effort would cause air to go into the airway, and water out.  

Some such methods included: 
  1. Chest compressions, or pressing down on the chest  (1, page 102
  2. Abdominal thrusts, or pushing down on the abdomen just below the rib cage. (1, page 102)
  3. Rolling victim over a cask, and repeating this motion 
  4. Placing victim on horse's back and set horse to a trot
These methods were ideal for near drownings.

There were also methods meant to stimulate a breath only, such as: 
  1. Stimulating the mind (if the mind was stimulated the patient would wake up)
    •  Rubbing the body with spirits (14, page 57-58)
  2. Stimulating the nose (irritation of nose was believed to excite breathing (12, pages 8,9)
    • Insert fireside bellows into anus & blow tobacco smoke into rectum (12, page 17)
    • Tickling the nose with a feather (8)(12, page 8)(14, page 61)
    • Tickling the nose with a feather dipped in spirits of hartshorn, strong mustard, aromatic spirit of vinegar, etc.(12, page 8)(14, page 60)
    • Blowing a pinch of snuff or pepper into the nose (14, page 61)
    • Applying stimulants (tobacco, bright light, etc.) to the eyes for several minutes (12, page 8)(14, page 56-57)
    • A sharp shrill sound of a horn (12, page 8)
    • Inducing vomiting using emetics such as epecacuanha,  emetic tartar or antimonial wine.(14, page 67 and 75)
    • Fumigations, or placing smoke in a bowl and blowing it in the victims face or rectum (15, page 1)
  3. Artificial Breathing
    • Breathing for patient using mouth to mouth breathing (1, page 102)
    • Fireside bellows (conveniently available in most fireplaces) (8)
    • Rolling victim on their front over a cask or barrel (8) (15, page 2)
    • Placing victim on a horse that was then set to a trot
  1. Electric shocks:  (14, pages 63-66)
    • The best known stimulant (14, pages 63-66)
    • Known to excite contraction of the heart and other muscles of the body (14, pages 63-66)
    • Should not be performed until all of the other methods have failed (14, pages 63-66)
    • Dr. James Curry recommends moderate shocks to the chest. (14, pages 63-66) 
Depiction of tobacco smoke being blown into rectum to reanimate victim.
After year of experience, the following methods were ultimately rejected by the society: 
  1. Holding up the victim by the heals (too hard to do, and too much trauma caused to the victim)(12, page 10)
  2. Rolling on casks (due to trauma caused by such efforts)(12, page 10)(15, page 2)
  3. Emetics tend to hasten recovery and action of vomiting is hazardous.  They may act as a sedative poison upon the vital principle in children, even when they don't cause vomiting.  (12, page 10)(14, page 67)
  4. Rubbing (Friction) with salt or spirits (produces sores)(12, page 10)(14, page 57-58)
  5. Injection of tobacco infusion (probably determined to be senseless)(12, page 10)
  6. Fumigations by filling a bowl with smoke and blowing this smoke into the patient's airway or rectum may have opposite effect as desired. (12, page 10)(14, page 58-59)(15, page1)
  7. Blowing a pinch of snuff into the nose to excite breathing (may be swallowed and cause sickness and disorder when the patient wakes up, if not fainting and death)(12, page 10)(14, page 61)
  8. Inflation of the lungs by breathing into them (due to fears it contributed to spread of disease) (12, page 10)
  9. Electric shocks to the brain (14, page 64)
  10. Infusing tobacco up the rectum (studies showed it could kill a dog) (15, page 1)
Some of the methods listed above, such as stripping the victim of his clothing and wrapping him in a warm blanket, were recommended done as soon as the person was removed from danger.

There was no set timetable for any of the other methods to be performed. For example, there were many descriptions of cases whereby the victim did not receive breaths for several hours after he was removed from danger.  

References:  See post "1774:  The birth of the Royal Humane Society"

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