POISON. DROWNING.

immersed in, or having inhaled noxious gas, whether from the fumes of burning charcoal, the exhalations of lime-kilns, the gas from fermentations, the choak-damp of mines, the gas from wells, or the gas in the lower parts of caverns, the following method must be pursued for their recovery.

Expose the patient to atmospheric air without any fear of the cold; remove all his clothes and place him upon his back, with the head and breast somewhat elevated so as to promote respiration. On no account administer tobacco fumigations or place the sufferer in a warm bed. Give a few glasses of lemon-juice and water, or vinegar weakened by the addition of three parts water; sprinkle the body, particularly the face and breast, with cold vinegar; after this rub the body with cloths steeped in vinegar, camphorated spirits of wine, or any other spirituous fluid; at the end of two or three minutes wipe the parts which have been wetted with a warm towel, and after the interval of two or three minutes recommence the sprinkling and rubbing with cold vinegar and spirits. These means must be persevered in for some time. Irritate the soles of the feet, and palms of the hands, and the whole course of the back with a brush; administer a clyster consisting of one part vinegar and two parts water; after a few minutes administer another prepared with two ounces of common salt and one ounce of Epsom salts dissolved in water. Irritate the nostrils by a little roll of paper or a feather; or burning matches, or volatile alkali, taking care that the phial containing this last article be not held long at the The lungs should also be inflated. All these methods failing, the patient should be bled in the foot if the face continue red, the lips swoln, and the eyes as it were starting from their sockets. Emetics should be avoided, except where persons recovering are troubled with excessive nausea; when the patient is restored to his senses, he may be put into a warm bed in an apartment having all the windows open. He may then take a few spoonfuls of some good wine, as sherry, or Madeira; the wine may be warmed and sugar added. It has often happened that five or six hours have elapsed before persons have been restored.

rose.

A well attested account has recently been published, of the speedy recovery of a person, who had become insensible by reason of noxious vapor, at the bottom of a well, by means of cold water dashed from

above on his head.

DROWNING is the act of suffocating or being suffocated, by a total immersion in water. The length of time during which a person may remain in this element, without being drowned, is very unequal in different individuals, and depends as much on the temperature of the water as on the particular constitution of the subject: in general, however, there is less prospect of recovery, after having continued fifteen minutes in a watery grave. In such cases, death ensues from impeded respiration, and the consequent ceasing of the circulation of the blood, by which the body loses its heat, and with that the activity of the vital principle. Dr. Goodwyn justly observes, that the water produces all the changes which take place in drowning, only indirectly, by excluding the atmospheric air from the lungs, as they admit but

DROWNING.

a very inconsiderable quantity of fluid to pass into them during immersion. Hence we find, that inflation of the lungs is one of the principal means of restoring life.

Previous to any active measures being taken for recovering drowned persons, the following circumstances ought to be duly weighed by those engaged in this humane office :-1. The season and weather. 2. Length of time the person has continued under water. 3. The state of his mind when the accident happened; whether he was intoxicated, frightened, &c. 4. Constitution of the body, and whether he was in a state of perspiration. 5. The height from which he fell, and whether his head plunged foremost. 6. Depth of the water; whether it was cold or warm, sea, or river water, and how he was dressed. Lastly, 7. The manner in which he was taken out, whether by the legs, and without receiving any injury, or by instruments; and whether he was rolled about in a tub, or what other methods were pursued for his restoration.

Few improvements appear to have been made in the treatment of the drowned, since this important branch of medical science was first discussed. We shall briefly state the principal rules of conduct to be observed, with respect to persons in that deplorable situation.

SYMPTOMS OF APPARENT DEATH BY DROWNING.-Coldness; paleness of the whole body; the lips of a livid hue; the mouth either open or firmly closed; the tongue blue, swelled and protruded; the eye-lids closed, the eyes turned, and their pupils dilated; the face swelled and blue; the lower belly hard and inflated. The first signs of returning animation are, convulsive starting of the muscles of the face, or feet; motion of the eye-lids; a spasmodic shivering of the body.

TREATMENT.-1. After having been carefully taken out of the water by the arms, so as to prevent the least injury to the head and breast, the body ought to be carried to the nearest house, in a bier if possible, with the head somewhat raised; or, in fine warm weather, the resuscitative process may with more advantage be performed in the open air,es pecially in sun-shine.

2. When the subject is deposited, the upper part of the body should be supported half-sitting, with the head inclining towards the right side.

3. The clothes are to be taken off without delay, but with the greatest precaution; as violent shaking of the body might extinguish the latent spark of life.

4. The mouth and nose must be cleansed from the mucus and froth, by means of a feather dipped in oil.

5. The whole body should now be gently wiped and dried with warm flannel cloths, then covered with blankets, feather-beds, hay, straw, &c. In cold or moist weather, the patient is to be laid on a mattress or bed, at a proper distance from the fire, or in a room moderately heated; but in the warm days of summer, a simple couch is sufficient.

6. If the patient be very young, or a child, it may be placed in bed between two persons, to promote natural warmth.

7. In situations where the bath cannot be conveniently procured,

DROWNING.

bladders filled with lukewarm water should be applied to different parts of the body, particularly to the pit of the stomach; or a warming-pan wrapped in flannel gently moved along the spine; or aromatic fomentations frequently and cautiously repeated.

8. As the breathing of many persons in an apartment would render the air mephitic, and thus retard, or even prevent the restoration of life, not more than five or six assistants should be suffered to remain in the room where the body is deposited.

STIMULANTS GENERALLY EMPLOYED. 1. Moderate friction with soft warm flannel at the beginning, and gradually increased by means of brushes dipped in oil till pulsations of the heart are perceptible.

2. Inflation of the lungs, which may be more conveniently effected by blowing into one of the nostrils, than by introducing air into the mouth. For the former purpose, it is necessary to be provided with a wooden pipe, fitted at one extremity for filling the nostril, and at the other for being blown into by a healthy person's mouth, or for receiving the muzzle of a pair of common bellows, by which the operation may be longer continued. At first, however, it will always be more proper to introduce the warm breath from the lungs of a living person, than to commence with cold atmospheric air. During this operation, the other nostril and the mouth should be closed by an assistant, while a third person gently presses the chest with his hands as soon as the lungs are observed to be inflated.

3. Stimulating clysters, consisting of warm water and common salt, or a strong solution of tartar emetic, or decoctions of aromatic herbs, or six ounces of brandy should be speedily administered. We do not consider injections of the smoke of tobacco, or even clysters of that narcotic plant, in all instances safe or proper.

4. Let the body be gently rubbed with common salt, or with flannels dipped in spirits; the pit of the stomach fomented with hot brandy, the temples stimulated with spirits of hartshorn, and the nostrils occasionally tickled with a feather.

5. Persons of a very robust frame, and whose skin after being dried assumes a rigid and contracted surface, may be put into a sub-tepid bath, of about 65° which must be gradually raised to 75o or 80° of Fahrenheit's scale, according to circumstances; or the body carried to a brewhouse, and covered with warın grains for three or four hours; but these expedients generally require medical assistance.

6. Violent shaking and agitation of the body by the legs and arms, though strongly recommended, and supposed to have often forwarded the recovery of children and boys, apears to us a doubtful remedy, which can be practised only in certain cases.

7. Sprinkling the naked body of a drowned person with cold water; submitting it to the operation of a shower-bath, or the sudden shocks of the electric fluid; as well as whipping it with nettles, administering emetics, and blood-letting, are desperate expedients, which should be resorted to only after the more lenient means have been unsuccessfully employed.

It is, however, a vulgar and dangerous error to suppose that persons apparently dead by immersion under water are irrecoverable, because

CHOKING.

life does not soon re-appear; hence we seriously entreat those who are thus employed in the service of humanity to persevere for three or four hours at least in the application of the most appropriate remedies above described; for there are many instances recorded of patients who recovered after they had been relinquished by all their medical and other assistants.

TREATMENT ON THE RETURN OF LIFE. As soon as the first symptoms of that happy change become discernible, additional care must be taken to cherish the vital action by the most soothing means. All violent proceedings should, therefore, be immediately abandoned, no farther stimulants applied, nor even the ears of the patient be annoyed by loud speaking, shouting, &c. At that important crisis, moderate friction only is requisite. And, if the reviving person happen to be in the bath, he may either remain there, provided his sensations be easy and agreeable, or be removed to a comfortable bed, after being expeditiously dried with warm flannels: fomentations of aromatic plants may then be applied to the pit of the stomach; bladders filled with warm water, placed to the left side; the soles of the feet rubbed with salt; the mouth cleared of froth and mucus, and a little white wine, or a solution of salt in water, dropped on the tongue. But all strong stimulants, such as powerful electric shocks, strong odors of volatile salts, &c. are at this period particularly injurious. Lastly, the patient after resuscitation, ought to be for a short interval resigned to the efforts of Nature, and left in a composed and quiescent state: as soon as he is able to swallow, without compulsion or persuasion, warm wine, or tea, with a few drops of vinegar, instead of milk, or gruel, warm beer, and the like, should be given in small quantities frequently repeated.

CHOKING. As soon as any person is observed to be choked, and more particularly children, the obstructing body should be felt for with a finger at the top of the throat; it is possible many times to remove it directly, and should we fail in this, the puking excited by the finger frequently removes the offending body.

Food, and foreign substances are sometimes lodged in the top of the wind-pipe and produce immediate suffocation; help in this case must be afforded at the moment, by introducing the finger. Sometimes, however, a bunch of thread with several small nooses, secured upon the end of a piece of whalebone, will frequently be serviceable, in removing sharp pointed bodies, as fishbones, needles, &c. Should this fail, a piece of sponge may be fastened to the whalebone, and passed into the stomach, and when it becomes enlarged by moisture, it most frequently brings away any foreign substance which may be present: the enlargement of the sponge may be forwarded by the patient swallowing a little water. Vomiting will sometimes succeed; though this should not be attempted when the substance is sharp and pointed.

Unless the offending body can be seen, any apparatus is unsafe except in the hands of an experienced surgeon.

Presence of mind will enable any person to do much, in all cases of casualty, and particularly in this, and the directions above, are sufficient. The finger, and the vomiting it is sure to produce, will do much more at the instant than is commonly thought.

FAMILY DISPENSATORY.

LIGHTNING. Persons apparently dead from lightning may be frequently restored by proper means. Sprinkling or affusion of cold water, and in general the means laid down for aerial poisons, are to be persevered in. A rigidity of the limbs usually attends persons recovering from a stroke of lightning; sprinkling, and rubbing the parts with cold water should often be used.

The means to be used for the recovering of persons suddenly deprived of life, are nearly the same in all cases. They are practicable by every one who happens to be present at the accident, and require no great expense, and less skill.

The great aim is to preserve or restore the vital warmth and motion. This may in general be attempted by heat, frictions, blowing air into the lungs, administering clysters, cordials, &c. These must be varied according to circumstances. Common sense and the situation of the patient, will suggest the means of relief. Above all we would recommend perseverance. Much good may, and no harm can result; who would grudge pains in such a case?

SECTION III.

FAMILY DISPENSATORY.

EVERY family should know something about the weights and measures which are used by apothecaries, and the signs by which they are denoted.

The grain weights are stamped with punch marks, indicative of the number of grains each is equivalent to.

A table spoonful is supposed to be equal to half an ounce, or four drachms-yet many of the modern spoons will contain five drachms. A tea spoonful will equal sixty or seventy drops. A drop will contain a quantity proportioned to the size of the mouth of the vial from which it falls. A common ounce vial should be a medium size.

Where the dose furnished for an adult is a certain quantity, the proper dose for a person of fourteen years will be two thirds of that