SECT. VIII.
Of Drowning
A Man who unfortunately falls over board, and is taken up for drowned (immediately) should not be given up for lost. As this is a circumstance of the utmost consequence to a sea-faring man, I shall think my time well rewarded in explaining the method of recovery contributing to the preserving the life of my fellow creature.
There are different ways of drowning; and according to the nature of the accident, the probability of recovery is founded.
A man, before he comes into the water, may receive an unlucky blow, that will not only stun him, but make him expire his breath (which is generally the case in high falls) as before observed. In this case his senses are benumm’d, and by the inspiration apt to draw in a quantity of water into his lungs instead of air; thence, both from the blow, and from the total stoppage of respiration, he may have some blood vessels burst, both in the lungs and in the brains, whereby he is instantly irrecoverably dead, beyond all hopes. In this case it may happen, that either way, separately, is enough to kill him.
A man may also, in the very act of drowning, swallow a prodigious quantity of water; not only filling his stomach and intestines; but thence forcibly infuse the water into the lacteals, thereby overload them, and force it into the blood vessels that they burst. The great quantity of cold water will also be apt to chill the stomach and intestines; thereby destroy the sensibility, and prevent them from performing the peristaltic motion; and by the universal consent, destroy the whole nervous system, which is the spring of life, that promotes the blood to circulation, and consequently stops the animal motion, and life itself.
But the most common way of drowning is by suffocation; namely, a sudden constriction of the respirative organs; whereby the supply of the air is cut off, and consequently the circulation of the blood must stop. This is verified by the frequent instances we have of people drowned, who have scarce any water, either in their bellies or in their lungs.
To understand this properly, we must first observe, that a continual supply of fresh air is requisite for the circulation of the blood; partly and principally for its motion, and partly from the nourishment the blood actually receives from the air. In the next place, we must also consider, that the lungs, appropriated barely for respiration, are so very delicate in the irritability throughout the larynx, aspera, bronchea, and vesicles themselves, that the least heterogeneous particle stimulates them to a convulsive expulsion, of what seems obnoxious to them, and thence excites a cough. But, when the parts are too irritating, the lungs are excited to a universal constriction, and occasions strangling. This we find is the case when in drinking or swallowing our aliment, that the least morsel happens by mischance coming the wrong way (as it is called) that is, into the larynx, occasions a heavy cough, or even a suffocation; to obviate which, nature has formed the epiglottis in the larynx, like a flap, that opens in respiration, but is always shut in the act of deglutition, except by some mischance or other, that it becomes lame, and unable to do its office.
These circumstances considered, we shall not only be able to account for the act of drowning, but discover the principles that furnishes us with probabilities of restoring life again.
I have mentioned three kinds of drowning that at present occurs to my memory; and unless that some blood vessels, either in the lungs or in the brains, or in some other principal viscera are burst; or, that the lungs are so much filled with water, as to be unable to recover their respirative functions again, (which is seldom the case) or, that the whole nervous system has received a universal paralytic shock by the chill of the Water in the stomach, so as to be robbed of its irritability, either way of drowning is recoverable. For the whole mystery consists, in setting the animal automaton or clock-work in motion, again; to stimulate the nerves to their sensation; to set the heart a pumping; and the lungs, in order to push forward the fluids, in respiration. I could say much on the subject; but philosophy aside, let us endeavour to recover the man to life again.
The Method to recover a drowned Person.
Three things are to be the intention to restore life in a person taken up for drowned.
1. To liquify the fluids. For the moment the circulation of the fluids is stopt, the blood and lymph congeals; and after this, putrefaction gradually commences.
2. To stimulate the nerves. For on the irritability of the nerves life itself depends; and which sets every thing in the animal fabric in motion.
3. To restore respiration. For without this, neither can the blood circulate nor the nerves have sensibility.
The moment therefore you receive the person drowned, strip him of his wet cloaths, and wrap him up in three or four dry blankets; if his belly is swelled with water lay him across a chair or barrel upon his belly, in order to make him void the water; but in this spend not much time, but be as quick as possible. Take a good quantity of salt, the more the better, with which employ three or four handy men to rub him all over;—his temples, his wrist, his arms, his breast, his back, his groins, his knees, his ancles, &c. let this friction either be by the hands or rough woollen cloaths pretty briskly; and, whilst this is doing, let one apply his mouth to that of the patient, stop his nostrils, and with all effort blow gradually into his lungs, and try to make him breathe. If the lungs are open to this, there is a good prospect of recovery, and let the breathing into the lungs be briskly repeated. In the mean time, try to open a vein in the arm; if the head is bloated, as it frequently is, open the jugular vein, or whatever vein that appears distended in and about the head.
On signs of life, continue the friction briskly, rub some essential oil of peppermint (U) in and about his nostrils. If he recovers, at first he will open his eyes, heave his breast, his heart will beat, and gradually he will move some of his limbs. If he opens his mouth put a little salt in it at first, next give him the following draught.
No. IV
Take essential oil of peppermint (U) six drops, upon a lump of sugar, which dissolve in a table spoonful of elixir proprietatis (H).
If he inclines to vomiting, promote it with decoction of camomile (11) or a vomit of ipecacuanha (S); besides all this, blankets should continually be warming, so as to preserve a warmth of the body.
If he is fortunately brought to life, put him directly into a warm bed, and give him a dose of the fever powder, and let him drink freely of good sage punch, in order to promote a perspiration, which is here very requisite.
No. V
Take sage about a pugil (that is as much as you can well take betwixt three fingers) on this pour boiling water, one quart; to which add sugar and good old Jamaica rum, sufficient to make it agreeable, but not too strong. Or instead of this give him some mulled wine.
A fever always attends a patient after the recovery of Drowning; therefore care should be taken when he is brought to himself, that he is not over heated by liquor; as this is liable to throw him into a disease as dangerous as the narrow chance he has just escaped.
Should however the above methods not succeed, you must not despair. If the lungs, or the larynx seem so contracted that it appears impossible to blow breath into him by the mouth, recourse must be had to bronchotomy, that is, opening the wind-pipe betwixt the third and fourth cartilage; to which a man should put his mouth and inflate the lungs; the throat should be tickled with a feather, a little pepper blown up the nostrils and the body here and there scratched with pins, or small wounds made in the legs and arms, and plentifully rubbed with salt. If there is salt enough to do it, the patient ought to be covered all over.
We have instances that patients, after two hours application, have been brought to life again; therefore every means possible should be tried. Of all the various stimulants, salt, or potashes, is the best; spirits must not be made use of, nor indeed vinegar, in the time of recovery; as that is liable to congeal the blood, and prevent it from circulation, till the recovery is procured; when the sage punch, or mulled wine, or some other cordial may be proper. Spirits of hartshorn, if it is on board may also, with propriety, be held to the nose, or poured a little down the throat, as that is stimulating, but not coagulating.
When at length the patient has recovered, let him take the forementioned draught No. [IV]. as also the warm sage punch No. [V]. and take all possible care for his recovery.—If Bronchotomy was obliged to be performed, let the wound carefully be washed, closed, and dress’d with dry lint; over which lay a compress with warm claret intermixed with camphor spirits; and the more to favour the healing, let his head constantly be inclined; rest should also be promoted as much as possible, for which purpose 8 or 10 drops of liquid laudanum will be very proper; likewise silence should be strictly imposed on him; and that should be a material object to be observed, by those who tend him. In every respect else, let him be treated as is directed under the head of fevers and other circumstances, as they shall occur.
Here then I shall conclude this lecture, and beg leave to observe, that as mankind are ever liable to accidents, particularly that class I have here devoted myself to serve, it behoves us ever to be provided with preconsiderations, that we may be always ready to give our friendly assistance in the hour of distress. In time of need, the mind is too much hurried to read with any attention; and dangers particularly from accidents admits of no delay.
The prudent seaman, especially the father of his Crew will therefore make himself acquainted with all these circumstances in his hours of tranquillity, by which he may ever be ready with his friendly aid, and receive the blessing of him that is benefited by his Humanity and generous care.