TREATMENT OF THE APPARENTLY DROWNED.
Help to the drowned does not properly come within the province of judiciary medicine, being rather a humane question that belongs to public hygiene. Systematic writers, however, treat the subject at considerable length, and the statistics of institutions for helping the drowned give such marvellous results that it would manifestly not be out of place to cite briefly some of the means employed for restoring life to persons taken from the water asphyxiated and apparently dead.
The prime object in resuscitating the drowned is the introduction of air into the pulmonary vesicles, which is best accomplished by artificial respiration, and the employment of such means as excite the nervous system with a view to reanimate sensibility and develop the reflex movements that contribute to the re-establishment of the respiratory function.
The exigencies of drowning also call for special means to restore the animal heat and the circulation, as well as the precaution of removing mucus and fluids from the obstructed air-passages.
As the knowledge of securing patency of the air-passages by artificial respiration is generally diffused among medical students and is taught in some schools, it would be superfluous to repeat in detail the procedures of Hall, Sylvester, and others.
Laborde’s method of resuscitating those apparently dead has lately gained some notoriety. It consists in stimulating the respiratory reflex by regular rhythmical traction of the tongue, which should be vigorously pulled forward fifteen or eighteen times a minute, to correspond in frequency to the normal respiration.
Another method, alleged to have marvellous effects over the respiration, is that of anal dilatation. Its advocates claim that irritation of the anus is a much more effective measure in resuscitating the drowning or narcotized.[940]
Respiration may be further promoted by alternate dashes of hot and cold water on the face and chest, by smelling-salts, tickling the throat and nares with a feather, and by electrization of the diaphragm and inspiratory muscles. Protracted galvanism may, however, prove dangerous.
When signs of life appear, a warm tonic stimulating drink should be given. A hypodermic injection of caffeine is also recommended.
Whatever means are employed should be used on the spot in the open air and without a moment’s delay.
Restorative efforts may be kept up for two or three hours, although in the majority of cases life is extinct in the human subject after two minutes’ submersion or even less, and the chance of restoration after five minutes’ complete submersion is doubtful. To be sure, trained tank performers remain under water longer than two minutes, and exceptional instances occur of recovery after twenty minutes’ submersion in individuals in a state of syncope or with catalepsy.