Rule II. To Expel Water from the Stomach and Chest (see [Fig. 1]).—Separate the jaws and keep them apart by placing between the teeth a cork or small bit of wood, turn the patient on his face, a large bundle of tightly rolled clothing being placed beneath the stomach; press heavily on the back over it for half a minute, or as long as fluids flow freely from the mouth.

Fig. 1.

TO EXPEL WATER FROM STOMACH AND CHEST.

Patient lying face downward; roll of clothes beneath stomach; jaws separated by piece of wood or cork; note rescuer pressing on back to force out water.

Rule III. To Produce Breathing (see Figs. [2] and [3]).—Clear the mouth and throat of mucus by introducing into the throat the corner of a handkerchief wrapped closely around the forefinger; turn the patient on the back, the roll of clothing being so placed as to raise the pit of the stomach above the level of the rest of the body. Let an assistant, with a handkerchief or piece of dry cloth, draw the tip of the tongue out of one corner of the mouth (which prevents the tongue from falling back and choking the entrance to the windpipe), and keep it projecting a little beyond the lips. Let another assistant grasp the arms, just below the elbows, and draw them steadily upward by the sides of the patient's head to the ground, the hands nearly meeting (which enlarges the capacity of the chest and induces inspiration). ([Fig. 2].) While this is being done let a third assistant take position astride the patient's hips with his elbows resting upon his own knees, his hands extended ready for action. Next, let the assistant standing at the head turn down the patient's arms to the sides of the body, the assistant holding the tongue changing hands if necessary[1] to let the arms pass. Just before the patient's hands reach the ground the man astride the body will grasp the body with his hands, the balls of the thumb resting on either side of the pit of the stomach, the fingers falling into the grooves between the short ribs. Now, using his knees as a pivot, he will, at the moment the patient's hands touch the ground, throw (not too suddenly) all his weight forward on his hands, and at the same time squeeze the waist between them, as if he wished to force something in the chest upward out of the mouth; he will deepen the pressure while he slowly counts one, two, three, four (about five seconds), then suddenly let go with a final push, which will spring him back to his first position.[2] This completes expiration. ([Fig. 3].)

Fig. 2.