ARTIFICIAL RESPIRATION.
“Major J. H. Patzki, Surgeon, U.S. Army, reports that in 1882, at St. Augustine, Florida, a lady patient of his had an attack of tetanus, caused by a scratch upon her foot by a nail while bathing. The convulsive symptoms commenced in the muscles of the face, and increased in violence in spite of energetic treatment, until the fifth day, when the respiratory muscles became involved. The breathing was completely suspended by the spasmodic action, and the radial and carotid pulse ceased. The cardiac sounds became utterly inaudible to careful stethoscopic examination repeatedly employed. The lady assumed all the appearances of death, and there was rigor mortis, the result of muscular spasm. Artificial respiration was resorted to, but not until after the expiration of eighteen minutes did the first faint efforts of respiration, and a feeble action of the heart, become perceptible. Artificial respiration was continued for an hour afterwards, and the life of the patient was saved, although the muscular spasms continued to some extent for six days.
“This case is instructive in showing that tetanus, when it involves the chest, may produce a state of apparent death, by interfering with the respiratory and cardiac functions; and that artificial respiration, if persistently employed, may rescue patients so affected from the perils of apparent death.”
DR. JOHN OSWALD’S OPINION.
Dr. John Oswald, in “Suspended Animal Life,” Philadelphia, 1802, p. 65, says:—“The books of authors on this subject are replete with criteria to judge of the existence or non-existence of the vital principle. It is not necessary to take a separate view of the propriety or impropriety of adopting any of these ambiguous signs, when we have the accomplishment of so great an end as that of restoring suspended life! Our exertions should never be influenced by any of them, but continued with ardour and unremitted attention for a length of time. It would be more happy for our unfortunate patients, and a source of greater satisfaction to ourselves, were they expunged altogether. They are all fallacious to a certain degree, and ought never to have the smallest influence on the propriety or impropriety of persevering in our attempts to revive the latent spark; for it is an unfortunate fact, in consequence of an ignorant confidence placed in them, that persons who might have been restored to life, to their friends, and to society have been consigned to the grave.... This important subject has been anxiously investigated by philosophers, to discover a just criterion of judging with more certainty in these cases whether life is extinct, and our patient a mass of dead matter, or whether, by our perseverance, he may not be again recovered. The most indubitable sign is allowed to be putrefaction of the body, or disorganisation of the fibre.”
The following extracts from an instructive but apparently forgotten article in Dickens’ “All the Year Round,” July, 1869 (à propos of a pamphlet, “Lettre sur la Mort Apparente, les Conséquences Réelles des Inhumations Précipitées, et le Temps pendant lequel peut persister l’Aptitude à être rappellé à la Vie,” by the late regretted Dr. Charles Londe), afford valuable suggestions:—
“Suffocation by foul air and mephitical gas is not a rare form of death in the United Kingdom. It is possible that suspended animation may now and then have been mistaken for the absolute extinction of life. Dr. Londe gives an instructive case to the purpose. At the extremity of a large grocer’s shop, a close, narrow corner, or rather hole, was the sleeping-place of the shopman who managed the night sale till the shop was closed, and who opened the shutters at four in the morning. On the 16th of January, 1825, there were loud knocks at the grocer’s door. As nobody stirred to open it, the grocer rose himself, grumbling at the shopman’s laziness, and, proceeding to his sleeping-hole to scold him, he found him motionless in bed, completely deprived of consciousness. Terror-struck by the idea of sudden death, he immediately sent in search of a doctor, who suspected a case of asphyxia by mephitism. His suspicions were confirmed by the sight of a night-lamp, which had gone out, although supplied with oil and wick, and by a portable stove containing the remains of charcoal partly reduced to ashes. In spite of a severe frost, he immediately had the patient taken into the open air, and kept on a chair in a position as nearly vertical as possible. The limbs of the sufferer hung loose and drooping, the pupils were motionless, with no trace either of breathing or pulsation of the heart or arteries; in short, there were all the signs of death. The most approved modes of restoring animation were persisted in for a long while without success. At last, about three in the afternoon—that is, after eleven hours’ continued exertion—a slight movement was heard in the region of the heart. A few hours afterwards the patient opened his eyes, regained consciousness, and was able to converse with the spectators attracted by his resurrection. Dr. Londe draws the same conclusions as before—namely, that persons suffocated by mephitism are not unfrequently buried when they might be saved.”
DANGER TO CHOLERA PATIENTS.
“We have had cholera in Great Britain, and we may have it again. At such trying times, if ever, hurried interments are not merely excusable, but almost unavoidable. Nevertheless, one of the peculiarities of that fearful disease is to bring on some of the symptoms of death—the prostration, the coldness, and the dull livid hues—long before life has taken its departure. Now, Dr. Londe states, as an acknowledged fact, that patients pronounced dead of cholera have been repeatedly seen to move one or more of their limbs after death. While M. Trachez (who had been sent to Poland to study the cholera) was opening a subject in the dead-house of the Bagatelle Hospital, in Warsaw, he saw another body (that of a woman of fifty, who had died in two days, having her eyes still bright, her joints supple, but the whole surface extremely cold) which vividly moved its left foot ten or twelve times in the course of an hour. Afterwards, the right foot participated in the same movement, but very feebly. M. Trachez sent for Mr. Searle, an English surgeon, to direct his attention to the phenomenon. Mr. Searle had often remarked it. The woman, nevertheless, was left in the dissecting-room, and thence taken to the cemetery. Several other medical men stated that they had made similar observations. From which M. Trachez draws the inference: ‘It is allowable to think that many cholera patients have been buried alive.’”
“Dr. Veyrat, attached to the Bath Establishment, Aix, Savoy, was sent for to La Roche (Department of the Yonne), to visit a cholera patient, Thérèse X., who had lost all the members of her family by the same disease. He found her in a complete state of asphyxia. He opened a vein; not a drop of blood flowed. He applied leeches; they bit, and immediately loosed their hold. He covered the body with stimulant applications, and went to take a little rest, requesting to be called if the patient manifested any signs of life. The night and next day passed without any change. While making preparations for the burial, they noticed a little blood oozing out of the leech-bites. Dr. Veyrat, informed of the circumstance, entered the chamber just as the nurse was about to wrap the corpse in its winding-sheet. Suddenly a rattling noise issued from Thérèse’s chest. She opened her eyes, and in a hollow voice said to the nurse: ‘What are you doing here? I am not dead. Get away with you.’ She recovered, and felt no other inconvenience than a deafness, which lasted about two months.”