These are not the same in causation ; but the danger is in both the same - stoppage of breathing by an obstruction in the windpipe. In choking, properly so called, the obstacle is within the throat; in strangling, it is from a cord, etc., outside of and around it; as in hanging.

Choking is most frequently caused by getting something "the wrong way" in swallowing. That is, what should go down into the gullet orsvvallowing throat( pharynx and esophagus) gets into the windpipe (larynx and trachea). The windpipe is just in front of the swallowing gullet; the latter is next to the spine. When one laughs, or in any way breathes, while swallowing, this accident may happen. Even a drop of water going the wrong way, will cause a distressing spasm of the windpipe ; but this is over in a few moments. Danger follows when a solid mass - as a mouthful of meat,- slips into the larynx; or when a large piece of meat gets stuck fast in the pharynx (gullet) so as to press on the trachea (wind-pipe) forcibly enough to keep air from being breatned through it into the lungs. Commonest of all, perhaps, is a fish-bone, or a chicken-bone, getting crosswise, so that it 540 neither goes up nor down. Other things may slip into the windpipe.

No time is to be lost, when any one is choking. A long-fingered person should try to dip a forefinger at once into the throat as far as it will reach, to draw up and out the offending bone, or whatever it is. If it is a child, lift him up by the heels and slap him smartly, while in that position, between the shoulders. Children sometimes swallow pins ; they stick, as bones are apt to do, across the entrance to the throat, pretty far up. Surgeons have long slender forceps and other instruments with which to seize such articles and withdraw them. All such things, everything except a piece of solid food in the swallowing throat, should be taken out, not pushed down. If time allows, a piece of wire may have a loop made in its end, and then be curved near that end, so as to be passed down, behind or below the obstacle, to draw it out. A proof that the thing is in the windpipe is obtained if the person can swallow a drink of water, yet has great distress and difficulty in breathing. This difficulty is great in expiration (out-breathing) as well as in inspiration. A physician being sent for immediately, in an urgent case, fatal suffocation being threatened, may find it necessary to open, the larynx or trachea, by an incision, in order to save life. If the immediate danger be passed, the question of such an operation may still have to be considered, when a foreign body remains in any part of the air-passages.

Strangling is best known in the form of hanging, which is a frequent mode of suicide. If any one is found hanging by the neck, hold up the weight of the body, and at once loosen the cord at the neck ; cutting it will generally be the speediest way, if a knife is at hand. Then lay the person down, and, with as much fresh air around as possible, dash cold water lightly on the face (if it be in a warm place, on the bare chest also). Rub the arms and legs briskly, especially upwards, to favor the movement of blood in the veins, which is towards the heart. Heat a poker or flat-iron, not quite to a burning heat, but so that a hand cannot rest on it long with comfort; and touch that gently upon the pit of the stomach, and then draw it along down each side of the back. Apply mustard-plasters to the legs. But all these things should be got ready and done by the secondary assistant or assistants. If a person cut down from hanging does not breathe, he should be laid on his back on the floor or ground, wherever he is, without loss of time. A roll of clothing, like a round knapsack, should be placed under his shoulders; and then artificial respiration should be attempted, by Silvester's method. See Drowning.

ARTIFICIAL RESPIRATION.

ARTIFICIAL RESPIRATION.