Drowning, is the aft of suffocating, or being suffocated, by a total immersion in water. The length of time during which a person may remain in this element, without being drowned, is very unequal, in different individuals; and depends as much on the temperature of the water as on the particular constitution of the subject: in general, however, there is less prospect of recovery, after having continued fifteen minutes in a wa tery grave. In such cases, death ensues from impeded respiration, and the consequent ceasing of the circulation of the blood, by which the body loses its heat, and, with that, the activity of the vital principle. Dr. GOODWIN justly observes, that the water produces all the changes which take place in drowning, only indirectly, by excluding the atmospheric air from the lungs, as they admit but a very inconsiderable quantity of fluid to pass into them, during immersion. Hence we shall find, in the progress . of this inquiry, that inflation of the lungs is one of the principal means of restoring lile,
Before we describe the various methods and instruments that have been successfully adopted, for recovering drowned persons, it will be useful to advert (on the plan of Dr. Stkuve) to those circumstances which deserve 10 be duly weighed, previously to any active measures being taken on such unfortunate occasions: 1. The season and weather ; 2. Length of time the person has continued underwater; 3.The state of his mind when the accident happened : whether he was intoxi-cated, frightened, etc.; 4. Constitution of the body, and whether he was in a state of perspiration ; 5. The height from which he fell, and whether his head plunged foremost; 6. Depth of the water; whether it was cold or warm, sea, or river water, and how he was dressed. Lastly, 7. The manner in which he was taken out, whether by the legs, and without receiving any injury, or by instruments ; and whether he was roiled about in a tub, or what other methods were pursued for his restoration.
Few improvements appear to have been made ;in the treatment of the drowned, since this important branch of medical science was first discussed, in a popular manner, by the late Dr. Tissot; yet the names of Cullen,Goodwyn, Cogan, Hawes, and Coleman, in Britain, as well as those of UnzEr, Reimarus, and Struve, in Germany, deserve to be respectfully mentioned: from their various publications, and especially of the two last mentioned, we shall briefly state the principal rules of conduct to be observed, with respect: to persons in that deplorable situation. Symptoms of Apparent Death by Drowning. - Coldness; paleness of the whole body; the lips of a livid hue; the mouth either open or firmly closed; the tongue blue, swelled and protruded ; the eye-lids closed, the eyes turned, and their pupils dilated; the face swelled and blue; the lower belly hard and inflated. The first signs of returning animation are, convulsive starting of the muscles of the face, or feet; motion of the eye-lids ; a spasmodic shivering of the body.
Treatment. - 1. After having been carefully taken out of the water by the arms, so as to prevent the least injury to the head and breast, the body ought to be carried to the nearest house (if possible, in a bier, as represented in the Plate, which is described p. 191), with the head somewhat raised; or, in fine warm weather, the resuscita-tive process may with more advantage be performed in the open air, especially in sun-shine.
2. When the subject is deposited, the upper part of the body should be supported halt-sitting, with the head inclining towards the right side.
3. The clothes are to be taken off without delay, but with the greatest precaution; as violent shaking of the body might extinguish the latent spark of life.
5. The whole body should now be gently wiped and dried with warm flannel cloths, then covered with blankets, feather-beds, hay, straw, etc. In cold or moist weather, the patient is to be laid on a mattress or bed, at a proper dis-tance from the fire, or in a room moderately heated; but in the warm days of summer, a simple couch is sufficient.
6. If the patient be very young, or a child, it may be placed in bed between two persons, to promote natural warmth. (See also the Warming Machine, delineated in the second Plate, and described P. 192.)
7. In situations where the bath cannot be conveniently procured, bladders filled with lukewarm water should be applied to different parts of the body, particularly to the pit of the stomach ; or a warming-pan wrapped in flannel gently moved along the spine ; or aromatic fomentations frequently and cautiously repeated.
8. As the breathing of many persons in an apartment would render the air mephitic, and thus retard, or even prevent the restoration of life, not more than five or six assistants should be suffered to remain in the room where the body is deposited.
2.. Inflation of the lungs, which may be more conveniently effected by blowing into one of the nostrils, than by introducing air into the mouth. For the former purpose, it is necessary to be provided with a wooden pipe, fitted at one extremity for tilling the nostril, and at the other for being blown into by a healthy person's mouth, or for receiving the muzzle of a pair of common bellows, by which, the operation may be longer continued. At first, however, it will always be more proper to introduce the warm breath from the lungs of a living person, than to commence with cold atmospheric air. During this operation, the other nostril and the mouth should be closed by an assistant, while a third person gently presses the chest with his hands, as soon as the lungs are observed to be inflated. - For a more effectual method of alternately introducing fresh air into the lungs, and expelling that which is rendered mephitic, or unfit for respiration, we refer the reader to the second plate, Fig. 1, described in p. 190, and following.
3. Stimulating clysters, consisting of warm water and common salt ; or a strong solution of tartar emetic ; or decoctions of aromatic herbs; or six ounces of brandy, should be speedily administered. - We do not consider injections of the smoke of tobacco, or even clysters of that narcotic plant, in all instances safe or proper.
4. Let the body be gently rubbed with common salt, or with flannels dipped in spirits; the pit of the stomach fomented with hot brandy; the temples stimulated with spirit of hartshorn; and the "nostrils occasionally tickled with a feather.
5. Persons of a very robust frane, and whose skin alter being dried, assumes a rigid and contract-cd surface, may be put into the sub-tepid bath, of about 6*5°, which must be gradually raised to 75 or 80°, of Fahrenheit's scale, according to circumstances; or the body carried to a brewhouse, and covered with warm grains for three or four hours : but these expedients generally require m dical assistance.
6. Violent shaking and agitation of the body by the legs and arms, though strongly recommended, and supposed to have often forwarded the recovery of children and boys, appears to us a doubtful remedy, which can be practised only in certain cases.
7- Sprinkling the naked body of a drowned person with cold water; submitting it to the operation of a shower-bath, or the sudden shocks of the eleclric fluid; as well as whipping it with nettles, administering emetics, and blood-Jetting, —are desperate expedients, which should be resorted to only after the more lenient means have been unsuccessfully employed.
It is, however, a vulgar and dangerous error, to suppose that persons apparently dead by immersion under water, are irrecoverable, because life does not soon re-appear: hence we seriously entreat those who are thus employed in the service of humanity, to persevere for three or four hours at least, in the application of the most appropriate remedies above described; for there are many instances recorded, of patients who recovered, after they had been relinquished by all their medical and other assistants.
Treatment on the return of life : As soon as the first symptoms of that happy change become discenrible, additional care must be taken to cherish the vital action, by the most soothing means. All violent procedings should, therefore, be immediately abandoned, no farther stimulants applied, nor even the ears of the patient be annoyed by loud speaking, shouting, etc. At that important crisis, mo-derate friction only is requisite. And, if the reviving person happen to be in the bath, he may either remain there, provided his sensations be easy and agreeable, or be removed to a comfortable bed, after being expeditiously dried with warm flannels: fomentations of aromatic plants may then be applied to the pit of the stomach; bladders filled with warm water, placed to the left side; the soles of the feet rubbed with salt; the mouth cleared of froth and mucus, and a little white wine, or a solution of salt in water, dropped on the tongue. But all strong stimulants, such as powerful elctric shocks, strong odours of volatile salts, etc. are at this period particularly injurious. Lastly, the patient, after resuscitation, ought to be for a short interval resigned to the efforts of Nature, and left in a composed and quiescent state .- as soon as he is able to swallow, without compulsion or persuasion, warm wine, or tea, with a few drops of vinegar, instead of milk, or gruel, warm beer, and the like, should be given in small doses frequently repeated. Having stated the leading particulars to be attended to, in the practical treatment of persons who are on the eve of suffering from aquatic suffocation, we shall accompany them with a few directions, addressed to those humane assistants who often fall victims for want of due precaution in th execution
Instruments for recovering the Drowned execution of their benevolent design.
As many fatal accidents happen to individuals who wish to rescue others in danger of being drowned, especially when the former are un-.skilful in the useful art-of swimming, which ought to be.learnt at an early period of life, we think it our duty to remind the reader of the two excellent contrivances already described in our first volume, under the articles Air-jacket, and Bamboe Habit. Every fami-ly dwelling on the banks of lakes or rivers, or. near ponds, ought to be always provided with two or three such useful articles, to serve in cases of emergency ; as it will generally be too late to procure them on the spur of the occasion. Beside the various Instruments represented in our first plate on this subject, and immediately to be described, there is another method of discovering the body of a drowned person, when immersed under water. Although we do not give implicit credit to novel and improbable schemes, yet, independently of its presumptive authenticity, we think the following narrative entitled to attention : it is inserted in the 37th volume of the Gentleman' s Magazine, for April 1767The body of a child drowned in the river Kennet, near Newbury, Berks, was discovered by a very singular experiment. - After diligent search had' been made to no purpose, a two-penny loaf, with a quantity of quicksilver put into it, was set afloat from the place where the child had probably fallen in, which loaf steered its course down the river upwards of half a mile, before a great number of specta-tors, when the body happening to lie on the opposite side of the river.
the loaf suddenly tacked about, swam across the river, and gra-dually sunk near the child, when both the child and loaf were immediately brought up, with garblers ready for that purpose. - In apparent confirmation of this extraordinary occurrence, we meet with the following account in Dr. Struve's Practical Essay on the Art of Re-covering Suspended Animation, etc. (12mo. pp. 21O.3s.0d.Murrayand Highley, London, 1801). - A student of a certain university being drowned, an unsuccessful search was made for the body. A bye-stander advised his young friends to procure a large loaf; to scoop out part of the crumb 5 fill the hollow part with mercury, and then to throw this quicksilver-pye upon the current: he averred that it would become stationary at the place where the drowned was lying. They followed his advice, and the body was actually found.— As we have had no opportunity of ascertaining the truth of these narratives, by the test of experience, we shall only add, that there appears to be no chemical affinity between mercury and the human body, while in a living and healthy state ; and that the swimming of a loaf, partly filled with that metal, may perhaps be attributed to a similar degree of specific gravity procured by this artificial combination.
Explanation I. Of the Plate representing the " Instruments for recovering the Drowned."
Fig. l, A forked instrument with blunt points, for making a superficial search after the drowned body, and sounding the particular situation in which it lies..
Fig. 2, A ladder with a long, jointed handle, and which we have already mentioned, vol. i. p. 299, when treating or' the Ice-boats : a model of these boats may be inspected in the Repository of the "Society for the Encouragement of Arts, Manufactures," etc. Adel-phi, London.
Fig. 3, An extractor, or a linked pair of tongs, which in the plate appears closed; but, on immersing it into water, opens by its own weight, as well as by the sliding down of the iron ring 0 from the part marked x, to that of u. It may again be closed, by pulling the double rope fastened to the ring 0, which is thus shifted upward from u to x: by means of expanding the iron arms n n, which are likewise connected with this ring, the mouth or flaps of the instrument r r, may be shut : and to prevent their opening till required, the two ropes are firmly tied round the iron bolt s s; in which situation they remain till the body is extracted. - This instrument, together with that represented, Fig. 1, cost 3bout 2l. at Hamburgh. Great attention is required in preserving them from the effects of rust; and, independently of the weight of iron-work, Fig. 3, is perhaps the most complete piece of machinery that can be contrived for this purpose.
II. Of the Engraving in which the "Implements of restoration from drowning,'' are represented.
Fig. 1, A pair of bellows with two separate bags, so contrived that by opening them, when applied to the nostrils or mouth of a patient, one bag will be filled with common air, and the other with the mepliitic air extracted from the lungs; and, by shutting them again, pure atmospheric air will be introduced into those organs, and that drawn out, consequently discharged into the room. Thus, the artificial breathing may be continued, while the other operations on the surface of the body are carried on ; Which could not be conveniently done, if the muzzle of a common pair of bellows were introduced into the nostril.
a, Is an intermediate board, but which admits of no communication between the two bags. In the external board of each side, there is the usual hole, marked b, provided with a valve ; and the cylindrical part through which the air is expelled in common bellows, is here soldered to a copper box, within which two other valves are applied to the tubes conducting the air. The cover d of this box, which may be unscrewed by means of an interposed leather ring, is almost of the shape of a funnel, to the neck of which is fastened a flexible tube e, made of varnished silk cloth, and a spiral wire that forms the cavity. To the extremity of this tube is attached a small ivory pipe f, the front of which may either be tubular and round, for introducing it into the nostril: or flat like the top-piece of a clarionet, if it be intended for the mouth. The valves (which cannot be represented in a plate), consist of stiffened taffety, and are so arranged, that the cor-responding ones stand in an inverted order. If, therefore, both bags of the bellows be expanded, two of the valves open themselves towards the internal part of the machine : one of these is fixed to one of the side-boards, but the other is within the box, on the mouth of the conducting tube belonging to the opposite bag of the bellows.
By this contrivance, the air enters both bags of the bellows at the same time, and is, on compression, again expelled by means of two other valves, which open from within toward the external parts. Both bags of the bellows terminate be-low the valve in one principal tube of communication ; because, tho' the action of both bellows is simultaneous, the stream of air, conformably to the arrangement before pointed out, can only enter, and escape, alternately. - In using this machine, the small ivory pipe is applied either to one of the nostrils, or put into the mouth : in the former case, the other nostril and the mouth must be closed ; in the latter, both nostrils. When the bellows are set in action, one of the bags receives a column of atmospheric air through its valve; while the other, by means of its flexible tube and its valve, extracts a portion of air from the lungs. But, if the bellows are again shut, one of the bags parts with the impure gas drawn out of the pulmonary vessels ; and the second conveys pure atmospheric air to the organs of respiration. By properly repeating this alternate process, the patient may again be enabled to exercise the important function of breathing. As, however, a precipitate and irregular method of proceeding might be productive of injury, this delicate operation ought to be performed by persons who are acquainted with the mechanism of respiration.— In some cases, where the patient has, for a considerable time, lain under water, or was afterwards neglected for want of due assistance, it would be desirable to introduce into his lungs oxygen, or pure Vital, dephlogisticated air, instead of that of the common atmosphere; as the latter is generally more or less corrupted on such occasions by the breath of many persons in the same room. For this purpose may be used a bladder, marked g, which is provided with a cock and pipe fitted or screwed to the board of the inspiring valve and bag of the bellows. If, therefore, after opening the cock, the machine is set in motion, it will extract the pure air contained in the bladder, and, on the subsequent compression of the bellows, force it into the lungs of the patient.
Fig. 2, A machine for injecting the smoke of tobacco by way of clyster, in those desperate cases which require the application of this remedy. It consists of a pair of bellows, to the muzzle of which is fitted a metal box, a, provided with a ring, in the middle of which it may be unscrewed, and again closed, after being filled with tobacco, and set on lire : the pipe c (which, by mistake, is represented with a sharp point in our plate, but should be perfectly round and blunt at the top) of the flexible tube b, is introduced into the fundament; and thus, by means of the bellows d, the smoke is forced into the rectum.
Fig. 3, A bier of wicker work, in the form of a slanting, oblong basket, for conveying the body of the drowned, in a posture somewhat raised. This simple contrivance has the advantage, that the water may easily run off, while the patient is carried : and, as many unfortunate persons are materially injured by rough treatment, before they arrive at a house of reception, so that their recovery is thus often frustrated, we recommend the universal adoption of this useful implement. It costs at Hamburgh only ten marks currency, or about 15s.
Fig. 4, The Warming Machine of block tin, or other metal, was originally invented by Mr. HaR-vey, of London, who suggested it to our Royal Humane Society, and it was subsequently improved by M. Braasch, an ingenious mechanic, of Hamburgh. Its object is to procure an uniform degree of warmth, throughout the apparatus, in the most expeditious manner, by filling the hollow or double bottom and sides of the whole implement with boiling water. - a is the body of the machine, seven feet long, and made of solid pieces of block-tin, to prevent" the necessity of soldering them, and consequently the formation of iron-rust: it jests on two wooden legs ff, and may be easily carried by the handles g g. -The water is poured in through both funnels d, d, in order to warm it more speedily ; and each of these Is provided with a stopper (as represented in the Plate, suspended on a chain), with a view to prevent, if necessary, too sudden evaporation and cooling of the water :— h is the intermediate spacebetween the two metallic plates, producing a vacuum of 2| inches, in which the fluid is diffused over the whole machine; - b is a wooden desk to support the head of the patient, and to protect it from the immediate contact with the heated parts ; but, on the opposite end of the machine, there is an enlarged intermediate space c, for holding such a quantity of water and vapours as will procure an additional, or at least a more permanent, degree of heat towards the lower extremities, than to the trunk of the body. For discharging the water, when it is not wanted, or changing it when too cold, there is a cock at e. The hollow sides of this machine are about twelve inches high ; and in order to ensure an uniform warmth, the body apparently dead should be placed on a straw mat-tress, and tucked in with blankets. A pailful of water is required to fill the whole machine, as a smaller quantity would, warm the sides only for a short time, by means of the vapour.
It deserves to be remarked, that this ingenious contrivance may also be used for a warm bath; for which purpose, the inner space in which the body lies, should be supplied with writer. The whole apparatus, in its present improved state, made of copper, costs at Hamburgh about 200 marks, or from 14 to 151.
Lastly, we cannot conclude this subject, without affording the reader a view of the different articles belonging to a complete chest of instruments, and other materials, employed in the various processes for recovering suspended animation from drowning. The merit of these institutions in England, is due to Drs.CoGAN and Hawes, the founders of the Royal Humane Society at London; but the improved arrangement of the chest now to be described, together with the choice of internal and external remedies, were made by one of our most esteemed surgeons, Mr. Kite, in 1/88, though considerably extended in l790, by Mr. Redlich, a respectable medical practitioner at Hamburgh. This gentleman is likewise one of the most active members of the Humane Society in that city, and has offered the following articles for sixty-five marks, or about four guineas and a half. - His complete chest contains :
A small bottle of rectified spirit of wine;
Ditto, white wine vinegar.
Ditto, sweet oil.
Ditto, white French brandy.
Ditto, volatile sal ammoniac.
Ditto, vitriolic aether.
A machine for injecting the smoke of tobacco. A leather tube, together with a pair of bellows, for inflating the lungs. Another tubs of leather, for introducing medicines into the stomach. A small syringe for clearing the throat of mucus. Three woollen covers, or blankets.
Four brushes, and six woollen cloths, for performing friction. Several emetics. Two lancets for blood-letting. One pound of tobacco.
Common salt - and a printed copy (in German) of rules and direc-tions for treating the drowned.
Conceiving that a chest containing all these articles could not be purchased in London for less than double the price above stated, beside the additional trouble of procuring them, we have inserted this account; especially as. the com-mercial intercourse between Hamburgh and this country, is daily hiring.