The evening tribune. (Pawtucket, R.I.) 189?-190?, 1896-12-09
IN CASE OF SYNCOPE.
MoMENTARv HEART PARALYSIS THAT
REQUIRES sTIMuLANTS.


Different Methods Of Treatment and How
They Should He Applied-whatever II
Done Must Be Done without Delay,
which II Dangerous.
It is an everyday occurrence to see
persons in q weak condition, just up
from a sickbed or under the influence
of some great emotion, grow suddenly
pale, lose consciousness and faint. A
more or less complete suspension OF
breathing takes place, corresponding to
q check, or, at any rate, to consider
able decrease in the circulation OF the
blood. This condition is called syncope,
and is in reality momentary paralysis
of the heart. If immediate help is not
afforded, syncope may In some cases be
the cause of death.
Nothing is better known than the
different means to be used in case OF
syncope; the most important points are
to facilitate the flow Of the blood, to
keep up what remains of the weakened
energy Of the heart contraction and to
remove every obstacle to restoration Of
the circulation Of the blood.
From these points of view to place
the patient in horizontal position is
practice that is as efficacious as it is
habitual. In this way not only is it
easier for the heart to keep the mass Of
blood in motion, but the head, which it
is best to put in lower position than
the body, receives q larger supply of
blood than before, so that the lack of
blood in the brain, the initial cause Of
the syncope, is very largely compen-
stated.
To carry still further this relative
congestion of the brain, it has even been
suggested to stand such patients liter
ally on their head, and by following
this practice, as nearly as could be done,
Nelaton and Campbell reported cases in
which patients were brought back to
consciousness who would otherwise have
infallibly succumbed.
1t is with similar purpose that we
patients corset, to loosen collar and
cravat-in a word, to loosen all the
clothing-and to carry the patient into
the open air. In this way many OBJ
stacles to the circulation Of the blood
are removed. but the special advantage
in the practice is that the expansion of
the lungs becomes less impeded and
easier.
If, however. in spite Of these meas
ures of relief, the syncope continues, we
must have recourse to remedies of an
other kind, numerous and varied in ma
ture, but all designed to bring back and
stimulate the contraction Of the heart
muscle.
The return Of general consciousness
should be stimulated by sudden and vio-
lent shaking Of the patient. by dash
ing cold water on the face and by rub.
bing the skin with alcohol or vinegar.
These are best applied to the temples,
lips or palms Of the hands, 1t is also
we'll to rub the hands and feet, limbs
and even the entire surface Of the body
in an energetic manner with hair
glove or any other rough tissue with
which any stimulating lotion that may
be at hand can be applied, snch as BRAN
dy or eau de cologne.
The special senses should also be
stimulated. The patient should be made
to breathe any strongly smelling stuff
that may be at hand-sal volatile, vim
egar, acetic acid or ammonia. BY these
different means, which are more or less
energetic and almost always effica-
cious, the stimulants of the heart con-
fractions bring back its beats, while the
resumption of circulation carries once
more to the brain the blood necessary
for its working.
If these different means are still in
sufficient, artificial respiration should
be resorted to without delay. The pa
tient should be placed on the back, the
head as low as possible, turned to one
side and the mouth wide open. The op-
orator stands at the side Of the head,
seizes the two elbows firmly and draws
them as far upward and away from the
body as possible, thereby dilating the
chest and allowing the air to enter the
lungs.
An assistant. placed by the patients
legs, rests both hands on the sides Of
the base of the chest and brings pres
sure to bear on it at the very moment
when the patients elbows are being
brought back to the sides again after
having been raised to a maximum. In
q word, the assistant acts in such way
as to help to drive out the air that has
been sent into the lungs by the extern
sion Of the arms. Two skillful opera
tors can in this way, by working well
together, carry on an almost normal de-
gree Of breathing.
1t is advisable not to go too quickly,
as the average human being does not
breathe more than about l6 times a
minute.
If in one or two minutes the syncope
has not come to an end, there is no use
relying any longer on this measure, and
1t will be best to resort to rhythmical
fractions of the tongue according to
the method Of M. Laborde of Paris.
This method, which is constantly Civ
ing the most unhoped for results in
cases Of asphyxia, consists in opening
the patients mouth, in seizing the