The daily morning journal and courier., 1907-05-08
QUICK AID FOR
 APPARENTLY DROWNED Simple Directions For The Restoration of the Nat
 ural Respiration. HOWARD DIRECT PLAN Procedure Arranged for the United States Life
 Saving Corps.
HOWARD DIRECT PLAN

or means for securing deeper inSpira- tion. The method heretofore published, known as the Howard or direct meth- cd, has been productive of excellent re- suits in the practice of the service, and is retained here It is, however, here arranged for practice in combination with the Sylvester method, the latter producing deeper inspiration than any other method known, while the former effects the most complete expiration. The combination therefore tends to pro- duce the most rapid oxygenization of the blood-the real object to be gained. The combination is prepared primarily | for the use of life saving crews where assistants are at hand. A modifca- 1 of Rule ILL, however, is published as guide in cases where no assistants are at hand and one person is compel led to act alone. In preparing these di- rections the able and exhaustive re- port of Messrs. J. Collins Warren, M D., and George B. Shattuck, M. D., l committee of the Humane society of | Massachusetts, embraced in the annual report of the society for 1S95-96, has been availed of, placing the department under many obligations to these gentle men for their valuable suggestions.
 Rule I.-Arouse the patient-Do not move the patient unless in danger of fire ezing; instantly expose the face to the air, toward the wind of there be l any; wipe dry the mouth and nostrils; l rip the clothing so as to expose the chest and waist; give two or three quick, smarting slaps on the chest with the open hand.
 If the patient does not revive pro- | ceed immediately as follows:
 Rule II.-To Expel Water from the Stomach ana Chest-separate the jaws and keep them apart by placing be- tween the teeth 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 1 half minute, or as long as fluids flow 1 freely from the mouth.
 Rule III.-To Produce Breathing I Clear the mouth and throat of mucus | by introducing into the throat the cor | ner of a handkerchief wrapped loosely | around the forefinger; turn the patient l on the back, the roll of clothing being so placei as to raise the pit of the l stomach above the level of the rest of the body. Let an assistant with hand kerchief or piece of dry cloth draw the 1 tip of the tongue out of one corner of the mouth (which prevents the tongue from falling back and choking the en- trance to the windpipe), and keep 1t projecting little beyond the lips. Let 1 another assistant grasp the arms just below the elbows and draw them stead- fly upward by the side of the patient s head to the ground, the hands nearly meeting (which enlarges the capacity of the chest and induces inspiration.) While this is being done let third as- sistant take position astride the pa tient's hip with his elbows resting upon his own knees, his hands extended ready for action Next, let the assis- tant standing at the head turn the pa tents arms to the sides of the body, the assistant holding the tongue, how ever, must not be released. Just before the patients hands reach the ground, the man astride the body will grasp the body at the hands, the ball of the hand 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 patients 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 anything in the chest upward out of tie mouth; he will deepen the pressure while ke counts slowly. one, two, three four (abolt five seconds), then sudden ly let go with a final push, which will spring him back to his first position. A child or more delicate person must of course, be more gently handled. This completes expiration.
 At the instant of his letting go, the man at the patients head will again draw the arms steadily upward to the sides of the patients head as before (the assistant holding the tongue again changing hands to let the arms pass if i necessary hol1ing them there while he slowly counts one, two, three, four (about five seconds)
 Repeat these movements deliberate- ly and persevoringly twelve to fifteen times in every minute-thus initiating the natural motions of breathing.
 If natural breathing be not restored after a trial of the bellows movement for the space of about four minutes, then turn the patient second time on the stomach, as directed in Rule IT., rolling the body in the opposite direc- ton from that in which 1t was first turned, for the purpose of freeing the air passage from any remaining wa ter. Continue the artificial respiration from one to four hours, or until the patient breathes, according to Rule III, and for a while after the appearance of returning life carefully aid the first short gasps until deepened into full breaths. Continue the drying and rub ping, which should have been unceas- ingly practiced from the beginning by the assistants, taking care not to in- terfere with the means employed to in- duce breathing Thus the limbs of the patient should be rubbed, always in an I upward direction toward the body with firm grasping pressure and energy, us- ing the bare hands, dry fiannels or handkerchiefs, and continuing the fric- ton under the blankets or over the dry clothing. The warmth of the body can also be promoted by the application oi hot ]annels to the stomach and arm pits, bottles or bladders of hot water,
 heated bricks, etc, to the limbs and
 soles of the feet.
 Rule IY.-After Treatment-Exter- nally: As soon as breathing is estab- liehed let t,,n nn tin1nt he st1.lnrad of a II