ON THE STATE OF APPARENT DEATH.

CONSIDERING that the stroke of death, in natural and accidental cases, is not always, nor even often, a decisive blow:—that from the first appearance of its signs, to the fatal moment, some time elapses:—that some bodies for an hour, and more, lie in a swoon, without breathing, and without a discoverable circulation of blood, or action of the heart and lungs; that all motion and senfation have ceased, with a gradual diminution of natural heat:—and that, nevertheless, such inanimated bodies have eventually recovered life:— It has rationally been inferred, that the vital powers suspended and dormant in such bodies, might by some process analogous to the cause of motion, be rouled, and that when rouled, their former effects would naturally recommence. This theoretic argument, reduced to experiment and trial, became verified; and it is now affirmed that gentle irritation, and stimulation, produced in different parts of the body, by various means, are the principal agents that can roule and recall the latent powers, provided the application be immediate, and continued until its effects become visible.

The general aptitude of this discovery, has few limitations, but where parts essential to life are destroyed; for in all cases of suffocation, and suspension of breath and circulation, recoveries have been obtained by its effects. Its merit extends still further, and its aid proves a satisfactory test either of life or death, when premature interment is dreaded, as justly may be, from the performance of particular religious rites, and the state of bodies, in hot climates, where dissolution rapidly follows the appearance of death. A body that receives no benefit from a steady application of the proper means, is deemed absolutely dead, and may safely be configned to the grave.

The successful treatment proceeding from this great discovery, was disclosed upon the most liberal plan; and the means proving plain and easy, within the reach of confined abilities, were taught to the common people,

who

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who being present at deaths of all forts, exerted themselves, and performed every where numberless cures.

Wherever it has in a public spirited manner been communicated and practised, it has produced most beneficial effects. In Holland, where it originated, the magistrates throughout the republic, patronized, aided and encouraged the generous proceedings of the discoverers; they published edicts to inform the people that it was allowable freely to take, move, remove and treat for recovery, the bodies of all persons, who, from accidents, bore the appearance of death, or seemed to be deprived of the powers of life;—they exhorted them to practise such humane duties, recommending thereto the use of the means disclosed by the discoverers;—declared that the bodies upon which the treatment might not be attended with successes, should be decently buried:—in some parts, they offered rewards for successes; but in all, they enjoined their subaltern officers of police the duty of attending and giving all possible assistance, where such diffressing casualties happened.

Under such philanthropic Patronage, the practice flourished, and spread its beneficent aid to neighbouring countries, where similar protection produces the like fortunate effects. In all other parts, when it comes to be adopted, under the fostering hand of any judicious regency, it will produce fruit in abundance: But where it is left defitute of superior protection, there it will be seized and managed as medical practice, mysteriously and interestedly; because funds raised for charitable purposes, can be made to answer private interest, that will outweigh all the advantage that could accrue to the public from a liberal administration of a most beneficial subject. No government should lose the opportunity of adding to their system of police, a matter of so much concern to the community of which they have charge; as they cannot give stronger proofs of a properly directed attention to its welfare, than by promoting the means that fave and prolong life, and at the same time tend evidently to encrease population.

DIRECTIONS

FOR AN
EXTENSION OF THE PRACTICE
OF

Recovering Persons Apparently Dead:

TAKEN FROM THE INSTRUCTIONS AT LARGE,
PUBLISHED BY

ALEXANDER JOHNSON, M.D.

(INTRODUCER OF THE PRACTICE IN ENGLAND.)

And confirmed by REPORTS received from ABROAD:

Tending to shew, that more Benefit will arise to the Nation, from extending the Knowledge of the Original Treatment here set forth, to be exercis'd generally by Men of all Denominations, than from its being restrained to the Efforts of a comparatively small Number of Medical Affiftants and Country Practitioners, recommended by the several Humane Societies in this Kingdom; and who, professionally occupied, cannot be at Hand to give that instantaneous Affiftance upon which the Hope of Success is founded, at that critical Moment when fleeting Life exifts but like a Spark.

I.

DROWNING is the casualty in which trials to recover persons apparently dead, first proved successful. The treatment of such cases stands therefore first described; although they be but as one of many to which the same fort of means proves happily applicable. In regard to bodies, found where they cannot easily be treated in their defenceless state, caution is given against using them roughly, rolling them in or upon a cask, shaking or holding them with the head downwards, to discharge water, of which they hold but a small quantity that will otherwise be voided. Such bodies, if the boat or barge into which they are first received be not spacious or convenient enough, are to be carefully conveyed on a hand-barrow, a ladder, or a broad board, to some proper neighbouring house, where they are immediately to be stripped, dried, and laid upon a bed, a blanket, a horfe-cloth, or a great coat, examined whether they be hurt in any

A

part,

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part, and then to be rubbed with warm cloths of the softest
kind, to raise some heat in them; an essential circumstance,
the production of which can farther be promoted by the ap-
plication of hot water in stone bottles, of hot bricks and
tiles, and of hot sand, all in coarse flannel or cloth bags, to dif-
ferent parts of the body; also, by laying them before a moderate
fire, or in the rays of the Sun, while rubbing and other opera-
tions are going on; easier with children, but yet usefully with
grown persons, the body may be taken into a moderately
warmed bed, in blankets, between two healthy persons, who
will be kind enough to rub, cheer and chafe the patient. Other
methods of applying heat, by baths and immerfons, in different
fluids and substances, unwarily advised by the directions of the
London Humane Society, must carefully be avoided; such as
putting the body in a warm water bath, into brewer's grains,
fope leys, ashes, embers, and hot sand: they offer injudicious
trials, from which no good can ensue, as some destroy irrita-
bility and elasticity, and others unpardonably waste precious
moments, in which approved means might happily be used.
Improper advice is discoverable from its not agreeing in all
parts: for instance, when, after stating that free air is neceffary
for inspiration at the time of recovery, it is said, almost in the
fame breath, that to restore heat to a body thoroughly cold, a
warming-pan should be used; that advice must be deemed bad
and contradictory, because the live coals or embers haftily put
into that unwieldy utensil, must taint the air, and tend to keep
the patient in a state of suffocation. Indiscriminate,spirited efforts
prove hurtful; rubbing violently, and with subftances that in-
jure the skin, raises more heat and inflammation than the faint
powers of life are able to bear; they overmatch the faint
remaining ability, and the patient subfides under them.

The treatment of the drowned differs from all other accidents
only in two neceffary means, namely, drying and warming.—
The farther means to be used are applicable to all cafes of suf-
focation, or apparent death, excepting those proceeding from
fulphurous

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sulphurous fumes, subterraneous damps, frost-bitten parts, and
strokes of lightning, for which a remedy, of another kind, shall
hereafter be mentioned.

II.

Rubbing the body, back-bone, the sides, belly, palms of the hands, and soles of the feet, with soft and dry cloths, is a principal and essential operation, generally in all cafes, excepting the few above-named. The effect of rubbing, or friction, on the surface of the body, with a substance least likely to injure or inflame the skin, is to raise a genial warmth, and produce a moderate degree of irritation, that can call forth the latent powers, and re-animate the weakened system, if the vital principle be not totally lost. Diligence and affiduity are equally requisite and commendable; but any thing vigorous and violent, or out of the line of fteadlines and moderation, is liable to bad, nay to fatal consequences.

III.

When bodies have been long deprived of breath, it is rational, in order to recover them, immediately to try to restore it. Friction often makes the lungs to move, as soon as any other part of the body; but if it has not that effect directly, it is useful to try to blow air into the lungs, through the mouth and nose, by the breath of a bystander, or with a bellows, that ought to be clean, otherwise it might suffocate the patient; the latter way is deemed preferable to the intrusion of naufeous breath. The way to make the blast effectual, is to close the mouth, and one of the nostrils, and then to force the air through the other. —It is a general opinion, that efforts of this kind are attended with successes, and therefore they ought unremittingly to be made. They may, at least, be considered as irritating means to the tender lining of the nose, mouth and throat. In the fame fene, such stimulation may likewise be considered ufeful in the state of new and full-born children, who, of all beings, claim the first right to humane attention. They often lay breathles and motionles, while by moving, chafing, cheering, and, as most nurses believe, by blowing breath into them, they may be brought to life.

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life

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life again. In fact, many prove recoverable of those who formerly were laid out as dead, and really became so, by gradually losing their natural heat.

#### IV.

Introduction of Air and Vapour into the body by the fundamental, injecting warm vapour and air, the smoke of tobacco, for strong habits, and of aromatic herbs, for tender constitutions, has always proved efficacious; where a fumigator is not found, a common smoking pipe, a wooden clyffer pipe, or the addition of a reed, a hollow tube, the sheath of a knife or sciffars, of which the point is cut off, are ready conveyors of the smoke, or vapour, which, thus intruded, acts with elasticity, and excites internal motion; during the operation, the belly should be gently moved with the hand, and stroked upwards. Sharp clyffers, imprudently recommended by the Humane Society, act in a contrary manner, weakening, fickening, and rendering the parts flaccid, and a recovery more difficult.

#### V.

Emetics produce no effect, while all sense of feeling is suspended; and, when life is restored, they improperly tend to make the patient sick and faint, which is a drawback upon recovery; for whatever affects the stomach with debility, spreads that effect directly to every part of the body. This, therefore, and all other cruelly invented means, bl Costing, cupping, scarring and cauterising, must cautiously be avoided; they do not tend to re-animation, they are not felt till signs of life be obtained by other means; and when such signs appear, the suffering they cause is intolerable, and the regret of applying them must encreafe, as it becomes evident that they impede the progress of recovery. Wrenching the jaws, when locked, is another act of cruelty; it loofens and breaks teeth, that cannot be restored, and it proves unfelefs, as the jaws unlock at the return of life. Whatever is necessary for cleansing, if the mouth appear full of froth or mud, or to try whether any liquid can be swallowed, may be done with a small syringe, and warm water, injected between the cheek and teeth, the body being laid on its side to discharge the fluid.

To

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#### VI.

To move a patient on and by the blanket on which he lies, proves useful; it changes the position of the inward parts, and their pressure upon each other; offering at the same time new outward parts of the body for friction. But shaking by the legs and arms, and violently agitating a body in its defenceless state, is an injurious and injudicious direction.

#### VII.

In attempts for recoveries, recourse is not to be had to bleeding, although left to medical option, by the Humane Society; where the principle and powers of life are so much lowered as to keep the body in a fainted state, that operation will encreafe the evil, by destroying two powers essential to life, irritability and elasticity; it always proves hurtful; often fatal, with faint signs of recovery;—when performed, it requires bandages that obftruct friction and circulation. In advanced stages, where from violent inward agitation, it has been confidered as the immediate means of relief, it has, with fallacious effects, proved weakening, and has been found easily and efficaciously replaceable, by cooling and compositing things, saline draughts, camphor julep, almond milk, some drops of laudanum, from all which no bad consequences ensue; and in this particular part of treatment, a common affixant is safer than a medical one, who will hardly refrain from the custom of using his lancet.

#### VIII.

All acids are hurtful; they cause constriction and stagnation; they congeal and coagulate the fluids, and harden the solids. Their effects are the opposite of those that prove salutary by producing fluidity, and promoting the circulation of the blood and humours.

#### IX.

Cafes of suffocation by the fumes of charcoal, by the damps of mines, and the foul air of cellars, as likewise those in which the body is numbed by intense cold, and partly frozen; to which may probably be added, those struck lifeless by lightning, require a particular treatment: the aspersion of cold water, has proved a moft

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most effectual remedy for them; and it has long been known,
that the application of snow, ice, and cold water, was a cure
for frost-bitten parts. The patient hurt by one of the above ac-
cidents, is laid in a floping posture naked, the head upper-
most, on boards, in the open air, and the coldmost water is
thrown or dashed in small quantities in the face, and on other
parts of the body, rapidly and smartly, for a length of time,
without intermission, until signs of life be obtained.—This me-
thod answers better than plunging a lifeless body repeatedly
into a cold bath, which is not so easily refreshed, as cold water
can again and again be brought for respiration. A person thus re-
covered, wants no further treatment, than to be well dried,
clothed, and cheered with cordials that are not spirituous.

X.

The first signs of life are discovered by gasping, fighting,
yawning, stretching, contractions in the face and eyes, a blush
on the cheeks and lips, and a faint beating of the pulse and
heart. These are followed by spasms, convulsions, anxiety,
groaning, puking, purging,icks, and a violent headache. As soon as the first are observed, then cordials that do not heat, cinnamon and peppermint water, wine and spirits lowered with water, are directly to be given, by a tea spoonful at a time, to make sure of their going down into the stomach, where they will soon appear to have a good effect.—At that time also, and sooner, if the flesh acquires a kinder feel, the temples, ears, and neck should be chafed with volatile spirit of sal ammoniac, or of hartshorn sprinkled upon a linen rag: some of the same spirit may be spread upon hot water, in a cup, held near the patient's face, that he may breathe the vapour as it rises. Use may then also be made of a feather, to irritate the throat, and produce the effort of reaching; or tickle the nose, and provoke sneezing.

Patients recovering by common means, are to be kept quiet,
moderately warm, calmed with camphor fulep, almond mil-
fage, and balm tea; and when sleepy, to have wine whey.

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When they can take food, mulled eggs, animal substances, and
other things are proper; butter and fat meat are not so.

XI.

Electricity, and other speculative means, ought not to be
propofed to common operators; they have neither instruments,
heads, hands, nor time for experiments: it is likewise dangerous
to lead them away by fancy, from a salutary practice, to the
exercise of which they are equal.

XII.

The means prescribed are to be suited to the age and strength
of the patient; children and young persons are to be treated
with more tenderness than grown persons: People dying after
a long or short illness, have proved as recoverable, as those ap-
parently dead from accidents:—with those, therefore, as with
others, strict attention must be had to overdo nothing, and not
to overpower the remaining principle of life, as far as its state
can be discovered. The different operations must be conducted
discriminately, but without intermission, and for a great length
of time, as life often returns tardily. Affixants, nurfs, and at-
tendants on the sick, must be seriously warned, not to uncover or
draw away the pillows of their charges at the time they seem
to expire, as it may confirm their death; and should believe
there is still a chance of recalling them, and thence proceeding
to the means, they must not be discouraged if successes does not
immediately ensue, but steadily, for a number of hours,
exert their best endeavours, which will be rewarded, either by
the recovery of the person apparently dead, or by the furens
that they have ascertained the body to be a corpse, that may,
without fear of reproach to them, be confided to the grave.
Such is the precaution by which the terror of premature inter-
ment can at all times be made to vanish.

These Instructions, collected from the original Directions,
confirmed by observations upon a large field of foreign commu-
nications, and set forth in plain language, intelligible to the most
limited capacities, are recommended to be learnt by all classes of
men, and followed with confident hope of success, as they point

out

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out what is necessary to be known, and leave nothing to fanciful choice, or what in itself proves destructive of the salutary end proposed: circumstances not attended to, or guarded against by the Publisher of the London Humane Society's late improved and abridged Plan, of the Modes of Treatment for the Recovery of Persons drowned, or otherwife suffocated, to which these Instractions are meant to serve as a corrective, and a further guide for all persons humanely disposed, like the good Samaritan, to exert their abilities to save and restore their fellow creatures, in the moment of distress and danger; as likewise for nurses and attendants on the sick, to make decisive trials on their dying charges; for which purpose these revised instructions are offered, gratis, to all those that are desirous of information on the subject, or inclined to promote it, by teaching the practice to the common people.

An excess in drinking a hurtful quantity of fiery spirits, for foolish wagers, from impatience under calamities, or despair when life becomes a burden, causes a state of stupidity and apparent death, which is to be treated, with gently and infrequently rubbing the body with dry flannels, chafing the nose, temples, ears and neck, with volatile spirits and salts, clearing the stomach of the spirits it may contain, and giving oily mixtures after that. When bleeding has in such cases been performed the patient has funk under that operation, and expired.

N. B. The things generally to be kept at hand, are volatile spirit of Sal Ammoniac and of Hartfhorn, Eau de Luce, and the common smelling Salts—peppermint and cinnamon water—raisin wine—all-spice and ginger for infusion—sweet herbs dried, and tobacco cut for smoking—blankets, flannels, stone bottles for hot water, clean bricks and tiles to heat—clean small bellows, pipes, and leather tubes, to convey air and vapour—blanched almonds for emulsion—a phial of laudanum, and some tinclure of castor, to soothe irritated nerves.

An Ointment for tender skins, parts hurt, for scalds and burns, is made with fallad oil, in which some camphor is dissolved, shaken in a phial together with a small quantity of spirits of hartshorn, or two parts of quick lime water to one of oil. It proves of frequent use in Families.

London: Printed and distributed at the LOGOGRAPHIC PRESS; at No. 169, Piccadilly, and at most other Book sellers.

## EXHORTATION.

SAVING and prolonging of lives, considered as much a duty to society, as an act of humanity, enforces a moral truth, that the necessary assistance explored for unlucky patients, ought never to be refused: the gift is always meritorious, and in small measure still useful; for instance, where funds cannot be raised for a particular institution, the very spreading of the knowledge of the means of recalling dying people to life, will answer a most useful purpose: it can be done at the small expence of reprinting and freely distributing these Abridged Instructions; they cost but four shillings the hundred, and 500 copies suffice at a time for a common district in England: the sum of 20 shillings is then the expence at which the salutary knowledge can be diffused to a considerable number of persons; and it may thence be asked, where is the parish in which that sum cannot be found; and where is the person who would not contribute his share for the chance of successes in saving, were it but, one valuable life? How ample a reward would be the tidings of so lucky an event!

Inculcating the knowledge of the salutary means, into the minds of all classes of the people, would enable every common man to affift and relieve his neighbour when in distress for life; his ability would lead him eagerly to exertion; the want of reward would not blunt that fellow-feeling ever alive in a breast that is not utterly depraved. From the infrustion beftowed upon the common class of people, a most desirable effect would arise; among them are found midwives, nurses, and servants attendants on the sick; from their knowledge of the proper means, the successes of the practice would be brought within doors, where it is wanting; for the number of those that die there, is superior to that of the accidents out of doors: and there is in common practice but little contrivance of aid for still-born children, women fainting in child-bed, first strokes of apoplexies, of lethargies, of fits and convulsions; where these suddenly happen, the patient is condemned in course, and left to die unaffifted:—Not so will it be with those who shall have about them persons infrusted in the salutary means of recovery; they will not remain untried; the event of long or short lafting

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ing illneſs, will not deter them, ſucces having fol-
lowed after both; a ſpeedy application will ſoon reſtore
thoſe in whom the powers of life can be revived: Cafes
of all kind, from which the efficacy of the treatment
have been demonſtrated, will be re-produced; bedrid-
den patients will not, at firſt appearance of death, be laid
out to chill and become ſtiff; thoſe that drop down in
fits, will no more haſtily be ſentenced dead without ap-
peal. The final teſt will, laſt of all, prove that no indi-
vidual can prematurely be doomed to the grave, where
this ſalutary practice is freely and generally exerciſed.
What then is to prevent earneſt representations and
exhortations devoid of ſelf-interested motives from being
favourably received, and the plan of inſtruction and ap-
plication of the means carried into execution? The be-
neſts to arife from it, are demonſtratively ſo far beyond
the trouble and expence of introducing and eſtablish-
ing it, as to make all heſitation or delay of acceptance
unaccountable.

P. S. The writer of these inſtructions, rémonſtrances,
and exhortations, hopes that gentlemen of the medical fa-
culty, will not take offence at the free manner in which
he has treated a ſubject of immediate national concern,
and originally intended not to be limited to their pro-
vince. There can be no doubt of their aid and advice
being preferable to all other, in conducting recoveries;
but the treatment to be applied is ſo plain and eafy, and
cafualties require every where ſuch a number of ready
hands, that theirs can by no means anſwer the exigent
haſtly calls for inſtantaneous affiſtance. Had the direc-
tors of humane ſocieties in England, followed the original
liberal plan, or its imitations abroad, for inſtructing the
common people, they would have done more honour
to their management, than by confining the practice to
themselves, and to a ſmall variety of cafes; a partial
conduct, that has repeatedly called for the writer's ex-
ertions, to prevail upon them to enlarge their mode of
proceeding; and to inform the public, that the practice
he introduced into these kingdoms, has been, and
ought, from the generous contributions they receive,
to be made productive of far more beneficial ſervices,
than have hitherto derived from it, to the nation.