ORIGIN and PROGRESS of the Practice for
Recovering Persons Apparently Dead.

THE Discovery of this extenſively beneficial
Practice, owes its birth to the philanthropy
of a few wealthy Gentlemen at Amsterdam, in
Holland, who accidentally hearing that all drowned
perſons were not really dead when taken out of the
water, believed it might be poffible to recover thofe
who were only in appearance dead; and thought,
if the furmife proved true, they would be blame-
able for not making the attempt. The informa-
tion which, upon enquiry, they got, was but lit-
tle, yet they published it; and to obtain more,
they offered a reward for trials, and particular ac-
counts of their event. The ambulant mechanics
and boatmen in that commercial city and fea-port,
ſoon found ſubjects for trials, and making them
with caution and ſteadineſs, became ſuccesſul,
and able to bring diſtinct reports, that were cheer-
fully received, and readily rewarded. Thus in-
formed, the Gentlemen managers, published the
cafes and the means employed; renewed the offers
of reward, and extended them over the territory
of the Republic, without propofing a ſubscription,
or asking any contribution, to raise a fund to re-
lieve them from ſo confiderable an expence; and
when the ſuccesſs of their undertaking procured
them donations and legacies from benevolent per-
ſons, they never repaid themselves, but ſtill pro-
mised, that when the gifts were expended, they
would again ſupply what might be requisite. The
Police was active to give energy to their meaſures.

In proceeds of time, the ſcale of recoveries en-
larged, and from particular cafes related, it became
evident, that perſons hanged, ſtrangled, and other-
wife violently deprived of breath, were recoverable
by

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by the fame means. From this extenſion, more
and more convinced, that the greater number of
Aſſiſtants, produced the greater number of reco-
veries, they reminded the people, that the means
were in their own hands, and encouraged them at
large, to undertake every Cafe that bore an appear-
ance of death. This invitation did not exclude
medical perſons, it was general.

To ſuch example, and ſuch exertions, all the
Inſtitutions and Societies of the kind in Europe,
and a few in America, owe their origin; and from
their general endeavours and trials has flowed the
certainty of the extenſive utility and application of
the particular treatment: The exerciſe of it has in
no way been ſubmitted to a limited medical ma-
nagement, but in ſuch places where a want of social
convention, has made it to be connected with hof-
pital duties, except in England, where a junto of
the Faculty ſoon engroſſed, and ſince, has kept the
diſplay to itself, greatly to the diminution of the
benefit that might have been reaped from it here.
France has a hundred ſuch Inſtitutions in its Pro-
vinces, but not one perſon in the direction that
enjoys a ſtipend for diſpenſing humane offices.

Sudden deaths being more common in this than
in other countries, and but few Inſirmaries or
Hofpitals held open to thofe accidents, it is plainly
requifite that every County in England ſhould
have a Society of its own, while hardly eight have
any eſtablishment of the kind. The Magiſtrates
of the reſpectiue diſtricts in the Counties, have, ne-
vertheleſs, been addreſſed and exhorted to take
ſome ſteps towards ſaving ſuch a number of ſub-
jects, were it only by informing the people of the
means they have in their power, to recover ſuch
of their fellow creatures, who, from a want of
aſſistance, fall too early victims to death; the coun-

A 2

try

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try papers relate thesee caufalties, of which the fatal effects might thereby have been prevented; yet the urgency of the representation has not produced the desired effect! How can this inattention or indifference be accounted for, in a country like this, where sentiments of liberality and generofity are so manifest, and generally prevalent? Are there not County-meetings? Are there no Assemblies and Clubs in moft parts of the country, where an interesting matter of this kind could be proposed and fet on foot? Can the institution of an Humane Society in London be commended and largely supported, without raifing a spirit of emulation, and a desire of following the salutary example in the county towns?

Notwithstanding all fupineneſs, and the lamentable loſs of time, let us yet hope, that ſome generous and compassionate Gentlemen, ſuch as diſtinguſhed themselves by endeavours to reſtore liberty to a race of unfortunate beings, doomed to ſlavery, will now ſtand forth to ſave the lives of numbers, who might be reſtored useful members to the community; but, from ignorance, are condemned to the grave. Aſſistance provided throughout the country, would reſcue hundreds every year, were only the average of 58 drowned, reported by the London Humane Society, taken as one 20th part of what may be recovered from the innumerable accidents to which individuals in the course of life are expoſed.

Should any prejudice remain with the people, of an imaginary danger in meddling with bodies apparently dead, the reſpectable Magiſtrates of the Districts, following the voluntary example of the Dutch Regencies, will find the moſt effectual opportunity of removing it, in publishing and commending the means by which life is reſtored to such unfortunate beings.

INTRODUCTION

TO THIS

PUBLICATION.

A Gentleman, whose humane feelings have induced him to extract from Dr. ALEXANDER JOHNSON's often published Inſtructions, the principal Rules for reſtoring Life to perſons who appear to have loft it, and who has put them into verſe, perſuaded they will, in that ſhape, be better remembered, and, from being more impressed on the mind, will become productive of more extenſive effect, has ſent them, in compliance to the Doctor, as introducer of the practice into theſe kingdoms, for his approbation and publication, if he thought them clearly enough ſtated. The Doctor finding they concisely point out all that is immediately required in the ſituations that generally occur, and deeming them very proper for publication, not only to do honour to the Compoſer's generous intention, but also to contribute to the extenſive knowledge of the treatment, now kept in the hands of a few Medical Perſons, while on a large field of benefit, it ought to be in common practice with all men; has thought proper, in order to render them more plainly intelligible, to accompany them with Explanatory Notes, and in that ſhape to offer them for general acceptance; induced only by the extenſive utility of which, it is certain, they can be to the community at large.

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MEANS

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MEANS successfully used, and particularly recom-
mended, for RECOVERIES of LIFE, from AP-
PARENT DEATH, by DROWNING, and every
other Stoppage of Breath, and generally by all
Causes, natural or violent, where the Parts essen-
tial to Life are not destroyed; to be applied by every
Class of People: for the former Cafes, chiefly by
Nurses, and Servants attendant on the Sick; and
for the latter, by all those that are present, or become
first apprised of the Accident: all without the Aid
of MEDICAL ASSISTANTS, the Treatment being
plain, and unconnected with Medical Knowledge.*

IN every instance of departed life,
Nature, still struggling, holds a doubtful strife.
In cafes the most common that we meet, (1)
Ere death the last decisive stroke complete,
Some time elapses; —yet uncertainty
Attends that space—it long or short may be:
Therefore employ that interval to try
If yet some sparks of life may dormant lie,
And either a recovery safe procure,
Or from that worst of horrors thus ensure
Of quick interment. For experience shows,
That many women, from child-bearing throes,
And new-born infants, breathless long remain
In swooning strances, —yet revive again (10. 11. 12. 13)
By means here recommended.—Then beware
None perish thro' your want of thought or care;
But try those means which every willing hand,
At any time and place, may well command.

At

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At first discovery of apparent death,
Lose not a moment; for the fleeting breath
May yet be stay'd—while life's last spark remains,
Patient attend, nor spare or time or pains.
Avoid the dangerous practice now decry'd,
By ignorance and prejudice oft try'd,
Rolling with violence, nor shaking try,
Nor yet suspending—who those means apply
To force discharge of water, to the grave
Consign the wretch whom gentler means might fave.
First, from wet cloaths the body free,—with care
Wrap it in flannels soft and warm;—beware
You no sharp salt, nor yet corrosive ply;
Nor rub with wetted cloths, but keep all dry.

These early steps when taken with the drown'd,
(On whom successes first afcertain'd was found)
What follows equally relates to all (2).
Those who into a death-like swooning fall, (3)
Or feeming choak'd—like treatment will demand,
Cheering and rubbing with a gentle hand. (4)

The purple stream of life alike beware (5)
Not to diminish; and, with anxious care,
Avoid emetics, which may ills diffuse (6)
Through all the frame, deem'd fatal by the muse.
Shun all those cruel methods that impair
The skin, (4. 6) nor, by your ill-directed care,
Congeal those humours, which to keep alive, (9)
In fluid state, you anxiously should strive.
Attempt not, by excruciating pain, (6)
Some knowledge of the patient's state to gain;

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For

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For know, thofe trials are a vain pretence,
While all ſenſation lies in dead ſuſpenſe.
With patience wait, left, by ſuch cruel haſte,
Life's feeble lamp you ignorantly waſte: (4)
From care and caution better comfort flows, (7)
And jaws, tho' lock'd, will of themselves uncloſe.

With cordial drops endeavour to revive (8)
The fleeting ſpirits, and life's current drive
Back to its native channels.—Try to heal,
With opiate draughts, the irritated feel,
Caus'd by reviv'd ſenſation.—Next attend,
With needful help, and frequent turn or bend, (10)
Provoking motion in the languid breast,
Nor leave the body in lethargic reſt. (11)

Inject warm vapour, (12) and blow in fresh air;
And let it likewife be your constant care (13)
To chafe the temples, palms, on every part
Moſt ſenſible, exert that needful art.

Take a clean feather, with it, tickle, teize
The throat, and up the nose, to force a ſneeze.

In ſuffocations cauſed by noxious air,
Or bodies froſt bitten,—be it your care
With water icy cold, or even ſnow,
Repeatedly apply'd, to raiſe a glow: (16)
Despising all absurd exploded ways, (15)
With ſhock electrical the dead to raiſe,
Or reeking ſheep's-blood pour'd in human veins;
True judgment all thofe vain attempts diſdains.

Convulsions, ſwoonings, wear the face of death,
Still is the pulſe, ſuſpended is the breath;

Here

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Here ſpirits volatile and hartſhorn uſe,
With gentle friction—ne'er inactive muſe
O'er the extended patient; but apply
Means unremitted, every method try; (16)
Raſe, turn, and chafe the temples, give not o'er,
Watch 'till returning breath your friend reſtore.
In this, and ev'ry caſe, quick help and care,
With gentle friction, change of poſture, air,
With patience infinite, with watchful eye,
And frequent touch, each ſymptom to deſcry
Of faint pulſation, warmth, or rſing glow,
Are the beſt helps attendants can beſtow. (17)

These ſymptoms a return to life portend,
And with affiduous care theſe signs attend;
Contractions of the muſcles, face and eyes,
A ſpreading bluſh o'er cheek and lips arife,
Then ſpaſms and ſufferings ſtrong exertions cauſe,
Break out in ſad complaints, deep groaning draws;
Vomitings, head-ach, fail not to ſucceed,
The patient then your quickeſt help will need;
Pain-stilling drops, and ſaline draughts apply,
With camphor julep, cooling mixtures try,
Eaſe and ſome kind refreshing ſleep to gain, (18)
Which, in few hours, may happieſt ends obtain.

Yet ſtop not at the firſt faint glimpſe of life;
While struggling nature holds a doubtful ſtrife,
Continue ſtill the means, nor ſpare your pain,
Left in lethargic ſleep they ſink again.

NOTE.

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NOTE on the Propriety of Employing the Common Classes of Men in the Operation of Recovering Persons under the Appearance of Death.

* The extensive degree of benefit that can arise to the nation from a practice known capable of affording relief in all cases of apparent death, by a treatment sufficiently plain, to be applicable by every person of common ability, is proportionate to the universality of the knowledge of it, and to the number of hands humanely employed in its efficient operations: the number of medical assistants proposed by the Humane Societies for this beneficial work, is small, and thinly spread, comparatively to the multitude of men found every where, ready to tender aid on all urgent occasions. The greatest advantage, therefore, that can derive from this practice, must be reaped from the multitude of hands, not from the confined number to which it is restrained. As the success will likewise depend upon the celerity of applying the means; life, in that suspended state, existing but as a spark,

NOTES on the verified INSTRUCTIONS.

(1) The appearance of death is known to be equivocal; none but the symptoms of mortification can be called certain; prudence therefore directs to trust to none; and every apparent corpse ought to be put to trial, by the means here indicated, for a decisive test of a possible recovery, or a certain state of dissolution.

(2) Drowning is the casualty in which trials to recover persons apparently dead, have originally proved successful; the treatment

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treatment of it, therefore, stands foremost in description; but its application not being confined to that accident, proof has been obtained of its successful application in numberless cases, where life has appeared suspended. Its superiority in number, therefore, exists no longer, than inattention confines its success to such partial endeavours: the occurrences to which it ought to be extended, may, beside hanging and strangling, be enumerated as follows: stifling, suffocating from damps of mines, flagrated air in pits, wells, and vaults, from the effluvia of fermenting liquors in cellars; farther, from the suspension of life in apoplexies without rupture of vessels, in lethargies, swoonings, in accidents happening to women in child-bed, and to new and still-born children, in convulsions and hysterical fits, effects of violent passions, excess in drinking spirituous liquors, of surfeits, and of cold liquors drank in heat. So unbounded is the efficacy of those means, that no state, bordering on the appearance of death, should be left unattempted, on the smallest view of recovery.

(3) A body become cold (any way but by frost) may be warmed in the following manner: it may be laid before a moderate fire, or the cloths with which it is rubbed, may alternately be made warm before they be applied: stone bottles with hot water, and bricks or tiles heated to a middling degree, or hot sand, feverally put up in flannel, may be laid near different parts of the body. To restore heat generally, (which may easily be done with children and small sized persons) the body is to be taken into bed between blankets and two healthy persons, who will by gentle rubbing, cheering and chafing, bring on a mild glow, that has often brought forth life in a short space of time.

(4) Indiscriminate, spirited, vigorous efforts, have frequently proved hurtful; rubbing violently, and with substances that can

( 12 )

can injure the skin, have raised a greater degree of irritation and
consequent inflammation, than the remaining powers of life
were able to bear, and the patient has thereby subfused. The
endeavours should be proportioned to the powers, as they are
discovered. An over quantity of action may destroy the powers
themselves. Inactivity, dilatoriness, doubt, and apprehension,
on the other hand, are equally dangerous; the lots of time, is
oft the lots of life, it ought then not to be wasted in vain at-
tempts, incautiously recommended by the Humane Societies,
such as immersions into warm water, brewers grains, soap leys,
aflames, embers, and hot sand; their effects prove contrary to
those wanted, and the precious moment can better be employed
in a recourse to means of known success.

(5) Bleeding proves hurtful, often fatal in first attempts for recovery: it reduces the principle and the remaining powers of life. If a person recovering from a swoon, be bled, he will relapse into it again, because two qualities essential to life, irritation and elasticity, will be destroyed in him. It requires bandages that obstruct circulation, and every other necessary operation. In advanced stages, and violent agitations, where its fallacious effects have given support to a belief of its use, it can effectually be replaced by cooling and composing things, saline draughts, camphor juleps, almond milk, some drops of laudanum; from all which no bad consequence ensues: and in this particular treatment, a common affiant will be safer than a medical person, who will hardly refrain from the use of his lancet.

(6) Making sick, means giving emetics; these, and blinding, cupping, scarifying, cauterising, produce no effect, while the sense of feeling is suspended; but on its return, the cruel effects of such trials prove intolerable, and thwart whatever else could promisingly have been done. In surfeits from eating or drinking, with some remains of life, puking is found useful.

(7) The

( 13 )

(7) The mouth and nose (of drowned persons) are sometimes filled with mud, or (in others) with froth, which ought directly to be cleared away; but the jaws being fixed, it is best, without wrenching them open, to inject some warm fluid with a small syringe between the cheek and the teeth, keeping the body on its side to vent it again. The jaws will unclose without trouble, when the first signs of life appear.

(8) Such cordials as do not heat, cinnamon and peppermint water, wine and spirits diluted with water, should be given as soon as possible: a tea spoonful at a time only; to be sure that they go down to the stomach, where they will have a good and speedy effect.

(9) Acids are hurtful: they cause constriction and stagnation, congealing and coagulating the fluids, and hardening the solids. Their effects are the opposite of those that prove salutary: the most promising symptoms being the fluidity and circulation of the blood and humours.

(10) It proves useful to move a patient on and with the blanket upon which he lies; it makes a change in the position and pressure of the inward parts, and offers a new field for friction. Violent shaking and agitation, would have a contrary and unfavourable effect.

11. Injecting warm vapour, the smoke of tobacco, fage, or other aromatic herb, up the fundament, has always proved efficacious; the first for strong habits, the last for tender constitutions; a pipe, a common wood clyster pipe, a reed, or some other hollow utensil may be found for it, where the new common fumigator is not to be had.—Sharp clysters and other evacuants, are unsafe; they weaken and affect the stomach and the body.

(12) Fresh

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(12) Fresh air is better blown in at the nose than the mouth: it is done with a pair of bellows, which must be quite clean, otherwise they will sooner suffocate, than restore respiration: the mouth is held close at the time: it has often been done by a transmission of breath from the mouth of an affixant, into the lungs, (as is thought) of the patient; though this is not held to be the best way: however, as great stress is laid by many upon the effect of this operation, it is right to attempt it in the most convenient way that may offer.

(13) Chafing the temples, ears, neck, and other most sensitive parts, is done with volatile spirit of sal ammoniac, or of hartshorn, or Eau de Luce, sprinkled upon a part of the cloth, or a separate bit, with which the patient is rubbed; it is held under his nose, and some being spread upon warm water, rises and forms an atmosphere of vapour and air around the patient, very fit for his lungs, as he recovers his breath.—When a little of this spirit is used diluted in the wine, or other cordial above advised, it sensibly encreases their effect.

(14) The aspersion of very cold water thrown rapidly and for a length of time in the face and on other parts of the body, has proved a most efficacious remedy for persons suffocated by fumes of charcoal, the damps of mines, and the foul air of cellars, as likewise for those that are seized with intense cold and are partly frozen, for which the application of snow and ice, or the coldest water, is known to be efficaciously used: while on the contrary, the raising of heat by fire and by friction, would prove destructive, and produce mortification. Some favourable indications lead to believe, that persons struck with lightning would receive benefit from a like aspersion with cold water. The patient is laid in a sloping pofture, the head uppermost, on boards, in an open place, and the coldest water dashed in his face and on other parts, smartly and without interruption,

a

miffion,

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miffion, until signs of life be obtained. This method answers better than plunging a lifeless body into a cold bath, which is not easily done; and cannot produce as much effect from coldness, as the renewal of fresh water, in smaller quantity, readily does to an affected limb. Persons thus treated, want, upon recovery, no other management, than to be well dried, clothed, and cheered with cordials that are not spirituous.

(15) Speculative means should not be proposed to common operators; they have neither instruments, hands nor heads, for experiments, and ought not to be led away from a salutary practice, to the exercise of which their abilities are equal.

(16) Suiting the means prescribed to the age and strength of the patient, implies an adjustment of them to the remaining principle and powers of life, as far as they are discoverable. Care must be taken not to overpower or destroy the capability of receiving aid; but to go on attentively, and without interruption, as life often returns tardily, after many hours operation.

(17) Of all beings under the appearance of death, new and still-born infants claim a first right to attention; by chafing and cheering, many are recoverable of those who formerly were laid out as dead, by midwives and nurses. Such persons, therefore, (and all affixants and attendants on the sick) must not be discouraged by any unpromising aspect, but steadily continue their endeavours to ascertain the true state of their charge, either to restore life, or to make sure that there be no error in configuring it to the grave.

(18) The care to be taken, the steady assistance to be given, and the symptoms of returning life, being well set forth, the mode of proceeding with persons that are restored, remains to

be

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be described : those who are recovered by common means, are to be kept quiet, moderately warm, calmed with camphor julep, almond milk, sage and balm tea; and when sleepy, to have wine whey. When they can take food, they should have mulled eggs and other animal substances, and all strengthening things. Butter and fat meat are not proper.

N. B. The things generally to be kept at hand for eventual use, are volatile spirit of Sal Ammoniac and of Hartshorn, Eau de Luce, and the common smelling Salts, all kept close stopped: peppermint and cinnamon water—raisin wine—all-spice and ginger for infusion—sweet herbs dried, and tobacco cut for smoaking—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—sweet oil and camphor for usection—blanched almonds for emulsion—a phial of laudanum, and some tincture of castor, to soothe irritated nerves.

A cooling Ointment for tender skins, parts hurt, scalds and burns, is made with fallad oil, in which some camphor is dissolved; a spoonful put into a phial, with two spoonfuls of volatile spirit of sal ammoniac, or hartshorn, or three of quick-lime water, and well shaken together, form a thick cream, that will be found useful on many occasions.

The emulsion of sweet and bitter almonds, called orgeat, or almond milk, is made, by rubbing them down (blanched) in a marble mortar, with some moist sugar, to a paste, in which some of the sediment of the above camphor oil may be incorporated, so as to disappear. Part of this paste spread thin in a large bason, and hot water poured by degrees upon it, makes, by abraiding, a kind of milk or cream, very pleasant and cooling.

( i )

ON THE STATE OF APPARENT DEATH.

THE appearance of death is ever diffusing, as
life, with all the drawbacks upon its enjoy-
ments, is still precious to every individual, while it
stands exposed to numerous calamitous accidents
that shorten its duration, againft which prudence
is seldom confulted for a preventive! The art of
medicine provides relief in many disorders and dif-
eases with which the human body is afflicted; but
offers no aid for the prefervation of life, at the cri-
tical moment of the approach of death: a patient
within its verge, is deferted by medical persons,
and left to the management of an uninfructed nurſe,
with whom the laſt spark of his life is allowed, or
haſtened, to extinguifh.

Some gentlemen abroad, attentive obſervers of
the course and contingencies of life, confidering
that the ſtroke of death, in natural and accidental
cafes, 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 ſenſation have ceased, with a gradual
diminution of natural heat; and that, nevertheless,
ſuch inanimated bodies have eventually recovered
life: they rationally inferred, that the vital powers
ſuspended and dormant in ſuch bodies, might, by
ſome proceeds analogous to the cauſe of motion, be
rouſed; and that when rouſed, their former effects
would naturally recommence. This theoretic ar-
gument, reduced to experiment and trial, was veri-
fied; and it became aſcertained, that where parts
eſſential to life are not injured or destroyed, and
where the powers of action and motion are only ſuſ-
pended, in ſuch ſtates the cauſe of inaction can be
removed, and the parts of the body reſtored to their
usual functions.

The

copy 1

The

(ii)

The general aptitude of this discovery to every appearance of death, natural or accidental, has few limitations; in all cases of suffocation by damps or fumes, suspension of breath and circulation, fits, swoonings, and those sudden ceifications of motion, in which persons drop down in the streets, recoveries have been obtained. Beyond these its merits farther extend; for, by timely application, it proves a sufficient proof 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 diffusion 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 confided to the grave.

The mode of treatment arisen from this discovery, proved simple and easy to administer; it was found, that gentle stimulation and irritation, in various parts of the body, produced by different applications, are the means thatrouse the torpid powers, and restore motion, provided the application be immediate, and cautiously continued until the effects become visible. It appeared that heat is a stimulant to a cold body, and that cold is a similar actant upon inward heat.

The fortunate treatment, its proceeds, and its extensive utility, were disclosed upon the most liberal plan; and the use of the means being within the reach of confined abilities, was taught to the common people, who being present at deaths of all forts, exerted themselves, and performed everywhere numberless cures.

From this free disclosure, it spread to several parts of Europe; but its striking proceeds was owing to thespirited manner it was first encouraged. 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,

(iii)

Discovery, 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 distressing casualties happened.

Under such philanthropic patronage, the practice flourished and spread its beneficent effects to distant countries. In all parts, where it comes to be adopted, under the fostering hand of a judicious regency, it will produce fruit in abundance: but where it is left destitute of superior protection, there it will be seized and managed as medical practice, myfteriously and interestedly; because funds raifed for charitable purposes, can be made to answer private interests, 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 save and prolong life; and, at the same time, tend evidently to increase population.

The directions accompanying this paper, have been published and republished during a space of more than seventeen years, and are still as fit to be followed as at first, being systematic, framed upon the first successes, and confirmed by the practice held abroad: they prove true to the effects they foretell, and those they forewarn.

The Humane Societies in England, implicitly following the dictates of that in London, have, from the

(iv)

the beginning, prescribed several means inconsistent with those that proved successful. They direct the body to be rubbed with salt, or with mustard, by which excoriations have been produced, and so great an inflammatory heat has been raised, as to overpower the small remains of life. They have advised the use of a suffocating bed-pan, with live coals, to warm a chilled body, in a place where the air was, by their own desire, to be kept so pure, as not to be tainted by the breath of a number of spectators. They recommend a sharp clyster, as a succedaneum to fumigation, not considering that the evacuation it causes, is weakening and fickening, whilst the smoke of herbs operates with elasticity on the bowels. They advise agitation and shaking of the body for five or six minutes, calling them powerful auxiliaries; whereas, strong motion is hurtful to the body when in a defenceless state, and they themselves have forbidden other prejudiced practices, as rolling on a caulk, &c. They propose immersion in grains, lees, ashes; means very unlikely of success, difficult, and contradictory to a salutary process which they supercede and dangerously obstruct. Bleeding they do not sufficiently forbid, but leave it to optional fancy, while a deal of mischief can be laid to its charge. All the means pointed out, they say, should be applied with vigour; an expression which has led their affixants to overdo what with moderation would have proved salutary, and prevented their discovering, what their reports fully prove, that vigorous efforts very soon overpower the faint remains of life and accelerate death.

It is not from want of warning, that so many lives remain unre restored, while people abroad lament the loss of one out of seven; the low class of men, when instructed, will attempt twenty forts of cafes, where the few medical hands undertake two or three, either hanged, drowned, or suffocated. The rules of prudence will ever prevail; mild means, affiduously applied by many hands, as originally recommended, will prove successful, where the great efforts of a few, and extraordinary inventions will frequently fail.

RELIEF FROM
ACCIDENTAL DEATH;
OR SUMMARY
INSTRUCTIONS

Given by the GENERAL INSTITUTION
to be CONDUCTED BY
Dr. ALEXANDER JOHNSON,
TO INTRODUCE AND ESTABLISH
In all the EXTENT of
His MAJESTY'S BRITISH DOMINIONS,
An approved PRACTICE
For Recovering Persons who meet with Accidents producing the Appearance of SUDDEN DEATH.

THE Public having often been informed, that of the number of Persons daily perishing by Accidents of various kinds, the greater part may be recovered by a suitable Treatment applied within a short time after such Accualties happen; it is proper to explain, that the Accidents which produce the appearance of Sudden Death (without destruction of the parts essential to life) are either such as proceed from External Causes, as drowning, hanging, strangling, suffocating, flailing and smothering; of cold and strokes of lightning; or such as arise from Internal Disorders, as some apoplexies, all swoonings, convulsions, hysteric and other fits; the effects of violent Passions, of surfeits, and of cold liquors hastily drank during profuse perspiration: —
***
And

x INSTRUCTIONS.

And as the Purposes of that information cannot
be effectually answered, unless the means of
securing the advantages accruing to mankind
from this beneficial practice, be also generally
known; it is paying an additional Tribute to
Society, to show from experience, how Life
can be restored in a variety of cases, by a proper
application of the following Rules of Treatment.

I. WHEN a casualty of the kind here de-
scribed, happens out of doors, the body must, as
soon as possible, instead of being bled or tam-
pered with, be carefully conveyed upon a hand-
barrow, or other convenient carriage, into a
neighbouring house, and there immediately
stripped, laid slopingly, the head somewhat
raised, upon a couch, a proper table, or a
broad bench, in blankets, and, for obvious
reasons, examined from head to foot, before a
fire if the weather be cold, or the body wet
and chilled; otherwise, in the moderate warmth
of a room. The success of a recovery depends
much upon the state of the body: should any
of its parts be found injured, the prospect will
be less, proportionably to the hurt. When
the body cannot be housed speedily, the two
following operations must directly be performed
where best practicable.

II. Rubbing is a most essential operation; it must begin directly, be continued with diligence, and perfused in for a length of time. It is best done with dry and warm flannels, along the back-bone, the sides, belly, and breast; on the palms of the hands, and soles of the feet: a flesh-brush, when at hand, may very well be used for this necessary work.—With heavy, sluggish bodies, some sal volatile, or a little spirit of sal ammoniac, or of harts-horn,

INSTRUCTIONS. xi

horn, mixed with brandy, sprinkled upon the rubbers, will be proper for the back-bone, the breast, neck, and face. Nothing so sharp as to injure the skin, should be used.

III. Directly after stripping, and during the rubbing, or before either, the body being conveniently placed, some warm Vapour must be forced up into the bowels. The Smoke of Tobacco may be used for strong, robust subjects; but with weak delicate persons, women and children, whom that smoke convulses and hurts, the Vapour of dried Rosemary, Marjoram, Mint, and other spicy Herbs, and ordinary stimulating Clysters, are to be injected. The operation is performed with a tobacco-pipe inverted upon an ordinary wooden clyster-pipe; † with a tobacco clyster-fyringe, called a Fumigator; or with a sheath open at the point, for the vapour; and with the usual implement, for liquid clysters. Common air often proves sufficient, and may be blown in with an ordinary bellows through a clyster-pipe: at the same time the belly must be gently moved and pressed upward with the hand. This indispensable operation must be repeated, and continued, till signs of life be obtained.

IV. If the body be chilled, heat must be applied, and the admission of cold air prevented: stone bottles filled with hot water, and wrapped in flannel; also heated tiles or bricks so wrapped up, but with more precaution, are to be laid at the sides, hands, and feet; a number of cloths heated, put about the head, and applied to the cold

cold.
† Two Tobacco-pipes may occasionally serve, the bowls
being held together by some short tube with a pierced thin
place in the middle, to prevent the sparks palling forward;
or by a Barrel-like pocket Nutmeg-grater, open at both ends,
made at the Turners. The Fire is kept in with a bit of
Touchwood, or punk, put among the dry Leaves.

## XII INSTRUCTIONS.

coldest parts of the body, and successively renewed, should likewise be used where conveniently to be had. Another way of communicating heat to the body shall be described under Art. VIII. The farther means contrived and tried, are, either not expedient, or not practicable in places where conveniencies are wanting.

V. When a body has some degree of heat, attempts must be made repeatedly, and as strongly as possible, to force air into the lungs, by the mouth, holding the nostrils close. The air of the room in which the treatment is performed, being better than that immediately breathed by the operator, a small clean bellows may be used by a second person, while the first holds it in the mouth and keeps the nostrils close.—Some dextrous persons attempt to convey the air through a metal pipe, called a Canula, having a crooked end, which with the finger they cautiously guide into the wind-pipe, to produce a more immediate effect.

VI. During the treatment, when the livid colour of the body changes to the natural, it must be in a wary manner moved about upon the bed, or pulled forward and backward by the blanket, that it lay not long in the fame position: the nostrils and throat are to be tickled with a crow-feather; the temples, ears, and neck, chafed with the *Spiritus Aromaticus*, commonly called *Sal Volatile*, (to be had at the apothecary's) or the spirit of hartshorn mixed with brandy; and volatile Salts are to be held to the nose.

VII. If some motion or pulse be perceived in any part of the body, attention must then be

## INSTRUCTIONS. xiii

be had to do diligently what has been recommended, the moment being critical, and the exertion decisive:—some wine, or spirit with warm water, is to be put into the mouth, by degrees, not more than a tea spoonful at a time; it must be allowed to go down flowly, and repeated when swallowed. No force is to be used in doing this.

VIII. The body acquiring heat gradually, may remain for some time upon the couch, with the artificial warmth about it, to give rest to the affixtants, who nevertheles must not leave it whilst so liable to sudden change: but the progress not being palpable, recourse may be had to the effect of a warm bed, laying the body in a blanket, between two healthy persons undressed, who must continue rubbing, and a gentle agitation, to preserve the share of life then acquired, and to obtain as much more as possible.

IX. Bleeding, hitherto indiscriminately practiced, is not with chilled bodies rationally to be attempted; till some degree of heat be restored it cannot be done, and must not then be considered as absolutely necessary; for it often made recoveries languid, and sometimes proved fatal to the patient. Whatever some persons may expect from it, it is of moment to warn, that it must not be among the first attempts for restoring life; the flowing blood manifestly obstructs the necessary operations, and bandages visibly prevent the success of the treatment.

X. These practices being applicable to a variety of accidents, the respective Directions must strictly be followed, and the operations per-

xiv INSTRUCTIONS.

perfevered in for the space of several hours,
not less than fix, without discouragement,
'till life be recovered, or 'till it plainly appear
that no benefit can arise, and the body becomes
quite cold and stiff.—The conduct to be held
with newly recovered persons, who mend so
flowly as not to return home in the course
of the day, is to keep them quiet, moderately
warm, to give them fage and balm tea, and to
support them with fack-whey, and strengthening
things, with spices, a little at a time, and
often repeated.

The Cualties happening within doors,
in which relief may be administered, must
now generally be named, to convey a de-
gree of confidence, that also in such cases
similar measures are purfued with success.

The appearance of the less of life, either with-
out a known cause, or from the sudden effects of
surfeits, or cold liquors taken hastily during free
perspiration, and of violent agitation of the passions,
convulsions, chaking, strangling, smothering, or
overlaying, swoonings, hysterical and other fits,
require immediate chafing and rubbing with
volatile Spirits; the use of a Decoction of
spices (such as Ginger and Jamaica Pepper)
mixed with some strong wine, or common
spirits, put into the mouth by tea spoonfuls;
and the injection of a vapour-clyster; as also
repeated trials to blow up the lungs, and to
raise the cheft.

Suffocation by noxious air, by the vapour of
live coals, of sulphur, of arsenic, bituminous damps,
and others in mines, in pits, wells, and vaults, poi-
sonous exhalations, the effects of excessive cold,
and strokes of lightning, require an attentive and
very patient treatment; for though some per-
sons

INSTRUCTIONS.

XV

born brought up as dead out of coal-pits did
speedily recover; yet in other cases, those
stifled by the vapour of live coals and stagnated
air, required much time and trouble to restore
life to them. Some previous signs being obtained,
the availing remedies used, were Blisters, and
plunging in cold Water. Emetics proved
greatly diffusing.

In cases of Drowning, the affixtants need not
be anxious about the water contained in the
body; the quantity is never so great as to prevent
the effects of the operations.—It is for many
reasons needful to clear the mouths of such
persons, of the slime, or other matter, they
often contain; repeated injections of some
luke-warm tea, the body lying upon its side,
will loosen and bring it out: what will not thus
wash out, must be cleared away with a goose
feather, or a soft painter's pencil: there is no
need of wrenching the jaws afunder when they
happen to be fixed, the lips and cheeks
offering room enough, till the mouth open
of itself by the success of other attempts.
—Some old methods, founded on custom and
prejudice, should studiousl+y be discountenanced
and prevented; such as rolling the body on a
cask, holding it upside down, hanging it up,
and otherwife straining and bruising it in its
most defenceless state. They are ever attended
with bad consequences, prevent recoveries,
cause discharges of blood, and haften death.
—Unpromising, embarassing practices are
cautiously to be avoided; warm Affairs, dry
Salt, sharp Liquids, Nettles, and other things
injurious to the skin, must give way to more
natural and easy means.

The

xvi INSTRUCTIONS.

The manner of varying these means, appli-
cably to particular situations, and trying others
that are rational, especially that operation of
cutting the windpipe, though happily per-
formed and singularly efficacious under cri-
tical circumstances, are not touched upon
in these Instrucitions, but remain subjects for
observation and reflection, to be practised
with judgment in difficult obstinate cafes, by
persons of experience.

A proper attention to these plain Rules will
probably enable every man to save the life of
his neighbour; and will also determine doubt-
ful situations in families, when patients after
some time of illnesses seem to die, and the per-
sons who have nurtured them incur blame by
laying them out too soon, while the warmth of
a bed might still prove reviving, as several
cafes have shewn.—Precautions of this kind
will also remedy an evil hitherto much dreaded,
that of being confined to a coffin, or com-
mitted to the grave, with remaining sparks of
life. The disquietude arising from imprecions
made by instances of persons buried alive,
will therefore, it is hoped, by these easy means
happily be removed.

Republished in London, 1775— & to 1790.

( v )

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 afflirtance implored for un-
lucky 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 recal-
ling dying people to life, will answer a most useful purpose:
it can be done at the small expence of reprinting and freely
distributing these Instruchions; in a compressed manner they
cost but a few shillings the hundred, and 500 copies suffice at
a time for a common district in England: the sum of 20s.
or 30s. is then the expence at which the salutary knowledge
can be diffused to a considerable number of persons; and
where is the parish in which that sum cannot be found;
or the person who would not contribute his share, for the
chance of successes in faving 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
diffretfs for life; his ability would lead him eagerly to ex-
ertion; the want of reward would not blunt that fellow-
feeling ever alive in a breast that is not utterly depraved.
From the inftruction beftowed upon the common clafs of
people, a most defirable effect would arise; among them are
found midwives, nurses, and ſervants attendants on the
fick; from their knowledge of the proper means, the suc-
cefs of the practice would be brought within doors, where
it is wanting; for the number of thofe that die there, is
fuperior 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 convulfions; where
thefe suddenly happen, the patient is condemned in courfe,
and left to die unaffifted:—Not ſo will it be with thofe
who ſhall have about them perſons inſtructed in the falu-
tary means of recovery; none will remain untried; the
event of long or ſhort laſting illneſs, will not deter them,
ſucces having followed after both; a ſpeedy application
will ſoon restore thofe in whom the powers of life can be
revived: Cafes of all kind, from which the efficacy of the
treatment has been demonſtrated, will be re-produced;
bed-ridden patients will not, at firſt appearance of death, be
laid

( vi )

laid out to chill and become stiff; those that drop down in fits, will no more haftily be sentenced dead without appeal. The final teft will, laft of all, prove that no individual can prematurely be doomed to the grave, where this salutary practice is freely and generally exercifed. What then is to prevent eafneſt repreſentations and exhortations devoid of ſelf-intereffed motives, from being favourably received, and the plan of inſtruction and application of the means carried into execution? The benefits to arife from it, are demonſtratively ſo far beyond the trouble and expence of introducing and eſtablishing it, as to make all heſitation or delay of acceptance unanſwerable.

The writer of these inſtructions, remonſtrances, and exhortations, hopes that gentlemen of the medical faculty, 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 province. There can be no doubt of their aid and advice being pre-ferable to all other, in conducting recoveries; but the treatment to be applied is ſo plain and eafy, and caſualties require every where ſuch a number of ready hands, that their can by no means anſwer the exigent haſty calls for inſtantaneous affiſtance. Had the directors of humane So-cieties 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; while the generous contributions they receive, can be made productive of far more beneficial ſer-vices, than have hitherto derived from it, to the nation.

P. S. The matters to be kept at hand are the following:

Spirit of hartſhorn, or volatile ſpirit of ſal ammoniac; eau de luce*, and the common ſmelling falts, kept close ſtopt; peppermint and cinnamon water; raifin wine; all-ſpice and ginger; blanched almonds†; ſweet herbs dried, and tobacco cut; camphor diſsolved in ſweet oil‡; tincture of caſtor, and a little laudanum; flannel; blankets; ſtone bottles for hot water; clean bricks and tiles for heating; clean ſmall bellows and ſmoking pipes.

* Eau de luce is made with oil of amber, one part, and ſtrong ſpirit of ſal ammoniac, three parts, ſhaken together in a phial.

† Almonds, ſweet and bitter, blanched and bruifed, made into paſſe, with ſome moſt sugar, and rubbed down with hot water, in a bafon, make the cooling almond milk.

‡ Sweet oil with camphor, one part, and lime water from fresh hot lime, three parts; make an uſeful ointment for bruifes, ſore plaſes, ſcalds, eruptions, and pain in limbs.

( vii )

IMPLEMENTS FOR USP.

( viii )

DESCRIPTION OF THE IMPLEMENTS.

Fig. 1. THE pipe to convey air through the nofe, is a piece of tough wood, about five inches long, two and a half broad, and one and a quarter thick, of the shape here delineated; convex on the upper side, and scooped out of the under, to fit the mouth and chin: the short tubes for the nostrils are carefully cut round: the conduit for the air, is made by boring from A up to B with a bit equal to the nozzle of a small pair of bellows: the nostril tubes are bored with a small bit straight down one inch and a half; and the channel of communication is bored from the shoulders D D flanting to B; but these making openings through which the air would escape, they must be lightly corked up at the shoulders: the lower part is cut up at A, to receive the nozzle of the bellows easily, and the piece appears cut through the middle.

A leather tube, shaped like a short two pronged fork, might answer the fame end, but would be of more difficult and costly construction.

The figures 2, 3, 4, are too generally known to want description.

* Is a fheath of a knife or scissars, open at the point.

5. A fumigating syringe, the pifton of which draws the smoke of the herb burning in (e) into the vacuity of its cylinder; and, on being returned, forces it into the long flexible tube (f), through a valve at (b), that opens for the purpose, and fhuts when the smoke is drawing from the herb through the other valve (a); that, in return, clofes when the smoke is forcing up the long pipe.

(a) Place of the strong valve for admitting smoke into the large cylinder and preventing its return when forced up the tube (f).

(b) Place of a smaller valve, admitting the smoke into a long tube.

(c) Make and shape of the valves kept in store.

(d) Cylinder connecting the bent canula of the syringe with the fire-box.

(e) The fire-box, with its perforated cover, for burning herbs.

(f) Long flexible tube, conductor of smoke.

(g) Wooden canula added to the conductor, for insertion into the fundament.

( i )

THE appearance of death is ever distressing, as life, with all the drawbacks upon its enjoyments, is still precious to every individual, while it stands exposed to numerous calamitous accidents that shorten its duration, againft which prudence is seldom confulted for a preventive! The art of medicine provides relief in many diforders and difeases with which the human body is afflicted; but offers no aid for the prefervation of life, at the critical moment of the approach of death: a patient within its verge, is deferted by medical perſons, and left to the management of an uninſtructed nurſe, with whom the laſt spark of his life is allowed, or haſtened, to extinguifh.

Some gentlemen abroad, attentive obſervers of the course and contingencies of life, confidering 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 disſcoverable circulation of blood, or action of the heart and lungs; that all motion and ſenſation have ceased, with a gradual diminution of natural heat; and that, nevertheless, ſuch inanimatèd bodies have eventually recovered life: they rationally inferred, that the vital powers ſuspended and dormant in ſuch bodies, might, by ſome process analogous to the caſe of motion, be rouſed; and that when rouſed, their former effects would naturally recommence. This theoretic argument, reduced to experiment and trial, was verified; and it became ascertained, that where parts effential to life are not injured or destroyed, and where the powers of action and motion are only ſuspended, in ſuch states the caſe of inaction can be removed, and the parts of the body restored to their usual functions.

**

The

Copy 2

( ii )

The general aptitude of this discovery to every appearance of death, natural or accidental, has few limitations; in all cases of suffocation by damps or fumes, suspension of breath and circulation, fits, swoonings, and those sudden cessations of motion, in which persons drop down in the streets, recoveries have been obtained. Beyond these its merits farther extend; for, by timely application, it proves a sufficient 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 mode of treatment arisen from this discovery, proved simple and easy to administer; it was found, that gentle stimulation and irritation, in various parts of the body, produced by different applications, are the means that route the torpid powers, and restore motion, provided the application be immediate, and cautiously continued until the effects become visible. It appeared that heat is a stimulant to a cold body, and that cold is a similar actant upon inward heat.

The fortunate treatment, its proceeds, and its extensive utility, were disclosed upon the most liberal plan; and the use of the means being within the reach of confined abilities, was taught to the common people, who being present at deaths of all sorts, exerted themselves, and performed everywhere numberless cures.

From this free disclosure, it spread to several parts of Europe; but its striking proceeds was owing to the spirited manner it was first encouraged. 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,

( iii )

Under such philanthropic patronage, the practice flourished and spread its beneficent effects to distant countries. In all parts, where it comes to be adopted, under the fostering hand of a judicious regency, it will produce fruit in abundance: but where it is left detitute of superior protection, there it will be seized and managed as medical practice, mysteriously and interestedly; because funds raifed 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 increase population.

( iv )

the beginning, prescribed several means inconsistent
with those that proved successful. They direct the
body to be rubbed with salt, or with mustard, by
which excoriations have been produced, and so great
an inflammatory heat has been raised, as to over-
power the small remains of life. They have ad-
vised the use of a suffocating bed-pan, with live coals,
to warm a chilled body, in a place where the air was,
by their own desire, to be kept so pure, as not to be
tainted by the breath of a number of spectators.
They recommend a sharp clyster, as a succedaneum
to fumigation, not considering that the evacuation it
causes, is weakening and sickening, whilst the smoke
of herbs operates with elasticity on the bowels.
They advise agitation and shaking of the body for five
or fix minutes, calling them powerful auxiliaries;
whereas, strong motion is hurtful to the body when
in a defenceless state, and they themselves have for-
bidden other prejudiced practices, as rolling on a
calk, &c. They propose immersion in grains, lees,
ashes; means very unlikely of successes, difficult, and
contradictory to a salutary process which they super-
cede and dangerously obstruct. Bleeding they do
not sufficiently forbid, but leave it to optional fancy,
while a deal of mischief can be laid to its charge.
All the means pointed out, they say, should be ap-
plied with vigour; an expression which has led their
affixants to overdo what with moderation would
have proved salutary, and prevented their discover-
ing, what their reports fully prove, that vigorous ef-
forts very soon overpower the faint remains of life
and accelerate death.

It is not from want of warning, that so many lives
remain unre restored, while people abroad lament the
lofs of one out of seven; the low class of men, when
instructed, will attempt twenty forts of cafes, where
the few medical hands undertake two or three, either
hanged, drowned, or suffocated. The rules of pru-
dence will ever prevail; mild means, affixiously ap-
plied by many hands, as originally recommended,
will prove successful, where the great efforts of a
few, and extraordinary inventions will frequently fail.

Given by the GENERAL INSTITUTION
To be CONDUCTED BY

Dr. ALEXANDER JOHNSON,

TO INTRODUCE AND ESTABLISH

In all the EXTENT of

For Recovering Persons who meet with Acci-
dents producing the Appearance of
SUDDEN DEATH.

THE Public having often been informed,
that of the number of Persons daily pe-
tishing by Accidents of various kinds, the greater
part may be recovered by a suitable Treatment
applied within a short time after such Casualties
happen; it is proper to explain, that the Acci-
dents which produce the appearance of Sudden
Death (without destruction of the parts essential
to life) are either such as proceed from External
Causes, as drowning, hanging, strangling, suffo-
cating, suffling and smothering; of cold and strokes
of lightning; or such as arise from Internal Dif-
orders, as some apoplexies, and lethargies, all
fwoonings, convulsions, hysterick and other fits; the
effects of violent Passions, of surfeits, and of cold
liquorshaftily drank during profuse perspiration :

***

And

x INSTRUCTIONS.

And as the Purposes of that information cannot
be effectually answered, unlefs the means of
securing the advantages accruing to mankind
from this beneficial practice, be also generally
known; it is paying an additional Tribute to
Society, to ſhow from experience, how Life
can be reſtored in a variety of caſes, by a proper
application of the following Rules of Treatment.

I. WHEN a caſualty of the kind here de-
scribed, happens out of doors, the body muſt, as
foon as poſſible, inſtead of being bled or tam-
pered with, be carefully conveyed upon a hand-
barrow, or other convenient carriage, into a
neighbouring houſe, and there immediately
ſtripped, laid slopingly, the head ſomewhat
raſed, upon a couch, a proper table, or a
broad bench, in blankets, and, for obvious
reaſons, examined from head to foot, before a
ſire if the weather be cold, or the body wet
and chilled; otherwife, in the moderate warmth
of a room. The ſuccesſs of a recovery depends
much upon the ſtate of the body: ſhould any
of its parts be found injured, the proſpect will
be leſs, proportionably to the hurt. When
the body cannot be houſed ſpeedily, the two
following operations muſt directly be performed
where beſt practicable.

II. Rubbing is a moſt eſtential operation;
it muſt begin directly, be continued with dili-
gence, and perſilted in for a length of time.
It is beſt done with dry and warm flannels,
along the back-bone, the ſides, belly, and
breast; on the palms of the hands, and ſoles of
the feet: a fleſh-brush, when at hand, may
very well be uſed for this neceſsary work.—
With heavy, fluggish bodies, ſome ſal volatile,
or a little ſpirit of ſal ammoniac, or of harts-
horn.

INSTRUCTIONS. xi

horn, mixed with brandy, ſprinkled upon the
rubbers, will be proper for the back-bone, the
breast, neck, and face. Nothing ſo ſharp as
to injure the ſkin, ſhould be uſed.

III. Directly after ſtripping, and during the
rubbing, or before either, the body being
conveniently placed, ſome warm Vapour muſt
be forced up into the bowels. The Smoke of
Tobacco may be uſed for ſtrong, robust sub-
jects; but with weak delicate perſons, women
and children, whom that smoke convulſes and
hurts, the Vapour of dried Rosemary, Mar-
joram, Mint, and other ſpicy Herbs, and or-
dinary ſtimulating Clyſters, are to be inſected.
The operation is performed with a tobacco-
pipe inverted upon an ordinary wooden
clyſter-pipe; † with a tobacco clyſter-fyringe,
called a *Fumigator*; or with a ſheath open at
the point, for the vapour; and with the uſual
implement, for liquid clyſters. Common air
often proves ſufficient, and may be blown in
with an ordinary bellows through a clyſter-pipe:
at the fame time the belly muſt be gently moved
and preſſed upward with the hand. This in-
dispensable operation muſt be repeated, and
continued, ’till ſigns of life be obtained.

IV. If the body be chilled, heat muſt be applied,
and the admiffion of cold air prevented: ſtone
bottles filled with hot water, and wrapped in
flannel; alſo heated tiles or bricks ſo wrapped
up, but with more precaution, are to be laid at
the ſides, hands, and feet; a number of cloths
heated, put about the head, and applied to the
**cold**

† Two Tobacco-pipes may occasionally ſerve, the bowls
being held together by ſome ſhort tube with a pierced thin
plate in the middle, to prevent the sparks paſſing forward;
or by a Barrel-like pocket Nutmeg-grater, open at both ends,
made at the Turners. The Fire is kept in with a bit of
Touchwood, or Spunk, among the dry Leaves.

## INSTRUCTIONS.

V. When a body has some degree of heat, attempts must be made repeatedly, and as strongly as possible, to force air into the lungs, by the mouth, holding the nostrils close. The air of the room in which the treatment is performed, being better than that immediately breathed by the operator, a small clean bellows may be used by a second person, while the first holds it in the mouth and keeps the nostrils close.—Some dextrous persons attempt to convey the air through a metal pipe, called a *Canula*, having a crooked end, which with the finger they cautiously guide into the wind-pipe, to produce a more immediate effect.

## INSTRUCTIONS.

VIII. The body acquiring heat gradually, may remain for some time upon the couch, with the artificial warmth about it, to give rest to the affixants, who nevertheless must not leave it whilst so liable to sudden change: but the progress not being palpable, recourse may be had to the effect of a warm bed, laying the body in a blanket, between two healthy persons undressed, who must continue rubbing, and a gentle agitation, to preserve the share of life then acquired, and to obtain as much more as possible.

IX. Bleeding, hitherto indiscriminately practiced, is not with chilled bodies rationally to be attempted; 'till some degree of heat be restored. it cannot be done, and must not then be considered as absolutely necessary; for it often made recoveries languid, and sometimes proved fatal to the patient. Whatever some persons may expect from it, it is of moment to warn, that it must not be among the first attempts for restoring life; the flowing blood manifestly obstructs the necessary operations, and bandages visibly prevent the success of the treatment.

xiv INSTRUCTIONS.

perfevered in for the ſpace of several hours,
not leſs than fix, without discouragement,
'till life be recovered, or 'till it plainly appear
that no benefit can arise, and the body becomes
quite cold and stiff.—The conduct to be held
with newly recovered perſons, who mend ſo
flowly as not to return home in the course
of the day, is to keep them quiet, moderately
warm, to give them ſage and balm tea, and to
ſupport them with ſack-whey, and ſtrengthen-
ing things, with ſpices, a little at a time, and
often repeated.

The Caſualties happening within doors,
in which relief may be adminiſtered, muſt
now generally be named, to convey a de-
gree of confidence, that also in ſuch caſes
ſimilar meaſures are purſued with ſuccesſs.

The appearance of the leſs of life, either without a
known cause, or from the ſudden effects of apoplexies,
surfeits, or cold liquors taken haſtily during free per-
ſpiration, and of violent agitation of the paſſions, con-
vulsions, choaking, ſtrangling, ſmothering, or over-
laying, lethargies, ſwoonings, hysterical and other ſits,
require immediate chaſing and rubbing with
volatile Spirits; the uſe of a Decoction of
ſpices (such as Ginger and Jamaica Pepper)
mixed with ſome ſtrong wine, or common
ſpirits, put into the mouth by tea ſpoonfuls;
and the iſ injection of a vapour-clyſter; as also
repeated trials to blow up the lungs, and to
raſe the cheſt.

Suffocation by noxious air, by the vapour of
live coals, of sulphur, of arsenic, bituminous damps,
and others in mines, in pits, wells, and vaults, pot-
ſonous exhalations, the effects of excessive cold,
and strokes of lightning, require an attentive and
very patient treatment; for though ſome per-
ſons

INSTRUCTIONS. xv

ſons brought up as dead out of coal-pits did
ſpeedily recover; yet in other caſes, those
ſtifled by the vapour of live coals and flagnated
air, required much time and trouble to refiore
life to them. Some previous ſigns being obtained,
the availing remedies uſed, were Blifters, and
plunging in cold Water. Emetics proved
greatly diſtreſſing.

In caſes of Drowning, the affiſtants need not
be anxious about the water contained in the
body; the quantity is never ſo great as to prevent
the effects of the operations.—It is for many
reasons neeſful to clear the mouths of ſuch
perſons, of the ſlime, or other matter, they
often contain; repeated injeſtions of ſome
luke-warm tea, the body lying upon its ſide,
will looſen and bring it out: what will not thus
wash out, muſt be cleared away with a gooſe
feather, or a ſoft painter's pencil: there is no
need of wrenching the jaws aſunder when they
happen to be ſixed, the lips and cheeks
offering room enough, till the mouth open
of itself by the ſuccesſs of other attempts.
—Some old methods, founded on custom and
prejudice, ſhould ſtudiousſly be diſcountenanced
and prevented; ſuch as rolling the body on a
caſk, holding it upſide down, hanging it up,
and otherwife ſtraining and bruſing it in its
moſt defenceleſs ſtate. They are ever attended
with bad consequences, prevent recoveries,
caufe diſcharges of blood, and haſten death.
—Unpromiſing, embarraſſing practices are
cautiousſly to be avoided; warm Aſhes, dry
Salt, ſharp Liquids, Nettles, and other things
injurious to the ſkin, muſt give way to more
natural and eafy means.

The

xvi INSTRUCTIONS.

The manner of varying these means, appli-
cably to particular situations, and trying others
that are rational, especially that operation of
cutting the windpipe, though happily per-
formed and singularly efficacious under cri-
tical circumstances, are not touched upon
in these Instručtions, but remain subjects for
observation and reflection, to be practised
with judgment in difficult obstinate cases, by
persons of experience.

A proper attention to these plain Rules will
probably enable every man to save the life of
his neighbour; and will also determine doubt-
ful situations in families, when patients after
some time of illness seem to die, and the per-
sons who have nurfed them incur blame by
laying them out too soon, while the warmth of
a bed might still prove reviving, as several
cafes have shewn.—Precautions of this kind
will also remedy an evil hitherto much dreaded,
that of being confined to a coffin, or com-
mitted to the grave, with remaining sparks of
life. The disquietude arising from impreffions
made by instances of persons buried alive,
will therefore, it is hoped, by these easy means
happily be removed.

Republished in London, 1775—&c. to 1790.

(v)

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 afflirtance implored for un-
lucky 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 recal-
ling dying people to life, will anſwer a moſt useful purpofe:
it can be done at the ſmall expence of reprinting and freely
distributing theſe Inſtructions; in a compressed manner they
coft but a ſew ſhillings the hundred, and 500 copies ſuffice at
a time for a common diſtref in England: the ſum of 20s.
or 30s. is then the expence at which the ſalutary knowledge
can be diffuſed to a considerable number of perſons; and
where is the parifh in which that ſum cannot be found;
or the perſon who would not contribute his ſhare, for the
chance of ſuccesſs in ſaving 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
diſtref for life; his ability would lead him eagerly to ex-
ertion; the want of reward would not blunt that fellow-
feeling ever alive in a breast that is not utterly depraved.
From the inſtruction beſtowed upon the common class of
people, a moſt defirable effect would arife; among them are
found midwives, nurſes, and ſervants attendants on the
ſick; from their knowledge of the proper means, the ſuc-
cesſs of the practice would be brought within doors, where
it is wanting; for the number of thofe that die there, is
fuperior to that of the accidents out of doors: and there is
in common practice, but little contrivance of aid for ſill-
born children, women fainting in child-bed, firſt strokes of
apoplexies, of lethargies, of fits and convulfions; where
thefe suddenly happen, the patient is condemned in courſe,
and left to die unaffiſted:—Not ſo will it be with thofe
who ſhall have about them perſons inſtructed in the ſalu-
tary means of recovery; none will remain untried; the
event of long or ſhort laſting illneſs, will not deter them,
ſuccesſs having followed after both; a ſpeedy application
will ſoon reſtore thofe in whom the powers of life can be
revived: Cafes of all kind, from which the efficacy of the
treatment has been demonſtrated, will be re-produced;
bed-ridden patients will not, at firſt appearance of death, be

laid

( vi )

Laid out to chill and become stiff; those that drop down in fits, will no more haftily be sentenced dead without appeal. The final teft will, laft of all, prove that no individual can prematurely be doomed to the grave, where this salutary practice is freely and generally exercifed. What then is to prevent earneſt repreſentations and exhortations devoid of ſelf-intereſted motives, from being favourably received, and the plan of inſtruction and application of the means carried into execution? The benefits to arise from it, are demonſtratively ſo far beyond the trouble and expence of introducing and eſtablishing it, as to make all heſitation or delay of acceptance unanſwerable.

The writer of these inſtructions, remonſtrances, and exhortations, hopes that gentlemen of the medical faculty, 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 province. There can be no doubt of their aid and advice being preſerable to all other, in conducting recoveries; but the treatment to be applied is ſo plain and eafy, and cauſalties require every where ſuch a number of ready hands, that their's can by no means anſwer the exigent haſty calls for inſtantaneous allſtance. Had the direſtors 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 conſining the practice to themſelves, and to a ſmall variety of cafes; while the generous contributions they receive, can be made productive of far more beneficial ſer-vices, than have hitherto derived from it, to the nation.

Spirit of hartthorn, or volatile ſpirit of ſal ammoniac; eau de luce*, and the common ſmelling salts, kept close flopt; peppermint and cinnamon water; raiſin wine; all-ſpice and ginger; blanched almonds†; ſweet herbs dried, and tobacco cut; camphor diffolved in ſweet oil‡; tinſture of caſtor, and a little laudanum; flannel; blankets; ſtone bottles for hot water; clean bricks and tiles for heating; clean ſmall bellows and smoking pipes.

* Eau de luce is made with oil of amber, one part, and strong ſpirit of ſal ammoniac, three parts, ſhaken together in a phial.

† Almonds, ſweet and bitter, blanched and bruſed, made into paſte, with ſome moſt ſugar, and rubbed down with hot water, in a bafon, make the cooling almond milk.

‡ Sweet oil with camphor, one part, and lime water from freeh hot lime, three parts; make an uſeful ointment for bruſes, fore places, ſcalds, eruptions, and pain in limbs.

( vii )

IMPLEMENTS FOR USE.

( viii )

Fig. 1. THE pipe to convey air through the nose, is a piece of tough wood, about five inches long, two and a half broad, and one and a quarter thick, of the shape here delineated; convex on the upper side, and scooped out of the under, to fit the mouth and chin: the short tubes for the nostrils are carefully cut round: the conduct for the air, is made by boring from A up to B with a bit equal to the nozzle of a small pair of bellows: the nostril tubes are bored with a small bit straight down one inch and a half; and the channel of communication is bored from the shoulders D) D slanting to B; but these making openings through which the air would escape, they must be lightly corked up at the shoulders: the lower part is cut up at A, to receive the nozzle of the bellows easily, and the piece appears cut through the middle.

* Is a sheath of a knife or scissors, open at the point.

5. A fumigating syringe, the piston of which draws the smoke of the herb burning in (e) into the vacuity of its cylinder; and, on being returned, forces it into the long flexible tube (f), through a valve at (b), that opens for the purpose, and shuts when the smoke is drawing from the herb through the other valve (a); that, in return, cloves when the smoke is forcing up the long pipe,