IMAGE EVALUATION TEST TARGET (MT-3) / O / V ^1^ spx p.< :/ 1.0 I.I 1.25 IIIIIM HIM 12.2 W 2.0 1.8 iA III 1.6 V] <^ /a '^A ^: signifie "A SUIVRE", le symbole V signifie "FIN ". Maps, plates, charts, etc., may be filmed at different reduction ratios. Those too large to be entirely included in one exposure are filmed beginning in the upper left hand corner, left to right and top to bottom, as many frames as required. The following diagrams illustrate the method: Les cartes, planches, tableaux, etc., peuvent dtre filmds d des taux de reduction diffdrents. Lorsque le document est trop grand pour §tre reproduit en un seul clichd, il est filmd & partir de Tangle supdrieur gauche, de gauche d droite, et de haut en bas, en prenant le nombre d'images n6ce8i.aire. Les diagrammes suivants illustrent la mdthode. 1 2 3 1 2 3 4 5 6 ',iV;, ii ft.-'' m f^"': IFE-SAVINQ HAND-BOOK OF THE Royal Ganadiak Humane Association Containing Special Directions fob Rescuing Dbownino Persons^ WITH Suggestions as to the Best Means of Resuscitating THE Appakently Dead, Either from Drowning, Lightning, Dynamic EiiECTRiciTV, etc. ' ' I 'l ' ■>» ■ • -1 } > FROM THE Ptr^UOATIONS OF THE RoTAL HuMANE AND TUB NATIONAL kFF-SAVING SOOIITIKS OF ENGLAND, AND FROM OtHBR SoUBCRS. BY J. GEORGE_HODGINS, M.A., LL.D, HONOKARV BBORBTARY OF THE ABBOCIATIONk TORONTO: PRINTED FOR THE ROYAL OANADUN HUMANS ASSOOIATIOB BY WILLIAM BRIGGS, WJ^SLEY BUILDINGS. 1896. y f ■^«f«MMMBaMHlki*«*i»llMlkM I' U i i 'Hi i iMr >i » ii || ii»i iw i .l |iij | p , ) ^ ."'ii ,lS^&M .11 '"i . - \ V 'M '"•"i '■■^^^■i'.. ^J fm V. "IBP" ■(r t aNADA NATIONAL LIBRARY BIBLIOTH^aUE NATIONALE iLp '*', .is*. -rTy C •'.'<: V '•"gvi ',vJ-i / ^■^-^ -y -C"-"- LIFE-SAVING HAND-BOOK OF THE Royal Canadian Humane Association Containing Special Dikections for REsouiNrj Dro\vnin(j Persons ; WITH SutiOESTIONS AS TO THE BeST MeANS OF ReSI'SOITATIVC THE Apparently Dead, Either from Drowning, Lkjhtninc, Dynamic Electricity', etc. Compiled from the Publications of the Royal Humane and thk National LlFE-SAVINfi SOCIBTIKS OF EncLAND, AND FROM OtHBR SoURCKS. BY J. GEORGK HODGINS, M.A., LL.D, HONOKAKY 8ECHETAKV OK THK ASSOCIATION. TORONTO: PRINTED FOR THE ROY.iL CANADIAN HUMANE ASSOCIATION BY WILLIAM BRIGCJS, WESLEY BUILDINGS. i8gr>. Mr ■♦.» PREFATORY NOTE. In addition to the Ijarge Sheet, with illustrations on Life-Saving, issued by the Hoyal Canadian Humane Association, it has l)een thought (lesiral)le to insert the illustrations on that Sheet in a separate Han(l-H(H)k. This has V)een done ; and full and explicit directions in regard to Life-Saving have also l)een given, as will lie seen in this Hand-Book. It is clear that in the hurrv and excitement attending the rescue of a person from drowning, it would be difficult to promptly act upon the directions given on the Large Sheet — although they are in large, clear type — without some previous knowledge of them. It is, there- fore, with a view to enable persons to make themselves acquainted with the various modes of rescue of the drowning, and also with the three best methods of resuscitating the apparently dead — either from drowning or electricity —that this Hand-Book has been prepared. In this Hand-Book — with its larger space available — ampler details are given than was possible to give in the Large Sheet ; while the three-fold method of resuscitation therein given by medical experts is more fully described. One Chapter is devoted to an explanation, with detailed sugges- tions, of the i-ecently -discovered method of restoring to consciousness persons struck with lightning, or who ma}' have come in contact with dynamic electricity, in the shape of " live wires," etc. Another Chapter contains an explanation of Dr. De Baun's appar- atus for restoring the lost action of the lungs. This is a subject which has engaged the earnest attention of medical men, and its ccmsideration is full of interest. 4 A brief Chapter is devoted to suggestions as to how to deal with the case of a rescued person before tho arrival of a doctor or other skilled expert. In such cases, promptitude may be life, the want of it may be death. Immediate measures are, therefore, absolutely necessary in order to insure success. Delays in such cases are truly dangerous, as life then hangs upon a very slender thread, the clue to which may Vje lost if there is any hesitation in applying the prescribed remedies at once. It is due, in issuing this Hand-Book, to refer to the noble efforts of Mr. Thomas Tinning, and those oi Capt. W. D. Andrews, of Toronto ; of Mr. F. W. Fearman and Captain Campbell, of Hamilton, who devoted some of their best years to saving the lives of others from drowning in Toronto and Burlington Bays and elsewhere, and in resuscitating them when rescued. The heroic act of Mrs. Abigail Becker, of Long Point, Ijake Erie (now Mrs. Henry Rhorer, of Walsingham), in rescuing, at the I'isk of her own life, seven ship- wrecked sailors off Long Point Island, Lake Erie, should also be remembered and recorded, as it has been nuKle memorable in a poem by Miss Amanda T. Jones, which has been reprinted in the " High School Reader," an authorized book for use in these schools of Ontario. There wa« then no society or association in existence in "this Canada of ours" to reward these brave men for their heroic deeds. They had to look to the chance sympathy and genei osity of their fellow-citizens, or to the Dominion Government, the Royal Humane Society in England, and other similar organizatitms else- where. Toronto, May, 189o. : ■- . ;■ FORMS OF THE ROYAL CANADIAN HUMANE ASSOCIATION. GOVERNOR FOR THE YEAR OF THE ROYAL CANADIAN HUMANE ASSOCIATION. To Henry McLaren, Esq., Treasurer of the Royal Canadian Hurmme Association, Hamilton : Dear Sir, — You will please place my name on the Roll of your Humane Association as one of its Governors for the year 189. . I enclose herewith, in a registered letter, my annual subscription of Five Dollars {%b) for that purpose. Dated at Post-office. GOVERNOR FOR LIFE OF THE ROYAL CANADIAN HUMANE ASSOCIATION. 7V> Henry McLaren, Esq., Treasurer of the Royal Canadian Humane Association, Hamilton: , ■;>{:■( V' Dear Sir, — You will please place my name on the Roll of your Humane Association as one of its Governors for Life. I enclose herewith, in a registered letter, my subscription of Fifty Dollars (.|50) for that purpose. Dated at Post-office. 3. FORM OF liKQUEST FOK TIIK HKNKKIT OF THE KOYAL ( ANADIAN Hl'MANK ASSOCIATION. I, A. B., do hereby give and l)e(|uejith to tlie H«»H(»rarv Treasurer, for the time being, of the ROYAL CANAIHAN IlI'MANK ASSOCIATION, established in this Dominion in the year of our Lord one thousand eight hundrefl and ninety-four, the sum of doUars, to be applied to the uses and purposes of the Association. And I declare that the receipt of the said Treasurer, for the time being, shall be a full and sufficient discharge for the amount, of the said bequest herein made by me. Witnesses Dated at , this | . .day of , 18.. J 4. FORM OF PARCHMENT CERTIFICATE FOR LIFE- SAVING, ETC. The Committee on Awards having considered certain cases laid before it, and reported thereon, THE KOVAL CANADIAN HUMANE ASSOCIATION have unanimously resolved that is justh' entitled to this Honorary Testimonial of the Association, inscriberl on parchment, which is hereby awarded to the said for Treasurer. PreHident. Dated at , this] . .day of , 18. J Secretary. CO NTH NTS, PRELIM IXARY-CHAPTKK I. Objeiits of the Roj'al Canadian Humane Association J) CHArTKR II. Coniinittee of tiie Royal ('anadian Humane Association on Awards for Life-Saving ------.-....] | CHARTER III. The Royal Humane an1 CHAPTER VII. Thiee Best- Known Methods of Resuscitation v>4 CHAPTER VIII. The Silvester Method of Restoring the Apparently Dead, Recommended by the Royal Humane Society of England 2r) CHAPTER I.X. Directions for Restoring the Apparently Drowned (Silvester Method) - 'JH CHAPTER X. The Marshall-Hall Metho«l of Resuscitation 32 I ( s The Howard Method of R CHAPTER XI. esu.scitatron— American rif^ K. • i.. ■ •-imencan Lite-Savmg Society CHAPTKR Xfl Kn.e.-gency Treatn.ent in the Absence of the Doctor CHAPTER XIII. Miscellaneous Remarks and Suc.estions i,. H . < . Accidents, Death, etc. _»°'''_^'""^^ '» Hegar.l to l.ife-.Sav i"g. Metliod for Resuscitation fr, CHAPTER XIV. 1U1 an Electric .Shock, etc CHAPTER XV CHAPTER XVI. Various Hints and Directions t,. u .1 «aving Society of EnilZl '':^''""' '''':' ''^ ^'^ ^^^^ional Life- CHAPTER XVII. Other Life-Saving Appliances and Aids to the Injured CLAPTER XVIII. Hints on the Treatment of the I„ju,e,l CHAPTER XIX. The Esn.arch Triangular Randacre . I' Mia 35 •AH Hi) 45 4() 51 53 54 34 35 THE ROYAL CANADIAN HUMANE ASSOCIATION FOR THE DOMINION OF CANADA. INSTITUTED iN 1894. .'{S tVJ Patron - - Governor-General, His Excellency the Earl of Aberdben. Preddent - Adam Brown, Esquire, Hamilton. Secretary - J. George Hoixjins, LL. D., Toronto. TreoMitrer - Ma.jor Henry McLaren, Hamilton. 45 4() 51 53 54 PRELIMINARY— CHAPTER I. OBJECTS OE THE ROYAL CANADIAN HUMANE ASSOCIATION. This Association rtwards persons who, with promptitude and bravery, and at personal risk or hazard of their own lives, save, or make strenuous efforts to save, the lives of others, in any of the following cases : — 1. That of drowning. 2. That of Boat Accidents. .'i That of Railway Accidents. 4. That of Accident at Fires. 5. That of Ice Accidents. 6. That of Freezing Exposure. 7. That of Asphyxia, in Mines or Wells. ><. That of Asphyxia from Escaping (his,. 9. That of Accidents from Lightning and Dynamic Electricity. 10. Other unenumerated cases. The Association has added this ninth (and an entirely new) case of reward for attempts at life-saving ol persons struck bv li'ditnin" «'■ ^>y dynamic electricity (" live wires," etc.)— it having been recently ascertained by experiments in France and in the United States, that {)ersons so affected can be restored, as in the case of drowning, and are set forth in this Hand-Book. 10 hi Jirlrlition to this, tlie lioyal Canadian Humane Association seeks to stimulate and help the local attiliatetl Humane Societies, in the various Provinces <»t' the l)*)minion, in their good work. It also supphes lists and prices of appliances for life-saving ii. case of drown- ing, ice accidents, and those from live wires, etc. Tt has also carefully prepared a large sheet (36 x 26 inches) of illustraticms of life-sa\ ing in the case of drowning and drowned persons, based upon the latest systems adopted l)y the lioyal Humane Society of England and oi the Life-saving Society of the same country. (See list at the end of this pamphlet.) The Officers strongly appeal for aid to all those who sympathize with the truly beneficent objects of the Royal Canadian Humane Association, to leward the hei'oic efft)rts oi life-saving, and the many noble acts of self-devotiim in life-saving, which are so constantly taking place in the wide area of this Dominion of Canada, and the practice of which tends so mucii to develop among our Canadian people a lofty spirit of self-reliance and maidy courage. Persons can become (lovernors for the year at ii?,'), or for life at $50, which should be sent to Major McLaren, Treasurer of the Association, Hamilton. A FEW WOUDS TO THOSK WHO SVMPATFIIZK WJTll THK OR.) Ef'TS OF THE ROYAL HUMANE ASSOCIATION. Life-saving is heroic wttrk, but the Royal Canadian Humane Association cannot reward it without generous financial support. The Association desires the hearty co-operation of all humane persons in the prosecution of the lutble work (>f life-saving. Sym{)athy is very pleasant, but generous help will enable the Association to sh(>w a good record <»f i-e wards for heioism. Canada should generously reward her own sons for their personal risk and hazard in saving the lives of others. 11 CHAPTER 11. COMMITTEE OF THE ROYAL (WNADIAN HUMANE ASSO- CIATION ON AWARDS FOR LIFE-SAVTNG. The (Constitution oi the Association provides that "There shall be a C^ommittee of five Governors of the Association — one of whom shall act as 8ecretai'y - who shall encjuire into the particulars of all acts of braveiy, personal risk, or hazard of life in savin^j; others, or attempt- ing to do so, which uiay he re[)orted to them, or, on whose behalf, a{>plication for reward for such l)ravery, risk, or hazard, has been made. This Conunittee, or any three of them, shall have full power, upon due enquiry, to decide upon all cases brought before them, and may make awards upon all such cases at their discretion. The par- ticulars of each case of award shall be fully reported to the xVssocia- tion." The Committee of (xovernors appointed' under this section of the Constitution is as foHows : Messieurs A. S. Irving and H. P. Dwight Toronto : Richard Fuller ami Jose{)h (Jreene, Hannlto.'. , and Ciiarles Black, Niagara Falls, Ontario. NATURE OF TIIK RKWARHS CRANTRD HV THK ASSOCIATION. For the present, tiie rewards granted by the Association in terms of the foregoing extract from the Constitution are: (1) Bronze Medals: (2) Certificates on Parchnient ; (.'i) Resolutions in the form of Minutes. Should special donations be made to the Association, or legacies be given specifically for that j)urpose, gold (as in the case of the 8anford Mell^s leijuisiteH tm )iage ')'2 of tliis Hand- Book. J5 n ACTION OK A l)ltOWNIN(i PERSttN IN THK WATKIt. When Ji persitii unjil)le to switn falls into the water he usually fisfs to the surface, throws uj) his anus and calls for help. Tliis, with the water swallowed, will make hiui sink, rnd if the arms are moved above t,he head when under the water he will, as a natural conse- «]uence, sink still lower The struggles will '^m prolonged a few seconds and then probably cease for a time, allowing him to rise again, thougli perhaps net sufficiently to obtain another breath of air. If still conscious, he will renew his struggles, more feel)h' perhaps, but still with the same result. As soon as insensibility occurs, the body sinks altogether, owing to the loss of air and the filling of the stomach with water. The general belief that a drowning person must rise three times before he finally sinks is a fallacy. The question whether he does so at all, or how often he rises, entirely depends upon the circumstances. NECESSITY FOR PROMPT RKSCrE. On seeing a person struggling in the water, in danger of disowning, the first thing to be remembered is to lose no time. As already stated, the drowning person may sink and not rise again, and in that case it may be verj' difficult for the rescuer to find the object of his search. If the person attempting to save life is unacquainted with the proper methods of rescue and release he should exercise great caution, because through ignorance two lives may be placed in jeopardy. It is a well-known sayitig that a drowning pers n^ forward by taking a fresh hold. It is possible where the ice is very thin to reach shore in this way. The ice in the vicinity of a break is seldom strong enough to climb upon, when encumbered with wet heavy clothing and .skates. To get out in that way is not an easy task, and it is generally best to wait for assistance. The easiest way to render help is to v a long ladder, boaitl, or pole, or a number of persons might craw^ along the ice, holding each othei-, thus forming a human ladder. By this means the weight is distributed over a larger surface, and the ice theref«)re able to bear a greater weight. If the break in the ice is only local, assistance could be rendei-ed by a rope held at each end and the centre allowed to di'ojt, or, if that cannot be done, a skate with a ro})e attached to it might be slid within reach of the drowning pei-son. '■/- l(j 1^ .1' TAKING OFF SUPERFLUOUS rLOTHIXC;. The question whether tlie rescuer, before entering the water, sliould remove a portion of his clftthing is a matter of judgment. If the drowning person is on tlie sui'face and close to the shore, the rescuer will probably be in the water for a very short time. There is no need to remove much clothing, for, although it luay somewhat impede his movements, yet th' elotlies l)eing inflated with air will assist floating until saturated with watei'. In all cases it is advisa))]e to remove as much clr * hing as time will permit. Commence with the heavy garments and boots, which are the greatest hindrance to swimming; but use judgment, as a moment's delay may mean the loss of a human life. If the rescuer has to enter the water from a great height, as from a bridge, vessel or pier, and is not used to diving and plunging, it is best to drop in feet first. CAUTIOUS APPKOACH NECESSARY. The next thing to consider is how best to approacli any one in danger of drowning. There is an element of risk from the clutch of a drowning person, unless the rescuer has been properly instructed h(»w to effect a release. Many writers on the subject state that it is sheer madness to approach a drowning person from the front. With some it might lead to disaster, but witli a swimmer who knows the right way to deal with a man struggling in the water there is no danger. In advocating the approach from the front, it do not necessarily follow that this should be done in every case ; indeed, as a general rule, it may be better not to do so ; but it is necessary to know what to do if face to face with a drowning pei'son. If a person in distress is approached from the front and grasped firmly when being turned on his back, he will probably give up his struggles and submit (juietly, finding himself supported and able to breathe freely. PROMPT ACTION' N DEALING WITH THE DROWNING CLUTCH. The rescuer may, through some mistake, find himself seized by the drowning person, who will probably not let go until foi'ced to do so. If this should happen, there must be no hesitation or scruple to use any means necessary to obtain release. One necessary thing for the rescuer to do is to take advantage of his knowledge of the water and keep uppermost. This will Ije of material service, as it will weaken the drowning person, and make the difficulty of getting away much easier. 17 CHAPTER V. FOUR METHODS OF RESCUING l)ROVVNlN(i PERSONS. Tlieiv jivd four piacticul metluxJs of i-escuing a person in the water, and those who are ignoi-ant of what to do in cases of enier- gency can, in the course of ten or twelve pi'actical lessons, become thoroughly proficient and able to render valuable aid in saving life without risk oi- danger to themselves. Trie methods are as follows : I'lKST MKTHOI> Of" llESUUK. f lllii^triitwn Xo. I.) First MKTMOD. — When the. dromnlny person, in not xtruygliny turn him on his back, provided he does not struggle, place your hands on either side of his face. Then turn on your back, hold him in front of you, and swim with the back stroke, taking care to keep his face above the water. IS 19 •20 1! ii KOURTH MKTH»)I)-^IN 'JA.SK OK (!IIAMI'. (JlhiKtrnhu,, .V... /,.; Fonrni mktiiou. -To render assistance to a swiniinei- attacked hy ci-ainp, or exhausted, as well as those in danger of drowning, who may he ohedient and remain (juiet ; the person assisted must lie upon his back, face upwanls, perfectly still, placing his hands on your shoulders close to the neck, with his arms at full stretch, and the head turned well back. Being uppermost, and having arms and legs free, swim with the breast stroke. It is by far the easiest method of the four, and the rescuer who swims with the breast stroke can, with- out undue exertion, carry a person a much longer distance than l)y any othe)* methooat or other aid mav arrive. CHAFIEK VI. THREE METHODS i^*^ UELEASE FROM THE (.'LUTCH f.T? ,-, - lOWNlNG. The following are the ni. io >. 0) First INriiTHOD. - //' tin' rp.^rner he held hy thr wrixtx, turn both iinus simultaiit-ously against the (irowiiing peisou's thumbs, outwards, and bring tlie aims at right angh-s to the body, thus dish>cating the thuinl)s of tlic (bowiiing person if he does not leave go. SKOOND MKTJIOI) OI' KKLKASK. ( llliist ration Xn. ti) Second Mkthoi). —If I'hdrhed round the neck, take a deep breath and immediately bring the knees up against the lower part of the chest, and then, by means of ji strong and sudden imsh, stretch the legs straight out, throwing the whole weight of your body backwards. This sudden motion will break the clutch, and leave the rescuer free. *ii ll 28 'I'linr- MKTIIOl) (»F KKLKASK. (lUuntrnt/nii So. ;.) Thihd Mktiioj). — //' f/tifr/ti'f/ round till' Itoilij ittnl i(n)is rather Jmv do/rn, lean well ovei- the di'owuinn; person, take a breath as liefore, and withdraw one arm in an upward direction in tVont of his body. Then with the thumb and forefinger pinch the nostrils close, and at the same timie place the palm of the hand on the chin, and })ush it away with all force possible. The holding of the nose will make the drowning man o[)en his mouth for breathing. Being under, choking will ensue, and the rescuer will gain complete control. Fourth Mkthod. —//' rlntrhid maud thi' hod}/ irnd iirniH hiijh up, lean well ovei- and raise one arm. thereby making the arm of the drowning person slip on t(t your shoulder, and leave your arm free t(» proceed as in the case of Methods 2 and 3, or eithei- one of them. 24 Many a gallant lite has been lost, in the attempt to rescue n fellow-creature from drowning, through a want of knowledge of these simple metluKls. All that is necessary is careful study and frequent practice in the water. If this be properly done even a niodei'ate swimmer can feai-iessly go to the aid of the drowning. IlECOVEin OK A DROWN IN(i MAN KliOM TIIK HOTTOM. In some cases it may be that the drowning per.son has sunk ti> the bottom and does not rise again. In that case the rescuer should look for bubbles rising to the surface before diving to the rescue. In still water the bubl)les will rise perpendicuhirly. In running water they will rise obli(|uely, so that the. rescuer must look for his object higher up the stream than where the bubbles appear. It must also be remembered that in running watei- a V)ody will l)e carried along, and must be looked for in a straight line in the direction in which the current is running. A swimmer who wishes lo be thoroughly proficient must therefore know something of plunging and diving. Before diving take a full inhalation of fresh air, and avoid staying under water for long periotl;', as it exhausts the i)owers for fresh effort. Where weeds abound, and there is danger of entanglement, progress should be made by gentle motions in the direction of the stream. On reaching a drowning person who has sunk to the bottom, seize him by the head or shoulders. Place the left foot on the ground, and the right knee in the si. a'*' "f his back. Then give a vigorous push, wliich will cause both to : i.-,e easily to the surface. CHAPTER VII. THREE BEST-KNOWN METHODS OF RESUSCITATION. When a person is lifted out of the water in an ;ippar(Mitly drowned condition, there must be no loss of timci in attempting i-estoratioii, jis a moment's delay nuiy prove fatal. The means used to restoie life must be carried out with caution, perseverance and continuous energy, as life has, in many cases, been restored after long hours of unceasing w»trk. There are three well-known metlKMls of restoi-ing luitural respira- tion by artificial means. The methods of Dr. Silvester and Dr. Marshal I -Hal I are best known and generally practised in (ireat Britain and the Continent, while that suggested by Dr. Howard, of the New York Life-Saving Association, is practised by humane societies and life-boat instituvions in the ITnited States of America. 25 The "Marshall-Hall " method in the mildest, though pcirhaps the least efficacious, of the three, and re(|uireH considerable practice and care to be successfully put into operation. The " Silvester " and the " Howard " methods, l)eing simple, but vigorous, are more generally used. In the lattt^r method there is a danger of injuring the patient by too forcible a pressure if practised by unskilled persons. The Life-Saving Soci^^ty, after careful consideration, recommends the use of Dr. Silvester's method, which has been approved by the Royal Medical and Chirurgical Society, and adopted by the Royal National Life-Boat Institution and the Royal Humane Society of London. The following are a few reasons for recommending its use : 1. The process is to a great extent in harmony with that of Nature. 2. The expansion of the thorax is artificially insured and wholly under the control of the operatoi'. .*?. The patient is not liable to be injured by the manipulations. 4. Both sides of the chest are equally inflated, and a large amount of air inspired. 5. It is most easily adopted and remembered ; can be put into operation b}' one person. CHAPTER VIII. THE SILVESTER ME'I'BOI) FOR RESTORING THE APPARENTLY' DEAD, RECOMMENDED BY THE ROYAL HUMANE SOCIETY OF ENGLAND. If KHOM l)ROWMN(i, OR SlIKKOOATIOX. Send at once for medical assistance, blankets and dry clothing, but proceed to treat the patient inMantly. The points to be aimed at are — first, and immediately, the restora- tion of breathing; and secondly, after breathing is restored, the promotion of warmth and circulation. The efforts to restore life must be persevered in until the arrival of medical assistance, or until the pulse and breathing have ceased for an hour. Dit. H. R. SiLVKSTKii's Mkthoi) ok IIkstoiiinc Natural Bkkathinc;. Rule \.—To tufjunf the patient^ position. — Place the patient on his back on a flat surface, inclined a little from the feet upwards ; raise and support the head and shoulders on a small firm cushion oi* folded article of dress placed under the shoulder-blades. Remove all tiglit clothing from about the neck and chest. 26 INSPIRATION-THE SILVKSTKK METHOD, No. 1. (lUustmtInn So. sj KXPIHATKtN-THE SM-VKSTKH METHOD, No. >. (Illmtrati,,,) So. '.).) To iltUHtinte the ponition of the Imdi/ during the emplmitiifnt nf Dr. U. U. SilwHei-'x Melhwt <>/ Inducing ltesi>ii'atii>n. 27 Rule 2. — To mainfain a free entram-t' of air into tlie /tnndpipe. — Cleanse the mouth and nostrils ; open the mouth ; draw forward the patient's tongue, and keep it forward: an elastic l»aud over the tongue and under the chin will answer this purpose. Rule .3. — To imitate the movpnients of hreathiny : First. — Induce Tnspikation. — Place youi-self at the head of the patient, grasp his arms, raise them upwarrls by the sides of his head, stretch them steadily but gently upwards, for two seconds. [/y*/ thiH means fresh air is dra/cn info the lungs hij raisin;/ the ribs. See Engraving No. 8 — Inspikation.] Secondly. — Induce Expiration. — Immediatel}' turn down the patient's arms, and press them firmly but gently downwards against the sides of his chest, for two seconds. \^lh/ this means fold air is expelled from tlie Inngs bif depressing the rihs. See Engraving No. 9 — Expihation.] Thirdly. — Continue these Movements. — Repeat these measures alternately, deliberately and perseveringly fifteen times in a minute, until a spontaneous eiFort to respire be perceived. [//v/ this means an exchatige of air is produced in the lungs similar to that effected by natural respiration.^ When a spontaneous effort to respire is perceived, cease to imitate the movements of breathing, and proceed to induce circulation and warmth {as heloiv.) Rule 4. — To excite respiration. — During the employment of the above method, excite the nostrils with snuff or smelling salts, or tickle the thro.at with a feather. Rub the chest and face liriskly, and dasli cold and hot water alternately on thenj. Friction of the limbs antl body with dry flannel or cloths should be liad recourse to. When there is proof of returning respiration, the individual may be placed in a warm bath, the movements of the arms above described being continued until respiration is fully restored. Raise the body in twenty seconds to a sitting position, dash cold watei* against the chest and face, and pass ammonia under the nose. Should a galvanic apparatus be at hand, apply the sponges to the region of the dia- phragm and heart. 2H (^HAt^TliK IX. DIRECTIONS FOI{ KEKTOIUNCJ THE Al'PARENTLY DROWNED (SiLVKSTKR MrTHOd). The Nutioiial Life Saving Society of Eni^hiiul strongly recommend tliat the following directions he inserted in all Boat-club books : — Rf^LK 1. If no sign of life can be oViserved, noi- the heart's action heard, lay the patient flat on the back and place a roll of i-lothing under the shoulder blades. . (ip^ r. THE Sir,VESTER MKTHOI) ENUI.ISH l,IKK-SAVIN(; SOCIKTV. ( lUiixh-atlon A'o. ;('.; Rhlk "2. Immediately release all tight clothing routul the neck and chest, especially the braces or corsets, and at (»nce pi'occed to clear the mouth and throat. RuLK 3. To do this, turn the patient face do\vr)wards, the head resting on one of the arms, and wipe the mouth and nostrils. HuKK X. Replace the patient on the back, and place the roll of clothing under the shoidder blades. RuLK 5. Dr-aw the tongue foi-ward, and keep it projecting beyond the lips by fastening it in position with piece of handkerchief or string tied undei- chin. n ^.ri: 29 Hulk 0. Kncfliiig has been restored, friction bv the assistant over the surface of the body should be resorted to, using handkerchiefs, flannels, etc. (by these meiins fhn hlooil is jiropelled alouy the veins towards the heart), while the operator attends to the mouth, nose and throat, seeing also that warmth is properly encouraged. Wrap the patient in blankets or some dry clothing. The iriction on the legs should all be upward, and along the arms towards the body, and must be continued under the blankets or over the dry clothing. Promtite warmth by the application of liot tlannels, bottles or bladders of hot water, heated bricks, etc., to the pit of the stomach, the armpits, between the thighs, and to the soles of the feet. Tf tlie patient has been carried to the house, be careful to let the air circulate freely about the room and prevent crowding round the patient. On the restoration of life, a teaspoonful of warm water should lie given; and then, if the power of swallowing has returned, very small (juantities of wine, warm brandy and water, beef tea or coffee should be administered. The patient should be kept in bed, and a disposition to sleep should be encouraged. r+" there be pain or ditKculty in breathing, apply a hot linseed- meal poultice ovei' the chest. Watch the patient carefull}' for some time to see that breathing does not fail ; should an}' signs c»f failui-e appear, at once resume artificial respiration. SI rjGESTIVK AND USEFUL REMARKS. In all cases send for iiudical assistance as soon as possible. Avoid rough usage, especially twisting or bending of limbs, and do not allow the patient to remain on the back unless the tongue is pulled forward. Under no circumstances hold the patient up by the feet, nor allow him to be carried face downwards. In laying the patient down f)n the back, the head should be at a slightly higher level than the feet. In the event of respiration not being entirely suspended when a person is lifted out of the water, it may not be necessary to imitate breatliing, but natural respiratirm may be excited by the application of irritant suVistance to the nostrils and tickling the nose. Smelling salts, pepper or snuff may be used in doing this, or hot and cold water alternatelv be dashed on face and chest. 31 These vai-ious liiuts, instructions and explanations are here given in order tliat the (h-ills which follow may be better understood and more easily accjuired, so that the risks which attend the eflForts of a rescuer in rendering humane aid in the hour of danger may, to a great extent, be obviated. A description of the " Marshall- Kail " and "Howard" method will be found further on in this Hand- Book. DKSCRIPTIONS OF THK ORGANS OF RESHIKATION. In order to convey to the non-professional mind some general idea why certain methods are adopted in life saving and resuscitation of the apparently drowned, it is thought desirable to give as brieHy as poisible a general outline of the structui'e of the human chest, as well as to explain the process by which bieathing is accomplished, and the great necessity for a good supply of pure air to enable respiration to be carried (»n properly. One of the chief impurities taken up by the blood in its passage through the body is a gas called Carbonic Acid. If this be allowed to remain in the blood, it will soon cause suffocation. To get rid of it the blood passes through the l.iigs. The process by which this purification is completed is called respiration, and is divided int«» two parts, viz., inspiration and expiration. The lungs are two lai-ge bodies, which, with the heart, fill the cavity of the thorax, oi- chest. They rest upon an arched mtiscle called the diaphragm, or midrifiF, which divides the thorax or chest from the abdomen. The trachea, or windpipe, is a flexible tulje which runs down the front of the neck from the root of the tongue to the top of the breast-bone, where it divides into two bi-anches, one running to the I'ight, the other to the left ; these again tlivide and sub-divide until they form very small closed tubes. At tlieir termination, the tubes bulge out, forming air cells. The lung is made up of these cells, covered bj' a net work of capillaries, formed by the division of the pulmonary arte. les. Inspiration is the act of filling the lungs with air. It is performed by all the muscles which raise the ribs contracting and drawing them upwards, thus increasing the depth of the thorax (or chest) from the breast-bone to the spine. At the same time the diaphragm acts and becomes flattened instead of curved, thus increasing the depth of the thorax from al)Ove down- wards ; the air then rushes in through the trachea, and fills the air- cells. Expiration, or the act of emptying the lungs of air, is caused by the muscles relaxing, and allowing the vibs, by their elasticity and weight, to fall, and by the diaphragm resuming its arched position. While passing through the capillaries round the air-cells, the :{2 WIockI is brouj^lit iiitt^ close relation with the air in them. The air contains a gas called oxygen, which is taken up by the bloo*!, while the carljonic acifl passes from the 1)1o(h1 into the air-cells, thus rendering the air in them impure. At the next expiration tliis is forced out of the lungs, and a supply of pure air is taken in at the next inspiration. CHAPTER X. i i v.* THE MARSHALL-HALL METHOD OF RESUSCITATION. Provided there appears to be no sign of life the operator may proceed with the Marshall-Hall Method, as follows : liiLK 1. — The chief operator should lean forward and take hold of the patient's left shoulder with his left hand, and witli assistance, tui-n the patient (as ff)r clearing the throat) o\er on his right side until he is lying face downwards with his chest supported on a pillow or I'oll, and the head resting on the right arm. Then turn the patient gently on to his i-ight side by })ulling the latter up towards himself Ijy the left shouldei- and hip. Again push the })atient back until he is again lying face downwards and supported as before. (See Illustration No. 11.) KuLE 2. — As the patient's body is resting on the pillow and the head upon his right arm, the operator with his left hand will jiress firmly upon the back between and on the shoulder blades. These movements, as directed in Rule 1 al)ove, and in this Rule 2, are to be continued in regular time, twice in succession. RuLK .'». -The operator will now step over to the patient's right side, kneel down and take hold of the patient's right shoulder with his left hand, and the right hip with his right hand. The assistant will take } Ad of the patient's left arm with his right hand, sup- porting his liead with his left hand, and place the patient's left arm under his hiad so that it may rest upon it. (See Illustration No. 12.) RuLK 4. — After completing this last motion, the operator will replace the patient upon his back face upward, and his amis laid quickly at his sides. He will then step over the patient ai\d resume his first kneeling position. The assistant will then aid in removing the pillow or roll to its original position, and continue as before. NoTK.— Tlie motions directed in Rules I and 2 alwve will be eontinued in regular time twiee in succeasion — the right hand (in Rule 2 above) to be aub stituted for the left in pi-essiiig firmly on the back Itetween ami on the shoulder hla«les. 33 34 CHAPTER XI. THE H(>WARD METHOD OF RESrsCITATlON— AMERICAN LIFE-SAVING SOCIETY. There are only two movements in this method which is of a very- simple nature, and can l)e easily put into practice, but there is <;reat danger of injuring the patient by too forcible pressui-e, if great care is not exercised. k / ( A T \ • J \iJk::5%, "vm W^ ^^k. ^t* ^ Wlfylm^ "^ V Ii L: ^ Li] HI «^H/l{ HI h|^ 1 fB . ''IIb^ ^ i^^jjBjB^* P-'ji^ :2^^^gB|i ;:9i^^9f^s '^^j^'^^JK -.^^■^^i*^* f-^^^O^^^^^^^Mti^, •M^y/'^&5jB^^^^^^^^^^g J^^^^^T tly and firmly. As the arnis are drawn up over the head, he slowly and stefwlily withdraws his pressure upon the riV>s in the same time as does the chief operator with the ai-ms. The first evidence of the restoration of the functions of life is a change in color. The pallifl face assumes a pinkish hue, a purplish countenance begins to fade to a lighter shade. There is a little trembling of the nostrils, perhaps a ttuttering of the e3'^elids, pre- liminary to the actual resumption of vitality. When the natural |[)reathing is finally resumed the artificial methtMl should be aban- doned, and other metho-is of assisting the vital functions inaugurate!!. Rubbing the body dry, wrapping it in warm blankets and applying hot water bags or bottles, hot bricks or fiat-irons alniut the btxly to keep it warm, are now more serviceable. As soon as he l>ecomes able to swallow, hot drinks should be given, not freely, but a tea- .spoonvul at a time. There is nothing Iwtter than hot milk or coffee for ti> i ^vuy se. Ho! 8ut;yld be placed in bed and kept there until the shock has been relie\ed ;i!id his normal condition restored. By these simple measures, and without any special professional study, anyone nuiy, without previous experience, be the means of .saving lives that would otherwise Ije unnecessarily lost, and it is ^emphatically urged that they l)e learned by all. 38 CHAPTER XIII. MISCELLANEOrS REMARKS AND SUGCJESTIONS IN RE(JARD TO LIFE SAVlN(i, ACCIDENTS, DEATH, ETC. The Royal Humane Society of England has issued the following instruction for the resuscitation of persons who are unconscious from the eflFects of "Intense Cold," "Intoxication," "A[)oplexy,"' oi' "Sun- stroke " : Ik from Intrxsk Colu.— Rub the Ixnly with snow, ice or cold water. Restore warmth by slow degrees. It is highl}' dangerous to apply heat too early. If from Into.xication. -Lay the indivi(hial on his sioe on a bc-3. At the conclusion of an article in that majfazine hy Mr- Alexander McAdie, headed, " Protection from Lij^htninif," the writer said : — "If you are near a person who has been struck by lightiiinsj;, yjo to work at once to try and restore consciousness. Try to stimulate the respiration and circulation, and do not cease in the ert'ort to restore animation for at least an hour." (Page HV-\.) In Current Literature for September, IcS'.),'}, the statement and exposition of a theory on the same subject by Professoi- d'Ai-souval,* "one of the most distinguished scientific men of F'rance," is published. He maintains that the use of dynamic electricity produces in man a kind of ansesthesia, under cover of which he is mangled aM\e by the knives of the surgeons who make the autopsy. (Page \'1\.) Recently Professor d'Arsouval reported a case to the Krencli Academy of Hcience on wliich he bases his theory. The case is as follows, and it has become noteworthy from the fact of the successful employment of artificial respiration to resuscitate the victim : — " A sudden sparkling on one of the dynamos of the electric-light station of St. Denis, near Paris, indicat<^d a short circuit on the line. The dynamo was quickly cut out and stopped. The voltmeter i-ead ing was 4,500 volts l)etween two wires, and the ammeter read 7-')() mille-amperes on the wire, " The accident occurred at a place where the three wires were suppt)rted eighteen feet alK)ve ground on a bracket fastened to a stone wall. The bracket carried several (U'oss-pieces, and on the lowest one sat the laborer who had received the shock, holding the conductor with one hand. He had been sent up to fasten a telegraph wire, had touched the live wire with the wire he held, and thus short- cii'cuited the current through his hand and back to earth. The man had, therefore, received a 4,r)00-volt current of fifty-five alternation.s per sec(md perhaps for several minutes, and when he was found fully a (juarter of an hour had elapsed since he received the shock. He gave no sign of life, and it took another half hour to remove him from his perilous position and stretcli him on the ground. " The attempt was at once mjide to cause the lungs to act l)y moving the arms alternately up and down, but without avail. The nu)uth was then forcibly openecl and the tongue was {)ulled out and allowed to recede. This being the best methixl of producing respira- * HavIiik written to tho Editor of the Popular Scicnre Monthly for information ill regard to I'rofeHsor d'Arsouval. the Editor replied to Dr. IIodKins im follows : " Wo find M. d'ArHoiival rreituetitly quoted in our French journalH. and have no doubt he would be xlad to Kive you the information yon are HeelcinK " 41 tion artificial Iv, the linn's actually boyan their functions almost immediately. Two hours later the man was al)le to speak. He hatl hums on his hand and ))ack, l)Ut otherwise not injured." Commenting upon these facts, Professoi" d'Arsouval cruisiders electrocution objectionable, and of doubtful effect. Another field of e.xperiment in which most interesting result have l)een attained is that instituted by Dr. J. Kratter, of Graz, Austria. His researches extend to the physiological and pathological eft'ects on the animal organism of currents of 2,000 volts or less. He experi- mented on white mice, I'abbits, guinea l)igs, cats and dogs, and in his recently published i)aper, read before the International Medical Congress, at Home, his conclusions are thus stated : — "The death of the animals resulted mostly from tlie sudden stoppage ()!• primary cessation of the respiration. The functional disturbance lasted in some cases a sufficient lengtli of time after tl ■ end of the irritation to produce death by suffocation. During toe asphyxia the heart action still continued ; but if tlie res})iration is allowed to stop for about two minutes, secondary ce.ssation of the heart action ensue.s, the same as in cases of mechanical sutfocatirk Worhl (|S<)4) appears a reference to the appa- ratus to restore persons struck by lightning, or dynamic electricity, invented by Dr. (Jibbons, of Syracuse, \.Y.* The extract fr(Mn the World is as follows : — "'Notwithstanding the decision of Attorney -(Jetieral Haticock,' * Dr. (llbbons rocelvetl the dogrocs of B..\. and M.A. from the l-'nIverHlty of Ottawa. 42 said Dr. (iibl)Oiis, ' I still have some Ixipe of iHiin;^ allowed to perform my experiment upon the IxKjy of an electrocuted man. I am perfectly confident that the alternatinii; current, as now applied in the death chamber, does not kill. Animation is suspended, of course, and the kni\es of the auto})sy surgeon ai-e the real executt)rs of the law. " ' I do not claim that this apparatus wliich 1 bi'ought here to place in Bellevue Hospital will bring the dead to life ; but T am satisfied, as the result of a long series of experiments upon animals, that it will resuscitate any man who has received in his ImmIv the alternating curi'ent now applied at executions in the State prisons, viz., 1,700 volts. As you see, the contrivance is merely a double bellows, one- half of which will send pure air int<) the lungs, while the other half will pump out the btul air. " 'This rubber tube can be placed m the mouth of the subject, or, preferably, in the trachea after the operation of tiacheotomy has been performed. The lattei- condition is usually most favorable for work- ing of the apparatus, because often in cases of suspenderl animation it is necessavy for nourishment to be given by mouth. " ' Of course ! not say that the alternating current will not kill uien provided enough power is applied ; but at pi-esent 1,700 volts aie used, ajul this is not deadly.' ** Dr. Giblw^ns has experimented lai-gelj' on dogs, rabbits, cats, and even sheep and cattle. He has applied a current of from 1,^00 to 2,000 volts, and these animals have permanently recovered as full possession of their faculties as before the current was turned into their system. The j)eri(Mls of apparent death had varied from a few moments to several hours. Dr. (Jiblxms has still in his employ an assistant who received 1,000 volts in Cleveland in 188')." I Dr. Hodgins having wi-itten to Dr. (libbons for an explanation of his meth(td of resuscitation from the effects of lightning, etc., he replied as follows, under date of February Kkli, 189') :- "Your request for my 'Method of Resuscitation from Electric (Shock ' was i-eceived in due time. "You will find enclosed in brief form what I think will answer the purpose for which you wish it. I also send you a phcttograph of the front and back views of the apftai'atus itself. "With liest wishes for the H()val Canadian Humane Associa- tion,'' etc. 43 Tlu' fdUowini; i^ A METHOD FOR HESISCITATION FROM ELECTRIC SHOCK. BY PETER J. (JIBBONS, M.A., M.D., SYHACU8E, N.Y. " Wliei) Ji pei-.soii receives an electric sliock sufficient to produce suspended aniination, tlie l)reathing and heart's action cease ; the eyelids ai-e generally half closed, the pupils dilated ; the tongue approaclies to the under edge of the lips ; finally coldness and pallor of the surface increase. "When one in whom the vital spark may possibly not yet have tied is found, two objects should be aimed at, viz., first, to restore breathing ; and seconfl, to promote warmth and circulation. " When an electric-shocked person is found, he must be treated on the spot in the o})en air. On no account waste precious time by renittving him to a house, unless the weather is intensely cold. Secure a return of breathing, first protecting him from the severe cold by coats, l)lankets, etc., if necessary. Keep bystanders off fifteen or twenty feet, place him on his back, loosen all tight clothing, remove false teeth and f(»reign bodies from mouth and nose. To excite bieathing, resort to Silvester's method, (»r any of the well-known methods, for resuscitation from drowning, remembering there is no water to be expelled. Tf no success follow, imitate breathing by inserting the distal end of the tube of my apparatus into the nostrils (»!• the mouth, [treferably the nostrils, as in this way the air, during inspiration and expiration, comes in contact with the lining membrane <»f the nasal chandlers. Tn doing so, it allows the membrane to carry out its normal physiological acti(m, and by this means we get so much nearei- a utjrmal respiration. The air thus breathed is both wai-med and saturated to a certain extent with waterj' vapor, and much of the dust and other foreign matter floating in the air is removed by adhering to the moist mucous membrane, 'i'lie nostrils should be excited with snufi", hartshorn and smelling salts. This can be readily done with(mt the removal of the tul>e, by allowing the exciting agent t«» enter the bellows with the fresh air or oxygen. "To liESTOKE CiKCULATioN. — The alx)ve measures are directed wholly to re,storing the breath. This is the first necessity There should })e no rubbing of the surface while this is going on. Should the inclemency of li«' weather demand the removal of the patient indoors, the above movements must be kept up, even wliile he is Vx^ing removed ; and on no account should he be taken into a warm or crowded r(M»m. When the patient begins to breathe, commence rubbing the limbs. Hub them upward with ct)nsiderable l)riskne8s and pressure, t'se silk somewhat warmed ; throw a «juilt or blanket 44. over the patient, and odntinue friction under tliis. Tlie friction in this way will create electricity and iieaf. Put wann l)rick.s or bottles of warm water at the feet, between the thigliK, and under the arm- pits ; but be very careful not to have these thin«^s too warm, or mucl, above the temperature of the healthy body. "The above rules are for laymen. ''Physicians may insert the distal end of my apparatus throuifh the mouth, into the laryngeal entrance, as they would introduce a tul)e for intubation of the larynx. Some will probably find it more convenient to do tracheotomy, and insert the tube into the trachea. He can also use electric batteries to keep up body heat, IwHiy elec- tricity, and to excite the heart and the lungs to action. " My method, or any other used, should not l>e discontinued for at least three to six hours, and the operatoi* should not be discouraged if he saw no symptoms of returning life, until this amount of time has elapsed. Why no symptoms of life are seen for one or two hours, and may be shown later, T shall not attempt to explain ; but such is the case in my expei-ience. Befoi'e giving up all hope 1 recommenfl the injection of an alkaline solution into the body, such as has been tried upon people who have bled to death. "When we cease artificial respiration nature may refuse to perform its duty, and we might be obliged to resort to the artificial method again. Sometime.:! it is necessary to carry r by lifting him from the ground head downward, atul in other ways. Then he is laid on his back, the arms raised t(» expand the lungs, and a rhytlnnic contraction and expansion of the chest walls effected by alternate |)ressure and relaxation. Sometimes the forcing process has been kept up for hours witli ultimate success ; but considering the possibilities recog- nized in artificial respiration the results have l)een, in many cases, iiiv from (Micouraging. Dr. De P>aun has w(»rked (»n an entiiely new line, and the result of his experiments and observation is a method of internal respira- ti<»n which, he claims, cannot possibly fail. His attention was first directed to the subject by a case of suspended animation in a newly- b(»rn child. It has \wen the practice in such cases to force air into the lungs of tl.e infant by breathing into its m(»uth and then con- tracting the lungs V)y pressure upon the chest. But this is a disagree- able, and not always a successful operation. Dr. De Baun decided to tiy a new expedient. He [)asHed a small rubbei- tube through the nose of the infant and down into the throat. Closing the mouth, he foi'ced air through the tube from a rubber bag, 46 inriuting the luuj^s ; tlien, releasing the pressure from the mouth, found, as expected, that the elasticity of the muscles of the chest caused immediate contraction of the lungs, forming a complete respiration. This was kept up for forty-five minutes, when natural respiration had heen restored, and a life had been saved. Since then Dr. De Baun has perfected this hastily-improvised apparatus, and finds that animation may he often restored within fifteen mirnites. XATL'RK OF THE APPARATUS EMPLOVKl). The ap])aratus is as simple as it is ingenious. It consists of a long I'ubber tube, near one eAid of which is a piece of soft rubl)er witli which to cover the mouth and nose. At the other end are two rubber bulbs. After the tube has been inserted between the teeth, and the mouth and nose covered slightly, the lower bulb is compressed, forcing air into the second bulb, which acts as a reservoir. This second bulb is much more elastic thaii the other and maintains a steady pressure of air through the tube. Tt is covered with loose netting, which acts as a sort of safety valve against over-pressure. The tube is fitted with a sto]»cock, that may be used to lend force to the first few respirations. A few compressions of the lower bulb are sufficient to fill the lungs. Then the pressure on nose and mouth is relaxed, and the lungs are emptied by the natural elasticity of the muscles of the chest. This elasticity remains even after detith, and with this instru- ment it is (|uite possible to make even a dead man breathe regularly as long as the application continues. Tn some of the doctor's experi- ments on dead l»odies this simulation uld be short and the expiration long. As soon as the lungs are well cleared, a spring forward should be made and a deep inspiration taken. The bo rtoat pr()|n'rly it is lu-st to inm'tisc in (leej) water; the dt-ptli increases the (hMisity :iii counteract until the true balance be found. Remember that fi'eijuent practice is required, and so long as there is weight beyond the head, in order to balance the feet, one may lie on the surface without any muscular ettbrt. Of course, it is much easier to Hoat in salt water on account (tf its gieater density. A knowledge of Hoating is very useful tt) tlmse attempting ti) save life, and its actjuirement vastly in<'reases the confidence of a, swiunner when in the water. There are <:ccasions when, beset with dangei- and tion of its aims and objects. Kach of them .should take the position of instructor in turn, whilst the other four go c.'.refully an(i delibeiately through the drills at the wtii'd of t;oni- mand. 51 CHAPTER XVII. OTHER LlFE-8AVlN(i APPLIANCES AND AJDS TO THE INJrRED. WoohKN UK |{AIJ>. ( lltiiftioHo,, X„. ;«;, ; The lloyal Canadian Hinnaiu^ Assuoiation, knowing liow fre- «|uently accidentH occur in skatitij* parties and iceVxtats at certain peritnls of tlu yeai" (in the earl}' winter and in the sprinjj), have pro- cured fi'oni tlie St. .John Anil (uhuice Association of London, Kngland, an admirable Wooden Ice Hall, the use of which is shown in the accompanyinff illustration. The hall may he thrown as shown in that illustration, or it may he rolled as a hall at ciicket, «»r at nine-pins. The latter is the better wav. As the hall is wooden it will float * when it reaches the water. ACT <>K THROWI\(} THE ICK BALL IIOLLKII TO A MAN IMMKKSKU IN THK WATKR. ( I Hunt rat ion So. 17. ) The other appliances which have been provided hy the Royal Canaflian Humane Association are as follows : 1. The noted " Esniarch Handaf;;e," trianj^ular in form an cents ; by post, 10 cents. '>. In addition, the association is having prepared and printed a 'arge Shei't, on special paper-cl»)th nuiterial, showing, by a nunil>er of o3 enlarged illustrations how persons can lie rescued in the watei", and how they may lie resuscitated when rescued. In sheets, 35 cents ; on rollers, ">0 cents ; in a frame, f 1. Carriage extra. 6. Dr. Gibbons' instructions how to resuscitate persons struck by lightning or dynamic electricity. 7 cents ; by post, 8 cents ; 10 copies for oO cents, postage 5 cents extra. 7. Life-Saving Hand- Hook of the Association, containing direc- tions on the.se various matters. 6S cents ; by post, 70 cents. (NoTK. — Wlieii several thiiig.s are ordered togctiier or a muiilier of copies of tlie Hand- Book, a rethiction will he iiuule in the )»ri(es (|Uoted.) CHAPTER XVIII. HINTS ON THE TREATMENT OF THE IN.H'RKD. From the Hand- Hook of the St. John And)ulance As.sociation, of London, England, the following useful chapter, prepared by Dr. E. MacDowel Cosgrave, is taken : PRKPAKATION FOR RKCKI'TIOX OK A(;CIDENT CASKS. When news of an accident comes, prepai-ations should at once be made so as to have everything ready before the injured person is brought in. ( )f course the jireparations needful will vary according to the nature and extent of the injury, but the following are the chief things which may have to be done : CHOICK AND PRKFARA'rroX OK ROOM. A room nmst be chosen. In a bad case this should be one easily reached, as it is ditticult to carry an injured pei-son through narrow passages and up stairs. Uidess there is some such reason against it, the injured person's own room is best. The way to the room must be cleared, projecting furniture and loose mats in the hall or in lobbies should be removed. If the injured i)er.son is carried on a door or shutter, or even on a stretcher, a couple of sti-ong kitchen chairs should be placed ready to support it wherever the bearers W(juld he likely to reijuire rest. Useless furniture should be removed from the bedroom. The l)ed should be drawn out from the wall so that lx)th sides can be appioached, and the clotiies turned liack to one side to their fuii length. A hot bottle should be got ready. If there is much collapse several hot Ixittles and hot blankets may be re(|uired ; c<»ver the hot botbleM with Hannel. 54 Tf thi' injury is very severe, if inud-staiiietj clothes have to l>e removed, or if extensive (h-esKinj^s have t<» he appHed, it may hf* necessary to have anothei- hed, a couch, <»r a table phiced near the hesite the h»\ver lau'der may be named the point, th*' two <»thers the mdn. (See p. 52 of this Hand- Hook.) When not in use it should be folded ()ei|)en(iicularly wer b<»rd.', by .'^i inches. For use it is foldeiimla OK THK S(!ALP. — Fold the lower lM)rdei' lengthways to form a plait like a hem 1 }, inches wide, place the middle of the bandage oil the head so that the plait lies crossways befoi-e the forehead, the point hanging downwards over the nape of the neck. Carry the two ends backwards above the ears, cross at the back of the head on the nape of the neck, bring forward and tie <»n the forehead. Then stretch the j)oint downwards, and turn it up over the back of the head, and fasten it on the top with a pin. Fr.\cti'hkd Jaw. - Fold the bandage narrow, place the centre under and slightly over the chin, carry the ends upwards, one at each side, passitig (me end over the top of the head until it meets the «»ther above the ear, twist it behind this and take it across the fore- head and the other end behind the hejwi anii tie over the opposite ear. Wound ok thk Evks oit sidk of tmk Face. -Fold the bandage narrow, placf' the centre ovei* the injured ytai't, and tie on the opposite side. WoLNl) ok Shoulokk. Lay the centre of the bandage on th»^ top of the arm with the point up the side of the neck, and the lower border lying on the middle of the upper arm. Carry the two ends round the arm, and crossing them on its inner side, bring them back and tie on the outside. Take a second bandage, foUi it and make a smaller arm sling of it ; then draw the point of the sluiulder bandage under the sling, fold it back on itself and fasten with a pin on the top of the arm. Wound ok tmk Uppkii Arm. — Place the centre of the brojid- folded bandage on the front of the limV), carry the ends round to the opposite side, cross them, bring them back and knot them t<»gether. Xext take a second broad-folded bandage, thi-ow one end over the shoulder on the wounded side, carry it round the neck so as to be visible at the opposite side ; then bend the arm carefully and carry the wrist across the middle of the bandage hanging down in fi-ont of the chest. This done, take the lower end over the shoulder on the sound si«le and knot the two ends together at the nape of the neck. This is (!alled the suuiller arm sling. WouM» OF THE FoKKAHM. Dress and bandagt' the wound as in the last case. Then take a second bandage, throw one end over the 'm 4; v; .■*■ \.'., ^tM-/*^^'".^ •"*' '^■■• 56 slioiikler !it the sound side, aiul curry it round the hack of the ncrk, so as to Im' visible at the ojtposite side, where it is to he held fast, place the point l)ehind the elbow i»f the injured arm and draw down the end in front of the patient. Next bend the arm carefully and place it across the chest on the middle (»f the cloth. Then take the lower end upwards over the shoulder on the wounded side, and knot to the other end at the nape t»f the neck. This done draw the p(»int forward I'ound the ell)ow, and fasten it with a pin. This is called the larjijer arm sling. WouNU ON TliK CiiEHT. — Place the middle of the bandage on the chest with the p<»int over the shoulder, carrying the tw<» ends rtuind the chest and knot at the back. Next draw the point over the shouldej" downwards and tie or pin it to one of the ends. Wound op thk Hand. — Take a banchige, spread it out, and lay the wrist on the lower border with the fingei's towards the point. Next turn the point over the fingers and carry it over the wrist. This done take the ends round the wrist, fixing the point, cross them, carry them back again and knot together. Take a second bandage and suj>port the forearm in the larger sling as ab(»ve. Wound of thk Hic. — Fold one bandag«^ narrow, and tie it i-ound the body as a waist-belt above the hips. Liiy the centre of a ban(J- age on the wound with the point u])wards, pass the ends round the upper part of the thigh, cross and carry it to the front and knot them together, next pass the point under the waist-belt and fasten it with a pin. Wound ok tiik Foot. —Take a bandage, spretui it out and place the sole of the foot on its centre, witl> the toes in the direction of the point. Draw the point upwards over the tews and instep of the foot ; then take the ends forward above the ankles, and cross in front of tlie leg, carry them downwards under the sole of the foot, and k!u»t them together above the ankle. To SECURK Fractukks. — Surgical or improvised splints may be adjusted to a broken limb by taking two triangular l)andages folded broad or narrow, according to circumstances, and tying them securely one aVM)ve and the other l)elow the fracture. As many moi-e baiuj- ages can Vje added as nuiy be considered necessary to Mfnire the limb Fractured Collar Bo\k. -Place a j)ad in arm-})it on injured side, and suspend the arm in a large arm sling, then fix the arm to the side with a snuill narrow bandage j>assing round the chest and fastened under tlie sound arm. The triangular bandage may be applied in many other ways ; but the alnwe directitms are quite sufficient to indicate its different uses. < •^J ,<, ■v.. >'. ^1 c, m ^'■^t