tery grave. In such cases, death ensues from impeded respiration, and the consequent ceasing of the circulation of the blood, by which the body loses its heat, and, with that, the activity of the vital principle. Dr. Goodwyn justly observes, that the water produces all the changes which take place in drowning, only indirectly, by excluding the atmospheric air from the lungs, as they admit but a very inconsiderable quantity of fluid to pass into them, during immersion. Hence we shall find, in the progress of this inquiry, that inflation of the lungs is one of the principal means of restoring life.
Before we describe the various methods and instruments that have been successfully adopted, for recovering drowned persons, it will be useful to advert (on the plan of Dr. Struve) to those circumstances which deserve to be duly weighed, previously to any active measures being taken on such unfortunate occasions: 1. The season and weather; 2. Length of time the person has continued under water; 3. The state of his mind when the accident happened: whether he was intoxicated, frightened, &c.; 4. Constitution of the body, and whether he was in a state of perspiration; 5. The height from which he fell, and whether his head plunged foremost; 6. Depth of the water; whether it was cold or warm, sea, or river water, and how he was dressed. Lastly, 7. The manner in which he was taken out, whether by the legs, and without receiving any injury, or by instruments; and whether he was rolled about in a tub, or what other methods were pursued for his restoration.
Few improvements appear to have been made in the treatment of the drowned, since this important branch of medical science was first discussed, in a popular manner, by the late Dr. Tissot; yet the names of Cullen, Goodwyn, Cogan, Hawes, and Coleman, in Britain, as well as those of Unzer, Reimarus, and Struve, in Germany, deserve to be respectfully mentioned: from their various publications, and especially of the two last mentioned, we shall briefly state the principal rules of conduct to be observed, with respect to persons in that deplorable situation.
Symptoms of Apparent Death by Drowning.—Coldness; paleness of the whole body; the lips of a livid hue; the mouth either open or firmly closed; the tongue blue, swelled and protruded; the eye-lids closed, the eyes turned, and their pupils dilated; the face swelled and blue; the lower belly hard and inflated. The first signs of returning animation are, convulsive starting of the muscles of the face, or feet; motion of the eye-lids; a spasmodic shivering of the body.
Treatment.—1. After having been carefully taken out of the water by the arms, so as to prevent the least injury to the head and breast, the body ought to he carried to the nearest house (if possible, in a bier, as represented in the Plate, which is described p. 191), with the head somewhat raised; or, in fine warm weather, the resuscitative process may with more advantage be performed in the open air, especially in sun-shine.
2. When the subject is deposited, the upper part of the body should be supported half-sitting, with the head inclining towards the right side.
3. The clothes are to be taken off without delay, but with the greatest
