THE NEW ZEALAND GAZETTE.
449

For the District of Roslin, Messrs. William Johnston
and Thomas Swale.
For the District of Waihopai, Messrs. Jabez Hay and
James Wilson.
For the District of New River, Harry Armstrong,
Esq,
have been duly elected.

FRED. A. WELD.

Instructions respecting the Treatment of the Apparently
Drowned.

Colonial Secretary's Office,
Auckland, 5th December, 1864.

THE following Instructions respecting the Treat-
ment of the apparently drowned, received from
the Royal National Life Boat Association, are pub-
lished for general information.

FRED. A. WELD.

DIRECTIONS FOR RESTORING THE
APPARENTLY DROWNED.

THE leading principles of the following directions for
the restoration of the apparently dead from drowning
are founded on those of the late Dr. Marshall Hall,
combined with those of Dr. H. R. Silvester, and are
the result of extensive inquiries which were made by
the Institution in 1863-4 amongst medical men,
medical bodies, and coroners throughout the United
Kingdom. These directions have been extensively
circulated by the Institution throughout the United
Kingdom and in the Colonies. They are also in use
in Her Majesty's fleet and in the Coast-guard
Service.

I.

Send immediately for medical assistance, blankets,
and dry clothing, but proceed to treat the patient
instantly on the spot, in the open air, with the face
downwards, whether on shore or afloat; exposing the
face, neck, and chest to the wind, except in severe
weather, and removing all tight clothing from the
neck and chest, especially the braces.

The points to be aimed at are—first and imme-
diately, the restoration of breathing; and secondly,
after breathing is restored, the promotion of warmth
and circulation.

The efforts to restore breathing must be commenced
immediately and energetically, and persevered in for
one or two hours, or until a medical man has pro-
nounced that life is extinct. Efforts to promote
warmth and circulation beyond removing the wet
clothes and drying the skin must not be made until
the first appearance of natural breathing. For if
circulation of the blood be induced before breathing
has recommenced, the restoration to life will be
endangered.

II. TO RESTORE BREATHING.

To clear the throat—Place the patient on the floor
or ground with the face downwards, and one of the
arms under the forehead, in which position all fluids
will more readily escape by the mouth, and the
tongue itself will fall forward, leaving the entrance
into the windpipe free. Assist this operation by
wiping and cleansing the mouth.

If satisfactory breathing commences, use the treat-
ment described below to promote warmth. If there
be only slight breathing—or no breathing, or if the
breathing fail, then—

To excite Breathing—Turn the patient well and
instantly on the side, supporting the head and
Excite the nostrils with snuff, hartshorn, and
smelling salts, or tickle the throat with a feather,
&c., if they are at hand. Rub the chest and face
warm, and dash cold water, or cold and hot water
alternately, on them.

If there be no success, lose not a moment, but
instantly.

To imitate Breathing—Replace the patient on the
face, raising and supporting the chest well on a
folded coat or other article of dress.

Turn the body very gently on the side and a little
beyond, and then briskly on the face, back again;
repeating these measures cautiously, efficiently, and
perseveringly, about fifteen times in the minute, or
once every four or five seconds, occasionally varying
the side.

[By placing the patient on the chest, the weight of
the body forces the air out: when turned on the side,
this pressure is removed, and air enters the chest.]

On each occasion that the body is replaced on the
face, make uniform but efficient pressure with brisk
movement, on the back between and below the
shoulder-blades or bones on each side, removing the
pressure immediately before turning the body on the
side. During the whole of the operations let one
person attend solely to the movements of the head,
and of the arm placed under it.

[The first measure increases the expiration, the second
commences inspiration.]

*** The result is respiration or natural breathing:
and if not too late, life.

Whilst the above operations are being proceeded
with, dry the hands and feet; and as soon as dry
clothing or blankets can be procured, strip the body
and cover, or gradually reclothe it, but taking care
not to interfere with the efforts to restore breathing.

III.

Should these efforts not prove successful in the
course of from two to five minutes, proceed to imitate
breathing by Dr. Silvester's method, as follows :—

Place the Patient on the back on a flat surface,
inclined a little upwards from the feet; raise and
support the head and shoulders on a small firm
cushion or folded article of dress placed under the
shoulder-blades.

Draw forward the patient's tongue, and keep it
projecting beyond the lips; an elastic band over the
tongue and under the chin will answer this purpose,
or a piece of string or tape may be tied round them,
or by raising the lower jaw, the teeth may be made
to retain the tongue in that position. Remove all
tight clothing from about the neck and chest, espe-
cially the braces.

To Imitate the Movements of Breathing.—Standing
at the patient's head, grasp the arms just above the
elbows, and draw the arms gently and steadily up-
wards above the head, and keep them stretched up-
wards for two seconds. (By this means air is drawn
into the lungs.) Then turn down the patient's arms,
and press them gently and firmly for two seconds
against the sides of the chest. (By this means air is
pressed out of the lungs.)

Repeat these measures alternately, deliberately,
and perseveringly, about fifteen times in a minute,
until a spontaneous effort to respire is perceived,
immediately upon which cease to imitate the move-
ments of breathing, and proceed to induce Circulation
and Warmth.

IV. TREATMENT AFTER NATURAL BREATHING HAS
BEEN RESTORED.

To promote Warmth and Circulation.—Commence
rubbing the limbs upwards, with firm grasping pres-
sure and energy, using handkerchiefs, flannels, &c.
(By this measure the blood is propelled along the veins
towards the heart.)

The friction must be continued under the blanket
or over the dry clothing.

Promote the warmth of the body by the applica-
tion of hot flannels, bottles, or bladders of hot water,
heated bricks, &c., to the pit of the stomach, the arm
pits, between the thighs, and to the soles of the feet.