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breaking out, as they often do, miles, perhaps hundreds of miles, from where any case ever occurred, unless we suppose that germs have been conveyed there by winds, by storm clouds, or currents of air, to await, in a dormant condition, the quickening influences of suitable environments? How can their causative effect to produce disease be so closely associated with polluted water and not with water organically pure, unless polluted water is a culture fluid, not only to vitalize one germ but to nourish its multiplied millions, and unless the probability of becoming inoculated is greater from drinking a thousand disease germs than from drinking one?
If a man should remove the body of a rat just drowned in his well, would he not most easily prevent pollution of the water ? Grant, then, that no possible kind of filtration can remove bacteria, but what if they should be prevented? There are evidently two cases connected with the subject of germs and water : one where the water supply simply conveys the germ, the other where it is both a culture fluid and a vehicle. Therefore, whatever removes or destroys organic matter in water not only prevents the increase of poison from further decay, but also retards the multiplication of germs by removing their pabulum. An ounce of prevention is better than a ton of cure.
TREATMENT OF THE DROWNED.*
ISSUED BY THE NEW HAMPSHIRE STATE BOARD OF HEALTH.
The numerous cases of accidental and suicidal deaths by drowning during every month in the year, and especially the accidental during the winter months occasioned by treacherous ice and unwisely daring individuals, seem to call for the promul. gation of some methods, simple in practice and easily understood by every intelligent person, when carefully studied, by which many individuals might be saved from death every year.
There are several ways of accomplishing the resuscitation of the drowned, the same principle and object governing all, that is, the restoration of respiration, or breathing, and the normal warmth of the body. The methods herewith presented are quite as effectual as any.
Two things to be done : Restore breathing; restore animal heat.
• The cuts which illutrate this article, as well as a large part of the latter, were first presented by the Michigan State Board of Health several years ago. The Rhode Island State Board of Health has recently published the article here given, and through the courtesy of that board the cuts are furnished.
Rule 1. Remove all obstructions to breathing. Instantly loosen or cut apart all neck or waist bands; turn the patient on his face, with his head down hill; stand astride the hips with your face toward his head, and, locking your fingers together under his belly, raise the body as high as you can without lifting the forehead off the ground (Fig. 1), and give the body a smart jerk to remove mucous from the throat and water from the windpipe; hold the body suspended long enough to slowly count one, two, three, four, five, — repeating the jerk more gently two or three times.
Rule 2. Place the patient face downward and, maintaining all the while your position astride the body, grasp the points of the shoulders by the clothing, or, if the body is naked, thrust your fingers into the armpits, clasping your thumbs over the points of the shoulders, and raise the chest as high as you can (Fig. 2) without lifting the head quite off the ground, and hold it long enough to slowly count one, two, three. Replace him on the ground with his forehead on his flexed arm, the neck straightened out, and the mouth and nose free. Place your elbows against your knees, and your hands upon the sides of his chest (Fig. 3) over the lower ribs, and press downward and inward with increasing force long enough to slowly count one, two. Then suddenly let go, grasp the shoulders as before and raise the chest (Fig. 2); then press upon the ribs, etc. (Fig. 3). These alternate movements should be repeated ten to fifteen times a minute for an hour at least, unless breathing is restored sooner. Use the same regularity as in natural breathing.
Rule 3. After breathing has commenced, restore the animal heat. Wrap him in warm blankets, apply bottles of hot water, hot bricks, or anything to restore heat. Warm the head nearly as fast as the body, lest convulsions come on. Rubbing the body with warm cloths or the hand, and slapping the fleshy parts may assist to restore warmth and the breathing also. If the patient can surely swallow, give hot coffee, tea, milk, or a little hot sling. Give spirits sparingly, lest they produce depression. Place the patient in a warm bed, and give him plenty of fresh air ; keep him quiet.
BEWARE! Avoid delay! A moment may turn the scale for life or death. Dry ground, shelter, warmth, stimulants, etc., at this moment are nothing; artificial breathing is everything, is the one remedy, all others are secondary.
BE PROMPT ! Do not stop to remove wet clothing before efforts are made to restore breathing. Precious time is wasted, and the patient may be fatally chilled by exposure of the naked body, even in summer. Give all your attention and effort to restore breathing by forcing air into, and out of the lungs. If the breathing has just ceased, a smart slap on the face or a vigorous twist of the hair will sometimes start it again, and may be tried incidentally, as · may, also, pressing the finger upon the root of the tongue.
Before natural breathing is fully restored, do not let the patient lie on his back unless some person holds the tongue forward. The tongue by falling back may close the windpipe and cause fatal choking.
If several persons are present, one may hold the head steady, keeping the neck nearly straight ; others may remove wet clothing, replacing at once with clothing which is dry and warm ; they may also chafe the limbs, and thus promote the circulation.
Prevent friends from crowding around the patient and excluding fresh air ; also from trying to give stimulants before the patient can swallow. The first causes suffocation; the second fatal choking.
Do not give up too soon. You are working for life. Any time within two hours you may be on the very threshold of success without there being any sign of it.
In suffocation by smoke or any poisonous gas, as also by hanging, proceed the same as for drowning, omitting effort to expel water, etc., from the air passages.
In suspended breathing from effects of chloroform, hydrate of chloral, etc., proceed by Rule 2, taking special pains to keep the head very low, and preventing closure of the windpipe by the tongue falling back. Grasp the tongue between the forefinger and thumb, draw forward and hold.
PERSISTENT EFFORTS TO RESUSCITATE THE DROWNED. Prof. C. R. Kedzie, ex-president of the Michigan State Board of Health, says in relation to the foregoing article, and in urging persistence of efforts to resuscitate the drowned :
“ This bulletin has been widely distributed, and it has been republished by many papers in our State. It has been adopted by many other state boards of health and by city boards of health. It has secured a wide dissemination in our country. How much good has thereby been secured, it is impossible for me to state; but I have good reason to fear that life is often sacrificed because energetic efforts at resuscitation are abandoned too soon. I desire once more to urge upon the public the duty of