The Treatment to Restore Natural Breathing
and Circulation

-  Peter Shepherd, M.B. "Surgeon Major," Army Medical Department Associate of the Order of St. John of Jerusalem

Rule 1 - "To Maintain a Free Entrance of Air into the Windpipe - Cleanse the mouth and nostrils; open the mouth; draw forward the patient's tongue, and keep it forward: an elastic band over the tongue and chin will answer the purpose. Remove all tight clothing from about the neck and chest."

Rule 2 - "To Adjust the Patient's 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 or folded article of dress under the shoulder blades."

Rule 3: Dr. Shepherd goes on to describe the method of manual artificial respiration developed by Dr. H.R. Sylvester.  To wit:

The procedure should be done "deliberately and perserveringly, fifteen times a minute, until spontaneous effort to respire is perceived, immediately upon which, cease to imitate breathing and proceed to INDUCE CIRCULATION AND WARMTH."

"Should a warm bath be procurable, the body may be placed in it up to the neck, continued to imitate breathing. Raise the body for twenty seconds in a sitting position, dash cold water against the chest and face, and pass ammonia under the nose. The patient should not be kept in a warm bath for longer than five to six minutes."

Rule 4 - "To Excite Inspiration - During the employment of the above method excite the nostrils with snuff or smelling salts, tickle the throat with a feather. Rub the chest and face briskly, and dash cold and hot water alternately on them."

Rule 5 - "To Induce Circulation and Warmth - Wrap the patient in dry blankets and commence rubbing the limbs upwards firmly and energetically. The friction must be continued under the blankets or over the dry clothing. Promote the warmth of the body by the application of hot flannels, bottles or bladders of hot water, heated bricks etc., to the armpits, the pit of the stomach, between the thighs and the soles of the feet."

"On the restoration of life, when the power of swallowing has returned, a teaspoon of warm water, small quantities wine, warm brandy and water, or coffee should be given. The patient should be kept in bed and a disposition to sleep encouraged. During reaction, large mustard plasters to the chest and below the shoulders will greatly relieve the distressed breathing."

      - First Published in 1878