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 |   Related post: PRINCE: RESUSCITAriON IN SUSPENDED ANIMATION. 203 pharyngeal space will simultaneously be increased while raising the epiglottis. The next cardinal indication after extending the head is the stimulation of i-espiration and circulation. Regarding the method to be pursued at this juncture there is a difference of opinion. The majority of the refer- ences on the subject indicate a preference of the Sylvester method over that of Marshall Hall. In the decision of this question it is to be borne in mind that death from chloro- form may be occasioned either by the arrest of pulmonary or cardiac action. It is likewise admitted that it is seldom known in the emergency which is the primary failure, hence it would seem rational to prefer the method which had the greatest likelihood of simultaneously stimulating the action of both organs. It is believed by the author that tlie Sylvester method of raising the arms and thus expanding the chest through the action of the pectoral muscles is cal- culated to secure the admission of the greatest amount of air to the lungs ; but, while this is the case, it is the con- viction that the rolling method of Marshall Hall, which throws every member into motion and enables the weight of the patients as well as that of an attendant to be ren- dered efficient in the expulsion of the blood from the heart, combines in a superior manner the double advantage of a stimulant to the circulation at the same time that it secures the continuance of respiration. The opinion is therefore urged that when the body is in a horizontal posture, with the head extended, and the patient is threatened with sus- pended animation, the first thing to be done is to roll him in a vigorous manner, not to exceed once in two seconds. Should audible respiration not follow after a few rota- tions of the body, the next cardinal indication urges itself upon us — viz., secure cerebral vascular dilatation in the simplest manner and in the shortest possible time. This indication is based on the fact that chloroform causes a contraction of the cerebral vessels, to overcome which there are but two practicable means — viz., the inhalation of nitrite of amyl, and the inversion of the body. It might be urged that the guide for practice in a des- perate case should be the guide in all cases. In a desperate case the absence of respiration (except that of an aitificial character), and the delay which would often occur in pro- curing the drug, would militate against the amyl in favor of the mechanical method of inversion. So far as my information goes, Nelaton was the first to perform the experiment of restoring functional action after the suspension of animation by inversion of the body. A number of mice were rendered comatose, and, after waiting for a time, every alternate one was taken by the tail and swung in the air, thus forcing the blood to the brain by centrifugal motion. It was observed that those not so treated died, while most of the others survived. This ex- periment became the basis of practice in his critical cases. In the event of failure to restore animation by artificial respiration in the horizontal posture, he resorted to susj)en- sion of the body head downward, and while in this postuie practiced the Sylvester method of artificial respiration. This method has not been extensively published, and has not been practiced to any great extent in this country. but an account given by Sims of a case of impending death in a clinic of Nelaton's, in Paris, led me to resort to a modi- fication of the method for the first time in the following- case : On December 10, 1890, I administered chioroforni to a lad fourteen years old, tor the purpose ot cauterizing a chronic ul- cer. The boy was vigorous and healthy imd took tlie anicstlietic kindly, and all was effected witliout a ripple of ditficulty. While the dressing was being applied and after the eliloroform had been entirely removed, he suddenly ceased to breathe. 1 liad seen arrest Buy Lady Era of respiration many times in niy experience and that of my father, and simply i)roceeded to roll the piitient according to the method of Marshall Hall. I rolled him for sev- eral minutes, how inany I can not tell, to no ettect. Still I rolled. I dared not change this for any expedient in which 1 had less faith, so I continued to an unknown period, while the hands became cold and the lips purple. I was filled with a painful realization that unless something radically different was done in a very few minutes, a dead hoy would be on my hands. Sims's account of N61aton's method suddenly entered my mind, and in a moment the boy's ankles were in my grasp, and a moment later his knees were flexed over my shoulders and his head and arras were dangling toward Lady Era Tablets the floor. Without stopping for classical preparation, he was subjected to a double-quick motion around tiie operating room, and after about three minutes my ears experienced the welcome sounds of restored respiration. At first air was heard to enter at con- siderable intervals, w^hich became shorter until it was deemed safe to place the child again on the table. No sooner was this done than the breathing again became arrested, and a resort was a second time had to the suspension, which was followed very soon again by restored respiration. Related links: generic celexa, Thyroxine Cost, 2.5 Benzoyl Peroxide Gel Products, Voltaren Gel Uk, zithromax over the counter, seroquel 25 mg high, Buy Zithromax No Prescription Needed, fha purchase renovation loan, Seroquel 50 Mg, Aldactone Tablets
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