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Fig. 3.

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. (See Figs. 3 and 4.) Repeat these measures alternately, deliberately, and perseveringly, about fifteen times in a minute, until a sponta

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 upwards above the head, and keep them stretched upwards for two seconds. By this means air is drawn into the lungs. Then turn down

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Fig. 4.

Treatment after Natural Breathing has been Restored. To Promote Warmth and Circulation.

Wrap the patient in dry blankets; commence rubbing the limbs upwards, with firm grasping pressure and energy, using handkerchiefs, flannels, etc. By this measure the blood is propelled along the veins towards the heart. The

neous effort to respire is perceived, immediately upon which cease to imitate the movements of breathing, and proceed to induce circulation and warmth.

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friction must be continued under the blanket 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 pit of the stomach, the armpits, between the thighs, and to the soles of the feet. If the patient has been carried to a house after respiration has been restored, be careful to let the air play freely about the room.

On the restoration of life, a teaspoonful of warm water should be given; and then, if the power of swallowing have returned, small quantities of wine, warm brandy and water, or coffee, should be administered. The patient should be kept in bed, and a disposition to sleep encour aged.

The above treatment should be persevered in for some hours, as it is an erroneous opinion that persons are irrecoverable because life does not soon make its appearance, persons having been restored after persevering for many


The appearances which generally accompany death are entire cessation of breathing and of the heart's action; the eyelids are generally half closed; the pupils dilated; the jaws clenched; the fingers semi-contracted; the tongue approaches to the under edges of the lips, and these, as well as the nostrils, are covered with a frothy mucus; coldness and pallor of surface increase.


The employment of this class of agents has become so much more general in recent times, that it is deemed desirable and expedient here to embody some of the practical conclusions arrived at by scientific and other authorities on the subject. A knowledge of the means of prevention of the spread of malignant or infectious disease in communities is undoubtedly of greater importance than their cure in individual cases.

The Principles of Disinfection.'

Fresh air and pure water, constant ventilation, warm clothing, good food, and thorough cleansing, are natural means of preventing and destroying the causes of infection and disease. But there may be infected or foul places and things, and there are times of special necessity or sudden danger from the presence of infectious epidemic disease, which require the instant arrest or destruction of the infection and all its removable causes; this is disinfection. The clothing from persons with smallpox, scarlatina, or typhus, and even the air in the sick-rooms of such patients, is infectious; and the sick with typhoid fever or cholera discharge excremental matters which possess infective properties that should be immediately destroyed.

1 The valuable recommendations contained in the following pages, many of which are almost inaccessible to the general practitioner through any other channel than that now offered, have been carefully collated from the admirable chapter on the subject in the Annual Report of the Board of Health of New York for 1873, and from other trustworthy sources, with numerous additions by the author.

In this memorandum the words infection and disinfection are employed just as they are understood, as referring to the preventable causes that are concerned in repropagating specific kinds of disease; these causes are:

1. The specific infectious property or contagious substance of any one of the pestilential disorders.

2. The local impurities and moisture in the house and grounds where the outbreaks of disease have occurred or are liable to occur.

3. The foul exhalations and atmospheric impurities which injure health or help to propagate pestilential epidemics.

Experience has proved that it is possible, by certain chemical agencies (such as are or will be hereafter described), wholly to destroy or prevent the operation of the specific infecțion or contagion of any disease; but to do this, it is necessary that precise rules should be observed in applying the disinfectants; and, as regards cholera and typhoid fever, it is especially important that the infective discharges from the sick should be disinfected as soon as voided from the body, and that whatever clothing or surfaces may have been soiled by such discharges should be disinfected as soon as practicable. The fact should also be borne in mind by all persons who have charge of infected things, that the infective property or virus of some diseases, and of cholera especially, is capable of rapid increase in filthy places and in a foul, damp atmosphere. Therefore, the cleansing and disinfection of such places should, if possible, precede the arrival or outbreak of any such pestilence. Every unclean and damp place about dwelling houses, warehouses, factories, places of assem blage, passenger vessels, railway depots, and hotels, should be made and kept perfectly clean and dry. All drains, necessaries, and water-closets, should be kept as clean as

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