An inquiry into the phenomena attending death by drowning and the means of promoting resuscitation in the apparently drowned : report of a committee appointed by the Royal Medical and Chirurgical Society.

  • Royal Medical and Chirurgical Society of London
Date:
1904
Catalogue details

Licence: In copyright

Credit: An inquiry into the phenomena attending death by drowning and the means of promoting resuscitation in the apparently drowned : report of a committee appointed by the Royal Medical and Chirurgical Society. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    liminaiy inhibition—deep and convulsive, becoming after- wards gradually quieter and shallower, cease, so that the heart- and blood-pressure are maintained longer than the respiration. If artificial respiration is now begun such cases often rapidly recover. In other cases the heart ceases along with the respiration, and in yet others the heart stops first and respirations proceed for a time after the heart has ceased and the blood-pressure is at zero. The heart ^failure is probably the result of the pai-alytic action of the blood surcharged with CO^ u]3on the rhythmic function of the heart-muscle.^ The differences of result observed may have to do with the character and amount of the aniesthetic used, or they may depend on individual idiosyncrasies, or upon the physiological condition of the nerve-centres and of the heart at the moment of immersion. In any case they would be likely also to show themselves in cases of drowning in the human subject—at least, in so far as they are independent of ansesthetics. Since one of the most marked ultimates ymptoms of death by asphyxia from drowning—as by other forms of asphyxia—is the extreme lowering of blood-pressure owing to paralysis of the vaso-motor system, it was hoped that such a drug as supra-renal extract might, by antagonising this symptom, produce, in association with artificial respira- tion, rapid recovery; the more so because this drug is known also to increase the force and rate of the heart's action. But it is obvious that it would only act if there were some sort of circulation going on to promote its absorption and to carry it to the peripheral vessels ; and even then it could only produce permanent benefit if the artificial respirations were efliciently promoting the aera- tion of the blood, since as long as the venous condition of the blood continues the paralysis of the vessels and heart could not be more than quite temporarily relieved. This IS, in fact, what is found to occur, for in cases in which owmg to froth m the bronchi, the diffusion of the ' Richet (' Arch, cle physiol./ 1894) infers that a specific cardiac poison IS produced in asphyxia. caimac