Artificial respiration

“ Had artificial respiration been now stopped the heart would have ceased to beat almost at once."
At noon the next day the dog appeared as if it would recover. "The eyes had lost the glazed appearance, lachrymation was restored, and there were winking of the lids on dropping water into the eye, attempts at deglutition when water was put into the mouth, and the heart was beating vigorously."
As artificial respiration must be kept up for hours, or even for days, Dr. Fayrer recommends the use of a special apparatus for this purpose, to be worked by steam. ”

“ Slow rhythmic artificial respiratory movements are a useful adjunct, and unless the operator is very skillful in gauging the alternate pressures and releases with the thumb according to the oxygen pressure, it is vitally necessary to fill and deflate the lungs rhythmically by one of the well known methods of artificial respiration. ”

“ These experiments all tend to show that by far the most efficient method of performing artificial respiration is that of intermittent pressure upon the lower ribs with the subject in the prone position or face downward. It is also the easiest to perform, requiring practically no exertion, as the weight of the operator’s body produces the effect, and the swinging forwards and backwards of the body some thirteen times a minute, which alone is required, is by no means fatiguing, and has the further great advantage that it can be effectively carried out by one person. ”

“ Should we have the ill-fortune to be half-drowned, suffocated by unwholesome gases or vitiated air, or to fall down in a fit, Dr Woillez is ready with his new apparatus for artificial respiration. The patient's person, all but the head, is placed in a cylinder of iron, from which one stroke of a powerful pump extracts the air; the lungs and chest of the sufferer expanding as the vacuum is formed. ”

“ Apply warmth and rubbing, and when he is conscious give him hot water, coffee, or lemonade. Artificial breathing is of greatest consequence. Do not give up. Many persons have been resuscitated after many hours of incessant labor. Artificial respiration may be performed in the following way:
First—Immediately loosen the clothing about the neck and chest, exposing them to the wind, except in very severe weather. Get the water out of the body, first by tickling throat with a feather, or applying ammonia to the nose ”

“ By some it has been argued that it is better that the foul air should pass off below the level of the person, so that the products of respiration may be immediately drawn below the mouth, and be replaced by descending pure air. But the resistance to be overcome in drawing down the hot air of respiration is so great that there is a considerable waste of power, and the obstacle to the discharge is sometimes sufficient, if the extracting power be at all lessened, to reverse the movement. ”

“ In the above cases, death often may be prevented by prompt recourse to artificial respiration. To accomplish this, place the patient on his back with the head lower than the body; grasp the arms near the elbows and draw them upward and outward until they are stretched above the head, on a line with the body. By this means the chest cavity is enlarged and an inspiration produced. To produce an expiration, carry the arms downward, and press them against the chest, thus forcing the air out of the lungs. ”

“ Whilst one person is carrying out artificial respiration in this way, others may, if there be opportunity, busy themselves with applying hot flannels to the body and limbs, and hot bottles to the feet, but no attempt should be made to remove the wet clothing or to give any restoratives by the mouth until natural breathing has recommenced. ”

“ Some blow fresh air into one of the nostrils by means of bellows, while the other nostril and the mouth are kept firmly closed. But, as far as my experience goes, by this treatment the air is much more likely to get into the stomach than into the lungs. If it is necessary to induce artificial respiration, it is better to alternately press the arms of the patient firmly to his chest and then to raise them above his body, or, what is even more simple, squeeze together every two or three seconds both chest and abdomen with the hands. ”

“ The unexpanded lungs are brownish-red, firm in consistence and distinctly lobulated. Air-containing lung floats in water and crepitates, and gives off bubbles when cut beneath the water. Attempts at artificial respiration may draw some air into the lungs. Gas-bubbles may be produced by decomposition. In white pneumonia the lung is pale, grayish-white and airless. The larynx, trachea and bronchi are to be examined for presence of mucus, [Pg 185] amniotic fluid, meconium, foreign substances, etc. ”

“ The first rule, therefore, to be laid down in reference to perfect ventilation, prescribes the entire removal of the whole stratum of air tainted in a room by each respiration; for by no less a movement do we conceive it possible to take away the polluted air. This removal must be effected no less than twenty times per minute. Part of the expired air being rarefied by the heat of the lungs will rise, and part—the carbonic-acid gas—will fall. ”

“ I base my hopes upon the chance that the lungs and heart will automatically resume their functions, being in their most perfect medium. But if air were admitted before the bodily machine had become, so to say, synchronized, the swarm of micro-organisms would make short work of our subject. Besides, the hasty respiration produced by this rush of air would produce immediate death by its transformation into carbon dioxide. ”

“ These different modifications, in the respiratory organs of the higher and lower orders of animals, are all formed with the same intention, viz. that the blood may be exposed more or less to atmospherical air. In consequence of this the blood undergoes a process similar to combustion, which extracts from it a part of its carbon, in the form of carbonic acid, and by this means increases the relative proportion of its remaining elements. The inspired air at the same time is deprived of a part of its oxygen, which is the elastic fluid which commonly supports respiration. ”

“ The supply of oxygen for the purpose is brought to the tissues by the blood, which acquires it in the lungs, and the waste product of combustion, carbon dioxide, is carried off in the same manner. The lungs are, therefore, adapted to take in large quantities of air and to keep up a rapid exchange of oxygen and carbon dioxide in the blood. This process of supplying oxygen to the tissues and of removing carbon dioxide and other waste is ordinarily an involuntary act, though it can be regulated temporarily, and is known as respiration or breathing. ”

“ The quality of the air for breathing has also been much improved by the admixture of a considerable proportion of oxygen with the air supplied, so that one respiration of this oxygenated air is only required where many respirations of non-oxygenated air would be needed. ”

“ As every boy knows, oxygen is the property in the air we breathe that gives us life. Also, every boy knows that physicians and surgeons use pure oxygen stored in iron tanks to restore respiration to the lungs of their patients when breathing has almost stopped. Until the invention of the pulmotor, how ever, this oxygen was simply introduced into the patient's lungs by placing the tube in his mouth and turning on the valve. ”

“ The respiratory, or breathing process, is not instituted for the benefit of man alone, for we find it both in the lower order of animals and in plant life. Nature is very economical in the arrangement of her plans, since the carbonic acid, which is useless to man, is indispensable to the existence of plants, and the oxygen, rejected by them, is appropriated to his use. In the lower order of animals, the respiratory act is similar to that of the higher types, though not so complex; for there are no organs of respiration, as the lungs and gills are called. ”

“ It can readily be seen that the air in the lungs at no time contains the full percentage of oxygen, since one at no time completely exhales the entire amount of air. In this way the residual air loses some of its oxygen and collects carbon dioxide.
Animal life is sustained by the oxygen in the air while the carbon dioxide is essential to plant life. The oxygen is carried into the lungs during the inhalation which is produced by the expression of Innate Intelligence through the organs of respiration. ”

“ Oxygen can be introduced into the chamber itself as need is shown by the tension equalizer.
The ventilating air-current is so adjusted that the air which leaves the chamber is caused to pass through purifiers, where the water-vapor and the carbon dioxide are removed, and then, after being replenished with fresh oxygen, it is returned to the chamber ready for use. The general scheme of the respiration apparatus is shown in fig. 27. The air leaving the chamber contains carbon dioxide and water-vapor and the original amount of nitrogen and is somewhat deficient in oxygen. ”

“ Certainly, if any one would draw breath out of one bag, and discharge the tainted air from his lungs into another, he would always breathe good air. But it is calculated that a man will taint and render unwholesome by mixture 17,500 cubic feet of air in the twenty-four hours; for every respiration not only robs the imbibed 24 cubic inches of a certain portion of its oxygen, but it has mixed with it a quantity of carbonic-acid gas and some vapor; and theoretically, at least, the second respiration, drawn from a room in which the air is stagnant, begins the process of blood-poisoning. ”

“ It is, however, known by experiments on animals that if the inhalation be prolonged beyond the period necessary to produce these effects, the respiratory functions are interfered with by the insensibility extending to the nerves on which they depend. The breathing of an animal thus treated becomes irregular, feeble, or laborious, and death ensues. However nearly dead from inhalation of ether vapour the animal may be, provided respiration has not actually ceased, it always recovers when allowed to breathe fresh air. ”

“ As the man continued to breathe, however, each measure of air returning from the lungs would serve to pollute that abiding in the room, until at last the whole mass would become cloudy and discoloured, and we should see such a change as occurs when water is turned from a pure and clear state into a muddy condition. The air does become polluted with each respiration, and although it is colourless, it is as impure as if with every breath given off from the lungs it became of a dark colour in proportion to its impurity. ”

“ Nearly one-third of the excretions of the body are eliminated through the lungs. The average adult contaminates about five thousand cubic inches of air with every breath. The importance of having an abundant supply of pure air at all times is obvious.
In ordinary respiration an adult abstracts sixteen cubic feet of oxygen from the atmosphere every twenty-four hours, and adds to it fourteen cubic feet of carbonic acid in the same time. ”

“ In a great variety of cases I have observed that there is a remarkable diminution of common, or respirable air, in proportion to which it is always rendered unfit for respiration, indisposed to effervesce with nitrous air, and incapable of farther diminution from any other cause. ”

“ There the blood is separated from the air by a membrane so delicate that gases can readily pass through it; and, hence, on leaving the lungs the blood has got rid of the waste carbon dioxide, and its red corpuscles are laden with fresh oxygen. This exchange of useless carbon dioxide for oxygen constitutes respiration or breathing.
The mechanism of respiration.—In active animals the air inside the lungs soon becomes vitiated, unless there is some means of changing it. Under ordinary conditions a man changes the air in his lungs from thirteen to fifteen times a minute. ”

“ If the room is occupied by one or more individuals, however, then the air in the room soon deteriorates, until the impurities therein reach a certain degree incompatible with health. This is due to the fact that with each breath a certain quantity of CO2, organic impurities, and aqueous vapor is exhaled; and these products of respiration soon surcharge the air until it is rendered impure and unfit for breathing. In order to render the air pure in such a room, and make life possible, it is necessary to change the air by withdrawing the impure, and substituting pure air from the outside. ”

“ Inasmuch as the gaseous interchange between the lungs and the blood takes place only in the terminal air sacs it follows that, at the end of each respiration, the rest of the respiratory tract is filled with air low in oxygen and high in carbon dioxide, which on inspiration is drawn back into the lungs, diluting the fresh air. ”

“ The lungs in their natural state are charged with a large quantity of impure air; this being a portion of the carbonic acid gas which is formed during respiration, but which, after each expiration, remains lodged in the involved passages of the pulmonary tubes. By breathing hard for a short time, as a person does after violent exercise, this impure air is expelled, and its place is supplied by pure atmospheric air, by which a person will be enabled to hold his breath much longer than without such precaution. ”

“ The mode of death from the inhalation of carbonic oxide, and, correlatively, the method of avoiding or preventing death from inhalation, have been made known only through vivisection. So also "all that we know in hygiene of the quantity of air necessary to support life is the result of experiments on dogs and rabbits. Sometimes a precise knowledge of the conditions of respiration has served to prevent men from perishing." ”

“ A slight abnormal accumulation of this gas in the air cells of the lungs would check this outward leakage or expulsion of waste products and retard regeneration of the blood, but respiration automatically regulates this function. Exhausted air, with deficiency in oxygen and excess of carbonic acid, to sustain equal force, thus requires increased respiration, an unconscious effort, gradually lapsing as the gathering waste products react upon the blood and through it upon vitality. The weakened light of a candle flame in exhausted room air very aptly illustrates also its effect on human beings. ”