coal trade bulletin - Clpdigital.org

46 THE COAL TRADE BULLETIN.
COMMISSION ON RESUSCITATION FROM ELECTRIC SHOCK
RECOMMENDS MELTZER APPARATUS
The older rules for artificial respiration, which
were widely posted in this country, described
the Silvester method, a method which directs
that the victim of the accident be laid on his
back, and his chest expanded and compressed by
drawing his arms forward and then pushing them
back against his ribs. After these rules were
published, however, a new method of artificial
respiration was devised by Sir E. A. Schafer, of
Edinburgh, called by him the "prone pressure
method." It consists in laying the victim on his
belly and applying pressure rhythmically on the
loins and lowest ribs.
Since there was some difference of opinion regarding
the relative merits of these two methods
of artificial respiration, and since the time seemed
ripe for a revision of the old rules and for a
possible standardization of new rules for resuscitation,
President Gilchrist, of the National
Electric Light Association, requested that the
American Medical Association and the American
Institute of Electrical Engineers co-operate with
his own Association in this undertaking. Through
the appointment of representatives of these Associations
a Commission on Resuscitation from
Electric Shock was organized in the autumn of
1911, with the following membership:
For the American Medical Association, Dr. XV.
B. Cannon (chairman). Professor of Physiology,
Harvard University; Dr. George W. Crile, Professor
of Surgery, Western Reserve University;
Dr. Yandell Henderson, Professor of Physiology,
Yale University; ancl Dr. S. J. Meltzer, head of
the department of Physiology and Pharmacology
in the Rockefeller Institute for Medical Research.
For the National Electric Light Association,
Dr. E. A. Spitzka, Director and Professor
of General Anatomy, Daniel Baugh, Institute of
Anatomy, Jefferson Medical College, and Mr. Wm.
C. L. Eglin, Past-President of the National Electric
Light Association. For the American Institute
of Electrical Engineers, Dr. A. E. Kennelly,
Professor of Electrical Engineering, Harvard
University, and Dr. Elihu Thomson, Electrician,
General Electric Company. Mr. XX. D. Weaver,
editor of the "Electrical World," was elected
Secretary of the Commission.
The Commission was confronted with three
problems: (1) The determination of the best
manual method of artificial respiration that can
be instantly applied by laymen, and the clear
description of that method; 12) a consideration
of special mechanical appliances for continuing
*The Commission read its report before the National Electric
Light Association Convention, Chicago, June. 1913.
artificial respiration, and the possible invention
of a simple and effective arrangement the action
of which might be quickly and easily learned;
(3) an investigation of the possibilities of restoring
the fibrillating heart to its natural pulsation.
The third of these problems has not been
solved, and possibly, because of the sensitiveness
of important nerve cells of the brain to lack of
blood supply, a sensitiveness which results in
abolition of their functions wdien deprived of
blood for about ten minutes, the solution of the
problem in a manner permitting the life of the
individual to continue may be impracticable.
The advantages of the manual method of artificial
respiration as exemplified by the Schafer
and Sylvester methods are discussed, and the
commission then says:
The foregoing observations indicate that, so far
as the amount of ventilation of the lungs is concerned,
the Schafer method, reinforced by the
extension of the arms forward, is decidedly better
than that suggested by Silvester. Ancl this advantage,
taken in conjunction with its greater
simplicity ancl safety, caused the commission to
vote unanimously in favor of the prone pressure
method of artificial respiration as an effective
means of giving immediate aid.
Mechanical methods of artificial respiration are
then taken up and the Pulmoter and the Dr.
Watt apparatus are thoroughly discussed and
then the report goes on to say:
About a year ago Dr. Meltzer published a brief
communication on pharyngeal insufflation as a
method of artificial respiration. It was based
upon the following considerations. When air is
insufflated into the pharynx it may escape from
there through the nose, the mouth, into the
stomach and into the lungs. In order to have it
enter the lungs the facilities for escape through
the other exits must be prevented or greatly reduced.
The escape through the nose was practically
prevented by the elastic tube in the
pharynx which raised the soft palate and thus
shut off the exit into the nasopharynx. The
escape through the mouth was sufficiently restricted
by applying pressure under the chin.
The evil effects of the entrance of air into the
stomach were met by two methods: In one a
tube was introduced into the stomach; this tube
restricted on the one hand the entrance of air
into the oesophagus, and on the other hand readily
removed the surplus air from the stomach.
In the other method a heavy weight was placed
upon the abdomen, which effectively restricted
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