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 EXPERIMENTAL INQUIRY 
 
 INTO THE 
 
 PROXIMATE CAUSE OF BEAT 
 
 FROM 
 
 SUSPENDED RESPIRATION 
 
 IN 
 
 DROWNING AND HANGING, 
 
 WITH THE MEANS 
 
 OP 
 
 RESUSCITATION. 
 
 Submitted as an inaugural essay to the public examina- 
 tion OF THfi; trustees and professors op the Collegf. 
 OP Physicians and Surgeons in the university of 
 
 THE state op NeW-YORK, 
 
 SABIUEL BARD, M, D. President, 
 
 FOR THE 
 
 DEGREE OF DOCTOR OF MEDICINE, 
 On the 3d of May, 1814. 
 
 BY ANSEL W. IVES, 
 Honorary Member of the American Msculapian Societi/, 
 
 NEW-YORK : PRINTED FOR THE AUTHOR, 
 

 
 
 7. 
 
 M 
 
,*^ 
 
 TO 
 
 VALENTINE MOTT, M. D. 
 
 Professor of the Principles and Practice of Surgery in the Univer- 
 sity of the State of New-York, Corresponding Member of the 
 Medical Society of London^ SfC. SfC. 
 
 This humble Essay- is respectfully inscribed as the only tribute 
 in the Author's power to offer, for private friendship, and profes- 
 sional instructions, which no tribute, however ample, could com- 
 pensate. Y 
 
 That the success of DOCTOR MOTT, in his professional pur- 
 suits may be equal to his inerit, and that the first disposition of 
 bis heart — the desire of doing good to his fellow-men, may be 
 fully gratified, will ever be the first wish of his 
 
 Sincere friend, and 
 
 grateful Pupil. 
 
 ANSEL W, IVES. 
 
N • 
 
TO 
 
 DOCTOR BARTOW WHITE, 
 
 Pkesident op the Dutchess Medical Society, New-Yor^j 
 DOCTOR ELISHA NORTH, 
 
 New London, (conn.) 
 
 AND 
 
 DOCTOR ERASTUS L. HART, 
 
 Goshen, (Conn») 5 
 THIS DISSERTATION 
 
 IS MOBT RESPECTFULLY DEDICATED BY THEIB- 
 GRATEFUL FRIEND AND PUPIL, 
 
 THE AUTHOR, 
 
AN 
 
 EXPERIMENTAL INGIUIRY, &c. 
 
 The investigation of the proximate cause of death in Sus- 
 pended Respiration from Drowning and Hanging, is difficult and 
 ibstruse, as it immediately involves the consideration of the es- 
 sential principles of life. Not to dwell on the incomprehensible 
 connection between mind and matter ; and the mysterious law 
 ly which one operates upon, and vivifies the other ; not to deal 
 1 speculations too deep and refined for the human intellect to 
 ^rasp, let us for a moment, advert to the complexity of the 
 human machine, considered as matter alone. We see a machine 
 operated on by a power which we cannot define cannot exam- 
 ine cannot comprehend. Let us, therefore, dismiss this invisi- 
 ble agent, and confine ourselves solely to that machine. Every 
 part of this curious piece of mechanism is essential to the per- 
 fect operation and unabated energy of the whole : one part in 
 a greater, another part in a lesser degree. But our greatest in- 
 quiry is, what parts are, and what parts are not essential to its 
 operating at all. 
 
 By determining on these, we shall find those principles on which 
 fe most immediately, and in the strictest sense essentially depends ; 
 id of course the cause of those disorders which instantly stop 
 '^ vital action of the Hnmo- r..y;.-. This subiecti*j^r''^>- 
 
( 8 ) 
 
 important, than curious and interesting. In those disordeia of 
 our slender machine which produce their effect slowly, there is 
 time for the Physician, who may be called the human mechan- 
 ist, to study their cause, and to vary his expedients ; but where 
 the vital functions are instantaneously suspended, the effort must 
 he immediate. Stop to consider, and the patient is irrevocably 
 lost. 
 
 Those vital functions upon which life so immediately depends^ 
 were formerly supposed to be the Brain, the Heart, and the 
 Lungs. The Brain was considered as the only source of nervous 
 power ; that is, the only source of motion, and sensation. But 
 many phenomena were found inconsistent with this Theory, as 
 for example, the life which remained in decapitated animals, 
 and in the heart when detached from the body. To obviate this 
 difficulty a fourth power was added by Haller, denominated vis 
 insita, a mysterious principle which no one pretended to under- 
 stand, and which might therefore be made a safe head of refer- 
 ence for every incomprehensible phenomenon. Thus the expla- 
 nations of philosophy are often more unintelligible than the facts 
 she attempts to explain, and when she cannot enlighten, she 
 shrouds her subject in deeper mysteiy. 
 
 In the course of this essay, I shall attempt to show, that there is 
 a fourth vital organ which has been but recently understood ; the 
 functions of which, \\dll explain all the phenomena formerly at- 
 tributed to the vis insiia ; and therefore as there is no longer any 
 need of this mysterious principle, the offspring of Hypothesis, it 
 is, or ought to be exploded. But before I attempt this, it will be 
 necessary briefly to state the Hallerian doctrine. 
 
 Taking it for granted that the Brain was the only source of 
 nervous power, Haller supposed that the nerves and the Spinal 
 Marrow which he considered as a larger nerve, were the agents 
 
( 9 ) 
 by which the brain performed its office. He also supposed that 
 the muscles possessed a contractile pouter, or disposition to con- 
 tract, which he called irritability or vis insita. All animal motion 
 was attributed by him to this contractile power, acted upon by 'a 
 stimulus, the stimulus being dilTerent according to the muscle on 
 which it was to act. Thus he supposed the muscles which are 
 submitted to the control of the will, and therefore called volun- 
 tary muscles, are stimulated to act by the Brain through the 
 medium of the nerves ; but those muscles which contract inde- 
 pendent of the will, do not in any measure depend on the nervous 
 power, as the Heart and Stomach for example, which are suppo- 
 sed to be stimulated by their respective contents, without any aid 
 or agency of the nerves. This Theory accounts in a beautiful 
 manner for the action of those muscles in coma when the will 
 is sleeping on its post. But however ingenious and convenient 
 the theory, it never fully satisfied either Haller or his Disciples- 
 various modifications were introduced and even facts were con- 
 troverted. Difficidties, inexplicable, v/ere involved in the theory 
 itself, and removing one absurdity, only introduced another. It 
 was denied for instance, that the heart possessed any nerves ; and 
 though this removed, the Heart entirely from the influence of the 
 Brain, and gave M up wholly to the vis insita; yet it introduced 
 another absurdity — .that the Heart could be operated upon by the 
 passions, v.dthout the intervention of nerves. 
 
 As the science of Anatomy advanced ; as the distribution and 
 connection of the nerves were better understood ; and the func- 
 tions of the vital organs more clearly defined, difficulties in the 
 way of this doctrine multiplied. 
 
 The medical profession are in the highest degree indebted to 
 
 M. Bichat, for the light he has thrown on this subject. Though 
 
 in his physiological researches, he did not hit upon the novel ideas 
 
 of Le Gallois, his experiments actuallv tended to the same coil' 
 
 B 
 
C 10 ) /. 
 
 elusion, Gontraiy as that concIiiEiou was, to dwn belief. To 
 attempt to overthrow a doctrine so well established and supported 
 by the great body of the profession, required more than ordinary 
 boldness ; yet it found opponents in men distinguished for science 
 and talents. The difficulties which embarrassed it, would, in 
 spite of prejudice, predilection, and the fear of ridicule, force 
 themselves on the mind of the original thinker, and compel him 
 to doubt. As an instance of the dissatisfaction which ingenious^ 
 and reflecting men felt with this theory, an^ of the advances 
 Whith were making to the true hypothesis, I insert the follow- 
 ing extract from a manuscript lecture of Doctor Hosacki de&vered 
 at Columbia College, in this City, 1798: 
 
 After describing the distribution of the nerves, he adds, " see- 
 ing, therefore, this universal distribution of the nerves through the 
 differenft parts of the body— -the means by which the capacity of 
 performing their functions is preserved, and the numerous connec- 
 tions which takes place between the nerves of the various and 
 distant parts of the body, by means of the great sympathetic 
 Derve, and by plexus, we injer the presumpHoUf that they serve 
 the great purpose of supplying the body, not only with sensation, 
 hut motion ; and that the vis insita is unnecessary J&i' this purposed" 
 
 But without multiplying authorities, it will be sufficient, briefly 
 to state, that in 1809, Dr. LeGallois, a distinguished French phy^ 
 siolygist, performed his experiments on the principles of life. He 
 took a path untrodden by former anatomists. The discoverie* 
 which he made, were wonderful, and such as have caused, or will 
 cause, an entire revolution in the theory of the vital functions. 
 
 From all his experiments he deduces the following principles : 
 That the brain is the organ of intelligence, but not as Haller 
 ftupposed of sensation and motion. 
 
( H ) 
 
 That the only part of the brain which is immediately essential 
 io life, is that portion of the medulla oblongata, from which the 
 par-vagunii or eighth pair of nerves arises, via : the Corporfa 
 Olivaria. 
 
 That if this portion of the medulla oblongata be preserved^ 
 life will not be destroyed, though the remainder of the brain be 
 dissected off. 
 
 That this portion of the Brain is essential to life in a two fold 
 capacity. 
 
 1st. As the origin of the eighth pair of nerves, which are dis- 
 tributed to the Heart, the Stomach and the Lungs, and upon which 
 #ie functions of the Lungs exclusively depend ; and, 
 
 2dly. As it gives influence to the nerves which supply the res- 
 piratory muscles. 
 
 That the Medulla Spinalis is the source of sensation and motion, 
 independent of the Brain, and that if artificial respiration be kept 
 Wp in decapitated animals, life will be preserved. 
 
 But as*the Brain is the residence of the intellectual functions, 
 the motions of the body, in this case, will be accidental, and not 
 under the control of the will. 
 
 That the life of every portion of the body depends upon the 
 lierves of a corresponding portion of the Spinal Marrow, and 
 lience if the Spinal Marrow be cut into diflferent sections, each 
 section will be a distinct center of sensation and motion. 
 
 That the Heart receives its principles of life and of power 
 from the Medulla Spinalis, but not like the trunk from a limited 
 portion of itj but from the yvholo 
 
( 13 ) 
 
 Hence if any portion of the Spinal Marrow be destroyed, the 
 force of the Heart will be weakened, but if the whole be destroy- 
 ed, its action will suddenly cease. 
 
 That this influence which the Medulla Spinalis exercises over 
 the Heart, is through the medium of the great sympathetic nerve. 
 
 That as this nerve arises from every portion of the Medulla Spi- 
 nalis, and not like the nerves supplying every other part of the 
 body, from a single point, it serves to explain why the action of 
 those organs to which it is distributed, is uninterrupted and invol- 
 untary. 
 
 That the action of the Heart is not more dependent upon the 
 nervous power than the nervous power is upon the blood. 
 
 That if a portion of the aorta be included in ligatures, a para- 
 lysis of the corresponding portion of the body ensues. 
 
 Finally he concludes, that the Brain and Spinal Marrow are the 
 Bources of sensation, and motion, in short ; of every thing which 
 constitutes life ; and that life is produced, and maintained, by the 
 impression of arterial blood upon these organs. 
 
 Thus we see that to support life, a reciprocity must be main- 
 tained in these functions, the destruction of which is always the 
 proximatef whatever may be the remote cause of death. 
 
 We liave said that the Brain and nerves were excited to actio© 
 by the impression of arterial blood. But this blood in its passage 
 through the arteries from the left side of the heart to the most 
 extreme parts of the body, and in its return through the veins to 
 the right side of the heart, acquires a superabundance of carbon. 
 This has the effect of changing it from the florid colour observed 
 in the arteries, to the dark purple it exhibits in the veins. But 
 what is more important, it is by this means rendered urMfov the 
 
■( 13 ) 
 
 purposes of nutrition, and secretion, and its sfimiilating effect 
 upon the Brain and nerves is destroyed. But these principles 
 are restored by Respiration; for in passing through. the Lungs, 
 carbon is emitted through their thin air vessicles, and uniting with 
 the oxygen of the inspired air, is evolved in the form of carbonic 
 acid gas. Thus the blood is constantly acquiring properties 
 which would destroy its agency in supporting liie j but by this 
 process it is as constantly purLled. 
 
 Such are the physiological and chemical principles on which i 
 have founded my opinion, as to the proxm.ate cause of death in 
 Suspended Respiration. T/ : : ; /: of the disease mil natu- 
 rally result from, and be su^^--.cd * y U^e cause. But before I 
 proceed to state mj own opinion; I shall examine the most popu- 
 lar Theories which have hecn advanced on Ibis subject. Yolumes 
 on volumes have been written, and almost everj^ author has 
 started a Theory of his own : some have enlightened, others have 
 only afforded more matter for doubt-. Men of great ingenuity and 
 ability, they have erred like great men and have supported each 
 Ms own Hypothesis with a strength of argument which appeared 
 matchless and unanswerable till you read his opponent. It has 
 been from its own nature an object of great importance to ascer- 
 tain the best mode of treatment in this disease, and to this intrin- 
 sic importance, adventitious motives have been added. The 
 Humane Society of London have offered rewards to the most 
 successful champion in this arduous and honorable contest. 
 The prize has been won, only to be contended for and won again. 
 The reason of this seemingly interminable doubt as to the proxi- 
 mate cause of the disease, subsisted in the imperfect knowledge 
 and misapprehension of those functions upon which life immedi- 
 ately depends. 
 
 It was formerly the most prevalent opinion that death was re- 
 motely caused in Drowning, hy the presence of water in the Lungs, 
 
( U ) 
 
 aad that the circulation of the blood through the pulmunary arte- 
 ides was by that means interrupted, which was the immediate cause 
 of death. Others supposed water to get into the stomach, and by 
 distention to produce apoplexy. The practice founded upon this 
 opinion was to suspend the patient by'the heels and agitate him as 
 much as possible with the intention of exciting the action of the 
 visera, and evacuating the water. Though the bad effects of this 
 practice were acknowledged by its advocates ; yet they contended 
 that remedies in some respects hurtful, should be used when the 
 advantages arising from them preponderated. Not to mention 
 the great number of Theories previously advanced, it will be 
 sufficient for our present purpose to recur no further back than 
 to the important experiments of Doctor Goodwin, 
 
 His first object was to ascertain whether death was caused by 
 water in theLungs. For this purpose he immersed cats and 
 dogs in coloured fluids, and in quicksilver. Eight Cats were 
 suffocated in quicksilver; in three of which none was found 
 in the Lungs after death ; and in no case was there more 
 than half an ounce. As the specific gravity of quicksilver 
 is so much greater than that of water, he concluded that a 
 much greater quantity would force itself into the Lungs. But 
 even the greatest quantity of quicksilver taken in, was only equal 
 !n bulk, to seventeen grains of water. But more fully to ascer- 
 tain the fact, he next injected two ounces of water into the 
 trachea of a Cat. The only inconveniencies were a difficulty of 
 breathing, and feeble pulse. Hence he concluded, that the small 
 quantity of water which might sometimes be taken in, was not 
 sufficient, in any case, to cause the death of the animal.* This 
 opinion of Doctor Goodv^dn has been confirmed by the subse- 
 quent experiments of Messrs. Kite and Coleman. And in a 
 number of Cats which I have dissected, after drowning, but a 
 
 * Goodwin on the connection of life -with respiration = 
 
( 15 ) 
 
 very small quantity of water was found in the lungs. As no 
 mention has been made by the above authors of the appearances 
 of the Limgs, when the animal had been long in the water after 
 motion had ceased, and as we might be induced to suppose water 
 might be admitted from the relaxation of the glottis which ensue?, 
 I determined on making the following : 
 
 EXPERIMENT: 
 
 A Cat was drowned and suffered to remain under water twenty 
 minutes. After motion had ceased, no air escaped trom the 
 Lungs, and on examination they were found to contain no more 
 water than had been obsferved after ordinary drowning. This 
 experiment was repeated with the same result; from which it 
 appears that water in the Lungs, in no case, has any agency in 
 destroying life. 
 
 Doctor Goodwin having proved that death was not caused by 
 water in the Lungs, be eould only suppose it to be from suspen- 
 ded respiration, but whether this effected the system mechanically 
 or chemically, was a question unsettled. He supposed it to be 
 chemically, that the black blood in the right side of the Hearty 
 was unfit to stimulate the left side to action, and that the change 
 the blood underwent in the circulation, was solely to prepare it 
 for that purpose ; that in consequence of Suspended Respiration^ 
 the blood in the left side became black, and " that the left auricle 
 and ventricle first cease to act, from the inaptitude of venous 
 blood to excite theif contraction, and that in Drowning" — this is 
 the immediate cause that suspends circulation— -that by the con- 
 tact of black blood in the left side of the Heart, its motions became 
 weaker and wealj:er till they ceased ; whereas, the right side 
 being stimulated by the black blood to which it had been accus- 
 tomed, continued to contract with full force. But the appearance? 
 on dissection do not correspond with ths Theory of Doctor GootV 
 
( 16 ) 
 
 will. If as lie supposed the left side of the Heart ceased to act 
 in consequence of the sedative effect of the black blood, then 
 the left Bide of tlie Heart would be found engorged with blood, 
 instead of the right, and the right which according to him retains 
 the power of forcible contraction, would be found empty ; for it 
 13 obvious that the blood must be lodged in the part where there 
 is the greatest obstriicticn to its passage, and the least power to 
 overcome ih - 
 
 Mow Doctor C4oodwin has acknowledged that from his o^vii 
 ej-perimcnts, he !:j"::!icvG3 the Lungs are never entirely destitute 
 of air, but even after tlie most complete expiration in Drowning 
 or Hanging, Ihat they contain a considerable quantity. Though I 
 am not induced from my own experiments to believe the quantity 
 (o be Yerj great, 1 am fully satisfied that they are never empty. 
 Taking it for granted then, that there is always more or less air 
 in the I. d that tiicre is in the blood a stimulating quality 
 
 which i. ;_ ...L.iaed by carbon, I shall upon this supposition 
 attempt to account for the accumulation of blood in the right 
 side of the Heart. It cannot be owirjg to the greater thinness of 
 the parietes, for vre must suppose that each side has power pro- 
 portional to the oft»*e through which it lias to propel the blood. 
 But is it not owing to the greater ini:?iuiity of the blood in the 
 right side of the Heart Ihaii in .\ ■_ . I am aware that it may 
 foe said m objection that the blood is always more impure in the 
 ' right side than in the leit, and that there is not a greater relative 
 difference of impurity when respiration is stopped, than when it 
 goes on freely. But admitting this, let us recur to another con- 
 sideration, which we ought by no means to disregard. 
 
 We suppose that the siimuIatlDg quality of the blood can be 
 completely neutralized with carbon, and this wii! take place when 
 the satiiri.-icn :3 cciDj/kro, And will not tiiis happen first in the 
 
( ^i ) 
 
 light Side of the heart ? When Respiration is suspended, blood 
 arrives at the left side, but imperfectly purified, and is it not rea^ 
 sonable to conclude that it may be saturated with carbon before 
 coming again to the right, as it passes through and imbibes carbon 
 from the whole system ? But the blood which passes from the 
 right side of the Heart to the left, though overloaded with carbon 
 at the moment it starts, is never completely saturated, for M so, 
 the contraction of the ventricle would not be sufficient to propel 
 it through the Lungs, and it passes from the right to the left side 
 of the Heart without any new accession of carbon, as its whole 
 course is through the Lungs, in which it has been shown that a 
 small quantity of air remains We may rather suppose that evea 
 to the last, it receives some degree of purification in passing 
 through the pulmonary vessels, and should conclude a priori that 
 the blood in the left side of the Heart, would never be completely- 
 saturated with carbon. With this supposition experiments per- 
 fectly agree, for in six cases which I examined after death, the 
 blood in the left auricle was more or less fiorid. Hence the rea- 
 son why little or no blood is found in the left ventrical ; for there 
 the last stimulus is excited, and the last efficient contraction takes 
 place. 
 
 It may be asked why, if this Theoiy be true, the right ventricle 
 contracts longer than the left ? The reason is obvious ; the right 
 ventiicle is stimulated by warmth and distension, which would no 
 doubt excite a feeble contraction even if the distendhig fluid wera 
 water. But its contractions are without power,* and though more 
 frequent, are evidently less forcible than those of the left side 
 while they continue. And after the left side has stopped beating, 
 if the blood in the right side could be transmitted to the left, the 
 left ventricle would contract, as was proved by the experiments 
 of Blchat.f 
 
 • Le Gallois, Experiments on the principles of I'fe. 
 
 t Physiological Researches, p. 182,. 
 C 
 
( 1§ j 
 
 Mr. Kite supposes that in consequeuce of suspended respira* 
 lion the motion of the Lungs cease, and a collapse succeeds, whicl^ 
 mechnaically obstructs the passage of the blood from the right 
 to the left side of the Heart ; and that death is produced by an 
 effect of this obstruction either on the Heart, the Lungs, or the 
 Brain. This effect, he thinks, is not produced on the Heart, 
 because the right side, where the greatest quantity of blood is 
 accumulated, continues to beat longer than the left; nor on the 
 Lungs, because their office is merely passive ; and, he therefore 
 concludes, that it can only be produced on the Brain, by a €on* 
 gestion of blootl upon this organ, causing apoplexy.* 
 
 The objections to the opinion, that the biood is mechanically 
 interrupted in its passage through the Lungs, will be mentioned 
 hereafter. I shall at present attempt to show that death is not 
 caused by a congestion of blood in the Brain. This is a 
 theory that has not only been supported by Mr. Kite, but also by 
 the celebrated Doctors Borehaare, Cullen, and others; and ai 
 the present day, it is believed by many physicians of the first 
 eminence, that in Hanging, the pressure of the cord upon the super- 
 ficial veins of the neck, prevents the return of the blood fpom the 
 head, and produces a fatal apoplexy. If apoplexy is produced in 
 either of the diseases under considieratioa, if would'most probably 
 be in Hanging, for there is the same collapse of the Lungs as in 
 Drowning, and there is also the pressure of the cord on the veins 
 of the neck, to prevent the return of blood from the Brain. 
 
 In reasoning from analogy, we cannot suppose that if apoplexy 
 was produced in this disease, death would ensue in the short 
 space of five or six minutes after the stoppage of the blood ; for 
 Mr. Kite acknowledges, that " extravasation does not take place 
 in any part of the Brain;" and it is well known, that even in apc^ 
 
 * Kite's Medical Essays* 
 
( i9 J 
 plexy, produced by extravasation, which is of all others, the mofct 
 suddenly fatal— death rarely happens so soon. But the opinion 
 of Mr. Kite is not merely rendered improbable hy analogy ; it is 
 incontrdvertably disproved by experiments. 
 
 Mr. Coleman secured both the Carotids of a Dog, and in half an 
 hour after suspended him by the neck. Ke died in four minutes. 
 On examination, the vessels of the Brain were found less distend- 
 ed than ordinary.* This experiment has been so often repeated 
 with the same result, that there can be no doubt of its correctness. 
 
 EXPERIMENT. 
 
 1 secured the jugular and thyroidal veins of a Cat by ligatures 
 at the same moment ; no symptoms of apoplexy were apparent. 
 At the end of twenty minutes the animal was killed, and on 
 removing the cranium, the vessels were found much distended, 
 but there was no extravasation. This experiment was repeated 
 on another animal, and the jugular and thyroidal veins remained 
 in ligatures forty five. minutes — the result was the same^ 
 
 EXPERIMENT. 
 
 The trachea of a Cat was laid bare, and an opening made just 
 below the Thyroid cartilage, a cord was passed round the neck, 
 Immediately above the opening, by which it was suspended. 
 Air was inspired through the opening in the trachea, and respiration 
 went on without apparent inconvenience. There was no visible 
 change in the colour of the lips, tongue or nose, and the eyes 
 appeared perfectly natural. At the expiration of ten minutes, it 
 was taken down, the hole in the trachea closed, and it breathed a& 
 usual. It was again suspended in the same manner, and the opeu- 
 fng closed. It immediately struggled violently, the lips, nose and 
 
 * Coleman on Respiration, page 143, 
 
( 20 ) 
 
 tongue gradually turned purple, the eyes became glassy, and it 
 appeared to be dying. At the expiration of one minute, air was 
 again admitted into the trachea, and all symptoms of suffocation 
 disappeared. 
 
 From these experiments is it not incontrovertably proved, that 
 apoplexy is not the cause of death in Hanging ? And is it not 
 rendered fully evident by the last experiment, that want of air is 
 the only cause of distress to a suspended animalj and ultimately 
 of death ? 
 
 Mr. Coleman, in his Treatise on this subject, has attempted to 
 prove that the proximate cause of death is both mechanical and 
 chemical ; that in Drowning and Hanging, the muscles of expira- 
 tion continue to act till they expel all the air from the Lungs, 
 which they are capable of acting on ; that in consequence of this 
 exhausted state of the Lungs, their air cells collapse, which pro- 
 duces a mechanical obstruction to the passage of the blood in 
 the small branches of the pulmonary vessels, and that this, 
 together with the want of latent heat in the blood, constitutes the 
 proximate cause of the disease.- 
 
 That the Lungs are in a collapsed state after Drowning and 
 Hanging will readily be granted. But the collapse is not perfect. 
 It has been proved by Doctor Goodwin, that after the most com- 
 plete expiration, they contain a sufficient quantity of air to per- 
 mit the passage of the blood ; and I have before observed, that 
 from my own experiments I was fully satisfied that they were 
 Bever empty. 
 
 But granting for the present, that the air is all exhausted in the 
 last efforts to respire, and the collapse of the Lungs complete, I 
 shall attempt to prove, that even in this case, the blood would 
 Mot be mechanically obstructed. We know that the blood circu- 
 
 * Coleman on Respiration: 
 
lates freely in organs which are alternately distended, and col- 
 lapsed ; as in the Heart, Stomach, and urinary bladder — and that 
 in other parts of the system, though the vessels are contorted 
 and convoluted, as in the motions of the limbs, the mesentery, 
 &c. ; and though these changes take place, while the blood is 
 flowing from the part, they neither prevent nor impede it. Judg- 
 ing from analogy, therefore, we have no reason to conclude that 
 a mechanical obstruction takes place in the Lungs, And to 
 show that it is not the case, we have not only analogical proofs 
 but experiments to ascertain the truth directly in point. Bichat, 
 to ascertain the truth of this doctrine, adapted the tube of a syr- 
 inge to the trachea of a dog, after cutting it transversely, and sud* 
 denly emptied the Lungs of all their air, at the same time opening 
 the caroted artery. In this experiment, the ciroulation, he observe?^ 
 should have been suddenly interrupted, as the pulmonary vessele 
 passed all at once from their ordinary degree of extension, to the 
 greatest possible involution ; yet the blood continued for some time 
 to be thrown out with force by the open artery, and consequently, 
 to circulate through the collapsed Lungs.* 
 
 But to ascertain if possible, more decisively, whether the great. 
 quantity of blood found in the right side of the Heart vms owing 
 to a collapse of the Lungs, I had recourse to the follovang 
 
 EXPERIMENTS : 
 
 The trachea of a Cat was cut transversely, and the capacity ol 
 the Lungs about half filled with atmospheric air. The ti*achea 
 was then secured by a hgature. The left ventricle continued tt> 
 contract forty minutes. The right ventricle continued to con= 
 tract twenty minutes longer, when all motion ceased ; on ex- 
 amination, the quantity of blood, in the right side, was to thai 
 In the left, as two to one. 
 
 * Physiological Researches, p, 174. 
 
C 22 ) 
 jexperiment. 
 
 The thorax of a Cat was opened and from the pressure of the 
 dense atmosphere, the Lungs suddenly collapsed and respiration 
 ceased. The Heart and arteries contracted with great force, and 
 on opening into the abdomen, the mesenteric arteries continued 
 to pulsate distinctly. As their florid colour gradually changed to 
 purple, their motions became feeble ; but at the expiration of 
 twenty minutes, the blood evidently circulated through the Lungs. 
 On opening into the Heart, the right ventricle and auricles were 
 found surcharged with venous blood, the left auricle and ventricle 
 contained a small quantity of blood, but more florid than that in 
 f^e right. 
 
 From the first of these experiments, it appears, that death en- 
 sues in Suspended Respiration, when the Lungs are not collapsed ; 
 and that the blood is found as in death from other causes, prin- 
 cipally lodged in the right side of the Heart. From the second, 
 that the circulation continues sometime after the Lungs are col- 
 lapsed ; whereas, if it was impeded by the collapse, the obstruction 
 vrould be as complete at the time of the last expiration, as it 
 would at any future period. This fact is sufficient to disprove 
 Mr. Coleman's opinion, for he does not agree with ]VIr. Kite, that 
 the circulation is impeded by a want of motion, but says, " the 
 right side of the Heart can propel blood to the left immediately 
 Sifter the last expiration, independent of the mechanical action of 
 the Lungs, and as it can perform this function after Respiration 
 has ceased, it is probable that the Lungs have naturally no active 
 power of propelling the blood onward." 
 
 Te what has been said against Mr. Coleman's theory, so far as 
 respects the collapse of the lungs, I shall only add one of his own 
 experiments, by which he attempted to disprove the opinion of 
 
 Mr- E^t^ r 
 
( 23 ) 
 
 " EXPERIMENT." 
 
 <« The trachea of a Dog was laid bare, and secured by a ligatur^^ 
 and this was endeavoured to be performed at the instant an en- 
 spiration was made; in less than four minutes he ceased t@ 
 struggle. On examining the Heart, we found the quantity of 
 blood in the left, when compared to that of the right, as thirteen 
 to twelve. A portion of the cranium was removed, and the 
 veins of the head were evidently less distended than natural, 
 "Here then," says Mr. Coleman, '•' there being no obstruction to 
 the passage of the blood through the lungs, it could not be col- 
 lected in the right side of the heart, and consequently no ac- 
 cumulation was found in the head, and yet this animal died as 
 soon as other animals from ordinary Hanging, which carries 
 conviction to my mind, that apoplexy forms no part of the 
 disease,"* 
 
 In this experiment of Mr. Coleman's, I have found it difficult 
 to account for the death of the animal by any theory at that time, 
 extant. He proves that it did not happen by apoplexy, and full 
 as conclusively, that it did not happen by a collapse of the lung?^ 
 and we must conclude, a priori, that the senses of Mr. Coleman 
 deceived him, and that the animal did not die; otherwise we 
 must deny this poor Dog the common right exercised by all ani- 
 mals, of dying philosophically. 
 
 If then a collapse of the lungs is not the proximate cause of 
 death, I shall next examine whether it is a diminution of animal 
 heat. 
 
 Mr. Coleman supposed the motion of the Heart to depend upos 
 irritability, which was always in proportion to the degree of animal 
 heat ; that animal heat was generated by Respiration al©ae ; conse- 
 
 * Coleman on Respiration, page 142. 
 
C 24 ) 
 
 quently Suspended Respiration would be a remote, and a diminu^ 
 tion of animal heat, b. proximate cause of death. 
 
 I have already shown that the contractions of the Heart do not 
 depend exclusively on irritability, and in some late experiments 
 3Ir. Brodie has demonstrated that animal heat is neither generated 
 solely by Respiration, nor is it immediately essential to life. He 
 kept alive decapitated Dogs and Rabits, two hours, by artificially 
 inflating the Lungs, though the heat in the thorax diminished in 
 the mean time sixteen degrees. This experiment was frequently 
 repeated, and in every case the heat diminished faster in animals 
 kept alive by artificial respiration, than in those of the same age 
 and species which were suffered to 61e. Hence he concludes 
 that the generation of animal heat depends upon the influence of 
 the Brain, though by supporting respiration, life may be preserved. 
 These experiments were repeated by La Gallois, and though he 
 says " the results did not appear to him as regular as pretended 
 hy Brodie, the temperature was considerably reduced." If, in 
 addition to this, we reilect that experiments are recorded in the 
 philosophical transaclions, in wliich, by a person being placed in 
 a cold bath, and afterwards exposed to a cold easterly wind, the 
 heat of the body was diminished sixteen degrees, without causing 
 any material injury; we cannot suppose a diminution of animal 
 heat to have any immediate effect in destroying life. 
 
 Dr. Fothergill, in his excellent treatise on Suspended Respira 
 tlon, from drowning and suffocation, supposes the proximate 
 cause of death to be " the exclusion of air from the lungs, and 
 the extinction of irratibility." The first part of this theory is 
 practically, but not critically correct. The exclusion of air from 
 the lungs is the remote or exciting cause of the disease, but is not 
 the proximate cause, accoTdino: to the gener?! J^ccpptation of the 
 term. 
 
As to thesecond part of Dr. Fothergill's theory, viz : that Which 
 Tespeets the extinction of irrijibility, a more particular examina' 
 tion of it is necessat^. The Doctor insists upon it with great 
 tenacity and zeal, and introduces it for the solution of a variety 
 of phenomena. We have already had occasion to object to the 
 existence of irrij/lDility, as independent of the nerves. That 
 there is an irriljfbility existing in the muscles, will not be doubted^ 
 but we consider this irritability as depending, in all caseSj on the 
 vis nerveUj which, as heretofore explained, is sufficient to accouzit 
 for all the phenomena of the animal economy. Why then resort to 
 a hypothetical agent, of whose existence there was never any 
 other proof, than that it was convenient as a medium of explana- 
 tion, and helped the physiologist out of difficulties, from which 
 he could not otherwise escape ? 
 
 • In prQof, that the motions of the Heart do not depend upon the 
 aerv-es, it has been said by some, that the heart had no nerves § 
 by others, that it had but few, and that those were not effected by 
 irritation.^ But other anatomists, who have been either more 
 honest, or more perspicacious, have affirmed^ that the nerves of 
 the Heart are as numerous, and are distributed in th« same man» 
 ner, as in the other muscles.f If, on irritating the nerves of the 
 Heart, they do not disturb the motions of that organ, it only 
 proves, that these nerves are sui generis, and sensible to a peculiar 
 stimulus. In apoplexy, says Dr. Fothergill, all the functions de- 
 |)ending on the nerves, are suspended ; but not the motions of the 
 heart; and this he adduces as a proof, that these motions do not 
 depend on the nerves. But sensation is not destroyed in apo-" 
 plexy ; as the Braua is diseased,^ which is the organ of volition, 
 that faculty is suspended, and of course has no power to direcl 
 laie action of the muscles. For if (he liuqib of an appopleclic 
 
 * Fothergill on Suspended Respiratinn, p. 65. 7 Le Gallois, 248, 
 
 D 
 
( 28 ) 
 
 person be pinched, or pricked, it will be partially drawn up. 
 Though this motion be weak, the reason^s obvious, for as Le 
 Gallois observes, " the Medulla Spinalis is in a morbid state, 
 after the injury or destruction of the Brain, as there is an 
 intimate connection between them." 
 
 Dr. Fothergill supposes, that the vis nervea would be insuffi« 
 cient to support the continued action of the Heart. " It does 
 not," says he, " like other muscles, become weary by incessant 
 motion ; neither does it become less irritable to the blood by the 
 daily repetition of the stimulus, any more than the eye does to 
 light the ear to sound, &,c." But the Doctor seems to have for- 
 gotten, that the eye and the ear exercise their functions through 
 the medium of nerves ; and that it is a law of the animal econo= 
 my, that the nerves of certain organs should be operated upon 
 by stimuli, peculiar to themselves, and that the heart may as we!! 
 be supposed to be an organ of this description, and to have 
 nerves excited by a pecuHar stimulus, as the eye or the ear. 
 And the Doctor seems also to have forgotten, that the eye and 
 the ear are excited by a continued stimulus, in nearly the same 
 manner as the Heart. 
 
 EFFECTS OF SUSPENDED RESPIRATION FROM 
 DROWNING. 
 
 When an animal is immersed in water, it immediately struggles 
 #olently, and from its disposition to breathe, air is expelled from 
 the Lungs, as is evident from the bubbles rising through the 
 water. As the distress for the want of air, increases with every 
 expiration, efforts to inspire are repeated, and the expiration 
 made more complete. During these struggles which continue a 
 sniBute^ aiid m some eases, a minute and a half, the eyes gradu- 
 
< S7 ) 
 
 4iiy assume a glassy appearance, and are somewhat protruded^ 
 the pupils are, unusually dilated, and the nose, lips, and tongue, arc 
 In same cases pale, in others, lived. After all external motion 
 has ceased, and the animal is taken from the water, the Heart is 
 felt to beat feebly ; on pricking, or pinching the legs, they are 
 partially drawn up, and if amputated, dark coloured blood issues 
 from the arteries. 
 
 On openmg into the Thorax, the Lungs are found much 
 collapsed ; a small quantity of frothy fluid, can generally b^ 
 squeezed from them ; being evidently, the mixture of the air re-' 
 maining after the last expiration, with a small quantity of watef^ 
 which in the attempt to inspire was taken in. The Veins appear 
 preternaturally full, and of an unusually dark colour; the right 
 auricle and ventricle, are much more distended than the left, and 
 are of a darker colour ; both auricles and ventricles now contract 
 miiformly, but their motions soon become weak. In about twenty 
 minutes, the contractions in the left ventricle begin to intermit ; 
 the right auricle and ventricle, are comparatively much distended, 
 and are of a dark purple; their contractions continue, butarefee- 
 ble and ineffective, and much less forcible than those of the left 
 aide when they do occur. The right ventricle next ceases to con- 
 tract, and the last motion is seen in the corresponding auricle, 
 commonly at the expiration of an hour and a half. If after all 
 motion has ceased, the Heart be opened, the right ventricle and 
 auricle, and all the contiguous veins are tilled with black blood, 
 the left auricle contams aboutone third as much blood as the 
 Tight, and it is of a more florid colour^ 
 
 On opening into the Brain, the superficial veins appear a little 
 more full thau ordinary, bat in no case is there aoy ©xtravaeatioB 
 
r 
 
 BFlPBCTS OF SUSPENDED RESPIRATION FROM 
 HANGING. 
 
 Wlien an animal is suspended by the neck, death is not so im 
 mediate as in drowning, for as observed above, in the one case 
 motion ceases in a minute, or a minute and a half, whereas, in the 
 other, it commonly continues five or six minutes. This is prob- 
 ably owing to the imperfect stoppage of the trachea in Hanging, 
 and the admission of a small quantity of air in the efforts to in- 
 spire. Tliis imperfect exclusion of the air, is no doubt the cause 
 of the difference in the appearances in Drowning and Hanging, du- 
 ring and after death. For in Hanging, the mouth and nose gradually 
 assume a livid hue, and before death, are of a dark purple colour^ 
 the eyes are more prominent than in Drowning, and the muscles 
 in some cases are stiff. 
 
 On opening into the chest, the Lungs are collapsed the same 
 %s in Drowning, they contain but a small quantity of air, and the 
 Heart, and bloodvessels in both cases exhibit nearly the same ap- 
 pearance. 
 
 The vein^,; of the Brain are a little more turged than 
 4fter Drowning, but as in that case there is no extravasation. 
 
 After describing the changes effected by Drowning and Hang- 
 ing, and the appearances of the vital functions after death, we 
 xnay conclude, that whatever is the proximate cause of death in 
 the one, is also the proximate cause of death in the other ; that 
 the trifling difference in the appearances on dissection, is owing 
 principally to the difference, both of the medium in which the 
 animal is destroyed, and the time in which it is dying. 
 
 In Drowning and Hanging, the ingress of air into the lungs is 
 Ijiterriaptedj stud their mechaDical action arrested. The effect 
 
( £9 .) 
 
 iipon the system is immediate; for upon this mechanical actioB» 
 is that chemical process founded, which is indispensable for the 
 purification of the blood. The blood now returns to the right 
 side of the Heart, and is again propelled through the lungs. 
 A portion of the carbon is disengaged by uniting with the small 
 quantity of oxygen yet remaining ; but the quantity is so small^ 
 that the change is imperfect. The blood now begins to loose it& 
 influence upon the nervous system : but where, and in what de* 
 gree, is this effect produced ? Is it as some have supposed upon 
 a particular organ ? We presume the paralysis to be limited only 
 by the extent of the nervous power. If it has more effect upon 
 one side of the Heart than the other, it is only because in that 
 aide, its impurity is greatest. For though every part of the body 
 suddenly feels the effect, it is exclusively through the medium of 
 the nerves, and the failure of excitement is always in proportion 
 to the change of colour in the blood, that is in proportion to the 
 accumulation of carbon. Hence I conclmle the Proximate Cause 
 of the disease, to be an excess of carbon in the blood. 
 
 Whether this effect of carbon on the nerves, is negative or 
 positive, mediate or immediate, may be doubted; or in other 
 words, it is doubtful, whether carbon paraUzes the nerves them- 
 selves, or destroys some stimulating quality in the blood, and 
 causes it to fail in its usual effect in exciting the nervous energy. 
 But I am inclined to the latter opinion, namely : that the carbon 
 neutralizes some quality of the blood ; for when Respiration is 
 restored after being suspended, and the carbon is thrown off", the 
 nerves instantaneously recover their tone : whereas, if the influ- 
 ence upon them had been positive, their tone would not be instanta- 
 neously, but gradually recovered. But in either case, where 
 does this deleterious principle first exert its influence? It first 
 comes in contact with the Lungs and the Heart; the vis nerva 
 feels the want of its accustomed Btimu!us«-the power of the heart 
 
( 30 ) 
 
 begiRB to diminish— the carbonized blood enters the coronary 
 arteries, and every fiber of the Heart feels the effect. No sooner 
 is the blood propelled through the sj-stem, than the Brain and 
 Spinal Marrow begin to loose their influence upon the Heart. 
 No longer excited by the arterial blood, upon which their energy 
 depends, the effect is now as extensive as the nervous system. 
 The glands and absorbents loose their power of action, and the 
 secretions and excretions are stopped. The nerves of the Heart, 
 accustomed to the stimulus of the blood, continue to excite it to 
 contraction, after the energy of every other part is destroyed. 
 The left ventricle, which, for reasons before mentioned, is most 
 powerfully stimulated, forces the blood through the arteries, it 
 returns slowly in the veins, incapable of exerting a contraction, 
 sufficiently forcible in the right side of the Heart to propel it 
 through the Lungs, it accumulates in the veins, and right side of 
 the Heart ; and by warmth and distention, excites a feeble motion 
 in the right auricle and ventricle, till life is totally extinguished. 
 
 TREATMENT, 
 
 It would be highly interesting and important, to ascertain pre- 
 cisely how long Respiration may be suspended without destroying 
 life. " The last signs of life" says Doctor Le Gallois, " are sen- 
 sation and the circulation of the blood." We have already said 
 that Doctor Le Gallois, supposed life to be produced, and main- 
 tained by the impression of arterial blood upon the Brain and 
 medulla spinalis, or by a principle, resulting from this impression.* 
 Life, therefore, can only be restored in those cases, where the 
 Heart has sufficient power to propel the Mood to the Spinal Mar- 
 row, that the Spinal Marrow may be excited again to give energy 
 to the Heart But there is no infallible criterion, whichVill ena- 
 ble us to determine the degree of nervous energy remaining in 
 
 * Er:periment3 oi tbe Principles of Life, 
 
{■ ■ 31 ) 
 
 the Heart. Much wiil idepend upon the age and constitution ot 
 the person. Cases are related by the Royal Humane Society, of 
 recoveries, thirty, thirty five, and in one case, forty five minutes 
 after submersion. But in others, after the utmost exertion the 
 patient died, though he had been in the water but three minutes. 
 
 Seldom is a person recovered after he has been under water 
 fifteen minutes. Either no credit is to be given to the accounts 
 of certain early writers, or we must conclude the people of their 
 time to have been amphibious. Kunckel, says, " that in Sweden, 
 no one doubted the possibility of restoring the life of a person 
 who had been under water eight days ;'* and Burmann, relates a 
 case, where " a person continued under water seven weeks, 
 notwithstanding, which, he not only recovered, but enjoye(^ 
 health many years after." 
 
 We may, however, form some opinion, aa to the probability of 
 a recovery, when we can obtain no information respecting the 
 time the body has been in the water. If pricking or pinching the 
 limbs excites any motion ; if they are flexible, if on placing a 
 thermometer under the tongue, we find that animal heat is not 
 all extinguished, there is hope of recovery. But if the limbs 
 and body be stifif, the countenance cadaverous, the eyes dim and 
 sunken, and the heat of the body extinguished, we have no more 
 encouragement to attempt Resuscitation, than after a natural 
 death. But if all the circumstances attending the submersion can 
 be ascertained, it will aid us much in forming an opinion as to 
 the probable result of the case. It is important to kuovr whether 
 the person was timid, intoxicated, or subject to fits, or whether 
 he fell from a great height. The temperature of the water oughl 
 also to be taken into consideration. But we would tolerate no 
 inquiries at the expense of time. The most important, nay th^ 
 essential means of recovery, first to be tised,is i» all cases the same. 
 
r 
 
 ( 32 ) 
 
 We have been recommended to convey the patient carefuliy to 
 the most convenient place for using the means of recovery ; but 
 if we reflect that the force of the Heart diminishes with every 
 pulsation, and that if life is restored, it can only be done by re- 
 storing the circulation, we shall never be driven from the spot^ 
 except by intensity of cold, until respiration is restored. 
 
 I shall not attempt to detail the numerous modes of treatment 
 that have been recommended and adopted, by various writers on 
 this subject. If the cause which has been assigned for the disease 
 foe correct, the treatment will be simple, viz. those means that are 
 immediately essential to restore Respiration. Neither the symp- 
 toms that will exist, nor the treatment which will be necessary 
 after Respiration ia restored, can be anticipated. The one will 
 in all cases naturally result from the other. 
 
 When a person is taken from the water, unless we know he has 
 been immersed so long that there are no hopes of his recovery, 
 we would immediately attempt to renew Respiration, by artificial 
 means. This we would do with the first instrument that came to 
 hand, by which air could be conveyed into the Lungs. A bellows 
 would be prefered, to any article in common use. In case we 
 could procure no instrument for inilating the Lungs, we would 
 make use of Astley Cooper's expedient, and by pressing on the 
 sternum and ribs, compress them, when by lifting the hands, those 
 parts by their elasticity will restore themselves, the chest be ej.- 
 panded, and the air rush in. 
 
 We have supposed the caase of the disease, to be excess of 
 carbon in the blood, that while the circulation continued, a small 
 quantity was emitted to unite with oxygen gas, in the Lungs, and 
 we must conclude, therefore, that the air inthe Lungs, is not only 
 absolutely unfit for Respiration, but positively deleterious, the oxy- 
 gen gas being changed into the form of carbonic acid gas. This 
 
( 33 ) 
 
 deleterious air, can only be expelled from the Lungs, by inflating 
 them with pure air, with which it will mix, and gradually be 
 thrown out by artificial expiration. 
 
 In order to inflate the Lungs, we would place the body in a 
 convenient posture, with the head elevated, and introduce the 
 pipe of a bellows into one nostril, while the other nostril and 
 mouth were closed by an assistant. The inflation should be 
 gradual— after which the air should be pressed out by the assis- 
 tant, and this process continued. To prevent the passage of the 
 air into the stomach, and direct it into the trachea, the assistant 
 should press upon the thyroid cartilage, and to raise the epiglottis 
 for the admission of the air, the tongue may be pulled forward. 
 This process should be commenced as soon as the patient is 
 taken out of the water, and no other means should ever be suf= 
 fered to interpose a moments delay. Many things may be done, 
 which are in some degree advantageous, but nothing can com- 
 pensate for the neglect of inflating the Lungs. Thus the wet 
 clothes should be stripped ofl*, and the body should be wiped dry, 
 wrapped in flannel^ and rubbed with a flesh brushj or with Uiq 
 hand. 
 
 Electricity will be found very beneficial in stimulating the 
 action of the Heart. It should be communicated through the 
 region of that organ in slight shocks ; and in order to aid the 
 purification of the blood, the excitement should be given while 
 the Lungs are inflated. Care should be taken that the shocks be 
 not too violent. It is well known from experience, that a very 
 powerful shock paralizes, instead of stimulating the energy of the 
 heart. 
 
 When the body has been taken from under the ice, and gene- 
 rally whenever we have reason to believe that it is very much 
 chilled, we should be cautious in the application of warmth. We 
 
 E 
 
s^ 
 
 ♦^ , :, ia such cases, endearour to place the patient in a tempeia= 
 a few degrees higher, than that from which he had been 
 .en, and increase it as warmth returned to the body. The 
 )^mperature of the body may be best regulated by a bath, 
 in which the patient onght always to be placed when it can 
 be procured. We suppose that artificial Respiration has been 
 kept up, and been made to resemble natural Respiration as much 
 as possible, both in manner and degree, that the body of the pa- 
 tient has been wiped d.-j — that he has been placed in a proper tem= 
 perature, and that his skin has been gently rubbed with the hand, 
 or with a flesh brush. These are the means on which we rely 
 for Resuscitation; and if these fail, after a faithful trial of about 
 three hours, the case is hopeless. But persons are frequently 
 taken from the water in a lifeless state, who have been other- 
 wise seriously injiirged, than by drowniDg ; as by a fall from a 
 great height, by intense cold, &.c. and when we have reason to 
 conclude, that such has been the case, we shall of course, vary 
 pur treatment. 
 
 As to bleeding, emetics, enemas, kc. it is sufficient to say geyie- 
 rally, that we consider all depleting remedies as injurious in the 
 first stage of cure that is, before the full re-establishment of Res- 
 piration. Even if bleeding should remove the black blood fron 
 the right side of the Heart, which we much doubt, it would no 
 restore its arterial quality, on which life immediately depends 
 We shall not point out the path to be pursued in the second stage 
 of cure. The treatment will be regulated by the symptoms oi 
 the patient, and the Judgment of the physician. If oxygen could 
 be procured, it would unquestionably be a much more probable 
 means of purifying the blood, and restoring the circulation, than 
 common ainiospheric air ; but 've cannot expect, in ordinary 
 cases, to be able to procure if. 
 
( 35 I 
 
 TREAT]\IENT IN HANGING. 
 
 In attempting to restore life, after Hanging, the means we 
 would practise, are much the same as above described. The 
 most important thing to be done, is to inflate the Lungs, and to 
 establish artificial Respiration. Bleeding is very generally re- 
 commended, but as we have reason to believe, from our experi 
 ments, as Vi^ell as those of others, that apoplexy seldom takes 
 place, we would bleed only in cases where there is more than 
 ordinary reason to believe, that either apoplexy, or a turgescence 
 of blood in the Brain has ensued, as v/here the patient has been 
 long hanging, or was uncommonly heavy. In such cases, wc 
 would open a jugular vein. But in the mean time, artificial Re3= 
 piration should never be intermitted ; and we wish it to be well 
 understood, that we consider artificial Respiration as the great 
 and paramount remedy, as well in Hanging, as in Drowning, and 
 all other remedies, as merely subservient to it. To stop artificial 
 Respiration, for the purpose of practising any other opedientj 
 would, in our opinion, be as inexpedient, as to open a vein, or 
 apply a blister in an ordinary case, and at the same time, to suf- 
 focate the. patient, by immersing his head in water. 
 
 Before I conclude, 1 cannot deny myself the pxcasure of 
 expressing my sentiments towards the Professors of this Univer- 
 sity. The zeal which they have shown for the improvement of 
 their pupils, and the ability with which that zeal has been second- 
 ed, must have left an impression upon the mind of every student, 
 which time will not obliterate. It is a subject on which I feel 
 more than I shall venture to express— a subject on which the 
 heart would dictate, without any toil of the intellect. When I 
 contemplate the satisfaction with which I shall, through the whole 
 coiu'se of my life, look back on the time I have spent in this 
 
f 36 ) 
 
 tJni < • sity, I cannot forbear to take a parting glance at theadvan- 
 lag-'js I have enjoyed, and to return thus publicly, my thanks to 
 *ne gentlemen, whose instructions have contributed to my im- 
 provement, and whose benevolent condescensions, have triily 
 made the paths of wisdom " ways of pleasantness." 
 
 FINIS, 
 
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