remarkable that, notwithstanding all which has been written about
ready remedies for drowning, no one present knew anything about them,
although living in a seafaring community.

I immediately directed that the patient should at once be placed upon
the ground, which was sloping, and arranged his rubber boots under the
back of the head and nape of the neck, so that the head should be
slightly elevated and the neck extended, while the head was turned
somewhat upon the side, that fluids might drain from the mouth. The
day was clear and moderately warm. Respiration had ceased, but no time
was lost in commencing artificial respiration. The patient had on a
shirt and pantaloons, which were immediately unbuttoned and made
loose, and placing myself at his head, I used the Silvester method,
because I was more accustomed to it than any other. It seems to me
more easy of application than any other, and I have often found it of
service in the asphyxia of the newly born.

The patient's surface was cold, there was extensive cyanosis, and his
expression was so changed that he was not recognized by his fellow
townsmen, but supposed to be a stranger. The eyelids were closed, the
pupils contracted, and the inferior maxilla firmly set against the
superior. One of the men who had brought him ashore had endeavored to
find the heart's impulse by placing his hand upon the chest, but was
unable to detect any motion.

I continued the artificial respiration from 9.45 until 10, when I
directed one of his rescuers to make pressure upon the ribs, as I
brought the arms down upon the chest. This assistance made expiration
more complete. When nature resumed the respiratory act I am unable to
say, but the artificial breathing was continued in all its details for
three-quarters of an hour, and then expiration was aided by pressure
on the chest for half an hour longer. Friction upward was also applied
to the lower extremities, and the surface became warm about half an
hour after the beginning of treatment.

About twenty minutes after ten, two hypodermic syringefuls of brandy
were administered, but I did not repeat this, since I think alcohol is
likely to increase rather than diminish asphyxia, if given in any
considerable quantity. A thermometer, with the mercury shaken down
below the scale, at this time did not rise. At 11.8 the pulse was 82;
respiration, 27; temperature, 97.

After a natural respiration had commenced, the wet clothing was
remove