l remains.
My experience with this case has taught me that, unless the data have
been taken very accurately, we cannot depend upon any statements as to
the time of submersion in cases of drowning. My first supposition was
that my patient had been from thirteen to fifteen minutes under water,
but a careful investigation reduced the supposed time by one-half.
This makes the time of submersion about six minutes, and that which
elapsed before the intelligent use of remedies about three minutes
longer.
For a long time the opinion of Sir Benjamin Brodie concerning the
presence of water in the lungs of the drowned was accepted, who says
"that the admission of water into the lungs is prevented by a spasm of
the muscles of the glottis cannot, however, be doubted, since we are
unable to account for it in any other manner."
Later experiments made by a committee of the Royal Medico-Chirurgical
Society, of London, demonstrated, on the contrary, that "in drowned
animals not only were all the air passages choked with frothy fluid,
more or less bloody, but that both lungs were highly gorged with
blood, so that they were heavy, dark colored, and pitted on pressure,
and on being cut exuded an abundance of blood-tinged fluid with many
air bubbles in it." Dr. R.L. Bowles[1] also holds that the lungs of
the drowned contain water, and supports his views by a list of cases.
In his words, "These examples show very conclusively that in cases of
drowning in man, water does exist in the lungs, that the water only
very gradually and after a long time is effectually expelled, and that
it is absolutely impossible that any relief should be afforded in that
way by the Silvester method." Dr. Bowles believes that the method of
Dr. Marshall Hall is superior to any other in this class of cases. He
thinks that on account of the immediate adoption and continued use of
the prono-lateral position, this method is more to be trusted than any
other for keeping the pharynx clear of obstruction. "It also empties
the stomach and gradually clears the lungs of the watery and frothy
fluids, and will surely and gently introduce sufficient air at each
inspiration to take the place of the fluid which has been expelled."
In the light of even my limited experience I cannot but feel that Dr.
Bowles' opinion concerning the Silvester method would admit of some
modification. This is often the case with very positive statements
concerning medical matters. In my own case t
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