A New Method of Artificial Respiration

The two main recognized methods of artificial respiration, namely, Schafer's and Silvester's, depend for their efficacy on the elastic recoil of the chest wall and diaphragm, which can happen only when the integrity and tonicity of the muscles of the respiration are maintained. Schafer's (1907-8) method consists in Maying the subject prone, and pressing gradually for three seconds with both hands close together flat on the back over the loins, the fingers extending over the ribs. The abdominal contents are indirectly pressed upon, driving the diaphragm up into the chest and forcing air out of the lungs therebyWhen the pressure is released, the diaphragm is expected to move down by its own elasticity, and perform the inspiratory process in consequence. Silvester's method consists in squeezing the chest with the arms and elbows of the patient. The elastic recoil of the chest wall is supposed to help the inspiration of air. Both methods are useful but very imperfect. The weak points in Schafer's method have been clearly described by Eve (1943). In the deeply unconscious state, whether due to drowning, electrocution or general anaesthesia, the elastic tone of the respiratory muscles fails progressively. Barclay has shown by radiograph that in the prone position the diaphragm is pushed up into the full expiratory position. This will be accentuated in a toneless body. Silvester's method, which depends on the elastic recoil of the chest wall, also fails in the semi-final stages of incomplete death when the intercostal muscles would have lost their tone. The incompleteness of both the methods is due to their efforts being directed towards. helping the expiratory process rather than the process of inspiration. When the tone of the respiratory muscles is partially