IN the year 1864, after making exhaustive inquiries extending over some years, the Committee of Management • of the ROYAL NATIONAL LIFE-BOAT INSTITUTION issued to all its Lifeboat stations the regulations for the restoration of the apparently drowned, ; drawn up by the distinguished physiologist, the late Dr. Marshall Hall, whose views were approved by ! numerous other medical men. In the : case of Dr. Hall's method not proving successful the Institution recommended that the rules of the late Dr. Silvester should be resorted to. These rules were printed side by side with those of Dr.

Hall, and have since been circulated by the Institution in all parts of the world. There is no doubt that, as a result, a very large number of persons apparently drowned have been resuscitated, in many cases after hours of perseverance and when success had seemed almost unattainable.

Last year the Board of Trade informed the Institution that the attention of the Board had been drawn to the method of restoring the apparently DIRECTIONS FOE BESTORING The following Directions are those of Professor E. A. Schafer, P.B.S., etc., Professor of Physiology in the University of Edinburgh, and they have been adopted by the Board of Trade, by the Metropolitan Police Force, the St.

John Ambulance Association, etc. The Committee of Management of the ROYAL NATIONAL drowned advocated by Professor E. A. Schafer, F.R.S., Professor of Physiology in the University of Edinburgh. This method had been adopted by the Board of Trade, by the Metropolitan Police Force, and by the Royal Life-Saving Society. The Institution as a result made inquiries and were informed by the Royal Society of Medicine that the : Society considered the Schafer method " better than any other method known, or any combination of other methods." The Institution thereupon decided to adopt and circulate the Schafer rules, which will shortly be issued to all the I Institution's Life-boat Stations. The District Inspectors of Life-boats will, as opportunity offers, explain to the coxswains and selected members of the Life-boat crews the new rules and instruct them in their use for " first aid " in the Life-boat service.

The rules are fully given and illustrated here and it is hoped that the publicity given to them in this Journal will be of service to the cause of life-saving which this Institution has at heart.

THE APPARENTLY DROWNED.

LIFE-BOAT INSTITUTION have ordered their use , in its Service. The directions will be extensively circulated by the Institution throughout the United Kingdom and in the Colonies, and will henceforth supersede the directions which have, for very many years past, been issued by the Institution.Send immediately for medical assist-' ance, blankets, and dry clothing, but proceed to treat the Patient instantly on the spot.

The points to be aimed at are— First and immediately, the Restoration of Breathing ; Secondly, after breathing is restored, the Promotion of Warmth and Circulation.

TREATMENT.

Immediately after removal from the water, lay the patient face downwards with the arms extended. Turn the face to the side. Kneel or squat astride or on one side of the patient (Fig. 1, A B).

Place the hands on the small of the patient's back, one on each side, with the thumbs parallel and nearly touching (Pig. 1).

Bend forward with the arms straight, so as to allow the weight of the operator to bear on B FIG. 1.

The efforts to restore Breathing must be commenced immediately the patient is removed from the water—no time should be lost in removing or loosening clothing —and persevered in energetically for two or three hours, or until a medical man has pronounced life to be extinct.

Efforts to promote Warmth, and Circulation must be postponed until after the first appearance of natural breathing.

his wrists and thus make a steady, firm, downward pressure on the lower part of the patient's back (the loins and lowest ribs), as shown in Fig. 2. (This part of the operation should occupy the time necessary to count — slowly—one, two, three.) Immediately after making the downward pressure, the operator should swing backwards so as to relax the pressure, but without lifting his hands from the patient's body (Pig. 1).

(This part of the operation should occupy the time necessary to count—slowly—one, two.)Repeat the forward and backward movements (that is, the pressure and relaxation of pressure) without any marked pause between the movements. The downward pressure forces the air out of the lungs and the relaxation of pressure causes the air to be drawn in again.

Continue the movements at the rate of pits and feet; but the movements of artificial breathing must not be interfered with.

After natural breathing is restored, the wet clothing may be removed and a dry covering substituted. This must be done without disturbing the patient, who should be allowed to lie quiet, and watched, for at least an hour, and encouraged to sleep.

FIQ. 2.

about 12 per minute until natural breathing has recommenced.

When natural breathing is fairly begun, cease the movements. Watch the patient closely, and if natural breathing ceases, repeat the movements as before.

When natural breathing has commenced, the patient should be allowed to lie in a natural position on one side, and treatment for the promotion of warmth and circulation may be proceeded with.

The movements of artificial breathing are of the first consequence. If the operator is single-handed, he must attend to these alone until natural breathing is restored. If other assistance is at hand, a dry and warm covering may be placed over the patient, and warm wrung-out llannels, hot bottles, etc., may be applied between the thighs, and to the arm- TREATMENT AFTER NATURAL BREATHING HAS BEEN RESTORED.

To PROMOTE WARMTH AND CIRCULATION.— Commence rubbing the limbs upwards, with firm grasping pressure and energy, using handkerchiefs, flannels, etc. : [by this measure the blood is propelled along the veins towards the heart].

Dry the hands and feet; and as soon as dry clothing or blankets can be procured, strip the body and cover, or gradually reclothe it. The friction must be continued under the blanket or over the dry clothing.

Promote the warmth of the body by the application of hot flannels, bottles or bladders of hot water, heated bricks, etc., to the pit of the stomach, the armpits, and the soles of the feet.On the restoration of life, when the power of swallowing has fully returned, small quantities of warm coffee, or tea, or milk, or broth, or other light warm nourishment, should be administered. The Patient should be kept in bed, and a disposition to sleep encouraged.

GENERAL OBSERVATIONS.—The above treatment should be persevered in for two to three hours, as it is an erroneous opinion that persons are irrecoverable because life does not soon make its appearance.

APPEARANCES WHICH GENERALLY ACCOMPANY DEATH.—Breathing and the heart's action cease entirely; the eyelids are generally half-closed ; the pupils dilated ; the jaws not clenched; the fingers semi-contracted; I the tongue approaches to the under edges ] of the lips, and these, as well as the nostrils, are covered with a frothy mucus. Coldness and pallor of surface increase.

CAUTIONS.

Prevent unnecessary crowding of persons round the body, especially if in an apartment.

Avoid rough usage.

Under no circumstances hold the body up by the feet.

On no account place the body in a warm bath unless under medical direction and even then it should only be employed as a momentary excitant.

Spirits are on no account to be given without direct medical orders, as the giving of spirits may lead to a fatal result.