In event of drowning, blow smoke up bottom

Samuel Auguste André David Tissot was an eminent Swiss physician of the eighteenth century, best known as the author of one of the first scholarly studies of migraine, and for his much-cited work on the evils of masturbation, L’Onanisme.

In 1761 he published Avis au Peuple sur sa Santé, a little book aimed at the general public and translated into English as Advices with Respect to Health.  Although much of his guidance remains valid today, other sections are, well, a little outdated.  Take, for instance, his advice on first aid in the event of near-drownings, which begins sensibly enough:

Whenever a person who has been drowned, has remained a quarter of an hour under water, there can be no considerable hopes of his recovery: The space of two or three minutes in such a situation being often sufficient to kill a man.  Nevertheless, as several circumstances may happen to have continued life, beyond the ordinary term, we should not give them up too soon: Since it has often been known, that after the expiration of two, and sometimes even of three hours, such bodies have recovered.

Tissot then lists several measures that should be taken in order to improve the chances of recovery.

1. Immediately strip the sufferer; rub him strongly with dry coarse linen; put him as soon as possible into a well heated bed, and continue to rub him a considerable time together.

Before the advent of CPR – a surprisingly late discovery which was only made in the 1950s – rubbing the body was thought to be the best way of restoring the circulation, even if the heart had stopped.  Artificial respiration, however, was already known in the 18th century:

2. A strong and healthy person should force his own warm breath into the patient’s lungs; and the smoke of tobacco, if some was at hand, by means of a pipe, introduced into the mouth. This being forcibly blown in, by stopping the sufferer’s nostrils close at the same time, penetrates into the lungs, and there rarifies that air, which, blended with the water, composed the froth. Hence that air becomes disengaged from the water, recovers its spring, dilates the lungs; and, if there remains within, any principle of life, the circulation is renewed.

Unconscious patients aren’t often given a fag in the ambulance these days; I wonder why not.  This being the 18^th century, bleeding is central to the treatment, of course:

3. If a surgeon is at hand, he must open the jugular vein, and let out ten or twelve ounces of blood. Such a bleeding renews the circulation, and removes the obstruction of the head and lungs.

And why stop at blowing tobacco smoke into the patient’s lungs?  Two orifices are better than one.

4. The fumes of tobacco should be thrown up, speedily and plentifully as possible, into the intestines by the fundament. Two pipes may be well lighted and applied; the extremity of one is to be introduced into the fundament; and the other may be blown through into the lungs.

Tissot even recommends using a pipe attached to a bladder for this purpose, much like the manual respirators used today by paramedics.

5. The strongest volatiles should be applied to the patient’s nostrils. The powder of some strong dry herb should be blown up his nose, such as marjoram, or very well dried tobacco.

It’s a wonder the patient had any space left in his airways for oxygen, with all these substances being inserted into them.

6. As long as the patient shews no signs of life, he will be unable to swallow. But as soon as he discovers any motion, he should take within one hour, a strong infusion of carduus benedictus, of camomile flowers sweetened with honey; And supposing nothing else to be had, some warm water, with the addition of a little salt.

Carduus benedictus, also known as Holy Thistle, was believed to be a panacea by early medics: in Much Ado About Nothing Margaret says to Beatrice: “Get you some of this distilled Carduus Benedictus and lay it to your heart; it is the only thing for a qualm.”

7. Notwithstanding the sick discover tokens of life, we should not cease to continue our assistance since they sometimes expire after these first appearances of recovering.

Lastly, though they should be manifestly reanimated, there sometimes remains an oppression, a coughing and feverishness: And then it becomes necessary sometimes to bleed them in the arms; and to give them barley-water plentifully.

The barley-water doesn’t sound too bad an idea, at least.  Some of his suggestions are fairly dreadful, but Tissot concludes by condemning certain other treatments which are even worse:

1. These unhappy people are sometimes wrapped up in a sheep’s, or calf’s, or a dog’s skin immediately flayed from the animal: But their operations are more slow, and less efficacious, than the heat of a well-warmed bed.

Yuck!

2. The method of rolling them in an empty hogshead is dangerous and misspends a deal of important time.
3. That also of hanging them up by the feet ought to be wholly discontinued.  The froth which is one of the causes of their death, is too thick and tough to discharge itself by its own weight.  This must also be hurtful, by its tending to increase the overfullness of the head and lungs.

He concludes with another helpful tip:

The heat of a dung-heap may also be beneficial: and I have been informed by a sensible spectator of it, that it effectually contributed to restore life to a man, who had remained six hours under water.