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 removed, and the patient was placed in blankets.  Ammonia was occasionally applied to the nostrils, since, although respiration had returned, there was no sign of consciousness; the natural respiration was at first attended by the expulsion of frothy fluid from the lips, which gradually diminished, and auscultation revealed the presence of a few pulmonary rales, which also passed away.  There were efforts at vomiting, and pallor succeeded cyanosis; there were also clonic contractions of the flexors of the forearm.  The pupils dilated slightly at about one hour after beginning treatment.  Unconsciousness was still profound, and loud shouting into the ear elicited no response.  Mustard sinapisms were applied to the praecordium, and the Faradic current to the spine.

Coffee was also administered by a ready method which, as a systematic procedure, was, I believe, novel when I introduced it to the profession in the Medical Record, in 1876.  I take the liberty of referring to this, since I think it is now sometimes overlooked.  It was described as follows: 

“A simple examination which any one can make of his own buccal cavity will show that posterior to the last molar teeth, when the jaws are closed, is an opening bounded by the molars, the body of the superior, and the ramus of the inferior maxilla.  If on either side the cheek is held well out from the jaw, a pocket, or gutter, is formed, into which fluids may be poured, and they will pass into the mouth through the opening behind the molars, as well as through the interstices between the teeth.  When in the mouth they tend to create a disposition to swallow, and by this method a considerable quantity of liquid may be administered.”

After I had worked with the patient in the open air, for four and three-quarter hours, he was carried to a cottage near by and placed, still unconscious, in bed.  There had been an alvine evacuation during the time in which he lay in the blankets.