Schäfer, with the co-operation of Dr P. T. Herring, and the results obtained were embodied in the report of the committee, which was presented to the Royal Medical and Chirurgical Society in 1904, and published as a supplement to volume 86 of the Transactions of the society. As the direct outcome of these experiments, Professor Schäfer was led to believe that a pressure method of resuscitation was not only simpler to perform but also more efficacious than any other. This conclusion was put to the test by measurements of the results obtained upon the normal human subject by the various methods in vogue; from these measurements, which were published in the Proceedings of the Royal Society of Edinburgh in December 1903, it appeared that when such pressure is exerted in the prone position the highest degree of efficiency as well as simplicity is obtained. The description of this method was communicated to the Royal Medical and Chirurgical Society, and was published in the following year (1904) in volume 87 of the Transactions of the society.
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| Fig 8.—Schäfer method of treatment of the apparently drowned. Position A. |
Thus it came about that by investigating the phenomena of drowning, and the means of resuscitation in dogs, and by applying the results obtained to man, the method which the society now advocates as the best was arrived at. In the experiments referred to, it was found necessary to drown 38 dogs, all but two of which were from first to last in a complete state of anaesthesia, the two exceptions having been simply drowned without anaesthesia. It is important that the public should understand that the evolution of a method which will probably be the means of saving thousands of lives has resulted from the painless sacrifice of less than 40 dogs, a number which would doubtless in any case have been destroyed by drowning or some other form of suffocation, but without the benefit of the anaesthetics which were employed in the experiments.
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| Fig. 9.—Schäfer method of treatment of the apparently drowned. Position B. |
Professor Schäfer describes the method as follows:—Lay the subject face downwards on the ground, then without stopping to remove the clothing the operator should at once place himself in position astride or at one side of the subject, facing his head and kneeling upon one or both knees. He then places his hands flat over the lower part of the back (on the lowest ribs), one on each side (fig. 8), and then gradually throws the weight of his body forward on to them so as to produce firm pressure (fig. 9)—which must not be violent, or upon the patient’s chest. By this means the air, and water if any, are driven out of the patient’s lungs. Immediately thereafter the operator raises his body slowly so as to remove the pressure, but the hands are left in position. This forward and backward movement is repeated every four or five seconds; in other words, the body of the operator is swayed slowly forwards and backwards upon the arms from twelve to fifteen times a minute, and should be continued for at least half an hour, or until the natural respirations are resumed. Whilst one person is carrying out artificial respiration in this way, others may, if there be opportunity, busy themselves with applying hot flannels to the body and limbs, and hot bottles to the feet, but no attempt should be made to remove the wet clothing or to give any restoratives by the mouth until natural breathing has recommenced.
In his paper read before the Royal Society of Edinburgh in December 1903 Professor Schäfer gave the following table of the relative exchanges of air under different methods:—
| Mode of Respiration. | Number per minute. |
Amount of air exchanged per respiration. |
Amount of air exchanged per minute. |
| Natural respiration (supine) | 13 | 489 c.c. | 6·460 c.c. |
| Natural ” (prone) | 12·5 | 422 ” | 5·240 ” |
| Prone (pressure), “Schäfer” | 13 | 520 ” | 6·760 ” |
| Supine (pressure), “Howard” | 13·6 | 295 ” | 4·020 ” |
| Rolling (with pressure), “Marshall Hall” | 13 | 254 ” | 3·300 ” |
| Rolling (without pressure), “Marshall Hall” | 12 | 192 ” | 2·300 ” |
| Traction (with pressure), “Silvester” | 12·8 | 178 ” | 2·280 ” |
These experiments all tend to show that by far the most efficient method of performing artificial respiration is that of intermittent pressure upon the lower ribs with the subject in the prone position or face downward. It is also the easiest to perform, requiring practically no exertion, as the weight of the operator’s body produces the effect, and the swinging forwards and backwards of the body some thirteen times a minute, which alone is required, is by no means fatiguing, and has the further great advantage that it can be effectively carried out by one person.
See Taylor, Medical Jurisprudence; “Description of a simple and efficient method of performing artificial respiration in the human subject, especially in cases of drowning,” by E. A. Schäfer, F.R.S. (vol. 87, Medico-Chirurgical Society’s Transactions); “The relative efficiency of certain methods of performing artificial respiration in man,” by E. A. Schäfer, F.R.S. (vol. 23, part i. Proceedings of the Royal Society of Edinburgh); A Method for the Treatment of the Apparently Drowned, by R. S. Bowles (London, 1903); Handbook of Instruction, Royal Life Saving Society (London, 1908). (W. Hy.)
Penal Use of Drowning.—As a form of capital punishment, drowning was once common throughout Europe, but it is now only practised in Mahommedan countries and the Far East. Tacitus states that the ancient Germans hanged criminals of any rank, but those of the low classes were drowned beneath hurdles in fens and bogs. The Romans also drowned convicts. The Lex Cornelia ordained that parricides should be sewn in a sack with a dog, cock, viper and ape, and thrown into the sea. The law of ancient Burgundy ordered that an unfaithful wife should be smothered in mud. The Anglo-Saxon punishment for women guilty of theft was drowning. So usual was the penalty in the middle ages that grants of life and death jurisdiction were worded to be “cum fossa et furca” (i.e. “with drowning-pit and gallows”). The owner of Baynard’s Castle, London, in the reign of John, had powers of trying criminals, and his descendants long afterwards claimed the privileges, the most valued of which was the right of drowning in the Thames traitors taken within their jurisdiction. Drowning was the punishment ordained by Richard Cœur de Lion for any soldier of his army who killed a fellow-crusader during the passage to the Holy Land. Drowning was usually reserved for women as being the least brutal form of death-penalty, but occasionally a male criminal was so executed as a matter of favour. Thus in Scotland in 1526 a man convicted of theft and sacrilege was ordered to be drowned “by the queen’s special grace.” In 1611 a man was drowned at Edinburgh for stealing a lamb, and in 1623 eleven gipsy women suffered there. By that date the penalty was obsolete in England. It survived in Scotland till 1685 (the year of the drowning of the Wigtoun martyrs). The last
