perseveringly, about fifteen times in a minute, until a spontaneous effort to respire is perceived, immediately upon which cease to imitate the movements of breathing and proceed to induce circulation and warmth.

Should a warm bath be procurable, the body may be placed in it up to the neck, continuing to imitate the movements of breathing. Raise the body in twenty seconds in a sitting position, and dash cold water against the chest and face, and pass ammonia under the nose. The patient should not be kept in the warm bath longer than five or six minutes.

To excite Inspiration.-During the employment of the above method excite the nostrils with snuff or smelling-salts, or tickle the throat with a feather. Rub the chest and face briskly, and dash cold and hot water alternately on them.

Treatment after Natural Breathing has been restored. To promote warmth and circulation, wrap the patient in dry blankets, 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. 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, between the thighs, and to the soles of the feet.

Warm clothing may generally be obtained from bystanders.

If the patient has been carried to a house after respiration has been restored, be careful to let the air play freely about the room. On the restoration of life, when the power of swallowing has returned, a teaspoonful of warm water, small quantities of wine, warm brandy and water, or coffee should be administered. The patient should be kept in bed, and a disposition to sleep encouraged. During reaction large mustard plasters to the chest below the shoulders will greatly relieve the distressed breathing.

The above treatment should be persevered in for some hours, as it is an erroneous opinion that persons are irrecoverable because life does not soon make its appearance, persons having been restored after persevering for many hours.

CHAPTER IX.

Insensibility-Drunkenness-Apoplexy and compression of the brain— Hysteria Fainting fits - Epilepsy - Uræmia - Retention and suppression of urine-Concussion.

Insensibility may be due to injuries to the brain or nervous centres, diseases of the brain, impurities of the blood, or the result of poisons introduced into the system. In cases of injuries to the brain there will be of course a history of violence.

Diseases of the brain and its membranes, or some defect in the blood supply, will induce apoplexy, epilepsy, or insanity.

It is difficult in some forms of insensibility to arrive at a correct diagnosis; even medical men are liable to err. This being the case it is not to be wondered at that people who have not received a medical education should frequently make mistakes.

It is a good rule in cases of suspected drunkenness, when there is the least uncertainty, to give the patient the benefit of the doubt, and seek medical aid. Certain symptoms and signs lead one to suspect grave mischief, still be it remembered that no single sign or symptom can be relied on in forming a just

conclusion, for it not unfrequently happens that disease is complicated with the effects of drink. A man not feeling very well may take something to drink just before he goes off into a fit; because his breath happens to smell of spirits, we must not condemn him as drunk.

When drunkenness causes insensibility, the insensibility is not complete, that is to say, it is possible to rouse the patient by pinching him or howling into his

ear.

There is nothing particular to notice about his eyes or pulse, but the temperature of his body, if taken with a thermometer, will be found to be two or three degrees below normal. Hence the folly of people taking ardent spirits with the idea of keeping out the cold. The effect of spirits is primarily to increase the circulation of the blood, but this soon goes off.

The best stimulant before going out of doors on a cold winter's night is a cup of hot coffee.

The treatment of insensibility caused by drink is to keep the patient warm, and administer an emetic.

Apoplexy and Compression of the Brain.—In apoplexy a blood vessel due to disease of its coats gives way, either in the substance or on the surface of the brain; this effused blood not being able to escape on account of the unyielding nature of the cranium causes compression of the brain from within. In the case of an accident, where the bones of the skull cap are smashed in, compression of the brain is the result,

but in this instance the compression is from without. The symptoms of compression of the brain and apoplexy are similar, so we will speak of them together.

In the first place the attack is more or less sudden, and the insensibility is complete, that is to say, it is impossible in any way to rouse the patient, he is unable to speak, and unconscious alike to all impressions. The pupils of the eyes become fixed, there may or may not be some squinting of one or both eyes, and the conjunctiva covering the eye-ball is no longer sensitive to the touch. A peculiar rasping, loud, sonorous breathing shortly supervenes, spoken of as stertor, and during expiration the cheeks are puffed out. The pulse is laboured, wiry, and not easily compressed.

Paralysis either of one or both sides of the body is the result.

Until medical aid is procured, all that a nurse can do in these cases is to place the patient in the recumbent position with the head slightly raised, put a mustard plaster on the nape of the neck, and apply warmth to the extremities.

Hysteria. People who indulge in this complaint, and behave in the eccentric way they do during the attacks, would assuredly refrain if they had the power, that is, if they were in perfect health of both mind and body. The management of this disease, for it is a disease, requires firm but kind treatment,