Another way is to take your belt or handkerchief or a piece of rope and loop it over the patient's feet if he is lying on the wire, and thus pull him off. If an ax is near at hand use it to cut the wire, but first make sure that the handle is dry or wrap it with a coat or cloth.

TREATMENT.

After the patient has been freed from the wire, do not stop to loosen his clothing, but begin giving artificial respiration at once.

SUFFOCATION AND ASPHYXIATION.

Suffocation or asphyxiation may be caused either by something that blocks the windpipe and prevents air from entering the lungs or by the inhalation of gas that acts as a poison itself or prevents the air from entering the lungs. In mines suffocation and asphyxiation are most commonly caused by breathing smoke, carbon dioxide, carbon-monoxide gas, and atmospheres deficient in oxygen.

TREATMENT.

Quickly get the patient to fresh air; do not stop to loosen his clothing, but give artificial respiration at once.

There are several methods of performing artificial respiration. The two most effective methods, namely, the Schaefer method and the Silvester method, are described below. The following description of the method of teaching and applying the Schaefer method was prepared by the commission on resuscitation from electric shock, representing the American Medical Association, the National Electric Light Association, and the American Institute of Electrical Engineers. The commission recommended the Schaefer over all other methods.

SCHAEFER METHOD OF ARTIFICIAL RESPIRATION.

Remove the victim to fresh air as quickly as possible. Rapidly feel with the finger in his mouth and throat and remove any foreign body (tobacco, false teeth, etc.); then begin artificial respiration at Proceed as follows:

once.

Lay the subject on his belly with arms extended as straight forward as possible and with face to one side so that his nose and mouth are free for breathing (fig. 7). Let an assistant draw forward the

subject's tongue.

Kneel straddling the subject's thighs and facing his head; rest the palms of your hands on his loins (on the muscles of the small of the back), with the fingers spread over the lowest ribs (fig. 7).

With arms held straight, fingers forward, slowly swing forward so that the weight of your body is gradually and without violence brought to bear upon the subject (fig. 8). This act should take two

to three seconds. Then immediately swing backward so as to remove the pressure, returning to the position shown in figure 7. Repeat regularly 12 to 15 times per minute the swinging forward and backward, completing a respiration in four or five seconds.

FIGURE 7.-Schaefer method of artificial respiration. Inspiration.

As soon as this artificial respiration has been started and while it is being conducted an assistant should loosen any tight clothing about the subject's neck, chest, or waist. Continue the artificial respiration without interruption until natural breathing is restored (if necessary, two hours or longer) or until a physician arrives and takes charge. If natural breathing stops after having been restored, use artificial respiration again.

FIGURE 8.-Schaefer method of artificial respiration. Expiration.

Do not put any liquid in the patient's mouth until he is fully conscious.

Give the patient fresh air, but keep him warm.

Send for the nearest doctor as soon as the accident is discovered.

SILVESTER METHOD OF ARTIFICIAL RESPIRATION.

Place the patient on his back, fold a blanket or coat, and put it under his shoulders so as to throw the chest forward.

Press open his mouth, grasp his tongue, draw it forward, and let an assistant hold it or tie it out with a gauze bandage or a shoestring, or tear a handerkerchief into strips and tie them together, thus making a string. Place the bandage or string over the tongue, draw the end's down, one on either side of the jaw, crossing them underneath the chin, and bring back one end to each side of the head. Tie the ends on top of the head. This action holds the tongue forward. In an emergency, the tongue can be held forward with a safety pin.

The Bureau of Mines relief kit contains an oral screw with which to force open the jaws, a pair of tongue forceps for grasping the tongue and drawing it forward, a glass tube in which there is a curved needle, and a sterile catgut thread. In case of emergency, the firstaid man can run the needle and thread through the tongue and thus hold it out. Every first-aid miner is required to carry one of these cases at all times.

After getting the tongue out, kneel by the patient's head, grasp both arms just below the elbows, and draw them upward and backward toward you as far as they will go (fig. 9). This action allows cir to enter the lungs, producing inspiration. Then raise the arms and bring them inward and downward to the chest, applying pressure sufficient to expel the air, thus producing expiration (fig. 10). These movements should be performed at the rate of 16 to 18 times per minute. As soon as signs of life appear the lower limbs should be elevated and rubbed vigorously toward the heart. Hot applications should be used over the heart if practicable. If there is no sign of life, keep up the artificial respiration for at least two hours, as the patient may be breathing, although no appearing to be doing so. Some patients have been revived after several hours of hard work. If the patient regains consciousness and is able to swallow, give hot coffee or half teaspoonful doses of aromatic spirits of ammonia and treat as in shock. (See "Shock.")

USE OF RESUSCITATION DEVICES.

In all cases of insufficien respiration—that is, when the patient breathes regularly but very slowly-artificial respiration should not be given, either by the Schaefer or the Silvester method, but, if possible, nature should be allowed to restore the natural rate of breathing unaided.

The patient may with advantage be allowed to breath pure oxygen, which may be supplied from a cylinder containing the gas under pressure; a reducing valve to lower the pressure, and a breathing bag with connecting tubes, face mask, and inspiratory and