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. 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.

SYLVESTER 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 handkerchief into strips and tie them together, thus making a string. Place the bandage or string over the tongue, draw the ends 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 air 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 one hour, as the patient may be breathing, although it is impossible to detect it. 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 aminonia and treat as in shock. (See "Shock.")

USE OF THE PULMOTOR.

Most coal mines at present are equipped with the pulmotor (fig. 11), which is an apparatus that automatically causes breathing by a person to whom it is applied. The essential parts of the pulmotor are a steel tank containing oxygen under pressure, a bellows for filling the lungs with oxygen, a mask, which fits the face tightly over the mouth and nose and is connected by a tube to the bellows, and a bellows for exhausting the used air from the lungs. As pure air is only one-fifth oxygen, the pure oxygen supplied to the lungs by this device is five times as invigorating as pure air. The pressure of

FIGURE 9.-Sylvester method of artificial respiration. Extending the arms.

the oxygen is the power that enables the pulmotor to run itself. The pulmotor causes the patient to breathe sixteen times a minute, adapts itself automatically to lungs of any size, and does away with all need of the hands, as required in the method of artificial respiration. The important details to remember in its use are to draw forward the tongue with tongs provided for the purpose, in order to prevent the patient from swallowing it, and to close the gullet (food pipe, or esophagus) by pressure of the finger on the throat, so that the pulmotor will not inflate the stomach with oxygen. The pulmotor should be at all large mines and should be ready for quick use in all

those cases for which artificial respiration is of value in taking patients through the critical moments when life is at a low ebb.

BANDAGES.

Bandages are used to keep dressings in place, to retain splints on broken limbs, to stop bleeding by pressure, and as slings. The kinds of bandages in use are the triangular bandage, the roller bandage, and the special bandage of the United States Army.

THE TRIANGULAR BANDAGE.

The triangular bandage is particularly useful in general first-aid work, as it can be easily made and is not difficult to apply. The material used in making a triangular bandage should be unbleached cotton cloth, linen, or muslin; some are made of a kind of cheesecloth, but they are too soft and are difficult to fold properly. sheeting or pillowcases make good triangular bandages.

Bed